Important facts regarding concussions or traumatic brain injuries

Do you have to strike your head to suffer a concussion or brain injury?

Not necessarily.  Concussions are typically thought to involve some type of impact to the head, but the injury to the brain mostly comes from the impact and motion that occurs within the skull.  The injury from a concussion or brain injury most often occurs when the brain impacts the inside of the skull or the layers of the brain rub upon each other due to the sudden acceleration or deceleration of the head.  This type of motion can occur when you are moving and suddenly stop.

What are the most common causes of concussion or brain injury?

According to the Center for Disease Control (CDC) the most common causes occur as the result of falling, motor vehicle accidents, unintentional impact to the head by moving objects and sports such as football, hockey and soccer.

What are the symptoms of a brain injury?

Symptoms of concussion or brain injury can be broken down into the categories of physical, cognitive, sleep and emotion.  The chart below lists the symptoms according to category.  Someone who has suffered a concussion or brain injury may have one or any combination of these symptoms.

Who are the people most likely to suffer a concussion or brain injury?

The people most likely to suffer a concussion or brain injury include children and young adults.  Statistics have shown than the ages of injury victims within this group range from 5 to 25 years old.  Another group of people who have been shown to suffer a higher frequency of concussions and brain injuries is those adults over the age of 75.  It is believed that older adults often sustain concussions and brain injuries due to falls.

What should I do if I believe that I or someone I know has suffered a concussion or brain injury?

If the injury has just happened, it is best to go to the emergency room of your local hospital.  If the symptoms have been present for more than 2-3 days, it is best to go to your physician, or if you can, go to a neurologist who has experience in treating concussions or brain injuries.  Another type of specialist is a physiatrist; that is a doctor who specializes in the field of physical medicine and rehabilitation.  Neurologists and physiatrist are often better trained and experienced in diagnosing and treating concussions and brain injuries than other specialist.

Once you get to the emergency room or doctor’s office, expect the doctor to perform an examination and have you undergo tests such as an MRI and CT scan.  These types of tests look for visible injuries to the brain and the skull.

Unfortunately, concussions and brain injuries are not often able to be detected on MRI and CT scans.  The reason for this is the fact that the injury to the brain is many times found on a microscopic level and the current MRI and CT scan technology isn’t able to identify damage on such a small scale.  In such cases, more testing may be required.  It is important to realize that just because there are no abnormalities found on your MRI or CT scan; it does not mean you have not suffered a concussion or brain injury.  Further testing known as neuropsychological testing is used to determine what processes of the brain have been affected due to injury to the brain.

Why is it important to hire an attorney with experience handling brain injury cases?

The damage caused to the brain from a concussion or brain injury is often so subtle, most doctors and attorneys don’t recognize it.  It is therefore essential to the success of your case and your medical care that your attorney know what to look for and what type of treatment you should be getting.  As experienced brain injury attorneys, we are able to recognize the signs of a brain injury and make sure you are being treated by the right medical professionals.  Don’t leave it to chance; call Hensley│Chalfant, P.A. today for a free consultation. (727)781-3433.

Nurses have the legal responsibility of keeping their patients safe, which includes preventing medication errors.  Unfortunately, many nurses fail to double check medication orders and verify correct dosages that should be prescribed when physicians order excessive doses.  

Our firm is currently representing an estate of 4 minor children who lost their 44 year old mother because of a serious medication error that wasn’t investigated by the nurses before giving her excessive dosages of anti-depressant medication.  The children’s’ mother had been admitted to a New Port Richey, Florida hospital for depression because she had run out of her usual anti-depressant medication.  For many years she had been taking 40 mg of Celexa (generic name citalopram) every day, which had been effective in treating her depression.  After she was admitted to the hospital the on-call psychiatrist (who did not know this patient) was called in the middle of the night for medication orders.  Without checking with the woman’s usual psychiatrist and without checking her medical records to confirm her medication dosage, the psychiatrist ordered 120 mg of Celexa.  The Physician’s Desk Reference (”PDR”), the drug manufacturer, the FDA, and all other Nursing Medication Handbooks recommend 40 mg of Celexa as the maximum that should be prescribed.  Nurses know (or should know) that patients should never be given this excessively high dosage, and they also know that all medication dosages should be verified before being given to patients.  In situations where excessive medication dosages are ordered by a physician, nurses are required to question and investigate the order.  When the nurse verifies that the dosage is in fact excessive and determines that the excessive dosage may cause harm to the patient, the nurse is legally required to be an advocate for the patient and should refuse to give the medication to the patient.

After receiving excessive amounts of medication for 3 days, the 44 year old woman was found dead in her hospital bed.  Autopsy results revealed toxic levels of Celexa and her cause of death was determined to be “drug toxicity.”   The nurses who gave the excessive medication to this woman all admitted in deposition that they knew the medication was excessive when they gave it to their patient, yet they didn’t question the doctor’s order and they didn’t hesitate to give it.

We all know that in our everyday lives accidents occur and when an automobile accident occurs, one may be confused about what steps to take.  In the state of Florida, everyone is required to carry automobile insurance.  As part of that insurance coverage, one must have $10,000.00 in PIP coverage, which may be contracted for with or without a deductible.  If an individual can afford the insurance without a deductible, this is certainly preferable because in many cases, when an individual is hurt the first thing they are told is that they have to pay their deductible before the insurance company will begin to cover their medical injuries.  This is always bad news and certainly comes at a very bad time.

What to do at the accident scene:

When involved in a motor vehicle accident, it is important that the police are contacted and that an accident report is written to document whom is at fault.  It is important to record the date of accident, who the police agency is that conducted the investigation, write down the make and model, tag number, vehicle identification number of the person who hit you, and gather the same information with regard to your own vehicle.  Write down the insurance information, policy number of the individual who hit you and gather the same information with regard to your own vehicle.  Contact your insurance company immediately.

Your insurance company may want to take a recorded statement that will be preserved for later use.  You may also want to contact the insurance company of the person who caused the damage to your vehicle to discuss your property damage.  Be mindful that they also may want to take a statement from you and possibly record it.  You do not have to agree to a recorded statement.  If you do not want to be recorded tell them. It is important to write down how the accident occurred.  You may want to write that down so that when you meet with an attorney at a later date, you will have this information to present.  If there are any witnesses on the scene who saw the accident, you may want to write down their names, addresses, and phone numbers so that the attorney can contact them for further interview.

After the accident:

Take your vehicle to a reputable body shop for repairs, get estimates.  Get checked out by your family physician and if your injuries are such that require immediate care, go to your local emergency room.  Be sure that they record all of your complaints at that time.  Be mindful that whatever you say will be written into the medical record.  It is important to observe whether or not you were wearing your seatbelt because the at-fault party’s insurance company will use this as a defense if you fail to wear your seatbelt.  It is important to note whether you were carried to the hospital by rescue or by your own personal vehicle.  Record the names of the doctors that you visit for further interview by your attorney and for gathering records at a later date.  Make notations on whether x-rays were taken and where and when.  Collect any pertinent past medical history that may be of interest to your attorney.

Missed Work:

You may also miss time from work because of your accident.  Provide the name of your employer, your job title, your pay rate, and how much time you have missed from work.  You may also have to obtain a 13-week wage statement from your employer showing your past earnings prior to the accident to establish your lost earnings for future reimbursement.  It is important that you keep track of dates that you missed from work.  If there were others in the vehicle with you at the time of the accident that suffered injuries, they too may also have claims that require representation by an attorney.  Following an accident, your immediate concern will be who is paying my medical bills.  When an accident occurs, it is the responsibility of your personal injury protection carrier, the company that insures your motor vehicle, to pay for the first $10,000.00 of your medical coverage unless you have a deductible.  In addition, you may have also contracted with your automobile insurance carrier for additional medical coverage.  This is known as med. pay.  This will pay for things that your personal injury protection will not pay for.  These monies will be paid until they are exhausted.

When these monies are exhausted, then your health insurance becomes the primary insurance carrier and your health insurance will then cover whatever medical occurs after the PIP and the med. pay have been exhausted with your automobile carrier.  Your health insurance will have a lien against any recovery you make in your personal injury action against the at-fault driver and it is important to keep track of this information.  When you meet with your attorney, you will want to provide him with the name of your health insurance company and the policy number so that the attorney can gather the information and be mindful that a potential third party lien is involved in your case.  In Florida, a doctor must determine that you have a permanent injury in order to recover under the Florida Automobile Act against the at-fault party.  If you know someone who has been injured in an automobile accident, ask him or her how their insurance company treated them during the course of their medical and lost income periods.  This will give you a good idea of how an insurance company might treat you if you were in the same situation.

Many people take it for granted that the insurance company will live up to its word or its motto.  In many cases this is not true; however, there are still some very good insurance companies out there.  In many cases, they can be sought out simply by asking questions of your friends and family members.

Should you have additional questions regarding your automobile insurance rights or if you have been in an automobile accident and need assistance, help is a phone call away.  Call Hensley│Chalfant, P.A. (727)781-3433 or visit our website www.nurse-attorney.com.

Misconception #1: The insurance company must be right.  After all they wrote the policy.

Not true. It’s not a matter of right or wrong.  Insurance companies have one goal: to keep your money in their bank account.  When you file a claim, they ask you to believe every conceivable reason why they won’t pay you benefits.  They know that in many cases, you will believe whatever they tell you.  This is a mistake.  Any time an insurance company denies a disability claim, make sure you consult a lawyer for a second opinion.  After all, the only time insurance companies are put to the test is in front of a jury.  And the number of multi-million dollar verdicts against insurance companies proves that juries don’t always agree with the insurance company’s opinion.  Bottom Line: don’t accept what an insurance company says.  If they deny your disability claim, make sure you speak with a lawyer skilled in overturning disability claims that insurance companies have denied.

Misconception #2: You can’t appeal a denial.  The insurance company has the last word

Not true.  You can hire a lawyer to build a case and approach the insurance company on your behalf.  And if the insurance company doesn’t listen to reason, then your lawyer can sue them on your behalf and take them to trial.  Insurance companies have a lot of money, but they never have the last word.  That belongs to the jury.

Misconception #3: Fighting back will be too stressful on you.

Not necessarily true.  Your lawyer and his staff should build your case and do nearly all of the work.  Still, no one will say you won’t feel stress because you probably will.  But consider which situation is more stressful:  When the insurance company has your money and won’t pay you.  Or when you go to trial and recover money that should be yours.  Regardless of whether the insurance company settles your case before trial or whether you win your case at trial, a big check from an insurance company can go a long way to reducing your stress.

Misconception #4: You can’t win even when you do fight back.  The insurance company is just too big.

Not true.  Skilled plaintiffs’ lawyers know how to get money from insurance companies.  Policy-holders and their lawyers win cases against insurance companies every day of the week.  Whether you win depends on the facts in your case and the contents of your disability insurance policy.  Not surprisingly, insurance companies always interpret the facts in their favor.  Your lawyer interprets the facts in your favor.  You can fight back. And, after reviewing your policy, a skilled disability lawyer can help you evaluate your likelihood of success.

Misconception #5: It’s just not worth it.

Maybe, maybe not.  Until you know what your claim is worth, you’ll never know whether it’s “worth it.”  Do yourself a favor; don’t make any decisions about your insurance policy or insurance claim until you ask a disability lawyer to review your claim.  Once you know the potential value of your claim, then your lawyer can give you an informed opinion about the outcome.  From that, you can decide whether you think the claim is worth pursuing.  But don’t jump to conclusions too soon.  After you talk with a skilled disability attorney, you may be amazed what your claim is really worth.

Secret #1: Recognize the problem (disability) when it arises.  You don’t have to be catastrophically injured or terminally ill to collect.  Many policies provide money for partial disability.  Look for such things as loss of productivity, loss of income or the inability to perform the material and substantial duties of your occupation.

Secret #2: Give the insurance company notice of your claim as early as possible.  Late notice could result in a substantial loss of monthly benefits.

Secret #3: Use multiple witnesses to identify the material and substantial duties of your occupation such as a colleague, a vocational evaluation expert and yourself.  Before you can get disability benefits, the insurance company or jury must clearly understand the important duties of your occupation.  Don’t leave this to chance or only your testimony.  Make sure you offer witnesses that identify and verify the duties of your position.

Secret #4: Identify and focus on the material and substantial duties of your occupation that you cannot perform due to physical or mental limitations.  Once the insurance company or jury understands what your occupation entails, then they must understand what you are no longer able to do based on your disability.

Secret #5: Document your loss of productivity with business records or even appointment calendars.  The court looks for you to prove your disability.  Since memories often fade, you present a stronger case when you rely on something more than your memory.  Written records, such as an appointment calendar and even a daily journal greatly increase your credibility and give the jury the support they needs to decide in your favor.

Secret #6: Use business records and income tax returns to document your loss of earnings based on your loss of production.  The more money you can prove you lost, the more likely the jury is to recognize your problem as a disability.

Secret #7: Use past medical records to demonstrate onset and progression of the disability.  Your doctor’s medical records provide accurate snapshots of your symptoms and condition.  The more your doctor documents your condition, the more likely the jury is to believe your claim.

Secret #8: Maintain a regular schedule for medical treatment.  Make sure you do not allow lapses in treatment to occur.  When they see lapses, insurance companies always suggest that you aren’t very sick or disabled since you haven’t gone to your doctor.  In fact, the carrier could cut off your benefits if you don’t maintain an ongoing course of medical treatment.

Some of the following terms apply only to group policies.  Others apply to both group and individual disability policies.  These terms were provided by Hartford Life.

Active, Full-time Employee. An individual must work for the employer on a regular basis in the usual course of the employer’s business to be considered an active, full-time employee and eligible for coverage.  Usually, the policy specifies a minimum number of hours of regular work.

Benefit Percentage. The benefit payable is usually determined as a percentage of the insured’s pre-disability income up to an overall maximum benefit amount.

Conversion Privilege. If included, this option allows employees who are terminating employment to continue some or all of their LTD coverage at their own expense without submitting evidence of insurability.

Definition of Total Disability. One of the most important provisions in a disability contract is the definition of disability that will be used to determine an employee’s eligibility for benefits.

• Own Occupation (Own Occ): Under this definition, an insured will be considered disabled only if he or she is unable to perform the material and substantial duties of his or her occupation.
• Any Occupation (Any Occ): Under this definition, an insured will be considered disabled only if he or she is unable to work in any occupation for which he or she is qualified by education, training or experience.  This is closely related to the definition that the Social Security Administration uses in determining disability.

Definition of Partial/Residual Disability. This further definition of disability applies when an insured is able to return to work part-time or even full-time (with a loss of earnings).  If the employee works in this limited capacity and earns less than a certain level of income, he or she will still be eligible for limited benefits under the plan.  Not all disability insurance carriers use this terminology to describe a part-time work situation, but most provide some type of benefit to encourage return to work.

Elimination Period. This is the period of time between the date the disability begins and the start of the benefit payment period.  It is the period during which an employee must be disabled before payment of benefits begins.  It is sometimes referred to as the Qualifying Period.

Evidence of Insurability. Group disability coverage is generally sold as “guaranteed issue,” which means that evidence of insurability is not required.  However, under certain circumstances (e.g., late enrollment or a high benefit maximum), an employee must provide medical or financial information as proof to the insurance company that he or she is insurable.

Exclusions. Group disability plans include specific provisions that exclude coverage in certain situations.  Typically, a plan will not pay benefits for disabilities arising from war, participation in a riot, commission of a felony, or self-inflicted injury.

Family Care Expenses. A disabled employee who has family care responsibilities may need extra help when trying to return to work.  This type of benefit provides an incentive to the employee who is taking part in a rehabilitation program by allowing credit or partial reimbursement for certain expenses incurred for family care.  This is generally an optional benefit under most long term disability policies.

Indexing. Indexing is designed to provide some protection against inflation.  After the first year of disability, a disabled employee’s pre-disability earnings are usually increased (or indexed) by a certain percentage on an annual basis.

Limitations. Group disability plans may include specific provisions that limit coverage in certain situations.  Often only limited benefits are payable for specific conditions or under specific circum-stances, such as mental illness and pre-existing conditions.

Mandatory Rehabilitation. A mandatory rehabilitation provision encourages disabled employees to participate in rehabilitation efforts whenever appropriate.  This provision allows the insurance company to stop paying benefits if the employee refuses to cooperate or participate with a rehabilitation plan.

Maximum Benefit Period (Benefit Duration). This is the maximum length of time the insurance company will pay benefits as long as the employee remains continuously disabled.

Maximum Monthly Benefit. This is the highest dollar amount a disabled employee can receive on a monthly basis under the long-term disability plan.

Mental Illness and Substance Abuse Limitations. When a disability is caused by a psychological/ behavioral/emotional disorder, or by alcoholism or the non-medical use of narcotics, sedatives, and so on, benefits are usually limited to a period of 12 or 24 months unless the employee is confined to a hospital.

Minimum Monthly Benefit. This is the lowest amount paid as a monthly benefit after reductions for Other Income Benefits.

Other Income Benefits (Benefit Integration). While disabled, an insured may be eligible for benefits from other sources.  Benefits payable under the LTD plan may be reduced by other sources of disability income such as Social Security, workers compensation, or disability benefits received from other employer-sponsored plans.

Pre-Disability Earnings. This is the amount of an employee’s wages or salary that was in effect and covered by the plan on the day before the disability began.

Pre-Existing Condition Limitations. When an insured has a physical or mental condition that existed prior to the effective date of his or her insurance coverage, it is considered a pre-existing condition.  Most plans exclude or reduce disability benefits for any illness or injury for which an employee received medical treatment or consultation within a specified time period before becoming covered under the plan.

Recurrent Disability. The recurrent disability provision protects an employee who tries to return to work but becomes disabled again from the same or a related cause.  If this happens within a certain period of time, the employee will be considered disabled from the original disability, and will not be subject to a new elimination period.  This encourages an employee to return to work without fear of losing benefits.

Rehabilitation. Rehabilitation means the restoration of or improvement in an employee’s health and functionality.  It usually involves a program of clinical and vocational services with the goal of returning a disabled employee to an active, productive life and a meaningful occupation, if possible.

Return to Work Provision. To encourage employees to return to work as soon as they become physically able, an added incentive is usually provided for a certain period of time, called a return to work provision.  Under this provision, the employee can receive up to 100 percent of pre-disability earnings based on a combination of disability benefits and return-to-work earnings.

Survivor Benefit. This is a lump sum payment that will provide benefits to the insured’s eligible survivors in the event the insured dies while receiving disability payments.  This is an optional benefit in most policies.

Waiting Period. In order to become eligible for coverage under the policy, a person must satisfy a certain number of continuous days of service as an active, full-time employee.  This is known as the waiting period. (In addition, a waiting period can also be the time period between when a disability occurs and when payments from the disability insurance policy begin.)

Waiver of Premium. When an individual becomes disabled and eligible for benefits, the person does not have to pay disability premiums as long as he receives benefits.

Workplace Modification or Accommodation. This benefit helps an employer when a disabled employee requires modification of the workplace or special adaptive equipment in order to return to work.  The employer will usually be reimbursed up to a set amount for the cost of modifications.

A surprising number of professionals face the real danger of suffering a disabling injury during their careers.  The U.S. Census Bureau says workers have a one in five chance of suffering a disability.  In 1997, the Census Bureau released results of a study showing that 152,000,000 people between ages 21 and 64 have a disability.

The American Council of Life Insurers reports that a person 35 years of age is six times more likely to suffer a disabling injury than die before he/she reaches age 65.  This is why so many professionals need and buy long-term disability (LTD) insurance.

When a disabling injury robs you of your ability to earn a living, you and your family could face devastating financial problems. Some professionals have savings accounts that can support them for a few months, but most people cannot afford to stop working for an extended period.  This is where long-term disability insurance can help.

What is Long-Term Disability Insurance?

When short-term disability benefits run out — usually after twelve to twenty-four months — your long-term disability benefits kick in. T he LTD policy usually pays you half to two-thirds of your salary for whatever term your policy specifies, often until you reach 65 years of age.

Disability insurers often work with employers, vocational experts and their own doctors to force you return to work as quickly as possible.  They know they can save a lot of money if you return to work soon.  When you start drawing long-term disability benefits, insurers start managing your claim with the goal of terminating your payments as quickly as possible.

Disability insurers are even likely to aggressively manage your claim if you are only “partially disabled,” which means you can continue to work but in a capacity that pays much less than you previously earned.  If your disability forces you to earn a lower salary, LTD insurance will pay you added money, as follows:

Suppose you work as a professional and draw a salary of $400,000 annually.  You carry disability coverage that pays $100,000 annually.  You suffer an injury or illness and can no longer perform the material and substantial duties of your occupation.  You take a position in an office that pays $150,000 per year.  If your LTD policy provides for partial disability payments, you may be entitled to a percentage of your full monthly payment equal to the percentage of wage loss you have incurred.  In this example, you may be entitled to 62% of your LTD benefits.  You collect income from the new job — and you benefit from disability income as well.

In some cases, disability insurers give companies an incentive to have employees return to work on a part-time basis.  Insurers usually give employers a premium reduction on the group policy if they allow a person with a partial disability to come back to work on a part time basis.

If you suffer a disabling injury and start receiving benefits, you no longer must pay premiums.  Your policy may refer to this as a “waiver of premium.”

In addition, if you paid your premiums with after-tax dollars, your disability income will not be taxed.  If your employer pays for your disability insurance with pre-tax dollars, you will pay income taxes on your benefits.

If your employer does not offer group disability insurance — or if you feel your coverage is not adequate — consider buying an individual short-term or long-term disability policy.  According to the American Council of Life Insurers, a person 35 years of age who has a disability for 90 days will likely be disabled for an average of three years.  If you don’t have an individual long-term disability policy, you could find yourself bankrupt if you don’t work for three years.

Premiums on employer provided group policies are often only 10 to 20% of the premium for an individual policy, depending on your age, occupation and income.  However, these policies have more stringent definitions of disability and are governed by laws that strongly favor the insurance companies and employers.

An individual disability policy pays you a fixed amount each month, usually not exceeding 80% of your current salary.  When determining whether the insurer will cover you — and for what premium amount — the insurance company looks at your occupation, income and other sources of insurance.  When the insurance company determines your rate, it places you in a rating class with people who share similar characteristics as yours.  And if you choose to buy an individual policy, you must take a medical exam.

You can buy most disability policies on a non-cancelable or guaranteed renewable basis.  ”Non-cancelable” means the insurer cannot cancel your coverage or raise your premiums after it issues your policy.  ”Guaranteed renewable” means the insurer cannot cancel your coverage as long as you pay premiums, but it can raise your rates.  Even so, the insurer cannot raise rates on an individual basis.  Instead, it will raise rates if you are part of an insured group that has filed a high number of claims.

In most cases, you can buy individual disability policies that will cover you for two years, five years, or until you reach age 65.  Also, most individual policies allow benefits to keep up with inflation or gradual increases in salary, such as a cost of living adjustment, which adds each year to your coverage.  You can also purchase a policy that allows you to increase your monthly benefit as your income rises.  This is called an increased benefit rider.

Disability insurance is an important part of your financial plan.  And since you’re much more likely to suffer a disabling illness or injury than die, you need disability insurance as much as, if not more than you need life insurance.

Disability Defined. What constitutes a disability?  Some policies pay benefits only if you cannot perform the duties of your normal occupation.  Others pay only if you cannot work at all.

Payment Trigger Date. Some policies allow you to determine when your payments begin.  You choose the waiting period at the time you apply for coverage. (Same as Payment Start Date)

Extent of Disability. Some policies require that you be totally disabled before you receive payments.  On occasion, some policies pay for your partial disability for a limited time, but in most cases, only if your partial disability follows a period of total disability for the same cause.

Residual Benefits. Residual benefits help make up the difference in your income if you are able to work, but are limited in your earning capacity due to your disability.

Presumptive Disability. Some policies pay benefits if you are still able to work but have lost your sight, speech, hearing, or use of limbs.

Payment Start Date. You choose when you want to start receiving disability payments, anywhere from 31 days to six months after becoming disabled.  The longer you wait without receiving payments, the lower your premiums.

Term of Coverage. You can usually select how long you want to receive payments.  You may choose to receive payments for two years, five years, or until you reach age 65.  Some companies offer policies, which will pay monthly benefits throughout your lifetime.  The longer you receive payments, the higher your premium.

Inflation Adjustments. You can buy a cost-of-living adjustment (COLA) to add to your disability insurance policy.  This provision usually boosts payments to you by 4 to 10 percent each year.

Waiver of Premium. Most policies allow you to stop paying premiums if you have been disabled for at least 90 days.

1. What is the definition of disability used by Social Security?

Under the Social Security Act, “disability” means “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than 12 months.”

2. How many different types of Social Security disability benefits are there?

There are at least five major types of Social Security disability benefits.  Disability Insurance Benefits is the most important type of Social Security disability benefits.  It goes to individuals who have worked in recent years (five out of the last 10 years in most cases) who are now disabled.  Disabled Widow’s and Widower’s Benefits are paid to individuals who are at least 50 and become disabled within a certain amount of time after the death of their husband or wife.  The late husband or wife must have worked enough under Social Security to be insured.  Disabled Adult Child Benefits go to the children of persons who are deceased or who are drawing Social Security disability or retirement benefits.  The child must have become disabled before age 22.  For Disability Insurance Benefits, Disabled Widow’s or Widower’s Benefits and Disabled Adult Child benefits, it does not matter whether the disabled individual is rich or poor.  Benefits are paid based upon a Social Security earnings record.  Supplemental Security Income benefits, however, are paid to individuals who are poor and who are disabled.  It does not matter for SSI whether an individual has worked in the past or not.  SSI child’s disability benefits are a variety of SSI benefits paid to children under the age of 18 who are disabled.  The way in which disability is determined is a bit different for children.

3. How do I apply for Social Security disability benefits?

The best, surest way to file a Social Security disability claim is to go to the nearest Social Security office in person and wait (often for a few hours) to see someone to file the claim in person.  In the alternative, a person may contact Social Security by telephone and arrange for a telephone interview to file the claim.

4. I am disabled, but I have plenty of money in the bank.  Do I have to wait until this money is gone before I apply for Social Security disability benefits?

No.  If you have worked in recent years or if you are applying for Disabled Widow’s or Widower’s benefits or Disabled Adult Child benefits, it does not matter how much money you have in the bank.  There is no reason to wait to file the claim.

5. I used to work but lately I have been staying home taking care of the kids. I have now become sick.  Can I get Social Security disability benefits?

Possibly.  If you have worked five out of the 10 years under Social Security before becoming disabled, you will have enough earnings in to potentially qualify for Social Security disability benefits.  For individuals 31 or less, the requirements are a little different, since such individuals have not had such a long time to work.  Unless a person has been staying home and taking care of their children for quite a long time, however, it is very possible that they will qualify for Social Security disability benefits based upon their own earnings.  Also a homemaker, if poor enough, can qualify for Supplemental Security Income (SSI) whether he or she has worked in the past or not.

6. How long do I have to wait after becoming disabled before I can file for Social Security disability benefits?

Not even one day.  You can file for Social Security disability benefits on the very same day that you become disabled.  Many individuals make the mistake of waiting months and even years after becoming disabled before filing a Social Security disability claim.  There is no reason to file a Social Security disability claim if one has only a minor illness or one which is unlikely to last a year or more.  However, an individual who suffers serious illness or injury and expects to be out of work for a year or more should not delay in filing a claim for Social Security disability benefits.

7. I am still on sick leave from my employer.  Can I file for Social Security disability now or do I have to wait until the sick leave is exhausted?

No, you do not have to wait until the sick leave is exhausted.  You should file for Social Security disability benefits now, if you believe that you will be out of work for a year or more.

8. I got hurt on the job. I am drawing worker’s compensation benefits.  Can I file a claim for Social Security disability benefits now or should I wait until the worker’s compensation ends?

You do not have to wait until the worker’s compensation ends and you should not wait that long.  An individual can file a claim for Social Security disability benefits while receiving worker’s compensation benefits.  It is best to file the Social Security disability claim as soon as possible because otherwise there may be a gap between the time the worker’s compensation ends and the Social Security disability benefits begin.

9. Can I get both worker’s compensation and Social Security disability benefits?

Yes.  There is an offset, which reduces Social Security disability benefits because of worker’s compensation benefits paid, but in virtually all cases, there is still some Social Security disability benefits to be paid.  In a few states the offset works the other way – - worker’s compensation benefits are reduced because of Social Security disability benefits.

10. How can I tell if I will be found disabled by Social Security?

Unless your disability is catastrophic (such as terminal cancer, a heart condition so bad that you are on a heart transplant waiting list, total paralysis of both legs, etc.), there is no easy way for you to tell whether you will be found disabled by Social Security.  In the end, the decision of whether or not to apply for Social Security disability benefits should not be based upon whether or not the person feels that Social Security will find them disabled.  Attorneys familiar with Social Security disability can make predictions about who will win and who will lose, but even they can seldom be sure.  An individual should make the decision about whether or not to file for Social Security disability based upon their own belief about their condition.  If the individual feels that he or she is disabled and is not going to be able to return to work in the near future, the individual should file for Social Security disability benefits.  If denied, the individual should consult with an attorney familiar with Social Security disability to get an opinion as to the chances of success on appeal.