How To Appeal A Veteran’s Disability Denial The Right Way

Even if you’ve crossed your T’ s and dotted your I’s, a denial of your claim is still a strong possibility Many veterans have seen their claims denied on the first try. But that doesn’t mean the VA gets the last word. You have the right to appeal the VA’s decision, but you do have to follow procedure to make sure it’s done correctly. An attorney with experience in VA denial appeals can also help increase your chances of a successful outcome.

How To Appeal A Veteran’s Disability Denial The Right Way

Time Limits

There may be any number of reasons why your claim was denied, that’s why it’s important not to take the initial denial as a final decision. This list of common VA errors may give you several reasons and methods for your appeal.

You’ll have one year from the date of your VA decision letter to file your appeal. If you miss the deadline, you’ll have to start over with a new claim, but you’ll have a new date of application. The time spent working on the first one won’t count towards the second one.

Notice Of Disagreement

The first step is to file an NOD (Notice of Disagreement) with the VA within one year. It’s just a simple statement informing the VA in writing that you disagree with their rating decision. While there isn’t a specific form for it, VA Form 21-4138 is typically used, or just type a letter stating that you disagree with the VA’s decision. You can get the Statement in Support of Claim form online at the VA’s website.

When writing your NOD, don’t begin by listing all the reasons you disagree with the VA; save that for the hearing. You’ll be able to discuss why you disagree with the VA at that point, and you must be specific when you do.

At the top of the letter or Form 21-4138, write “Notice of Disagreement.” Include the date of the letter and the denial decision. State that you plan to appeal and that you disagree with all of the reasons of the denial decision. If you do decide to list some of your reasons, state that it’s not a complete list, and your disagreement is not limited to these reasons.

Sign your letter and make sure to keep a copy for your files (and with your denial letter.) Mail it certified, return-receipt requested to the VA office that sent you the denial letter (unless your file has been moved to a different office. Keep the documents from the post office in your file to show that you met the deadline.

Once that’s completed, start collecting and assembling more evidence to bolster your claim.

Don’t Re-Use the Same Evidence

The evidence you used in your original claim wasn’t enough to get an approval, so you’ll need to find and pull together additional evidence, both from military and VA doctors and from civilian doctors you’ve seen and consulted with. Information from private doctors is allowed, so make sure you’re covered. Get new and additional evidence to support your claim, including:

·         Medical experts—if you have a specific medical condition, your specialist will have strong information to bolster your claim. For instance, if you’ve had a heart attack, your cardiologist would be your best “medical expert.”

·         Vocational experts—if you’re unable to work due to your disability, a vocational expert can write a report supporting your disability claim, explaining why you’re unable to work. This is especially helpful for Total Disability Individual Unemployability (TDIU) claims, which can also be appealed if denied.

·         Psychologists—if your disability is mental in nature, or if your physical condition has caused a secondary service-connected mental condition (i.e., depression due to being in chronic pain), a psychologist or psychotherapist has specific information on how your disability affects you.

·         “Buddy Statements”—if your medical records have been lost (and it happens), a “Buddy Statement” is one given by friends, family, and/or fellow service members who can testify to your service-connected disability. For instance, a colleague who witnessed your disability when it happened is a strong statement verifying your claim. A friend or family member who is involved in your disability care can also verify your day-to-day difficulties and how the disability affects you now. A Buddy Statement can be used for physical or mental disabilities, or both. They are particularly useful when no records of your injuries were kept at the time they occurred.

·         Secondary service-connected disabilities—you may have just one form of disability, but two or three conditions that are less prominent than the first one. With medical evidence to support your claim, make sure any secondary conditions that came out of the primary condition one are listed and included with your claim.

Two Types Of Appeals

You can chose to have our appeal heard by a decision review officer (DRO) or by the Board of Veterans Appeals (BVA.)

If you chose a DRO, you can either request a review of your file and claim, or request a personal DRO hearing. Both offer a somewhat shorter waiting period.

If the DRO denies your claim, you can still appeal to the BVA, but it will take longer. The DRO is an additional chance for a reversal of your claim decision.

Information From the VA

The Veterans Administration website also lists a number of resources, that can help you with your appeal. Use this information when assembling your evidence and starting your claim.

Let Us Represent You

Denied by the VA? Don’t rely on someone who hasn’t had VA claims and appeals experience. We have. Call The Herren Law Firm today at 713-682-8194 (or use our online form) to schedule your free consultation. We’ve helped over 4,000 Houstonians navigate the VA’s complicated application and appeals process to get the benefits they deserve. There’s up-front fee and no obligation, and you won’t owe us a fee until we win your case.

Is Depression A Long Term Disability?

Depression as a disability can be a difficult thing to pin down.

It can be “case of the blues” for two weeks, or something that prevents you from walking outside of your front door for a while. If you’re suffering from a depression that is more than just “a case of the blues,” you may be unable to do your job, or even live a regular life.

Is Depression A Long Term Disability?

Different Types Of Depression

Nearly everyone has felt depressed once or twice in their life or at least knows someone who has. Many cases are short-term and resolve without any intervention.

So-called “situational depression” happens after a sudden, unexpected life change that impacts the individual. These changes can include:

  • Loss of a loved one (partner, spouse, etc.)
  • Loss of employment (layoff, firing, loss of clientele, business closing)
  • Serious illness or injury
  • Any kind of accident

When the situation has been righted, (i.e., the unemployed individual finds a new job) or enough time passes, this depression eventually resolves in most people.

But serious, debilitating clinical depression is an entirely different matter. Some of these symptoms as possible indicators are:

  • Trouble concentrating, remembering details, and making decisions
  • Fatigue
  • Feelings of guilt, worthlessness, and helplessness
  • Pessimism and hopelessness
  • Insomnia, early-morning wakefulness, or sleeping too much
  • Irritability
  • Restlessness
  • Loss of interest in things once pleasurable, including sex
  • Overeating, or appetite loss
  • Aches, pains, headaches, or cramps that won’t go away
  • Digestive problems that don’t get better, even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Suicidal thoughts or attempts

When mental symptoms turn into physical symptoms, it’s time to seek out medical help. There isn’t a blood or lab test to detect depression; the diagnosis usually comes from the patient’s discussion with his or her physician. A doctor may conduct some testing to determine if it is caused by a medical condition or a medication.

Once diagnosed, suggested treatments may include psychotherapy and medications to manage the condition. In some circumstances, these treatments may be nominally effective, or even ineffective. Depression then may turn into a disability.

Is It A Long-Term Disability?

Depression that doesn’t resolve on its own, or with treatment, may be considered a “disability,” but there are a number of caveats that go with it. Getting approved for long-term disability may take some time, and be more difficult than SSDI (Social Security Disability Insurance) if depression is stopping you from working.

Many long-term disability policies don’t allow mental illness as a disability, or put a two-year limitation on them (if your claim is only for depression.)  Because they’re more difficult, you’ll need to prove your condition according to your policy’s disability definition. In other words, you’ll need proof that your disability is so serious and acute that it prevents you from working and inhibits your life in general. Review your policy to find out exactly what it says on the subject so you can gather up the proper paperwork and evidence.

You’ll also need to seek proper care for your depression, and have it documented (i.e., medical records.) If your depression is a result of another underlying medical issue (i.e., injury, chronic pain) you may be able to receive benefits without the two-year limitation. Additional medical evidence that your physical disability alone prevents you from working may be sufficient to secure long-term disability.

Denied? Appeal Your Decision

Anytime you apply for long-term disability, it can be a long process, and your claim may be denied outright. If your depression is holding you back, and making work difficult or impossible, you need time to heal. An attorney skilled in disability cases can work with you to file your long-term disability as well as handle any appeals. It may take time, but you can get help for depression.

Helping You Get Help

If your depression is keeping you from working and living your life, you need help on the way to getting better. The Herren Law Firm can help you with your application, appeals and help you get the long-term disability benefits you need so you can treat your depression and get on with your life. Contact us 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.

Is Your Veterans Disability Rating Inaccurate? Here’s How To Get Your Benefits

The Veterans Administration uses a rating system to determine how “disabled” someone from injuries received during military service. This is the Veterans disability rating that can be inaccurate at times if not properly performed. Your rating determines your monthly disability payments, so it’s important that you’re accurately rated for your condition.

Is Your Veterans Disability Rating Inaccurate? Here's How To Get Your Benefits

Injuries and/or illnesses must be acquired (or aggravated) during your military service to qualify. Many service-related injuries and illnesses may increase over time, increasing your current disability.

How The VA Determines Disability

The VA uses the Schedule of Ratings Disabilities for baseline criteria to determine the percentage that a veteran is disabled. Originally created in 1945, the Schedule is being updated, taking into account the advances in medicine and treatments that are available now.

Before you begin, find out for sure what your current disability rating is now. You may have a letter from them, but you can also research it at the VA’s eBenefit website.

Re-examinations may be required to verify the continuance of your disability. Your ratings may be changed based on these new medical exams.

Type Of Requests

If it has been less than a year since you’ve been awarded benefits, you should file an appeal of your original decision.

If your benefits were awarded more than a year ago, the process for increasing or correcting your disability rating is simpler. Use the VA’s online form 21-526 EZ to start the process. You also can apply in person from a VA regional office, state or county veterans affairs office. Help is also available from accredited veterans assistance organizations. Fill out Form 21-526b, Veteran’s Supplemental Claim For Compensation, if you’re not going online.

Medical Evidence

Before you begin, acquire a copy of your VA claim file. You need to see what’s in it before you proceed. If your claim has been denied, you may find the reason for it, as well as what’s missing in order to re-evaluate your claim.

Make sure that your all of your medical evidence backs up your claim; the VA won’t just take your word for it. Much of it may be in your claim file.

If you’ve been treated by the VA, you’ll need to include the name of the facility where you’ve been treated for your disability. (This includes both VA and military medical facilities.) If your treatment is from private doctors, hospitals and clinics, you will need Form 21-4142 along with your medical records.

Consider Potential Outcomes

Understand that if you request the VA re-evaluate you for a re-rating, they will re-examine your entire case. They may find errors in the original evaluation, and your rating could also be downgraded, leading to a reduction in your disability payments.

That’s not to say that you shouldn’t consider requesting a re-evaluation. You must file based on an increase in your disability not a need for increased benefit payments. Be aware of the possibility of a reduction, and do whatever you can to win an increase. If your claim is denied, you can file an appeal.

The VA does make mistakes. But just because you’ve been told “no” doesn’t mean it’s all over. You have rights, and The Herren Law Firm stands ready to help.

Overwhelmed?

Dealing with the VA can be an exhaustive process. You don’t have to do this alone. The Herren Law Firm have helped over 4.000 Houstonians get the veteran’s benefits they deserve.  Contact us today at (713) 682-8194 or (800) 529-7707 for a free consultation for help with a VA claim. Our contingency fee arrangement means you won’t owe us anything unless we win your case.

What is ERISA and How Might it Affect My Long Term Disability Claim?

ERISA is short for Employee Retirement Income Security Act, established in 1974. It’s is a 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.”  Unfortunately, it doesn’t always work that way.

What is ERISA and How Might it Affect My Long Term Disability Claim?

ERISA governs long-term disability policies and only applies to most private employers that offer benefits. It was created to ensure that plan administrators didn’t misuse pension and other employee funds. Public (governmental) or church employees (including church-owned hospitals) and private policies are excluded. ERISA only establishes minimum standards for employers who do offer benefits for their employees. It doesn’t require them to offer benefits.

ERISA And Long Term Disability Policies

A lot depends on what your company and the policy calls “disability.” Research your policy and find out exactly how yours defines it since it could determine if you can get LTD and for how long.

Some policies say “any occupation,” which means you’re unable to work at any job. “Own occupation” indicates that you can’t work in your current occupation, but you could work in a different one. (For instance, an injured construction worker who becomes a project manager.)  Some policies go from “any occupation” to “own occupation” after 24 months, meaning you could work another job, even if you can’t work in the one you had before.

Claim denials are common for even the most legitimate disability cases.

ERISA means that if your LTD plan is employer-funded if you should need to file suit, you will:

  • Have a hearing with judge, but no jury
  • Not be awarded attorney’s fees
  • Not be able to recover any damages
  • Likely to be ruled against in a court proceeding

Plan administrators are given considerable leeway in the administration of a plan.

How ERISA Can Keep You From LTD

It was intended to “protect” your rights, but ERISA ends up protecting the rights of the insurance companies. ERISA preempts most state law “bad faith” lawsuits, denying you the right to sue your insurance company should your claim be denied. Unlike a personal injury suit, where you can sue for damages, attorney’s fees and other compensation, ERISA prevents you from doing that. The most you can receive from a lawsuit would be the monies you were originally due when the insurance companies denied your claim to begin with. In the administrative hearing, the judges can only determine if the insurance company committed an “abuse of discretion.”

ERISA has complex rules and regulations that must be followed exactly, and deadlines that must be met without exception. Miss one deadline, or make one mistake in your claim, and the claim will be quickly denied without any opportunity to appeal or reopen your case.

Your employer may have additional requirements, with deadlines, for you to follow before you can access LTD. Ask for any and all related documentation so you can review it yourself. Deadlines and other requirements should be detailed in these documents, so read them carefully and take note of all deadlines you need to be aware of.

Your Doctor

When submitting your LTD claim, you’ll need to prove your disability. Before you file, you’ll need to have copies of all medical records, test results, X-Rays, your doctor’s communications with the insurer, and any other medical evidence related to your case. If you find errors in any of your records, write your doctor a letter and request that they be corrected.

If your doctor declines to help you in your disability case, find another one. A doctor who does support you in your claim can’t guarantee a successful outcome. But a doctor who doesn’t support you can easily sink your claim.

Submit All Evidence In Your Original Claim

Should your case proceed to federal court, you will NOT have the opportunity to submit additional evidence. The judge is limited to whatever is in your claim file. Neither you nor your doctor will be allowed to testify. Make sure that all relevant evidence—medical reports, testing, expert opinions, evaluations, etc.—is included in your claim. Include more favorable evidence than you think you need while the claim is open to ensure it’s complete.

Deadlines Count

Insurers have specific deadlines for filing claims as well as appeals. ERISA appeals are complex and detailed.

The Herren Law Firm can help you with your application, appeals and help you get the long-term disability benefits you need. Contact us 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.

Can I Get Back Pay For My Veteran’s Disability?

You may have already applied for your VA disability payments. You may already be receiving your benefit payments. But are you getting what you’re entitled to? You might be eligible for back pay.

Can I Get Back Pay For My Veteran’s Disability?

Disability benefits are paid from the date of application. But because it takes a long time to receive benefits, the VA begins benefit payments from the date of application. Since it takes so long before monthly benefits start, accumulated benefit amounts from the waiting period are usually paid in one lump sum. The VA even calls it “back pay.” You may receive a substantial amount of money at one time as a result of your waiting period.

Establishing The Service Connection

Injuries and illnesses that are deemed “service connected” are eligible for VA disability benefits. This includes a pre-existing condition that was exacerbated by your military service.

To be eligible, you must have served in the US military, active or inactive duty for training, received a discharge that was not dishonorable and incurred a disease or injury while in or was aggravated by your military service.

You’ll not only need medical evidence of the service connection (records, etc.), you’ll need evidence to show the relationship between your military service and your illness or injury.

The VA also presumes that certain veterans have a “presumptive disability” by nature of their service record, even if there is no direct evidence of a service connection.

Application Date

It’s important to note that when you apply directly relates to when your benefits start, and when you’ll receive back pay.

Ideally, you should submit your application within one year of your discharge from the military so that your application date is the same as your date of separation.

If you apply one year or more after your date of separation (even one day), the application date is the first day of the month after the VA receives your claim. Most veterans are not aware of this and have the potential to lose a year’s worth of benefit payments.

If your “effective date” is incorrect, the VA may owe you back pay. Many veterans and their families have been given incorrect application and effective dates, and don’t realize they could be owed money.

Re-opening Your Claim

If your original claim was denied, but you have new evidence to support your claim, this could lead to “back pay” when the claim is finally processed. If a medical condition is not noted in your service record, but a later medical exam offers evidence that it was, your claim may be re-opened and re-evaluated. Back pay would result from the original application date to current day.

Pre-Discharge Claims

If you’re now on active duty or in the National Guard and have a discharge date, the VA suggests applying within the period 180 to 90 days before you leave. Formally known as “Benefits Delivery At Discharge,” your claim can be processed much faster, and all medical records can be expedited. Should you be found to be medically unfit for duty, you’ll be given a proposed VA disability rating and a separation date. Use these to file your pre-discharge claim, and avoid losing any time or benefit money.

Are You Owed VA Back Pay?

If you believe the VA has underpaid you, unfairly denied your claim or you need help filing an appeal, The Herren Law Firm is ready to help. We’ve helped over 4,000 Houstonians get the veteran’s benefits they deserve, Call us at (713) 682-8194 or (800) 529-7707 for a free consultation for help with a VA claim. Our contingency fee arrangement means you won’t owe us anything unless we win your case.

FINALLY Get The Long-Term Disability You Deserve In 2018

If you’ve been out of work after a disabling accident, illness or injury, chances are you have a lot going on at once. Between doctor visits and other necessary outings, you’re taking care of yourself and trying to heal while dealing with insurance company requirements. But what about long-term disability?

FINALLY Get The Long-Term Disability You Deserve In 2018

Are you trying to get long-term disability, or headed in that direction? Here are a few things you need to know.

Disability Defined

The definition of your disability is whatever your policy says it is. But the policy definition, rules and exclusions define what they consider to be “disabled.” Your policy definition may look something like this:

Disability exists when, due to illness or accidental injury, you are not able to perform, for wage or profit, the material and substantial duties of your regular occupation.

This definition, known as “own occupation,” means that your illness or injury prevents you from performing your current job and/or occupation. However, an “any job” definition means that you may not be able to perform your current job/occupation, but you are well enough to perform another one, even if it pays less than your current salary. This assessment is also based on your training, education, and experience.

Some policies change from “own occupation” to “any occupation” after 24 months, and benefits may be terminated at that time, particularly if there has been significant medical improvement.

Are You Still Using Paid Time Off?

Long-term disability has a waiting or “elimination” period, generally three to six months, before you’re eligible. You’re required to exhaust all of your sick, vacation, personal and any other paid absence time before you can become eligible for LTO.

Short-Term Disability

The elimination period LTD also takes into account the short-term disability payments you may be receiving. This type of insurance typically lasts less than six months and is intended for a short-term illness that isn’t work-related.

Long-term disability starts when your short-term disability ends.

Short-term disability differs from worker’s compensation, which is for employees who have work-related injuries and/or are injured on the job.

The Length Of Long-Term Disability

LTD starts three to six months after your disability begins, and after you’ve exhausted all time off and short-term disability.

Some policies will pay you until the age of 65 when most people generally retire and will file for Social Security (retirement) and Medicare. If not, there is a limit to the number of years the policy will pay you. Most will pay between 50% and 80% of your former salary.

Social Security Disability Insurance

Most LTD policies will require you to apply for SSDI. If and when your SSDI application is approved, and you start receiving benefits, your LTD payments will be offset by that amount. For instance, if your monthly LTD payment is $2500, and you’re awarded $1800 in SSDI, your insurance company will reduce your LTD payments by that amount, to $700 per month. You’ll still receive $2500 a month, but not from one source.

Working While Collecting LTD

It is possible (although not necessarily recommended) to work while you’re collecting long-term disability. Your benefits could be cut or terminated, particularly if you make too much. Before you start sending out resumes for a new job, even for part-time work, it’s best to read your policy and make sure you understand it first. Speak to your claims administrator to answer any questions.

Some policies may discontinue your benefits even if you’re still technically disabled, especially if you make more than 80% of your previous income. If yours is an “own occupation” policy, you may be able to work in a different occupation and still collect LTD. Again, this is based on how the policy is written, so you’ll need to read it before you start.

Some policies have “return to work” incentives, limiting your benefits and income to 100% of your previous earnings. If your earnings and LTD payments exceed 100% of your previous income, your benefits will be reduced to your pre-disability earnings and will reduce further over time.

Denied Your LTD?

If your insurance company (or your employers) has unfairly denied your claim, stopped your benefits or you need help filing an appeal, The Herren Law Firm is ready to help. We’ve helped over 4.000 Houstonians with their long-term disability cases and can answer any questions.  Call us at (713) 682-8194 or (800) 529-7707 for a free consultation. Our contingency fee arrangement means you won’t owe us anything unless we win your case.

Getting A Divorce? Here’s How It May Affect Your Disability

It’s bad enough that you’re getting a divorce. But can it negatively impact your disability status?

Divorces do tend to increase with the onset of a disability, and factors like the inability of one (or both) to take care of themselves, moving, dividing a household and alimony/support payments can make it even more difficult. If one spouse is a caretaker, that role could change, leaving the disabled person needing professional assistance. And because the disabled person may not be able to work, he or she may be entitled to additional spousal support to make up for the loss of marital income.

Getting A Divorce? Here's How It May Affect Your Disability

It’s a complicated subject, and the answer isn’t cut-and-dried. In this article, we’ll discuss the different facets of divorce and the impact it may have on your disability.

What Kind Of Disability?

There are two types of disability payments:

·         SSI, or Supplemental Security Income—based entirely on financial need, for individuals who have a limited work history and resources. If you are married, your spouse’s income is used to calculate your income needs. There are limits on how much in liquid assets you can own, and you can’t own any “family assets.”

In a divorce, SSI is not considered “income” for the purpose of calculating alimony. If your spouse is no longer supporting you, you may find that your SSI payments increase due to additional financial needs. Alimony is considered “unearned income,” and will be used to determine eligibility and benefit amount.

·         SSDI, or Social Security Disability Insurance—this disability payment is based on your own working record, calculated on “recent working years.” SSDI is granted for medical conditions that prevent you from working and last more than a year. If you are judged “disabled,” you can receive benefits regardless of income. You can receive SSDI for as long as you are disabled.

SSDI would not be directly affected by divorce, and alimony would not be considered for eligibility. If you are required to pay child support or alimony to a prior spouse, this income can be garnished to satisfy the requirement. However, SSDI will be taken into consideration in court when awarding alimony in a divorce proceeding.

Getting Disability From A Former Spouse

If you were married to your former spouse for over 10 years, you may be able to receive disability from his or her record if it would pay better than your own. You can receive these benefits if you are

·         Over the age of 62

·         Unmarried

·         Your former spouse is entitled to retirement or disability benefits through Social Security

·         You would receive less based on your own work record than you would from your former spouse.

You would be able to receive one half of your former spouse’s full disability (or retirement) if you begin receiving benefits at retirement age, but not any delayed retirement credits. If you remarry, you would not be able to receive anything from your former spouse, unless your current marriage ends (by death, divorce or annulment.) The Social Security Administration has additional information on its website. You can find more information about receiving income from a former spouse here.

If Divorce Is In Your Future

You should find out all you can about the financial impact it could have on your disability benefits and your disability status before you file for divorce. The Herren Law Firm can help you protect your disability benefits in the event of divorce. Call us today at 713-682-8194 to schedule your free consultation. There’s no obligation, and we’ll be ready to discuss your case to help you decide your next move. (Please note that we a law firm that handles disability cases, and does not practice divorce law.)

A First Look At 2018 Veterans Disability Rates

If you’re receiving VA disability payments, you’re getting a raise. Check out the new veterans disability rates below.

Veterans who rely on disability benefit payments saw only a small increase of .03 percent in 2017, and there were no increases in 2016. But in 2018, veterans will see full 2% increase (called cost-of-living adjustment, or COLA) in their monthly disbursements.

A First Look At 2018 Veterans Disability Rates

House Bill 1329, titled the Veterans’ Compensation Cost-of-Living Adjustment Act of 2017 authorized this increase. The president signed it into law on November 2nd, 2017.

This is the largest increase in VA disability benefit payments since 2012.  The new, increased rate became effective on December 1, 2017, and will appear in payments issued beginning on December 31, 2017.

If you are a retiring veteran this year, you’ll also see a temporary COLA increase from the increase in active duty military pay given in January.

COLA Calculations

Cost of living adjustments are computed by examining the Consumer Price Index (CPI-W) from the US Bureau of Labor Statistics. Using the CPI-W from the third quarter of both the current year and the previous year (July, August and September), the COLA is based on the increase percentage from the 2016 third quarter to the third quarter in 2017.

This year’s weather disasters in the southern US may have contributed to the assigned increase as well, due to higher gas and other consumer prices  as well as other inflation-related items.

How Much?

If you’re at 10% disability and have no dependents, you’ll receive an additional $136.24 per month, or $1,634.88 for the year.

If you’re at 20% disability without dependents you’ll see an increase of $269.30 per month, or $3,231.60 for the year.

These ratings have no other adjustments for spouses, parents or children. However, things get a bit more complicated with higher ratings.

If your rating is between 30% and 60%, and you’re alone, you’ll receive $417.15 for 30% to $1083.52 for 60%. The rates increase with a spouse, a parent, spouse and parent (one or two), and an additional stipend for a spouse who needs “aid and assistance” (listed as a/a) as well as veterans with children.

For veterans rated 70% to 100% disabled with no dependents, the increased amounts start at $1365.48 for 70% disabled to $2937.96 for 100% disabled. With a spouse, dependent parents and/or children, there are also upward adjustments for each.

Your ratings consist of a single number for any and all conditions that rate you as “disabled.” You can review the complete breakdown of increase amounts here.

As A Reminder

VA disability payments are not listed as “gross income” on tax returns, since it is non-taxable.

Need Help?

If you’re applying to the VA for disability benefits, but can’t seem to get anywhere, call The Herren Law Firm. We’ve helped over 4,000 Houstonians navigate the VA’s complicated application and appeals process to get the benefits they deserve. Call us today at 713-682-8194 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 Receive Long Term Disability While on FMLA Leave?

If you find yourself needing to take time from your job for an illness, injury, pregnancy or other reason, there are a lot of things you’ll need to address. Replacing your income via disability insurance is one important factor to consider, particularly if your leave is unexpected. Here are some things to know when going on FMLA leave.

Can I Receive Long Term Disability While on FMLA Leave?

Long Term and Short Term Disability are two separate insurance policies that many people get through their employer. They’re used separately as well as in conjunction when you’re injured and can’t work.

To better answer this question, let’s examine the parts of it first.

FMLA

The Family Medical Leave Act of 1993 (FMLA) is a law that allows workers 12 weeks of unpaid leave for a variety of medial or family reasons. Your job is protected because your employer is required to hold your job for those 12 weeks. (Many states, localities and municipalities have also adopted their own supplemental “family leave” styled policies.) When you’re able to go back to work, you’ll return to that job or one that is “substantially similar,” assuming you are still able to do your job after your leave is over. You’ll have job reinstatement rights and continued health coverage during the 12-week period (but not after.)

FMLA leave is generally unpaid, although there are some employers who pay during the leave time. However, your health coverage and other benefits are still in place as if you’d never left (although you may be required to pay your portion if your employer covers most of it.)

The FMLA applies to companies with 50 or more employees who work within 75 miles of the company’s location. You must have worked for 12 months in the preview year, totaling at least 1,250 hours, part or full time.

Notification should be given to your company at least 30 days in advance, if possible. (This is for cases like pregnancy, scheduled surgery, etc.) FMLA leave can also be used intermittently, for medical treatments that can’t be done off-hours, physical therapy, etc. Your personnel department can advise you about the best way to schedule this leave and when to notify your supervisor that you’ll be using it.

Short Term Disability

Short Term Disability (STDI) is an income replacement insurance offered as a benefit by many companies, and isn’t available for purchase as an individual policy. STDI partially replaces your income (usually about 60% to 65%) for your immediate financial needs until you are able to return to work.

STDI lasts anywhere from 30 to 180 days, and doesn’t start until after you’ve used up all of your paid time off (sick time, vacation, etc.) Decisions are quick, and payments usually start within about 14 days. A lot of what and how long you’ll receive benefits depends on how your employer structures the benefit policy.

On-the-job injuries are covered under Worker’s Compensation.

Long Term Disability

Long Term Disability (LTD) is an income replacement insurance that begins when your short-term disability ends. LTD is both an employee benefit at many companies as well as a policy you can purchase yourself.

This type of coverage pays you a reduced amount of your salary (generally two-thirds) for the length of your disability. Most disabilities last anywhere from six months to three years, but some may be lifelong disabilities. Your policy will cover you according to how it’s structured. Depending on your disability, LTD could replace your income until you reach retirement age.

Generally, LTD policies require that you exhaust your STDI coverage before you can receive LTD payments, and there isn’t any “overlap.” The LTD elimination period is anywhere from one month to one year.

So To Answer The Question

It Depends.

FMLA leave only lasts 12 weeks (about 3 months) so most of it will depend on how long your STDI coverage lasts. If your STDI coverage is less than 120 days, you’ll have to apply for LTD after the STDI coverage ends, and you have no other “coverage” available (savings, lines of credit, etc.)

Should your STDI coverage last less than the 12 weeks, and you need to cover the rest of your leave with LTD, it is possible to use LTD during an FMLA period.

If You Need Help

Call The Herren Law Firm at 713-682-8194. We’ll be happy to help you with claims, appeals, and other insurance claim related issues that you’re having trouble with. We’ll give you a free consultation and offer a contingency fee arrangement to make payment easier.

How Can I Help My Elderly Family Member With SSDI?

Elderly individuals don’t always have the capacity, understanding or frame of reference to take care of their needed affairs in the face of everything online. Many seniors have gone online, taking care of their accounts and joining Facebook to keep up with faraway family members. But there are still many elderly people who just won’t go near technology.

How Can I Help My Elderly Family Member With SSDI?

When it comes to applying for SSDI (Social Security Disability Insurance), they may not know where to go or who to call or what to do. Fortunately, by becoming an advocate, there are some things you can do to help them.

What Is Disability?

Strictly speaking, the Social Security Administration considers a “disability” as a condition that prevents someone from doing “substantial gainful activity” for a period of 12 months or expected to keep them from such activity for the coming 12 months. For someone who’s working, that means they cannot earn more than $1170 per month (current 2017 guidelines.)

A disability decision will also depend heavily on medical records and an individual’s medical history. The records must contain evidence of a “functional limitations,” or the inability to work. An individual’s age may be a supporting factor in an SSDI case since the Social Security Administration’s system weighs toward individuals over 50. A disabled individual can be working part-time when they apply, so long as they don’t earn more than the current guidelines.

Gather Important Records

Before you start an application, you’ll need to find your family member’s important records. You’ll need this information to complete the application. You can go online to complete the application at SSA, by phone at 1-800-772-1213, make an appointment and visit the nearest SSA office in person.

You’ll need:

·         Their Birth Certificate

·         Social Security Number/Card

·         Marriage/divorce/dependent records

·         Employment records going back 15 years, the last date worked and accompanying W-2 forms

·         Any public assistance they are currently receiving (food stamps, etc.)

·         Medical records, particularly those documenting the disabling condition

·         Any current prescriptions taken by the family member

·         Names and contact information for doctors and/or hospitals prescribing the medications

Medical Evidence

To substantiate the disability claim, the individual must have current medical records that support the claim and explain exactly how the condition (physical or mental) prevents him or her from working (called “functional limitations.”)  If medical records meet all the requirements to a Social Security Impairment Listing, showing exactly why the individual is unable to work, they’ll be approved immediately for benefits. If not, Social Security will then determine what kind of work the individual is suited for.

Disability claims are based primarily on evidence in someone’s medical records. So if your family member hasn’t had a medical evaluation, make sure they get one as soon as possible to establish a “disability.”

How Age Affects The SSDI Application

If your family member is over 50, Social Security considers them to be “close to retirement.” Education and work history is also a consideration, including things like transferable work skills. Residual functional capacity, or what type of work an individual is suited for in their present condition, is also taken into consideration.

Social Security uses a “medical vocational grid” to establish an individual’s ability to work based on prior work and age. Individuals over 65 who are still working but are forced to retire because of a disability generally won’t be required to find other suitable work.

The Hearing

Applicants will be required to attend an in-person or phone interview for their SSDI application. These are primarily to discuss the facts of the case, and a determination won’t be made at that time. You’ll need to have all of your family member’s records available so he or she can answer questions without wasting time.

The hearing is simply a meeting with an administrative law judge whose job is to determine if your family member meets the criteria for “disability.” Answering questions clearly and succinctly are key in getting a determination. An SSDI attorney cases can help with “rehearsing” beforehand or offer a list of questions that may be asked in the hearing.

Patience Is Required

SSDI’s application process takes a long time, and acceptance is not guaranteed. An appeal is almost a necessity before an individual is approved for disability.

Denied for SSDI?

Herren Law has helped over 4,000 Houstonians get the disability benefits they deserve, and we’ll be happy to help you. Call us at (713) 682-8194 or (800) 529-7707 for a free consultation. We’ll talk with you about your case and let you know how we can help. Our contingency fee arrangement means you won’t owe us anything unless we win your case.