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Overwhelmed by the Social Security Disability Process? We May be Able to Help

By Rick Fleming

When it comes to applying for Social Security Disability benefits, you have two options. You can apply yourself or you can apply with the help of a Social Security Disability lawyer.

More than two-thirds of those who file for Social Security Disability the first time are denied, according to the Social Security Administration. And 88% are denied a second time. That is just one (or two) good reasons to consider hiring an experienced Social Security Disability lawyer. We cannot light a fire under the government, but we can try to do everything possible to make sure your case is solid and keep it moving forward.

Here are more good reasons to consider a James Scott Farrin Social Security Disability lawyer to help you make a claim for benefits.

Inside Experience at Social Security Disability

The majority of the people who work in our Social Security Disability department used to work for the Social Security Administration where initial applications are accepted or denied.

We can tell you from firsthand experience, you cannot be over prepared when it c

omes to having your paperwork in order and when preparing for your interview.

Our inside experience is helpful in when it comes to navigating the system, including:

  • What the Social Security disability examiners look for to approve a claim
  • The importance of filing the correct forms, filling them out correctly, and meeting demanding and unwavering deadlines
  • What medical records you need to produce – and which ones not to produce

The paperwork alone can be overwhelming for one person, and your peace of mind is high on our priority list. Not only can we help you complete all the required forms correctly, process them on time, and in the manner in which Social Security Disability requires, but we can also follow up in a timely manner and try to keep the process moving forward. Moving forward is key. The current wait time for Social Security Disability hearings in North Carolina is between 19 and 21 months.

We can also help obtain your medical records so that if your case goes to hearing, we know we've tried to do everything possible to make sure your information will not be denied because of a technicality, for example.

We will make sure we ask you about all the personal and financial information the administration will want to know, like your living arrangements, income (including that of your spouse) and value of your assets and investments.

We will make sure you are kept up-to-date and contacted as necessary for added peace of mind.

We will be your advocate in every way possible. But there is one very important t

hing we cannot do for you, and so we ask each and every client to:

Keep your medical appointments.

We cannot tell you how many cases have been denied because people who say they are disabled do not keep their medical appointments. Without medical documentation of your disability, there is simply not enough medical evidence to support a disability claim.

With an experienced team by your side, you may be able to avoid the nuisance of meeting deadlines and constantly calling doctors and disability government offices. On top of trying to get the benefits you may need to survive, you are also recovering and rehabbing from an injury or illness. With our Social Security Disability team handling the paperwork and our paralegals and lawyers staying on top of the legal issues, you can focus on managing other areas of your life like trying to heal.

Attorney Fees – Capped by the U.S. Government

The federal government has capped the contingency fees of Social Security Disability lawyers to make legal assistance more affordable and within reach for those who are struggling financially and unable to work.

The contingency fee for Social Security Disability clients is limited to 25% of back-due benefits, or $6,000, whichever is less.

Get a FREE Case Evaluation From NC Social Security Disability Lawyers

Of all the attorneys licensed in NC, fewer than 1%* are Board Certified Specialists in Social Security Disability law. I am one of them. I also chair the N.C. State Bar's Social Security Disability Law Specialty Committee and I lead the committee charged with writing and grading examinations for attorneys who wish to specialize in Social Security Disability law. You could say I live, eat, breath, and sleep Social Security Disability law.

If you or your family have questions about the Social Security Disability process or if you are overwhelmed by the paperwork and the application process, contact us or call 1-866-900-7078. We will give you a free case evaluation and let you know if we can help you try to obtain the Social Security Disability benefits you potentially need.

*Percentage as of December 31, 2016. Figures provided by the N.C. State Bar as of December 31, 2016

Will My Health Insurance Continue if I File for Workers’ Comp?

By Ali Overby

Many people wonder how filing a workers’ compensation claim might affect their employment status and their benefits – especially their health insurance.

It’s important to understand that your employment relationship with your employer should remain the same even though you have filed a workers’ compensation claim for an on-the-job injury. Although you are pursuing a claim, you are still an employee of this employer and you should continue to receive benefits just as you always have. You should pay the same health insurance premiums, if any, that you are normally required to. Your employer should continue to pay their portion of your health insurance as they have been doing.

What Happens if I Go Out of Work Receiving Workers’ Compensation Checks?

If your authorized treating provider writes you entirely out of work or your employer is unable to accommodate your work restrictions, you will be placed out of work. You will stop receiving your regular paycheck and you should begin receiving weekly workers’ compensation checks from the workers’ compensation insurance company that services your employer.

This is called temporary total disability or TTD. Your TTD payments are two-thirds of your average weekly wage for the 52 weeks prior to your work injury. While you are out on TTD it is important to talk to your employer about how to maintain your health insurance coverage.

If you usually contribute to your health insurance premium through payroll deduction, your employer may not automatically notify you that you need to continue making these contributions to maintain your health insurance.

Do not assume your regular health insurance contributions are coming out of your TTD check!

If your employer continues to make health insurance payments for you, but you are not making your usual contributions, your health insurance may end up being cancelled before you ever realize you owe anything. Talk to your employer, and find out if you need to send in a check each pay period to keep your health insurance coverage current.

What Happens to My Health Insurance if I’m Fired?

Unfortunately, you can still be fired by your employer even if you have an open workers’ compensation case. If you are terminated, you can expect your health insurance benefits to end the same way that they would for any terminated employee.

You have the option of temporarily continuing your health insurance under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Your health plan administrator must give you a notice stating your right to choose to continue benefits provided by the plan. You then have 60 days to accept coverage or lose all rights to those benefits.

If you elect to continue coverage through COBRA you will have to pay the full cost of the coverage plus a 2% administrative charge. If your employer was paying the bulk of your health insurance expense before your termination you can expect that health insurance through COBRA will likely be much more expensive than you are used to.

COBRA generally applies to all group health plans maintained by private sector employers (with at least 20 full-time employees) or by state and local governments. If you work for an employer that has fewer than 20 full-time employees, North Carolina has a state continuation program similar to COBRA. Either way, you may want to shop around and consider other insurance companies to find your best options for obtaining private insurance.

Get a FREE Case Evaluation from NC Workers’ Comp Attorneys

If you are concerned that your employment status or your right to health insurance benefits may have been unduly affected by your workers’ compensation case, contact one of our workers’ compensation lawyers right away. There is a lot at stake, and if you are trying to negotiate on your own against a big powerful insurance company, you are likely at a huge disadvantage.

There is no charge to call us for an initial case evaluation. It is completely FREE to you.

Click here to contact us or call 1-866-900-7078 for a free case evaluation.

P.S. Think you can’t afford a James Scott Farrin workers’ comp attorney? Click here to see why you can.

Categories: Insurance Coverage

What is a Functional Capacity Evaluation and why is it so important?

By Susan Vanderweert

Your doctor is generally responsible for releasing you back to work when your medical treatment has concluded. To avoid liability and the risk of further injury, a medical release is usually required before you return to work. If your injury was minor and your recovery was complete, it may be relatively easy for the doctor to determine that you are capable of returning to your former job. However, in many cases, it is more complicated to determine just exactly how much work an employee is capable of doing.

Sometimes the doctor will feel comfortable assigning work restrictions based on their own opinion about your physical ability. Often, though, especially with more serious or complicated injuries, doctors prefer to base your work restrictions on a Functional Capacity Evaluation (FCE), which is supposed to be based more on science and facts than thoughts or opinions. In those cases, your doctor may refer you for an FCE.

An FCE will help your doctor determine:

  • When it is physically safe for you to return to work
  • When you are physically able to do the same job you did before you got injured
  • How much physical effort you can safely perform at work without reinjuring yourself

What Does a Functional Capacity Evaluation Check For?

FCEs are performed by a physical therapist or occupational therapist. The tests generally last for several hours and involve a number of physical challenges, such as repetitive lifting, bending, walking, and stair climbing. These tests are intended to measure your exact physical strengths and weaknesses and compare them to the actual requirements of your job.

How Some Providers Have Used the FCE Against Injured Workers

Often we have come up against situations where some insurance companies have used FCEs as weapons instead of useful tools in their efforts to try to:

  • Convince the doctor that our clients were faking or exaggerating their injury
  • Send clients back to a job that was too physical for them to handle
  • Release our client from treatment before they were physically ready

When the manager of an injured truck driver tried to get him to go back to work before he felt ready, he asked for a second opinion. That’s when things got ugly and he contacted us. Read Christopher’s story here.

Unfortunately, not all FCEs are created equal. FCE standards vary from provider to provider. Some FCE tests are more accurate than others at measuring a person’s capacity for actual work over an eight- to 10-hour work day. Some FCE tests are not based on scientific standardized methods.  FCEs are not always fair, nor are some FCE providers necessarily unbiased.

Truth be told, we have firsthand knowledge that some FCEs have been intentionally manipulated by a small number of FCE providers for the purpose of denying the injured worker continued workers’ compensation benefits.  The majority of FCE providers that we have seen do attempt to do a fair and reasonable job for their patients. However, it is the small number of unfair FCE providers that can be used as weapons by workers’ compensation insurance companies to try to maximize their profits and deny benefits to injured workers.

Manipulated Tests and Provider Notes

For example, we have seen one FCE provider consistently instruct injured workers to stop the test and take a rest break. Then that provider would write in the evaluation that the person did not give full effort on the test. Another FCE provider has regularly reported that injured workers had been faking or exaggerating their injuries, when other FCE providers and physicians have reached contrary conclusions for the same workers.

On the other hand, the Catch-22 is that if you put too much effort into your FCE test when you are pushed by the FCE provider, you could reinjure yourself.

You can see that, like Christopher, your doctor may rely on the FCE test to release you to return to work before you are ready or without the proper restrictions. At James Scott Farrin, we know who the more trustworthy and reputable FCE providers are and, on the other hand, the ones who may not have your best interests in mind and who may be more interested in results that please the workers’ compensation insurance companies. For these reasons, it is very important to contact the professional team at James Scott Farrin as soon as possible, and be aware of these issues when your doctor starts talking about releasing you from treatment or returning you to work.

How You Can Help Your Case

Remember that your employer and their insurance company may want to get you back to work as soon as possible. Even if it means getting you back to work before you are physically ready. And remember too, your doctor may not necessarily know exactly what your job requires of you physically or understand the laws of workers’ compensation about returning to work.  For example, some doctors may assume that, if an injured worker cannot perform a job after a trial return to work attempt, then workers’ compensation insurance companies will be perfectly willing to restart workers’ compensation checks. That assumption is very frequently inaccurate.

To protect your own interests, it is best to get a written description of your job functions and discuss it with your doctor in detail. If you are having physical issues or taking medications that will keep you from being able to safely perform your job, you need to let your doctor know. Also tell your doctor if your physical issues on the job could create a danger to other co-workers or the public.  No one knows as well as you the physical requirements and dangers of your job.

7 NC Board Certified Specialists in Workers’ Comp Law

More than half of our workers’ comp attorneys are NC Board Certified in workers’ compensation law. Of the approximately 28,000 North Carolina licensed attorneys* only 140 are North Carolina Board Certified Specialists in workers’ compensation law. Seven of them practice right here at our firm.

What does it mean to be board certified? It means you have an attorney who shows special knowledge and proficiency in their specific area of law, having undergone additional training (and other intense analysis) to become certified as a specialist.

Get a FREE Case Evaluation from NC Workers’ Comp Lawyers

We believe in caution and prudence. And there is a lot to know about workers’ compensation law and the system is extremely difficult to navigate successfully on your own.

That is why we urge anyone who has been injured on the job to contact us or call 1-866-900-7078 immediately after their injury. We will try to ensure that all the necessary measures are taken to preserve your right to workers’ compensation benefits and hopefully help you find medical providers who have your best interests in mind.

*  Figures provided by the N.C. State Bar as of December 31, 2016.

Contact Information

Raleigh Law Office

4325 Lake Boone Trail, Suite 100
Raleigh, NC 27607
Phone: 919-834-1184
Toll Free: 1-866-900-7078

Durham Law Office

280 South Mangum Street, Suite 400
Durham, NC 27701
Phone: 919-688-4991
Fax: 800-716-7881

Fayetteville Law Office

2915 Raeford Road, Suite 204
Fayetteville, NC 28303
Phone: 910-488-0611
Toll Free: 1-866-900-7078

Charlotte Law Office

1001 Morehead Square Drive, Suite 350
Charlotte, NC 28203
Phone: 704-599-1078
Toll Free: 1-866-900-7078

New Bern Law Office

1505 South Glenburnie Rd, Unit P
New Bern, NC 28562
Phone: 252-634-9010
Toll Free: 1-866-780-3422

Greenville Law Office

702 G Cromwell Dr.
Greenville, NC 27858
Phone: 252-355-5205
Toll Free: 1-866-780-3227

Greensboro Law Office

300 N. Greene Street, Suite 850
Greensboro, North Carolina 27401
Phone: 336-665-7072
Toll Free: 1-866-900-7078

Goldsboro Law Office

214 South William Street, Suite 3
Goldsboro, NC 27530
Phone: (919)-731-2581
Toll Free: 1-866-900-7078

Henderson Law Office

514 Dabney Drive, Suite 200
Henderson, NC 27536
Phone: 252-492-4600
Toll Free: 1-866-900-7078

Roanoke Rapids Law Office

709 Julian R. Allsbrook Highway
Roanoke Rapids, NC 27870
Phone: 252-537-9670
Toll Free: 1-866-900-7078

Rocky Mount Law Office

3202 Sunset Avenue, Suite B
Rocky Mount, NC 27804
Phone: 252-937-4730
Toll Free: 1-866-900-7078

Sanford Law Office

703-B South Horner Boulevard
Sanford, NC 27330
Phone: 919-775-1564
Toll Free: 1-866-900-7078

Wilson Law Office

2315 Airport Blvd Suite A
Wilson, North Carolina 27896
Phone: 252-246-9090
Toll Free: 1-866-900-7078

Winston-Salem Law Office

301 N. Main Street, Suite 2409-C
Winston-Salem, NC 27101
Toll Free: 1-866-900-7078