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:
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.
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.
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!
What is Social Security Disability and who may qualify?
Social Security Disability (“SSD“) is a federal insurance program designed to provide income to people who are physically restricted in their ability to be employed i.e. they are totally disabled and unable to work.
Others who may receive benefits are:
Blind workers; children of blind or disabled workers; widow(er)s; adults disabled since childhood.
There are several factors that must be satisfied in order for a person to qualify for SSD:
- A claimant must have worked at job(s) covered by Social Security and paid taxes into the system;
- The claimant must have worked at least five of the preceding ten years from the alleged onset date, at a job covered by Social Security (the Social Security Administration refers to it as having worked “twenty (20) of the previous forty (40) quarters.”)
- The claimant must have a medical condition that meets Social Security’s definition of a disability. This definition is very strict and only applies to total disabilities, not partial or short term disabilities. A claimant is considered totally disabled if:
- a. they have a physical or mental condition that prevents them from engaging in any “substantially gainful activity,” and
- b. their disability has lasted or is expected to last for at least one year from the alleged onset date or result in death.
- they are under the age of 65 (Under retirement age)
If a claimant meets this heavy burden, then the claimant will receive monthly cash benefits——–the more they paid into the system, the more they get. Moreover, these benefits will continue until a claimant is able to work again on a regular basis, or they reach full retirement age and the disability benefits will automatically convert to retirement benefits. Medicare kicks in after the person receives benefits for two years.
Be careful: Not all companies and persons who represent claimants applying for SSDB are attorneys! An experienced SSD attorney is the best choice to help claimants who have been denied SSD, receive the benefits they deserve.