About Citizens Disability Llc:
Since 2010, Citizens Disability has been Americas premier Social Security Disability institution. Our services include helping people in applying for SSDI benefits, managing the process through Reconsideration, and representing people in person at their Hearing, and if necessary, bringing their case to the Appeals Council. Our mission is to give a voice to the millions of Americans who are disabled and unable to work, helping them receive the Social Security Disability benefits to which they may be entitled. Learn more about us and disability benefits like SSDI & SSI or give us a call at 492-3260.
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Chapter : Individual Disability Claims Are Regulated By State Insurance Law
Private LTD policies are contracts between you and the insurance provider. Claim disputes under these policies are governed by state contract and bad faith law. If an insurer denies your claim, you can appeal the decision. However, these appeals are often nothing more than an internal review with the same insurer that initially denied the claim.
When an acceptable settlement with an insurance company cannot be reached, bad faith insurance claim litigation becomes necessary. Litigation of private policies are held in state or federal court. The burden of proof is the same as a civil trial. You are allowed a jury trial, and may fully engage in evidence and discovery.
State Protections Available
Depending on the state, the protections and damages that are available to you in a dispute over a private disability claim include:
- Emotional distress
How Aflac Group Accident Plan Works
- You have selected Aflac High Group plan.
- You met with an accident and injured leg and you are taken to hospital with the help of an ambulance.
- You are diagnosed and there is a fracture in your leg.
- Doctor treats you for the fracture.
- You are on the crutches when you leave the hospital
- Aflac plan will pay you $3050
Now we will demonstrate through table what will be the expenses covered with Aflac Group Accident Payout. Here are the benefits and aflac group accident claim payouts for various injuries and hospitalization charges.
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Chapter : The Administrative Law Judge Hearing
The most important level of appeal before the Social Security Administration is what is known as an ALJ Hearing. The hearing is informal and is conducted by an Administrative Law Judge . The hearing takes place in the third step of the appeals process.
The hearings are usually conducted in a small conference room with the judge versus an official-looking courtroom. The hearing is recorded by a person known as a hearing monitor. All testimony is taken under oath, on penalty of perjury.
The hearing generally lasts about an hour to an hour and a half. It is seldom that these hearings take more than two hours.
The Administrative Law Judge
An ALJs job is to issue an independent decision on your Social Security disability case. The decision should not be influenced by the fact your case was initially denied or reconsidered.
Fortunately, more than half of the ALJ decisions nationwide are in favor of the claimant.
Informal Non-Adversarial Hearing
The ALJ hearing is a non-adversarial hearing, which means there is no lawyer on the other side who is going to ask you questions . The hearing is solely for a judge to find out the facts about your disability claim by asking you questions and/or calling other professionals to testify.
Who Comes to the Hearing
Besides these officials and the hearing monitor, no other persons are able to attend the hearing without your permission.
What Questions Will the ALJ Ask?
When Do I Have To File My Claim
You must file your claim within 30 days from the first day you become disabled. If you file later than this, you will have to show “good cause” for why you didn’t file the claim on time. To do this, attach an explanation of why the filing was delayed to your claim form. If good cause isn’t shown, you may be ineligible for benefits, or your benefits may be reduced.
Note that you cannot file your claim before you become disabled even if you know, for example, the date of the disabling event that will prevent you from working.
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Do You Work In My State
Yes. We are a national disability insurance law firm that is available to represent you regardless of where you live in the United States. We have partner lawyers in every state and we have filed lawsuits in most federal courts nationwide. Our disability lawyers represent disability claimants at all stages of a claim for disability insurance benefits. There is nothing that our lawyers have not seen in the disability insurance world.
Talk To A Disability Lawyer
Need a lawyer? Start here.
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Fibromyalgia And Degenerative Disc Disease
Another condition that might be found alongside degenerative disc disease is Fibromyalgia. Fibromyalgia can lead to a loss in muscle strength. This lack of strength in the muscles surrounding the spine can play a part in causing degenerative disc disease.
It is hard to qualify for disability benefits with fibromyalgia alone. Diagnosing fibromyalgia is difficult because there are no definitive tests to use as evidence. The diagnosis process generally involves a doctor ruling out other conditions and leaving just fibromyalgia. If you are applying for disability benefits with fibromyalgia, you should make sure that you have been checked for degenerative disc disease first.
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Whats The Va Disability Rating For Degenerative Disc Disease
The rating for degenerative disc disease is usually 20%, independently of how severe your condition may be.
The VA provides benefits for qualifying Veterans with degenerative disc disease, and these benefits can make life much more manageable for people living with the disability. If a Veteran with DDD qualifies to receive disability benefits, this means they will get monthly compensation based on the severity of their condition. However, the path to obtaining these benefits can be filled with obstacles. Many Veterans struggle to get the disability benefits that they need and deserve for degenerative disc disease. If you are struggling to obtain a fair VA disability rating for degenerative disc disease, Berry Law Firm can help.
For more than 50 years, our attorneys have helped Veterans secure the VA disability benefits they deserve. Many lawyers who are long-term members of our team are Veterans themselves, having served in multiple branches of the military. As a team of Veterans helping Veterans, we are committed to helping you get the disability benefits that you need and deserve, whatever it takes.
Call our office or contact us online to arrange a free consultation today.
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Qualifying For Disability Due To Back Problems
If your back condition, as described in your treating doctors reports, matches an impairment listing in the SSAs blue book of impairments, you will automatically be approved for disability benefits. This is not easy to do only very severe and well documented cases of back pain will match the SSAs listing for disorders of the spine. Your condition can also be considered to be equivalent to the listing for disorders of the spine, if it doesnt match a listing exactly but it is similar and has the same level of severity. The SSA will decide with the help of a medical consultant whether your back condition is equivalent to the spinal disorders impairment listing.
There are three main categories of back problems that can qualify for disability under the SSAs official impairment listing for disorders of the spine. The SSA specifies the symptoms and severity required to match each of these listings. Specifically, to match the listing for disorders of the spine , the SSA requires that your spinal disorder includes one of the following three conditions:
- nerve root compression
- arachnoiditis, or
The SSA notes several examples of back conditions that involve nerve root or spinal cord compression, which can cause problems from mild chronic pain to paraplegia in the worst cases:
- herniated disc
- vertebral fracture.
How Much Will You Get Paid When You Take Short
When you take advantage of your short-term disability benefit, your time off is paidbut that doesnt necessarily mean youll be getting your full paycheck.
The amount youll earn is dependent on your specific plan. Some plans offer full salary replacement, but most dont. Instead, they offer a percentage of compensation with a dollar amount cap.
There are also programs that award you different amounts based on your longevity with the company, says McDonald. If you are there for 10 years and have a 26-week disability period, you might get three months at 100% and then three months at 50%.
If you live in one of the five states where short-term disability benefits are mandated, then the amount youll be compensated will be regulated as well.
Q: What If I Cant Find An Std Policy That Fits My Budget And Requirements
In this rare situation, financial experts often recommend the same financial safety net of a savings worth at least three to six months salary. If you find yourself pregnant and without adequate savings or an STD policy, explore your financial options as soon as possible if youre worried about paying the bills while taking time off to heal and bond with your newborn.
Illiniois Short Term Disability Laws
Short-term disability insurance is very important. It provides some income usually a percentage of current income to help if someone becomes temporarily disabled and unable to work. Unfortunately, in the state of Illinois, there is no state mandate for disability insurance.
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If You Do Not Meet The Requirements Of The Listing You May Still Qualify For Disability Benefits If You Are Unable To Work
Social Security will conduct a residual functional capacity assessment to evaluate your limitations. Social Security will also consider your age, education, and job experience to see if there are any jobs you are capable of performing. Among the functions they will test are
- Your ability to turn or bend your neck
- Your ability to lift objects that weigh more than 20 lbs.
- Your coordination and ability and use your arms and hands
- If and how much pain interferes with your concentration.
Chapter 1: Step Four Proving You Cant Do Your Past Relevant Work
The SSA will find that you are not disabled if your impairment does not prevent you from being able to perform any of your past relevant work.
Past relevant work is generally defined as full-time work that meets the following criteria:
- You performed the work in the past 15 years
- The work lasted long enough for you to learn to do it
- The work was substantial gainful activity
When the SSA cannot make a decision based on your current work activity and medical facts alone, and it is established that you have severe impairments, RFC plays an important role.
Your Burden to Establish an Inability to Perform Past Relevant Work
You have the initial burden of proving disability by establishing a physical or mental impairment that lasts at least 12 month and prevents you from engaging in any work. You maintain this burden of proof for the first four steps in the five-step sequential evaluation.
At this step SSA does not consider your age, education, employability, or whether past relevant work exists in significant numbers in the national economy.
The fifth step is when the burden shifts to the SSA to show if you can perform other work.
ALJ Considers RFC & Physical and Mental Requirements of Past Work
The ALJ will review your RFC and physical and mental requirements of your past jobs in order to decide whether you can do work you did in the past.
Work performed for a short period of time is not considered relevant.
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Chapter 1: Psychological & Cognitive Disabilities
Disability Compensation for Mental Disabilities Other Than PTSD
If your case concerns a mental disorder, various unique issues may be present during the claim process. First you must be sure to have your mental disability professionally diagnosed. Once diagnosed, you will need to identify which particular mental disorder you are seeking benefits for you will also need to show that the disability is service-connected in one of five different ways.
The 5 Ways to Service Connect a Mental Disorder in a VA Claim
Disability claims involving mental disorders can be extremely challenging, and more than one mental disorder can exist.
Note: if you have applied for the wrong mental disorder, that alone is not basis for denial. As long as some of the symptoms overlap, the claim can be applied to the correct disorder once it has been diagnosed. You may be required to provide new evidence in the case.
Glossary of Key Terms Used in Mental Disorder VA Claims
Buy Early To Save Money
If you purchase your disability policy while youâre still in school, you can lock in low rates based on your future earning potential. This can save you a lot of money in the long run.
You can also save by opting out of an own-occupation policy. Own-occupation means that youâll receive your disability benefit as long as you canât do the tasks of your job, even if you can do other work. Itâs the most comprehensive form of protection, but also adds to the cost of your policy.
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What If Am Denied Benefits Or The Benefit Amount Is Wrong
You can appeal a decision by the Division of TDI if you think it is wrong. Your appeal must be in writing and contain an explanation of why you disagree with the decision. It has to be received by or postmarked within seven days of getting your letter of determination, or within ten days from the date the letter was mailed to you. You can also fax your appeal or submit it online.
Once your appeal is received, you’ll get a letter that advises you of the date, time, and location of the appeal hearing. An Appeal Tribunal examiner will conduct the hearing, and you must be present for it. You don’t need an attorney, but you can bring an attorney or a friend or relative with you. The examiner’s decision will be sent to you by mail.
If you’d like legal representation at the hearing, contact a disability lawyer in your area.
Chapter : Establishing Service Connection Through A Medical Nexus
Making successful VA compensation claims is dependent on several factors. Perhaps the most important of these is establishing a service connection, or a nexus, between your current disability and a triggering incident during your period of military service.
The main cause of denied VA claims is a lack of medical evidence used to provide proof of this nexus.
Why Is Medical Evidence Needed to Prove a Nexus?
Veterans are often called to testify during hearings for VA compensation claims about their symptoms and the service-connected incidents that led to their symptoms. Some of your testimony may be deemed competent evidence if you appear capable of identifying the medical condition in question. However, most cases involve conditions in which a medical expert must provide specialized expertise for a diagnosis. In these instances, the fact that you may not be a medical expert makes your testimony invalid when it comes to proving the service connection.
Again, a veterans testimony or lay evidence can only be used to establish a diagnosis. It does not identify the connection between diagnosis and an inciting service-connected incident. Most VA compensation claims are lost due to lack of sufficient medical documentation of the nexus. An accredited VA attorney or agent will be aware of this requirement and can help you provide the proper medical evidence of the service connection.
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Chapter 1: How To Obtain Medical Evidence To Support Your Claim
Before you undertake a VA compensation claim, it is critical to understand what is involved in obtaining the medical evidence to satisfy the nexus requirementor linkage evidence. The format is simple all you generally need is a letter or statement from a doctor/medical expert. This can be your private medical provider or one employed by the VA.
Occasionally the linkage evidence will be provided by way of military medical records or a physicians in-person testimony.
Just as important as the medical records is the careful wording and thoroughness of the doctors statement. The medical opinion connecting a veterans disability to a triggering service incident must be based on examination and reasoning, not just the veterans testimony, and must specify the rationale used by the physician to arrive at the opinion.
The terms and language of the doctors statements should be very clear and specific. Ambiguous or careless phrasing has been a frequent cause of claim denials in past cases.
The VA often rules medical experts opinions insufficient if analysis and reasoning are not clearly expressed in the opinion. Always review your medical records when you attend doctors appointments, to be sure your physician is very clear in his or her details on your records.
Some medical experts are better than others choose carefully, and search out highly trained individuals who have a good reputation in your local community.
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