• Ohio

    (513) 351-5997
  • Kentucky

    859-371-5997
  • Google Hangout | Facetime | Skype
    Upon Request
Inner Banner
Working Hard for the Working Class

We devote all our resources to getting the best possible result. Contact us today to start your FREE case evaluation.

Case Study: Back Injuries, Depression and Permanent Disability

Posted on Monday, October 29th, 2018 at 2:55 pm    

The following post is part of our Law Student Blog Writing Project, and is authored by Joe Trammell, a 2020 Juris Doctorate Candidate at The Ohio State University Michael E. Moritz College of Law.

Case Study: How Back Injuries and Depression Lead to Permanent Total Disability (PTD) or Permanent Partial Disability (PPD), But Not Both

When the Ohio Workers’ Compensation laws were written, one would have to think people like Sherry L. Redwine were who lawmakers had in mind. What is, or rather was, unknown was how far the benefits to someone in her situation would extend.

Ms. Redwine was injured while working for Ohio Presbyterian Retirement Services, Inc. in 2003. The life-changing damage she was left with included, according to State ex rel. Ohio Presbyterian Retirement Servs., Inc. v. Indus. Comm. (Ohio Presbyterian), “lumbosacral strain, radiculopathy right lower extremity, aggravation of pre-existing degenerative disc disease, depression, and ruptured disc at L4-5 with free disc fragment.” Her psychological injuries were enough to qualify her for what is known as “permanent-total disability” under § (section) 4123.58 of the Ohio Revised Code.

To qualify for this permanent-total disability, Ms. Redwine’s injuries had to be serious enough to prevent her from doing any sustained work, and that she will never make a full recovery. This does not legally prevent someone from doing any work, but the work can only be every once in a while, and not for a long period of time. No sustained wages can be earned. If an individual is able to do sustained work, the State believes she does not need permanent-total disability.

There is another option known as “permanent-partial disability,” located in Ohio Revised Code § 4123.57(A). In this case, a disability has to restrict one’s ability to work but not totally prevent it.

In Ms. Redwine’s case, she actually fit both categories. She had a psychological condition in the aftermath of her injuries that earned her permanent-total disability, and she began receiving disability payments in 2010. Three years later, she applied for permanent-partial disability for her physical injuries and was awarded it as well.

This was the dispute in Ohio Presbyterian. Ohio Presbyterian Retirement Services went to court arguing that Ms. Redwine could not receive both permanent-total and permanent-partial disability. They had good reason to do so, because employers are the ones responsible for workers’ compensation payments. They believed the language in the Ohio Revised Code does not allow for concurrent workers’ compensation. Ms. Redwine argued that since the two disability awards were for different things, she was eligible for both. This, of course, would affect how much she was paid.

In deciding the case, the Ohio Supreme Court had to take into account an Ohio Revised Code statute that says the workers’ compensation statute is to be interpreted as favoring the worker. This put Ohio Presbyterian Retirement Services at an immediate disadvantage. However, the Ohio Supreme Court mentioned a previous case that says courts cannot entirely “rewrite the statute,” or in other words stretch its meaning past what makes sense just to favor the worker.

What seems to be the crucial factor in the Ohio Supreme Court’s decision was a case they decided 90 years ago. Industrial Commission v. Kamrath, as the court explained in Ohio Presbyterian, says that “an injured employee has a right to recover workers’ compensation benefits only as specifically allowed by statute.” The court looked to the fact that there are other types of workers’ compensation that can be earned concurrently, and since they are mentioned specifically, the fact that permanent-total and permanent-partial are not mentioned specifically as being able to be earned concurrently means that they cannot be given out concurrently. This is a common way of interpreting laws known as expressio unius est exclusio alterius.

The significance of this ruling by the Ohio Supreme Court is that people who have multiple permanent injuries cannot receive multiple payments. The permanent-total disability payment is two-thirds of the injured worker’s average weekly earnings before the injury. Permanent-partial disability also awards two-thirds, but only up to 200 weeks. The percentage of the disability is the percentage of those weeks that are given. So someone with a 50 percent disability will get two-thirds of her average weekly earnings for 100 weeks. Ms. Redwine only gets the first calculation.

No doubt for Ms. Redwine and others like her it is a difficult and unfortunate situation; it would frustrate if not downright anger a person left in that position. However, this ruling is for the best. The argument might be made that concurrent payments would make up for the payment only being two-thirds of the worker’s average weekly earnings. There are several problems with this.

First, this is not the way to fix that sort of problem. If there is an issue with the payments, they should be fixed in the law, not through the commission handing out multiple awards and the courts consenting to it. That is the responsibility of the legislature.

Second, this would be too narrow in its solution. Not everyone qualifies for concurrent payments as they were given in the case of Ms. Redwine. Someone who does not have multiple types of injuries could not get both payments. Again, it should be the legislature that changes the law.

Third, there is not necessarily a problem with the system as is. The two-thirds payment does not include the other benefits, which include medical payments, rehabilitation, and funeral expenses. It also does not include other forms of government payments.

However, all those costs would never have happened had it not been for the injury. It might be a better system to award the full amount or even more if the employer was at fault. The system is not a perfect one. But the Ohio Supreme Court had it right in deferring to the legislature. The discussion to change these laws may be a needed one, but the courtroom was not the venue for it.


Cincinnati Area Insurance Companies Try to Choose Your Social Security Disability Attorney for You – Is This Good or Bad?

Posted on Friday, August 31st, 2018 at 3:52 pm    

The following post is part of our Law Student Blog Writing Project, and is authored by Dayna Wilson, a law clerk at Lawrence and Associates, who is pursuing her Juris Doctorate at Chase College of Law.

If you suffer from an illness or injury that leaves you unable to work for an extended period of time, and you have long-term disability (LTD) insurance, there are some circumstances where your LTD coverage may affect the process of applying for Social Security Disability Insurance (SSDI) benefits. The LTD contract that you signed most likely contains a provision that requires you to apply for SSDI benefits while you receive your LTD benefits. Because this LTD contract requires you to apply for SSDI benefits, your LTD carrier will probably refer your case to a SSDI advocate firm or attorney whom they work closely with. This referral may be confusing to you because the LTD carrier may not clearly explain why they are making this referral. Because this process is not thoroughly explained, you might unsure how to move forward with this unfamiliar advocate group or attorney.

During this difficult time in your life it is important to keep in mind your ultimate goal – to be covered and protected – and to relay that goal to the LTD carrier’s advocate group or attorney who you have been referred to. This blog will explain your options for your SSDI case when you have LTD benefits, as well as, what you should do if your LTD carrier refers you to an advocate group or attorney so that you can ensure your goals are being met.

What You Should Do If Your Long-Term Disability Insurance Company Refers You to an SSDI Advocate Group or Attorney?

If your LTD carrier refers you to its own advocate group or attorney, keep in mind that you are not required to retain this specific advocate group or attorney. You are allowed to hire any representative that you want to assist with your SSDI case. All Social Security representatives charge the same type of fee for their representation. The LTD referral is no cheaper than any other attorney in your area.

Sometimes the LTD carrier will tell you that the group or attorney that they are sending you to does not cost you anything up front, keep in mind that this is also the case with a local attorney of your choice. All representatives charge the exact same rates under Social Security’s rules. The only difference between an attorney of your choice and your LTD carrier’s attorney is that the LTD’s attorney may send your LTD carrier a cut of their fee as part of their referral arrangement.

Your Long Term Disability carrier’s ultimate goal when referring your SSDI claim to this advocate group or attorney is to get you approved for SSDI as soon as possible. This is most likely also your goal. Your LTD carrier wants you to be approved for SSDI because, if you are approved for SSDI then your LTD benefits will terminate. This is the case whether or not you use the advocate group or attorney that the LTD carrier suggests.

Do You Prefer a Greater Cincinnati Area Law Firm, Where You Can Meet Your Attorney Face to Face?

The advocator group or attorney that your LTD carrier refers you to will most likely be a large national group or firm. This is not necessarily a bad thing, but there are things to be considered. Chances are with a large national group or firm you will never meet your attorney/ representative until the day of the hearing. This can make for an impersonal process, which can make you feel like just another name on a list and can potentially result in the representative or attorney leaving out essential information in your case. Meeting with your attorney/representative prior to your hearing is important so that your attorney/representative can fully prepare themselves, and you, for what to expect during the hearing. A local attorney/representative is more likely to go over your file and prepare you for the questions the judge will ask you at least a few days prior to the day of your hearing. This more personal experience can help you feel confident and prepared going into the hearing.

Searching for the Right Social Security Attorney.

Remember, you have the right to choose your own attorney. Do not feel like you have to use the attorney or representative that the LTD carrier suggests. The Social Security Disability application process can be overwhelming. You should find a disability attorney who you like and trust. No matter who you decide to retain, be sure to communicate your ultimate goals and interests to your attorney. Retain an individual who makes you feel confident and comfortable with their legal representation. A good Social Security Disability attorney will ensure that you have a fair hearing. It is important that you choose an attorney who is familiar with the Social Security laws so they can offer you the best chance at getting your claim approved. It is important that you do not sign any forms or contracts that your long-term disability carrier sends you regarding the SSDI process until you have researched the firm and you are confident that they are the right fit for you. If you decide not to use the representative that the LTD carrier suggests, and instead hire someone else, be sure to inform your long-term disability carrier in writing that you have retained an different attorney and provide the LTD carrier with your attorney’s name and contact information.

Make Sure You Ask The Right Questions

questionFinding an attorney willing to take your Social Security should not be very difficult. However, finding a qualified disability attorney can be a tough process. Whether you use the representative that the LTD carrier suggests or someone of your own choosing, you should ask the right questions to determine whether the attorney truly has your best interests in mind. The first question you should ask is how accessible the attorney will be. Some social security attorneys handle large volume of cases, because of this, an attorney may not be able to provide adequate individual attention to your case. This should be one topic of your conversation. If your attorney understands your concerns and needs in the beginning, future misunderstandings can be prevented. Next, make sure the attorney has experience in the field of Social Security. This will ensure the attorney understands the nature of the Social Security Disability claim process. Finally, make sure you and your attorney get along. You want to trust your attorney and you want to make sure they have your intentions and goals in mind. The process will run much more smoothly if you hire a representative who will work hard for you, no matter if they are part of a national or local organization.

If you feel like a local firm is a better fit for your needs, Lawrence & Associates may be able to help you obtain the benefits that are owed to you by the Social Security Administration. We are strong advocates who focus on individual attention and stand up for your right to recover the benefits you’ve worked hard for. The Social Security Disability process can be exhausting, but with us you will have a personal experience with a local attorney for the same rate as a national organization recommended by your LTD carrier. We’re Working Hard for the Working Class, and we want to help you!


How Age, Education, and Residual Functional Capacity Help Cincinnati Residents Get Social Security Disability

Posted on Thursday, July 19th, 2018 at 4:43 pm    

The following post is part of our Law Student Blog Writing Project, and is authored by Dayna Wilson, a law clerk at Lawrence and Associates, who is pursuing her Juris Doctorate at Chase College of Law.

This blog is designed to provide you with an easy understanding on how three important factors – age, education, and residual functional capacity – all work together to determine the amount of Social Security Disability you may receive.

How is Residual Functional Capacity Determined?

There are many factors to be considered when determining if you can collect Social Security benefits. One important factor is called residual functional capacity (RFC). When determining your ability to work, Social Security evaluates your residual functional capacity. Social Security will assess the types of activities and tasks an applicant can still perform on a regular and continued basis. A Social Security disability claim will only be approved if it is established that you cannot perform any work.

The Code of Federal Regulations, defines residual functional capacity as what an individual can do despite limitations. Residual functional capacity will take into account all limitations and medical conditions. In other words, Social Security will evaluate how much you can do and how long it will take to perform the function. A Social Security claim examiner will assess all impairments, including serious and minor impairments when evaluating residual functional capacity. Manipulative or postural activities are assessed such as reaching, handling, and lifting. Environmental conditions are considered such as the ability to tolerate high and low temperatures or wet and dry conditions. The RFC also encompasses mental conditions such as the ability to maintain concentration and attention for extended periods of time. Also, how well you can understand and remember duties throughout the day are considered. When these important factors are not clearly explained in your medical records, Social Security often finds you can perform these functions. It is important your doctor assess your ability to twist, bend, reach, grasp, kneel, and climb. Social Security also takes into account nonexertional factors such ability to follow directions; perform work at a normal rate and persistence throughout the day; and one’s overall reliability.

What happens if one retains Residual Functional Capacity?

If residual functional capacity is obtained to perform any common work in the national economy, an individual will not be found to be disabled. If Social Security examiners determine you can perform light, semi-skilled work, examiners will compare your residual functional capacity with those in the Dictionary of Occupational Titles and will match you with any jobs listed in that publication which call for light, semi-skilled work.

What is the importance of Residual Functional Capacity?

A complete understanding of all the factors that go into residual functional capacity determination is important for you to have a successful Social Security disability claim. In the Cincinnati Social Security office, medical records are an essential component in the determination of residual functional capacity. Often times, many of the factors such as bending, twisting, and kneeling are irrelevant to a doctor’s actual treatment of a medical condition. However, they are important for a Social Security Administration (SSA) examiner in determining benefits because SSA focuses on your functional ability not just your medical history.

How Does Social Security Determine your Social Security Benefits Eligibility?

Social Security uses your “Full Retirement Age” to determine the amount of monthly income you will receive. Full retirement age is based on your year and day of birth. Full Retirement Age determines when you are able to receive your full benefit amount. If you have started claiming benefits before your full retirement age, you become eligible for delayed retirement credits.

What is the difference Between Retirement Age and Stop Work Age?

Retirement age and stop work age must be distinguished in order to get a better understanding of how age can affect Social Security benefits. According to the Social Security Administration, your retirement age is the age at which you begin receiving Social Security retirement benefits. Stop Age is the age at which you leave the labor force and no longer work. This age affects the amount of Social Security benefits you may collect. Retirement benefits are based on your highest 35 years of earnings and your age when you start receiving benefits.

What Happens if you Stop Work Before your Retirement Age?

Social Security Administration will use a zero for each year without earnings, then they complete their calculations to determine the amount of retirement benefits you are due. If you stop working between the age of 62 and full retirement age, you may receive reduced benefits. The earliest you can start receiving retirement benefits is age 62. If you retire when you reach full retirement age, you will receive retirement benefits. In the Greater Cincinnati area, many individuals often work past full retirement age. Here, you are presented with two options: you can work and get full retirement benefits no matter how much you earn; the second option is to delay getting retirement benefits and earn credits that increase your benefit amount.

Are there any consequences of claiming Social Security Early?

There are consequences for receiving Social Security benefits early. If you are married you are reducing the survivor benefit available to your spouse. This will occur if your benefit amount is greater than theirs. Next, if you claim Social Security Benefits before your full retirement age and continue employment and make too much, then benefits will be reduced. It is important to note; investment income does not count toward the annual earnings limit. The only income that counts is income earned by working.

How does Education Affect Social Security Disability?

When applying for Social Security Disability, the Social Security Administration will ask what is the highest level of education you have completed. This information is used to assist with determining what kind of work you are capable of performing given your age and impairments. Education level can be measured to determine one’s ability to adapt to skilled work. The presence of additional education does not necessarily mean you can perform skilled work. A judge may determine the education you have received is outdated that it doesn’t affect your ability to perform present work. If you are over the age of 50, it is important to have your education evaluated. The rules assume that older individuals who cannot perform their past work because of physical and/or mental limitations will have the hardest time adapting to new work given their again. Therefore, it is generally easier for older individuals to be approved.

Age, education, and residual functional capacity all work together to determine the amount of benefits you will receive. It is essential for you to know how these are assessed and we want to make it easier for you to receive benefits. At Lawrence & Associates, we want to help you recover the benefits you have worked hard for. We’re Working Hard for the Working Class; call us today for a free, confidential consultation!


SSDI: What Can Cincinnati and Northern Kentucky Residents Do to Help Their Social Security Disability Cases?

Posted on Tuesday, July 10th, 2018 at 10:51 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Madelyn Stampley, a law clerk at Lawrence and Associates, who is pursuing her Juris Doctorate at NKU Chase College of Law.

In order to receive social security disability, you must go through a five-step sequential evaluation process by the Cincinnati branch of the Social Security Administration. During the fifth and final step of the sequential evaluation, the Social Security Administration must prove that work exists for you in the national economy that you will be able to adjust to considering your impairment(s), age, education, and past work experience. If they cannot prove that work exists for you, then you are found disabled. To have a ruling in your favor, there are a few simple things you can do to help. Attending all of your medical appointments and keeping a log of all of those appointments is very helpful. Making sure to also track your symptoms, your medications, and the side-effects of your medications. Lastly, making sure your doctor is writing detailed medical reports and stating his medical opinion about your impairments and how they limit your abilities in your work life can be extremely helpful to lead to getting disability.

Firstly, making sure that you attend all of your medical appointments is very important to your claim. In Northern Kentucky and Cincinnati, the Social Security Administration uses your medical records to determine if you are disabled or not. If you fail to attend your medical appointments that also means you are failing to obtain medical records, which means the Social Security Administration will have nothing to base their determination off of for your disability. The more medical records you have the more proof you have to show that you are severely and permanently impaired and ultimately unable to work.

Secondly, along with attending your medical appointments, keeping a log of all your appointments helps your case as well. Write down when and where you were treated, who you treated with, and what impairment you were treated for. It makes it easier for your attorney to obtain the proper medical records and have a record of every time you went to the doctor. Along with keeping a log of your appointments, also make sure to track your symptoms. Keeping a daily log of your impairments and how they affect you gives your attorney more information that they can use to win the case. Along with this, also track your medications with their corresponding side effects. Keeping a log of everything speeds along the social security process and helps everything run more smoothly.

When you go to your medical appointments it is also important to ask your doctor to write detailed and clear medical reports. Generally, when doctors write their medical records, they are writing them for themselves. They often times neglect being too detailed and instead write quick and concise notes. Ask your doctor for a medical report that includes a detailed narrative that explains all of your impairments and functional limitations. The Social Security Administration reads through all of your records and a detailed narrative is very helpful to you case.

You should also ask your doctor to include his medical opinion in your medical reports. Have your doctor state whether or not they believe that you are so severely and permanently disabled that you should not and cannot return to work. While the Social Security Administration will not take your doctor’s opinion as their answer, having your doctor’s opinion in your medical records can help prove that you are disabled. It never hurts to have more than one opinion attesting to your disability.

Along with asking your doctor for a more detailed medical report, also ask them to complete a Residual Functional Capacity (RFC) report as early in the process as you can. A Residual Functional Capacity report is an accounting of your capacity for full-time work. It allows your doctor to check off boxes allocating your limitations, like how much you can lift, how far you can walk, and whether you can bend or stoop. It is a great way for the Social Security Administration to get the information they need to make a determination of your disability.

Another thing you can do to help your case is making sure you are seeing the appropriate doctors for your impairments. While it is convenient to see the same doctor for everything, it is important to make sure you are receiving care from doctors that specialize in the area in which you need treatment for. For instance, instead of seeing your primary care physician for your mental health impairments, you should see a doctor who specializes in mental health, like a psychiatrist. This will ensure that you are getting the best possible medical records and opinions from someone who specializes in the disability that you have.

Lastly, strong communication and cooperation with your attorney is very important. It is crucial that you come to all of your meetings with your attorney and are easy to get a hold of. Making sure to fill out the forms we give you correctly and in a timely manner helps the social security process move along quickly. If you have questions about the process or are confused about something asked on one of your forms you have to fill out, it is best to contact your attorney instead of guessing.

The fifth step of the sequential evaluation by the Social Security Administration is the final step in determining if you are considered disabled or not. If they cannot prove that work exists for you, then you are found disabled. There are several ways you can help bring about the result you want in this fifth step along with your case as a whole. Make sure to attend all of your medical appointments so that the Social Security Administration has medical records to base their ruling off of. Obtaining good medical records and opinions by the appropriate doctors as well as having your doctor fill out a Residual Functional Capacity report goes a long way. Keeping a detailed log of your symptoms, your medication and its side effects, and a list of all of your medical appointment dates and your provider is also very helpful.

If you believe you have a Social Security Disability claim, don’t go it alone. Lawrence & Associates has helped many Cincinnati and Northern Kentucky residents just like you get disability benefits. We’re Working Hard for the Working Class, and we want to help you! Call today for a free, confidential consultation.


How Many Work Credits Do I Need to Get Social Security Disability in Ohio and Kentucky?

Posted on Monday, July 2nd, 2018 at 11:27 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Dayna Wilson, a law clerk at Lawrence and Associates, who is pursuing her Juris Doctorate at Chase College of Law.

Today, many people are unfamiliar with work credits requirements. Further, some people have not even heard of the term. This blog is designed to make you to have a simple understanding of social security work credits and the importance of them. Here at Lawrence & Associates, we encourage you to call us for a free consultation! We are qualified representatives who can help determine whether you qualify for Social Security Disability.

What are Social Security Work Credits?

Let’s jump into Social Security benefits and what you should know about them. The Social Security Administration refers to these work credits as the “building blocks” which Social Security uses to determine whether you have worked long enough to qualify for benefits. Work credits are earned throughout your employment history.

You qualify for Social Security benefits by earning Social Security credits when you work in a job and pay Social Security taxes. Credits are based on your income during the year, no matter when you did the actual work. When an individual works they can earn up to 4 credits in a year. It is important to keep in mind that it does not matter if you earn $5,000 or $500,000 in a given year, you can only earn up to four credits in a given year. Currently, a worker must earn $1,320 to earn one work credit. This figure gets adjusted based on inflation every year. Your average earnings during your working years determine how much your monthly payment will be.

How Many Credits Do You Need to Be Eligible in the Cincinnati area?

The number of work credits needed for disability benefits depends on your age when you become disabled. In general, you need 40 credits, with 20 earned in the last 10 years ending with the year you become disabled. However, younger workers can qualify with fewer credits. For example, if you are 24 or younger, you may qualify if you have six credits earned in the three-year period ending when your disability starts. If you are between the age of 24 to 31, you may qualify if you have credit for working half the time between age 21 and the time you become disabled. For example, if you become disabled at age 27, you would need credit for 3 years of work (12 credits) out of the past 6 years (between ages 21 and 27). For individuals 31 through 42, the number of credits needed for disability benefits is 20.

In this video, Social Security Attorney Danielle Lawrence, explains to be considered for Social Security Disability at the age of 46, you will need 24 work credits in the last 10 years. On the other hand, if an individual is 58, 36 work credits are needed in the last 10 years in order to qualify. Social Security will use those work credits from the 10 years prior to disability to determine whether an individual may receive Social Security disability benefits.

A common misconception among many people is that Social Security Disability is the same as Social Security Retirement. People may think if they are working hard and paying into their retirement, then they can easily qualify for Social Security benefits. However, it is important to know that is not the case.

Special Rules for Some Jobs

Are you an individual who is self-employed? If so, then you earn Social Security credits the same way employees do (one credit for each $1,320 in net earnings, and no more than four credits per year). There are special rules that apply if you earn less than $400. It is important to note, if you are in the military then you also earn credits the same way civilian employees do. Additional earnings may also be considered based on certain conditions.

How You Can Ensure Accurate Work Credits

Each year, your employer sends a copy of your W-2 (Wage and Tax Statement) to Social Security. Social Security Administration compares your name and Social Security number on the W-2 with their records. Your earnings shown on the W-2 are recorded on your lifelong earnings record. Your lifelong earnings record is what Social Security uses to determine your future benefits and the benefits amount.

Your name and Social Security number on your Social Security card must agree with the information on your employer’s payroll records and W-2. It is important to protect your benefits by ensuring that your employer has the correct social security number and name.

Why Are Work Credits Important to Social Security Disability Determinations in the Cincinnati Area?

According to the Social Security Administration, in 2017, about 173 million people worked and paid Social Security taxes about 62 million people received monthly Social Security benefits. Social Security reaches almost every family, and at some point, impacts the lives of nearly all Americans.

Social Security Attorney Kelsey Westermeyer explains the importance of work credits. She states, “If you do not have enough credits, you cannot get disability.” If you do not have enough credits, then Social Security Administration does not have to pay you monthly checks. A statement from your doctor saying you are disabled is not enough to qualify for Social Security disability benefits.

In sum, The Social Security Administration uses work credits to determine whether an individual qualifies for Social Security Disability benefits. An individual may earn a maximum of four work credits a year. Today, a worker must earn $1,320 to earn one work credit. As an individual gets older the more work credits are needed to qualify for benefits.

If you are unsure about the amount of credits you have earned then it is important to contact a qualified representative. Here at Lawrence & Associates, we are strong advocates for your rights in the Social Security system. We recognize your hard work and efforts and we are here to help you recover your benefits you have worked so hard for.

We offer a free, confidential consultation in order to determine whether you qualify for Social Security Disability. Call today! We’re Working Hard for the Working Class, and we want to help you.


How Can a Local, Cincinnati Attorney Help Get Social Security Disability Approved?

Posted on Thursday, June 28th, 2018 at 11:53 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Jennifer Tressler, who is pursuing her Juris Doctorate at The Ohio State University Moritz College of Law.

Social security disability attorneys can help make an overwhelming process seem much more manageable. While hiring a lawyer specializing in social security disability cases is not required, it will likely be extremely beneficial during a difficult time when your health is suffering. Social security disability attorneys have experience dealing with the Social Security Administration (SSA) and, as such, will be able to handle any of the various issues that could arise during the application process. You can expect your social security disability benefits attorney to review your case with you and ask you a variety of questions, both to gather information on your case and to prepare you for questions you may be asked should a hearing be necessary in the future. Your social security disability attorney will function as the liaison and communicator between you and the SSA. This is just one of the duties that you can expect your social security disability attorney to carry out on your behalf. But it is an important one, as the language and application process of social security disability is complex and often foreign to the average person. At Lawrence & Associates, Kelsey Westermeyer  handles the vast majority of social security claims and consistently achieves high approval ratings.

How Can My Attorney Help Get Approval for SSDI Through the Cincinnati, Ohio or Florence, Kentucky Social Security Offices?

Another one of the duties of your social security disability attorney is to complete an initial review of your case. This will happen no matter at which stage of the application process you are. After this initial review, your social security disability attorney will determine the best strategy for you moving forward. He or she will assist you in crafting a compelling story around your case and develop some strategies for how your case will be won.

One of the most common (and significant!) mistakes made by individuals applying for social security disability benefits is filing with an incomplete claim. The majority of applicants for social security disability benefits are denied during the initial stages, mostly due to incomplete applications. Having your social security disability attorney review your application and ensure its completeness is one of the best ways to ensure your application will go undo review in the proper channels.

Your social security disability attorney will collect and sort medical evidence on your behalf. Many social security disability cases are won and lost on medical evidence. After obtaining proper medical release forms, your social security disability attorney will help you gather the relevant medical evidence needed for your application. He or she will review your medical records and work alongside you to collect any missing medical information or tests. Most importantly, he or she will sort through the hundreds of pages of medical documents to determine which information is the most important. Many social security disability attorneys will work directly with your medical provider, physician, or other healthcare provider to gather supportive opinion statements and letters. Having this evidence strengthens your case and makes it more likely that you will be granted social security disability benefits. Additionally, if your social security disability attorney determines that additional testing is necessary to bolster your application, he or she can request a consultative examination from the Social Security Administration doctors or ask that you get the additional testing completed on your own.

Your social security disability attorney is responsible for staying in communication with the Social Security Administration. The Social Security office is enormous and has an immense volume of claims pass through it. The application process of social security disability benefits is complex, filled with multiple deadlines and various formalities that must be adhered to. Your social security disability attorney will communicate directly with the SSA on your behalf, so that you have less to worry about regarding your application and more time to work on your health. Having a middleman communicate with the SSA on your behalf protects your best interests during this already stressful time. Your social security disability attorney will work to push your social security disability benefits application through the system with minimum effort and work from you.

How Can My Attorney Help Represent Me in Front of a Social Security Administrative Law Judge at a Hearing?

If needed, your social security disability attorney will file the necessary appeals for you. According to the Social Security Administration, less than forty percent of social security disability applications are approved at the initial application level. If your case is one that receives an initial denial, you are entitled to appeal the decision. The appeals process contains several specific and distinct steps that much each be completed within a certain amount of time. Hiring and retaining a social security disability attorney can help you navigate the appeals process, should your initial application be denied. To that end, your social security disability attorney will represent you at disability hearings, if necessary. The majority of successful disability claims are won at the hearing level. If you are originally denied disability benefits and you and your attorney appeal the decision, you are offered a hearing in front of an administrative law judge.

The hearing process is stressful, and having adequate preparation is critical to your success. Having a social security disability attorney will ensure that you are adequately prepared for your hearing. Though you will still need to speak for yourself, your social security disability attorney will represent you during the process and prepare you to testify. Your social security disability attorney will ask questions of your witnesses and address any expert witnesses, such as medical or vocational experts. If you have already been granted social security disability benefits but feel that you are not receiving adequate compensation, your social security disability attorney can help you request additional financial aid in the form of SSI benefits.

Your chances of success when applying for social security disability benefits dramatically improve if you are working with a social security disability attorney. Even if you are struggling financially due to your illness, hiring and working with a social security disability benefits attorney is well worth your time, energy, and money when you consider that without their help, winning your case can be exponentially more difficult. If you are overwhelmed by the social security disability benefits application process and would like some assistance from qualified, experienced individuals, contact Lawrence & Associates today. We can help you obtain that fresh start that you deserve! Call today for a free consultation at (859) 371.5997. We’re Working Hard for the Working Class, and we want to help you!


Social Security Disability: Five FAQs and Facts

Posted on Tuesday, June 19th, 2018 at 2:59 pm    

Enduring the process of applying for Social Security Benefits can be extremely stressful to any person. Fortunately, we are here to help ease your mind and speed up the process. In this blog, we are going to cover five frequently asked questions and other facts about Social Security Disability Income.

ONE: What Conditions Qualify for Disability Benefits?

One of the most common questions we hear when talking to social security disability candidates is this: “What disabilities qualify for benefits?” One way that the Social Security Administration answers that question is by using a Listing of Impairments (Part A) also known as the “Blue Book.” The Blue Book has several categories and is then broken down to sub categories.

The main categories for adults are listed below:

  • Musculoskeletal System
  • Special Senses and Speech
  • Respiratory Disorders
  • Cardiovascular System
  • Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders that Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Cancer (Malignant Neoplastic Diseases)
  • Immune System Disorders

The Blue Book also has a Listing of Impairments for Children (Part B). The children’s Listing of Impairments is broken down into main categories and sub categories as well.

The main categories for children are listed below:

  • Low Birth Weight and Failure to Thrive
  • Musculoskeletal System
  • Special Senses and Speech
  • Respiratory Disorders
  • Cardiovascular System
  • Digestive System
  • Genitourinary Disorders
  • Hematological Disorders
  • Skin Disorders
  • Endocrine Disorders
  • Congenital Disorders that Affect Multiple Body Systems
  • Neurological Disorders
  • Mental Disorders
  • Cancer (Malignant Neoplastic Diseases)
  • Immune System Disorders

The Social Security Administration describes the Listing of Impairments as: “Impairments considered severe enough to prevent an individual from doing any gainful activity (or in the case of children under age 18 applying for SSI, severe enough to cause marked and severe functional limitations).”


TWO: My Disability is listed in the Blue Book. Do I Still Need an Attorney?

You may have a disability that is displayed on the Listing of Impairments, but may not be seen as “severe enough” by the SSA to fulfill eligibility requirements. Your disability must then be proved “severe enough” to qualify.

Even if your disability is listed, your benefits are not automatic. By hiring an experienced Social Security Attorney, you are letting go of the reins and letting a professional take over. So many people have had applications denied because of mistakes on their applications. Don’t let this happen to you.


THREE: My Doctor Says I am Disabled. Why do I Keep Getting Denied by the SSA?

The SSA may have denied you for medical reasons. In order to prove you have an impairment that is found in the Blue Book, you will need to obtain proper medical evidence that supports what you have claimed to be disabled for. Your attorney can obtain this medical evidence by requesting medical records, reports and more from your doctor(s).


FOUR: What is the Importance of My Attorney Getting Medical Records for My Case?

Claims for Disability benefits are approved or denied based on medical evidence. Medical records establish the severity of your impairment and helps the SSA understand your disability.

According to The Code of Federal Regulations, medical evidence that can be used or submitted with your claim include:

    • Objective Medical Evidence
      • Medical Signs
      • Laboratory Findings
    • Medical Opinion
      • This can be a report from your doctor stating things that you CAN do, despite your impairment.
    • Other Medical Evidence
      • Medical History
      • Clinical Findings
      • Diagnosis and more

If your application lacks these key evidence types, your claim could be denied. An attorney can request these medical records for your claim and help your claim get approved.


FIVE: Can I Work While Getting Disability Benefits?

SSDI recipients generally can’t do Substantial Gainful Activity (SGA) while receiving full benefits. The SSA describes SGA as “A term used to describe a level of work activity and earnings. Work is “substantial” if it involves doing significant physical or mental activities or a combination of both.” They describe “Gainful” Work activity as “Work performed for pay or profit, work of a nature generally performed for pay or profit, or work intended for profit, whether or not a profit is realized.” Your eligibility for SSDI benefits depends on whether or not you are able to do SGA.

SGA has two parts. Hours worked and income earned. If you work more than 20 hours per week that is SGA and will cause you to be ineligible to received benefits. According to the SSA the income portion of SGA for 2018 “for statutorily blind individuals for 2018 is $1970. For non-blind individuals, the monthly SGA amount for 2018 is $1180. SGA for the blind does not apply to Supplemental Security Income (SSI) benefits, while SGA for the non-blind disabled applies to Social Security and SSI benefits.” In other words, if you are a non-blind individual, you can make up to $1,180 per month while receiving benefits and for blind individuals, you can receive up to $1,970 per month while receiving benefits. According to the history of SGA amounts, they have slightly increased almost every year since 1975. This is because the amounts change based on the National Average Wage Index.

If you are concerned about your application to the Social Security Administration for SSI or SSDI, call Lawrence & Associates to talk to one of our trained intake specialists about setting up a completely free consultation to talk to one of our Social Security Attorneys. Lawrence & Associates will be with you every step of the way and will help you fight for your benefits. We practice Social Security in the states of Ohio and Kentucky.

Call us today to find out how we can help you now!


Demystifying Social Security Disability Insurance (SSDI): Calculating Benefits from Past Wages after the Finding of Disability

Posted on Monday, December 11th, 2017 at 2:19 pm    

The following post is part of our Law Student Blog Writing Project, and is authored by Thomas Rovito, who is pursuing his Juris Doctorate at the Ohio State University.

The Social Security Administration (SSA), which has local offices in Cincinnati, Ohio and Florence, Kentucky, publicized in its report Disability Benefits that “a 20-year-old worker has a 1-in-4 chance of becoming disabled before reaching full retirement age.” This imperative displays the need to demystify the byzantine process of the calculation of benefits from past wages after the finding of disability through the SSDI formula from 42 U.S.C. § 415. This article details SSA and third-party resources on calculating SSDI benefits, as well as the fundamentals of calculating SSDI benefits.

Fortunately, the SSA has created a benefit calculator to expedite the math. In addition, my Social Security provides online statements to “show” the SSA’s work. The Congressional Research Service has produced white papers on this topic. In addition, legal self-help companies and newspapers, such as Nolo and the Washington Post, have simplified the SSDI benefit process.

But for those wanting to explore the process further into the actuary tables and formulas from the Social Security Handbook, this guide is designed to provide an overview on the fundamentals of the SSA benefit calculation process for SSDI. Please note that this article concerns the Title II SSDI program (for workers who have paid into Social Security over the course of their career), and not the Title XVI Supplemental Security Income (SSI) program (for disabled persons with limited assets).

Much like a high school algebra problem, the SSDI program calculation requires several steps, and can be best illustrated through hypothetical problems. The first step is to multiply the beneficiary’s nominal earnings by the yearly index factors to determine the beneficiary’s indexed earnings. The index factor settles at the flat rate of 1.0000 when the beneficiary is eligible for benefits, with the same rate applying to the two years before the beneficiary claimed eligibility. To find the index factor for previous years, divide the Average Wage Indexing Series (AWI – or the average wage for the year) when the beneficiary turned sixty by the AWI of the year of employment. The beneficiary would then multiple his nominal earnings by the index series to obtain his yearly indexed earnings.

Social Security Administration, Average Wage Indexing Series Graph

These concepts can be vividly illustrated through a hypothetical question (similar to two hypothetical illustrations by the SSA). Beneficiary (B) is eligible for SSDI benefits in 2018 at age sixty-two; thus, a flat rate of 1.0000 would apply as his index factor for 2017 and 2016. For previous years of employment, he would take the AWI from when he turned sixty by the AWI for his year of employment. B would then multiply his nominal earnings by the index factor for each year to determine his indexed earnings.

B’s Earnings from 2017-2012 (with Subsequent Years Omitted)
Formula: Nominal Earnings x Index Factor = Index Earnings
Index Factor = AWI of B at 60 / AWI of Year of Employment

The next step would be to calculate the “average indexed monthly earnings” (AIME). This amount is computed from the top thirty-five years of indexed earnings added together, and then divided by the number of months within the thirty-five years, or four hundred and twenty months. If the beneficiary worked for more than thirty-five years, only the thirty-five largest indexed earnings would count, and the other years would drop off from the calculation.

Returning to B in the hypothetical, let’s say he worked for forty-five years before suffering his disability. Only the largest thirty-five years of indexed income would apply. The largest thirty-five indexed income rates would be summed. This amount would then be divided by four hundred and twenty to yield the AIME.

Formula: (Largest 35 Index Earning Summed) / 420 = AIME
420 came from 12 (months) x 35 (years)

The third step is to use the AIME figure to assess the beneficiary’s primary insurance amount (PIA). The PIA formula is a function of the AIME, which is contingent on the year of first eligibility. The PIA formula will consist of bend points. The amounts for 2018 are:

  1. 90 percent of the first $895 of his/her average indexed monthly earnings, plus
  2. 32 percent of his/her average indexed monthly earnings over $895 and through $5,397, plus
  3. 15 percent of his/her average indexed monthly earnings over $5,397.

Using the numbers from the another SSA hypothetical, B, who was eligible and retired in 2018, has a AIME of $4,059, with the 2018 first PIA bend point of $895, and the PIA second bend point of $5,397. Cost of Living Allowance (COLA) does not apply.

.9 (First PIA bend point of eligible year) + .32 (AIME – First PIA bend point of eligible year) = Gross Monthly SSDI Calculation (truncated to the next lowest dime)
.9 (895) + .32 (4059 – 895) = $1,817.90 (truncated from $1,817.98)

On the other hand (again, using the numbers from another SSA hypothetical, B2, who was eligible in 2014, but did not take until 2018, would have access to COLA adjustments from 2014 through 2018. In addition, if B2 had an AIME of $9,144, the first 2014 PIA bend point of $816, and the second 2014 PIA bend point of $4,917, the respective calculation would be:

9 (First PIA bend point of eligible year) + .32 (Second PIA bend point of eligible year – First PIA bend point) + .15 (AIME – Third PIA bend point of eligible year) = Gross Monthly SSDI Calculation (truncated to the next lowest dime)
.9 (816) + .32 (4,917 – 816) + .15 (9,144 – 4,917) = $2,680.70 (truncated from $2,680.77).
The COLAs of 2014 through 2017 apply (1.7%. 0.0%, 0.3%, and 2.0%), which yield $2,788.90.
COLA x Gross Monthly SSDI Calculation = Modified Monthly SSDI Calculation
.04 x 2,680.70 = 107.28
107.28 + 2,680.70 = $2,787.90 (truncated from $2,787.93)

While this calculation yields the Gross Monthly SSDI Calculation, several other factors may impact this determination. For instance, there will be a deduction is the beneficiary is disabled before the Full Retirement Age (FRA) to the Gross Monthly SSDI Calculation. If the beneficiary has dependents, the Maximum Family Benefit (MFB) may trigger. According to the SSA, the MFB is “is the maximum monthly amount that can be paid on a worker’s earnings record.” This amount may not exceed:

  1. 150 percent of the first $1,144 of the worker’s PIA, plus
  2. 272 percent of the worker’s PIA over $1,144 through $1,651, plus
  3. 134 percent of the worker’s PIA over $1,651 through $2,154, plus
  4. 175 percent of the worker’s PIA over $2,154.

In addition to the fourth step of adjusting for these extraneous factors, it also important to consider the broader implications of claiming SSDI, including its impact on the beneficiary’s federal taxes, and the ability of the beneficiary to claim Medicare or Medicaid coverage. Moreover, SSDI benefits may become modified if the beneficiary returns to work, leaves the United States, has a change in marital status, has additional dependents, is convicted of a crime, or has a material change in income.

While the SSDI calculation may appear to be complex on its face, it may be analyzed as several step-by-step formulas. While the SSA does provide online statements and a benefits calculator, knowing the nuances of the formula, such as what constitutes the indexed income, AIME, and PIA, can empower you, and your attorney at Lawrence & Associates to make an informed and personally tailored decision about your SSDI benefits.

Lawrence & Associates has offices in West Chester, Ohio and Fort Mitchell, Kentucky. We’re Working Hard for the Working Class, and we want to help you!


In the Cincinnati Hearing Office, Does Getting VA Disability Guarantee Success with Social Security Disability?

Posted on Thursday, December 7th, 2017 at 11:00 am    

The following post is part of our Law Student Blog Writing Project, and is authored by Raphael Jackson, a law student from the Chase School of Law.

In the Cincinnati Hearing Office, Does Getting VA Disability Guarantee Success with Social Security Disability?

The short answer is no. The common misperception among many, is that being granted VA Disability automatically renders you eligible for Social Security Disability. This misconception likely has its origins in the fact that in how the two disability processes were related in the past. In the past, attainment of full disability from the Veterans Administration weighed heavily in the favor of the applicant who applied for Social Security Disability. However, this is no longer the case, and many decisions from the Cincinnati hearing office have confirmed that no weight will be given to the VA Disability decision.

Social Security and Veterans disability are both forms of government based disability payout programs. However they are operated by two separate and independent governmental departments. Each department has established its own criteria for determining who is eligible for disability payments, what qualifies as a disability, and how much each recipient may receive.

To understand why veteran benefits no longer have such a meaningful effect of the outcome of your Social Security Disability, it is important to explain a short background about each agency and an explanation about how each individual agency determines the disability of the applicant.

While many different iterations of Veterans Benefits programs have existed since the time of the Civil War. The Veterans Bureau, the precursor to the Veterans Affairs Administration, was established by an act of Congress in 1919. While Social Security Disability Insurance, or SSDI, came into law in 1959. SSDI is available to all workers because it is funded by a payroll tax. This program, which is federally insured, is designed to provide income supplements for people who have been prevented from working due to a physical impairment.

What Is Veterans Administration disability?

VA disability is a monthly tax-free benefit paid to veterans who are at least 10% disabled due to injuries or illness incurred during active duty service. Active duty service includes active duty training. These injuries can be either physical such as a knee or back injury, or psychological such as Post Traumatic Stress Disorder. The VA measures disability on a percentage system and it is recorded in increments of 10% up to 100%. Those who have a compensation rate of P&T are considered 100% disabled.

P & T means permanently and totally “disabled”, which essentially means that the VA has considered the injury to be reasonably certain to continue throughout the life of the disabled veteran.
38 U.S.C.A. § 3501 (West)

How Do Cincinnati and Northern Kentucky People Get Social Security Disability?

As opposed to Veterans Disability, the majority of Americans who have worked for the past ten years – whether or not they are or have been military veterans – will qualify for Social Security Disability Insurance.

The official name of Social Security Disability is called Social Security Disability Insurance, or SSDI. You are eligible for disability benefits from Social Security only if you have been working for at least five of the last ten years. Unlike VA disability, SSDI is primarily concerned with “work credits,” i.e. how long you paid out into the system. The amount that you receive is calculated based upon your earnings history in your civilian occupation, as well as your military occupation if applicable.

The standard for receiving disability under the Social Security administration is:

  • The applicant is unable to do substantial work due to one or more medical condition(s);
  • The applicant’s medical condition is expected to last more than a year.

Social Security Disability is a monthly cash benefit which is granted to federal employees that have a disability that meets the Social Security Administrations definition of disability. There are 14 different general categories of disabilities that fall under the Social Security administrations definition of disability. These disabilities range from muscular skeletal disorder to auto immune disorders. The Social Security Administration calculates your monthly benefit payments by reviewing your previous income in your civilian and military jobs, as well as the date that your served. The maximum SSDI payment is $2639 per month in 2016.

In order to qualify for Social Security disability, you must have be working with a severe disability that lasts for more than a year, or a disability that can lead to death, or a disability that prevents you from working. If the recipient goes back the work the benefits will be terminated.

What Are the Differences in Social Security and Veterans Administration Disability Benefit Calculations?

Veterans Affairs calculates the applicants benefit payments based on the severity of the applicants’ disability. SSDI follows no such scheme. Another difference is that VA grants disabilities based on a percentage ratings system. Veterans who are partially disabled may receive VA benefits in proportion to their disability percentage rating. SSDI, on the other hand, will only grant an applicant benefits if they are fully disabled and unable to work as classified by either:

  1. The VA, in the that the applicant is a veteran; or
  2. By a professional from an SSDI review board in the case that the applicant is a civilian who is not a veteran.

How the Cincinnati Hearing Office Changes Priority Status

Even though receiving VA disability has no bearing on the outcome of your Social Security disability claim, the good news for Veterans is that as of March 17, 2017, being granted 100% P&T disability by the Veterans affairs Administration qualifies you to have your application for disability expedited by the Social Security Administration.

If you are 100% P&T then your application is considered high priority by the Social Security administration, and the application will be expedited.

Some veterans must wait as long as 125 days in order to receive a response from the VA to determine whether they are eligible to received disability. In addition to the long wait times, navigating the Veterans Affairs Disability process may prove to be a long and tedious process for many. Thus, is beneficial to seek the assistance of an experienced attorney when handling such cases. The waiting period for a Social Security Disability claim is even longer, and thus it makes sense to get an experienced attorney for these claims as well.


Eligibility Under Workers’ Comp and the Social Security Disability Insurance Program

Posted on Wednesday, November 8th, 2017 at 3:00 pm    

The following post is part of our Law Student Blog Writing Project, and is authored by Jessie Smith, a law student from the University of Kentucky.

A disabling injury or medical condition can strike anyone at any time. While rehabilitation and regaining one’s health is limited by the realities of modern medical science, maintaining economic security during these trying times is possible. Depending upon one’s personal circumstances, eligibility under a state’s workers’ compensation program or the federal government’s Social Security Disability Insurance program may provide the financial security blanket needed to guarantee one’s solvency, allowing one to remain focused on what matters most: healing.

Requirements for Eligibility Under Workers’ Comp Programs

Since workers’ compensation programs are administered by individual states, the specific requirements that must be fulfilled in order to be eligible for benefits of the program vary. As a general proposition, any injury or illness for which one seeks workers’ compensation must have been sustained on the job, or must have arisen out of work-related activities.

Additionally, an individual attempting to obtain workers’ compensation benefits must be classified as an “employee.” Some states also distinguish eligibility based upon the type of work that an employee performs. Finally, one’s employer must carry workers’ compensation insurance, or, alternatively, be required to do so by law.

As alluded to earlier, the above requirements are not universal, and may differ from state by state. Generally speaking, however, these requirements are common throughout the United States. It is important to note that there is a laundry list of exceptions to the general rules that may render an otherwise eligible “employee” ineligible. In order to get a better sense of individual states’ quirks, a brief review of some of the eligibility requirements of Kentucky and Ohio follow.

According to the National Federation of Independent Business (“NFIB”), in Kentucky, all employers that (employ one or more employees are required to carry workers’ compensation insurance. That said, sole proprietors, “qualified” partners of a partnership, and “qualified” members of a limited liability companies are excluded from workers’ compensation coverage. Officers of corporations, on the other hand, are considered “employees” by statute, and, thus, workers’ compensation insurance is required for such individuals.

Like Kentucky, Ohio requires all employers with one or more employees to carry workers’ compensation insurance coverage, according to the NFIB. Under Ohio workers’ compensation law, workers’ compensation coverage for sole proprietors, partners of a partnership, individuals that have incorporated themselves as a corporation, and others, is optional. In addition, and unlike Kentucky, the only option for most employers to obtain workers’ compensation coverage in Ohio is via Ohio state’s own program (as opposed to obtaining or maintaining coverage through a private or commercial insurer).

Clearly, the state-administered workers’ compensation programs are unique and can differ greatly between states. While the eligibility requirements and laws governing workers’ compensation can vary wildly throughout the nation, the federally administered Social Security Disability Insurance program applies universally. A brief overview of the eligibility requirements of the Social Security Disability Program follows.

Requirements for Eligibility Under the Social Security Disability Program

So long as the basic requirements are met, employees are eligible for workers’ compensation from their very first day of employment. While not a requirement per se, it is nevertheless important to note that, unlike workers’ compensation programs, Social Security Disability benefits are only available to those that have worked for a longer period of time. As a general rule, in order to qualify for Social Security Disability, one must have accumulated forty “credits,” twenty of which were earned in the past ten years. The number of credits required is determined by the claimant’s age at the time of disability. A younger individual will require less work credits than an older individual. One “credit,” according to the Social Security Administration, is earned for every $1,300 of wages an employee earns. An employee may earn only four credits per year; thus, once an individual earns $5,200 for the year, that individual has earned their maximum four credits for that year.

In addition to earning the requisite number of credits, a person must meet the Social Security Administration’s definition of “disabled” in order to qualify for disability benefits. “Disability” means that a person “cannot do work that [they] did before,” one’s “disability has lasted or is expected to last for at least a year or to result in death,” and the Social Security Administration determines that the one seeking benefits “cannot adjust to other work because of [their] medical condition(s).” If these three definitional elements are met by an applicant, they will be considered disabled, and will thus have satisfied one of the requirements to be eligible for disability benefits.

In addition to the above requirements, one must have “worked in jobs covered by social security.” The individual’s affliction must result in “long-term impairment” that “preclude[s] any gainful work.” Finally, the affliction must be so severe that the social security disability applicant is unable to perform their previous work; further, the applicant must be unable to engage in “any other type of substantial gainful work.”

While the above list of requirements is by no means exhaustive, it is illustrative of what an applicant would be required to do and show in order to qualify for Social Security Disability benefits. Clearly, the eligibility criteria for workers’ compensation programs differ substantially from disability benefits. Nonetheless, under some circumstances, one may qualify for both workers’ compensation benefits and Social Security Disability benefits. When such a situation arises, the issue of offsetting becomes a concern.

The Offsetting Effect of Workers’ Compensation on Social Security Disability Insurance

The Social Security Disability Insurance program requires that, when an individual is eligible for both workers’ compensation benefits and disability benefits, said individual’s disability benefits be reduced. This reduction must result in the combined benefits from the two separate programs being less than or equal to eighty percent of the individual’s “average current earnings.” “Average current earnings,” according to the Social Security Administration’s website, is defined as “the highest of the average monthly wage on which the unindexed disability primary insurance amount is based, the average monthly earnings from covered employment and self-employment during the highest five consecutive years after 1950, or the average monthly earnings in the calendar year of highest earnings from covered employment during the five years ending with the year in which disability began.”

The receipt of workers’ compensation benefits may have an offsetting effect on disability benefits under other circumstances, as well. For example, when a particular state’s workers’ compensation program allows for the possibility of a lump-sum payment being made to the recipient, thereby discharging the obligations of the insurer and/or employer, but simultaneously permits the payment of benefits in a more structured, periodic nature, said settlement is affected by the offset. More specifically, the lump-sum payment is “prorated to reflect the monthly rate that would have been paid had the lump-sum award not been made.”

There are a multitude of exclusions that apply to the offsetting rules. For instance, certain sums expended for medical purposes “in connection with” workers’ compensation are subject to exclusion in figuring the amount of the offset. Likewise, legal fees incurred by an individual “in connection with” workers’ compensation may be subject to exclusion. Finally, many other government benefits may be excluded from the offset, as well, including VA benefits and needs-based benefits, to mention a few.

What Should You Do If You Are Eligible for Workers’ Compensation and Social Security Disability?

When faced with a disabling medical condition or health-related emergency, many may find themselves in dire straits, financially speaking. Luckily, certain government programs, such as the state-administered workers’ compensation programs and the federally administered Social Security Disability Insurance program, exist and may be able to help those in need. While the eligibility requirements may change from jurisdiction to jurisdiction depending upon the program, and can oftentimes be strict, those that qualify may receive the financial security they need to get through some of the most difficult times in their lives.

If you have any further questions, call one of the attorneys at Lawrence & Associates for a free consultation. Lawrence & Associates has handled thousands of claims for injured and disabled men, women, and children. We’re Working Hard for the Working Class, and we want to help you!

Super Lawyers
Avvo
Top 100
Million Dollar Advocates Forum
ASLA
Badge

Ready to get started? Contact us today!