Eligibility Requirements for Disability Benefits

Are you disabled? Does your disability prevent you from working? You may be eligible for social security disability benefits. Insler & Hermann knows that it’s not easy to apply for social security disability. We can help.

Most people are denied the first time they try

Call us today and let us help you get the disability benefits you deserve. We’re with you every step of the way. The sooner you meet with us, the sooner we can help you receive the benefits you deserve. We don’t get paid unless you win. Be our next success story.

By: Lew Insler

Veterans Affairs Issuing Impairment Protocol

My name is Gideon Miller, and I’m going to explain to you how ratings are issued by the VA, for multiple impairments including Post-Traumatic Stress Disorder. Multiple impairments are not simply added up to obtain a novel rating in a VA claim. Each decreasing impairment is seen as a percentage of what is left. For example, a 15% impairment leaves you with 85% remaining. A further 10% impairment is taken against the 85% to yield an additional 8.5% rating.  And the total of 18.5% would usually be rounded to 20%.

However, the VA can also pay a benefit greater than the 100% rating amount for cases of Individual Unemployability or IU. To qualify, you must have at least one service-connected disability rated at 60%, or alternatively, two or more service-connected disabilities with at least one disability rating at 40% or more, with a combined rating of 70% or more.  You must be unable to maintain substantially gainful employment as a result of your service-connected disability.

Individual Unemployability & Post-Traumatic Stress Disorder

Marginal employment such as odd jobs, is not considered substantial gainful employment for VA purposes. While Individual Unemployability can come from many combinations of impairments, it is frequently associated with claims for Post-Traumatic Stress Disorder. Due to the great deal of attention this condition has received in the past 10 to 15 years, there are now a number of presumptions in favor of a diagnosis of Post-Traumatic Stress Disorder.

For example, if you’ve served in combat, and you can prove that your PTSD is related to that combat experience, the presumption applies. But even if you think you meet one of the presumptive causes, there may still be difficulty showing the existence of the stressor to the VA satisfaction. You may be found to have a service-connected disability for Post-Traumatic Stress Disorder from a stressor that is not among the presumption. However, in that case, you will need a medical report connecting the stressor and the diagnosis called a Nexus Report. Nexus reports are needed for any condition for which a presumption does not exist in the law.

Exposure to Agent Orange

The other major condition for which there are presumptions, is for Vietnam arrow exposure of the Agent Orange. Proof of exposure to Agent Orange, and a diagnosis of certain conditions such as diabetes or leukemia, allow for a finding of service connection.  However, in any of the presumptive service-connected impairments, the rating is still subject to the usual factors.

By: Gideon J. Miller

Common Errors in Social Security Claims

Some of the biggest mistakes people make in filing for Social Security Disability is, first of all, waiting too long to apply, which can cost them retroactive benefits. Giving up when they’re turned down the first time, which is what Social Security wants you to do. Thinking that they can’t apply at all because the disability has to be permanent, but it only has to last for 12 months. And finally, failing to include all your medical problems. For example, only including things that are a result of an auto accident or a Workers’ Compensation claim when there are other impairments or medical problems that affect your ability to work.

By: Lew Insler

Railroad Retirement Act Benefits

Hi, I’m Gabe Herman, and today we’re going to speak about what benefits are available under the Railroad Retirement Act that are different from those received from Social Security. The Railroad Retirement Act provides for two kinds of benefits to railroad employees: tier one benefits and tier two benefits.

Tier One & Tier Two Benefits

A tier one benefit corresponds neatly with the benefits that a claimant would collect under the Social Security Act. Tier two benefits, on the other hand, are a pension benefit unique to railroad workers who retire or are rewarded a disability annuity. The combined tier one and tier two benefits are generally higher than what a Social Security beneficiary would collect.

Dual Benefit Reduction

If somebody is eligible for both Social Security and railroad benefits because of their work history, that person will only get the larger benefit, whether it is the Social Security benefit or the railroad benefit. This reduction occurs because benefits are based on combining railroad and Social Security credits, figured under Social Security’s formulas, and reflects what Social Security would pay if railroad work were covered by that system.

The dual-benefit reduction follows the principles of Social Security under which a beneficiary receives only the higher of any two benefits that are payable. Railroad retirement benefits rise with cost-of-living adjustments at the same rate and at the same time that Social Security benefits increase. Generally, tier one benefits are calculated using the same formulas as Social Security benefits.

By: Gabe Hermann

Qualifications for Occupational Disability Annuity

Hi, I’m Gabe Herman, and today we are going to speak about the difference between occupational disability and total disability under the Railroad Retirement Act. In order to be eligible for an occupational disability annuity, you need to be unable to work in your regular railroad job. While you might be able to do other work, the railroad is concerned specifically about the job you did for them.

In addition, you have to have a current railroad connection with either 240 months of creditable railroad service, which comes to 20 years in, or be at least 60 years old with 120 months of creditable railroad service, which is a ten year tenure. In addition, you have to be permanently disabled from the work you did in your regular railroad occupation. Regular railroad occupation is the job you did in the last few years that you were working for the railroad. For example, if you were a conductor, you have to be unable to do the jobs that the railroad requires a conductor to be able to do. If you were an engineer, you have to be unable to drive a train. If you worked in the office, you have to be unable to do the office work, whether it was clerical or computer or ticket taking.

Qualifications for Total Disability Annuity

If you have not worked for 20 years with the railroad, or if you are not over 60 and have 10 years in, the benefit that you are eligible from the railroad is the total and permanent disability annuity. In that case, you have to be unable to work in any kind of job at all. An additional qualification is you have to have at least 120 months of creditable railroad service and be permanently and totally disabled from any kind of regular work. If you don’t have 20 years into the railroad, but you have over 10 years of work with the railroad, and you are unable to work in any capacity at all, you might be eligible for a total and permanent disability annuity.

Again, you have to be unable to work in any other kind of job to qualify. Not just the work you did for the railroad, but any other work. You have to stop all work, but you do not have to have a current connection to the railroad. You should consult with an attorney to determine which kind of benefit is appropriate for you to seek, and exactly what you must do in order to be eligible for that benefit.

By: Gabe Hermann

Eligibility for Railroad Benefits

Hi, I’m Gabe Hermann and today we are going to speak about why you should have an attorney handle your railroad retirement claim. Eligibility for railroad benefits is dependent on a large number of factors, including your period of service, whether you have a current or remote service connection, the type of benefits you are due.

In addition to that, factors to be considered are the type of work you performed and your age. There is a complex interplay between eligibility for railroad benefits and for social security disability benefits. You will benefit from working with someone who understands how to make sure that you maximize the benefits to which you are entitled.

Winning Railroad Retirement Claims

As attorneys who have represented thousands of disabled clients, we understand what the decision makers at the Railroad Board are looking for, and we can best explain to physicians and treating sources what information is most critical to showing a disability. We understand the claims process. We know the hearing officers, and we are known by them. We can maintain channels of communication with the people who decide if you are disabled, and we make sure that they have all of the information that they need in order for them to make a determination.

In short, we know what it takes to win your railroad disability claim, and we help make sure to present your railroad disability claim correctly by actively monitoring your claim and making sure that the board’s decision makers follow the law and the applicable regulations when deciding your case.

By: Gabe Hermann

Working While Applying for Social Security Disability Benefits

Hi. This is Lew Insler from Insler & Hermann, and today we’re going to talk about working while applying for, or receiving social security disability benefits. We feel our clients are better off financially and emotionally if they’re working. We never tell a client not to try to work, as long as their doctor approves, and a full answer as to whether or not you can work, depends on the specifics of your case. But generally, the following holds true. You can work at a level below what’s called Substantial Gainful Activity, and the amount for that changes each year, and still pursue your claim or continue to receive benefits. During the claims process, you can work up to three months in most cases, and six months under limited circumstances regardless of your earnings, and still use the original date of disability. That’s called an Unsuccessful Work Attempt, and it may actually help your claim.

Working After Winning Disability Claim

After you have been found disabled, you’re entitled to a Trial Work Period of up to nine months of an unlimited earnings, and those months don’t have to be consecutive. They can be within the first five years of your disability, after which any month in the next five years, where you make more than the Substantial Gainful Activity amount, you’re no longer entitled to benefits for that month. After those five years end, any month above Substantial Gainful Activity ends your entitlement to ongoing benefits. If you’re self-employed, it’s more complicated than just how much you were earning. Pensions, disability benefits, and other sources of wage replacement, do not affect your benefits. However, workers compensation might. The total of your social security disability and your workers compensation, can’t go over 80% of your past earnings.

By: Lew Insler