Yearly Archives: 2009

SSD and Workers Comp in Utah

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Some state legislators will do just about anything to keep their state looking business friendly. A Utah law that reduces workers’ compensation benefits for workers over 65 that receive social security benefits has been ruled unlawful. In most states, only Social Security disability benefits are reduced when the injured worker receives periodic workers’ compensation payments. The law Utah tried to hold up essentially kicks injured workers’ off of periodic compensation payments simply because they turn 65. You can read the article here.

Insurance companies and business lobbyists will often push government to pass laws that keep older workers from receiving full workers’ compensation benefits. Having a workers’ compensation age cut-off reduces exposure for insurance companies and hurts the leverage of injured workers negotiating with insurance companies. This is something that businesses in North Carolina are actively pursuing. Unfortunately, state legislatures are often willing participants in passing these laws because it makes them look more business-friendly. I imagine this will continue to be the case as long as big business have more money to lobby with than injured and disabled people.

This article was written by Chip Permar

Understanding SSA Denial Paperwork

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It has finally been recognized that the Social Security Administration needs to provide more detail in denial notices. The US Government Accountability Office (GAO) determined that denied claimants sometimes received communications with inconsistent or hard-to-understand information. Medical sources and reports were not clearly linked to how a determination was made. The SSA generally agreed with the GAO but said that it would require computer system changes with funding for information technology. The story can be read here.

I have read hundreds of application and reconsideration denials. The Social Security sends out these form letters and except for a few lines in a few paragraphs, the denials are always very similar. It is almost impossible to understand exactly what information was used to make the denial. It is nice to see that the GAO has called out the Social Security Administration and that there is a chance something will be done.

This article was written by Chip Permar

Winston-Salem Company Offers Hope for Chronic Back Pain Sufferers

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Back injury is a frequent cause of concern among many of our clients. There are just so many ligaments, discs, nerves, muscles and tendons. Let’s face it — if your back hurts, you pretty much hurt all over. We recently heard about a new invention called VerteLoc. It’s hailed as a “minimally invasive spine stabilization system” and the inventors are in North Carolina. The implant is unique in that it uses human bone rather than metal screws and bolts to limit the motion of the affected spine segment.

With early intervention in back problems, there’s a shorter recovery time and you get back in your daily routine quicker. If you have lower back pain caused by osteoarthritis and spinal stenosis, VerteLoc may help you. News sources state that it was first implanted in May 2008. There are more than 330 US patients within this first year. Here’s a link to their website. We haven’t had a client yet who has used this device, but we’re all for people feeling better quicker. We’ll keep you up to date as we hear more about this invention.

This article was written by Chip Permar

Inclusive Health

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If you do not have a health plan with an employer and if you are looking at higher premiums because of a pre-existing medical condition, you may qualify for the North Carolina Health Insurance Risk Pool (NCHIRP), commonly called Inclusive Health. This individual health plan also helps people whose jobs have been lost due to overseas competition and people who have used all of their COBRA benefits.

Established by the State Legislature which underwrites the plan that began offering coverage in January, Inclusive Health participants may pay premiums that average $300 to $500 a month. This plan is only available to residents of NC who have no access to group coverage and who do not qualify for Medicare or Medicaid. This is not a family plan. Each family member who qualifies will receive his/her own separate rate which applies to his/her own circumstances.

Learn more about the program and to access enrollment details and forms by clicking on their website here. You will also see a list of medical conditions that automatically qualify a person for Inclusive Health Coverage.

Obtaining some type of medical treatment is crucial for those individuals applying for Social Security Disability. The Judges who hear your case want to know what the doctors are saying about your condition. No treatment often leads to a denial. Claimants applying for Social Security Disability need to be resourceful and determined to get treatment. Programs like this offer people who cannot otherwise afford private health insurance another option.

This article was written by Chip Permar

Why Are Injury Victims Expected To Wait So Long For Recovery?

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It has become customary for liability insurance companies to “delay and pay” claims of injury victims in North Carolina. Normally, when a person is injured in an automobile or other accident he or she must wait until the very end of the case to receive compensation from the negligent party’s insurance company. When legitimate questions of liability occur, it’s understandable that the insurance company will not pay a claim without more information or proof of negligence. However, what about the clear liability cases?Even these cases can go on for more than a year. In the meantime, the injured party is expected to carry on the payment of everyday bills and expenses.

How can an injury victim who is unable to work make ends meet? And what if the injured party does not have personal health insurance or medical disability coverage and so their doctor and hospital bills fall behind for payment, or, what’s worse, the injured person simply doesn’t go to the doctor and get the needed treatment because there’s no money to pay upfront. Many doctors refuse to treat patients without insurance, hoping for payment later when and if a settlement occurs. Who in the legislative system can right this wrong? It is not a law that the insurance company must wait until the end of the case to start payment. In clear liability cases, the insurance company normally settles the property damage portion of the case very quickly so they are accepting liability and fault on behalf of their insured. But the injury proceeds rarely come forth so quickly.

The insurance company wants to make one payment, in exchange for a complete release, to settle the case. And because of that position, injury victims must wait until they are sure they are finished with treatment before considering a settlement. It is merely the insurance company’s decision to wait and wait and wait to pay for lost wages and medical expenses until one global settlement is reached or until they are legally required by a court to do so. Unfortunately, this can set up the injured person for a catastrophic situation where he or she gets so desperate that the injured party actually considers the often ridiculous low ball settlement offers from the insurance adjuster just to get some money — any money — to survive. And for these injury victims, the “delay and pay” system doesn’t work.

This article was written by Todd P. Oxner