Is It Hard To Get Vision Disability Benefits In Houston?

September 14, 2020 by

Is It Hard To Get Disability Benefits For Vision Related Injuries And Conditions In Houston?

The CDC reports that about 2,000 people per day experience an eye injury. While many eye injuries happen on the job, eye injuries can also occur from a car or other accidents, fireworks, as well as incidents like falls. Veterans may also find themselves with injuries from combat or other duty.

Eye injuries can be difficult to overcome. If they’re severe enough, can inhibit your ability to return to work. You may eventually need to apply for disability after a vision-related injury. The cause of vision impairment or the length of time isn’t a consideration. However, the degree of vision impairment is, as well as how well your medical records support your claim.

Disability For Vision Loss

Your vision loss must be substantial in order to meet the definition set out by The Social Security Administration (SSA). If you have a good vision in one of the eyes, SSA will not consider you “disabled.”

SSA has three conditions for blindness, and most cases of blindness meet at least one. To qualify for disability, you must meet one of them:

  • Loss of central visual acuity (2.02), indicating that you have vision loss in your central field of vision, and your “better eye” is no better than 20/200
  • Contraction of the visual field in the better eye (2.03), indicating that your field of vision is shrinking and that you have a rather narrow field of vision
  • Loss of visual efficiency, or visual impairment (2.04), indicating blurry vision or total blindness, and the vision in your better eye is not better than 20/200 while wearing corrective lenses

A full description of these criteria is available in the SSA Bluebook.

Qualifying For Disability

In order to qualify, you’ll be required to show that your vision loss and/or blindness prevents you from working at any job. The SSA looks at a report called RFC, or “residual functioning capacity” to determine your current level of functioning and how it affects your ability to return to work. It looks at your inability to do things like drive. In other words, how much work are you capable of doing in your current condition?

The SSA also reviews your age, education level, and vocational skill set, and will qualify or disqualify based on their findings. If the SSA believes you are qualified based on the RFC, it will be based on your inability to do any kind of job. You will also receive a medical-vocational allowance.

Re-Employment

If you are considering returning to work, SSA allows a 9-month re-evaluation and trial period every 60 months (5 years.) These nine months do not have to be consecutive, but you should avoid using them all up at once if you don’t have to.

The “trial period” is to see if you are able to re-adapt and work, either in the same profession or in another one. You’re required to report your earnings, expenses, and work-related activities to the SSA.

You’ll still receive benefits if you don’t go over your monthly benefit amount (currently $2,040.) Your benefits will still be available (as long as you don’t earn more), and you won’t have to reapply. However, you’ll be required to report everything to the SSA so that your expenses can be calculated against your earnings.

Should your condition worsen and keep you from continuing working, you can apply for expedited reinstatement within 5 years.

Before beginning the re-employment process, speak with an experienced disability attorney who can guide you through the process.

Get Help For Vision Related Disability From Herren Law

Applying for disability benefits from the SSA brings increasing challenges to prove your case. With the help of an experienced disability attorney, you can make sure you have the evidence you need, your application is properly executed, and stand a better chance at getting the benefits you need.

Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges. You don’t owe a fee until we win your case.

Filed Under: Social Security 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: , ,

How Do They Decide If I’m Totally Disabled Or Partially Disabled In Houston, TX?

December 18, 2018 by

If you’re unable to work due to a disability, “hurry up and wait” is probably a term you’ve heard at least once. Determining disability can be confusing. Are you completely disabled, or only partly disabled? There are a number of questions to answer before you receive an answer.

How Do They Decide If I'm Totally Disabled Or Partially Disabled In Houston, TX?

Qualifying For Disability

In order to receive Social Security disability, you must have worked long enough and recent enough to earn work credits, up to four per year. Once you’ve earned $5,290, you’ve earned the four towards your total of credits.
Social Security only pays for total disability, not partial. You are considered disabled if:

• You cannot do the same work you did before
• You cannot adjust to other work because of your medical condition(s); and
• Your disability has lasted or is expected to last for at least one year, or will result in death

How Disabled Are You?

This question is answered by Social Security’s five-step process that determines how much work you can do, as well as if and when you can be expected to return to work. There are a number of things that are considered the process.
Social Security will ask about your education and work experience. They will also ask about your current job—how did you do it? Can you still do some of it? Can you adjust to doing a previous job, or change professions to perform a new vocation?

One way to determine your abilities is to review your Residual Functional Capacity (RFC.) With the help of their Listing Of Impairments, SS will determine what abilities you have in spite of the conditions of your disability (standing, sitting, interacting, taking directions, etc.)

The determining questions asked involve:

• If you are currently working, and if you earn more than $1,180 per month
• If your condition severely limits your basic work abilities for more than 12 months (lifting, standing, walking, sitting, and remembering)
• If your condition is found in the List Of Medical Conditions that are severe enough to prevent you from doing “substantial gainful activity”
• If your medical condition or impairment prevents you from doing the work you did previously
• If you can do any other type of work. Your age, education, medical condition, experience, transferable skills, and other factors are taken into consideration

One determining factor is whether or not you can do “light or sedentary work.” If you are under age 50 and can do light, sedentary work, you will not be considered “disabled.” However, if you are over the age of 55 with an RFC of “light or sedentary work” and don’t have transferable skills, you will likely be granted disability under the medical-vocational allowance. However, if you can do light work, the SSA will assume that you can learn and perform a new job or vocation.

Need Help With A Disability Claim?

If you’re assembling your application, you may be overwhelmed. There are numerous forms to fill out, doctor visits and conversations to handle correctly. One wrong item can sink your claim.

Let us help. We’re experienced in handling all types of disability claims and have helped more than 4,000 Houstonians get the disability benefits they need. Call The Herren Law Firm today at 713-682-8194 (or use our online contact form) to schedule your free consultation. There’s no obligation, and we’ll take your case on a contingency fee basis, with no up-front charges.

Filed Under: Social Security Disability Tagged With: , ,
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