Workers' Compensation and Disablity

Workers




DISCLAIMER


THE INFORMATION PRESENTED IS INTENDED TO PROVIDE A BROAD AND GENERAL INTRODUCTION TO THE TOPIC SPECIFIED, AND IS NOT INTENDED AS LEGAL ADVICE.

THERE IS NO SUBSTITUTE FOR LEGAL ADVICE, ONE-ON-ONE, FROM ATTORNEY TO CLIENT AND YOU SHOULD HAVE A CONSULTATION WITH A LICENSED ATTORNEY IF YOU WANT TO KNOW YOUR LEGAL RIGHTS.






WORKERS' COMPENSATION


IF YOU HAVE BEEN INJURED ON THE JOB OR BELIEVE THAT YOUR INJURY IS RELATED TO YOUR EMPLOYMENT, IT IS IN YOUR BEST INTEREST TO FILE A CLAIM WITH YOUR EMPLOYER IMMEDIATELY.

If you are injured "on the job" or while working for your employer, compensation for your injuries will be determined through the State Workers' Compensation system, as it relates to your employer. The Workers' Compensation system does not look at who was at fault for your injury, whether it was your employer, a co-worker, or you. The system does look, however, at the permanency of your injury, and how your injury affects your ability to work. In addition to a Workers' Compensation claim against your employer, you may also have the right to bring a personal injury claim against a third party working for your employer, such as a contractor.

The Workers' Compensation system has its own Court, Judge, and a different procedure for determining compensation than that of personal injury. Ultimately, if the case does not settle, a Judge will determine whether your injury is permanent and the amount of compensation to be paid. A Judge's determination will be made based on medical evaluations provided by your doctor, and, in many cases, an "expert witness" hired by your employer or an independent evaluator. The Workers' Compensation process is slow, and often claimants must wait several months before a determination is made. If additional evaluations are necessary, delays could take even longer.

Workers' Compensation matters are "contingent fee" cases, where your attorney will be paid only if you win. If you do not win in Workers' Compensation court, your attorney will not receive a fee for the legal services provided to you. Typically your attorney will advance the cost for medical evaluations and expert witnesses and, whether you win or lose, you will be responsible for reimbursing your attorney these costs. By law, your attorney's fee for representing you in a Workers' Compensation matter will be a percentage of the amount which you receive, not to exceed 20%. The ultimate amount that your attorney will receive will be determined by the Workers' Compensation Judge.




SOCIAL SECURITY DISABILITY


IF YOU BELIEVE THAT YOU ARE ELIGIBLE FOR SOCIAL SECURITY DISABILITY BENEFITS, IT IS IN YOUR BEST INTEREST TO APPLY AS SOON AS POSSIBLE. IF YOU HAVE BEEN DENIED SOCIAL SECURITY BENEFITS, THERE ARE STRICT DEADLINES FOR FILING RECONSIDERATION OR APPEALS. PLEASE BE SURE TO WATCH THE DEADLINES.

There are two programs through the Social Security Administration which provide benefits to persons with disabilities: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Although the disability related eligibility requirements for both of these programs are similar, the financial requirements and benefits of these programs differ greatly.

Under both programs, a claimant must have a severe disability to be eligible. In general terms, the disability must significantly effect the individual's life, and must have or be expected to last for a period of at least 12 months. Your social security claim is reviewed by a representative in your local social security office, and it typically takes three to six months to receive a decision.


SSDI - Social Security Disability Insurance

The Social Security Disability Insurance program (SSDI) is a program for persons who have a work history. Although the disability requirements are similar to the supplemental security income program, your benefits, if you are approved, are based on your income from your previous employment. Unlike SSI, the SSDI program is not an income based program. Although your disability maybe questioned if you have gainful employment, generally, your income is not considered in determining your eligibility for this program.

Once your social security disability benefits are approved, you are entitled to a retroactive payment. This means that you are entitled to receive a lump sum which is the total of the monthly benefit you would have received from the time that you incurred your disability. Unlike SSI, you are entitled to receive benefits from the onset of your disability as long as it occurred within one year of your application date. Your attorney's fee (discussed below) once approved by the Social Security Administration, will be paid from this lump sum amount.


SSI - Supplemental Security Income

The Supplemental Security Income program (SSI) is a program for disabled children, and persons who do not have a history of gainful employment. Unlike SSDI, the SSI program has income and asset limitations. In certain cases, if you or members of your household have substantive income or substantial assets, you may be denied SSI benefits.

Once your benefits are approved, you are entitled to receive a retroactive lump sum amount totaling the monthly benefit which you would have received from the time that you applied for benefits. Unlike SSDI, you are not entitled to benefits from the date of the onset of your disability, only from the date that you applied for benefits. You are required to pay your attorney's fee (discussed below) from this lump sum amount.


Attorney's Fees

For both SSDI and SSI programs, your attorney is paid on a "contingent fee" basis. This means that your attorney is only paid if you win your case. If your case is lost, the attorney will not receive a fee. Often an attorney will advance the cost of medical reports and, whether you win or lose, you will be required to reimburse your attorney for these costs. Your attorney's fee is limited to the lesser of $5,300.00 or 25% of the lump sum past due benefits you will receive upon approval. The attorney's fee must be approved by the Social Security Administration. In certain cases, your attorney may ask for an additional fee, if your case is complicated or if there are multiple representatives, (in different firms or offices) who are representing you in your social security disability case.

If your attorney agrees to take your SSD case (whether SSDI or SSI) you will be required to enter into a retainer agreement. If you have an SSI case, you will be required to pay a retainer to the firm, which will be held in escrow until your case is finished. If you win your case, your attorney's fee will be paid from this retainer. If this retainer is greater than the approved attorney fee, you will be reimbursed the balance by your attorney. If the retainer is less than the approved fee, you will be required to pay the balance. Often attorneys will advance the cost of medical evaluations, and ask for a separate retainer to cover these costs. Any unused portion of this retainer will be refunded to you at the conclusion of your case.




APPEALS

First Step of Appeal - Reconsideration

For both SSDI and SSI cases, there are several options for appeal. If you are initially denied benefits, you have the right to file for reconsideration. There are strict deadlines for filing an appeal and, if you miss the deadline, you may lose the right to collect benefits for a retroactive period. It is important that you file an appeal in a timely manner.


Second Step of Appeal - Reconsideration - Administrative Law Judge Review

If you are denied in the reconsideration stage, you have the right to have an Administrative Law Judge review your case. There are strict deadlines for filing an appeal after you have been denied upon reconsideration. If you do not file an appeal in a timely manner, you may lose a certain portion of your retroactive benefit. Information on the claimants disability will be compiled in a file, and reviewed in a semiformal process.


Further Appeals

If you are denied benefits by an Administrative Law Judge, you have the right to further appeals. The retainer agreement sets out limitations for representation in appeals from the Administrative Law Judge.




TO SCHEDULE AN APPOINTMENT


For more information on Workers' Compensation or Social Security Disability, or to schedule a free consultation to discuss your Workers' Compensation or Social Security Disability matter, please contact the law firm of Jacob & Chiarello, LLC at (856) 825-0700, or e-mail at injury@sjtrialfirm.com. At Jacob & Chiarello, LLC your representative for Workers' Compensation or social security disability will be Joseph M. Chiarello. Mr. Chiarello is an extremely capable and diligent attorney who is dedicated to securing for you all the benefits you are entitled to receive.

For purposes of confidentiality, legal questions cannot be answered over the phone or by e-mail, unless you are an existing client.

If you are unable to come in for an appointment at the firm, we are available to meet with you at your home or at the hospital.




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