Barnes Disability Gets a Big Win

In a very unusual move, the Utah Federal District Court ordered the Social Security Administration to pay benefits to Jerry S. after fighting for disability benefits for more than 10 years. The court stated that “the tortured history of [Jerry’s] claim and the sheer number of errors over the years by the agency weigh in favor of an immediate award of benefits.”

Jerry was working as a diesel and heavy equipment mechanic in October of 2011 when his dominant left hand was caught in a radiator fan. He sustained severe injuries to his hand including a partial finger amputation. He was eventually diagnosed with Complex Regional Pain Syndrome, a nerve condition that caused chronic, severe pain in his left hand.

With the help of Barnes Disability Advocates, Jerry filed for Social Security disability insurance benefits in February of 2012. His claim was denied at the initial and reconsideration levels. A hearing was held in front of an administrative law judge in February of 2014. That judge denied benefits, but in doing so found that Jerry had significant limitations in using his dominant left hand.

In the ensuing years, Jerry’s claim would be denied by Social Security three more times, with two intervening appeals to the Utah Federal District Court. In both of those appeals the Social Security Administration agreed that it could not defend the denials and voluntarily set the Jerry’s claim back to correct errors.

The last time Social Security denied Jerry’s claim, the judge found that he had no limitations in using his badly damaged left hand despite every prior judge finding that he did have significant limitations. Jerry appealed again to the Utah Federal District Court for a third time. Natalie Bolli, a Barnes Disability attorney whose practice focuses on federal court cases argued the case.

The District Court judge found that the overwhelming evidence demonstrated that Jerry’s left hand injury resulted in manipulative limitations in both handling and fingering. The Court also found that evidence from multiple vocational experts showed that there were no jobs available to Jerry in the national economy because those manipulative limitations. The Court concluded that “there is simply no evidence that there are jobs that exist in significant numbers in the national economy that [Jerry] could perform given his combination of impairments.”

In ordering an award of benefits the Court noted that Social Security is not entitled to litigate a claim forever until it finally applies the proper legal standard and gets the necessary evidence to support its decision. The Court also noted that Jerry’s claim had been pending for over a decade and throughout that time, include four hearings by administrative law judges, Social Security had made many errors. The Court therefore ordered that Social Security award benefits to Jerry going all the way back to his injury in October 2011.

Most cases do not take as long as Jerry’s, which is one reason this win is so significant. It is also quite rare for the Utah Federal District Court to order the Social Security Administration to award benefits. Usually, the Court prefers to point out errors and give the agency the opportunity to correct them. Jerry has been forced to rely on family and friends during the extended period of this claim and those resources were essentially exhausted. He has not returned to work since the October 2011 accident that so severely injured his hand. This decision will ensure that he gets the benefits he needs to help get his life back in order.

Student Loan Forgiveness for the Disabled Easier than Ever

One of the most frequent questions I get from my clients is whether their student loan debt can be forgiven if they are found disabled. The short answer to this question is YES.

First, this article applies to forgiveness of federal student loan debt because of a disability finding by the Social Security Administration only. There are many ways that federal student loan debt can be forgiven, so if this article doesn’t apply to you, keep looking, there may still be something out there that can help.

When a person is found disabled by the Social Security Administration they become eligible for federal student loan forgiveness. However, they must apply to receive that forgiveness and there are a lot of exceptions that can apply. You can learn more about how to apply here. Once they receive forgiveness they are subject to a three-year monitoring period. During this time the borrower is required to submit if annual earnings are to high, a new student loan is issued to the borrower, SSA determines that the borrower is no longer disabled, SSA determines that it will schedule a continuing disability review sooner that five to seven years.

On March 29th, the U.S. Department of Education announced that it will waive those post-discharge monitoring requirements for more than 230,000 borrowers during the COVID-19 emergency. More than 41,000 of these individuals who have already had the loans reinstated will have their loans put back into discharge status and have any payments made during the COVID-19 emergency refunded.

More recently, three advocacy groups, the National Student Legal Defense Network, Community Legal Aid Society of Delaware, and Justice in Aging filed a petition with the Department of Education requesting that it automatically forgive the student loan debt of borrowers who are awarded Social Security disability benefits. According to the press release “[a]s of 2020, SSA has identified over 625,000 individuals with disabilities who are entitled to a TPD discharge and has provided that information to the Department,” but two-thirds of those people have not had their loans discharged. Their petition asks the Department of Education to drop the requirement that Social Security disability recipients file a separate application for student loan forgiveness. This would be a huge benefit to those individuals by providing more than $14 billion in loan relief to about 400,000 borrowers.

Whether this petition is adopted or not, the recent changes to Department of Education policy will certainly provide significant relief to a lot of student loan borrowers who could use the help.

Social Security Updates Disability Rules for Spine and Joint Problems

Social Security recently updated its rules for evaluating musculoskeletal conditions including conditions affecting spine, joints, and soft tissues. These changes will make it more difficult to meet Social Security specific criteria of disability known as the “listings.” However, these changes are not likely to have a major impact on disability decisions.

What Are “Listings”

Social Security has a list of criteria for disability for specific conditions known as The Listings. The purpose of the listings is to set criteria for disability “severe enough to prevent an individual from doing any gainful activity, regardless of his or her age, education, or work experience.” 20 C.F.R. 404.1525(a) This standard is more stringent than the usual disability standard, which requires that an individual be unable to perform substantial gainful activity. If your condition meets the listing, the disability evaluation process stops and your team to be disabled.

What Changes Were Made

The new musculoskeletal listings set a basic functional standard of disability that is consistent between all the rules. Basically, to meet these listings an individual must be unable to walk or get around without using both upper extremities. For example, an individual claiming disability due to back problems would likely need to be using two canes, to crutches, a walker, or a wheelchair to meet the rules. However, the rules do account for situations where a person may have one upper extremity that cannot aid in getting around. For example, someone with a non-dominant upper extremity amputation and a medical necessity for use of a cane would also meet the functional limitations of the new listings because both upper extremities cannot be used for activities other than walking or getting around.

Before these changes, Social Security’s rules were similar but not as clear. The prior listings focused on a person’s ability to walk, and provided several examples that would qualify as ineffective walking. These examples included an inability to walk a block over rough or uneven surfaces at a reasonable pace without mention of any requirement for an assistive device. However, another example did specifically refer to an inability to walk without two crutches, two canes, or a walker. This left decision-making inconsistent and many people frustrated because some decision-makers would rely primarily on the uneven surfaces example while others used the two crutches, two canes, or walker example. By shifting focus to the criteria that both upper extremities be medically required for walking, Social Security has solved this inconsistency, but eliminated a less stringent requirement for disability.

How To Prove Disability for Musculoskeletal Problems

The other requirements of the listings have not changed significantly. So, when an individual is claiming disability for musculoskeletal problems like spine problems, joint problems caused by arthritis or something else, burns or other soft tissue injuries, or amputations documentation of certain physical findings on exam is essential.

First and foremost, these listings require imaging studies or physical exams that document the deformity. In the spine the deformity may be a herniated disc or arthritis known as spondylosis. In a joint, the deformity may be a loss of cartilage or arthritis. Sometimes the deformities are obvious on physical exam. If this is the case, the medical provider needs to provide a detailed statement of the observed deformity. Imaging studies help establish the existence of the condition, but don’t provide much information about how limiting the condition is, so more information is needed.

Physical exams should also document other musculoskeletal dysfunction such as weakness measured on a five-point scale, sensory loss, reflex loss, paresthesia (abnormal nerve sensations such as pins and needles, burning, and stabbing), pain, and bowel or bladder dysfunction. These sorts of problems should be documented in as many visits as possible, doing it once is simply not sufficient. A medical record that contains multiple statements of problems in these areas over time can be powerful evidence of disabling musculoskeletal problems. However, imaging studies and physical exams are often not enough on their own.To further document your physical impairments it is essential that you share examples of how your conditions limit your physical activities on a day-to-day basis with your doctor. For example, someone who has back pain could describe a visit to the grocery store that required use of the electric cart, help loading a gallon of milk into the cart, and help loading the groceries into the car. A person with knee problems might describe a similar trip to the store but with a need to sit and rest throughout the shopping trip, demonstrating an inability to walk more than a few hundred feet without stopping to rest. Of course, examples should include an assistive device like a single cane or single crutch if one is used. Again, multiple detailed examples of limitations in daily activities over time in the medical record are very powerful evidence supporting disability.

Conclusion

While the new musculoskeletal listing criteria are more stringent than the previous version, the basic types of evidence and the basic ways of documenting an individual disability have not changed. The key to winning a case for musculoskeletal conditions is to accurately and completely document the extent to which that condition interferes with daily activities.

How Can I Get Suspended Social Security Disability Benefits Reinstated?

If you’ve been getting Social Security Disability benefits, there’s a pretty good chance that they are your primary source of income at this point. That can put you in a tough spot if they end up suspended, to say the least. You need the income those benefits provide. So what can you do to get them reinstated?

Reasons Your Benefits May Have Been Suspended

Before you start figuring out how to get your benefits reinstated, it’s important to understand why they were suspended in the first place. That can give you valuable insight as to how to proceed and how to give yourself your best chance at success. The most common reason for benefits to be suspended is because the beneficiary returned to work and is employed in what is considered substantial gainful activity. You may also have your benefits suspended if you are no longer considered disabled by the Social Security Administration. Remember, the SSA may have a different idea than you do as to what it means to be disabled. Fair or not, it’s their definition that counts here. Other reasons include being incarcerated or institutionalized and reaching retirement age. Your benefits will also be suspended if you die, though your surviving children may be able to qualify for survivors benefits. If you’re found to have committed fraud in regards to your disability, that will also result in the suspension of your benefits.

Appealing the Suspension

As you may have guessed, some reasons for benefit suspension make much more sense to appeal than others. It doesn’t really make sense to appeal for the reinstatement of benefits when the beneficiary has passed away. On the other hand, if Social Security conducted a Continuing Disability Review and the claims examiner decides you are no longer disabled to the extent that you cannot work, but you feel differently, that makes a lot more sense to appeal. When that happens, you can request an appeal before a Hearing Officer to plead your case. If that doesn’t work, you can request a hearing with an Administrative Law Judge. All of that is subject to time limits though, so make sure you are on top of things and get your appeals filed on time. In the case of being institutionalized or incarcerated, the most likely outcome is that your benefits will be suspended while you’re being held and can be reinstated upon your release as long as it lasts for less than a year. When it comes to returning to work, that’s where things get a little trickier.

Getting Legal Help

It can be tough to navigate all the nuances of Social Security Disability Insurance, especially when it comes to arguing your disability and your ability to work. Having an experienced disability attorney on your side can go a long way towards helping you get the best results you can. They should know about things like the trial work period that allows you to test the waters and see if you’re able to work after all, or how much you can be earning or even what kind of work you can be involved in before you’re considered to be involved in substantial gainful activity. An experienced attorney should also be able to give you a heads up about things like how retirement impacts your SSDI benefits. If you want to get your benefits reinstated with minimal hassle, getting legal help may be one of the best things you can do for your case.

Preventing Future Suspension

Remember why it’s important to know why your benefits were suspended in the first place? Knowing that is one of the critical keys you’ll need in order to prevent suspension in the future. You don’t want to go through this ordeal again, so make sure you know how to avoid it. It’s important to note that there are differences between SSI and SSDI which can impact the suspension of benefits. Make sure that you’re clear on which benefits you’re receiving so you can get a clear understanding of what you should and should not do in order to maintain your benefits.

Getting your Social Security Disability benefits reinstated after they’ve been suspended is understandably a top priority for you. It helps if you understand why your benefits were suspended. That will come in handy when it comes to appealing the suspension and preventing it from happening in the future. As with many things related to Social Security, it can be tough to navigate things on your own. Getting qualified legal help can be highly beneficial. If your benefits have been suspended, take action sooner rather than later so you can get back to living your life the best way you can under your current circumstances.

Stimulus Payments Update for Social Security Recipients

Although many people have received the most recent round of stimulus payments, most Social Security recipients are still waiting for theirs. Much of that delay is because many Social Security recipients don’t file taxes with the IRS. That means that the IRS does not have updated information about how to send the stimulus payment to those individuals. That’s where Social Security comes in.

Social Security has extensive payment information about its recipients including bank accounts and addresses. But, Social Security is very limited by law in the information it can share with others including other government agencies like the IRS. That means that Social Security was not allowed to just send the IRS the payment information about its recipients. It had to have complicated agreements in place before it could make the payments.

Commissioner Saul said on Thursday, March 25th that “[o]nce we were free to move forward, we aggressively worked with Treasury and IRS to issue payments.” He also confirmed that the files were delivered to the IRS that same day. You can read about it in his press release here. While it appears that Social Security and Commissioner Saul were trying to do all they could, the real problem was with money. Social Security didn’t want to move forward until agreements were in place so that it could be paid for its efforts to supply IRS with the necessary information.

The IRS announced the day before Commissioner Saul’s statement that it was now working on releasing a second batch of stimulus payments. Some of the payments in the first two rounds were to Social Security beneficiaries, but the IRS said it was still waiting for information from Social Security to issue payments to those who did not file taxes in 2019 or 2020. Thus, if you are a Social Security beneficiary who hasn’t received a stimulus payment and didn’t file taxes in 2019 or 2020, you have more time to wait before you will receive your stimulus payment. The IRS has promised to share more information as soon as it becomes available.

If you want to check the status of your stimulus payment you can use the Get My Payment tool on IRS.gov.

All in all it looks like the Social Security Administration and the IRS are now working together and stimulus payments should be coming at some point for Social Security beneficiaries.

The Disability Decision Making Process

Understanding the Social Security disability evaluation process is important because it helps us understand how to prepare a better claim.

The Application

The first step in the disability process is for us to submit an application. On the application we include information about the doctors you seen, the medical tests you have had, procedures you have had, and medications you are taking. We also include information about your work history and your education. 

Once we submit the application it goes to the local Social Security office. At that office they make some technical determinations in your case. For example, they look at your work record to determine whether you have worked for long enough to qualify for disability insurance benefits. They also look at whether you are currently working (if you are doing substantial work, you are not disabled) and whether you meet the income and asset requirements for SSI.

If you meet the technical requirements for disability, they will send your claim to a state agency called the Disability Determination Services, or “DDS.” Once your claim gets to DDS it is assigned to a person called a Claims Examiner. The Claims Examiner is the person who will make the decision about whether you meet the medical requirements of disability.

The Claims Examiner

When the Claims Examiner gets your claim, that person will review the application and request the medical records from the medical sources you have listed. When those medical records are received, the Claims Examiner will write a short, usually one page, summary of those medical records. Then the Claims Examiner will send the claim to a different person at DDS called a Medical Consultant.

The Medical Consultant

The Medical Consultant will review your medical records and make a list of limitations in what Social Security calls “Basic Work Activities.” Basic work activities are the basic things that you need to do to be able to do any job. For physical activities, basic work activities include things like sitting, standing, walking, lifting, carrying, bending, kneeling, climbing stairs, and other similar activities. For mental activities, basic work activities include things like being able to remember and follow simple instructions, being able to get along with supervisors and coworkers, being able to work without being distracted by or distracting others, being able to maintain normal standards of hygiene and dress, and being able to maintain normal schedules.

A normal list of limitations in basic work activities will look something like this.

This person can occasionally lift 20 pounds and frequently lift 15 pounds. He can stand and/or walk about six hours in an eight hour workday. Likewise, he can sit for about six hours in an eight hour workday. He can occasionally (up to one third of the workday) climb ramps/stairs, ladders/ropes/scaffolds, balance, stoop, kneel, crouch and, crawl. He can reach overhead with both arms occasionally. He can do simple, routine work with occasional contact with others.

Making the Decision

After creating this list of limitations, the Medical Consultant will send the case back to the Claims Examiner. The Claims Examiner will then compare the list of limitations with the physical and mental requirements of the work that you have done in the past 15 years, called past relevant work. If the Claims Examiner determines that you can do any of your past relevant work, then you will be found not disabled. If you are determined to not be able to do any of your past relevant work, then the Claims Examiner will compare the list of limitations to all other work available anywhere in the national economy. If the Claims Examiner finds other work available your claim will be denied. If, on the other hand, there is no other work available you will be found disabled.

There are a couple of special situations to be aware of regarding age. If you are age 50 or older and you have never done a sit-down type of job and you don’t have the skills for a sit-down type of job, Social Security does not expect that you will work a sit-down job in the future. Therefore, even if you are found capable from a physical and mental standpoint of a sit-down type of job, Social Security will not require that you return to that job and will instead find that you are disabled.

Similarly, at age 55 if you are limited to what is called light work, which is work that requires standing on your feet for about 6 of 8 hours and lifting 20 pounds occasionally during the workday, and you have only done heavier manual labor types of work, Social Security will find that you are unable to return to other work and award disability.

Understanding this process, helps us to understand what sources Social Security looks to to determine your eligibility for disability benefits and what information Social Security is looking for in those sources.

How To Build a Better Claim

First, the primary source of information for Social Security about your disability is the medical records. That means that your limitations should be documented clearly and completely in those medical records.

Second, Social Security will be looking for limitations in basic work activities in those medical records. That means that you should make sure to discuss with your doctor how your medical conditions limit your ability to do daily activities such as cooking, cleaning, shopping, and interacting with others. The more specific and detailed the examples your doctor writes into the medical records the better.

If for example, you are over the age of 50 and your past work has all been truck driving, you will need to establish in the record that you are now limited to lifting less than 20 pounds occasionally and you are limited to standing/walking for less than six of eight hours. That means that you want to provide your doctor with examples from your daily activities that establish these limitations.

On the other hand, if you are under the age of 50 you will need to establish that you are unable to sustain any activities for an eight-hour workday sufficient for you to work. For example, if you have depression that keeps you from leaving the house several days a month you will need to establish that limitation in the medical record to show that you are unable to maintain normal schedules. If you have back pain that requires you to lay down for several hours during a normal eight-hour work., You will need to establish that in the medical records.

Using these simple techniques can substantially improve the quality of the evidence Social Security relies on determine your disability. Of course, having this information will not guarantee that you will win your case. However, having this information will definitely help you build a better claim and make your chances of winning much higher.

Questions to Ask a Social Security Disability Lawyer

If you’ve become disabled, you’re likely going through a lot of life changes in a very short amount of time. Disabilities have the power to impact virtually every aspect of life, including your employment. Depending on your disability, you may find yourself unable to work for an extended period of time. This can make your financial situation tenuous at best. Fortunately, Social Security Disability may be able to make up for some of your lost income. Of course, navigating these programs can be pretty tough to do on your own. You may find it most helpful to retain the services of a Social Security disability lawyer. Before you finalize your agreement, however, there are some important questions you should ask them.

What Experience Do You Have?

One of the first things you need to know about any lawyer before you retain them is what experience they have. There are a ton of different legal disciplines, and while one lawyer may be the best at their own discipline, that doesn’t necessarily mean that they’re going to be very good at a different one. There’s a reason they specialize, after all. If you’re hiring a lawyer because you need help with your Social Security disability claim, you need to find one who specializes in exactly that. You should be able to do that with a quick Google search.

Once you have a list of attorneys who look like they could be good options, ask more about the level of experience they have. A specific specialty doesn’t necessarily equate to experience. Ideally, the lawyer will have experience with your specific disability as well. The more experience a lawyer has and the more success they’ve had with their cases, the better your chances of having a similarly successful experience with your claim.

How Do You Charge for Your Services?

It’s important to know upfront how you will be charged. Keep in mind that it can change based on whether your claim is approved or denied. Knowing ahead of time how much to expect to pay your lawyer depending on how your case goes will help you avoid being blindsided by fees. That said, if your claim is approved the Social Security Administration caps the amount a SSDI lawyer can charge at no more than $6,000. They can charge up to 25% of the back pay you would get, up to that $6,000 limit. In most cases, this payment is automatically deducted from your back pay and sent to the lawyer so you don’t have to worry about making the payment yourself.

What Do I Need to Do?

There are multiple things your lawyer needs to prove for your case. While your lawyer will be the one doing the lion’s share of the work for your claim, there are some things you can do to help things along. The best way to figure out what you need to do is ask. Your lawyer can advise you on what documents need to be gathered, which you can then deliver to them. It is likely that they will recommend that you receive regular medical care and tell you that it is important to follow the advice given to you by any medical professionals you see.

What If My Claim Is Denied?

It isn’t uncommon for claims to be denied initially. As few as one third of claims are approved from the beginning. That means that the odds of you getting your claim denied the first time around are pretty high. Asking what happens if your claim is denied will help you be prepared in the event that it happens to you. Ideally, your lawyer will examine the decision to see if you have grounds for an appeal and then move forward with the appeals process. Not all lawyers will, so finding one that does is important.

How Can I Reach You?

This might seem like a silly question, but knowing what to expect when it comes to contacting your lawyer is important. Some may prefer that you contact them directly. Others prefer to have their clients go through another member of their team. It’s also a good idea to know what their preferred method of communication is, whether it’s via phone call, text, or email. Ask them what their timetable is like for getting back to their clients. The more clearly you can communicate and establish what expectations are, the better you will work as a team to manage your claim.

Navigating the ins and outs and nuances of a social security disability claim on your own can be incredibly challenging. Having an experienced, qualified lawyer on your side can help the process go more smoothly and help you get a better result. Make sure you ask the right questions so you can feel confident that the lawyer you choose to retain is going to be a good fit for you and your case.

What Qualifies as a Long-Term or Permanent Disability?

Dealing with a disability and getting appropriate compensation can be complicated and frustrating. While many people imagine that disabilities are something you are born with, in most cases disabilities usually occur later in life or develop over time. Disabilities can result from accidents or injuries, or even from acute or chronic illnesses. Understanding what qualifies as a long-term or permanent disability can help you to navigate disability coverage options and make the best choices for your future.

Long-Term Disability

First, it is helpful to have some definitions, and to have an idea of how the different kinds of disabilities are defined. The difference between long-term and permanent disabilities is usually unrelated to the type of illness or injury, but more about the length of time you are affected. A long-term disability is a physical, mental, or emotional health condition that affects you for at least one year. There are many conditions that can qualify for this kind of disability coverage, as long as the duration qualification is met.

Mental health issues like anxiety and depression, physical illnesses like cancer and heart disease and chronic illness and chronic pain can all potentially qualify as long-term disabilities. If you have personal long-term disability coverage, or are seeking long-term disability coverage from social security, and you have any of these conditions, you should be able to get the help you need. Though these long-term disabilities are in some cases related to a work related injury, most of the time they are due to unrelated medical or mental health difficulties that make it hard for you to continue doing your job.

Permanent Disability

Permanent disabilities generally start out as long-term disabilities and eventually progress to where they are unlikely to improve anymore. This can happen either because the injury or illness worsens over time, or because you have tried all medical interventions available, and there are no more options left to treat your disability. When a doctor has ruled out the likelihood of future intervention improving your symptoms or capacity to work, you are considered to have a permanent disability.

Sometimes medical advances may occur in the future that could more effectively treat your disability, but if at a current point of time there aren’t further interventions, the disability is considered permanent.

How to Qualify

Qualifying for disability is different depending on the kind of disability assistance you are trying to acquire. If you have disability insurance through your employer, then you will have to speak with HR and see if you qualify for disability through their benefit. If you have personal disability insurance, then you would need to qualify through the parameters set up by your insurance provider. And, if you want to qualify for disability coverage through social security, then there are also parameters you would need to meet.

For social security purposes, you would need to have worked a qualifying job before sustaining your disability. Then, you would need to document a medical condition that qualifies as well. Once you have established those two things, you should be able to receive disability social security benefits.

What it Means

When you are qualified to receive social security benefits, you will generally be able to qualify until you are able to return to work. There are also additional incentives that can help you as you make a transition back to working regularly. Social security monthly disability benefits average at around 1200 dollars a month, but depending on your situation, they may be higher. If you were a breadwinner for your family, you may qualify for more of the benefit in order to properly care for your other family members.  If you at some point are able to return to work, make sure to talk with the folks at social security so they can help you to get transition benefits while you return to the workforce and figure out the best way for you to begin making the transition.

Living with a Disability

Living with a disability can be difficult and complicated. Once you have secured your financial benefit to live on, it is also important that you take care of yourself mentally and physically. When you obtain a disability later in life, it can be difficult to make the transition and live your life differently. Make sure to maintain connections with the people you love, friends and family are an important part of a happy life, and you still deserve and need those connections after becoming disabled. Also, don’t be afraid to seek out resources that will help you live more fully and learn to manage your disability well.

With the right information on your side, you can manage your disability and get the benefits you need. Understanding how disability benefits work can help you to make the best possible decisions for your future and your quality of life.

What Does It Mean To “Settle” A Workers’ Compensation Case?

Few things throw a wrench into your life quite the way becoming seriously injured at work can. Whether you’re the sole breadwinner for your household or you share that burden with someone else, the vast majority of workers aren’t in a position to simply go without income until they recover. Workers’ compensation can help make up for the loss of income, but at some point there’s a good chance that you’ll be asked to “settle” your case. Thus, it’s important to have an understanding of what it means to settle.

What It Means to “Settle”

If you are unable to work, upon approval, , you begin to receive periodic payments based on what you had been earning. The insurance company or employer would also likely cover your medical injury-related expenses. Don’t let the payments you’re receiving fool you though. Insurance companies are in the business of making money, not handing it out. If there’s a way to stop paying you for time off work, they will find it.. Settling the claim is one way to do that. It means that you’ll receive a lump sum of money and the claim will be closed. The insurance company or employer won’t have to pay for ongoing time off work or, depending on the settlement language, for ongoing medical expenses.

Immediate Consequences

The immediate consequences of settling are as previously stated: you receive a settlement check, your claim is closed, and that is the end of the money you’ll be receiving, unless the details of your settlement indicate otherwise. Under some circumstances, the insurance company may attempt to recover the money they spent on your benefits from third-parties that contributed to the accident. This is called subrogation and may impact the amount you retain from the settlements of those other claims. Even though settlements are often made after your doctors determine whether you are able to return to work, the settlement has little to no bearing on when or how you return to work. That is between you and your employer.

Long-Term Consequences

In the case of some injuries, you may experience flare-ups, or your condition may worsen to the extent that you require additional medical care. This is where the details of your settlement become a critical factor. You may be entitled to having additional medical expenses covered if they are due to your injury, but that isn’t always the case. Because of this, it is absolutely critical that you carefully consider what care you are likely to need in the future because of your injury and factor that into the settlement you feel you should be receiving.

Your Responsibility

At the end of the day, you need to make the best decision for yourself. That can be tough, when you consider all the details involved in navigating a workers’ compensation claim and the fact that the insurance company absolutely has a lawyer working on their behalf. Your responsibility is first and foremost to yourself and making sure you obtain the best outcome for yourself. You need to take into account what your medical expenses have been, are likely to be in the future, and the wages you’ve lost as a result of your injury. All of that should have a role to play in the settlement amount. It may be tempting to take the first settlement you are offered, but it may not be a fair offer. It’s best to consult an attorney before accepting any settlement, regardless of whether or not you had one up to this point. 

Finding a good attorney for your case can be a challenge, but worth the time you’ll invest to do so. A good attorney can help you figure out what medical expenses you could reasonably expect to encounter in the future. Based on that, and other pertinent information, they can argue on your behalf to reach a fair settlement that gets you the money you are entitled to. If you sue more than one entity and the workers’ compensation insurance company is entitled to some or all of their money back, your attorney can help you navigate that too. 

Keep in mind that if you want to get temporary or permanent disability for time off work in the future as a result of your injury, you’ll need to reopen your case with the insurance company. It’s a good idea to familiarize yourself with your state’s restrictions and time limits regarding the reopening of a case.

The Insurance Company’s Responsibility

The insurance company has the responsibility to pay out the settlement to you, subtracting whatever your lawyer is due and paying that to them directly. Their responsibilities beyond that are dictated by state laws and the wording of your settlement agreement. Some states require ongoing medical coverage for care received because of the injury, while others don’t. If your agreement stipulates it, you can be reimbursed for such expenses. It’s your responsibility to submit the bill, though, at which point it becomes the insurance company’s responsibility to reimburse you.

People don’t plan to get injured on the job, but it does happen. If you’re receiving workers’ compensation as a result of a work injury, you’ll likely be approached about settling your case at some point. Make sure you know what it means to settle your case, the consequences of doing so, and what each party’s responsibility is going forward. This will help you make the best decision for yourself about whether or not you should agree to settle.

Do I Need Disability Insurance?

Accidents and illness are a part of life, and serious ones can leave you unable to work and without a source of income. So how do you protect yourself financially from losing income if you become disabled?

Short-Term Disability Insurance

Short-term disability insurance is a type of insurance that is intended to cover a portion of your income if you become disabled and temporarily unable to work. It is sometimes offered through employers, though this is not generally required. Only five states mandate that employers offer their employees short-term disability insurance. After waiting out the elimination period, you can expect to receive a percentage of your income from insurance, typically about 50-60% of your weekly earnings.

Why You Need It

Not all injuries and illnesses are permanently disabling. The recovery process may take longer than what you have available in paid time off, vacation time, or sick leave, but not so long that you don’t expect to return to work within a few months. While an emergency fund can be helpful to fall back on, 28% of adults don’t have an emergency fund at all. If you’re one of those adults, you’ll be in dire straits if you become disabled and unable to work. It is important to note that this form of insurance covers injuries or illnesses sustained while not on the job. Injuries sustained while working are usually covered under your employer’s workers compensation insurance.

How Much Should You Have?

How much insurance you end up needing will depend mostly on your pre-disability expenses. Recovery time varies depending on the disability, so the amount of income you need to replace will depend on your current expenses. There may be a dollar limit on your policy that prevents you from collecting more than a specified amount, even if it would be lower than the percentage you would otherwise be entitled to. If your employer offers short-term disability insurance, consider the details of the policy offered. If you became unable to work, would you be able to make ends meet based on the amount you would be collecting? If not, you may want to look into better coverage options. Remember that the more coverage you have, the more you will pay in your monthly premiums..

Long-Term Disability Insurance

Long-term disability insurance is similar to short-term disability insurance in that it replaces a percentage of your income in the event you become disabled and unable to work. The primary difference is in the amount of time you can receive benefits for. Long-term disability allows you to collect benefits for years instead of months. As long as you continue to qualify as being disabled, you can collect benefits until your policy ends. This could last until you turn 65 or reach regular Social Security Retirement Age.

Why You Need It

Some injuries or illnesses are permanently debilitating. You may never be able to work again, but you’ll still have living expenses to pay for. If you have a family you provide for, the stakes are even higher. Having a high paying job that you would have a hard time replacing income from or a technically skilled job you might not be able to perform if disabled are other good reasons to get this type of insurance. Long-term disability won’t replace your income entirely, but it can help you retain some form of income. Depending on the policy, you may also supplement your insurance policy with Social Security Disability Income to help increase the amount of the benefits you receive.

How Much Should You Have?

It is especially important to carefully read through your long-term disability insurance policy before signing up. Different policies have different qualifying requirements. There is a huge difference between being unable to work your own job versus being unable to do any job. A policy that covers being disabled and unable to work your own job will cost more, but is easier to qualify for. Keep in mind that the elimination period for receiving long-term disability insurance benefits is longer than the elimination period for short-term disability insurance benefits, generally about 6 months. Being able to cover your expenses during an elimination period is another good reason to have a robust emergency savings account.

It’s easy to think that disabling accidents and illnesses are things that happen to other people, but not to you. This can cause you to discount the importance of safeguarding yourself and your income. Short- and long-term disability insurance can help you in this regard. Make sure you have enough coverage to keep yourself financially stable in the event you become unable to work due to disability.