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Determining your rights after a disabling injury can seem an unsurmountable task, particularly when health concerns, rehabilitative care and family finances are the priorities.SSDI Boston

Still, it’s a struggle far too many adults must deal with each year in this country. Nationwide, statistics show 1 in 4 20-year-old employees will miss at least a year away from work due to disability at some point in their career.

Kiplinger Finance calls it an Alphabet Soup in discussing the differences among Social Security Disability Insurance (SSDI), long-term disability (LTD) and worker’s compensation (WC) benefits.

Investopedia reports the average Social Security Disability Insurance benefit next year is expected to be $1,234, little changed from this year.

Still, Congress is once again aiming drastic cuts and benefit reductions at the Social Security Disability Insurance (SSDI) and Social Security Income (SSI) programs.wheelchair5-300x214

The Hill recently reported Rep. Todd Rokita (R-Ind.) is among the most recent to introduce a bill, though he is far from lonely. The Making DI Work for All Americans Act of 2018 (H.R. 6352) would also make the program solvent over the long run, while setting the stage for a significant payroll tax cut, according to the press release. Unfortunately, when it comes to the SSDI program and the SSI program, the wolves have long been at the door. The truth is these two programs provide vital lifelines to fewer than 5 percent of the nation’s workforce. Those eligible for SSDI are entitled to such benefits by virtue of having paid into the system via payroll taxes for years before becoming disabled on the job. Those benefits are often so inadequate that they are still eligible for SSI, which is an income-based needs program designed to help the poorest Americans.

In recent years, the disability insurance program has paid about $140 billion annually, or about 0.8 percent of gross domestic product (GDP), in benefits to almost 9 million disabled beneficiaries, with about 2 million of those beneficiaries being spouses and children, according to the Congressional Budget Office. Between 1970 and 2014, the number of claimants more than tripled. The share of working-age people who receive disability insurance benefits as a result of their own disability, and whose disability benefits are calculated on the basis of their own disability and work history,  increasing from 1.3 percent to 4.5 percent, before declining slightly in 2015.

But this is to be expected with an aging workforce. Particularly when you factor in the fact that the Baby Boomer generation was the last to engage in heavy manufacturing and other industries where disability has been more likely because of the long-term physical consequences of such labor.

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The Social Security Administration has announced the edition of five conditions to its Compassionate Allowances program.

The five new health conditions added to CAL are:medicalrecords-200x300

  • Fibrolamellar Cancer
  • Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS)
  • Megalencephaly Capillary Malformation Syndrome (MCAP)
  • Superficial Siderosis of the Central Nervous System
  • Tetrasomy 18p

Fibrolamellar Cancer is a rare liver cancer that usually occurs in adolescents; Megacystis Microcolon Intestinal Hypoperistalsis Syndrome (MMIHS) is a rare congenital condition characterized by abdominal dissension; Megalencephaly Capillary Malformation Syndrome (MCAP) is a disorder characterized by overgrowth of several tissues in the body; Superficial Siderosis of the Central Nervous System is a rare condition that involves brain bleeding; Tetrasomy 18p is a genetic chromosome condition characterized by multiple medical and developmental concerns.

The Compassionate Allowances (CAL) program allows victims of severe health conditions to apply for expedited benefits. The CAL program began in 2008 and now lists 233 eligible conditions. The fast-track approval process allows patients suffering from severe conditions, including brain disorders and many types of cancers, to obtain benefits more quickly. Approval of SSDI benefits can happen in weeks, instead of the months or even the years that it often takes to secure disability benefits from the federal government.

The Social Security Administration provides a complete list of CAL qualifying conditions, which include leukemia, ALS, lymphomas, early onset Alzheimer’s, liver cancer, pancreatic cancer, mesothelioma, and thyroid cancer.

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According to a recent news feature from Huffington Post, people seem indifferent about the recent budget deal designed to prevent 11 million beneficiaries from facing 20 percent cuts in their benefits, hire new administrative law judges (ALJs) and make some changes to how the system operates. Had this or some other deal not been reached, the 20 percent benefits reduction would have been imposed across the board starting in late 2016. There would also be an increase in Medicare Part B premiums of over 50 percent had a deal not been reached.

white-house-washington-dc-november-2006-658257-mAdvocacy groups involved in the process of creating the legislation were essentially strong-armed into supporting it, because failure to support such a deal would result in the needless suffering on millions of Americans for which they purport to speak. One of the things they did not like about the bill was that it ends one program used by nearly half the states to award disability benefits to applicants, in some cases where they did not have independent medical exams. They obviously see this as a loss. Continue reading

According to a recent news story from ABC News, miscalculation of Social Security Disability Insurance (SSDI) is a major problem that affects more disabled Americans than one might think.   One woman interviewed for the news article failed to get the correct amount of Social Security disability benefits for over 14 years.

duntitled-1237498-mClaimant is a 65-year-old woman who is severely disabled and can barely stand up without assistance. She became disabled following a forklift accident that occurred in 1995. To make matters even more difficult, her husband died from cancer a few years after her accident. Since the death of husband, she was having difficulty paying her bills, buying food, and otherwise making ends meet. She needed help, but did no know what do about it in her condition.   Continue reading

Those seeking Social Security Disability Insurance benefits (or those who are already beneficiaries) need to know receiving workers’ compensation is likely to offset the amount they receive from SSDI.
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While former workers can be eligible for both at the same time, the Social Security Administration typically requires in such situations that SSDI benefits be reduced so the total monthly amount a worker takes in is no more than 80 percent of what was earned when he or she was fully employed.

The process by which a disabled person’s SSDI benefits are reduced by workers’ compensation is referred to as an “offset.” Offsets are done both for monthly workers’ compensation benefits, as well as lump sum awards.
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Hendron v. Colvin, a case from the United States Court of Appeals for the Fifth Circuit, involved a claimant who had applied three times for Social Security Disability Insurance (SSDI) benefits from the United States Social Security Administration (SSA).

gavel21.jpgClaimant filed her first application in 1999, and it was denied based upon a lack of sufficient evidence that she was disabled. The legal term for this type of denial is an “on the merits” denial. Her second application was filed in 2001, and it was denied on grounds of res judicata. An experienced Boston SSDI lawyer can explain that res judicata means that a court has already made a decision on the same issue on the merits and will not review it again.

Res judicata is often called the “one bite at the apple rule,” in that a claimant only gets one chance to make a claim related to a particular set of facts, and if he or she is not successful, the claimant is precluded from bring the same or a substantially similar claim again. The theory behind this rule is that it supports judicial economy.

Claimant filed her claim again in 2009, claiming that the disability began in 1995. The SSA again denied her application based upon res judicata, and she requested a hearing before an administrative law judge (ALJ).
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