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Trial Work Period

Posted by: MCVLawBlog In: Uncategorized 12 Jan 2017 Comments: 0

The Trial Work Period is a program where Social Security allows SSDI beneficiaries to try to return to work without losing their benefits.

During the first nine months that you return to work, you will continue to receive your SSDI benefits. At the end of nine months of work, your trial work period is over, and the SSA will decide if you have been doing “substantial gainful activity,” or SGA. (SGA for 2017 is generally earning $1,170 or more per month.) If your average earnings are over the SGA amount, your SSDI benefits will end. You must report your work activity and earnings to Social Security.

You are entitled to nine trial work months during your trial work period(which is 60 months), and a month doesn’t count toward your nine months if you make less than $840 (gross per month) or if you work less than 80 hours per month in self-employment (irrespective of the amount earned).

Also, if you have expenses that are incurred in the course of your employment that relate directly to your disability (such as needing a specific type of computer or a certain type of wheelchair), the Social Security Administration will deduct those expenses from your gross earnings before they determine if you are over the limit.

The part that traps a lot of people I speak with is that your nine trial work months need not be consecutive, so there can be gaps between your trial work months that count toward your nine-month limit. You only get 9 trial work months in a 60 month period.

Once you have used nine trial work months during any five-year period, you have exhausted your trial work period and are not entitled to another trial work period (unless your SSDI benefits end due to working, and you subsequently become entitled to benefits again by submitting a new application for SSDI benefits or through expedited reinstatement.

Still Have Questions On Trial Work Period? Get Answers From SSDI Lawyers

Contact our SSDI lawyers near Syracuse, NY and Watertown, NY for a free initial consultation.

A Workers’ Compensation Case Gone Wrong: Don’t Let It Happen to You

Posted by: MCVLawBlog In: Workers Compensation 27 Dec 2016 Comments: 0

NY State Workers’ Compensation Law states that anyone who files a claim for Workers’ Compensation and “knowingly makes a false statement… as to a material fact…shall be disqualified from receiving any compensation directly attributed to such false statement.”

In short, this means that if you intentionally lie about your Workers’ Comp. claim, you may be denied benefits. The Workers’ Compensation Board can also decide to permanently disqualify someone from getting any Workers’ Comp. benefits in the future.

This part of NY Workers’ Compensation Law, Section 114-a, took effect in 1996 and continues to be a problem for working people with Workers’ Compensation claims. Some examples that are included as part of this law:

When an injured worker doesn’t report doing something that’s legally considered work
When an injured worker doesn’t include relevant information in their claim
When an injured worker misrepresents their condition

NY Workers’ Compensation Law: A Case To Learn From

A recent Section 114-a case included a man who hurt his shoulder on January 2013. This worker continued to work light duty until May 2013, when he had surgery for his injuries. Following the surgery, the injured worker received temporary total disability benefits until he returned to work on October 2013.

The Injured Workers’ Employer Claimed Section 114-A of NY Workers’ Compensation Law

The injured worker’s employer claimed that the injured worker violated Section 114-a. This violation was based on the fact that the worker was caught on video using a riding lawnmower and weed trimmer from July and August 2013.

During a Workers’ Compensation hearing, the injured worker stated that he owned and operated his own lawn care and plowing business since 1994. During this hearing, the injured worker admitted that he did lawn care services twice a week while at the same time collecting lost wage benefits from Workers’ Compensation. The injured worker stated during the hearing that he told his surgeon that he worked part-time for his lawn business. The injured worker also said that the surgeon told him that he could do work for his lawn business as long as he limited his activities to things that didn’t require him to lift his injured arm above his shoulder. The injured worker said at the hearing that both he and his surgeon believed that the temporary total disability only applied to his regular work. The injured worker’s statements were supported by his doctor’s medical records.

The injured worker also stated at his hearing that while he collected temporary total disability benefits he asked his employer to return to work on light duty. The injured worker was told he could not return to work until his doctor cleared him.

The Independent Medical Exam

In July 2013, the injured worker received an independent medical exam, also known as an IME. The injured worker wrote on his intake form for the IME that he was not working or volunteering. At his hearing, the injured worker said that he misunderstood the intake form and thought that the form was asking if he was working at his primary job.

The Decision: The Injured Worker Violated NY Workers’ Compensation Law

The Workers’ Compensation Law Judge ruled that the injured worker did not violate Section 114-a. However, the decision was appealed. Then, the Board Panel reversed the original decision and ruled that the injured worker did violate Section 114-a. Because of this, the Board Panel ruled that the injured worker should be denied benefits. The Board Panel also ruled that the injured worker would be permanently disqualified from receiving future wage replacement benefits.

The injured worker then appealed the decision to the Appellate Division of the Third Department. The Appellate Division of the Third Department ruled that the injured worker did violate Section 114-a of NY Workers’ Compensation law. However, The Appellate Division ruled that a trial court should decide if the injured worker should be permanently disqualified from benefits. The Appellate Division reasoned that the penalty for breaking the law should not be disproportionate to the alleged wrongdoing.

NY Workers’ Compensation Law, Section 114-A & Volunteering

It’s pretty common for injured workers to be self-employed, have a side business or volunteer for local organizations like the American Legion or Fire Department. However, all of these activities could result in being accused of violating Section 114-A.

Violating Section 114-A of NY Workers’ Compensation law can have serious consequences. Injured workers could lose benefits and be banned from receiving future benefits. Because of this, it’s very important for injured workers to talk to their workers’ compensation lawyers, their doctors and IME doctors before doing any work, volunteering or otherwise. This work could violate Section 114-A, making it hard for injured workers to provide for themselves or their families.

Get Help from NY Workers’ Compensation Lawyers

MCV Law’s experienced workers’ compensation lawyers have helped protect the rights of injured workers for over 30 years. To get help from experienced, award winning workers’ compensation lawyers, contact us for a free initial consultation.

New York State Workers’ Compensation Law Sets New Rules For Opioid Meds

Posted by: William Crossett In: Workers Compensation 15 Nov 2016 Comments: 0

NY Workers’ Compensation law now includes a new process for opioid pain medications. Opioid pain medications include pills such as hydrocodone, methadone, morphine and oxycodone, among others.

The NY Workers’ Compensation law now has a new process for hearings to help determine if an injured worker should continue opioid usage or if the injured worker should be weaned from opioid medication.

New York Workers Compensation Law’s New Hearing Process On Opioid Meds

Insurers can request a hearing specifically to determine if an injured worker should be weaned from opioids. Form RFA-2 is a workers’ compensation form that can be filed by the insurance company or employer of someone who is receiving workers’ compensation benefits. When filing Form RFA-2, an insurance company or an employer now has the option check a box for “Opioid Weaning under Non-Acute Pain Guidelines.”

When the “Opioid Weaning under Non-Acute Pain Guidelines” box is checked, the insurance company or employer filing the form must provide details about the goals and recommendations for the change in an injured workers’ pain medication routine.

What Do Injured Workers Have to Do About This New NY Workers’ Compensation Law?

When Form RFA-2 is filed with the box for “Opioid Weaning under Non-Acute Pain Guidelines” checked off, the injured worker’s doctor who has been prescribing opioid pain medications then submits a medical report.

This responding medical report must include:

A review of the injured worker’s use of opioid medications
A list of the injured worker’s current medications
A review that determines whether an injured worker’s opioid medication complies with the new NY Workers’ Compensation law related to opioid medication.

Once an injured worker’s doctor has provided a responding medical report, a hearing takes place to determine if changing an injured worker’s pain medications is necessary.

What Can Happen From a Hearing About an Injured Worker’s Opioid Medications

There are three possible outcomes from a hearing about an injured worker’s opioid medications. These include:

There isn’t enough evidence for continuing opioid medication. Weaning the injured worker off opioid medications will then begin.
There isn’t enough evidence for continuing opioid medication. Weaning the injured worker off opioid medications will then begin. The injured worker will also enter an addiction treatment program.
The opioid medication has been shown to be effective and there will not be changes to the injured worker’s opioid medications.

Insurance will cover the cost of the new plan to wean the injured worker off opioid medications. Insurance also must cover addiction treatment program costs if addiction treatment is ruled as necessary for the injured worker.

Why Is There a Change in the New York State Workers Compensation Law?

While many injured workers need some form of pain medication, opioid pain medications have fueled the opioid public health crisis in New York State. Opioid pain medications are highly addicting. Opioid-related emergency department visits increased 73% from 2010 to 2014, according to 2015 NY State Department of Health report. This has also contributed to a 268% increase in heroin related deaths in New York in 2013 compared to 2009, the same report finds.

Because opioid pain medications are highly susceptible to abuse and chemical dependence, New York State Workers Compensation law has changed to help prevent injured workers from these opioid related health problems.

Get Help from Our Experienced NY Workers’ Compensation Lawyers

Dealing with potential changes to your medication routine can be confusing and frustrating. For over 30 years, MCV Law’s workers’ compensation lawyers have helped protect the rights of injured workers.

Our experienced lawyers near Syracuse, NY and Watertown, NY can help make the workers’ compensation process easy, empowering you to have more control over your life and workers’ comp. benefits.

If you or a loved one are on workers’ compensation and need dedicated and knowledgeable legal representation, contact us today.

Social Security Backlog

Posted by: MCVLawBlog In: ssdi 02 Sep 2016 Comments: 0

For those individuals waiting for their Social Security Disability claims to be scheduled for a hearing, they are painfully aware of how long it is taking. President Obama has requested funding for 2017 that would allow Social Security to begin reducing the disability claims backlog and to reduce other agency service delays. This request for funding is being met with resistance by Congress.

If you or a friend or family member has or is suffering through this ridiculously long process, I urge you to contact your Congressional Representatives and urge them to vote to fully fund the Social Security Administrations operating budget, at the levels requested in the President’s 2017 Budget. The cost of this backlog is devastating to people with disabilities who are struggling to make ends meet while they wait for decisions in their cases. Without adequate funding, the wait times will only increase. We cannot afford a Social Security Administration that is underfunded and understaffed.

New York 24th Congressional District
John Katko
440 S. Warren Street. #711
Syracuse, New York 13202
315-423-5657
https://katko.house.gov/

New York 22nd Congressional District
Richard Hanna
49 Court Street Suite 230
Binghamton, New York 13901
315-723-0212

Utica Office: 258 Genesee Street
Utica, New York 13502
315-724-9740
http://hanna.house.gov/

New York 21st Congressional District
Elise Stefanik
88 Public Square
Suite A
Watertown, New York 13601
315-782-3150
https://stefanik.house.gov/

Sen. Charles Schumer
100 South Clinton Street
Room 841
Syracuse, New York 13261
315-423-5471
www.schumer.senate.gov

Sen Kristen Gillibrand
100 South Clinton Street
Room 1470
P.O. Box 7378
Syracuse, New York 13261
315-448-0470
www.gillibrand.senate.gov

NADR Legislative Committee Asks for Your Help.

Based on what we’re hearing from the Hill and the Administration, the NADR believes that it’s urgent for advocates reach out directly to their Members of Congress as soon as possible in support of adequate appropriations for the Social Security Administration (SSA). As you know, SSA’s disability hearings backlog is now at record levels, with over 1 million people waiting over 575 days, on average. The human cost of this backlog is horrific as people with disabilities struggle to pay their bills, get the supports and services they need, and make ends meet while waiting. Without adequate funding, this crisis will only become more severe.

President Obama has requested funding for 2017 that would allow Social Security to begin reducing the disability claims backlog and to reduce other agency service delays.

Call your Members of Congress. Tell them:

I urge you to vote to fully fund the Social Security Administration’s operating budget, at the levels requested in President Obama’s 2017 budget.
Today, over 1 million people with disabilities are waiting over 575 days on average for a hearing on their Social Security and Supplemental Security Income disability claims. This is an all-time high. Most people have little to no income while waiting for a hearing, and run the risk of financial ruin and worsening health the longer they wait.
Social Security’s operating budget has been reduced by 10 percent from 2010 levels. Any further cuts will lead to even longer, more devastating waits and reduced service to the public.
Americans cannot afford a Social Security Administration that is underfunded and understaffed.
Please ensure that Social Security’s operating budget is fully funded for 2017 at levels the President has requested.

NADR Legislative Co-Chairs
Art Kaufman and Scot Whitaker

Fired While on Workers’ Comp.? Know Your Rights

Posted by: William Crossett In: Workers Compensation 08 Aug 2016 Comments: 0

You can be fired while on Workers’ Comp., but there’s a lot more to consider than what can be provided in a yes-no answer. You still may have means to protect your income if fired while on Workers’ Comp.

Being Fired While on Workers’ Comp. and the Family Medical Leave Act (FMLA)

While you can be fired while on Workers’ Compensation, employees who are covered by the Family Medical Leave Act of 1993 receive up to 12 weeks of unpaid, job-protected leave. The protections from the Family Medical Leave Act (FMLA) often are applied at the same time as NY Workers’ Compensation Benefits. The Family Medical Leave Act does not provide pay or benefits, but protects your right to return to your job within the 12 week period.

Not all employees are covered by FMLA protections. Generally, employees who are protected by the FMLA are given a written notice to their rights under the law. This notice is usually given around the same time a Workers’ Compensation case begins.

Being Fired While On Workers’ Compensation: An FMLA Example

For example, John files a NY Workers’ Compensation claim. John then begins his 12 weeks of unpaid, job-protected leave as part of his rights under the FMLA. During this 12 week period, John may be receiving Workers’ Compensation benefits.

During this 12 week period, John is fired while on Workers’ Compensation. John’s termination would be unlawful in this case, as he was fired during the protected 12 week period.

Is Being Fired While On Workers’ Comp. Discrimination?

According to New York State law, being fired while on Workers’ Compensation is not discrimination. This is because NY law allows employers to replace you if you’re unable to perform your work.

However, you cannot be fired while on Workers’ Comp. just for filing a NY Workers’ Compensation claim. You also cannot be fired for being a witness in another person’s Workers’ Compensation claim. If you were to be fired while on Workers’ Comp. with the only reason being that you filed for Workers’ Compensation or acted as a witness in another person’s Workers’ Compensation claim, this would be considered discrimination under NY workers’ compensation law.

Being Fired While On Workers’ Comp.: Section 120 Claims

If you’re fired while on Workers’ Comp. and your job termination was solely because you filed for Workers’ Compensation or you were a witness in another person’s Workers’ Compensation claim, you can make a Section 120 claim.

A Section 120 claim only applies to these two circumstances of wrongful termination. Because of this, it’s very difficult for a worker to prove a Section 120 claim. Most employers have a deep understanding of the law as it relates to Section 120 claims, and therefore are very careful with their reason for firing you while on Workers’ Comp.

Being Fired While On Workers’ Comp.: Unemployment Insurance

After being fired while on Workers’ Comp., you still may have ways to protect your income and provide for you and/or your family. If or when you’re fired while on Workers’ Comp., you may be able to collect unemployment insurance benefits if you have a partial degree of disability.

Have Questions? Let’s Talk

Determining if you were legally fired while on Workers’ Comp. can be very difficult to decide. The specifics to each case matters a lot in answering the question if you can be fired while on Workers’ Compensation.

For over 30 years, our Workers’ Compensation lawyers near Syracuse, NY have protected the rights of injured workers. To get a free case evaluation from our experienced attorneys, contact us.