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.

Filed Under: Veterans Disability Tagged With: , ,

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: , , ,

Overview of Long Term Disability Policy Age Limits

May 6, 2019 by

The average length of a disability that keeps people from working is about three years, and depends on the type of disability they have and their age. As recoveries go, a person in their mid-twenties usually recovers from a disabling illness or injury faster than a person in their mid-fifties or sixties. But depending on the type of policy you have, long-term disability (LTD) may last six months, a year, or longer. Will it last long enough?

houston disability lawyer

What Type Of Policy Do You Have?

There are two types of policy coverages.

  • Your policy may cover you for “any occupation,” meaning that you’re covered as long as you can’t work any job doing anything, whether or not it’s related to your current job and/or vocation, for the same or less money.
  • Your policy covers you for “own occupation,” meaning that you’re covered as long as you can’t perform your current occupation. Whether you can perform another occupation for which you’re qualified isn’t a determining factor.

Some policies combine the two, with “own occupation” for the first two years, and “any occupation” after that. Other policies offer a cost of living increase as an optional benefit that may cost more.

How Long Do LTD Benefits Last?

Most group LTD policies last until age 65, or until your actual retirement age. The presumption is that once you’re retired, you no longer need the income from your employment.

Most people assume they will retire at 65, but SSA has changed retirement ages for different individuals. Currently, individuals born in 1955 or later can retire at age 66 and 2 months. If you were born after 1960, your retirement age is 67.

Look for LTD benefits to end, with some exceptions, at your time and age of retirement.

Benefits Beyond 65

Purchasing a long-term disability policy with a benefit period longer than five years is more expensive, but comes with an additional benefit. You can choose a “lifetime” benefit period that will pay you as long as your disabled, even after retirement age, as long as you were disabled before the age of 60. This will be especially helpful if your disability is expected to last for many years, or is considered permanent.

These kinds of policies tend to be much more expensive, and could be harder to find. If you’re unable to get one, at least purchase a policy that will pay you until your legal retirement age. With an employer’s policy, your status will automatically change to “retired” once you reach that retirement age bracket.

Most LTD policies pay 60% to 70% of your regular salary and none will pay 100%. Different policies have different exclusions and restrictions.

Some policies have “level premiums,” which stay the same for the life of the policy. This is useful

Additional information, and a checklist for buying a policy, is available at the Consumer Federation of America’s website.

Houston Disability Lawyer Can Help With Your LTD Claims

Our Houston disability lawyer William Herren is experienced in handling all types of disability applications and claims including LTD claims, and our law office has helped more than 4,000 Houstonians, too. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation with one of our disability attorneys. There’s no obligation. There are no up-front charges, because we’ll take your case on a contingency fee basis. You only owe us a fee when we win your case.

 

Filed Under: Long Term Disability Tagged With: , ,

Long Term Disability Exclusions To Watch For In Houston, TX Insurance Policies

April 25, 2019 by

Applying for long term disability to protect you when you’re not working is a long, difficult process. After the doctor visits, test results and treatment plans, you’ll wait for a decision, sometimes for a while. You may also receive a denial letter, based on your condition.

Long Term Disability Exclusions Houston Texas

“Exclusions,” as they are called, are one of the many intricacies of long term disability policies—the things the policy and/or carrier doesn’t cover. The first step is to review your policy and find the Long Term Disability exclusions so you’ll have a better understanding. Here we’ll discuss the different types of exclusions.

What A Policy Won’t Cover

The most common LTD exclusions include:

  • Car accidents when you are driving under the influence
  • Self-inflicted injuries, whether sane or insane
  • Normal pregnancy
  • Suicide attempts

Some policies may also exclude:

  • Injuries caused by aircraft (exception: passengers on regularly scheduled flights)
  • Injuries on the job (these are covered by worker’s compensation)
  • Criminal actions you commit (or attempt to)
  • Civil disobedience actions, including riots, rebellions and insurrection
  • Other intentional acts that cause disability.

Some insurance policies also have a 2-year limitation on disabilities partly caused by substance abuse.

Pre-Existing Conditions

These are conditions that are currently diagnosed and you are currently being treated for when acquiring your policy. A pre-existing condition will require you to wait a designated period of time before you can be covered for it.

If you have a pre-existing condition, there are two periods: a “lookback period,” which can be anywhere from 90 days to as long as a year, and a “waiting period” before you can be covered.

Your insurance company will look back through your medical records for that period to see if you’ve been tested, treated, or otherwise knew that you had the condition.

Once that’s established, you’ll have a period where you must be covered before that condition can be covered. With some conditions, it could be as long as one to two years.

Getting LTD With A Pre-Existing Condition

You can, of course, get long-term disability with the pre-existing condition—you just won’t be covered for it. Anything in your medical  records is findable and fair game. Even if you don’t tell them, there’s a good chance they will find out eventually, and will use that as a Long Term Disability exclusion to deny you payments.

Different companies handle them in their own way, and some simply won’t cover you. Coverage will also depend on the severity of the condition, and you will likely pay higher premiums. But insurers also distinguish between recoverable conditions and non-recoverable conditions like cancer.

Mental/Nervous Disorders

One sticking point for a number of policyholders is the limit or exclusion of mental and nervous disorders, such as anxiety, depression, stress, and dementia. While some policies don’t exclude them, many do. Other policies have limits on these disorders, typically for 24 months or less.

However, if your disorder that is the result of a different physical condition or injury, (such as a back injury) there may be no limit or exclusion.

Alcohol/Substance Abuse

While this is classified in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-5), coverage may only extend for 24 months. Many policies don’t cover alcohol or substance abuse at all, so review your policy for this potential Long Term Disability exclusion.

Houston’s LTD Claims Attorney

Over 4,000 Houstonians have come to us for help with Long Term Disability exclusions, applications, claims, and appeals. With this experience The Herren Law Firm can help you with your LTD legal issues as well. Contact us today at 713-682-8194 (or use our online contact form) to schedule your free consultation with our Houston Long Term Disability attorney. There’s no obligation, no up-front fees, and we only collect if we win your case.

 

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

Can I Claim Disability Benefits For Hearing Loss In Houston, TX?

March 18, 2019 by

Most people think that losing your hearing part of “getting older.” But it can happen to anyone at any age for different reasons. Age-related hearing loss comes from the gradual loss of hair cells in the inner-ear.

While some individuals are born deaf, hearing loss happens with certain medical conditions, such as Meniere’s disease, an inner-ear disorder. Musician Huey Lewis suddenly found himself unable to hear onstage in 2018, and was diagnosed with possible Meniere’s disease. As a result of his inability to hear during concerts, Huey Lewis and The News canceled their tour schedule.

Can I Claim Disability Benefits For Hearing Loss In Houston, TX?

 

Causes Of Hearing Loss

Meniere’s Disease is just one of a number of possible causes for hearing loss. Other causes include:

  • On-the-job exposure to loud noises, or other exposures to sudden loud noises (power tools, etc.)
  • Tinnitus, ringing in the ears after loud noises (especially loud concerts)
  • Loud music with earphones or earbuds
  • Injuries, such as severe head trauma
  • Childhood illnesses such as measles, mumps, meningitis and chickenpox
  • Abrupt pressure changes from activities like flying or diving
  • Certain medications, such as antibiotics and cancer drugs
  • Chronic disease, such as heart disease, hypertension, stroke, diabetes, and some autoimmune diseases
  • Growths and/or tumor in the ear system
  • Ear wax buildup

If hearing loss prevents you from full-time work, or you are disabled and can no longer work, it may be time to apply for disability.

Qualifying For Disability With Hearing Loss

Like any other type of disability, you will have to meet the qualifications for disability with hearing loss. In this case, you’ll have to verify your hearing loss to medically qualify for benefits.

Although it’s covered by the Americans with Disabilities Act (ADA), you’ll still have to prove that your condition is serious enough that reasonable accommodations by your employer are not enough to enable you to continue working in any job that you might be qualified for. You’ll need to document the essential functions of your job, previous jobs, and how hearing loss prevents you from performing your job even with reasonable accommodations available.

SSA will also require you to have hearing testing using the “Blue Book” disability listing, conducted by an otolaryngologist or an audiologist certified by The American Board of Audiology or The American Speech-Language-Hearing Association. The testing must be done without any hearing appliances, such as hearing aids.

Inform your doctor that you will be applying for disability benefits for hearing loss, and request that he or she review the Blue Book requirements beforehand so your tests are conducted according to SSA’s rules.

First the doctor must conduct a physical exam of your ears, including the internal and external ear, middle ear and the tympanic membranes.

Secondary testing includes:

  • Pure tone and bone conduction audiometry—an average hearing threshold of 60 to 90 decibels or greater in the better ear, dependent upon the testing method, or
  • Word recognition test—a score of 40% or lower in the better ear

If you have hearing loss with a cochlear implant, you will automatically qualify medically for disability benefits for hearing loss at least one year after surgery. If your word recognition score is still 60% or below on a “hearing in noise” test more than one year after the surgery, your benefits will be extended until your hearing improves, if it does.

Translations: Communicating With SSA

If you need an interpreter to properly communicate with SSA, ask for one. SSA will provide a free sign language interpreter for anyone who needs help communicating with them. An interpreter will ensure that the applicant will have an accurate and complete translation of all related communications between them and SSA. Sign language interpreters are bound by confidentiality rules, and cannot repeat what they translated. This offers the same privacy as a person who can hear. A hearing-impaired person won’t have to rely on family members, or be embarrassed trying to communicate with a case worker because they can’t hear or understand the questions.

Let Herren Law Help With Disability Benefits for Hearing Loss

You may be able to collect disability after severe hearing loss, but you won’t know unless you apply. 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 Tagged With: , ,

How To Increase Your Odds Of Being Awarded Social Security Disability Benefits On Your First Try

March 4, 2019 by

Many people are denied when they first apply for Houston Social Security disability benefits. In fact, over 65% are denied on their first application, meaning less than 40% of applicants are approved. So what’s the difference?

Houston Social Security Disability Benefits

The Application Process

Contrary to popular belief, it isn’t SSA’s policy to delay and deny claims the first time around. One of the biggest reasons for an initial denial is an incomplete application form.

You’ll start with the application, and go from there. The Social Security Administration has a printable checklist on its website, along with instructions to complete it. You can download, print, and use this checklist to complete your initial application. If you meet certain conditions, you may be able to complete your application online, without visiting your Social Security office.

Your eligibility assessment is also assessed on your previous work history.

It’s important to have all of the requested information as well as medical information. If you haven’t been under the care of a physician, you may have a more difficult time proving a medical disability. You would need a very good reason, such as not having medical insurance or not being able to afford any, but you still have a very high chance of denial.

Ways To Increase Your Odds Of Approval

  1. File Your Claim Immediately. Getting approved for benefits can be a very long process, and if you wait, your disability insurance may expire. You will have to have worked five of the last ten years to be eligible, and waiting to apply may be too late.
  2. Get Help With Your Application If You Need It. Mistakes and missing information are the main reasons applications are denied. Contact a disability attorney, a family member, or someone from a Social Security field office for help.
  3. Find A Disability Attorney If You Have To Appeal. An attorney who specializes in disability work will know what to do and how to do it, and make sure you’ve done everything correctly by the deadline. More applicants win on appeal with an attorney than without.
  4. Keep Up With Doctor Visits And Medical Treatment. If your disability requires medical treatment, keep up with every appointment, test, prescription and doctor visit. Failing to seek medical treatment for your condition will lead SSA to believe that your condition is not serious enough to warrant disability. SSA believes you should be seen by a “provider” every two months. If you’ve lost your health insurance, using local “free clinics” or other available care may satisfy the requirement. You should also keep up with prescribed medications.
  5. Request An RFC Form From Your Physician. The Residual Functional Capacity (RFC) form is used by examiners to determine your functional ability with your medical condition. These forms are needed to close out a case, and are usually completed by a DDS physician or psychologist. If your treating physician completes it, the claims examiner may use it to create an internal RFC for your case.
  6. Use A Businesslike Demeanor With Everyone You Deal With. In other words, be nice, or it could make your journey a lot more difficult. Caseworkers deal with hundreds of individuals every day in the same situation, and losing your temper or being rude can lead to even more delays in your case. No matter what the situation, be polite and cordial no matter what the situation to maintain good relations and communications.
  7. Contact Your Local SSA Office or Office of Disability Determination Services to check on your case’s status. Don’t make the mistake of calling SSA’s toll-free number, where they don’t have the most current information. Contact the office where you made your application, or the Office of Disability Adjudication and Review if a hearing has been requested.

Why Are More Applicants Approved On Appeal?

It’s a little odd, but true. Administrative hearings may take a year or more to be scheduled. A individual’s disability progresses in that time, increasing his or her inability to work. When appearing in front of an administrative judge, he or she will see you face-to-face and determine disability on sight, rather than on paper. If it’s obvious from seeing you that you’re unable to work, as it is in a hearing, your chances of approval increase as well.

Of the applicants that file an appeal, 60% who hire a disability attorney are approved, compared to the 34% who don’t have legal counsel. A disability attorney who is experienced with Social Security disability claims is familiar with the application and appeals process, and can guide you through it.

Houston Social Security Disability Benefits Attorney

Getting disability is a long process, but we can make it easier. We’ve helped over 4,000 Houstonians win their claims and get the benefits they need. We have the experience to help you with your Social Security application and/or appeals process.  The Herren Law Firm can help you with your application and any necessary appeals. 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.

Filed Under: Social Security Disability Tagged With: , , ,
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