Can I Get VA Benefits For Hearing Loss In Houston, TX?

October 15, 2019 by

You may have noticed that you’re not hearing as well as you did before, or you keep asking people to repeat something. Did this happen during your time on active duty?

Doctor talking to an older female patient about Houston, TX VA disability benefits for hearing loss.

 

Hearing Loss Can Affect Anyone

Most people think of age-related hearing loss (the loss of the hair-like cells in your inner ear), or people who were born without hearing. But losing your hearing can happen to anyone anytime without an explanation. Even excessive earwax can cause hearing loss, but more common causes include:

  • Exposure to loud noises, including construction equipment, power tools, concerts, movies, and other high-decibel sounds without protection.
  • Listening to music too loud in earphones
  • Tinnitus (ringing in the ear, especially after loud concerts and movies)
  • Traumatic brain and other injuries to the head
  • Tumors and other growths in the ear area
  • Medications for conditions such as cancer and infections (antibiotics)
  • Sudden altitude and pressure changes during flying (or even driving)
  • Diseases in children such as:
    • Chickenpox
    • Smallpox
    • Meningitis
    • Measles
    • Mumps
  • Other chronic illnesses such as:
    • Heart disease and hypertension
    • Autoimmune diseases (such as Hashimoto’s thyroiditis and lupus)
    • Diabetes
    • Strokes

Veterans may have some of these causes, but their hearing losses are more commonly caused by experiences in the military, such as gunfire, transport, airplane and helicopter engines, and other artillery explosions (i.e., hand grenades.)

Like any VA disability claim, you’ll be required to establish a service connection for your hearing loss.

Three Steps

Just filling out an application will not help you get rated. In order to apply, you’ll need:

  • A current diagnosis of hearing loss from a licensed audiologist, who will administer two different diagnostic tests to be submitted to the VA:
    • Maryland CNC Test, which uses a 50-word list to determine how well you can recognize speech
    • Puretone Audiometric Test, which measures the lightest sounds you can pick up on and hear
    • Note: when you’re being tested, remove any hearing aids and let the audiologist know you’re taking this test to satisfy the VA’s requirement for establishing a service connection.
  • Establishment of a service connection, which may include examining your service records for evidence of any types of activity that could have contributed to or caused your hearing loss. Wartime service can be used to make that connection as well.
  • A corroborating medical opinion, one that can effectively link your hearing loss to your time in service

It’s not uncommon for hearing problems to develop some years after your discharge—but that doesn’t mean it isn’t service related. If you can demonstrate that you were exposed to loud noises during your time in the service, you still may be able to establish a service connection for your hearing loss.

Meniere’s Disease

This inner-ear disorder causes a number of symptoms, including hearing loss, vertigo, tinnitus, and pressure or “fullness” in the affected ear. It normally affects only one ear, and can also include fluid in the ear. While there are treatments for Meniere’s Disease, there is no cure.

The VA does rate on Meniere’s Disease, as much as 100% if you’re experiencing weekly bouts of vertigo and its related symptoms. Other inner ear disorders rate between 10% and 30%.

Hearing Loss Ratings

As with all disability ratings, the VA draws from the VA Schedule of Ratings Disabilities. Auditory (hearing) disorders are found under Section 4.87, in diagnostic codes 6200 to 6260. While tinnitus and hearing loss are common for veterans, there are other types of disorders that the VA will rate, including:

  • Cancer in the ear area. The VA gives a 100% rating for the six months following the end of treatments.
  • An inner ear problem called “peripheral vestibular disorder” rates at 10% if it causes you dizziness on occasion, and 30% if your dizziness is accompanied by staggering
  • The loss of one ear (external) is a 30% rating, whereas the loss of both ears rate at 50%, assuming that you have at least some hearing despite the loss of the ear itself.
  • The VA rates all cases of perforated eardrums at 0%.

If you have total hearing loss in both ears, you may also be eligible for a special monthly compensation.

Herren Law Can Help With Your VA Disability Benefits Claim

The VA does award disability benefits for hearing loss, but you have to apply, as you would for any type of disability. We can help make sure that your application is done correctly, and can also help with an appeal if your claim is denied.

Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges.

Filed Under: Long Term Disability, Veterans Disability Tagged With: , ,

In Houston, TX, Does My Wife Get My Veterans Disability Income If I Die?

September 26, 2019 by

As a disabled veteran, one of the things that may you may be concerned about is the fate and welfare of your spouse and family after your passing. It’s a difficult subject, but one you may need to give thought to in respect to your will and other estate planning matters.

If your Veterans disability income is an important part of your monthly budget, it is possible that your spouse can receive it after your death, but it isn’t automatic.

Woman with a pen completing a life insurance policy and Veterans Disability Income paperwork.

Dependency and Indemnity Compensation (DIC)

A spouse, child or parent of a veteran who died in the line of duty, a survivor of a Vietnam veteran who died from a service-related illness or injury may be eligible for DIC. This is a monthly payment to surviving spouses, children, and occasionally parents, and it is tax-free.

However, there are eligibility requirements to apply for and begin receiving DIC. A surviving spouse must fill out an application to request these monthly benefits, as well as notify the VA that the veteran is deceased.

Criteria For DIC

The VA uses the following criteria to define a surviving spouse, if he or she:

  • Were married to the veteran in excess of one year
  • Were married for any time period and the spouse died
    • On active duty
    • During training while on active duty or inactive duty
  • Were married to the veteran within 15 years of his discharge, and the veteran’s death was caused by or exacerbated by a service-connected injury or illness
  • If the marriage date was prior to January 1, 1957
  • Had a child with the veteran, and was:
    • Living with the veteran until his/her death, or
    • Separated from the veteran and was not the survivor’s fault

A spouse may be eligible if the veteran died:

  • On active duty
  • From a service-connected injury or illness
  • While doing training on active duty or inactive duty
  • Was receiving disability compensation from the VA:
    • For at least 10 years before passing
    • From his or her discharge date, for at least five years before passing away
    • For at least 1 year if he or she were a prisoner of war

Remarriage

If a spouse remarries and before reaching age 57 or before December 16, 2003, the VA won’t consider them a “surviving spouse.”  But they would be considered “surviving” if the remarriage happened after the age of 57 and after that date.

Survivor’s Pension

For low-income, unremarried surviving spouses, the Survivor’s Pension may also be available if your spouse is a deceased wartime veteran.

The veteran must have:

  • Served for at least 90 days of active duty and at least one day during a period of wartime if he or she joined on or before September 1, 1980.
  • Served for at least 24 months or for the full period of enlistment with at least one day during a period of wartime if he or she joined after September 1, 1980.
  • Been discharged from the service under other than honorable conditions

Your family’s income must be less than the annual pension limit set by Congress, and the VA will use your “countable income” against the set limit. Some unreimbursed medical expenses may be deducted from the “countable income” and lower the income for the year.

Other Survivor’s Benefits

In addition to DIC and the Survivor’s Pension, spouses and children may also be eligible for:

  • Survivor’s & Dependent’s Educational Assistance Program, available for spouses and children of disabled and deceased veterans who are interested in educational and vocational training, including college-level and university-level courses. There are time limits involved, particularly for children.
  • Home Loans for service members, veterans, and spouses to buy a home, as well as repairs, refurbishing, remodeling and modifications to accommodate specific needs (such as a wheelchair ramp.)
  • Fiduciary services for veterans and beneficiaries who are unable to handle their own financial affairs.
  • Will planning and benefit training, with a free online will service. Financial services professionals are available 24/7.

An Advocate For Disabled Veterans And Spouses

If you’re a disabled veteran, or the spouse of one, don’t let the application and appeals process for Veterans disability income confuse you—get help from someone who can guide you through it.  Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. Our contingency fee basis means you won’t owe a fee until we win your case, and there’s no obligation.

Filed Under: Veterans Disability Tagged With: , ,

Long Term Disability Death Benefits In Houston, TX

September 16, 2019 by

It’s difficult enough when you or a family member has to apply for long-term disability, especially if there is a terminal or progressive, degenerative illness, such as ALS, or an injury that will never heal. What’s even more difficult to think about is when the time comes that you or your loved one passes away.

But when the day comes, will you receive any death benefits from the LTD policy? This will depend on the terms of the policy, which should be reviewed completely before attempting to apply for LTD disability benefits.

Long Term Disability Death Benefits In Houston, TX

What Is A Death Benefit?

This is a lump sum paid to an insured’s family when the individual dies, and is most commonly associated with life insurance. In fact, life insurance is just that—insurance on someone’s life, which pays out to whomever the insured assigns as a beneficiary.

But with long-term disability, there may or may not be a “death benefit.” Some policies do offer a “survivor benefit” that pays a lump sum of LTD death benefits to survivors for a specific time period, usually one to three months. But as a rule, if the individual has passed away, there is no more need for the insurer to make payments, so they will stop.

If your LTD policy comes through your employer, it may or may not include a death benefit—check your policy. You may have been offered a rider for an additional charge to have that would provide your family or other selected beneficiaries a death benefit.

You may have selected this option for your own LTD policy as well. Again, read and check your policy to be sure, or contact your agent to clarify. You may have the option of adding this type of LTD death benefits, even if you’ve had your policy for some time.

An Alternative LTD: Accelerated Death Benefit

If your LTD insurance is not sufficient, or you are terminally ill and need help immediately, one possibility would be to request an accelerated death benefit on your life insurance policy. There are restrictions on requesting this benefit, and it will reduce the death benefit (total sum of money) paid to your survivors after you die.

You may also use this coverage if you are confined to a nursing home, or are deemed terminally ill. Some policies automatically pay this in circumstances of an imminent death. To qualify, you will have to be certified by a doctor or other medical professional that you are terminally ill, and that death is expected in 12 to 24 months. Some providers set the threshold at six months.

Critical illnesses that can also trigger this benefit include:

  • Stroke
  • Cancer
  • Heart attack
  • Kidney failure
  • Organ transplants
  • ALS

Chronic illnesses are not the same as critical illnesses. To determine if your policy allows an accelerated death benefit for your illness, as always, review your policy and speak with your insurance agent to be sure.

Your Houston LTD Disability Attorney

Long term disability can be an annoying process before you begin receiving benefits. The Herren Law Firm can help you with your application, appeals and help you through the process, and give you and your family peace of mind. Contact us today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and no up-front fees, because we will only collect if we win your case.

Filed Under: Long Term Disability Tagged With: , ,

Taxation of Disability Benefits in Houston, TX

August 26, 2019 by

One of the less-discussed parts of getting disability benefits is what happens when it becomes tax time. Do you pay taxes on these benefits? The answer depends on what type of benefits you receive, and how you receive them.

Long Term Disability Insurance

Taxes on LTD insurance comes down to one question: who paid for it?

If your disability benefits come from a policy you paid for with after-tax dollars, as a rule, your benefits are tax-free.

However, if your employer paid for the policy, and does not include the cost of the policy in your gross income, the benefits are taxable, as it would be if you were earning an income.

Taxation of Disability Benefits in Houston, TX

If you shared the cost of the premium with your employer, you will share the tax benefits as well. The part that you paid (with after tax dollars) for will be tax free, but the portion your employer paid for will be taxable.

Should you retire from your job on disability, lump-sum payments for accrued time (such as vacation) are not part of a disability package. It is taxable, and should be listed as income.

The IRS also offers additional information on their website.

Disability Benefits From Social Security—SSDI And SSI

SSDI can be subjected to income tax, depending on what other income you may have (such as a spouse’s income.) However, many recipients don’t have much in the way of income, and do not end up paying taxes.

Under Social Security, you would receive one of two types of income:

  • Social Security Disability Insurance, or SSDI, which is based on your working history and funded through payroll taxes
  • Supplemental Security Income, or SSI, a need-based program which is awarded to low-income individuals, or individuals who haven’t earned enough work credits to qualify for SSDI. SSI benefits are not taxed.

They are both separate and distinct programs administered by the Social Security Administration.

As an individual, if your annual income is less than $25,000, you would not pay any income tax. If your annual income is from $25,000 to $34,000, your SSDI benefits would be taxed at 50%. If your monthly income exceeds $2,834, and your annual income exceeds $25,000, your SSDI would be taxed at 85%.

Married couples have a similar taxation schema, with up to 32,000 untaxed, up to $44,000 at 50%, and over $44,000 at 85%.

  • “Back pay” of benefits—if you receive a lump sum of money for the previous months of benefits since your application date, you may be taxed at a higher rate because of it. However, with the help of a CPA or other tax professional, you can amend your previous tax returns to include the back pay money so that you are not taxed as heavily on your current year’s tax return.

Some states tax SSDI benefits, but Texas does not.

VA Disability Benefits

While military retirement pay may considered taxable income (if it’s based on age or length of service), military and/or VA disability benefit payment resulting from service-connected illness or injury is not.

Other veterans benefits paid to you or your family are also not taxable (from Military.com):

  • Education, training, and subsistence allowances
  • Disability compensation and pension payments for disabilities paid either to veterans or their families
  • Grants for homes designed for wheelchair living
  • Grants for motor vehicles for veterans who lose their sight or use of their limbs
  • Veterans’ insurance proceeds and dividends paid either to veterans or their beneficiaries, including the proceeds of a veteran’s endowment policy paid before death
  • Interest on insurance dividends left on deposit with the VA
  • Benefits under a dependent-care assistance program
  • The death gratuitypaid to a survivor of a member of the Armed Forces who died after Sep. 10, 2001
  • Payments made under the compensated work therapy program
  • Any bonus payment by a state or political subdivision because of service in a combat zone

The IRS publishes a guide specifically for military members to help with tax preparation, as well as one on taxable and nontaxable income. Additionally, the IRS can assist you with tax preparation if you need it.

Other Nontaxable Benefits

These types of benefits are also non-taxable:

  • Payments for blindness and other benefit payments from a public welfare fund
  • Workers’ compensation for occupational injury or illness if it’s paid under a workers’ compensation act or similar law
  • Compensatory damages for physical injury or physical sickness (punitive damages are taxable, however)
  • Disability benefits under a “no-fault” auto insurance policy for income loss or earning capacity as a result of injuries
  • Compensation for permanent disfigurement or the permanent loss or loss of use of a part or function of your body

If you have any questions about what is taxable or nontaxable, consult with your tax professional, or with a disability attorney.

Have Questions On Disability? Herren Law Can Help

The Herren Law Firm can help you with your application, appeals and help you through the process, and give you one less thing to worry about. Contact us today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and no up-front fees.  We only collect if we win your case.

Filed Under: Long Term Disability Tagged With: , ,

Disability Claims for Mental Disorders in Houston, TX

August 15, 2019 by

Applying for disability benefits for a physical condition is a time-consuming task long before you begin receiving monthly payments. But filing disability claims for mental disorders can be considerably more difficult in Texas, where more than 70% of initial claims are denied.

Girl in bed showing why disability claims for mental disorders in Houston, TX are so important. with her mother holding her hand

Although the Social Security Administration does recognize mental illness as something that can cause long-term disability, you must be diagnosed by a physician, and meet the same criteria as any other injury or illness. The SSA awards benefits for a physical and/or mental disorder that prevents you from working, but only after a long process of medical treatments, documentation, applications, and a lot of waiting.

Mental Disorders

There are a wide range of mental disorders for which you may be able to receive disability, including:

  • Autism spectrum disorders
  • Affective disorders, such as depression and bipolar disorder, and aren’t considered brain injuries
  • Anxiety related disorders, if you can show that they prevent you from working
  • Psychotic disorders
  • Substance abuse disorders
  • Mental retardation
  • Somatoform disorders, for which there is no obvious or discernable cause
  • Organic disorders that affect the nervous system, such as dementia, Alzheimer’s, delirium

The SSA’s guidelines for mental disorder are contained in its book of policies known as the “Blue Book.”

Qualifying For A Mental Disorder Disability

Proving disability claims for mental disorders requires providing more than adequate documentation in your claim application. In it, you must provide:

  • All sources of treatments, including names and contact information of doctors, hospitals, and other providers where you have sought and received treatments.
  • The types of treatments you’ve received, as far back as you have evidence for. While the SSA considers “current treatment” to be within the last 90 days, “back pay” will require information dating as far back as you can provide to show how long you have been dealing with your condition. Without current treatments, there is no way for the SSA to understand that you are currently unable to perform substantial gainful activity (work.)
  • Detailed work history, including companies, dates, job title and job duties, just as you would if you were filling out a job application.

You must have one severe impairment with considerable medical evidence (documentation) to support your claim for an approval. This impairment must affect you so severely that you are unable to return to any job you performed in the prior 15 years, and makes it impossible for you to do any other kind of “suitable work” at a level that brings in “substantial gainful activity” (SGA.)

Currently, that monthly dollar amount is $1,220, adjusted for inflation and before taxes. In other words, Social Security considers a “disability” to be the inability to work and earn at least that much for at least one year. If you’re earning more, your claim will likely be denied regardless of your condition.

Why You Need A Disability Attorney

Getting disability claims for mental disorders approved can be more difficult than a physical one. So it’s even more critical to not only have all your documentation for your claim, but to ensure that everything is done exactly right.

You may only be doing this once in your life, and will spend a considerable amount of time on it. A Houston disability attorney can not only help your chances of winning, he or she can also save you a considerable amount of time.

A disability attorney helps people every day get the benefits they need, and understands the laws, policies and procedures that govern the application and awards process. Instead of going into the claims process blindly, a Houston disability attorney will be your advocate through the claim process, and if necessary, appeals process. Claimants who are represented by an attorney have a much better chance of approval, either in the application process or in the appeals process.

Houston’s Disability Attorney

If you’ve been denied disability payments for mental illness, call us immediately. We’re ready to help.

We’ve helped over 4,000 Houstonians get their disability benefits. The Herren Law Firm in Houston, TX can assist with your application, appeals and records gathering to prove your case, and win your claim. Contact us today at 713-682-8194 (or user our online contact form) to schedule your free consultation. There’s no obligation, and no up-front fees, and we only collect a fee if we win your case.

 

Filed Under: Long Term Disability Tagged With: , ,

Veterans Disability For Autoimmune Diseases In Houston, TX

July 30, 2019 by

Autoimmune diseases encompass a number of different conditions that share one common trait: they attack the body’s tissues as if it were a pathogen by producing specific antibodies to attack the healthy cells.

Doctors aren’t sure what triggers this biological mistake, but some people are more likely to have it than others. Science has identified 81 different autoimmune diseases. These illnesses can develop at any age, but most commonly between 40 and 50.

Discussing Veterans Disability benefits For Autoimmune Diseases In Houston, TX with a disability benefits attorney

Types Of Autoimmune Disease

Of the 81 identified, the most common of these autoimmune conditions include:

  • Rheumatoid Arthritis
  • Multiple Sclerosis
  • Type 1 diabetes
  • Lupus
  • Inflammatory bowel disease (IBD)
  • Hashimoto’s Thyroiditis
  • Grave’s Disease
  • Vasculitis
  • Myasthenia gravis
  • Psoriasis
  • Chronic inflammatory demyelinating polyneuropathy
  • Guillain-Barre Syndrome
  • Human Immunodeficiency virus (HIV)

If left untreated, an autoimmune condition could lead to damage to different parts of the body, including joints, skin, nerves, and muscles.

Causes Of AD

While science doesn’t offer a direct cause, researchers suspect:

  • Genetics, since some conditions run in families (i.e., lupus and MS)
  • Increased exposure to chemicals and other environmental toxins
  • The “standard Western diet” (sometimes called SAD or Standard American Diet), consisting of highly processed foods, including a large amount of sugar and synthetic fats
  • The “hygiene hypothesis”—children use antiseptics frequently are now vaccinated for such a wide range of things that they aren’t exposed to the bacteria and other substances that they used to. Without the exposure to “everyday germs,” immune systems don’t develop properly, and tend to over-react to harmless substances.

PTSD And The Service Connection

Part of applying for VA benefits includes establishing a service connection, and proving that your condition or injury occurred during the time you were in the service. But with many conditions, that’s not as easy as it sounds, although PTSD is a common service-connected cause for VA benefits.

A study conducted at the San Francisco VA Medical Center demonstrates a strong link between PTSD and the onset of autoimmune diseases. With 666,000 Iraq and Afghanistan veterans as study subjects, those diagnosed with PTSD had a 51% higher chance of developing an autoimmune condition.

The research team cited a number of reasons for this correlation, including:

  • Immunity and/or hormonal changes that are brought on by PTSD
  • Habits that are prevalent in PTSD patients, such as smoking, drinking, a less-than-ideal diet, and insufficient sleep
  • Genetic and/or pre-existing genetic risk factors may lay the ground work for both conditions

It’s important to note that PTSD does not directly cause an autoimmune deficiency, only that there is a strong correlation. However, to prove a VA claim for compensation, one only has to establish a 50% probability of causation for the autoimmune condition. Therefore, the aforementioned VA study may be one part of your overall strategy.

Autoimmune As A Secondary Condition

If you already have a claim for PTSD, seeking a secondary service connection between the PTSD and the autoimmune condition may be your best bet for getting benefits for it.

Because no primary causes are established, it may be difficult to pinpoint where and when your autoimmune condition began. But proving that your autoimmune disease as a “side effect” of PTSD as a secondary service connection is a different matter.

You will have to prove your primary service connection first, which will require evidence including:

  • Medical records and diagnosis
  • Treatments
  • Psychological exams
  • Vocational reports
  • Other related, relevant documentation

Additionally, you’ll need to prove a connection to your primary condition in order to prove your secondary condition. This will require a letter from a medical professional demonstrating the connection between the two conditions. The VA offers some information here.

Getting help with your VA disability application is the best way to get a head start on what may be a long, difficult process. An attorney experienced in VA applications can help you get started. He or she understands the process, and will ensure that your application is done correctly.

Helping Houston’s Veterans

William Herren is a veterans’ disability attorney who has worked with veterans in the Houston area for more than 20 years to help them get the benefits they deserve. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges. We don’t charge you a fee until we win your case.

Filed Under: Veterans Disability Tagged With: , ,

What Is ERISA And What’s The Connection To Houston Disability Benefits

July 15, 2019 by

If your employer covers your benefits package, it’s likely governed by ERISA. Most employer-sponsored plans are ERISA-regulated, except for privately-purchased policies or those provided by governmental agencies, churches or church-owned hospitals.

What Is ERISA And What's The Connection To Disability Benefits In Houston, TX

Despite the title and description, getting disability benefits isn’t always as simple as filling out forms and waiting for a check. Although ERISA was created to protect employees’ benefits and rights, its complex requirements can sink your claim right after you file it. If you file a claim and don’t follow the ERISA guidelines exactly, you claim may be denied without the right to appeal. Missing a deadline for appeal can prohibit you from filing a future claim.

ERISA Basics

Employer-sponsored benefits plans are regulated by ERISA, or Employee Retirement Income Security Act, established in 1974.This federal law under the US Department of Labor that “sets the minimum standards for most voluntarily established pension and health plans in private industry to provide protection for individuals in the plans.”  If you apply for disability and are denied, ERISA gives you the right to sue the insurer in federal court.

ERISA requires that employers provide their employees with basic information that includes:

  • Details of what’s covered and not covered under the plan
  • Instructions on filing a claim if an employee becomes disabled
  • Details of the company’s appeal process if the company denies an employee’s claim

ERISA sets a limit on the insurer’s timeframe to accept or deny a claim once it’s filed. The insurer has 45 days to render a decision, but can add an additional 30 days, and must notify the employee in writing.

If the insurer denies the claim, it must provide the reasons in writing within 45 days. ERISA controls not only the employee’s time frame for appeal, it also controls the deadlines for insurers to approve or deny the appeal.

Providing Documentation

It’s important to have a wealth of documentation in your claim file at the outset. This includes medical records, test results, doctor’s notes, and other instruments that will prove your claim for disability. Your attorney can advise you on the ERISA requirements, what information you need, and what you’ll need to request.

Note that if your claim is denied on appeal and you decide to move forward with a lawsuit, you will not be able to add additional evidence or information as you would with a civil or criminal trial or appeal. Everything that is already in your file is all that the judge will see. That’s why it’s important to have as much documentation to support your claim as you can obtain as soon as you can.

Discretionary Clauses In Texas Are Denied

You may have heard the term “discretionary clause” when discussing your policy with your employer or with the insurer. This is language written into the policy and allows the insurer plenty of “wiggle room” to limit or deny their claims. The clauses also prevent a court decision from reversing the insurer’s claim decisions.

In 2012, the state of Texas passed a law prohibiting any insurance company from using “discretionary clauses.” That is, any policy written or renewed after January 1, 2012 in Texas cannot contain a discretionary clause.

Deadlines Count

Insurers have specific deadlines for filing claims for disability benefits as well as appeals. Don’t miss a deadline, and make sure your claim adheres to ERISA’s very complicated rules. Let an experienced Houston disability benefits attorney take care of your claim and make sure everything is taken care of.

The Herren Law Firm can help you with your ERISA application, appeals and help you get the long-term disability benefits you need. Contact us in Houston today at 713-682-8194 to schedule your free consultation. There’s no obligation, and no up-front fees.  We only collect if we win your case.

 

Filed Under: Long Term Disability Tagged With: , ,

Selecting A Houston Long Term Disability Attorney After Receiving A Claim Denial

June 27, 2019 by

Dealing with the rules of the long-term disability process can be confusing, at best, and downright frustrating, at worst. At a time when you likely need to rest and take care of yourself, you may find yourself facing a denial of coverage and knee-deep in paperwork, some of which you may not understand completely.

Disappointed man in wheelchair with arm on wheel after a claim denial.

But a denial isn’t the end of everything. Your letter should detail the reason your claim was denied, and how to go about filing an appeal. Pay close attention to the part about appeals—you have a very limited time in which to file that appeal. Once that deadline is passed, you’ll lose your right to appeal, and you may not be able to file again.

This is when you need help. An appeal is the time to select a long term disability attorney.

The Appeals Process

From the day you receive your denial letter, you will have a specific period of time to file an appeal. This period is usually 180 days, but it may not be—read your letter carefully. Once that deadline passes, your claim will be over.

During the appeal period, you will have the opportunity to gather additional evidence to support your claim. This can include medical records, test results, letters from a treating physician, functional capacity evaluation and vocational expert reports, and other relevant information. Your attorney can help you through the appeals process, and advise you on what information to obtain in order to go forward.

What’s In Your Insurance File?

The only way to find out is to request copies of your insurance file and find out for yourself. The insurer won’t hand it over unless you ask them to.

Once you see what’s there, you’ll be able to offer additional evidence and documentation to not only support your claim, but correct any factual mistakes that may negatively impact your claim. Your attorney can advise you on what kind of information you’ll need to add to the file in order to support your claim.

Getting An Attorney Who Knows And Understands Disability Law

When you’re dealing with a disability and with an insurance company, you’re already under a large amount of stress. Many companies are known to deny benefits to people who need them without explanation. Without help, you run a higher risk of making a mistake that could see your appeal denied as well. Don’t take that chance.

You need an attorney, but not just any one will do. Just like finding a physician who can help you with a specific medical issue, you’ll need to find an attorney who understands how the disability application and appeals process works.

Remember: the insurance company already has a team of lawyers to defend itself against paying claims, and especially against any lawsuits. Hiring your own will level the playing field and increase your chances of winning on appeal. Besides—claims appeals are probably not your forte. But an attorney who works with disability law understands all the ins and outs of applications and appeals, and does it every day. Shouldn’t you have that kind of help on your side?

Long Term Disability Appeal? Call Herren Law For Help!

If you’ve been denied long term disability benefits, don’t try to handle your appeal on your own—get help today. The Herren Law Firm can help you with your application, appeals and help you through the process, and give you one less thing to worry about. Contact us today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and no up-front fees.  We only collect if we win your case.

Filed Under: Long Term Disability Tagged With: , ,

Filing A Veterans Disability Claim In Houston, TX

June 3, 2019 by

If you’re one of the thousands of veterans who were injured in the line of duty and are now disabled, chances are you’ve at least once attempted to apply for disability benefits. If you’re reading this blog post, it’s also possible your claim has been denied. But whatever your current status, there is a process to filing your Veterans disability claim.

Filing a Veterans disability claim in Houston, Texas.

The VA’s website is the place to start, and offers basic guidelines and tells you what evidence you need to support your claim. This includes:

  • VA medical records that are either related to your injury/illness, or demonstrate that your rated disability is worsening
  • Hospital reports and other private medical records that are either related to your injury/illness, or demonstrate that your rated disability is worsening
  • Supporting statements from friends, family, fellow service members and others that can provide additional information on how your injury/illness occurred, or how it has worsened. This is also called “lay evidence.”

You can apply online at the VA’s website, by visiting your local VA office, by calling by calling 800-827-1000, or by printing the application here and mailing it to your local VA office.

If you need help, please see our recent blog post on getting assistance with filing your application.

Medical Records And Evidence

The VA provides a list on its website of all the evidence you’ll need to gather for your claim application in addition to VA Form 21-526 and your DD-214.

There are two options for submitting your claim:

  • A Fully Developed Claim, in which you’ll take full responsibility for gathering, organizing and enclosing all of your relevant medical records, supporting documentation, and certify that the VA does not need to recover any more of your records to support your claim. Once you certify that all the relevant records are enclosed, you will be required to attend any medical exams the VA needs and requests for them to reach a decision on your claim.
  • A Standard Disability Claim, in which the VA takes responsibility for recovering any documentation needed for your claim. You’ll need to specify in your application where the records can be obtained or found, especially if they are not with a federal agency. You may be asked to obtain some of these records, such as medical records from a private doctor or hospital, and you will also be required to attend any medical exams the VA needs and requests to reach a decision on your claim.

Lay Evidence

This is evidence that doesn’t require specialized knowledge to deliver, including:

  • Your personal testimony regarding the symptoms of your current disability
  • Your spouse, children or other relative’s testimony about a diagnosis you received many years ago at a military hospital
  • A “buddy statement” that corroborates something that happened to you while you were in the service
  • Performance evaluations done before and after an incident that caused your illness, injury or disability

This supporting evidence is usually submitted as a written statement, and is included with your claim.

Bureau of Veterans Affairs

Once everything is submitted, the BVA will review your file, and determine whether or not you qualify for disability benefits, and if so, assign a percentage.

However, you are ineligible for benefits if:

  • Your disability was caused by misconduct
  • You were dishonorably discharged
  • You were avoiding duty when the injury occurred, i.e., AWOL or deserting
  • You were injured while in prison or detained in relation to a court martial or a civil court felony

If you are denied and would like to appeal, contact an attorney who specializes in disability law. You have a short time frame for appeal, so get started immediately.

Helping Houston’s Disabled Veterans

Have you had trouble applying and qualifying for VA disability benefits? Been denied and need to appeal? It’s time to reach out for help. William Herren is a veterans disability attorney who can make the claims and appeals process easier. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. Our contingency fee basis means you won’t owe a fee until we win your case, and there’s no obligation.

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In Houston TX, Can I Get Veterans Disability Benefits For Sleep Apnea?

May 20, 2019 by

Good sleep equals good health. An individual needs as many hours as they need to get a good night’s rest. But for many, a good night’s sleep isn’t something that happens like it should.

Sleep problems affect as much as 70% of the population at one time or another. Among veterans, the rate is about 20%, with the rate increasing to 87% of veterans between the ages of 55 and 89. These numbers are irrespective of socio-economic class or other demographic.

In Houston TX, can I get Veteran Disability Benefits for Sleep Apnea?"

The American Academy of Sleep Medicine reports that sleep disorders have seen a dramatic rise in the veteran population. The article from the journal Sleep reports that sleep apnea was the most commonly diagnosed condition at 47% of the 9.7 million veterans studied. (Insomnia was second, at 26%.) Veterans with pre-existing PTSD are associated with a higher risk of sleep apnea and other disorders. The Department of Veterans Affairs reports that claims for sleep apnea have increased fourfold in the last several years, with more veterans requesting tests and applying for benefits.

What Is Sleep Apnea?

Sleep apnea is a condition in which your breathing is repeatedly obstructed while you’re asleep, forcing you to start breathing again. (The Mayo Clinic has more information.) Because you don’t always wake up, you might not be aware. But snoring and drowsy fatigue upon rising are signs that you might be experiencing sleep apnea.

Sleep apnea has three different causes, but all lead to the same outcome. Lack of sleep can lead to other conditions, such as heart disease, high blood pressure, weight gain, headaches, memory problems, stroke, diabetes, and depression. Drowsiness can lead to things like car crashes and other accidents if left untreated.

Although anyone of any age can find themselves with sleep apnea, it’s most common in men over 40, particularly if they are overweight. Diagnosis requires a sleep study to confirm apnea.

After a diagnosis, the usual treatment involves a CPAP (continuous positive airway pressure) machine. This device forces air into nasal passages that’s strong enough to bypass any obstruction and promote more normal breathing. Because it’s a treatment and not a cure, a CPAP must be worn nightly, or the patient experiences a return of apnea symptoms.

Getting Benefits For Sleep Apnea

Because sleep apnea may develop after your discharge, there may be no reason to have a sleep study done. Veterans in line-of-fire combat situations are not likely to request a sleep study while deployed, and sleep problems are usually tied to the occupation.

Like any condition, the VA is looking for one thing: a service connection.

The first step is to actually get a diagnosis, although that doesn’t guarantee a rating and benefits. Either your sleep apnea was caused by or aggravated by your time in the service.

The next step is to gather the medical evidence you need to establish a connection between your time in the service and your sleep apnea diagnosis.

If you have other conditions that are already service-connected, such as PTSD, your sleep apnea could be what’s called a “secondary service connected” issue. Sleep apnea could also be the cause of another condition.

The South Texas Veterans Health Care System in San Antonio  at the Audie L. Murphy VA Medical Center has a full diagnostic testing lab for veterans. The website also includes printable PDFs with information on better sleep.

But if you are experiencing severe sleeping problems, it’s important to get started on a sleep study and getting treatment (including a CPAP, if possible), even if it’s not service connected, so that you can start sleeping better. There are organizations that can help you get a CPAP if you’re unable to afford one on your own. Your doctor can work with you to determine if it is, in fact, service connected, and write a prescription for the CPAP.

If your claim for sleep apnea has been denied, it’s time to enlist the help of an attorney who understands the VA disability claim system.

Helping Houston’s Veterans With Sleep Apnea Claims

William Herren has worked with veterans in the Houston area for more than 20 years to help them get their VA disability benefits.  Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and with our contingency fee arrangement, we don’t charge a fee until we win your case.

Filed Under: Long Term Disability Tagged With: , , ,
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