What is the definition of disability by the Social Security Administration?
The official definition from the Social Security act is the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”
What is the difference between Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI)?
SSI benefits are for individuals with little or no work history. This would include children whose parents meet the income criteria of SSI. Individuals who receive SSI benefits may also be entitles to Medicaid. SSDI benefits are for individuals who have an extensive work history. Individuals who receive SSDI benefits will also be entitled to Medicare benefits.
When should I apply for Social Security Disability Benefits?
Apply as soon as you and your doctors agree that your disability is going to last a full year. You are not eligible for Social Security Disability Benefits if your condition doesn’t last a full year, so many people have to wait for a while to see what happens with their medical conditions. Others who have been struggling to work in spite of their disability and know the condition is not going away should apply as soon as they stop working.
How is onset date different from the date I last worked?
Sometimes it is not different. If, for example, you had an injury on the job or you have a car accident on the way home from work, it may be the same day. But sometimes our injury may be unrelated to your work, or it may have occurred at a different time. Then your onset date would be the date that you were hospitalized or injured, not the last day you worked.
I have applied for Social Security Disability Benefits and have been turned down. How long do I have to appeal?
Generally you have only 60 days to appeal any denial of Social Security Disability Benefits, so it is extremely important to contact our office as soon as you receive the denial.
How many stages are there in Social Security Disability (SSD)?
There is the Initial Application stage. You have 60 days to appeal after the initial denial. Most people are denied at the initial application. Once you have received the initial denial, contact our office immediately to make an appointment to request a hearing. The second stage is the most critical. It is the hearing stage. This is where you meet the Administrative Law Judge. If you are denied at a hearing, you have 60 days to appeal to the Appeals Council. If you lose at the Appeals Council, you have the right to file in federal court, though generally this is extremely difficult and cannot be done successfully without an experienced lawyer.
How long does it take to get an initial decision?
Each state has a separate state agency that is responsible for making the initial medical determination on a disability case. The amount of time depends on what state you are in. Generally, 6 months is not unusual.
Do I have to go to the hearing?
Yes, appearing at the hearing is helpful to your claim and can increase your chances of winning. It is an opportunity for the judge to see firsthand why you can’t work and the hardship you have endured as a result. This is also a chance for you to explain any inconsistencies in your medical file that the judge may have issue with.
I have been turned down and I have been told to apply for a hearing. How long will it take to get a hearing?
Typically, the hearing will take place approximately one year from the time the hearing is requested. The hearing office will contact our office to coordinate a date and time for the hearing about three months prior to the hearing date.
Is there anything I can do to expedite my hearing?
Some judges will try to conduct an early review of the cases they can easily grant because the medical evidence is so strong. If you have very strong medical evidence or a very serious condition, we will submit what is called an “on-the-record” letter to the judge hoping to expedite the matter. We write to the judge, summarizing the overwhelming evidence of disability in the hope that the judge will agree and grant benefits without the need for a hearing. However, some judges never grant on-the-record letters. If you are assigned to one of those judges, there’s not much you can do but wait for the hearing. Sometimes requesting an on-the-record decisions is not the most beneficial strategy because it could prompt the judge to seek further evaluation that may conflict with your treating doctors. Therefore, on-the-record requests will be at the discretion of the attorney, based upon the entirety of the case.
I was denied for Social Security Disability (SSD) benefits recently. Should I appeal or just file again?
It is generally better to appeal rather than re-file. There are some times, however, particularly after denial at the Appeals Council stage, that you may want to do both, especially if there is some new medical proof that makes your case stronger than before.
What makes a case strong?
The best cases are those where the medical evidence is extremely strong. In particular, the strongest cases are those in which your doctor supplies a residual functional capacity evaluation. In addition, age and severity of your disability and sometimes your past work play a large role in determining the strength of your claim.
How is a representative paid in a Social Security case?
A fee for a lawyer or a person eligible to receive direct payment is usually 25% of the past-due benefits, but most representatives only get paid if you are successful. During the hearing stage, a fee is capped at $6,000. This cap is set by the Commissioner and is always subject to change. If your case is appealed to the Appeals Council and beyond, the fee is 25% without a cap. You don’t owe anything unless you win your case.
Do represented people do better than unrepresented people?
It is almost always best to be represented. The Social Security process is not easy and can become quite complicated when there are deadlines to meet and specific evidence to obtain. Our staff is highly trained and experienced in Social Security law as well as being familiar with what the judges are seeking in terms of evidence when determining a disability claim. At the hearings there are often doctors and vocational experts who testify, and it’s almost impossible for a person untrained in these areas to effectively cross-examine either.
Does an Administrative Law Judge tell me the decision at the hearing?
Sometimes the judge will indicate what decision he or she is inclined to make regarding your case. However, more often than not, you will have to wait until you receive the decision in the mail to know the outcome of the hearing.
My case has been at the Appeals Council for two years. Is this normal?
The Appeals Council estimates that it could take up to 30 months to review your appeal. However, this is rare. Once your case has been at the Appeals Council for 18 months, my staff will call to expedite the claim. It’s not abnormal.
I was just awarded my benefits. When can I expect to receive payments?
Assuming there is nothing complicated about your particular circumstances, benefits can be paid in as little as 60 days. For Supplemental Security Income (SSI) claimants, if there is an emergency financial situation, you might be able to get benefits processed more quickly by going in person to the local office and explaining your dire financial needs.
What happens if my condition improves while I’m applying for benefits?
It is possible to request disability for what is called a “closed period” if your disability has lasted a full year or more. This would mean that you are only eligible from the onset date to the date you were able to return to work. There would be no ongoing benefits in cases like this.
What should I do if I’m injured at work?
Be sure to report your accident as soon as possible to your supervisor or appropriate person.
Some injuries occur with a gradual onset. As soon as you realize you are injured, be sure to let your employer know.
How do I file a claim form?
When you are injured, a claim form needs to be filed with the Division of Workers’ Compensation (DOWC). If this isn’t done at your place of employment, we can do it for you. It is very important to make sure all the information is accurate on the claim form.
What if I miss work because of my injury?
Your employer’s workers’ compensation insurance carrier will pay your lost wages at the rate of two-thirds your regular pay. These payments are not subject to tax. These payments are known as Temporary Total Disability pay or TTD.
What happens when I recover?
You will be sent for a Functional Capacity Evaluation or FCE. Your doctor will use the date from that evaluation to give you an impairment rating.
Depending on the rating you receive, you will receive an award based upon threating, your wage, and age. We can help you determine if you have received a fair rating.
Is there anything I need to watch out for?
Yes. If you receive a Final Admission of Liability or FAL, you need to act immediately. The terms and conditions of your case are spelled out on this form. You only have 20 days to object to the FAL. Otherwise, you will be left with potentially inadequate medical care or underrated wages, among a host of other problems. Call us right away.
If I have an accident, what should I do?
Be sure to get information from everyone at the scene. Exchange insurance information with the other party. Be sure you have their names with correct spelling, address, and phone number. Also, note the time of the accident. Be sure you know the names of the policemen and other emergency personnel that respond.
Take pictures at the scene.
Even if you do not receive immediate medical attention, you should go to your doctor. Sometimes the effects of the accident are not immediately apparent.
When should a person decide whether or not to hire a personal injury attorney?
Many auto insurance carriers seem cooperative and interested in helping you receive compensation for your losses. However, even if the company’s claims representatives are personable and sympathetic, their ultimate goal is to settle the claim at minimum cost. Even negotiations with the injured person’s own insurance company may be adversarial if the driver at fault and the victim share the same carrier or the loss is to be covered by the victim’s underinsured/uninsured motorist (UIM) policy.
In contrast to an insurance company, a personal injury attorney is ethically and professionally obligated to look out for the client’s best interests. The singular objective is to obtain the optimal outcome for the injured party. To that end, an experienced personal injury attorney will ensure that the damages are calculated correctly and the available sources of compensation are evaluated properly.
Moreover, a case involving bodily injury is often more complex than the victim may realize. For instance, the less typical sources of compensation could be missed without the involvement of an experienced attorney. An attorney will be able to coordinate the different aspects of the case in order to maximize the available recovery.
Retaining counsel is not as crucial when the accident caused only property damage. The appropriate compensation for property damage can be calculated based on market prices. Therefore, it is easier to evaluate the insurance company’s settlement offer and negotiate accordingly.
Calculating the appropriate compensation for bodily injury is more complicated. Certainly, the victim’s economic damages, such as medical bills and lost wages, should be included in any settlement demand. However, assigning a numerical value to non-economic losses, such as pain and suffering or disfigurement, is more difficult and requires the expertise of an experienced personal injury attorney.
How does a personal injury attorney get paid?
Obtaining proper medical care frequently imposes a considerable financial burden on the injured person and his or her family. However, it is possible to hire a personal injury attorney without paying either a retainer or an hourly fee. In fact, a contingency fee management is common in personal injury cases.
A contingency fee means that the client does not pay any attorney’s fees until he or she receives a settlement or a damages award. At that time, the attorney collects a pre-determined percentage of the recovery. This payment method allows the client to obtain legal representation without additional financial stress and helps to align the attorney’s financial interest with the client’s. An attorney will be able to explain in detail what a contingent fee agreement entails.
Are there time limits on bringing a claim?
Generally the injured person has three years from the date of the accident to bring a personal injury lawsuit. This time limit is called the statute of limitations. Once it expires, no legal action may be filed.
There are various exceptions to the general rule and shorter time limits may apply. For instance, cases involving a fatal injury are treated differently. As another example, in cases where suit may be brought against a government entity, the injured person must give notice of a possible action no more than 6 months following the accident. The failure to provide due notice forecloses future recovery from the government.
Regardless of the applicable time limits for filing a lawsuit, the demand for damages has to be made early enough to allow time for settlement negotiations with the insurance carrier. Thanks to aggressive and smart negotiations, many cases are resolved out of courts.
A settlement demand would usually be made after the victim’s condition has stabilized, which allows for a thorough evaluation of treatment options and the formulation of a long-term prognosis. The length of time necessary would depend on the type and severity of the injury. A premature settlement demand may result in an incomplete recovery due to an incorrect and rash assessment of damages.
It is to the injured person’s advantage to contact an experienced personal injury lawyer as soon as is practical following an accident that resulted in bodily injury. A lawyer will be able to develop a time-frame for handling the claim and advise the victim regarding any applicable time limits.
What is the typical amount of compensation?
The amount of recovery depends on the injuries suffered and the types of damages sustained. A settlement or damages award is meant to compensate the victim for his or her losses, including past and future medical expenses, lost income, pain and suffering, permanent impairment, and disfigurement. It is not possible to provide a specific figure until a careful examination of the medical and financial documentation is performed. However, an experienced personal injury attorney should be able to evaluate your claim, estimate your potential recover, and help you obtain due compensation for your injury by ensuring that all of the applicable damages are accounted for and that no sources of recovery are inadvertently forgone.
What is the timing of compensation?
A settlement demand should usually wait until the client has had a chance to undergo a thorough medical evaluation and to complete at least the initial stages of treatment. Otherwise, an informed and accurate calculation of damages may not be possible. Since haste could compromise final recovery, some initial patience is usually advisable to avoid future regrets. However, an injured person should not delay contacting an experienced personal injury attorney, since doing so may result in important deadlines being missed.
Once a settlement demand is made, time is required for the negotiations to take place. The insurance carrier will generally respond with an initial offer, and the victim’s attorney will work to bring that amount as close as possible to the figured quoted in the demand. This back-and-forth exchange may be quite informal or mediation may be scheduled.
What documentation supports my demand?
A settlement demand has to be supported by documentation that verifies your damages. An experienced personal injury attorney will assist you in obtaining and organizing the required information. Moreover, a careful examination of the relevant medical records, insurance policies, and financial information is indispensable. It will help your attorney correctly evaluate your claim and determine the applicable sources of compensation.
Your attorney will need all of the medical records and bills related to your accident. Your medical care providers will send this paperwork directly to your counsel’s office after you authorize them to release this information. This information will help to ensure that you are compensated for your past medical expenses, prospective medical costs, pain and suffering, and any permanent disfigurement or impairment. Moreover, if your injuries have caused you to lose income or your livelihood, you will need to provide financial information to help quantify your damages, such as pay stubs or income tax returns. Additional documentation may be necessary depending on the losses you have suffered.
Are there payment options for medical bills?
Even if you were not at fault, you may be required to pay for the initial treatment. However, any settlement or award of damages would serve to compensate you for those expenses, as well as cover any prospective medical costs. Moreover, many health care providers have experience with patients who do not have insurance or are otherwise unable to pay their bills immediately. In such cases, these care providers may postpone payment and assert a lien against your settlement or award of damages. This means that any bills will get paid from the money you eventually receive. There are a number of quality health care providers in Colorado who accept this form of delayed compensation. An experienced personal injury attorney can assist you with making the necessary payment arrangements.