Workers’ Comp: It’s Not Just For People Out of Work


Clearly one of the biggest misconceptions about Workers’ Comp is that you have to be out of work to collect. That’s because most people have a limited understanding of what benefits are available. In New York, there are many situations where injured workers can collect workers comp money benefits even if they are working:
Examples:

1. Permanent injuries to joints of the body, vision, and hearing, qualify for “schedule loss of use” awards regardless of whether a person is working or not. These awards are extremely common.

Lynn, a right handed office worker, tears her left rotator cuff (shoulder) at work. She normally makes $900 per week salary and she manages to keep going into work and doing her job even with the injury. One year later all of the doctors agree Lynn, who is still performing her job, has suffered a permanent, 20% loss of use of her left arm. An entire arm is worth 312 weeks of money benefits under New York law. This award would then be calculated as follows:
20% of arm= 20% of 312=62.4 weeks at the weekly rate of $600, which is 2/3 of Lynn’s salary. 62.4 x 600= 37,440.
Total monetary award that Lynn collects: $37,440.
All Workers’ Comp benefits are tax-free, BTW.

2. John is a union welder. A torch he is holding when he takes off his mask backfires, burning his face and neck. These leave permanent scars. John only loses one week from work after the accident.
Maximum award John can collect for his facial scars: $20,000.

3. Gina is a nurse. She injures her back at work. She requires physical therapy, pain management, medications, and surgery. After her back surgery, she goes back to work at reduced earnings since she can no longer work full time.
Her employer’s insurance company offers her a lump sum settlement to pay for future loss of earnings and her future medical costs for her back injury, even though she is working part time. The insurance company offers Gina $150,000 to settle the case.

So there are many instances where injured workers can be compensated even if they are working. Therefore, it is important to remember that workers injured on the job should always file a claim not only with their employer but with the Workers’ Compensation Board each and every time they are seriously injured at work whether they are working or not.

Injured workers too often “leave money on the table” that is rightfully theirs; they just don’t know the law.

That’s where The Law Office of Morrin & Sands PLLC can help.

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Citizens United II- The McCutcheon case

Soapbox: Definition——–The term is used to describe a person engaging in often flamboyant impromptu or unofficial public speaking, as in the phrases "He’s on his soapbox", or "Get off your soapbox."

OK so here I am back on my soapbox. As you may know, my political pet peeve is the ability of the wealthiest, richest people and corporations to now, after the Supreme Court decision in the case called Citizens United, essentially BUY our politicians.

 

Two articles in the New York Times on April 3rd talk about this subject. First, the main Editorial starts with these words: "The Supreme Court on Wednesday continued its crusade to knock down all barriers to the distorting power of money on American elections…" (referring to a follow-up case to Citizens United decided this past week called McCutcheon.)

The editorial goes on to state that "Thanks to Wednesday’s (McCutcheon) decision, the interests of the very few wealthiest Americans–which differ significantly from those of most Americans–will now get even more outsize consideration by legislators."

We now have a system where there is no limit on how much money can be given to a politician! Why? Because the Supreme Court said so, in Citizens United and McCutcheon.

Even more troubling: An Op-Ed article on the very next page of the New York Times on April 3rd. This article is by the Vice-Charperson of the Federal Election Commission (FEC.) She states that, "The Federal Election Commission is failing to enforce the nation’s campaign finance laws. I’m in a position to know. I’m the vice-chairwoman of the commission…"

The vice-chairwoman goes on to explain that the FEC continuously fails to pursue "investigations into potentially significant fundraising and spending violations" by political candidates. Why? Because "the three Republicans often vote as a bloc against pursuing" these cases.

So, what we NOW have is a Supreme Court and an Election Commission that are saying to the wealthiest tiny fraction of our population, "Go ahead, do whatever you want, we won’t look over your shoulder. Wanna "donate" thousands, or even millions of dollars for the purpose of controlling (bribing) politicians for your self-serving or even evil reasons? Go ahead! It’s OK with us!"

Bribery: Synonyms—–extortion, payoff, protection, slush fund, graft, hush money, enticement, payola, buyoff, corrupt money, influence peddling.

In a word, corruption. It’s now a government that can be bought by the highest bidder.

This is no joke. Educate yourselves about the result of these Supreme Court decisions, because they do affect everyone. The middle class has shrunk in huge proportions, in my opinion, because the wealthiest Americans have been able to BUY and therefore CONTROL the officials who are in power.

That’s not the Democracy we all want, or deserve. A Constitutional Amendment to reverse Citizen’s United could put our electoral system back to where it was, before Citizens United., where it should have remained.

Note: The views and opinions expressed on this web site are solely those of Morrin & Sands PLLC. These views and opinions do not necessarily represent those of any other individual or staff member of The Law Office of Morrin & Sands PLLC.

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Workers’ Comp Fraud: Employers (Not Employees) Are A Huge Problem

District Attorney, New York County

For Immediate Release March 25, 2014

DA VANCE: GRAND JURY RECOMMENDS SIGNIFICANT CHANGES TO PREVENT WORKERS’ COMPENSATION INSURANCE FRAUD

Empanelled at Request of Manhattan DA’s Office, Grand Jury Finds Evidence of Workers’ Compensation Insurance Premium Fraud Costing New York Nearly $500 Million Annually

Report Released on 103rd Anniversary of Greenwich Village Triangle Shirtwaist Factory Fire

Manhattan District Attorney Cyrus R. Vance, Jr., today announced that a New York State Supreme Court Grand Jury has issued a report examining the vulnerability of New York’s workers’ compensation insurance system to fraud and misuse. The Grand Jury’s report stemmed from investigations by the District Attorney’s Money Laundering and Tax Crimes Unit into false information provided to the New York State Insurance Fund in connection with applications for, and audits of, workers’ compensation policies.

 

Taking into account a June 2013 report of the Fiscal Policy Institute and other estimates, New York City’s construction industry in 2011 cost the City and State approximately $500 million based on worker misclassifications. The largest component of the loss was unpaid workers’ compensation premiums, with personal income tax, withholding, unemployment insurance, and various other business taxes accounting for the remainder.

Premium fraud affords wrongdoers an improper competitive advantage over all law-abiding businesses, makes workers vulnerable by depriving them of important protections and benefits, and deprives New York State and New York City of substantial revenue. Every lost dollar must be made up by a dollar increase somewhere else, usually by a cost-shifting phenomenon that affects us all. Every law-abiding employer is a victim of this criminal conduct, as is every hard-working employee, every consumer, and every honest taxpayer

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Social Security Disability: It’s Often A Long Road

It’s a standard question: How long will it take for me to be approved for Social Security Disability Benefits? (SSDB)

As with so many other things, the answer is: it varies. In truth, it can take from one month to up to two years or more!

Let’s look at this a little closer. First of all, not every one’s disability case is the same. Some individuals will present medical impairments on their disability applications that will immediately stand out as obvious approvals (though this happens in only a small percentage of cases). Examples of clear cut cases include ALS, advanced cancer, severe kidney disease, blindness, AIDs, and double amputations.

Social Security has a list of “225 compassionate allowance” diagnoses. The Compassionate Allowances program expedites disability decisions for Americans with the most serious disabilities to ensure that they receive their benefit decisions within days instead of months or years.

But what about the most common disorders—back injuries, depression, heart attack, etc? How long does the average case take?

Nationally, it takes an average of 120 days for a Social Security disability applicant to receive an answer from the Social Security Administration on his or her initial application. 35% are awarded benefits at this level.

In 2013, here was how many days it took to process an appeal from an initial denial (remember, at that point you’ve already waited 4 months) and have a hearing in front of a Judge on an appeal (in NY, this is the second step in the process) in some local regions:

Brooklyn: 478 days

Manhattan: 320 days

Bronx: 359 days

Queens: 363 days

Long Island (Jericho) : 292 days

just to get a hearing!!!!

Source: NOSSCR Social Security Vol. 5, No. 5,  May 2013

The waiting time for the Jericho (Long Island) Hearing Office, by the way, in 2013 was 8th fastest among 165 hearing offices in the country!

So to recap- if you file an application for benefits and you live in Long Island, it takes about 4 months to get a decision, and if you are denied, another 10 months to get a hearing. (And then a couple of months to get the actual decision from the Judge.)

And that’s comparatvely quick. In St. Louis, Mo., the worst hearing office in the country in terms of time to wait for a hearing, the wait to get a hearing in 2013 averaged 547 days!!!

And let’s not forget that since almost all SSDB applicants are not working, that’s an awfully  long time to wait for income.

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Workers’ Comp and Social Security Disability: They can go together

Many of my clients who are injured on the job in New York State are disabled and stay out of work longer than 12 months. In such an instance, can the injured worker ALSO receive Social Security Disability Benefits?

In many cases, the answer is YES.

If the Workers Compensation (WC) claimant (injured worker) is 24 years old and has a back injury, and stays out ow work longer than 12 months, I would say that person has a very low chance of winning a SSD claim. Probably too young. But let’s assume the injured worker is 55, speaks no English, has only had heavy jobs (requiring lots of lifting) their whole life and has that same back injury and time out of work (over 12 months.) Now, there’s a good SSD claim. I file both of these types of claims all the time for my clients………..if I win both, a client gets BOTH benefits at the same time!

The “catch” is that there is a monetary limit to how much a disabled worker can receive as a COMBINATION of SSD and WC. Here’s the rules:

1. SSD will only “offset” (lower its benefits) if the claimant also receives “public” benefits like WC, but not “private” benefits like a Long Term Disability policy that the client is covered by, or a private pension.

2. The applicable limit on receiving SSD and WC is the higher of either:

  • 80% of the worker’s pre-injury income, called “average current earnings,” or
  • the total amount of SSDI received by all of the members of the recipient’s family in the first month that worker’s compensation is received, called the “total family benefit.”

For most SSDI recipients, the 80% of earnings figure will be higher, and Social Security will use that figure in the offset calculation.

That’s why I practice in both areas of the law—–often, they go together like Batman and Robin, or peanut butter and jelly, or pork and beans, or…………..well, you get the picture!

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Citizens United: A major threat to democracy as we know it?

So I don’t usually talk about politics or give my opinion in this blog about non-legal issues not concerning my law practice. However, I am so concerned about something going on in this country, a country I love dearly, that I feel compelled to comment.

When this country was founded, democracy was established by the Constitution. All citizens had an equal right to be heard.

What the Constitution should not allow in a democratic society is this: Whoever has the most money, makes the decisions.

Citizen United vs. FEC was a decision by the Supreme Court stating that corporations (and unions) have the same “free speech” rights as people.

What this 2010 decision did, is to overturn decades of law that basically limited the amount of money a corporation or union could contribute to political candidates. Now, there is no limit.

Before Citizens United, the Supreme Court recognized in Austin v Michigan Chamber of Commerce that the government had a compelling interest in protecting our democracy from “the corrosive and distorting effects of immense aggregations of wealth that are accumulated with the help of the corporate form and that have little or no correlation to the public’s support for the corporation’s political ideas.” The Court that decided Austin was rightly worried that corporate wealth can dominate the political process and “unfairly influence elections.”

Well, Austin is now gone. With huge corporations and the richest 1% given free reign to dominate elections through unlimited spending, political equality suffers a huge setback. What’s ultimately at stake is how much say the average citizen has over the policies that govern his or  her life. The answer is clear: much less than before Citizens United.

I, for one, intend to back a nationwide movement to amend the Constitution and/or pass laws to abolish Citizens United.

In April, the U.S. Senate is expected to consider the Fair Elections Now Act, legislation that would create a voluntary system of small donations and limited public funding for congressional candidates. This citizen-funded election model would put all contributions on an equal playing field-corporate, union, PAC and your donations. Candidates opting into this system could accept contributions of no more than $100 and only from individual donors. In the current, money-driven political system, members of Congress and candidates spend countless hours each day raising money from the same lobbyists and special interests they’re supposed to oversee in Washington. The Fair Elections system would reduce members of Congress reliance on these special interest donors and encourage them to give more attention to their constituents.

You and me.

What can I do?

Please contact your member of Congress and ask them to keep big money out of politics by co-sponsoring the Fair Elections Now Act and similar proposals.  End the pay-to-play political system in Washington. To find out more information go to, among many others, www.commoncause.org/FairElectionsNowAct.

Attribution: Common Cause website

Note: The views and opinions expressed on this web site are soley those of Daniel M. Morrin. These views and opinions do not necessarily represent those of any other individual or staff member of The Law Office of Morrin & Sands PLLC.

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Attorneys: The Best Source of Info About Obtaining Workers’ Comp Benefits

The Workers’ Compensation Board’s recent and ongoing “BPR Initiative” has asked injured workers several survey questions. Here is one:

Question 7 asks “Who told you what to do to receive your benefits? You may choose more than one answer”.

 

Out of 5,623 responses, 3,579 (63.65%) responded Attorney, 1,178 (20.95%) responded Workers’ Compensation Board, 204 (3.63%) responded Insurance Agent, 1,316 (23.40%) responded Friend or Family Member, and 1,415 (25.16%) responded Employer.

Enough said.

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Who’s Your Employer’s Workers’ Comp Insurance Company??

My pet peeve of the week is New York employers who don’t assist their employees—and in fact obstruct them—from getting prompt, non-emergency medical care for injuries sustained at work- i.e., Workers’ Comp injuries.

According to Section 51 of the Workers’ Compensation Law, employers must post a notice of workers’ compensation coverage (Form C-105) in a “conspicuous” place in the workplace. EVERYONE HAS SEEN THIS FORM POSTED IN PLACES OF BUSINESS IN NEW YORK. FEW NOTICE IT OR READ IT. IT’S GOT A LOT OF FINE PRINT ON IT. USUALLY IT’S STAPLED TO A WALL NEAR THE EMPLOYEE TIME CLOCK. It tells employees the name and phone number of the workers’ comp insurance company, in the event of an on-the-job injury.

The Workers’ Compensation Board requires that the form include the name, address and phone number of the current insurer and the policy number of the employer. It must be posted in a conspicuous place in the employer’s place of business. Violations of this requirement can result in a fine of up to $250 per violation.

Here’s the problem: many employers don’t post it, or post an outdated one, and at the same time DON’T GIVE THEIR EMPLOYEES THIS IMPORTANT INFO ONCE AN EMPLOYEE IS INJURED ON THE JOB.

When an employee is injured on the job in New York State, they cannot obtain non-emergency medical treatment for their injuries UNLESS THEY KNOW THE IDENTITY OF THEIR EMPLOYER’S WORKERS’ COMPENSATION CARRIER. (Often, the insurance carrier changes year to year.) MANY EMPLOYERS HIDE OR WITHHOLD THIS INFORMATION FROM INJURED WORKERS, HOPING THE INJURED WORKER WILL GIVE UP AND NOT SEE A DOCTOR OR FILE A CLAIM FOR WORKERS’ COMPENSATION BENEFITS.

I have experienced many instances where I have instructed an injured employee to call their boss and obtain the employer’s workers’ comp insurance information. When they call, they often get the runaround are are totally ignored. Such employer behavior at the very least, delays treatment of workplace injuries. Why? Because private doctors simply won’t see a patient who was injured on the job without compensation insurance information. And often the required posting isn’t there at the workplace either. Obtaining this info directly from the Board, while possible, can be frustrating as well. Of course, many employers comply with the law. But many do not.

That’s why, if this has ever happened to you, please let me know. I am collecting data about employer witholding from employees, workers’ comp carrier information, and hope to compile such data to illustrate the problem to the powers- that- be at the Workers’ Compensation Board. After all, it’s a pet peeve of mine.

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YouTube Videos: Educate Yourself About New York Workers’ Comp!

Check out our YouTube Videos at: youtube.com/mydisabilityatty

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Age Matters: Filing for Social Security Disability

Age Matters: Social Security Disability Favors Older (50+ years old) Workers

 

Does age matter when filing a Social Security Disability claim? Yes it does. Here are the four categories that the Social Security Administration (SSA) uses when evaluating age:

 

“Younger Individual”— Ages 18 to 49;

 

“Closely Approaching Advanced Age”— 50-54;

 

“Advanced Age”— 55-59

 

“Closely Approaching Retirement Age”- 60-65

 

The three factors most often used to evaluate a claimant’s case other than medical condition are AGE, education, and work experience. Let’s look at an example.

 

Two construction workers suffer similar, severe back injuries. They are both unable to lift anything heavy and in fact are limited by the injury only to the physical ability to do easy, sitting-down , “sedentary” work.

 

Comparing the age,education and work experience of the two construction workers who can only do “sedentary” work:

 

Worker A: 48 years old. Can speak and write English. No skills other than construction work. High School Graduate.

 

Decision by Social Security: NOT Disabled- (Regulation 201.18)

 

Worker B: 50 years old. Can speak and write English. No skills other than construction work. High School Graduate.

 

Decision by Social Security: Disabled- (Regulation 201.12)

 

SSA’s regulations would grant benefits to the 50 year old, but not to the almost identical 48 year old. Why?

 

The regulations state that “Individuals (50 and over) may be significantly limited in vocational adaptability….(if they have) no transferable skills…” (Regulation 201.00 g.)

 

Translation? SSA doesn’t expect 50 year old and older workers to learn a new trade or skill that would allow them to work a sedentary (physically easy) job. But it does expect those under 50 to do so. Hence, the bias in favor of 50 and over workers.

 

It is much easier to win if you are 50 or over, period.

 

So, when you contact a Social Security attorney such as myself, the first question they will ask you is: How old are you? Because age really does matter in the world of Social Security Disability Claims!

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