Doctors Getting Rich With Fusion Surgery Debunked by Studies

Many of my workers' compensation clients suffer from work-related back injuries. They range from simple pulled muscles and pinched nerves to full blown herniated discs to severed spinal cords causing a paralyzing condition. The treatment for these injuries can be as simple as rest to physical therapy all the way to serious spine surgery.

One of the types of spine surgeries that many of my clients have undergone is spinal fusion surgery. This surgery entails screwing together, with a metal cage, several vertebrae in the spine in order to limit painful movement in the vertebrae. Here is a picture of what a typical fusion surgery looks like:

I recently came across a Bloomburg article about fusion surgeries that was very disturbing. From the article, I learned that the number of fusions at U.S. hospitals doubled to 413,000 between 2002 and 2008, generating $34 billion in bills, data from the federal Healthcare Cost and Utilization Project show. The number of the surgeries will rise to 453,300 this year, according to Millennium Research Group of Toronto.

In and of itself, the rise in the number of fusion surgeries should not be a concern, assuming the procedure helps patients live productive, relatively pain free lives. But the studies say different.

It’s amazing how much evidence there is that fusions don’t work, yet surgeons do them anyway,” said Sohail Mirza, a spine surgeon who chairs the Department of Orthopaedics at Dartmouth Medical School in Hanover, New Hampshire. “The only one who isn’t benefitting from the equation is the patient.

The Evidence

British and Norwegian researchers found fusion no better than physical therapy for disc-related pain in three studies, totaling 473 patients, published in the journals Spine, Pain and the British Medical Journal between 2003 and 2006. A 2001 Swedish study of 294 patients in Spine found fusion better than physical therapy that was less structured than the kinds used in the other studies.

Rates of complications from surgery in three of the European studies -- including bleeding, blood clots, and infections -- were as high as 18 percent. None reported complications from physical therapy. The four studies are cited in journals as the only head-to-head, randomized comparisons between the two treatments.

In a U.S. study in Spine in 2007, surgeons reported fusion was successful in only 41 percent of 75 patients suffering from lower-back disc degeneration. Success measures included pain reduction. Two years earlier in the same journal, surgeons found a 47 percent success rate among 99 patients, 80 percent of which were taking narcotics for pain two years later. Both studies compared fusion to artificial disc replacement in trials submitted to the FDA.

The Blommburg article, from which this information was taken, is quite extensive and has many personal examples of how this surgery has not helped people, but ruined their lives. In my practice, I have seen both sides of this issue. I have clients who have undergone the surgery and have had a good result and I have had clients have a bad result and have to return to the surgical table and ultimately, be diagnosed with failed back syndrome.

If you are contemplating undergoing this type of surgery, please consider all of the factors. Also, always obtain a second opinion. If this is a Pennsylvania workers' compensation injury, you would have a right to a second opinion that the insurance company would have to pay for.

Minimum Wage Laws

Many, many of our Pennsylvania workers' compensation clients also have wage law questions. These laws determine what employers can give as minimum wages and the hours that are set. These laws control how many hours an employee can work during the week as well as over time wages and breaks, etc. The laws can be very confusing given the many categories of employees and how the laws apply to each category. The following is a basic primer on minimum wage law, including Federal and State. I thank Attorney Darryl Parker, who is a Seattle employment lawyer, for some of this information.

Federal minimum wage is currently set at $7.25 an hour, with some states individual minimum wage set at higher or lower or the same as the Federal limit. Minimum wage laws are very confusing for both employers and employees alike, and is different from state to state, but that does not give a business an excuse for failing to properly pay its employees. I believe that with coherent information on how these laws work, everybody will be able to have a better understanding of the minimum wage. In this article, I will address some of the most common concerns on minimum wage.

Who has to be paid the minimum wage? The vast majority of employees fall under the umbrella of minimum wage laws. There are, however, a few types of employees that do not have to be paid minimum wage. Students working internships fall under this category. As long as the internship provides an academic experience, the student can receive compensation in the form of experience and school credit instead of money. There are also certain types of contract employees that may establish rates as they see fit with whoever is hiring them. These rates do not have to be at the minimum wage level. It is also important to note that the minimum wage is meant for people that are 16 years and older. This does not prevent 14 and 15 year olds from working, though. Their minimum wage is legally set to 85% of the normal minimum wage.

How is the minimum wage calculated? First, it should be noted that there is a Federal minimum wage and a State minimum wage. Employers are subject to abide by whichever number is higher. In Pennsylvania, the state level is the same as the the Federal level, and has been for a while. Because of this, businesses are required to pay their employees at least $7.25 an hour.

Can employers count tips in their calculation of minimum wage? Some states have a lower minimum wage for employees that make money off of tips, but Washington is not one of them. Valet parkers, waiters and anybody else who gets tips as a part of their job must still be paid the minimum wage by the business that employs them.

What can I do if my employer is not paying me minimum wage? If you are not being paid the minimum wage despite working a job that requires your employer to do so, then you should seek legal representation as soon as possible. The minimum wage is meant to protect employees and allow them to live on a reasonable wage. When employers do not abide by these rules, the employee should speak with an experienced employment lawyer about what they need to do to take legal action.

For more wage information, please see this quick reference guide. As always, if you have any questions, please call us for a free consultation.

The Wall Street Journal covers how the gas drilling boom has affected Towanda, PA

In an online slide show with accompanying article, the Wall Street Journal has written about how the gas drilling boom has affected Bradford County's capital, Towanda, PA.

See the slide show here.

Injured Workers Pharmacy

One of the many issues that haunt our Pennsylvania workers' compensation clients is the payment of work-related medical bills, particularly prescriptions. Often times, the insurance company withholds payments to the pharmacy or refuses to refund out of pocket prescription payments that the injured worker makes. Sometimes it's just a matter of too much red tape and paperwork that gets in the way, thus preventing injured workers their needed prescriptions in order to get better.

One of the ways to fix this problem is to insert a "middle-man" into the mix. That's where a company called Injured Workers' Pharmacy comes in. I'm not associated with this company in any way. However, many of my clients have used their resources.

Here's a blurb from their promotional materials:

IWP is a national pharmacy service working on behalf of injured individuals. As an advocate for those who have been injured, IWP takes the financial burden out of the medication process by shipping medications directly to the patient and collecting payment from the insurance company.

We provide Workers' Compensation medications for injured workers. We are an independent pharmacy service, which means we're concerned with your interest. And yours alone.

Call us and we'll ship your Workers' Compensation medications right to your door, hassle free. We'll work on your behalf, filling your prescription needs even if your claim has been denied or goes through litigation.

What Can I expect from IWP?

● Your prescriptions and medical equipment when you need it
● A dedicated customer service team
● Licensed pharmacists available for consultation
● Free next day home delivery for all approved claims
● Multi-lingual assistance
● Caring, respectful, professional service
● Freedom from time and stress spent on phone calls and paperwork

What Won't I Have to Worry About?

● Confusing claim forms
● Out-of-pocket expenses on approved Workers' Compensation claims
● Waiting for reimbursement

Pa. company admits crime in secret human bone-cement experiments

Because many of our clients undergo spine surgery to repair herniated discs caused by work injuries or automobile accidents, this story caught my eye. Basically, this company was giving untested bone cement to doctors to use during spinal surgeries, when the patients knew nothing of their guinea pig status. The company was experimenting on humans without their knowledge, and apparently, people died because of it.

What is unclear from the story is the role of the doctors. I could not confirm if any of the doctors who performed the surgeries were complicit in the crime.

The most painful warning sign EVER!

That looks like it hurts....

And that's why open machinery must be guarded, either by an actual guard or by distance or location. Many of our work injury cases stem from employees having their hands and arms caught in unguarded machinery, causing severe damage, including amputation.

What are the most important things an injured worker should know about Pennsylvania Workers' Compensation rights?

Below are some initial questions many clients have when they first contact Carroll & Carroll, P.C. The questions below may address many initial concerns you may have. If you don't find the answers here, you should contact us for answers to questions specific to your case. The consultation is free.

Q: What are the most important things an injured individual should know about workers' compensation rights?

• 
  Always report a work injury even if you might not lose time from work or need immediate medical care. It is critical that you require your employer to complete an accident report. Remember to keep an independent record of the date, time, and nature of your work injury. In addition, make a list of witnesses as well as the person to whom the injury is reported. Be sure to provide a complete and accurate account of the type of injury you sustained and how your injury occurred as well as your past medical history.
• If your employer fails to accept your claim within 21 days of the date you notify them, seek legal assistance and file a petition for compensation. Should your employer accept your injury, be certain that the wages upon which your compensation is based are accurate. In most cases your compensation should be 66 2/3% of your gross wages from all sources of employment.
• If, after receiving compensation, your employer or the insurance company asks you to see another physician, seek legal advice immediately as this is your employer's first step in their attempt to either terminate your compensation or modify your benefits. It is possible that your employer may offer you modified work based on medical proof that you are able to perform that work. This can cause you to lose your benefits by failing to accept the newly defined work.
• You might be contacted by a vocational rehabilitation firm attempting to find you a new job. Your compensation can be effected if you fail to cooperate with the vocational firm.
• Should you receive a petition in the mail to terminate, suspend or modify your compensation, seek legal advice. NEVER sign a supplement agreement or final receipt without having it reviewed by an attorney.

Slip and Falls during bad weather

It's that time of year again. The weather gets cold and the ice and snow start to fall. Un-cleared sidewalks become mine fields of danger. So, please be careful where and how you walk on slippery sidewalks.

As you know, we handle slip and fall cases at C&C Law. Either innocent pedestrians or innocent workers who slip and fall on snow/ice while working. So, here's a reminder to property owners. Make sure your public sidewalks and walkways are clear. Or you just might be getting a call from me....and you don't want that headache....

Here's a funny video to remind you of the dangers of slippery sidewalks.....

Moratorium on gas drilling passes New York legislature

On Monday evening, the New York State Assembly gave final approval to a six-month moratorium on natural gas extraction in New York, while state and federal agencies review its possible impacts.

The moratorium, which calls for no drilling permits to be issued until May 14, 2011, was approved by the state Senate in August, and then the Assembly approval that followed on Monday.

Here's the full article from the Towanda Daily Review.

In Pennsylvania Marcellus news, here's another article from the Towanda Daily Review about Governor-Elect Corbett and an advisory committee he has established. The gist of the article:

The 30-member panel includes former state environmental secretaries, environmentalists and alternate energy representatives as well.

Corbett formed the committee to advise him on issues and impending decisions involving the Department of Environmental Protection, Department of Conservation and Natural Resources and Public Utility Commission before he takes office Jan. 18.

These three agencies have a regulatory role over the natural gas drilling boom underway in Northeast Pennsylvania and other regions on issues ranging from drinking water protection, drilling on state forest land and pipeline safety.

Corbett has said he wants to develop the Marcellus Shale gas deposits as a long-term economic venture while maintaining environmental protections. Efforts to reach Corbett spokesman Kevin Harley Wednesday were unsuccessful.

The Marcellus lobbyists on the panel have other major businesses and organization clients too.

They include Peter Gleason of Kirkpatrick & Lockhart Gates who represents Cabot Oil & Gas Corp. and Chesapeake Appalachia, two firms active in Northeast Pennsylvania, according to lobbyist disclosure reports with the Department of State. Cabot is at odds with DEP over whether the company's natural gas drilling is responsible for water supply contamination in Dimock Twp.

Also lobbyist Stanley Rapp with Greenlee Partners who represents Range Resources-Appalachia, CNX Gas Corp. and NextEra Energy Resources. He represents PPL Corp. as well.

And lobbyist Pam Witmer with Bravo Group who represents Chief Oil and Gas, Chief Gathering LLC and RRI Energy.

The panel is chaired by David Kleppinger, an attorney with McNees Wallace and Nurick who lobbies for the Industrial Energy Consumers of Pennsylvania.

David Hess and Nicholas DeBenedictis, former DEP/DER secretaries under Govs. Mark Schweiker and Richard Thornburgh, are on the panel. So is John Oliver, a former DCNR secretary under Gov. Tom Ridge.

George Ellis, president of the Pennsylvania Coal Association, and Ellen Ferretti, Dallas, vice president of the Pennsylvania Environmental Council who works on Pocono land issues, are on the panel. Patrick Solano, Pittson, a former DEP deputy secretary, and John Rich, owner of a coal waste power plant in Schuylkill County, are members.

I wish the committee was made up of mostly environmental scientists and activists, as opposed to mostly industry puppets. We understand where Governor-Elect Corbitt's priorities are.

5 Things to Keep In Mind When Filing For Social Security Disability Benefits

For those of our readers considering filing for Social Security Disability benefits, we are posting this article from another source to give you things to consider. As always, if you have any questions, please contact us.

You should seek the advice of a social security disability lawyer before filing a claim for disability benefits. He will verify the information furnished and make changes if necessary taking care that your application fulfills the eligibility criteria specified by the social security administration.

Properly Filled Application

You can download SSD benefit application form from the SSA website or visit the local SSA office for a copy. For an average American filling in the form might seem a complex and daunting task. It would therefore be better to hire the services of a social security disability lawyer who will ensure that you fill in all the required details properly with adequate evidence to back your claims.

Timely Action

Never delay the filing of application for SSD benefits. The processing of the claim and approval might take at least a year even if you are fortunate enough to get through the first time. Any delay in filing the application or failure to furnish information requested by the SSA on time will sabotage your chances even though your case might be genuine.

Employment Record

SSA will take into account your employment history ten years prior to the date of your disability. You should have been employed gainfully for at least five of the ten years prior to being disabled. In addition to this it is important that social security disability insurance was being deducted from your salary. It is important that you have pay slips, bank account statements and other relevant documents to substantiate your claim. SSA will compare the evidence submitted by you with the form W2 submitted by your employer to verify your claim.

Letter from the Employer

You can request your employer to give a written statement that your disability was the cause for being unable to work. You can also ask him to include details of your job profile and your performance before you were disabled. This will give an idea of the way in which disability has rendered you incapable of performing any monetarily productive work. Take the help of a social security disability lawyer for proper guidance in these matters.

Medical Record

This is the most critical record upon which your claim's approval will depend. You should maintain a record of the hospital visits, medications prescribed, investigations done, record of any therapy done, medical bills, and other relevant information. This will serve to impress upon the SSA representatives the extent of disability and the expenditure you are incurring on healthcare after being disabled.

Social security disability lawyer might also request your doctor to give a letter describing your current health status, probable prognosis, and the time it might take for you to completely recover and undertake gainful employment.

It is important to understand the whole process and keep all the relevant data ready. A good social security disability lawyer will guide you at every step of filing the claim and will also regularly pursue the case and update you about the status.

Make an educated decision when looking for the right social security disability lawyer. It's wise to konw what you need to qualify, what to do if you've been denied a claim, and things to be careful of when filing. This social security disability site will break down each medical condition in an easy to understand way, and will help you win your claim!

Another gas worker fatality in the Marcellus Shale

There has been another gas worker fatality in Bradford County, Pennsylvania. In this unfortunate and sad instance, a dump truck driver hauling stone to a well site lost control of the truck and ran off the road. The accident occurred on Overton Road in Overton Township, Pennsylvania. Here is a link to an article on the incident from the Towanda Daily Review.

There was another Marcellus Shale gas drilling truck accident yesterday as well. A crane used at one of the drill sites overturned near Granville Township, Bradford County, Pennsylvania. Fortunately, the driver in this incident was not injured, as per the article about the incident in the Towanda Daily Review.

It appears that these types of truck accidents have been occurring on a regular basis. Why is that? Is it due to the amount of truck traffic on the road-- the more traffic will naturally generate more accidents? Is it that the gas workers are being worked too hard and not given enough down time? I don't know the answer.

Health Insurance For People with Pre-existing Conditions

Many of our clients have long-lasting, chronic injuries and conditions, even after their case is over. Most insurance companies will not insure them due to these pre-existing conditions. Well, now there's an option.

You may not know this, but Pennsylvania (and many other states) now offer health insurance for people with pre-existing conditions, who could not obtain health insurance from any other source. In Pennsylvania, the program is called PA Fair Care and information regarding signing up can be found here. There was a recent article in the Towanda Daily Review about the fact that not too many people know about this health insurance plan, so I'm trying to spread the word. Here are the details:

• The program offers benefits ranging from preventive care, physician services, prescription medications, diagnostic testing, hospitalization and mental health services
• To be eligible, applicants must be state residents who have been uninsured for six months prior to applying for coverage through the program
• Applicants must have a pre-existing medical condition, ranging from diabetes and hypertension to ulcers or arthritis.
• Individuals who are eligible will have a monthly premium of $283, plus copays and coinsurance

Check out the link above to PA Fair Care and see if it's a good plan for you and your family.

Manufacturer Pulls Darvon, Darvocet Pain Medicine

I'm posting this article because many of our Pennsylvania workers' compensation clients and auto accident clients take pain medications for obvious reasons. Many of these medications are for controlling chronic pain due to very serious injuries. Our clients suffer from life-long pain and disability due to these injuries. With these drugs off the market, although our clients will be safer, they will ultimately have fewer choices to manage their pain.

From ABC NEWS- Health:

"The U.S. Food and Drug Administration announced Friday that it is pulling off the U.S. market the prescription painkillers Darvon and Darvocet, which combines Darvon with the aspirin substituteacetaminophen, because of new scientific evidence they can damage the heart, even at recommended doses, or cause fatal cardiac abnormalities. The agency now is asking manufacturers of generic propoxyphene to do the same.

The drugs have been banned in Great Britain since 2005. The European Medicines Agency in June 2009 recommended their gradual removal from the European Union market after concluding risks, including the risk of fatal overdose, outweighed pain-relieving benefits."

Chesapeake Energy opens $7 million "Man Camp" in Athens Township

Finally, Chesapeake Energy and Nomac Drilling opened up the "Man Camp" in Athens Township, Pennsylvania. The facility will house approximately 276 employees of Chesapeake Energy and Nomac Drilling. The facility will also serve as a training center for new employees.

I hope the training will have a significant focus on safety. Carroll & Carroll, P.C. has handled many workers compensation cases for gas drilling employees, including drill site workers and truck drivers. Drilling sites can be dangerous places. There have been several employee deaths at the sites around Bradford County, Sullivan County, Tioga County and Susquehanna County.

Here are links to articles from the Towanda Daily Review and the Sayre Morning Times. The Daily Review article has an imbeded video presentation from a Nomac Drilling spokes-person.

The Eastern Training Center and Housing Facility, located on Lamoka Road, has 11 buildings, including six dormitories, a cafeteria, a training center, a non-smoking recreation center, a smaller recreation center for workers who smoke, and a laundromat.

Nomac Drilling LLC is a wholly owned subsidiary of Chesapeake Energy Corp

How much is this going to cost me?

I often hear this question when new clients come to the office for the first consultation. This question is often asked in both personal injury cases (auto accidents, slip and fall, defective products) as well as workers' compensation cases.

If you felt the need to contact a personal injury attorney, we can just go ahead and assume that you have suffered enough. Our initial consultation is free, and if we determine that you have a case, you won’t pay us a cent unless we get you good results. Our fee is based on a percentage of your settlement or judgment.

In Pennsylvania workers' compensation cases, our fee is set by statute at 20% of whatever benefits we obtain for you. Also, we will cover any litigation costs that are necessary to win your workers' compensation case. An average workers' compensation case could cost up to $5,000.00 to litigate. If we are successful, the workers' compensation insurance company will pay those litigation expenses, above and beyond any award you've won.

Water tanker truck rolls over in Camptown, PA

Via the Towanda Daily Review:

A Williamsport man was transported to Robert Packer Hospital after the water tanker truck he was driving rolled over in an accident Monday night on state Route 409 in Camptown, police said

The truck, which was operated by 49-year-old William McClelland of Williamsport, was carrying a full load of fresh water to a gas well site, state police said.

The truck was coming down "a steep grade" at the time of the accident, State Police Cpl. Roger Stipcak said. "It looks like his brakes failed" and the vehicle gained speed on the incline, he said.

C&C Law has been seeing a lot of these types of truck accidents. In many instances bad roads are the cause of the problem. There has been a significant increase in the amount of truck accidents in Bradford County and surrounding counties due to the Marcellus Shale gas drilling.

Law needed to stop cell phone use while driving

I know I keep harping on this, but it's important. Many of the cases that are handled at C&C Law are caused by distracted drivers. Cell phone use, either talking or texting, is one of the leading causes of driver distraction, thus accidents.

This opinion piece from the Towanda Daily Review caught my eye. It's a good read and provides many statistics to push home the idea that Pennsylvania needs a law that prevents the use of cell phones while driving.

2009 Work Injury Statistics

Good news. The US Labor Department released a report that work injuries in 2009 declined to 3.6 cases per 100 full time workers. Here's the report.

Injured Cargill employees 'resting,' says spokesman

Just a quick follow up from yesterday's post regarding the injured workers' at the Cargill meat processing plant in Wyalusing (formerly Taylor's Meat Processing). Here's an updated article from the Towanda Daily Review.

I hope that during the investigation Cargill retains all of the machinery involved. In a pump or pipe failed then that has to be investigated. Who manufactured the pump? Was it done correctly? Did they use inferior metals that gave way to the heat. There are a ton of standards that must be met in manufacturing these types of systems. If those standards weren't met then due to some company trying to cut costs, then someone needs to be held responsible for these workers' injuries.

Two Cargill employees injured in Wyalusing Plant

As per the Towanda Daily Review:

Two Cargill employees suffered burns in an incident at Cargill around noon Wednesday in Wyalusing, Mike Martin, spokesman for the company, said.

He said two male maintenance employees were working on a pump in the tallow rendering plant. He declined to name them.

Carroll & Carroll, P.C. has handled a lot of workers' compensation cases against this plant over the years. I hope these workers' recover from their burns. And I hope Cargill doesn't try to attempt to bring these injured employees back to work too soon, as they often do.

Questions remain in gas well accident in Tuscarora Township

From the Towanda Daily Review:

TUSCARORA TWP. - An accident Thursday at the Mowry natural gas well on Clapper Hill Road sent three people to the hospital and sparked an investigation into how the incident occurred.

Although scanner reports from Wyoming County Communications termed the accident an "explosion," Brian Grove, a representative from Chesapeake Energy Corp., which owns and operates the well site, insisted that no explosion occurred during the situation. Instead, Grove explained, what occurred was a "forceful uplift in tubing," which launched sections of tubing from the well bore into the derrick.

Two employees of a contract company at the scene were transported to a local hospital for evaluation and treatment of non-critical injuries, according to the press release. They were later released after treatment. A third contractor, who also suffered non-critical injuries, was later taken the hospital for treatment as well, and remains hospitalized as of 6 p.m. Thursday.

One of the interesting aspects of the influx in gas drilling is the amount of new gas workers coming to the area. So far, in our workers' compensation practice, it appears that the drilling companies are fairly safe-- there does not appear to be a signficant amount of accidents and injuries. Hopefully, it will stay that way.

Social Security Disability Benefits

One of the biggest possible mistakes that you can make when applying for a social security disability benefit is to go through the process unprepared. The reason why this is such a big mistake is because it has the power to waste an extraordinarily large amount of your time and effort. When you file for disability, the examiners never become aware of how much time has elapsed between when you decided to file and when you actually followed through on the filing, and what this means is that there isn't a penalty for actually taking the time to put your case together. However, the day that you decide that you would like to apply for social security disability benefits should be the day that you get the ball rolling on the process.

There are a number of reasons why people put off their filing for social security. In some cases, they seem to be simply hoping that the condition they are suffering from is going to improve, or that somehow the job that they are doing is going to be able to accommodate their disability. A lot of people tend to put filing off simply because they are afraid to admit on paper that they are disabled, because to them it means that they are incapable.

Many claimants end up feeling caught up in the process because they are worried about filing for disability and becoming denied. Unfortunately, when you are denied by your SSDI or SSI application, it may mean spending a great amount more time pursuing your claim by climbing the appeals ladder. For many of those applying, this is a scary idea and it leads them to stress themselves out about applying at all. Luckily, there are ways that you can eliminate or lessen these fears and focus your attention on properly and completely preparing

When you decide that you want to apply for these SSDI and SSI benefits, the first thing that you should do is to find out more information about having someone on your side, such as an attorney or an advocate. You can file as soon as you feel that you are ready, but you should not file until you have worked with a professional and determined whether or not you are fully prepared. Your attorney or advocate will be able to tell you if he or she feels that you will qualify for disability, and will help you shape your application or appeal accordingly. With this addition of support, you should be able to go through the process much more smoothly because there will be no doubt as to whether or not you are prepared.

If you are not working because of your disabled status or condition, then it is time to find out more about applying for SSI or SSDI benefits. When you have someone that is fighting on your side with you, it will make it easier for you to prepare your case and to determine whether or not you are prepared to file your claim.


Freedom Disability offers education and representation services to people living in the US seeking help applying for Social Security Disability Benefits. For additional information please contact Freedom Disability.

Five Myth-Busters: The Fiction And The Facts About Filing For Social Security Disability Benefits

There are many misconceptions about filing a disability claim with the Social Security Administration (SSA). Here are some of them, along with their factual counterparts:

Myth #1: You can't apply for benefits until you've been disabled for a certain period of time.

-- Myth-buster: Wrong! This is perhaps the biggest misconception about applying for disability benefits. Although you must show that your medical condition is severe enough to prevent you from working for a year or longer, you can and SHOULD apply as soon as you can no longer work, or as soon as your income drops below $980 per month in 2009 ($1000 per month in 2010) because your medical condition is preventing you from working full-time. Although it might take a year or longer for your claim to be granted, your benefits will be paid retroactively from the time of your filing or one year prior to the filing date in some cases. That means that if you wait six months or a year after you've become disabled to file your claim, you may forfeit being paid for that amount of time.

Myth #2: You can't apply for benefits if you're receiving sick leave from your job, worker's comp benefits or other work-related disability benefits.

-- Myth-buster: Wrong. You can apply for Social Security Disability benefits, even if you are getting other disability benefits.

Myth #3: You can't apply for benefits if you're working even a little bit.

-- Myth-buster: You CAN apply if you're not able to do 'substantial gainful activity.' According to SSA, substantial gainful activity means that you can make more than $980 per month, as of 2009, $1000 per month in 2010. If your medical condition is causing you to work less, you can apply for benefits even if you are still working a little bit.

Myth #4: Once I start receiving disability benefits, I will lose my benefits if I ever work again.

-- Myth-buster: Not true. If you get SSD (Social Security Disability) benefits, you can work for a trial period of eight months to assess your ability to return to the workforce,without losing or decreasing your benefits. If you're receiving SSI (Supplemental Security Income), you can work permanently within certain guidelines without losing or reducing your benefits.

Myth #5: If I'm a fairly young person, I'll have a harder time qualifying for disability benefits than an older person.

-- Myth-buster: Your age makes absolutely no difference in SSA's determination of whether or not you qualify for disability benefits. All that matters is whether your medical condition prevents you from being gainfully employed.


Sharon Christie is a nurse and an attorney in Timonium, Maryland. She handles Social Security disability and serious personal injury cases. Find out more about Sharon A Christie and request her popular free book, the Unofficial Guide to Social Security Disability Claims at www.SharonChristieLaw.com . You can also reach her at 410-823-8200.

Applying for Social Security Disability

Many of our clients ask us for help with applying for Social Security Disability. Below is a list of frequently asked questions about applying for SSD. If you, family member or friend has questions about Social Security Disability, contact me for a free consultation.

How can I tell if I am disabled enough to apply for social security disability benefits?

Social Security regulations make it easier to be found disabled as you get older. It becomes easier for a few people at age 45 (those unable to read English), for more people at age 50, for most people at age 55, and even more people at age 60. If you’re over age 55 and you cannot do any job you have done in the past 15 years, you should definitely apply. If you’re over age 50 and have a severe impairment that keeps you from doing all but the easiest jobs, you ought to apply.

But even if you’re a younger person, you don’t have to be bedridden in order to be found disabled. If you’re under age 45 or 50 and you cannot do your past jobs and you cannot work full time at any regular job, that ought to be enough.

How do I apply for Social Security Disability or SSI benefits?

The Social Security Administration (SSA) offers three ways for you to apply for Social Security disability benefits: by telephone, in person at a local Social Security office, or via the Internet. If you want to use the Internet to apply, go to www.socialsecurity.gov/applyfordisability/adult.htm.

If you want to complete an application for SSI or Social Security disability by telephone or in person, you must first telephone SSA at 1-800-772-1213. If you choose to go to a Social Security office to complete the application, the person at the 800 number above will schedule an appointment for you, give you directions to the Social Security office, and tell you what papers you need to bring along. If you want to apply by phone, you will be given a date and an approximate time to expect a phone call from someone at the Social Security office who will take your application over the phone. The application will then be mailed to you for your signature.

Do you have any advice about applying for disability benefits?

Yes. Give SSA all the information it asks for in a straightforward way. Be truthful. Do not exaggerate or minimize your disability.

Should I contact a lawyer to help me apply for Social Security Disability or SSI benefits?

As a rule, a person does not need a lawyer’s help to file the application. SSA makes this part very easy and, in fact, it usually will not let a lawyer (or anyone else) file the application for you.

What happens if I am denied benefits and I do not appeal within 60 days?

You’ll have to start over with a new application — and it may mean that you’ll lose some back benefits. So it’s important to appeal all denials within 60 days. It’s better if you appeal right away so that you get through the bureaucratic denial system faster. The quicker you can get to the hearing stage the better.

How do I appeal?

Your denial letter will tell you about appealing. The first appeal is called a “reconsideration.” You must request reconsideration and then, after the reconsideration is denied, you must request a hearing within the 60-day time limit.

You can appeal in one of three ways. (1) Telephone the Social Security Administration and make arrangements for your appeal to be handled by phone and mail. (2) Go to the Social Security office to submit your appeal. If you go to the Social Security office, be sure to take along a copy of your denial letter. And be sure that the Social Security representative gives you a signed copy of your appeal paper showing that you appealed on time. Or (3) appeal online at https://secure.ssa.gov/apps6z/iAppeals/ap001.jsp. Be sure to print and retain the receipt for your appeal so that you can prove you appealed on time.

What are the biggest mistakes people make when trying to get disability benefits?

Failing to appeal. More than half of the people whose applications are denied fail to appeal. Many people who are denied on reconsideration fail to request a hearing.

Another mistake, although much less common, is made by people who fail to obtain appropriate medical care. Some people with long-term chronic medical problems feel that they have not been helped much by doctors. Thus, for the most part, they stop going for treatment. This is a mistake for both medical and legal reasons. First, no one needs good medical care more than those with chronic medical problems. Second, medical treatment records provide the most important evidence of disability in a Social Security case.

Since medical evidence is so important, should I have my doctor write a letter to the Social Security Administration and should I gather medical records and send them to SSA?

SSA will gather the medical records, so you don’t have to do that. Whether you should ask your doctor to write a letter is a hard question. A few people win their cases by having their doctors write letters. You can try this if you want to. The problem is that the medical-legal issues are so complicated in most disability cases that a doctor may inadvertently give the wrong impression. Thus, obtaining medical reports may be something best left for a lawyer to do.

When is the best time for a lawyer to get involved in my case?

Many people wait until it is time to request a hearing before contacting us to represent them. Although everyone agrees that a lawyer’s help is essential at the hearing and the great majority of people who have lawyers win their cases at a hearing, how necessary it is to have the help of a lawyer at the early stages is a subject with arguments on both sides.

More than one-third of those people who apply will be found disabled after filing the initial application without a lawyer’s help. About 15% of those who request reconsideration are found disabled at the reconsideration stage, mostly without a lawyer’s help. If you are successful in handling the case yourself at the initial or reconsideration steps, you will save having to pay attorney’s fees. It is hard to predict which cases may benefit from a lawyer’s help early on.

We never get involved when someone is just filing an application. SSA makes it difficult for a lawyer to do much at this point. As a rule, we won’t get involved in a case until after an initial denial is issued and a legal controversy exists. About once or twice per year, though, a claimant points out to us an obvious (and quite unusual) legal problem with a case. We do consider getting involved in such cases before the initial determination is issued.

If you want us to consider becoming involved in your case at the initial or reconsideration steps, please telephone us to discuss your situation. Otherwise, the best time to call us is as soon as you get the reconsideration denial.

How much do you charge?

Almost all of our clients prefer a “contingent fee,” a fee paid only if they win. The usual fee is 25% (one-quarter) of back benefits up to a maximum amount set by SSA, currently $6,000.00. That is, the fee is one-fourth of those benefits that build up by the time you are found disabled and benefits are paid. No fee comes out of current monthly benefits. In addition to the fee, you will be expected to pay the expense of gathering medical records, obtaining medical opinion letters, etc.

Explosion occurs in silo at CraftMaster

From the Towanda Daily Review:

WYSOX - About 75 firefighters from four departments responded Wednesday night to the CraftMaster plant following an explosion at around 6:30 p.m. in a storage silo at the facility.

The explosion occurred inside a silo used to store wood fiber, according to Wysox Fire Chief Chad Benjamin. CraftMaster plant manager Matt Ameigh said the dust inside the silo reached ignition point, causing the explosion.

It appears from the story that thankfully no one was injured in the explosion.

Work related auto accidents

Recently, a person contacted our Firm asking whether or not they could receive workers’ compensation benefits due to injuries from an automobile accident in which they were driving their own car but were on company time. The simple answer is yes. As long as your actions come under the category of “furthering your employers business” then you can receive workers’ compensation benefits. It does not matter whether or not you are driving your car or the employer’s vehicle when the accident occurs.

Also, it does not matter whether you were at fault or someone else was at fault. Even if you are the one who caused the accident and was negligent and caused your own injuries, you are still entitled to workers’ compensation benefits. Those benefits would be wage loss, assuming that you have lost time from work, as well as the medical bills.

You may also be entitled to benefits from your own personal automobile insurance policy. You may have purchased wage loss coverage on your own personal automobile policy. If so, your auto insurance company will make up the difference that you have lost in workers’ compensation wage benefits up to the limit of the personal wage loss coverage.

Also, if the other driver was at fault, you can always pursue what is called a “third party action” against the negligent driver and receive pain and suffering money. This is always more advantageous then just strictly workers’ compensation because, under workers’ compensation, you are not compensated for any pain and suffering. In a negligence action you would be able to factor in how the injuries have affected your life.

If you have been involved in a work related automobile accident and you have questions, please do not hesitate to contact us at Carroll & Carroll, P.C.

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Medical Expert Testimony

In a recent case that was issued by the Commonwealth Court of Pennsylvania, Southwest Airlines v WCAB, the Court addressed what constitutes expert medical testimony regarding causation.

In this case, the Claimant’s physician relied solely upon self serving statements by the Claimant regarding a head and neck injury being related to work activities. The doctor did not know of Claimant’s numerous preexisting and prior injuries to his head and neck. The workers’ compensation Judge, nevertheless, awarded benefits.

However, the Commonwealth Court reversed and stated that the basis for the doctor’s testimony was not competent and therefore the doctor’s expert testimony regarding causation was not competent.

This case is indicative of several things including what you must prove in order to win your workers’ compensation case. First, your treating physicians must give an opinion that your injury or condition is related to work activities. Second, that opinion must be competent and have a substantial basis. Usually, the basis for these opinions are the history given by the Claimant, examinations, diagnostic tests and the doctor’s own experience and education.

In the above case, it is apparent that the Claimant’s attorney did not adequately prepare the doctor regarding the issues in the case, specifically the prior injuries. If the Claimant’s attorney had prepared the doctor with the prior facts and the prior medical records and the doctor still had the opinion that the injuries were caused by the work activities then I am sure this case would not have gone up on appeal. This is a teachable moment for practicing Claimant’s attorneys in preparing their cases adequately as well as their medical experts.

Lockheed Martin to cut 1,200 jobs

From the Morning Times in Sayre, Pa:

OWEGO — When announced Nov. 17, Lockheed Martin’s merger of two Electronic Systems businesses into a new Mission Systems and Sensors (MS2) business was expected to eliminate some positions, but officials were unsure of how many.

On Wednesday, with the establishment of MS2’s structure, Lockheed Martin officials announced that this merger would eliminate 1,200 positions nationwide, but that the specific effect to the Owego plant would not be known until April, when employees are notified.

Hopefully, not many of the Owego jobs will be cut. Our area can't take any more significant job cuts.

Can a 27 year old injury be deemed work related?

In the case of Lancaster General Hospital v. WCAB (Weber-Brown) the Commonwealth Court of Pennsylvania decided that a claim on a twenty seven (27) year old eye injury was not beyond the three (3) year statute of limitations for work injuries.

In this case, the injured worker was exposed to a virus in his eye in approximately 1980. The claim was never formally accepted. Throughout the years, the Claimant continued to have periodic infections in the eye due to the virus he contracted at work.

In 2007, the Claimant suffered another one of the periodic infections. However, at this point, the infection could not be treated properly and the Claimant lost the use of the eye. The Claimant then filed a Petition for specific loss of the eye.

Despite the fact that it was twenty seven (27) years later, the Court said that the important date was not the exposure of the virus but rather the date of the “injury.” The Court indicated that in this particular case, the “injury” was the specific loss of the eye which occurred in 2007. As long as a Petition was filed within three (3) years of when the Claimant lost the use of the eye, then the claim would not be beyond the statute of limitations.

Abnormal Working Conditions

The Commonwealth Court decided a case recently on what constitutes an abnormal working condition. As we’ve blogged about before, an employee can claim a work related injury for mental trauma; however, the claimant must show that an abnormal working condition caused the trauma.

Merely having something bad happen at work does not necessarily translate into an abnormal working condition. For example, in prior cases, the Courts have held that a police officer suffering from post traumatic stress disorder due to being engaged in a gun battle with criminals was not an abnormal working condition because police officers often are involved in gun battles. Also, being yelled at by your boss significantly does not constitute an abnormal working condition.

In my opinion, in the case of McLaurin v WCAB (SEPTA), the Commonwealth Court of Pennsylvania unjustifiably restricted, once again, the definition of “abnormal working conditions.” In this case, a bus driver was assaulted by several hooded young men with guns. Due to this, the claimant suffered post traumatic stress disorder as well as psychological problems.

The employer presented evidence which showed that such occurrences were not extraordinary and did happen somewhat often while being a bus driver, despite the fact that it did not happen ever to this particular bus driver. The Court held that this occurrence was not an abnormal working condition.

In my opinion, I think the Court is completely off base. The injured worker was a bus driver. He was not in law enforcement or in any type of position where he would receive the training and skills to cope with such a happening. Once again, this is evidence of the Commonwealth Court severely limiting the rights of injured workers.

Labor moves quickly on job safety, workers' rights

Do you think you would see news stories like this if more Republicans were elected? Here's a link to the AP article.

Her aggressive moves to boost enforcement and crack down on businesses that violate work place safety rules have sent employers scrambling to make sure they are following the rules.

* * *

But a November report from the Government Accountability Office suggested there is widespread under reporting of work place safety issues.