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: , ,

Is Long Term Disability Income Taxable in Houston TX?

January 22, 2019 by

One of the things you’ll deal with as you begin receiving long term disability income is the difference when you file your tax return. Is it considered taxable income, or not? You may have heard conflicting or confusing advice on the subject. The basic answer is, it depends. We’ll explain the difference.

Is Long Term Disability Income Taxable in Houston TX?

How Did You Pay Your Premiums?

You may have paid your premiums out of your paycheck, separately from your employer, or your employer may have paid it. Or you may have paid part of the premiums, while your employer paid the rest of it. How the premiums were paid makes a big difference.

If you have an individual policy and used after-tax dollars to pay for your LTD premiums, you’ve already paid taxes on the money, so your long term disability income payments are tax-free. However, you can’t deduct the payments as a medical expense like you would with health insurance.

Using pre-tax dollars to pay your individual LTD premiums reduces your taxable income until you begin receiving payments. Once you do, your LTD payment becomes a “taxable income,” because you saved taxes earlier. Therefore, you’ll have to pay taxes on the payments.

If you purchase a group policy through an association, the policies are similar to individual policies, but you can’t deduct the premiums. The tax ramifications are generally the same as the individual policies, and the benefits are tax-free.

Employer-Sponsored/Paid Premiums

The rules are a little different when you are under an employer-paid policy.

When your employer pays all of your premiums but doesn’t include it in your gross income, your long term disability income payments will be taxable.

If you pay part of your premiums, the tax liability will be shared. The same rules apply for pre-tax and after-tax dollars for the portion that you pay for yourself.

If your employer offers a so-called “cafeteria plan,” where you can choose disability as well as other insurance benefits, they’re normally paid on a pre-tax basis. In some cases, the employer for some benefits up to a certain limit. After that, you pay for additional benefits you choose over and above the set limit. These additional benefits can be paid pre-tax or after-tax.

Should you chose to pay with after-tax dollars, that part of your income will be considered tax-free, but you will be taxed on the employer-paid portion. If you pay with pre-tax dollars, you’ll be taxed on both your portion and the employer-paid portion.

Should You Use Pre-Tax Or After-Tax Dollars?

There are benefits to both methods. One way or the other, you still pay taxes on LTD income.

If you never need to file an LTD claim for benefits, you’ll save money on taxes by paying with pre-tax dollars. But if there’s a chance you’ll be filing a claim for disability, you may be better off using after-tax dollars. You’ve already paid taxes on the money you used, so your benefits will be tax-free.

How you pay for your LTD policy is a personal decision. The IRS offers some information on its website. Discussing your options with a tax professional can help you decide which method is right for you.

Your Houston Long Term Disability Attorney

We’ve helped over 4,000 Houstonians have received their LTD benefits. Need help? The Herren Law Firm can help you with your application, appeals and help you through the process, and give you one less thing to worry about. Contact us today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation and no up-front fees.  We only collect if we win your case.

Filed Under: Long Term Disability Tagged With: , ,

How Often Do I Have To Prove That I’m Disabled To Receive Benefits In Houston, TX?

December 11, 2018 by

Getting a determination of disability isn’t the end of your journey. Once you’re declared disabled, you’ll be subject to periodic reviews, depending on your condition. But reviews are part of the process and part of continuing to receive disability payments.

How Often Do I Have To Prove That I'm Disabled To Receive Benefits In Houston, TX?

What Type Of Disability Do You Have?

When you’re approved for disability, your caseworker will set dates for future disability reviews. Generally, these reviews are every three to seven years. However, it also depends on the severity of your disability.

There are three categories of disability conditions:

·         Medical Improvement Expected—if your disability is one that you’ll recover from, you can expect to have a review within six to eighteen months of your original determination

·         Medical Improvement Possible—for conditions from which you are reasonably expected to improve (such as mental illness), reviews are generally conducted every three years

·         Medical Improvement Not Expected—if you’re rated for a condition for which a recovery is not expected, reviews are conducted about every seven years. These conditions can include:

  • Autism
  • Blindness
  • Multiple Sclerosis
  • Deafness
  • Parkinson’s Disease
  • Some Cancers
  • Cerebral palsy

Children who receive SSI will have a review every 3 years. Children approved for low birth weight will be reviewed around their first birthday, and all children will be reviewed at the age of 18 regardless of what type of disability they have.

Navigating the CDR

Social Security is required by law to perform periodic reviews of individuals who receive disability benefits. This includes gathering medical records for review. The CDR, or Continuing Disability Review, is the process for determining your continuing disability.

When the time comes, Social Security will send you one of two forms to fill out and return:

·         If the likelihood of your recovery is low, you will be sent Disability Update Report (SSA-455-OCR-SM, or “the short form”

·         If your recovery probability is higher, you’ll be sent Continuing Disability Review Report (SSA-454-BK, or “the long form.”

From there, they will examine your medical records, any treatments, improvements in your medical condition and any other determining factors, such as vocational training that allows you to begin doing “substantial gainful work.”

Without any improvements, and the inability to return to “substantial gainful work,” your disability payments will likely continue. However, if they are changed, you do have the right to appeal any decisions.

What Can Affect Disability Benefits

Any major change in your medical condition, income, resources, living arrangements and other circumstances (such as marriage or divorce) can change your eligibility. Disability is need-based with limits on assets and income, so periodic “re-determinations” are regularly conducted. If you’re found to exceed the “allowable limits,” your benefits will be suspended or terminated.

Scheduled For A Review? We Can Help

Regular reviews for disability cases are common, they occur every three to five years, and don’t always mean your benefits will end. 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: , ,

Can You Get Long Term Disability for Migraines in Houston, TX?

September 14, 2018 by

If you’re one of the 28 million Americans who suffer with migraines, you know the signs when you’re getting one. Lethargy, increases in pain and the so-called “auras” are sure indicators that it’s about to happen. You may have stressors or triggers that bring on a migraine (like a smell or bright light) that tell you it’s coming. Once that happens, you know you’re down for the count until it passes.

Can You Get Long Term Disability for Migraines in Houston, TX?

You may have relatives, friends or coworkers who don’t offer support. You may even hear the comment, “but you don’t LOOK sick.”  You know you’re in pain, even if they don’t. Medications have varying degrees of effectiveness; some don’t help at all. And if you go to work anyway, instead of staying home, you know your quality of work will suffer until it passes. Meantime, you manage the best you can.

What Is A Migraine?

A migraine is a headache and condition that can seriously impact your quality of life. According to Migraine.com, migraines are the 7th leading cause of disability worldwide. Common symptoms include:

  • Light and/or sound sensitivity
  • Throbbing headaches
  • Blurred vision or other visual disruptions
  • Nausea
  • An “aura”—visual disturbances that includes blind spots, flashing lights, zig-zagging lines, and/or “seeing stars”

There may be other accompanying symptoms, such as fatigue and/or lethargy. Migraine episodes typically last 4 hours to 72 hours. These symptoms can also make work, social events and other everyday activities difficult or impossible to engage in.

Proving The Disability

Getting disability for migraine conditions can be difficult, even though one in four households are likely to have someone who suffers with it. As a neurological condition that’s not visible or diagnosed by a regular blood test, filing for long-term disability can be more difficult.

Note that “self-reporting” your condition may severely limit your benefits, or see them declined Migraines aren’t obvious or detectible through conventional medical testing. Supplying sufficient evidence to prove your inability to work is essential, so you’ll need to use other means of reporting to support your claim. Insurance companies want objective evidence for your diagnosis. A series of documentation will be required to successfully defend your claim, including:

·         Your own journal: record everything related to your condition truthfully and thoroughly—pain, frequency, intensity, severity, treatment, and your level of difficulty. Include dates, times, duration, and other relevant details, i.e., hospital visits, treatments given, side effects of medicines, etc. Your physician may include a review of your notes in your patient record, making it part of any claim evidence.

·         Work with your doctor: you’ll need your doctor’s support for your claim, so you’ll need to follow his or her instructions, including taking prescribed medications. If you’re unable to comply with your physician’s instructions (i.e., side effects of medication) make sure to inform him or her of these difficulties. Their records should indicate that you are doing your best to follow their instructions.

·         Other documentation to support your disability claim: this should include days missed from work, test results taken to rule out any other conditions, any treatments or medications you tried, their effectiveness, and any side effects

·         Testimony from family/friends supporting your activities that are limited by the headaches

·         Your doctor’s notes about your migraines (intensity, frequency, severity, etc.), and if these headaches are compounded by other illnesses or injuries.

·         Records of any hospital visits (including ER) related to your migraines

·         If you’re a veteran, medical evidence verifying the service-related connection, such as an incident that occurred during service time, or that it’s related to another service-related condition.

Migraines As A Catalyst

As painful as migraines are, they can also be a catalyst for additional conditions, such as fatigue, depression, sleep disorders, additional pain as well as other conditions.  If you also experience the “aura” symptoms, you may also be at increased risk for strokes and heart attacks.

Houston’s Attorney For Long-Term Disability Help

Filling for LTD can be a chore under the best of circumstances. With a condition like migraines, it’s more complicated, and of course, can be more difficult. But an attorney experienced in disability filings and appeals can help you gather the necessary information needed to file and increase your chances for a successful outcome.

Over 4,000 Houstonians have received the LTD benefits they need, and we can help you too. The Herren Law Firm can help you with your application, appeals and help you through the process so you can concentrate on getting better. 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: , , ,

What Kind Of Disability Benefits Can You Expect In Houston, TX?

August 30, 2018 by

If you’re applying for disability for the first time, you may be wondering what to expect after your application is approved and you’re successful. Of course, every case is different, and we can’t give specific legal advice here. But if you’re getting ready to apply for disability benefits, we can offer a general idea of what you might be able to receive.

What Kind Of Disability Benefits Can You Expect In Houston, TX?

Two Types Of Disability

Disability comes in two versions: SSDI and SSI. While they’re both commonly called “Social Security,” they’re slightly different, but use the same means for determining disability.

  • Supplemental Security Income—for those who have never worked, and/or have limited income. SSI is need-based, and is not related to work history. To apply, you must have less than $2,000 in assets of any kind (cash, stocks, bonds, life insurance, etc.) as an individual, or $3,000 as a couple.
  • Social Security Disability Insurance—for those who have worked and earned enough “work credits,” this program is paid into through payroll taxes (visible on your paycheck stub and W-2.) SSDI pays you or certain members of your family if you worked long enough and paid Social Security taxes through regular payroll deductions. You’ll also need to be “medically eligible,” that is, have a long term severe and total disability that keeps you from doing “substantial gainful activity.”

It’s also possible to receive both SSDI and SSI at the same time, depending on your situation. The current maximum federal benefit rate is $750. Should your SSDI fall below that, SSI could make up the difference, depending on what other incomes you may have. However, if you are living with someone, and they are providing food and/or shelter without charge, these “in kind” benefits can be subtracted from your monthly benefit checks.

Texas Disability Benefits

Once you’ve applied for either SSI or SSDI, your claim file is sent to the Texas’s Disability Determination Services (DDS) agency, part of the state’s Department of Assistive and Rehabilitation Services (DARS). DDS claim examiners will review your file, including medical information, and decide whether you meet Social Security’s disability definition. If your claim is denied, you can request a DDS reconsideration.

If you’re eligible for SSI in Texas, you are automatically eligible for Medicare, and should be automatically enrolled. If you’re not automatically enrolled, you should contact your local Social Security to ask about it. You may also be eligible for SNAP benefits (also known as “food stamps.”) These depend on where you live and what your monthly income is.

For disability recipients in who receive Medicare-paid institutional care, Texas adds $60 for those with “countable income” of less than $60 per month. Additionally, as a resident in institutional care, you would only be able to keep $30 of your federal SSI payments.

While Texas doesn’t award additional disability benefits, the state offers additional resources and programs for individuals who are on disability. You can find some Texas disability resources here.

The Texas Health and Human Services Commission is also available to help with applying for SSI, SSDI and SNAP benefits, as well as independent living services. You can call 211 from anywhere in Texas, or go to Your Texas Benefits website to find a local office.

Assistance is available in the City of Houston through The Houston Mayor’s Office For People With Disabilities. You can contact them by calling 832-394-0814, or email at mopdmail@houstontx.gov.

Waiting Periods

SSDI has a five-month waiting period to begin benefits. Even if your disability is approved on the first try, you won’t be receiving checks until at least the fifth completed month after you become disabled. However, it’s more likely that approval will take six months to a year. Once your payments start, you’ll also receive a “backpay” lump sum for the months you were eligible but weren’t paid.

Your Houston LTD Disability Attorney

Most attorneys aren’t familiar with the intricacies of disability filings, but we are. With over 4,000 successful cases, we focus on helping disabled people receive the benefits they need. We’ve handled multiple situations that are similar to yours. We have the experience to help you through the process for a successful outcome.  The Herren Law Firm can help you with your application, any necessary appeals and help you get the disability benefits you need so you can live 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.

 

Filed Under: Long Term Disability Tagged With: , ,
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