Meggesto, Crossett & Valerino, LLP
Social Security is warning people who have applied for Social Security benefits, or who are receiving Social Security benefits, about a text “phishing” scheme that has recently started. SSA has received reports from Disability Representatives indicating that some of their clients are receiving suspicious text messages, asking them to call a telephone number for information about their Social Security disability benefits, or about their disability claim, or about their disability hearing. This appears to be happening in a number of different cities and states.
According to these reports, individuals posing as Government officials have sent texts to several Social Security disability applicants and beneficiaries in an attempt to elicit a response—possibly to obtain their personal and financial information. These texts are being sent to many phone numbers, hoping someone will respond and give out personal information. Some of the texts may use language like:
“Disability Alert: Please call xxx-xxx-xxxx regarding your recent disability benefits application.”
“Disability Alert: Please call xxx-xxx-xxxx about your disability claim or your hearing may be delayed.”
“We are working on your disability case and we would like to speak to you. Please call xxx-xxx-xxxx.”
If someone asks you to give them any personal information, do not give out any information.
Social Security will never send you an unsolicited text message about your application for benefits. Social Security will never send you an unsolicited text message about your hearing asking for personal information. Social Security will never send you an unsolicited text message to get personal information about benefits you are already getting. Social Security already has your personal information!!
You should never provide your Social Security number, birth date, bank account numbers, or other personal information to someone who calls, emails or texts you unless you know the person asking for that information. Social Security representatives may call to follow up on a benefit application, or might call to remind you about a hearing date and time—but they will not send unsolicited text messages—and they usually will not ask for personal identifiers or financial information. There are many different versions of this type of phishing scheme which could lead to identity theft or Social Security benefit theft.
IF YOU RECEIVE A TEXT MESSAGE, E-MAIL, OR PHONE CALL FROM ANYONE CLAIMING TO BE FROM SOCIAL SECURITY OR ANY OTHER GOVERNMENT AGENCY REQUESTING PERSONAL INFORMATION, PLEASE CALL OUR OFFICE IMMEDIATELY AT 315-471-1664.
Social Security defines disability as the inability to engage in substantial gainful activity by reason of any medically determinable physical and/or mental impairment which can has lasted or can be expected to last for at least 12 months or result in death.
A medically determinable impairment is an impairment resulting from anatomical, physiological or psychological abnormalities which can be measured by medically acceptable clinical and laboratory diagnostic techniques. . The medical evidence must show signs,
The Social Security Regulations provide a five step sequential evaluation process for determining disability.
Yes. Social security has what’s called a listing of impairments. These listings include a number of physical and mental impairments, that will automatically qualify an individual for Social Security Disability benefits (SSDI) or Supplemental Security benefits (SSI), if the individual’s condition meet or equals the specific criteria for a listing.
You have the burden of proving you are disabled. You will need medical records from acceptable medical sources who have treated you. The preference is for evidence from physicians who have treated you. Social Security also looks for any diagnostic testing such as: MRIs, CT scans, Nerve Conduction studies, etc. it is also important to have Opinion evidence from your doctors as to the severity of your symptoms as well as the limitations that you have from your condition that limits your ability to work.
The application process can take about 4 to 6 months, so you should apply as soon as you are told that your condition will prevent you from working for at least 12 months or is terminal.
There are several ways to apply for benefits:
Social Security Disability is a federal benefits program, managed by the Social Security Administration that provides monthly benefits for disabled workers and certain members of their family. To be eligible for Social Security benefits, you must be insured, meaning you have to have earned a certain number of work credits.
You must have a severe impairment or combination of impairments that meets Social Security’s definition of disability. Your condition must be severe in that it interferes with your ability to do basic work activity and must have lasted or be expected to last at least 12 months.
The program also provides medical insurance in the form of Medicare benefits after an individual has been on Social Security Disability for the period of 24 months.
Social Security Disability and Supplemental Security Income or SSI, are two disability programs administered by the Social Security Administration.
The primary difference is that the Social Security Disability program provides benefits based upon an individual’s work history, whereas the SSI is a need-based disability program that provides monthly benefits to people over 65 who have little income, are blind or disabled.
SSI defines disability the same way as Social Security Disability, but it again applies to people with limited income and assets. To meet SSI income requirements, you must have less than $2000 in assets ($3000 if a couple) and no or very limited income.
Most people who qualify for SSI will also receive Medicaid from the state in which they live. There is no waiting period for SSI benefits.
You have to be insured for the benefits, meaning you’ve had to work for enough quarters and pay the Social Security tax. You must show that you have a severe impairment or a combination of impairments that has prevented you from working for a period of at least 12 months or is likely to keep you from working for a period of at least 12 months or end in your death.
The impairment is such that it renders you disabled for any jobs that you’ve held in the past 15 years, and that you are incapable of doing any other work in a meaningful way because of your impairment.
Many workers suffer injuries which lend themselves to a schedule loss of use. These cases typically involve injuries to the hands, arms, feet, legs, eyes, thumbs, fingers, and for hearing loss.
The schedule loss of use is calculated based upon a chart found in Section 15 of the Workers’ Compensation Law. This chart demonstrates how many weeks a particular extremity is worth. For instance, the hand is worth 244 weeks under Section 15. If you are found to have a 10% loss of use of the hand, the award is equal to 10% of 244 weeks, or 24.4 weeks. Schedules are paid at the total rate in your case and paid in a one-time lump sum. In calculating the award, you multiply 24.4 weeks times the total rate in your case. If the total rate in your case is $400, the schedule award would be $9,760. However, any prior payments made to you during the course of the disability are deducted from this award. If you previously collected $3,000 in lost wage benefits, your award would be $6,760.
A schedule loss of use is typically assessed about a year from the date of the injury or from the date of surgery. First, your doctor must opine that you have reached Maximum Medical Improvement. If this is found, your doctor will provide a loss of use opinion. At this point, the Insurance Carrier can either accept your doctor’s opinion or chose to obtain an opinion from an Independent Medical Examiner. It is often the case that there is a dispute between the two doctors’ opinions. Negotiation between the two opinions is encouraged under the law, however, if an agreement cannot be reached, testimony of the two physicians is taken and the judge will render a decision on which doctor he or she finds to be more credible.
Hearing loss is a little different. There are two types of hearing loss cases. The first is traumatic hearing loss, which results from an explosion or a one-type event. The second, and more common, is referred to as an occupational disease, where the hearing loss results from exposure to loud noise over a number of years, such as factory workers or tool makers. The injured worker must be removed from the noise for 90 days before a claim can be brought. The doctors will then give an opinion as to the percentage of hearing loss and an award is payable.
It is important to understand that a schedule loss of use is not a settlement. There are three important distinctions.
The Workers’ Compensation Law is a wage replacement statute, thereby allowing injured workers to collect weekly benefits if an on-the-job injury prevents them from working. These are referred to as “lost wage benefits.”
Lost wage benefits typically commence within 3-4 weeks after the injury. The amount of the benefit is dependent upon two things. The first is the injured employee’s Average Weekly Wage. This number is set by assessing how much money the injured worker made on average for the 52 weeks prior to the injury. Make sure that all extras such as bonuses, commissions and other money benefits are included. The weekly rate is based upon this number, so it is important to be sure it is as accurate as possible.
One important consideration that is often overlooked when calculating the average weekly wage is Concurrent Employment. This applies where an injured worker had more than one job at the time of the accident. If this can be shown, the average weekly wage is increased to account for all earnings.
The second factor in determining the weekly rate is the level of temporary impairment, which is given by the doctors. It is important to understand that the system is driven by medical evidence, however doctors are under very few guidelines or requirements when assessing degree of temporary impairment.
Every time you see your doctor, a report is filed with the Workers’ Compensation Board. Your doctor will provide a degree of disability in that report, which is expressed as a percentage ranging from 0 to 100. Sometimes the doctors will use narrative terms, such as mild, moderate, marked, or total, or some combination thereof. As a practical matter, mild means 25%, moderate means 50%, marked means 75%, and total means 100%.
For the most part, most people who are hurt at work are at least temporarily, totally disabled for a period of time after the injury. If you are temporarily, totaled disabled, you are entitled to collect 2/3 of your Average Weekly Wage from the Workers’ Compensation Carrier. For example, if your Average Weekly Wage is determined to be $600, you can collect $400 per week in lost-wage benefits.
If your degree of disability is assessed to be less than total, you will be paid in accordance with the percentage set forth by your doctor. Using the same example above, if your doctor assesses you to have a 50% degree of temporary impairment, you can collect $200 per week in lost-wage benefits.
The law also provides for Maximum and Minimum rates, depending on your date of injury. For injuries that occurred from July 1, 2014 through June 30, 2015, the maximum weekly benefit is $808.65. Therefore, regardless of your average weekly wage or degree of temporary impairment, you cannot collect more than $808.65 per week in lost wage benefits. The minimum rate for injuries occurring during this period is $150.00 per week.
Degree of disability applies where an injured worker is out of work. However, because the Workers’ Compensation Law is a wage replacement statute, the law also provides benefits for injured employees who return to work but earn less because of their injury. This is referred to as “Reduced Earnings.” In the event that you return to work but are earning less than at the time of the injury, you are generally entitled to collect 2/3 of the difference.
At MCV Law, we start with step one to make sure that the Average Weekly Wage is set as accurately as possible. This involves a review of the injured worker’s W-2 and most recent pay stubs, as well as other factors, in an effort to maximize weekly benefits.
In New York State, the Workers’ Compensation Law is an employee’s sole legal remedy for an injury that occurs on the job. What this means is that an injured employee cannot sue a co-employee or employer for negligence that caused the injury. There is one exception to this rule. That is, if the employer intentionally caused the employee’s injury.
While an injured worker cannot sue his or her employer or co-worker, the injured worker can, however, sue a third-party or other entity, if the third-party’s negligence caused the injury. These lawsuits are typically called “Third-Party Actions.”
If a Third-Party Action results in monetary benefits for the injured worker, either by settlement or a verdict, the Workers’ Compensation Carrier is entitled to reimbursement for any lost wages and medical benefits paid. This is also referred to as a “Third-Party Lien.” Calculating the lien and other expenses often gets very complicated, so it is important to seek legal counsel to assist with the process.
In addition, the Workers’ Compensation Carrier must also give consent for the injured worker to settle a Third-Party Action. Failure to obtain consent may result in a complete bar of future Workers’ Compensation benefits.
The most common type of Third-Party Actions arise out of motor vehicle accidents, where the negligence of a third-party motorist causes the injury. In New York State, not only is the injured worker entitled to Workers’ Compensation benefits and a potential Third-Party Action, but the injured worker may also be entitled to No-Fault Benefits. An injured worker who is injured as a result of a motor vehicle accident should seek immediate counsel, as the timeframe to file for No-Fault Benefits is very short.
As demonstrated, Third-Party Actions involve many important considerations, so it’s imperative to seek the advice of an experienced attorney. At MCV Law, we have attorneys experienced in both Workers’ Compensation cases and Third-Party Actions, and we work together to be sure the maximum benefits are achieved.
