Is Diverticulitis A Recognized Social Security Disability?

Some people wonder if diverticulitis is recognized as a Social Security disability. Diverticulitis is a condition in which small pouches form primarily in the large intestine but can occur anywhere in the digestive tract. The pouches themselves may not cause a problem. But if they become infected and/or inflamed, they can lead to a range of sudden-onset symptoms, including bloating, gas, constipation or diarrhea, nausea and vomiting, a tender abdominal area, fever, and chills, and a loss of appetite.

Is Diverticulitis A Recognized Social Security Disability?
But as bad as diverticulitis can be, it’s not recognized as a “disability” by Social Security. Their reasoning for this is that it is not only treatable but doesn’t last more than 12 months. As a rule, a condition needs to prevent you from working for 12 months or more or end in death. Diverticulitis usually doesn’t fit the criteria exactly. However, it is possible to receive SSDI (Social Security Disability Insurance) for diverticulitis.

Eligibility

Because diverticulitis generally improves within 12 months, the condition alone will likely not qualify you for SSDI. But if you experience complications such as abscesses, fistulas, dramatic weight loss, and/or intestinal bleeding, your chances increase that you will become eligible. If your medical history indicates a history of long-term digestive illnesses, your chances are higher yet that you’ll qualify for disability.

Social Security’s listing contains conditions that automatically qualify for benefits but does not have a listing specifically for diverticulitis. However many people experience some of the same symptoms as the other digestive listings, and so may become eligible under those conditions.

Qualifying Conditions

If you have one or more of these conditions, you may qualify for SSDI as part of other digestive-related conditions:

• Severe weight loss despite medical treatment and medications, measured as a BMI of less than 17.50 over a six-month period.
Inflammatory bowel disease (IBD), an umbrella term that covers several chronic intestinal digestive illnesses, including ulcerative colitis and Crohn’s.
• Gastrointestinal hemorrhaging, or serious, recurrent bleeding anywhere in the digestive system that required a blood transfusion.
• Short bowel syndrome, in which a significant amount of small intestine is removed, is known as “bowel diversion surgery.”

Social Security will rate you based on a Residual Functional Capacity assessment, or RFC. That is, you’ll be rated based on what you are able to do despite the limitations of your current medical condition.

If you can do some type of work with your current condition, SSA will deny your claim. However, SSA determines that there isn’t a job that can accommodate your condition, or you can’t perform based on your condition and its limitations, you may be approved or benefits under a medical-vocational allowance. In this case, SSA will examine your age, skill set, work history, and other factors to determine if you are able to continue working elsewhere or truly unable to continue working.

Houston’s Social Security Disability Insurance Attorney

As you can see, the laws surrounding SSDI are complex and the process can be difficult to maneuver. With an experienced disability law firm to help, you can get your application completed right the first time and have a better chance of receiving the benefits you deserve.

We’ve helped over 4,000 Houstonians get SSDI and other 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.

What Are Veteran Disability Ratings?

After submitting your application to the VA, you’ll receive a letter informing you about whether or not you’ve been approved for certain veteran disability benefits. The letter will also give you a specific rating for your veteran disability, which ties into the type of benefits you’re entitled to receive.

Veteran Disability Rating
This rating applies to the severity of your disability, and how disabled you are. The VA rates your  veteran disability by reviewing all the medical evidence submitted with your claim. If you have more than one disability for which you’re applying, the VA has a combined rating table that determines a total rating from the multiple disabilities. However, that rating will never be more than 100%, and the VA will choose the highest rating available for the conditions.

The Rating System

The VA assigns ratings as a percentage, in increments from 10% to 100%. This veteran disability rating represents the amount of disability and how it impacts a veteran’s everyday life.

The VA’s Schedule Of Rating Disabilities is the rulebook in which medical conditions are individually rated. The conditions are rated according to the body system, such as cardiovascular, respiratory, and digestive, and then individually by severity. The VA bases its rating on

For instance, in the section for Dental and Oral Conditions, the percentages for different conditions are arranged and rated accordingly:

• 9900—Maxilla or mandible, chronic osteomyelitis, osteonecrosis, or osteoradionecrosis of Rate as osteomyelitis, chronic under diagnostic code 5000.
• 9901–Mandible, loss of, complete, between angles, 100
• 9902—Mandible, loss of, including ramus, unilaterally or bilaterally:
• Loss of one-half or more,
• Involving temporomandibular articulation
• Not replaceable by prosthesis, 70
• Replaceable by prosthesis, 50
• Not involving temporomandibular articulation
• Not replaceable by prosthesis, 40
• Replaceable by prosthesis, 30
• Loss of less than one-half,
• Involving temporomandibular articulation
• Not replaceable by prosthesis, 70
• Replaceable by prosthesis, 50
• Not involving temporomandibular articulation
• Not replaceable by prosthesis, 20
• Replaceable by prosthesis, 10

If you have another condition such as diabetes alongside a dental condition, the VA rates diabetes separately and uses the combined table to calculate a total rating.

0% Disability Rating

Note that a 0% rating indicates that you will not receive payments even though the VA recognizes that you have a medical condition.

However, a 0% rating does render you eligible for other benefits, including:

• Free healthcare and prescriptions through the VA, if you meet the income requirements
• Higher priority for eligibility for healthcare
• Travel cost reimbursements related to medical care from a VA medical facility or a VA-authorized healthcare provider
• Automatic 10-point veterans’ preference while applying for employment with the federal government
• The right to apply for life insurance through the Service-Disabled Veterans Insurance Program (S-DVI)
• Admission to commissaries, exchanges, and morale, welfare, and recreation (MWR) retail facilities, online and in-person

However, you can also file an appeal if you believe your disability should be rated higher than 0%.

Qualifying For Veteran Disability Benefits

Veterans who have a physical or mental service-connected disability that makes everyday responsibilities challenging may be eligible for benefits from the VA for that disability. The veteran must meet the criteria set out by the VA:

• A veteran who became injured and/or ill while serving
• A veteran whose injury or illness worsened while serving
• A veteran whose service-connected injury or illness was not obvious until after their separation date

When applying for VA disability benefits, you need to include medical evidence to support your claim, which can include:

• Military personnel records
• Military medical records
• All private medical records related to the condition that is not from the VA
• All VA medical records pertaining to the condition or related VA medical records that the VA can request on your behalf

Working with an experienced VA disability lawyer can make the process easier from start to finish.

Get Help From A Houston VA Disability Attorney

Whether you’re ready to start your application, need help with an appeal, or want to investigate a case review, we’re ready to assist. You do have the right to legal representation whether you’re starting your application, facing a hearing, or dealing with an appeal.
Call The Herren Law Firm in Houston at 713-682-8194 (or use our online contact form) to schedule your free consultation for VA disability and other benefits. Our contingency fee basis means you won’t owe a fee until we win your case, and there’s no obligation.

Can a Change in Income Disqualify My SSDI Benefits?

Social Security Disability Insurance, or SSDI, is a federally funded program that provides basic minimum income to individuals with disabilities who have limited resources or income. SSDI is intended for individuals with a qualifying work history from their own employment or through a relative, such as a parent or a spouse. The payments are based on earnings history, not the degree of disability involved.

Can a Change in Income Disqualify My SSDI Benefits?

Qualifying For SSDI

Social Security’s criteria involve limits on what a recipient receives, such as:

Income—the 2021 limit is $794 per month
Assets—anything of value, with some exceptions, such as a primary residence. Recipients can’t have more than $2,000 in assets at any time.
Anything beyond those levels of income will disqualify someone from SSDI. Other factors include:
Income from family members—for a married individual, a working spouse’s income will be counted when figuring a payment amount for SSDI
Food/shelter—for someone who lives with another individual, such as a sibling or adult child, that pays for the disabled individual’s living expenses, the free food and shelter will count as “in-kind” income.
• Income earned from working, even part-time

These benefits continue as long as you are disabled. Social Security regularly reviews recipients’ medical conditions, known as a continuing disability review (CDR). If a review shows that your condition has changed so that you are able to return to work on a regular basis, your benefits will cease.

Substantial Gainful Activity

One issue that can affect or disqualify someone from SSDI is Substantial Gainful Activity (SGA), especially if it earns more than $1,310 monthly or $2,190 for someone who is blind. Earned income from a job indicates that a person may not be disabled if they’re able to work.
Volunteer work or work performed for a family member may also be considered SGA, even if they are unpaid. This can happen when the type and amount of work performed would be considered SGA under different circumstances. Even unpaid work can potentially impact SSDI monthly benefits if found to be substantial.

Returning To Work

As a rule, a person is considered “disabled” if the disability is expected to last 12 months or more or end in death. Social Security expects recipients to report any changes or additional income received that could impact benefit payments. However, if your disability isn’t permanent, or you’re interested in returning to work in a different capacity, Social Security offers a “Ticket To Work” incentive program. Recipients can “try out” working again without losing their benefits, including Medicaid/Medicare, as well as train to work in a different occupation.

Using a nine-month trial period—consecutively or non-consecutively—can help determine if you are able to return to work while under the auspices of SSDI. Social Security offers a more explicit explanation of returning to work on its website.

Houston’s Social Security Disability Insurance Attorney

The laws surrounding SSDI are complex and the process can be difficult to maneuver. With an experienced disability law firm to help, you can get your application completed right the first time and have a better chance of receiving the benefits you deserve.

We’ve helped over 4,000 Houstonians get SSDI and other 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 use 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.

Can You Work While Applying For Disability Benefits?

It’s a conundrum: you’re applying for disability benefits because you can no longer work (or will be soon unable.) But while you’re waiting and trying to qualify, the bills keep coming. You need income and have to work, even though you’re in pain and barely or unable to work. So what’s the solution?

Can You Work While Applying For Disability Benefits?

The short answer is: Yes. You can apply for disability while you’re still working, but there is a limit to how much you can earn. As long as you earn less than $1,310, the 2021 threshold for monthly income, you are able to continue working. For applicants who are legally blind, the limit is $2,190.

However, it’s not quite as simple as that.

Substantial Gainful Activity

One of Social Security’s deciding criteria is SGA or substantial gainful activity. In other words, how much are you working, and how difficult is it for you to work? If you are working part-time and earning the limit or under, and are working your claim you can no longer do, chances are you will not appear “disabled” to the SSA.

SSA will investigate your job, which includes both the type of work you do and how many hours you work in that job. They will also examine how much effort you are putting into the vocation, whether you’re working at a desk answering incoming phone calls or in a trade requiring physical labor (i.e., plumber, electrician, carpenter, etc.)

Chances are that if you do continue to work while waiting for approval, an appeal, or an administrative law judge hearing, your chances of approval will decrease. This is especially true for a part-time position doing jobs for which you are claiming disability.

Unsuccessful Working

You may still qualify for SSDI if you:

  • Stopped working due to your disabling condition
  • Applied for SSDI
  • Returned to work to pay the bills while waiting for SSDI approval
  • Were forced to stop working again due to your disability

This unsuccessful attempt at working means you are still eligible for SSDI, and shows that you made a good faith effort but were prevented by your disability.

Since every case is different, the SSA examines the type of work you were doing, what you may be doing now, and how your disability affects your ability to retain gainful employment.

If you believe you may return to work at some point in the future, you will have the opportunity to work again on a temporary “test” basis. If your condition improves, or things change, you will be able to start working again contingent on your abilities. Should you not be able to return to work, you will not have to reapply for SSDI.

Other Resources

Rather than working, you may be able to locate other resources in your community for help until you begin receiving disability benefits. Consider applying for:

Other options include borrowing or cashing out against a 401K, or borrowing against your home. Your disability lawyer can advise you if you’re considering utilizing assets.

Note that applying for Unemployment may be counter-productive. If you apply for Unemployment, the assumption is that you expect to return to work. You may be required to pay back those Unemployment benefits if you are eventually approved for SSDI.

Call Herren Law For Help With Social Security Disability Insurance (SSDI) Claims

If you are planning to apply for SSDI, we invite you to speak with us first, especially if you are still working. The application process is complex, and most are denied on the first try. Most applicants have better success with appeals.

We’re experienced in handling all types of benefit claims and have helped more than 4,000 Houstonians get the benefits they need. 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.

Can I Qualify For SSDI If I Can’t Work With Lupus?

Lupus offers frequent reminders of its presence, causing pain and wearing down the person carrying it. It can make life difficult, and some days, nearly impossible to continue any regular activity. For the individual who finds themselves unable to work, SSDI may be the next step. But just having lupus may not be enough to qualify for SSDI.

Can I Qualify For SSDI If I Can't Work With Lupus?

What Is Lupus?

Lupus is an autoimmune disorder that is characterized primarily by inflammation, pain, and fatigue. It most commonly affects women and some ethnic groups (including African-Americans), and can be crippling. For many patients, debilitating pain and chronic fatigue can make employment impossible.

Characterized by joint pain, fatigue, a “butterfly rash,” and occasionally, fever, lupus makes its presence known over time. The Lupus Foundation of America estimates that approximately 1.5 Americans live with the condition, and there are about 16,000 newly diagnosed cases every year.

Recognized By SSA

Lupus is listed in the Social Security Administration’s “blue book” under Immune System Disorders. Systemic lupus erythematosus is listed under Section 14.02.

Like any disabling condition, Social Security wants to know one thing: how lupus prevents you from working. Your records must show that you have two of these four conditions:

  • Acute, severe fatigue
  • Involuntary weight loss
  • Malaise
  • Lupus-induced fever

And affect two body systems (cardiovascular, neurological, respiratory, mental, etc.)

The condition must also appear frequently and regularly curtail your daily activities, including social functioning and completing tasks in a timely fashion.

Qualifying For SSDI

A diagnosis of lupus from your doctor is not enough—and only the start. Evidence such as medical notes, treatments, and other documentation must show that not only do you have lupus, but the effects are preventing you from engaging in substantially gainful employment. Furthermore, you must show that the effects will last at least twelve continuous months, or will end in death.

Building your case on solid medical evidence gives you a strong foundation for building your case. Working with your doctor and continuing prescribed therapies show that you are proactive in taking care of your condition. Working with an experienced disability lawyer can make this complex process easier.

However, if you don’t qualify for SSDI because your lupus symptoms do not meet SSA’s conditions, you may still qualify for a medical-vocational allowance. You’ll need to show SSA that your lupus symptoms inhibit your ability to work to the point where you cannot find suitable employment that fits your prior work experience, education, and age.

Houston’s Social Security Attorney

Whether you’re applying for Social Security or Disability through Social Security, the laws are complex and the process difficult to maneuver. With an experienced disability law firm to help, you can get your application completed right the first time, and have a better chance of receiving the benefits you deserve.

We’ve helped over 4,000 Houstonians get SSDI and other 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 use 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

Can Rheumatoid Arthritis Be A Qualifying Disability?

Rheumatoid arthritis (RA) is a condition with a range of symptoms and parts. Most people think of RA with swollen, disjointed fingers. This is only one outward symptom of a wide range. As an autoimmune disease, rheumatoid arthritis causes the body to attack the lining tissue in the joints. The painful swelling eventually leads to deformity in the joints and erosion of the bones.

Can Rheumatoid Arthritis Be A Qualifying Disability?

While there are multiple treatments available, they may not work for every patient. RA currently has no cure. The long-term progression of RA could mean eventual disability.

Symptoms

A person with RA may experience:

  • Joint stiffness is generally more difficult in the mornings and following inactivity
  • Tender joints that are swollen and warm
  • Fever
  • Fatigue
  • Loss of appetite

The smaller joints, such as fingers and toes, are generally the first to show signs of RA. However, the disease can attack any joints in the body. RA becomes progressively worse over time, spreading throughout the rest of the joints and the body.

Symptoms of RA can vary from person to person, and in severity. Roughly 40% of diagnosed patients have symptoms unrelated to their joints, such as:

  • Blood vessels
  • Bone marrow
  • Eyes
  • Heart
  • Kidneys
  • Lungs
  • Nerve tissue
  • Salivary glands
  • Skin

Although RA usually affects people in middle age, people of any age can develop it at any time. Women are more likely to develop RA, as well as those with a family history, smokers, and those carrying excess weight.

The RA Diagnosis

Just receiving a diagnosis is not enough to be considered “disabled.” Social Security does consider RA to be a qualifying disability only if it has progressed to severe enough symptoms that prevent you from working. This is the general standard Social Security uses for most conditions. Other criteria are if the condition will last longer than 12 months.

The Social Security Blue Book (Section 14.09) describes the various stages and degrees of RA that meet their specific criteria for disability. As long as you meet the criteria for RA set out in the Blue Book, chances are you’ll qualify for benefits. That doesn’t mean it’s easy—you will still have to demonstrate your disability to Social Security. You’ll need to provide documentation that proves your day-to-day limitations. This may include:

  • Documentation from a physician with a rheumatologist indicating the severity of your symptoms and the limitations they cause you
  • Diagnostics that show the progression of your RA—X-Rays, blood tests, and other lab work
  • Notes from your physician and other providers documenting the progression of your RA
  • Documentation of your response to prescribed appropriate treatments
  • A Residual Functional Capacity form (RFC) that your doctor has completed for you

The more documentation you have, the better. Offering the SSA a detailed and lengthy medical history gives them considerable proof to thoroughly examine your claim.

Detailed records show SSA examiners the full extent of RA symptoms and progression, and how this affects your ability to perform daily job tasks. Your work history also goes a long way in demonstrating your disability.

Conditions Related To RA

There are other co-existing conditions—called comorbidities—that frequently accompany RA:

  • Hypertension
  • Osteoarthritis
  • Sjogren’s
  • Lupus
  • Other diseases involving connective tissues

It’s possible to receive disability for one of these illnesses if you don’t qualify for RA.

Because RA does restrict, and eventually prohibit, a patient’s ability to work, about 35% of patients file for disability within 10 years of their diagnosis.

The period between applying for disability and receiving payments can be months or even years. Over 70% of people who apply for disability benefits for any reason are denied on the first try and must go through a lengthy appeals process.

Applying for disability is an overwhelming task on par with building a house or planning a wedding. A large amount of documentation required can take a long time to obtain. Then your application must be filled out absolutely correctly.

If you’re dealing with RA as well as trying to apply for disability, consider working with a disability attorney who understands the process and can help you ensure that your application is completed correctly. You may be able to receive benefits sooner and avoid the entire appeals process.

Let Herren Law Help You With Your Disability Claim For Rheumatoid Arthritis

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 use 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.

Will I Get Social Security Disability Benefits If I Have COPD?

Chronic Obstructive Pulmonary Disease, or COPD, is an umbrella term for diseases of the lungs that include emphysema and chronic bronchitis. COPD develops when the lungs and airways become irritated, inflamed, and ultimately, damaged. Both result in decreased airflow, more difficulty breathing, and always become progressively worse.

Will I Get Social Security Disability Benefits If I Have COPD?

COPD also adds to the heart’s burden, leading to pulmonary heart disease. Oxygen therapy, medications, and pulmonary rehabilitation are the main treatments available. While lung transplants are considered the “cure,” most patients aren’t healthy or strong enough to undergo the surgery.

Causes

The vast majority of COPD cases are from long-term tobacco smoking, either first-hand or second-hand. A few cases are due to workplace exposure to airborne substances, such as welding fumes, grain, flour and coal dust, cadmium dust, and fumes, among others. Smokers who experience these irritants may have an increased risk of developing COPD long before they would have with just smoking.

Most patients also have other conditions (called “comorbidities”) alongside COPD, including:

  • Hypertension
  • Diabetes
  • Coronary artery disease
  • Obesity
  • Depression and other mental illness conditions

Should you become unable to work due to COPD, disability may be your next option.

Qualifying For SSDI With COPD

A person who is unable to work due to advanced COPD can qualify for SSDI. Like any disability, a medical diagnosis is not enough. You’ll need evidence to prove that your condition is serious enough to prevent you from working for at least 12 months.

The “blue book” requirements for COPD are:

  • A Forced Expiratory Volume One (FEV1) is equal to or lower to the minimum for your height. This is between 1.05 for five-foot individuals and 1.65 for six-foot individuals
  • A Gas Diffusion Capacity (DLCO) of a single breath under 10.5 mil/min/mm Hg or a low amount of oxygen dissolved in the blood either during rest or exercise, determined a low partial pressure of oxygen (PO2) and high partial pressure of carbon dioxide (PCO2).

Additional required medical evidence for COPD disability includes:

  • Physician’s records and notes
  • Results from diagnostic testing, such as:
    • Lung function tests i.e., Lung Diffusion Capacity
    • Imaging: MRIs, CT scans, chest X-Rays
    • Blood tests
    • Arterial blood gas analysis, a test that demonstrates how well your lungs intake oxygen and exhale carbon dioxide
    • Spirometry results or the amount of air you can force out when exhaling), which includes the FEV1 reading

If you can show that your conditions are severe enough, you may qualify even without meeting the blue book listing. You’ll need to show that COPD prevents you from earning a minimum monthly income. The SSA will review your claim and decide upon a “Residual Functioning Capacity” (RFC). It can then approve you for a medical-vocational allowance.

Social Security also considers your age, past work history and experience, and age when making any decision. Additionally, you’ll need enough Social Security “work credits” to qualify for SSDI for any condition. If you do not, you will likely qualify for SSI instead.

Houston Attorney For SSDI

Applying for SSDI is a difficult and complex process. When you work with an experienced disability law firm, your application will be completed correctly the first time. You’ll have a better chance of being awarded the benefits you deserve and avoiding a long appeals process.

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 use 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.

Can You Qualify For Both Unemployment And Social Security Benefits?

The pandemic caused millions to lose their jobs or simply stop working when businesses shut down. Those who could work from home, but others with non-desk jobs had no choice but to leave and take unemployment.

Now that more shutdowns may be on the horizon, more people may be back on unemployment. But if you were also receiving Social Security benefits, you may be wondering how this will work. Can you get both?

Can You Qualify For Both Unemployment And Social Security Benefits?

It sounds odd, but you can, if you meet all of the criteria for Social Security. However, it’s not as easy as it sounds.

Basics

First, unemployment insurance (UI) does not prevent you from receiving Social Security benefits. Earned wages and income from work are what’s considered “income” and counted against the income limits. Unemployment benefits are not counted as “income” under Social Security’s guidelines.

However, UI is handled on the state level, much will depend on the state’s rules. In Texas, you’ll need to speak with the Texas Workforce Commission to find out exactly how the Lone Star State handles UI with Social Security.

At one time, most states reduced the amount of unemployment paid to older workers who also received Social Security. Illinois, Louisiana, Minnesota, and South Dakota still reduce the amount of UI without complete disqualification. In other states, these laws have been largely eliminated.

Qualifying

To apply for Social Security benefits, you must be at least 62 and have a qualifying work history. You must also be:

  • A U.S. citizen or a permanent legal resident of the United States with a documented residency period
  • Show a 10-year work history and have at least 40 work credits. Credits are earned after earning a minimum income level each quarter
  • Not specifically barred from program participation, such as railroad workers whose pension plans opted out of Social Security on their behalf
  • Disabled
  • The retired spouse, surviving spouse, or dependent of a program participant

Social Security Disability Insurance, or SSDI, may disqualify you from unemployment insurance. By receiving disability, it means that you are too disabled to work, and therefore, ineligible for UI.

You can apply for unemployment at any time online through your state’s agency website (such as the Texas Workforce Commission above.) In states other than the above ones, you will not be required to disclose Social Security payments, although it’s suggested that you should mention it to someone you speak with to ensure that everything is in order.

Both Social Security and UI have income limits on what you can bring in before a reduction in your benefit amounts.

Social Security vs. Unemployment Insurance

While it is possible to get both, remember that UI is short-term while Social Security is long-term.

During the pandemic, unemployment benefits were extended and enriched, helping many people make ends meet while they were out of work.

When the full force of pandemic shutdowns happened, many people from 62 to 65 who found themselves unemployed began applying to receive Social Security. While this may help in the short term, in the long term, your lifetime payments are reduced.

But waiting until your full retirement age, whether 65 to 67, depending on your birth date, will ensure that you receive 100% of your earned retirement benefits. If you wait until age 70, you’ll receive even more.

Rescinding Your Social Security Benefits

If you decided to begin taking Social Security while unemployed and change your mind later, you can withdraw your application for benefits until a future date. Here’s how it works:

  • You must file to rescind within 12 months of receiving Social Security
  • You must repay all benefits received, including family benefits
  • You can only do this one time

The advantage is that your application will be an “annulment” for your original start date, and you can continue to work and contribute. Your benefits will grow over time, and when you turn 70, you’ll automatically receive Social Security at a higher rate.

Call Us For Help With Social Security, Disability, And Other Claims

We’re experienced in handling all types of benefit claims and have helped more than 4,000 Houstonians get the benefits they need. 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.

 

Veterans To Receive Reimbursement for Out-Of-Pocket Expenses

Veterans who use the VA system for their healthcare are able to get the care they need without expenditures. But if the VA’s emergency care facility isn’t close enough, a trip to a local emergency room may be required.

A visit to an emergency room is just that—an emergency, usually a life-threatening one. Sometimes emergencies occur when a veteran isn’t able to make it to a VA facility. When time is of the essence, it’s important to find the closest available ER, whether or not it’s the VA’s.

Veterans To Receive Reimbursement for Out-Of-Pocket Expenses

Does The VA Cover Other Medical Expenses?

Veterans are told that if they need emergency care from outside the VA, they will be covered. But as veterans and their families have discovered, emergency care from a non-VA facility is quickly followed by bills. If a veteran has other health insurance, such as through their job, that may cover most of the expenses, outside of a deductible. But in many cases, private health insurance doesn’t cover absolutely everything, meaning that the policyholder must pay the balance out of his or her own pocket.

A veteran can file a claim with the VA to reimburse them for the balance, so long as that sum is no deductibles, co-payments, and co-insurance charges. Unfortunately, many veterans have seen their claims denied on that basis, even though that wasn’t the case.

The Deciding Court Case

In September of 2016, Coast Guard veteran Amanda Wolfe went to a local emergency room seeking treatment for an appendix that was ready to burst. Driving to the VA facility would be three hours and not enough time to be treated quickly as needed. With both her VA benefits and self-paid private insurance, Wolfe presumed that she would be covered.

Her expenses for the emergency visit totaled $22,348.25, and her private insurance covered all but $2,558.54. She filed a claim with the VA for the remainder, only to see the claim denied six months later. The reason, the VA said, was that amount fell under their exclusion for deductibles, co-payments, and co-insurance charges. This put Wolfe in financial hardship, and she personally paid off the amount in 2017.

Wolfe vs. Wilkie

In a case filed by Ms. Wolfe, the U.S. Court of Appeals for Veterans Claims (CAVC) found that the VA’s denial from a 2018 reimbursement regulation violates the Emergency Care Fairness Act of 2010 (ECFA). This regulation requires the VA to reimburse veterans for emergency care from a non-VA facility. The case was later certified as a class-action lawsuit on behalf of other veterans who were also denied reimbursements. The CAVC then ordered the VA to begin reimbursing veterans who saw their claims incorrectly denied.

The CAVC found that VA’s 2018 reimbursement regulation violates the Emergency Care Fairness Act of 2010 (ECFA) that requires VA to reimburse veterans for the emergency medical expenses they incur at non-VA facilities that are not covered by the veteran’s private insurance.

On April 6, 2020, the CAVC ordered the VA to begin mailing out “corrective notices” to more than 1 million veterans who were incorrectly notified that their expenses were not reimbursable by the VA. In the Wolfe case, the VA admitted that original notices with misinformation likely discouraged many veterans from submitting claims for reimbursements. The VA began sending out the corrective notices on April 13, 2020, and begin reviewing and re-deciding more than 72,000 denials beginning May 20, 2020.

Five years prior, in Staab v. Shulkin, the organization appealed to the CAVC after another veteran was denied $48,000 in reimbursements after open-heart surgery because he also had Medicare, which partly covered his bills. The CAVC found similar results in that case, and the VA violated the ECFA in its decision.

What This Means For Veterans Now

The VA’s website has a brief fact sheet on “community-based healthcare” for veterans available on its website.

For those who found their out-of-pocket expenses denied after an emergency room visit, it may be time to revisit the claim. You can call the VA to request information on your claim at 1-877-466-7124.

The VA’s Office Of Inspector General found that similar claim denials could add up to as much as $6.5 billion in repayments to veterans who were previously denied. The internal audit from the VA’s Inspector General is available online here.

Get Help From A Houston VA Disability Attorney

If you’ve been denied reimbursement for out-of-pocket expenses by the VA. You do have the right to legal representation when you come face-to-face with the VA’s bureaucracy.

Call The Herren Law Firm in Houston at 713-682-8194 (or use our online contact form) to schedule your free consultation for VA disability and other benefits. Our contingency fee basis means you won’t owe a fee until we win your case, and there’s no obligation.

Does Macular Degeneration Qualify Me for Veterans Benefits?

Vision problems are one of the many reasons people apply for disability. Macular degeneration, or MD, is a leading cause of vision loss for people over the age of 50, and for people in the US. It’s most common in people over 60. It’s also called “age-related macular degeneration,” or AMD.

Does Macular Degeneration Qualify Me for Veterans Benefits?

As a veteran, you may also experience this condition as well as other vision problems. MD can make everyday life difficult, including driving, working, reading, and seeing what’s right in front of you. If you notice that you are having a difficult time seeing things the way you did before, you may be overdue for an eye exam.

What Is Macular Degeneration?

The macula is a part of the retina in the back of the eye, in the center. That means a person with macular degeneration loses their central vision, but not their peripheral. For instance, when you look directly at a clock, you may see the numbers but not the hands.

Most people don’t completely lose their vision, but simply don’t see what’s right in front of them. In other cases, the vision loss is mild.

There are two types of MD:

  • Dry, the most common type, roughly 80% of the cases, where the macula itself thins considerably leading to the growth of tiny clumps of protein, called drusen
  • Wet, less common but more serious type, where new blood vessels begin growing under the retina and leak fluid into the eye.

Smoking, obesity, cardiovascular disease, and other risk factors contribute to MD’s development.

MD comes on slowly, and most people don’t realize they have it until they begin having blurring. There isn’t a “cure” for MD, and dry doesn’t yet have a full treatment. Regular ophthalmologist visits can detect it early and help manage if you do develop MD.

What Does The VA Say?

For many years, the VA didn’t recognize macular degeneration as a disability. Fortunately, that has since changed, allowing veterans with MD to seek treatment and receive benefits.

The VA puts MD into the Schedule of Ratings as “Organs of Special Sense.” They use these three tools as the basis for determining your eye problems and the impact of MD on your sight:

  1. Central acuity, or the ability to distinguish details and shapes at a distance using an eye chart
  2. Visual field, or everything you can see when staring ahead at a fixed point
  3. Muscle dysfunction, or how well the eye moves around to pick up sight

As with any condition you present to the VA, you’ll need to show MD as a service-related condition (primary or secondary), or provide proof from a physician of the connection.

The C&P Exam

The VA will also require you to take a Compensation and Pension exam, or C&P. This exam determines the degree of your disability and the rating for a disability, and determining the service connection.

The VA requires you to undergo an exam by either a licensed optometrist or ophthalmologist. You’ll also need to provide:

  • A current diagnosis for your eye condition
  • Evidence of an in-service event, illness, or injury that’s related to your condition
  • A “nexus letter” from a physician that connects the current eye condition to an in-service event, illness, or injury

All of these show a direct service connection. However, a secondary service connection is also possible. An existing illness or medication is taken for a different service connection may also cause or aggravate MD as a secondary condition. They can include:

  • Strokes
  • Diabetes
  • Lyme disease
  • Rheumatoid arthritis

If you already qualify for healthcare through the VA, you can also obtain these eye exams and diagnoses from the VA as well. This includes testing for conditions like glaucoma.

Macular degeneration is a relatively newly rated condition under the VA’s disability rules. Getting help from an experienced disability attorney can go a long way in making sure your application is done correctly.

Let Herren Law Assist You With The VA For Macular Degeneration

If you’re a veteran with vision issues including macular degeneration, you can apply for and receive VA benefits for this condition. Should the VA either deny or under-rate your condition, it’s time to get help and increase your chances of success.

Call the Herren Law Firm today at (713) 682-8194 or (800) 529-7707 to schedule your free consultation. Our attorneys are experienced in helping veterans successfully navigate through the application and appeals process, and we can help you too. Our contingency fee means you won’t have to pay until you start receiving benefits.