Have you ever wondered how Social Security Disability and unemployment benefits intersect? Are you currently receiving one of these benefits and wondering if you’re eligible for the other? The answer is not always straightforward.
When we speak with new clients my office goes through a list of questions that, at first glance, seem unrelated to a disability claim. Have you received unemployment? What is your education level? What do you do on a typical day? We don’t do this boring version of the “20 Questions Game” to be nosy or waste a client’s time. Instead, the answers to these questions can sometimes make or break a claim.
Let’s be clear: A Social Security Disability (SSD) case cannot be won without strong medical evidence. But a good representative knows that it is important to show that the claimant as a person, not just a stack of medical records. In this mini-series, we’ll look at a few of the non-medical factors that can impact a claim.
Receiving unemployment benefits after the date you say you became disabled (“alleged onset date”) can be big issue. There is a conflict between saying “I am disabled” while certifying for unemployment. In order to receive Unemployment benefits the worker has to be *able* to work and *actively seek new employment.* Certifying that those statements are true for Unemployment while alleging, at the same time, that a person is disabled and *unable to work* doesn’t always add up.
There are long delays associated with disability applications and appeals; how are claimants supposed to survive when they cannot work? This is a tough question the Social Security Administration does not clearly address. In 2006 the SSA’s Chief Administrative Law Judge, Honorable Frank Cristaudo, issued a memorandum that stated that receiving Unemployment benefits did not make a aclaimant ineligible for SSD benefits. However, in 2011, a federal court case, Roberts v. Astrue, affirmed that a Judge was correct in using an application for Unemployment against the claimant.
Social Security judges are not consistent with how they approach unemployment. Some do not focus on the issue and leave it up to the State of North Carolina. Others will not award benefits for the time period when a claimant received unemployment; an amended onset date may be required. Changing the onset date may impact the amount of retroactive benefits (“back-pay”) and the date of Medicare eligibility.
In short, when it comes to Unemployment, honesty is the best policy. If you decide to apply for Unemployment be truthful about your Disability application status. Also be sure your SSA Disability representative knows if you received unemployment benefits.
Have you or a loved one been diagnosed with a disability that limits your ability to perform daily tasks? If so, you may be eligible for Social Security Disability benefits. However, navigating the application process can be overwhelming, especially when it comes to proving your limitations in activities of daily life. But what exactly is the connection of Social Security Disability and Activities of Daily Life?
Activities of Daily Life (ADLs) refer to the basic personal care tasks that individuals perform on a daily basis to take care of themselves. These activities include things like bathing, dressing, grooming, eating, using the toilet, and transferring from one position to another. ADLs are essential for maintaining a healthy and independent lifestyle, and the inability to perform these activities can be a sign of disability.
“Trying to get Disability is like going out to dinner with a nosy person who asks rude questions. It gives me the creeps!” My client called after receiving a package from the Social Security Administration (SSA) questioning her daily activities, pets, eating habits, and chores. In my client’s mind the SSA had gone too far. They already knew her age, weight, and personal medical details. Why did they need to know what she had for lunch?
At the initial and reconsideration stages the SSA often mails lengthy questionnaires (“Adult Function Report”) to both the claimant and the claimant’s contact person. While it is unlikely that the intent of these questionnaires is to be sneaky the SSA does consider the claimant’s answers to get information not always directly asked.
My experience is that the SSA is not looking at if the claimant had a chicken salad sandwich versus pizza for lunch. What the SSA is looking at is if the claimant regularly chops, stirs, and stands for three hours slaving over a tricky recipe. Does the claimant say he cannot walk more than five minutes but takes his Labrador for a 20 minute jog every day? Or, does the claimant say she cannot be around people but is an active member of her church or local Girl Scout troop?
The best way to answer the questionnaires is truthfully. Did you dust the living room but then spent the next three days in bed? If you go to the store once a week but your son carries all the groceries to and from the car, tell the SSA! If, on the bad days you can’t get out of bed, but on the good days you might eat dinner with your family, let the SSA know! It is important to not exaggerate your problems – but it is equally important to not put on a falsely brave face. The Social Security Administration can only make a fair decision if they know the whole story.
Navigating the Social Security Disability (SSD) claims process can be overwhelming and confusing, especially if you are dealing with a medical condition that affects your activities of daily life. That’s where a lawyer can play a critical role in your SSD claim.
An experienced SSD lawyer can help you understand the complex laws and regulations that govern the SSD claims process. They can also help you gather the necessary medical evidence and documentation to support your claim. Additionally, a lawyer can represent you at your hearing, which is a critical stage in the claims process.
Overall, having a lawyer on your side during the SSD claims process can increase your chances of success and ensure that your rights are protected. They can provide invaluable support and guidance throughout the entire process, from the initial application to the final decision.
If you’re injured on the job and receive workers’ compensation benefits, you may also be assigned a nurse case manager to help coordinate your medical care. While having a nurse case manager can be helpful, it’s important to understand your rights and responsibilities when you have a nurse case manager.
A nurse case manager is a registered nurse who works with patients who have complex medical conditions or injuries. They act as a liaison between the patient, their healthcare providers, and their insurance company to ensure that the patient receives appropriate care and resources.
Nurse case managers work with patients who have workers’ compensation claims, disability claims, or other health-related claims. They assess the patient’s medical needs and create a plan of care that addresses their physical, emotional, and financial needs.
Nurse case managers also coordinate medical appointments, arrange for medical equipment and supplies, and educate patients about their medical condition and treatment options. They may also assist with transportation to medical appointments and help patients navigate the healthcare system.
Overall, nurse case managers play a crucial role in helping patients receive the care they need and ensuring that their rights are protected. It’s important for patients to understand who their nurse case manager is and what they do, so they can work together effectively to achieve the best possible outcomes.
Under NC Workers’ Compensation law, employers and their insurance carriers are allowed to hire nurse case managers to assist in coordinating medical treatment. Although the nurse case manager is paid by your employer, take comfort in knowing that they are expected to be impartial and exercise independent judgment. In fact, nurse case managers are required to adhere to the NC Industrial Commission Rules for Utilization of Rehabilitation Professionals in Workers’ Compensation Claims.
When working with a nurse case manager, make sure you know your rights. Here are a few key things to keep in mind:
If you disagree with your nurse case manager’s decisions, it’s important to take action to ensure that your rights are protected. The first step is to communicate your concerns clearly and respectfully to your nurse case manager. Explain why you disagree with their decision and provide any relevant information that you think they may have missed.
If your nurse case manager is unwilling to change their decision, you have the right to request a review by a higher authority. This could be the nurse case manager’s supervisor or the insurance company’s claims manager. Make sure to provide all relevant information and documentation to support your case.
If the review process still doesn’t result in a satisfactory outcome, you may need to consider hiring a lawyer who specializes in workers’ compensation cases. They can help you navigate the legal system and advocate for your rights.
Social media has become an integral part of our daily lives. We use it to share our thoughts, connect with friends and family, and even build our careers. But did you know that it is possible your social media activity can potentially harm your workers’ compensation case? In this article, we’ll answer the question, “How could social media be harming your workers’ compensation case?”
Insurance companies are always looking for anything that might cast doubt on the validity of a claim. For instance, if there was no witness, if there are conflicting reports of how the injury occurred, or if there was a delay in reporting the claim, then an insurer will want to look for other means to verify the claim. One such method is using social media.
Insurers will often use Facebook, Instagram, Twitter, and other social media sites, to investigate your activities to look for contradictions to your claims. For example, if you were to post a selfie of yourself on vacation, when you’re supposedly taking time for recovery, the insurance company may see that as grounds to cancel your benefits.
Other things they look for would be any evidence that you’re doing physical activity not related to your recovery, like posting pictures of yourself playing sports or working out at the gym. They also might look to see if you mention working at a second job. Basically, they’re looking for anything that would show that your injury is not as debilitating as you claim it is or that you’re not taking your recovery seriously.
Social media is a powerful tool that allows us to connect with others and share our experiences. However, when you’re going through a workers’ comp case, it’s important to be cautious about what you post on social media. Anything you share online can be used as evidence against you, so it’s important to use social media responsibly during this time.
Here are a few tips to help you use social media responsibly during your workers’ comp case:
1. Don’t Post Anything Related to Your Case
Avoid posting anything related to your workers’ comp case, including updates on your medical condition, conversations with your lawyer or insurance company, or anything else that could be used as evidence against you.
2. Keep Your Accounts Private
If possible, make your social media accounts private so that only your friends and family can see what you post. This will help you avoid unwanted attention from insurance companies, lawyers, or other parties involved in your case.
3. Avoid Posting Photos or Videos
Photos and videos can be particularly damaging, as they can provide visual evidence of your activities and behaviors. Avoid posting anything that could be used against you, including photos of physical activities or social events.
4. Be Careful About Who You Interact with Online
Be cautious about who you interact with online, as anything you say or do on social media can be used against you. Avoid engaging in arguments or debates, and be careful about what you say in private messages or direct messages.
By using social media responsibly during your workers’ comp case, you can avoid damaging your case and protect your rights. Remember, anything you post online can be used as evidence against you, so it’s important to be cautious and thoughtful about what you share on social media.
If you’re involved in a workers’ compensation case, it’s important to be extremely cautious about what you post on social media. Insurance companies and their lawyers will be monitoring your social media accounts looking for any evidence that could be used against you in court.
That’s why it’s a good idea to consult with an attorney about your social media use. Your attorney can advise you on what you should and should not post on your social media accounts, as well as how to adjust your privacy settings to limit access to your personal information.
In addition, your attorney can help you understand the potential consequences of your social media activity during your workers’ compensation case. They can explain the legal implications of certain types of posts and provide guidance on how to avoid making any missteps that could harm your case.
Ultimately, consulting with an attorney about your social media use can be an important step in protecting your legal rights and ensuring that you receive the workers’ compensation benefits you deserve.
Have you ever wondered if you’re covered by workers’ compensation when you’re coming and going to work? It’s a question that many employees have, but few know the answer to. After all, accidents can happen on the way to work just as easily as they can on the job site.
In this article, we’ll explore whether workers’ compensation covers employees during their commute. We’ll also discuss some of the exceptions and special circumstances that can affect your coverage. So, if you’re curious about your rights and protections as an employee, keep reading to learn more.
What happens if you sustain an injury coming from or going to work? Workers’ comp doesn’t cover any incidents that happen off your employer’s property—but it CAN cover injuries that occur when you are on the premises as you are going to or leaving work. This is called the “going and coming rule.”
The “Going and Coming” rule is a legal principle that governs workers’ compensation coverage for injuries that occur while an employee is traveling to and from work. In general, injuries that occur during a worker’s commute are not covered by workers’ compensation insurance because they are not considered to be within the scope of employment.
However, there are some exceptions to this rule. Walking into work from the parking lot or walking out of work to your car, for instance, are examples of typically acceptable cases for workers’ compensation benefits.
It’s important to note that the “Going and Coming” rule can vary by state, so it’s important to check your state’s laws to determine your eligibility for workers’ compensation benefits. Additionally, if you are injured while traveling for work-related purposes, such as running an errand for your employer or attending a business meeting, you may be covered by workers’ compensation.
In general, workers’ compensation does not cover injuries that occur during an employee’s commute to and from work. However, there are some exceptions to this rule.
If an employee is injured while commuting to or from work, but they were also performing a work-related task at the time, then workers’ compensation may cover their injuries.
Similarly, if an employee is injured while running an errand for their employer on their way to work, they may be covered by workers’ compensation.
Another exception is if the employee is injured while traveling as part of their job. For example, if an employee is a traveling salesperson and is injured in a car accident while driving to a client’s office, they may be covered by workers’ compensation.
If you are injured during your commute to or from work, it can be a confusing situation to navigate. Workers’ compensation typically does not cover injuries that occur outside of work, but there are some exceptions to this rule. Here’s what you should do if you are injured during your commute:
1. Seek Medical Attention
Your health and wellbeing should be your top priority. If you are injured during your commute, seek medical attention right away. Even if you don’t think your injuries are serious, it’s important to get checked out by a medical professional.
2. Report the Incident to Your Employer
Even if workers’ compensation does not cover injuries that occur during your commute, it’s still important to report the incident to your employer. This will help ensure that your employer is aware of the incident and can provide any necessary support or accommodations.
3. Contact an Attorney
If you are unsure whether your injuries are covered by workers’ compensation, it’s a good idea to contact an attorney who specializes in workers’ compensation law. They can help you understand your rights and options.
4. Consider Alternative Sources of Compensation
If your injuries are not covered by workers’ compensation, there may be other sources of compensation available to you. For example, you may be able to file a claim with your auto insurance or pursue a personal injury lawsuit.
Remember, every situation is different, and it’s important to seek guidance from a qualified professional to ensure that you are taking the appropriate steps to protect your rights and interests.
