North Carolina Workers' Compensation Case Mistakes: Not Knowing When to Return to Work

Most employers at the request of the workers’ compensation insurance company will provide light duty to injured workers. Either the employer or the insurance adjuster may then require the injured worker to return to work.

But what type of light-duty is being offered? Prior to returning to work it is necessary to know what you will be doing for the employer. Some employers simply say, “We will find you something”. Unfortunately this actually may breed a hostile environment which may have not only poor ramifications on your recovery but also your employment with the employer.

If you return to work without an established job position then the employer will be forced to come up with tasks over and over again. Other employees often resent having to do this and the immediate supervisor often begins to demean the injured employee without even realizing it simply due to this resentment. Also in this situation the injured employee is asked to do specific tasks without regard to their restrictions.

Social Security Administration Shows Benefits of Electronic File Transfers

An article in the American Medical News, which we found via the Disability News Blog (a great website to stay current on Social Security news) states that a test of electronic file transfer by the Social Security Administration and health providers has proved to be beneficial in receiving a quicker decision for people filing for Social Security disability benefits.

The initial test started with MedVirginia, a medical information exchange serving central Virgina. With this new process in place the Social Security Administration stated that the average waiting time on a decision was cut down from 83 days (roughly 3 months) to 32 days (roughly a month).

From February 29th to May 29th the Social Security Administration submitted 575 request for information via the electronic transfer. Out of those 575 request, 460 cases came back with evidence that was used to establish a need for benefits.

The test phase worked so well that the Social Security Administration will now begin exchanging information with a medical center in Boston. Later this year they will begin exchanging records with the North Carolina Healthcare Information and Communications Alliance.

Friday Feed #11

Friday! Friday! Friday! Enjoy the Feed and the Weekend and we'll see you on Monday.

7 Solar Sensations: From Your Pocket to the Sky
With world leaders committing to developing green energy there is going to be an influx of new innovation when it comes to the use of solar panels. ABC News takes a look at 7 potential products that could be mainstays in the years to come.

8 Crazy Condiments
Did you know Dr. Pepper had a BBQ sauce? Not shocking enough? Okay, Did you know there is a such thing as bacon flavored mayonnaise? Check it out.

Visions of Saturn
This one is pretty self explanatory. Some amazing photos of Saturn.

Ten Most Controversial Calls in Sports History
Refs and umpires, sometimes you kind of feel sorry for them for the guff they have to take. But these ten plays or situations deserved to be jeered.

And we'll end it this week with this amazing shot:

A Common Mistake of Workers' Compensation Cases in North Carolina is Settling For the Rating Only

We have been discussing many different mistakes that can be made during your workers’ compensation claim but what happens when the doctor releases you and says that you are as good as you are going to get? As noted previously, this is called maximum medical improvement. It is at this point in time that you may be entitled to a settlement.

The Industrial Commission has set out guidelines that outline to the treating physician how to assign a permanent partial disability rating. It is called the North Carolina Ratings Guide. It takes into account several different considerations including, but not limited to, the range of motion, the tendency to form arthritis, and the structural damage caused by the injury by accident or as a result of any surgeries that were necessary. Once the physician has assigned a permanent partial disability rating then the insurance company creates a Form 21 utilizing this information which establishes the settlement amount of your case.

In workers’ compensation there is no payment for pain and suffering and the amount of the settlement is guided by the law. The settlement amount is calculated by using a mathematical formula which includes your compensation rate multiplied by your rating then multiplied by the number of weeks assigned to your injured body part. This type of settlement should only be used if you have returned back to work with your employer and you have not had a reduction in your ability to earn wages. By this I mean that you are making the same or greater wages then you were before you were injured. If you are not back to work at a real job or you are making significantly less money then do not settle on the rating alone!

End Near For Five Month Waiting Period

I recently attended the National Convention for Social Security Lawyers (NOSSCR) in Washington, DC. I’ve been to many of these conferences, but this one was very informative. I missed going to all the attractions, but maybe next time. I did learn, which you have read about on this blog, that the 5 month waiting period to begin drawing Social Security disability benefits may be ending.

The waiting period was instituted when Social Security disability was created. It is unfair to people unable to work because of a physical or mental impairment and Congress is now, for the first time, addressing this issue. The amount of people entitled to benefits because of the aging population has increased dramatically resulting in increased attention to this problem.

A bill has been introduced in the United States House of Representatives calling for an end to the five month waiting period. IT WILL TAKE YOUR HELP TO GET PASSED! Write your representative and ask them to support H.R. 33: Social Security Disability Fairness Act of 2009, which is the bill that will change the law. Call our office for a sample letter to send your representative. Handwritten letters are more likely to be read and considered by the representative than an e-mail or computer generated letter. Please send us a copy of the letter in helping get this bill passed.

The burden this waiting period puts on the disabled people in America is unfair. Only if we all work together can this injustice be undone. In this office we are letting our representatives and senators know through examples of the hardships our clients endure. We are working to persuade these members of Congress and we need your help.

Through the efforts of the disabled, their attorneys and all the millions of people throughout America who are in dire straits may be able to receive benefits for the first five months they cannot work because of disability.

Until next time,

Ken

Still on Hold With Social Security? From the Atlanta Journal-Constitution

From the June 17th edition of the Atlanta Journal Constitution comes an article from Vicki Lee Parker on Social Security. The main point of the article, which is becoming a trend with Social Security articles and news, is the wait that is associated with the process.

As any seasoned writer knows you must catch your audience's attention early to keep them reading. Parker wastes no time getting to the facts in her article. Following is an excerpt how she starts her article:

Every day this year, about 10,000 baby boomers turn 62.

Many will have questions about their Social Security benefits, but few will likely get answers —- at least not quickly. The Social Security Administration has reduced its staffing by more than 5 percent since 2003, to about 60,000.

The article then goes on to tell the story of a Raleigh, North Carolina resident who had to call three different telephone numbers before he could get an answer. After that, his problem was still not resolved. Each time he calls in hopes to resolve the issue, he has to tell his story from the beginning. A very aggravating and tedious process when trying to get an answer on very important matters.

Friday Feed #10

It's Friday!!! An early Happy Father's Day to all the Dads as well.

11 Affordable Father’s Day Gifts Dads Will Want

If you're reading this and still haven't purchased your Dad anything, well, this guide might help.

FATHER'S DAY PICTURES: Best Animal Dads

National Geographic takes a look at 7 animal males that go above the call with raising their offspring. Cockroaches may get a lot of bad press, but they seem to be pretty good fathers.

9 Father's Day Outing Suggestions by WRAL Channel 5 (Raleigh)

Check out what is going on this weekend in and around Raleigh for Father's Day.

Top 10 TV Dads of All Time

Jackie Kass breaks down the top TV "Pops" from Dr. Huxtable to Andy Taylor. Well, in Andy Taylor's case, he was a "Paw."

12 Twisted Tornado Facts

Livescience.com breaks down tornadoes from how they get started to their history. Did you know Florida has the most tornadoes per square mile in the US?

10 Off-the-Wall Hot Dogs
You thought a chili-cheese dog was living on the edge. What about a Mac n' Cheese dog?

5,000 KM Beard Growth

Christoph Rehage planned to walk about 5,000 km from China to Germany, taking a photo of himself every day for one year—and not shaving once. Then he made a video of his travels. A pretty awesome video at that.

4 Steps to the Social Security Disability Determination Process

Step 1: Initial Application

To be awarded disability benefits, you first have to assert your right to them. You assert your right by filing an application with the Social Security Administration.

You can make this application in several ways:

- In person at your local Social Security office;

- Over the phone toll-free at 1-800-772-1213; or

- On the Internet at http://www.ssa.gov/

Once you have filed an application, Social Security will turn your application over to your state’s division of Disability Determination Services (DDS). This is an organization designed specifically for the purposes of determining whether or not a person is disabled for purposes of receiving government benefits.

You will go through a process of filling out questionnaires about your medical condition and how it affects you on a daily basis. DDS may send you to appointments with physicians and/or psychologists for further evaluation of your condition. They will also gather your medical records and may talk to your friends or family about your limitations.

Once they have gathered and evaluated all of this information, a decision will be made as to whether or not you are disabled. If you are approved, your benefits will be started. If you are denied you will be notified and you must appeal to continue your claim.

Step 2: Reconsideration

If your initial application is denied, you must file an appeal with the Social Security Administration. This appeal is known as a Request for Reconsideration. You cannot skip this step and go directly to a hearing. You must go through this process in order to have your claim properly heard.

Once you file this appeal, your claim goes through the same evaluation process it went through during the initial application. However, a different set of evaluators makes the decision. Only about 10% of all disability applications at this level of appeal are actually approved. If you are denied you must file the next appeal.

Step #3: Hearing

If your claim has been denied at the reconsideration stage, you now have the opportunity to request a hearing before an administrative law judge. The judge will evaluate all the medical evidence in your file and make a new decision in your case. You will have the opportunity to tell the judge in person about the limitations your condition causes and how these limitations affect you on a daily basis. The judge may ask expert medical and vocational witnesses to testify about your limitations.

You will also have the opportunity to have witnesses testify on your behalf if necessary. The judge will normally issue his decision in writing. Many cases that are denied in the earlier stages are approved at the hearing level.

Step #4: Appeals Council and Beyond

If your claim is denied by the administrative law judge, your case is NOT over. You have the opportunity to appeal your case to the Social Security Administration’s Appeals Council. Although you will not be entitled to a hearing, you can ask in writing that the Appeal’s Council approve your case or give you a new hearing based on the fact that the administrative law judge made a legal or blatant mistake.

If the Appeals Council denies your case, you have the option to sue the Social Security Administration in federal court for a reversal of the denial or a new hearing. You may also have the option of filing a new claim while you await your appeal.

4 Reasons Why Social Security Disability Claims Are Taking So Long

Many people seeking Social Security disability benefits are finding they have to plan an extremely long waiting game once they have filed an application for benefits. The outrageous backlogs within the Social Security disability appeals process have devastating consequences on claimants. Many former prosperous, hard-working individuals are being forced to spend down their savings and retirement accounts in order to survive while waiting to be approved for benefits they rightfully deserve. Numerous claimants also face foreclosure on or eviction from their homes.

So of course the big question on every one's mind is: WHAT IS TAKING SO LONG?

1. A complex multi-step appeal process

After a person has filed their initial application for disability benefits, it can take anywhere form 3 to 6 months to get a decision. If the claim is denied, they must file an appeal called a Request for Consideration within a specified time in order to keep the claim going. Once this appeal is filed, it can be another 3 to 6 months before the person is given an answer. If this appeal is denied, they must then file another appeal called a Request for Hearing. Once this appeal is filed, the person will more than likely have to wait anywhere from 18 to 24 months before they actually hear from the judge.

2. The "Baby Boom" Generation

Members of the generation of children born between 1946 and 1964, also known as the "Baby Boom" generation, are reaching ages in which chronic and acute health problems may begin. Some individuals of this generation are now experiencing debilitating impairments which hinder their capacity to work. The number of disability applications has mirrored the trend of the spiking birth rate of the "Baby Boom" era. As a result, more new claims are being opened each year than are being resolved. This, in turn, has led to huge backlogs at hearing offices.

3. Understaffed Social Security offices

The Social Security Administration simply has not kept up with the increasing amount of applications. Hearing offices are particularly understaffed with both judges and support staff. Local offices struggle with staffing issues as well. While Social Security is implementing new technologies to try to deal with these backlogs, the waiting times, at least for the moment, don't seem to be getting any shorter.

4. Uninformed and unrepresented claimants

Many Social Security claimants simply don't understand the disability claims process. Many don't realize that once their claim gets to the hearing office, they can actually request that their medical records be reviewed by a judge or staff attorney for a decision without having to go through a hearing. If the medical records alone exhibit that a claimant meets Social Securities standards of disability, a hearing is not necessary. This can cut the waiting time down dramatically.

By hiring an attorney who concentrates in Social Security claims on a daily basis, a claimant can have their case prepared and reviewed to see if such an "on the record" decision is possible. The attorney can also guide the case through the red tape of the process to avoid time lags, clerical errors and other snags along the way. While no attorney no guarantee a quick resolution, a claimant who seeks legal assistance with his or her claim will have a better chance of getting a positive outcome.

6 Bad Things That Could Happen In The Injury Claims Process After an Auto Accident

1. The insurance company could drag its feet in investigating the injury claim and accepting responsibility. (Typical)

2. The person at fault may not report the accident to their insurance company.

3. The person at fault may not have coverage for the damage that they caused you. If so, you may have to file an injury claim under your own auto insurance policy. If you do not have full coverage, you may have no way to make any recovery. This is why all auto owners should always add Uninsured and Under Insured Motorist (UM/UIM) protection coverage, as well as Personal Injury Protection (PIP) coverage, when they buy their auto insurance.

4. Your vehicle could cost more to repair than it is worth, and you may have to obtain a new vehicle.

5. You may have paid too much for your car, including the sales price and financing costs, and if your car is a total loss, you may become “upside down” in the value of the vehicle versus the loan amount due. In other words, you may end up with no car, but with an obligation to continue paying for it anyway. There is a type of insurance coverage, called Guaranteed Auto Protection (GAP) insurance for situations like this. This is good protection to get when you buy a new car.

6. You may not own the car yet, and your bank or car dealer may repossess the title if the payments are not current.

Hardison & Associates Client Appreciation Day

Some more pictures from our Client Appreciation Day Sunday, June 7th.

Friday Feed #9

It's Friday!!! Another day of articles, pictures and video from the Internet. Enjoy.

15 Things You Can Do to Help The Environment
The Daily Green, a website that is dedicated to environmentally clean living, offers 15 tips to make your day-to-day life more Earth friendly.

Seven Summertime Auto Myths Debunked
With gas prices on the rise every little drop counts. Ever wonder if you are using more gas with the windows down instead of the AC running? Does buying gas in the morning, when it is cooler, mean you are getting more gas for your buck as opposed to buying it later in the day? Find out as Popular Mechanics takes you through 7 myths of summertime car care and tells you if they are true or false.

Top 10 Innovative Ice Cream Flavors
Women's Day checks out 10 ice cream flavors that push the envelope. Bet you've never heard of "Candied Bacon Ice Cream" before. Well, now you have.

Worst Cars Ever
Radaronline.com takes a look at some of the rustiest, slowest and explosive cars of all time.

The World's Weirdest Hotels
We'll go back to Radar Online for a look at some of the weirdest hotels in the world. The tree top Amazon Towers one is nice.


See you all Monday!

A Note From The Muscular Dystrophy Association

The 6th annual Stride ‘n Ride took place last Saturday, June 6th at Cary Towne Center Mall. It was a historical walk for Muscular Dystrophy Association with record number of donations raised online, over 180 striders and riders and amazing entertainment! At the end of the day the event raised nearly $33,000! MDA was honored to have Hardison & Associates participate in this exciting community event! Hardison formed a walk team and collected donations around the office. Funds collected were then generously matched by Mr. Cochran and Mr. Hardison! The team took it to the next level for MDA by hosting a dunk tank at their Client Appreciation Picnic on Sunday, June 7th. Every 30 minutes a lawyer was available for dunking! $400.00 was collected from the entertaining activity! All together the team raised $1400.00 for MDA’s 2009 Stride ‘n Ride! It was a huge contribution to the event! The donations will stay in the Triangle and go towards medical equipment, support groups, clinic visits and summer camp for families with neuromuscular diseases. MDA is very appreciative and grateful for the relationship they have built with Hardison & Associates over the past several months and look forward to a long partnership!

-Krissy Profio, MDA Health Care Services Coordinator

Please visit MDA Website for more information.

Hardison & Associates Client Appreciation Day

More pictures from our Day of Fun, Under the Sun, in Dunn this past Sunday as we held our first Client Appreciation Day.

Failure to Comply With Medical Treatment in Your Workers' Compensation Case

In the State of North Carolina the workers’ compensation insurance company or employer generally has the right to direct the medical treatment of the injured worker. If you have been injured and you are out of work receiving weekly benefits from a workers’ compensation insurance company it is very important that you comply with the recommendations of the treating physician when it comes to attending medical appointments and therapies.

If you fail to attend medical appointments you may jeopardize your benefits. Medical appointments are appointments for any type of treatment that is reasonably necessary to effect a cure, give relief, or tend to lessen the period of disability. If the injured employee willfully fails to attend medical appointments that have been scheduled by the insurance company, employer, or the physician then the insurance company or the employer will request that the injured employee be ordered to attend these appointments by the Industrial Commission.

Of course you may be asking yourself why would the insurance company or the employer want to order the injured employee to attend medical appointments? Wouldn’t this cost them more money? Predominantly a request for an order to compel is done by the insurance company or employer when the injured employee is out of work receiving disability benefits.

If an employee is ordered to attend medical appointments, then if the injured employee willfully fails to comply with this order, the insurance company or the employer will file an application to terminate or suspend your benefits. If your benefits are suspended then it could be a very lengthy process to reinstate your benefits. It could take months to even years to get them reinstated.

Once again the rule to remember is to comply with medical treatment. Not only is it in your best interest physically, it keeps the insurance company from having a reason to terminate your benefits.

Hardison & Associates Client Appreciation Day

Sunday, June 7th we held our first Client Appreciation Day at Tart Park in Dunn, NC. This week we will be posting pictures from this event. Enjoy!

Hardison & Associates Client Appreciation Day

Yesterday we held our first Client Appreciation Day at Tart Park in Dunn, North Carolina. At the onset of the day it looked like it would storm, but everything held off and the sun came shining through. Liquid Pleasure kept the crowd entertained. BBQ Lodge of Raleigh kept the clients fed and the kids played all day on the huge bounces and slides provided by Stancil's On-Site Rentals from Fayetteville. Also, every attorney got dunked in the dunking booth at some point during the day.

Each day this week we are going to post some pictures from the event. Enjoy!

Friday Feed #8

Another Friday, another Friday Feed.


Stop Doing Sit-Ups: Why Crunches Don't Work
The sit-up has always been part of a healthy workout. Along with push-ups it's one of the most traditional work outs out there. Kate Dailey researches why sit-ups may be doing more bad than good in her Newsweek blog post.

The Top 10 Grocery Coupon Websites for Cheapskates
Makeuseof.com breaks down ten websites that will help you save money at the grocery store.

7 Ways to Better Recall Your Dreams
Ever had a vivid dream just to wake up to the details being fuzzy. Reader Digest offers 7 tips to easily recall dreams.

Memorable Moments of the NBA Finals
Since the NBA Finals tipped off last night, Sports Illustrated has offered up 20 of the most memorable moments in Finals history in the form of pictures.

Extraordinary Clouds and The Cloud Collector's Handbook
The Telegraph, a UK newspaper, takes a look at two new books out about clouds. Sound dull? Well, the 15 pictures the Telegraph previews in this slide show are worth a look.

25 Electrifying Pictures of Lightning Photography
Just figured we'd follow up the awesome pictures of clouds with some great photography of lightning.

We'll see you on Monday!

Little Know Nursing Home Research Tool

With the Baby Boomer generation aging, the need to place a loved one in a nursing home may be in the near future for some. People aren't simply going to put a loved one in a nursing home with out doing their research first. A decision like this may be one of the most research intensive in a person's life. A little know fact is that there is a tool out there to help people with their research at the tips of their fingers.

Set up by the Government's division of Medicare, Nursing Home Compare allows people to research nearby nursing homes. The system allows a look into the following:

- Five-Star Quality Ratings
- Health inspection results

- Nursing home staff data

- Quality measures

- Fire safety inspection results

This is a great tool to do initial research when facing this situation with a loved one. Of course, this website shouldn't be the say all, end all on the subject and people should always allow the loved one a say in the matter and always visit the residence.

The Basics of Retirement Benefits Within Social Security

Retirement benefits are available to those who have paid enough Social Security taxes (through income withholding) to be fully insured for retirement benefits. If you have worked and paid taxes on your income for a good portion of your life, you will almost certainly qualify for retirement benefits.

You are eligible to receive full retirement benefits when you have reached full retirement age. The full retirement age used to be 65. However, the full retirement age is rising. Depending on when you were born, your full retirement age may be anywhere between 65 and 67.

You can opt to receive retirement benefits prior to reaching your full retirement age starting at age 62. However, you will receive a PERMANENT REDUCTION PENALTY in the amount of your monthly benefit for opting for early retirement. The earlier you retire, the greater the amount of the reduction.

For example:

Jim has worked his entire life in heating and cooling repair and decides it is time to call it quits when he turns 62 years old. He has always paid taxes into Social Security and decides he wants to go ahead and draw his retirement benefits. When he applies, the agent at the Social Security office doesn’t tell Jim that his benefits will be permanently reduced. He begins drawing a retirement check in the amount of $1280 per month. When Jim turns 65, his full retirement age, he finds out that his full retirement amount should be $1600. However, he is not eligible to receive this monthly rate now. His monthly check will be $1280 for the rest of his life. If he had waited to retire, he would be receiving $320 more per month.

Common Mistake of Workers' Compensation Cases: Failing to Request a Second Opinion

Although the insurance adjuster may be correct in telling you that he/she can tell you where to treat, he/she cannot keep you from having a second opinion. In the State of North Carolina if you are directed to treat with a particular physician and that physician subsequently releases you after treatment at maximum medical improvement, then by law you are able to have a second opinion with a duly qualified licensed physician of your choosing. It is all too common that injured employees have contacted my office and told me that they were told that they could not have a second opinion. THIS IS NOT THE LAW!

Moreover, if you receive a permanent partial disability rating as a result of your injuries and you are not satisfied with this rating then you may also invoke your right to a second opinion. Do not allow the insurance company to mislead you.

If you have been released and you are still in pain then seek your second opinion. If the second opinion physician recommends additional medical treatment you may then apply to the Industrial Commission to have a change in treating physicians and then you can request the recommended medical treatment.

The insurance company or the employer is not going to freely allow this so it may be necessary for you to obtain legal representation to be successful in this endeavor, but remember, you are not simply required to stay hurt. There are options.

What is the difference between Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI) in Social Security disability?

What is considered a disability?

DIB: Physical or Mental Impairment that last 12 months or more that prevents you from working a full-time job

SSI: Same as DIB

Credit Requirements

DIB: Must have paid in enough taxes in to Social Security recently to be eligible

SSI: No credit requirements

Financial Limitations

DIB: If you are working part time, you cannot earn over the level for substantial gainful activity (2008: $940/month)

SSI: Household income and assets must be low enough to qualify

How Much Can I Get?

DIB: Depends on how much you have paid into Social Security

SSI: Currently, $637 maximum per month, but this decreases dollar for dollar with any income you have

Any Health Insurance Included?

DIB: Medicare: Eligible 2 years after you start receiving benefits

SSI: Medicaid: Eligible as soon as you are declared disabled

Can my children get benefits?

DIB: Yes. Children are entitled to a dependent’s benefit. But there is a family maximum.

SSI: Not as a result of your disability. Children must have a disability of their own.

Who are these Benefits For?

DIB: 1.) Anyone who has paid in enough to be insured 2.) Anyone who may be eligible on a spouse or parent’s work record

SSI: 1.) Adults of Retirement Age 2.) Disabled Adults Under Retirement Age 3.) Minor Children