Disabilities Caused by Strokes

Generally, strokes cause damage to an individual’s brain. Given the complexity of this organ, the types of damage (and the degree of disability) that follow a stroke are necessarily dependent on the aspect of the brain which is damaged. Nevertheless, the following are the primary types of disabilities that can be caused by a stroke:

• Motor Control Problems. Probably the most common stroke-caused disability, motor control problems typically manifest as paralysis, and cause difficulty walking, grasping objects, or even swallowing, depending on the damaged portion of the brain.
• Sensory Problems. Stroke sufferers may lose the use of one or more of the senses. As such, some stroke sufferers frequently experience chronic pain syndrome as a result of damage to the nervous system, or as a result of a joint that becomes immobilized due to lack of movement. Additionally, thalamic pain syndrome, a false signal of the sensation of pain in a damaged part of the body, can occur.
• Approximately 25 percent of all stroke sufferers incur a language impairment, such as the ability to speak, write, and understand spoken and written language.
• Memory Problems. Stroke can cause affect memory, learning, and awareness, including. anosognosia, the inability to acknowledge the reality of the physical impairments, or neglect, the loss of the ability to respond to stimuli located on the stroke-impaired side of the body.
• Emotional Senses. Finally, many stroke sufferers feel fear, anxiety, frustration, anger, sadness, and grief, primarily due to the psychological trauma of stroke. As a result, some stroke sufferers become clinically depressed, and, suffer from sleep disturbances, changes in eating patterns, lethargy, social withdrawal, irritability, fatigue, self-loathing, and suicidal thoughts.

Difficulties in Receiving LTD Benefits

Unfortunately, many LTD companies put up a fight when asked to payout on a policy following a stroke, as many of the related conditions are subjective in nature. Accordingly, it is imperative that a sufferer, along with his/her medical professional, ensure that the sufferer’s medical record contains objective evidence of the conditions caused by the stroke. Further, an LTD claimant should also be able to indicate how the symptoms caused by the stroke has affected his/her ability to function not only around his/her house, but also at his/her place of business. Working with an experienced disability benefits attorney, along with a medical professional, can help ensure that the claim is presented in the best possible, and most accurate, light.

Get Help

If you or a loved one recently experienced a stroke, and are worried about making ends meet, contact a disability benefits attorney as soon as possible. Submitting a claim with the help of an experienced disability benefits attorney can be the difference between acceptance and time spent on appeal. The legal team at Farrell Disability Law has the experience to help you. We will analyze your claim, educate you about the claim process, and develop a strategy to get you the benefits you deserve. Contact our Jacksonville office today.

Resource:

strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/PhysicalChallenges/Physical-Challenges-After-Stroke_UCM_308548_SubHomePage.jsp

What is Parkinson’s Disease?

PD is a neurodegenerative disorder that affects predominantly dopamine-producing neurons, causing cell death in a specific area of the brain called substantia nigra. Primarily affecting the motor system, symptoms of PD generally develop slowly over years. Further, the progression of symptoms varies from one person to another due to the diversity of the disease. People with PD may experience one or more of the following:

• Tremors, mainly at rest;
• Bradykinesia (slowness of movement);
• Limb rigidity; and
• Gait and balance problems.

The cause of PD is generally unknown, but is believed to involve both genetic and environmental factors. As an example, there is an increased risk in people exposed to certain pesticides and among those who have had head injuries, while there is a reduced risk in tobacco smokers and those who drink coffee or tea.

Treatment of Parkinson’s Disease by LTD Insurers

As LTD insurance companies understand that symptoms of PD can vary drastically between individuals, a simple diagnosis is usually insufficient to succeed in an LTD claim. Rather, the insurance company will analyze each individual on a case-by-case basis, looking at the following factors:

• Motor Function, and especially how motor deficits impact a claimant’s ability to work. That is, the insurance company will analyze a claimant’s ability to walk, stand, and remain balanced, as well as muscular rigidity.
• Mental Function. For this factor, the insurance company will analyze the claimant’s ability to stay organized, to communicate, to handle tasks, and any memory issues.
• With regard to this factor, the insurance company will not merely look at whether the claimant is tired, but also how the fatigue affects a claimant from working, such as the ability to handle both the sustained demands of his/her job, as well as the cognitive demands.
• Non-Motor Physical Symptoms. Finally, the insurance company may also look at non-motor related physical symptoms that PD may affect, such as vision, nausea, incontinence, and sleep deprivation.

An experienced disability attorney can help claimant create a strong body of support for a disability claim, and should be consulted on the best way to proceed in these cases to avoid delays and potential loss of benefits.

Get Help

If you, or someone you love, are considering filing for LTD benefits, based on a diagnosis of PD, contact a disability benefits attorney as soon as possible. Submitting a thorough and accurate claim for LTD benefits with the help of an experienced disability benefits attorney is essential to approval. The legal team at Farrell Disability Law has the experience with LTD claims and will work to get you the benefits you deserve as soon as possible. Contact our Jacksonville office today.

Disability Benefits for Employees

As alluded to above, if a disability leaves an employee unable to work, he/she may be entitled to one of the following three primary sources of disability income – SSDI, LTD, and WC. Each of these programs provides different benefits and has different requirements. Accordingly, it is important to assess all options to ensure that a disabled individual is seeking support from the maximum number of available disability benefits sources. An experienced attorney can help to ensure this is the case.

SSDI

To qualify for SSDI, employees must have worked for five of the past 10 years, be below full retirement age, and suffer from a severe injury, illness, or disability that will last at least a year or result in death. If approved, the amount received from the SSDI program varies based on the amount the employee paid in FICA taxes during his/her career, and the years he/she had been in the workforce. Among the benefits, SSDI automatically transitions to Social Security retirement benefits when the employee reaches full retirement age.

LTD

LTD, which may be offered by an employer, or may be purchased privately, is similar to SSDI in that it provides income replacement if an employee suffers a severe medical condition. However, unlike SSDI, the qualification requirements are generally less strict. Further, benefits typically constitute a fixed percentage of an employee’s salary, an amount substantially higher than SSDI benefits in most cases. Finally, there are typically time limits to the benefits one can receive from LTD, a limitation not faced by SSDI recipients. And, in some cases, LTD policies require an employee to apply for SSDI (or another benefit plan, such as WC or veteran’s benefits), and any benefits received from that program will offset the benefits received by the LTD policy.

WC

Unlike SSDI and LTD, workers’ compensation is a type of insurance that provides wages and medical benefits if an employee is injured while on the job. This is the key difference between WC and the other benefits – that the injury must have been a direct result of a work-related task. Also, unlike SSDI and LTD, WC is intended to be a temporary source of income for the employee while he/she is recovering from the injury. If the injury does become permanent, however, the employee may be eligible for either LTD or SSDI benefits. Although workers may be able to collect SSDI/LTD and WC simultaneously, there are some limits as to the amount of the benefits, and an offset may be in play.

Get Help

If you have suffered a disability, and are unable to continue in your present occupation, contact a disability benefits attorney as soon as possible. The legal team at Farrell Disability Law has the experience necessary to analyze your potential claim, and, help you develop a strategy to obtain the benefits you deserve. Contact our Jacksonville office today.

Resource:

gao.gov/products/GAO-18-248

Long-Term Disability Insurance

LTD insurance is a form of disability insurance that is offered through group plans and private policies. When offered as part of employee benefits package, federal law governs how it operates. In the simplest terms, if a policyholder suffers a disability which is expected to last long-term (at least one year) and prevents him/her from working in his profession, he/she may be eligible to recoup compensation pursuant to the terms of his/her LTD policy. Of course, in reality, making an LTD claim is not that simple. Insurance companies do not want to part with their money, and, as a result, will analyze each claim with a very exacting review. Ensuring the claimant truly has a disability, the extent of the disability, and whether he/she can perform other occupations are three of several areas an LTD insurance company will analyze as part of approving a disability claim.

Common Deficiencies

Unfortunately, most people do not realize that the disability coverage they have is insufficient until it is needed. To urge those considering a new policy, as well as individuals with existing coverage, of the vital importance of assessing the coverage levels, here is a list of the potential ways a policyholder’s LTD insurance policy can be deficient:

• Benefits for mental conditions. Such benefits, for disabilities based on mental and nervous conditions, are typically capped at 24 months, though there are some common exceptions (schizophrenia and organic brain disease, for example).
• Prohibition on abuse-based disabilities. Typically, disabilities arising from substance or alcohol abuse are excluded from coverage.
• Pre-Existing conditions. Most LTD policies will not compensate for pre-existing conditions for a specified period of time.
• Waiting period. Most LTD policies include a waiting period, during which the policyholder is not entitled to benefits.
• Duration of benefits. Most LTD policies will pay benefits for a set time – typically until the policyholder turns a specific age or for a specified number of years.
• The amount of benefits a policyholder can receive typically varies, with most paying between 50% and 80% of a policyholder’s salary.
• Other income benefits. Typically, LTD policies allow an administrator to reduce the monthly benefit if the policyholder is receiving income from a specified list of alternate sources, such as Social Security.
• Tax consequences. As most LTD plans are paid for with pre-tax dollars, the benefit is subject to federal, state, and, in some cases, city income tax liability.

Get Help

If you have suffered a disability, and need to secure LTD insurance benefits, contact a disability benefits attorney as soon as possible. The legal team at Farrell Disability Law has the experience and skill necessary to analyze your potential claim, and will help you develop a strategy to get you the benefits you deserve. Contact our Jacksonville office today.

Resource:

kiplinger.com/article/insurance/T012-C032-S014-dont-underestimate-need-for-disability-insurance.html

Social Security Disability Insurance

The Social Security Administration (SSA) administers both Supplemental Security Income, a program based on financial need, as well as SSDI, which is based on an individual’s work record. To qualify for SSDI, the following criteria must be met by the Applicant:

• The Applicant must experience a total and long-lasting disability that is expected to last for at least one year or result in death.
• The Applicant must be completely unable to work. That is, the SSA will not award partial disability benefits or short-term disability benefits.
• The Applicant must have contributed to Social Security, for a certain period of time. This is known as the duration of work test, and varies according to the age of the Applicant. More specifically, the minimum duration of work for an Applicant varies from 1.5 years for workers who become disabled before age 28 to 9.5 years of work for workers who become disabled after age 60.
• The Applicant must also satisfy a recent work test. That is, the Applicant must have worked 50% of the time, also depending on age, before becoming disabled. As an example, if an Applicant is over the age of 31, he/she must have worked for five of the last ten-year period immediately preceding the onset of the disability.

The Application Process

In addition to a formal application, the Applicant must also submit medical information showing evidence of his/her disability. This information will most likely include the names of doctors and hospitals where the Applicant received care, any medications he/she has taken, any medical records he/she may have, and any relevant lab test results. Additionally, details of work history, as well as the Applicant’s most recent tax return, must also be submitted. Only after all of this information has been received will the application be examined, which, unfortunately, may take a few months to a few years for a full analysis and decision.

Supplemental Insurance

It is important to note that SSDI benefits are designed to replace only about 40% of the average worker’s income. Consequently, these benefits may not be enough. An option everyone should explore is obtaining private long-term disability insurance, which should replace a greater percentage of income in the event of a disability. An experienced disability benefits attorney can help ensure these benefits are accessed as well.

Get Help

If you have suffered a disability, and are unable to continue in your present occupation, and are contemplating filing a claim to begin receiving SSDI benefits, and are curious as to how the process works and what to expect, contact a disability benefits attorney as soon as possible. The legal team at Farrell Disability Law has the experience necessary to analyze your potential SSDI claim, and, will not only help you develop a strategy, but will also help you along the way to get you the benefits you deserve. Contact our Jacksonville office today.

New Conditions

As alluded to above, the SSA, the entity that examines SSDI applications, recently added five new conditions to its Compassionate Allowance Program. Specifically, the following conditions are now part of the Compassionate Allowance Program:

• Fibrolamellar Cancer;
• Megacystis Microcolon Intestinal Hypoperistalsis Syndrome;
• Megalencephaly-Capillary Malformation Syndrome;
• Superficial Siderosis of the Central Nervous System, and
• Tetrasomy 18p.

The Compassionate Allowance Program

The Compassionate Allowance Program came about in response to complaints by SSDI applicants regarding long delays in the disability determination process. Essentially, the Compassionate Allowances Program provides a fast track for applicants having a predetermined disability. In such a case, an SSDI application, and the associated benefits, can be quickly approved to disability applicants whose medical conditions are so serious that they would qualify as disabled under an SSA impairment listing. Consequently, this Program allows the SSA to quickly target obviously disabled applicants and grant them benefits soon after applying. By way of example, the average processing time for a Compassionate Allowance applicant is 19 days.

As with any SSDI application, the applicant will still need to provide medical evidence to prove that he/she in fact has one of the conditions listed on the Compassionate Allowance Program list. In some cases, this may be the most time-consuming aspect of such an application, as it can sometimes take weeks or months for medical professionals to submit the necessary documentation to the SSA examiner. Engaging a disability benefits attorney prior to filing an SSDI application can help to ensure that the proper documentation is on hand when the application is filed. In any event, if an applicant is found to have a condition listed on the Compassionate Allowance Program list, then that applicant is placed on a fast track for approval.

One thing to keep in mind, however, is that, while the Compassionate Allowances Program allows a disability determination to be made more quickly, SSDI beneficiaries still have to wait at least five months after the onset of his/her disability to begin receiving benefits (and 24 months after the onset date before Medicare benefits begin).

Get Help

If you have suffered a disability which prevents you from continuing in your present occupation, contact a disability benefits attorney as soon as possible. Whether you are contemplating filing a claim for SSDI benefits, or have already begun the process, and are curious what your chances are, the  legal team at Farrell Disability Law has the experience necessary to analyze your claim, and help you develop a strategy to get you the benefits you deserve. Contact our Jacksonville office today.

Resources:

doverpost.com/news/20180821/social-security-adds-5-compassionate-allowance-conditions

Termination for Having a Disability

The law is pretty clear on whether an employer can terminate an employee because the employee has become disabled – it cannot, assuming some requirements are met. More specifically, the Family and Medical Leave Act (FMLA) provides eligible employees with 12 weeks of annual unpaid leave to deal with their own medical issues or to take care of a member of one’s immediate family. However, not all workplaces are subject to FMLA, and even in those that are, employees must meet certain requirements to be covered by the law. Generally, the FMLA applies only to companies with 50 or more employees located within 75 miles of each other, and workers must have worked at least:

• One year for the employer; and
• 1,250 hours in the preceding year.

The Effect of the FMLA

Although, as stated above, FMLA leave is unpaid, an employee can receive both short-term disability and/or LTD benefits while on FMLA leave. In fact, many employers require their employees to use their allotted FMLA time while on disability. Thus, even though many employees look at disability benefits as an afterthought to their general benefit package, for many disabled employees, FMLA is the most important form of job protection they enjoy.

One’s employer may not terminate an employee if he/she is on FMLA leave, as long as the employee does not use over 12 weeks of their annual FMLA leave allotment. Further, when the employee does return from FMLA leave, his/her employer must employ the employee in his/her former position or one that is substantially similar. However, if an employee does exceed the 12 weeks annual FMLA leave allotment, even by a single day, the employee runs the risk of being terminated for excessive absences. In such a case, if the employee was receiving disability insurance benefits, he/she will still receive benefits according to the terms of the policy.

Additionally, as long as the employee was covered by LTD insurance at the time he/she became unable to work, he/she may file for disability benefits, regardless of whether he/she is still employed. The decisive question is whether the employee was insured on the date of the onset of his/her disability, and not on the date the claim was filed.

Get Help

If you have been approved for LTD benefits, but have been terminated from your employment, and believe that your termination may have been a way for your former employer not to have to pay your benefits, contact an experienced LTD benefits attorney to help you navigate the process. The legal team at Farrell Disability Law has the experience necessary to analyze your situation, and, if it is apparent that you were terminated solely to avoid payment of LTD benefits, will help you develop a strategy to get the benefits you deserve. Contact our Jacksonville office today.

Resource:

www.inc.com/suzanne-lucas/former-home-depot-employee-says-he-was-fired-because-he-needed-surgery.html

Applying for SSDI Benefits – Medical Consultation

As alluded to above, the actual SSDI application is not the first step in applying for SSDI benefits; in other words, a disabled individual should not think that all he/she needs to do is fill out a form and money will be forthcoming. Rather, the applicant should do the necessary legwork to gain the knowledge and obtains the pertinent information that can potentially lead to a successful SSDI application. Thus, the first issue that must be resolved is whether an applicant’s condition qualifies as a disability for purposes of SSDI.

For this, the first person the application should consult is his/her medical professional (or, potentially, his/her medical professional team, especially if he/she has been seeing a number of specialists for a chronic issue) to see if he/she will support the applicant’s SSDI claim. This support is essential to success, because the SSA will require documentation of the applicant’s disability in the form of medical evidence. Thus, informing the medical professional of the applicant’s intention to file an SSDI application is necessary to this process, and should be accompanied with a request for a copy of the applicant’s complete medical file.

Additionally, requesting the medical professional to provide a detailed statement of the applicant’s medical condition is a beneficial step, as is a request that the medical professional provide his/her opinion of the depth of the applicant’s disability, especially as it relates to the applicant’s occupation. In fact, in situations in which the medical professional may be unfamiliar with SSDI protocol, it may be worthwhile to provide the medical professional with documentation regarding what the SSA looks for when determining the extent of an applicant’s injury.

Legal Assistance

Additionally, it is crucial to speak to an attorney experienced in SSDI procedures. While, they cannot speak to an applicant’s medical situation, they can provide the applicant with a roadmap for a potentially successful application, which the applicant can then provide to his/her medical professional. It is also important for the applicant’s legal counsel to understand the situation, so that when at the hearing, which is almost guaranteed given the percentage of disability denials, they can speak from a basis of knowledge when attempting to persuade the SSA judge of the merits of the applicant’s SSDI application.

Get Help

If you are considering submitting an application SSDI benefits, are at the pre-application stage, and what to be sure that your application has the best chance at success possible, contact an experienced SSDI benefits attorney to help you begin the process. The attorneys at Farrell Disability Law have the experience necessary to help you not only prepare a successful SSDI application, but also to navigate your application through the SSA. Contact our Jacksonville office today.

Resource:

lawfirmnewswire.com/2018/07/applications-for-social-security-disability-benefits-drop-amid-economic-growth/

Code of Federal Regulations

As is the case with all federal agencies, while Congress sets out the law, which provides a general understanding of the purpose of the agency, it is the agency itself that creates rules and regulations, which serve to fulfill the objectives of the law. These rules and regulations are set forth in the Code of Federal Regulations (CFR), and the SSA is no exception.

Most relevant to an applicant for SSDI benefits, the amended rules and regulations now require that a Claims Representative, the name given to the person representing another individual in front of the SSA, must:

• Disclose whether an employee or independent contractor of the Claims Representative drafted, prepared or issued the medical or vocational option of the applicant; and
• Disclose whether the Claims Representative suggested that the applicant seek an examination by any individual who provides an opinion as to the state of the applicant relevant for the purposes of the SSDI application.

Effect of the New Rules and Regulations

While, at first glance, these new rules and regulations may appear to be commonsensical, in reality, it can potentially poison the dynamics between the various players at the SSDI hearing. Specifically, at the SSDI hearing, currently, while there are three separate “sides” – the applicant represented by the Claims Representative, the SSA, and the ALJ, the intent is that all three sides will work together to achieve the correct result, whether that result is a denial or an approval of SSDI benefits.

However, as some commentators to the proposed new rules and regulations have indicated, requiring the Claims Representative to provide the notices listed above may have the effect of tainting this dynamic, and turning it into more of the adversarial process that is present in courtrooms across the country. Disclosing the above-referenced information could color the Claims Representative in the eyes of both the ALJ and the SSA, thereby severing any trust between these sides. Obviously, this could potentially have the effect of seeing more applications denied.

Get Help

If you are considering submitting an application for SSDI benefits, and want to be sure that your application has the best chance at success possible, contact an experienced SSDI benefits attorney to help you navigate the process. The legal team at Farrell Disability Law has the experience necessary to help you not only prepare a successful SSDI application, but also to shepherd your application through the SSA, especially in light of these new rules and regulations. Contact our Jacksonville office today.

Resource:

thinkadvisor.com/2018/07/26/supreme-court-ruling-to-shake-up-social-security-d/

Private v. Employer

There are two ways in which an employee can obtain LTD benefits – privately or as part of a group plan offered by his/her employer. If purchased through the group plan, the LTD policy is governed by the Employees Retirement Income Security Act (ERISA); if bought privately, it is governed according to the terms of the insurance contract. ERISA is a federal law that has effectively superseded the terms of the insurance contract between the insurance company and the insured individual.

Differences

As a result of the different terms governing the two types of LTD policies, there are also differences in trying to appeal a denial of benefits. Some of the more significant differences between private LTD policies and group, or employer-provided, LTD policies include the following:

• Since ERISA is a federal provision, all appeals from a denial of a group LTD policy must be brought in federal court. Further, since ERISA was developed by Congress in conjunction with the insurance companies, the laws controlling how they are applied may be skewed in favor of the insurance company. By contrast, a privately-purchased policy may be brought in state court, under legal rules and procedures that may be more favorable to the policyholder.
• Privately-bought LTD insurance may, at the insured’s choice, be decided by a jury of his/her peers, as opposed to a federal judge.
• No additional evidence may be submitted for the appeal of a denial of a group LTD insurance policy. By contrast, this restriction does not apply to appeals of private disability policies.
• Discovery (gathering information and evidence). In a privately-purchased LTD insurance appeal, the plaintiff may conduct discovery relating to any issue relevant to the appeal, including the right to bring expert witnesses to support the appellant’s claim. Unfortunately, with an appeal of most group LTD plans, this expanded discovery is not permitted, in light of the restriction on evidence, mentioned above.
• A successful legal appeal of a denial of group LTD insurance can only award a lump-sum payout of the policyholder’s actual policy benefits (that is, what he/she would have been paid in the first place), a clarification of the policyholder’s rights under the plan going forward, and, in some cases, attorney’s fees. By contrast, a privately-purchased LTD policy allows a successful appellant to recover several types of damages from the insurer, such as pain and suffering, emotional distress, bad faith and punitive damages.

Get Help

If you have received a denial on a previously-filed LTD benefits claim, and are curious about any options you may have at your disposal, including whether you have the ability to file a complaint in court, contact an experienced LTD benefits attorney as soon as possible. The legal team at Farrell Disability Law has the experience necessary to analyze your claim will help you develop a strategy to get you the benefits you deserve. Contact our Jacksonville office today.

Resource:

law360.com/articles/1054307/ex-nfler-wins-fight-with-league-over-disability-benefits