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Workers' Compensation
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IF I'M INJURED AT WORK, WHAT SHOULD I DO FIRST?Immediately report your injury or illness to your supervisor or other person in charge. Although Florida law allows you 30 days to report your injury, it is important for a number of reasons to do it as soon as possible. Waiting a few days or weeks because you think you are going to get better can cause suspicion that your accident happened off the job.
Also, there may be evidence that needs to be preserved that will help you prove your claim. Reporting your accident as soon as it happens, or as soon as possible thereafter, helps eliminate problems later on. Once you have reported your accident to your supervisor, your Employer will send notice of the injury to its Workers’ Compensation Insurance Company (Carrier).
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WHAT IF MY EMPLOYER FAILED TO NOTIFY OUR INSURANCE PROVIDER ABOUT MY INJURY?
You have the right to report the injury, and your employer is subject to a fine for failure to report the accident/injury. If you need assistance reporting your injury, contact a workers’ compensation attorney or the Employee Assistance Office of the State of Florida.
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MY INJURY SEEMS MINORāDO I NEED TO SEE A DOCTOR?
Some injuries do not require immediate medical attention and others may require a trip an immediate trip to the emergency room. If your injury is thought to be minor, there is no legal requirement that you seek medical attention. However, your employer may have a policy that requires you to have at least an initial examination by a doctor or company nurse just to get checked out.
Should you not be required to go to a doctor by your employer, you should seek medical care through your employer as soon as you think it might be necessary. It is better to have the initial examination as close to the injury date as possible to document your symptoms and what injuries the work accident has caused.
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WHAT IF THERE WAS NO ACCIDENT, BUT I DEVELOPED AN ILLNESS AT WORK?
Some conditions, such as carpal tunnel syndrome, degenerative disc/joint disease, and hearing loss can happen as a result of repetitive motion/noise at work over a period of time. These conditions can be covered under workers’ compensation. As soon as you know you have such a condition and you believe the condition was primarily caused by your work activity, this should be reported to your supervisor or other person at work in charge.
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DO I GET TO CHOOSE THE DOCTOR THAT TREATS ME FOR MY WORK INJURY?Not in Florida. Current law lets the Employer and/or insurance company pick the doctor that will treat the work injury. This may be a big disadvantage to you the injured because you may not feel comfortable with certain doctors, the doctors may be predisposed to give opinions about your condition, and the doctors chosen for injured workers in Florida may not be qualified to treat your type of injury.
While there are ways to request a one-time change of doctors, the employer or the insurance company will choose the replacement doctor, as well. It is strongly recommended you only request a change of doctor do with the help of an experienced Panama City workers' comp attorney who understands the state laws and can give you advice about the replacement doctors available in your area. Often, unrepresented injured workers request a change of doctor and end up in a worse situation.
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WHO PAYS THE MEDICAL BILLS RESULTING FROM MY WORK INJURY?The Employer or its workers’ compensation insurance company is required to pay all authorized medical bills (a co-pay of $10 may be required for doctor visits after you reach maximum medical improvement). Authorized doctors and medical facilities are required to send bills to the employer or insurance company for all treatment related to the work injury. You should not receive billing for authorized treatment of your work injury.
However, there is sometimes confusion about this and you may receive a bill. If this happens, you should contact the doctor or facility to let them know your treatment was for a work injury and the billing should be submitted to your Employer or workers’ comp insurance company. If billing to you continues you should consult with an experienced workers’ compensation attorney for advice about what can be done. If you have paid for any authorized medical bills or prescriptions out of pocket, you should submit your expenses to your Employer or work comp insurance company for reimbursement.
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WHAT IF I CANNOT MANAGE TRANSPORTATION FOR MEDICAL TREATMENT?Your employer or its insurance carrier is responsible for arranging and paying for transportation for medical appointments if you do not have transportation. If you have a car and drive to your medical appointments, you are entitled to be reimbursed for some of the expenses of getting back and forth.
Reimbursement will be based on the mileage to and from the appointment and can be requested by you with the use of a Medical Mileage Claim Form. It is very important to put exact mileage amounts on the claim form because your mileage reimbursement request amounts will be verified using computer programs that let the insurance company know the shortest distance to and from your home (or another point of origin) and the medical facility. An incorrect mileage reimbursement claim form can cause a lot of problems in your case.
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IF I CANNOT WORK, HOW MUCH WILL I RECEIVE IN BENEFITS?First, your authorized work comp doctor must have taken you out of work. If this has happened, you should receive your first check from the workers’ compensation insurance company within 8 to 21 days following your date of the accident. You will not be paid for the first seven days following your date of the accident unless your disability results in more than 21 days of lost time from work. If your doctor has taken you out of work or has placed significant limitations on your ability to work that prevents you from being able to go back to work, and you have not received a check within this time period, you should consult with an experienced workers’ compensation attorney to find out what can be done.
Your work comp check is based on how much money you were making at the time of your accident. In most cases, you will receive 2/3 of your average weekly wage calculated on your 13-week wage history immediately preceding your date of the accident. Keep in mind – There are exceptions to this rule. If your check is not at least 2/3 of your normal gross wages (before taxes & deductions), you should get advice from an experienced workers’ compensation attorney about whether you are being paid properly based on your circumstances.
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WHAT IS 'LIGHT DUTY?' CAN IT INTERFERE WITH MY BENEFITS?While there is no exact definition of “light duty” work, the term generally refers to work that may be available with an employer that fits what your doctor has said you are, or are not, capable of doing, e.g., no lifting more than 15 pounds. You may also hear the term “modified duty”. This refers to a position or job created by an employer to specifically comply with any physical limitations an authorized treating physician has placed on an injured worker. If such work is offered by your employer, you should attempt such work at your place of employment. The workers’ comp insurance company will not have to pay you for lost time if you refuse such work.
If your employer does not have “light duty” or “modified duty” work available, then your workers’ comp insurance company should send you a check for the timer period you are out of work until it is decided you have reached maximum medical improvement with regards to your work injury. This type of check is called temporary partial disability and the amount will be slightly less than the temporary total disability check you receive when the doctor has you completely out of work.
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CAN MY EMPLOYER FIRE ME WHILE I'M ON WORKERS' COMP?Maybe. Florida is not a “right to work” state and this allows employers to fire employees for any reason that does not violate a state or federal law. Under Florida law, your employer cannot fire you for filing a workers’ compensation claim. If it does, you may have a claim for coercion under §440.205 or a private cause of action for wrongful termination.
However, if you are fired for another reason that does not violate this law or another state or federal law, then there may not be anything you can do. You may wish to consult with an experienced attorney about this issue if you are fired following the reporting of a work injury.
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DOES MY EMPLOYER HAVE TO HOLD MY JOB FOR ME WHILE I RECOVER?
Unfortunately, there is no provision in Florida law requiring your employer to hold your job until you return. Typically, employers have policies within your employment contract that state the amount of time you may miss prior to being properly terminated for an extended leave of absence.
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IF I AM FIRED WHILE ON WORKERS' COMP, CAN I THEN RECEIVE UNEMPLOYMENT?
If you are receiving temporary total or temporary partial disability benefit checks from your work comp insurance company, you cannot receive unemployment benefits for the same time period.
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HOW LONG DO I HAVE TO FILE A WORKERS' COMP CLAIM?Keep in mind this is a different question than reporting a claim. While you only have 30 days to report your accident/injury, the time limit for claiming benefits that have not been provided (also known as the statute of limitations) is two years from the date of accident, or alternatively, two years from the date you knew or should have known that your injury or illness was related to your employment if your injury is a repetitive type.
Additionally, once a claim has been accepted and medical treatment has been authorized, you must treat once with an authorized doctor every 365 calendar days. If a claim has previously been accepted and disability benefits were subsequently terminated, you must file a claim for reinstatement of the disability benefits within one year of the date of termination. Regardless, the statute of limitations, and its exceptions is a very technical area of the law with exceptions that may help your case. It is highly recommended that you seek the assistance of a workers’ compensation attorney.
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IS A SETTLEMENT POSSIBLE? CAN I JUST RECEIVE A LUMP SUM?Yes, there are two parts to every Florida workers’ compensation claim: 1) the indemnity or lost wages, and 2) future medical treatment. Settlement of both or either part individually is entirely voluntary for both the injured work and the insurance company. No one can make you settle. No one can make the insurance company settle. But, if both sides want to close out a workers’ compensation case, a settlement can be negotiated.
It is customary for the entire work comp case to be settled at one time. This is called a washout settlement. Many times the employer and/or the insurance company will require a resignation of your employment if you still work for the employer.
If you wish to settle your workers’ compensation claim, it is very important to seek the advice of an experienced attorney to help make sure the proper language is in the settlement paperwork to protect you both now and in the future. For instance, if you have a separate claim against your employer, you may unknowingly and unintentionally waive your rights to this separate claim by settling your workers’ compensation case. Also, you may be asked to sign settlement paperwork that prevents you from receiving Social Security disability benefits, Medicare, Medicaid, unemployment or other need-based benefits. It is extremely important to have an attorney that is experienced in both workers’ compensation and Social Security issues help you with your work comp settlement.
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ARE WORKER'S COMP SETTLEMENTS TAXABLE?
No. However, workers’ compensation benefits paid directly to you or settlement proceeds paid to you are subject to deductions for child support arrearage.
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Social Security Disability
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DO I QUALIFY FOR SOCIAL SECURITY DISABILITY (SSD) BENEFITS?To qualify for SSD, you must have worked long enough in jobs where Social Security taxes have been paid for you. Usually, if you have worked in such jobs at least 5 of the last 10 years, you will have earned enough quarters of credit to be covered if you have a severe medical condition that has prevented you, or will prevent you, from substantial gainful work activity for at least a year, or is expected to end in death before that time period.
If you think you may be eligible for disability benefits, we can help you file your application online or appeal any denial you may have received.
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WHEN SHOULD I APPLY FOR SOCIAL SECURITY DISABILITY BENEFITS?
Apply as soon as you and your doctors agree that your disability is going to last a full year. You are not eligible for Social Security Disability benefits if your condition is not expected to last a full year. However, if you have been denied because Social Security believes your disabling condition is temporary, our attorneys may be able to speak with your doctors and get the right kind of evidence to show your condition is more permanent and will satisfy the one-year requirement. Others, who have been struggling to work in spite of a disability and know the condition is not going away, should apply as soon as work activity stops or falls to part-time levels.
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I WAS TOLD I DO NOT HAVE ENOUGH "CREDITS" TO QUALIFY. NOW WHAT?You must earn a certain number of credits over a certain time period to qualify for Social Security disability benefits. The number of credits you need depends on your age when you apply and the type of benefit application. No one needs more than 40 credits for any Social Security benefit.
To determine your number of credits, Social Security uses your total yearly earnings. The amount needed for one credit in 2016 is $1,260. You can earn a maximum of four credits for any year. The amount needed to earn one credit increases automatically each year when average wages increase. If you have almost enough credits to qualify for SSD, it is beneficial to talk to an experienced Panama City Social Security Disability attorney about how to correctly earn the additional credits in order to qualify.
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WHAT IS "SUBSTANTIAL GAINFUL ACTIVITY?"The term “substantial gainful activity” (SGA) is used to describe a level of work activity and earnings. Work is “substantial” if it involves doing significant physical or mental activities or a combination of both.
If you earn more than a certain amount and are doing productive work, we generally consider that you are engaging in substantial gainful activity. You would not be eligible for disability benefits.
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HOW DO I APPLY FOR SSD BENEFITS?Although you can apply for disability without having an attorney, the attorneys and staff at Syfrett, Dykes & Furr can help you start your online application for Social Security disability at no additional charge. Social Security has a helpful website (www.ssa.gov) that offers an online disability application. Most questions are straightforward about you, your medical condition, and your medical treatment. However, other questions about your past work history can be more confusing and potentially harmful if not correctly answered.
You can also call Social Security at 1-800-772-1213 (TTY 1-800-325-0788), wait on hold for a while, and then finally speak with someone, Monday through Friday from 7:00 a.m. EST to 7:00 p.m. EST. Or, if you are brave enough to fight the lines, you can go to your local Social Security office, pick a number, and wait to see someone in person. The easier way may still be to contact the Social Security attorneys and staff at Syfrett, Dykes & Furr.
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HOW LONG DOES APPLICATION PROCESSING TAKE?The time it takes to get a decision on your disability application can vary depending on:
- The type of disability you have
- What type of medical evidence is submitted with your application
- How quickly additional medical evidence can be put together that proves your disabling condition
- Whether it is necessary to send you for a medical examination
- Whether your case gets reviewed for quality purposes
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CAN I RECEIVE BENEFITS FOR MONTHS PRIOR TO MY APPLICATION?Social Security disability benefits can be paid for as many as 12 months before you apply if it is found you had disability dating back in time and you meet all of the other requirements.
This is not true of Supplemental Security Income (SSI) disability. Once financial considerations are undertaken and disability is proven, SSI disability benefits begin the month after the application for disability.
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WHAT'S THE DIFFERENCE BETWEEN SSD AND SSI BENEFITS?Both programs provide benefits for disability, but the two programs are financed differently. Employment taxes primarily finance Social Security retirement, survivors, and disability insurance benefits. Generally, SSD benefits are paid to eligible workers and their families, based on the worker’s earnings.
Meanwhile, general taxes fund the SSI program, which serves the needy. SSI eligibility depends largely on limited income and resources as well as meeting the definition of being disabled.
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HOW DO I KNOW IF I QUALITY FOR SSI BENEFITS?To get Supplemental Security Income disability benefits, you must be blind or disabled and determined to be in a defined financial need. This means you must have a limited amount of resources and household income. Generally, one must have less than $2,000 in resources ($3,000 if married) to qualify for SSI. Resources are things you own like cash, bank accounts, stocks, land, personal property, vehicles, or anything else that can be exchanged for cash to pay for food or shelter. Some resources will not be counted against you like the home in which you live or the vehicle you drive to doctor appointments. In Florida, if you are receiving any SSI you will also qualify for Medicaid.
One more important thing. Your living arrangements can affect how much you can get in SSI. If you are considered living in the household of another, you will get less money than if you are considered living alone. To be considered living alone, you need to be paying for your portion of rent or food or both OR have signed an agreement with the person who is helping you pay these expenses obligating you to pay them back.
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CAN I RETURN TO WORK WHILE RECEIVING SSD BENEFITS?Yes, you can return to work while receiving Social Security disability benefits. There are special rules that encourage you and help you get back to work without jeopardizing your initial benefits if you feel you are getting better. You may be able to have a trial work period for nine months to test whether you can work.
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MY SSD CLAIM HAS BEEN REJECTED. WHAT NOW?If your claim was denied and you believe you qualify for SSD benefits, don’t worry. You can file an appeal or you can get the help of a skilled Panama City SSD attorney to not only file the appeal but review the reason for the denial and help you try to put together better proof. There are several levels of determination for Social Security Disability benefits. You have 60 days (plus 5 days for mailing) to appeal a denial to reach the next level of determination.
If you fail to appeal a denial during the required time, you may still be able to appeal if there was good cause for not meeting the deadline (i.e., mental illness, hospitalization, delayed receipt of denial, etc.) If you do not have good cause, you can reapply for Social Security disability or Supplemental Security Income. Please keep in mind that "appealing" and "reapplying" are not the same thing. Reapplying means you have to start the process over again.
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HOW DO I RECEIVE AN SS STATEMENT THAT CONTAINS A RECORD OF MY EARNINGS?You can get your personal Social Security Statement online by using your my Social Security account that can be set up at www.ssa.gov. If you don’t yet have an account, you can easily create one. Your online Statement gives you secure and convenient access to your earnings records. It also shows estimates for retirement, disability and survivor benefits you and your family may be eligible for.
Social Security also mails Statements to workers attaining ages 25, 30, 35, 40, 45, 50, 55, 60 and older three months prior to their birthday if they don’t receive Social Security benefits and don’t have a Social Security account. Workers who do not want to wait for their scheduled mailing can request their Social Security Statement through the website. The Statement will arrive by mail in four to six weeks.
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CAN I RECEIVE DISABILITY AND RETIREMENT BENEFITS SIMULTANEOUSLY?Social Security disability benefits automatically change to retirement benefits when disability beneficiaries become full retirement age. The law does not allow a person to receive both retirement and disability benefits on one earnings record at the same time.
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WHAT ARE "COMPASSIONATE ALLOWANCES?"Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards. Compassionate Allowances (CAL) are a way of quickly identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. CALs allow Social Security to target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly. Compassionate Allowances is not a separate program from the Social Security Disability Insurance or Supplemental Security Income programs.
CAL conditions are selected using information received at public outreach hearings, comments received from the Social Security and Disability Determination Services communities, counsel of medical and scientific experts, and research with the National Institutes of Health (NIH). Our attorneys are familiar with CALs and can work with your doctors to put together the proof that is needed.
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IS THERE A WAITING PERIOD FOR SSD BENEFITS?If you are found to be eligible for Social Security disability benefits, there will also be a date that is used to establish the onset of your disability. Unless one is disabled on the first day of the month, no one gets paid for the month in which disability is established. Additionally, there is a five-month waiting period following the onset month before benefits will be paid. The first month for which benefits are paid is the sixth full month after the date your disability began. This waiting period does not apply to the payment of SSI disability benefits.
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WILL UNEMPLOYMENT BENEFITS AFFECT MY SSD BENEFITS?Social Security does not count unemployment benefits as earnings. However, if you are receiving unemployment benefits, you have likely signed a statement that you are ready, willing and able to work for the time period in which you receive these benefits.
In a disability hearing, some judges wrongly refuse to award benefits for time periods when unemployment was received. There are legal arguments to establish entitlement to disability benefits for the same time periods as when unemployment was received if the medical evidence supports only an ability to return to work part-time.
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CAN CHILDREN WITH DISABILITIES RECEIVE SOCIAL SECURITY BENEFITS?A child with a disability age 18 or older may get Social Security benefits when a parent gets retirement or disability benefits. The child also can get benefits if a parent dies. The child’s disability must have begun before age 22.
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WHAT IS THE TICKET TO WORK PROGRAM?The Ticket To Work Program can help Social Security beneficiaries go to work, get a good job that may lead to a career, save more money, and become financially independent, all while they keep their health coverage through Medicare. Ticket to Work is a free and voluntary program that gives beneficiaries real choices that can help them create and lead better lives. Individuals who receive Social Security benefits because of a disability probably already qualify for the program.
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CAN I RECEIVE SSD BENEFITS IF I ALREADY RECEIVE VETERANS' BENEFITS?Even if you meet the requirements to get veterans disability benefits, you may not qualify for Social Security disability benefits. Eligibility for each program is different. For example, the Department of Veterans Affairs pays benefits for partial disability. However, Social Security pays disability benefits only to people with impairments, which are so severe they prevent any kind of substantial gainful work.
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WHAT ARE SOCIAL SECURITY BENEFITS FOR WOUNDED WARRIORS AND HOW CAN I APPLY?This program expedites processing of disability claims of current military service members or veterans disabled while on active duty on or after October 1, 2001.
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WHAT ARE DISABLED WIDOW/WIDOWER'S BENEFITS?This is a disability program where you can apply for benefits based on a deceased spouse’s earnings record. For instance, if a wife or husband has stayed at home to raise children and take care of the household, she or he may not have the required number of credits to qualify for disability on their own account. Or, if a wife or husband has earned substantially less than her or his spouse, the monthly benefit may be higher on the spouse’s account. In order to qualify for disabled widow’s/widower’s benefits, you must be 50 years or older and the onset of your disability must be within seven years of your spouse’s death.
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WHAT ARE DIVORCED SPOUSE BENEFITS?You can apply for benefits based on your divorced spouse’s earnings record if you were married to your ex-spouse for at least 10 years, are at least, 62 years old, are currently unmarried, and obtaining benefits under your divorced spouse’s earnings record results in a greater monthly benefit than what you could receive based on your own earnings records.
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CAN I RECEIVE AN EXPEDITED DECISION ON MY SSD CLAIM?The Social Security Administration has rules in place for individuals applying for Social Security Disability or SSI benefits that need faster processing of their claim which they call “critical cases.” There are four situations Social Security recognizes as warranting critical case processing:
- The first is called a TERI case and applies if you have a terminal illness.
- The second is a Wounded Warrior or Military Service Casualty Case (MSCC) and applies if you are a veteran applying for Social Security disability based on a service injury occurring on or after 10/1/2001.
- The third is if your case is flagged as a Compassionate Allowance (CAL) case.
- The fourth type is a “dire need” case. A dire need situation exists when a person has insufficient income or resources to meet an immediate threat to health or safety, such as the lack of food, clothing, shelter or medical care.
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DO I QUALIFY AS A "DIRE NEED" CASE?You must be able to show one or more of the following:
- A lack of food (i.e., without and unable to obtain food)
- A lack of medicine or medical care (e.g., the claimant expresses that he or she needs medicine or medical care but is unable to obtain it due to lack of resources)
- A lack of shelter (e.g. shutoff of utilities such that home is uninhabitable, homelessness, expiration of shelter stay, or imminent eviction or foreclosure with no means to remedy the situation or obtain shelter).
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HOW ARE ATTORNEYS PAID FOR SSD WORK?Lawyers only get paid if the application is accepted and benefits are secured. The fee is most often by direct payment from Social Security and is usually 25% of the past-due benefits owed to you when you win. However, a fee is capped at $6,000. This cap is set by the Commissioner and is always subject to change.
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AM I ALLOWED TO EARN INCOME WHILE MY CASE IS PENDING?Yes and no. It is not uncommon for someone to have had a heart attack or other illness/injury, be out of work four or five months, try to go back to work, work a few weeks, and then be unable to do keep it up. That would be considered by most judges to be an “unsuccessful work attempt,” and would not preclude you from getting paid your SS benefits even for the period of time you were working.
Other people will try to work part-time while applying for disability benefits. If it is part-time and sporadic, most judges will agree this is also an "unsuccessful work attempt.” However, if you’ve still managed to work in spite of significant health problems and you are working 25 or 30 hours per week, then most all judges will deny your claim. Unfortunately, those who struggle to work generally will have a harder time winning than those who simply stop early on.
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HOW MUCH CAN I EARN AND STILL RECEIVE SSD BENEFITS?It is presumed that somebody working and earning under $1,010 per month is not working. But be careful! Just because you are earning less, it doesn’t mean you are safe from SSA saying you are able to work and are not disabled. They might rule that you are being underpaid (intentionally or unintentionally) or that you can actually work more than you are doing. So, while you can use the above amount as a rough guide, the only safe way to be considered “not working” is not to work at all or working substantially under the amount.
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IF I AM DISABLE, CAN MY CHILDREN RECEIVE BENEFITS?Children can receive benefits if an eligible parent is disabled, retired or deceased. They can receive benefits until they graduate high school or until age 18, whichever is later. The amount they receive depends on how much the adult receives. Certain adults who never earned very much money may find that the children do not receive cash benefits.
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WHAT TYPE OF DOCUMENTATION SHOULD MY DOCTOR PROVIDE ME ABOUT MY CONDITION?The best report from a doctor is a report he would give as if he were explaining your condition to other physicians. First, he should give a long history. What were the initial symptoms, when did they start, when did they become significant? He should then mention his initial examination or workup. What clinical observations did he make? Next, what treatment did he give and how well did it work? He should give the diagnosis and the prognosis. He should explain the basis for the diagnosis and the prognosis, that is, how did he make these determinations, what medical tests were used.
He should also describe your current clinical findings—that is, what he finds when he examines you. Lastly, he should summarize the impact on your ability to work—how these conditions have affected your ability to function. He should describe whether they limit your ability to sit, stand, and walk, to lift, to carry, to work on a regular eight-hour-day basis. If it is an emotional condition or has emotional components, he should describe the impact of stress, working with others, working under deadlines, your ability to concentrate and deal with the general public or coworkers, to remember instructions and learn a job.
Many times doctors are not aware of how to write an opinion about disability for Social Security. It is not enough for your doctor to just say you are disabled. If you have a doctor that is willing to help you, our attorneys routinely review medical records and consult with doctors about the type of language that will help you prove your case.
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MY HEARING NOTICE SAYS A VOCATIONAL EXPERT AND MEDICAL EXPERT WILL BE AT THE HEARING. WHAT DOES THIS MEAN?Let me start here by saying if you are not represented and your hearing notice says there will be a vocational or medical expert at your hearing, it would be a good idea to get a Panama City SSD lawyer as soon as possible to help you prepare for the hearing. Vocational Experts testify about the physical and mental requirements of your past work, as well as the jobs that may be available to you.
The Medical Expert will answer questions about your condition and what he/she believes about your ability to function either physically or mentally with your condition. You should have an experienced lawyer familiar with your medical records and condition who can also question the vocational and medical expert based on your limitations. Vocational testimony may sound very bad or good to your case but might actually be quite the opposite. It takes a lawyer who has cross-examined many vocational experts to know the difference and how to approach a given case.
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Personal Injury
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WHO PAYS FOR MEDICAL BILLS AFTER A CAR ACCIDENT?
In Florida, if you own a vehicle that is registered in your name in Florida, then by law you are required to have Personal Injury Protection (commonly called PIP) and this takes care of the first $10,000 of your medical bills and lost wages after a car accident. This coverage applies and pays regardless of who is at fault. This is why you hear that Florida is called a “no-fault” state.
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IF I WAS HURT AS A PASSENGER IN SOMEONE ELSE'S CAR, DO I HAVE TO NOTIFY MY INSURANCE COMPANY?
If you have any injuries and need medical attention then you should notify your insurance company. This will allow a PIP claim to be established so you can receive medical attention when you need it. If you were not injured and need no medical attention, then there would generally not be a reason to contact your own car insurance company.
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SHOULD I TAKE PICTURES OF MY CAR AFTER AN ACCIDENT?
ABSOLUTELY! This is something we strongly, strongly recommend for several reasons. First, the damage to your car may become critical later in determining how the crash occurred, where the crash occurred, the speed at impact, and a host of other issues. Pictures are easy, quick, and cheap. In our opinion, there is simply no good reason not to get photographs. We recommend starting at the front of the car and just walking around it and taking 12 good pictures. Imagine you are walking around a clock and taking a photo at 12:00; 1:00; 2:00 and so forth all the way around the car. More pictures can be taken at the site of the damage.
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SHOULD I TAKE PICTURE OF MY INJURY?
Same answer—ABSOLUTELY! Photos help establish the extent of your injury. They help tie the problems you are having to the wreck. They also become demonstrative evidence of the physical condition you were in following the crash. It will be your job to demonstrate your injuries and because the photos are easy, quick and cheap there is simply no reason not to document your injuries. The old saying a picture is worth 1,000 words still holds true.
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WHO PAYS TO FIX MY CAR?
If the other driver was at-fault, then his/her Property Damage Liability (PD) should pay to fix your vehicle. If your car is worth (fair market value) $8,000 and the other driver has $10,000 in coverage then you should be fine. The problems come in when your car is worth $25,000, it is totaled, and the at-fault driver only has $10,000 in coverage. In that scenario, the way to make up the difference is with your collision coverage. This is a specific coverage that you purchase on your car insurance policy. Further, if you were at fault in the wreck, your collision would still pay to fix your car for you.
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AM I ENTITLED TO A RENTAL CAR?If the other driver was 100% at fault, then YES that driver’s insurance company should provide you a rental car for the period of time necessary to get your car fixed or if totaled until you receive your check for your car. If the insurance company does not immediately provide you with a rental car, then do not lose hope. The law entitles you to the loss of use of your vehicle which equals the cost of a rental car. You are entitled to this whether you rent a car or not. So if you can’t use your car for 10 days due to repairs, then demand $20 or $25 per day for your loss of use. You are entitled to this whether or not you rent a car because you still incurred the loss of use of your vehicle.
If the wreck was partially your fault, then expect problems in this area. This is because the other driver’s insurance company will have a defense to your claim (your own negligence). If the other driver has insufficient coverage for all the damage they caused, then you can also expect problems. This is because the insurance company is they don’t have enough money to pay for the property damage itself and as a result, they may be unwilling to furnish you with a rental car. In either of these scenarios, you are still protected if you purchased rental car coverage on your own car insurance policy.
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SHOULD I GIVE THE INSURANCE COMPANY A TAPED STATEMENT?We strongly recommend against this. Put simply, the insurance company and your interest are not the same after an accident. You want your bills paid. The insurance company would prefer to pay no claims if at possible. When claims are required, the insurance company wants to pay the smallest amount possible. You want your car fixed. The insurance company wants to pay the smallest amount possible. You want your future medical bills paid. The insurance company wants to pay the smallest amount possible.
Whatever your issue is, remember the insurance company wants to pay the smallest amount possible. As a result, you need some basic information about how to protect yourself because your words can come back to haunt you. Not because you were not truthful or did not do your best, you simply were an amateur playing with the pros.
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HOW LONG WILL MY CASE LAST?
Generally, a case takes at least six to 18 months. There are several reasons why this is true. First, before you should even consider resolving your claim, you need to know how the injuries you sustained are going to affect you long-term. With only two weeks of treatment, you probably won’t know whether your pain and problems are going to be permanent or not. Until you complete your medical care you will not know if you may need surgery in the future, you will not know how much your medical bills are for all the treatment you will need. You will not know how the injuries are going to affect you on the job, with your family, and with your hobbies. All of these things are very important in evaluating before you resolve your case.
Now the exceptions: my injury occurred, I had surgery two days after the crash and the other driver only has $10,000 in coverage. In this case, it may not be necessary to wait another 6 months because your injuries may already warrant the other driver’s policy limits. Again, each case is different, and naturally, there are always going to be exceptions—especially in the area of law.
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HOW DO I KNOW IF I HAVE PERSONAL INJURY CLAIM?We ask 4 basic questions. One: Was the other party at fault or mostly at fault?
Two: Is your injury specific to a certain part of your body—broken arm, torn ligament in your knee—something that is readily identifiable? This is not always required, but it provides a better foundation for explaining your case to the insurance company.
Third: Did you seek medical attention soon after the accident? If the delay in seeking treatment was 10 days or greater, then do you have a very good reason why treatment was delayed?
Fourth: Does the other driver have the “right kind” of insurance and if not, do you have the “right kind” of insurance? The insurance questions are multiple and they are more than can be covered here. For more information on car insurance and what Florida requires and what the different types of coverage please download my book—The Ultimate Consumer Guide to Automobile Insurance in Florida.
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HOW MUCH IS MY CLAIM WORTH?
There is no set number for the value of any particular case. Case value is affected by many different things:
- How clear is it that the other person was at fault?
- How much do your medical bills total?
- How much do your lost wages total?
- How much will your future medical bills and future lost wages total?
- How has the injury affected your ability to work, play, sleep, run, dance, swim, ride, hunt, bowl, focus, study... this list is endless but what has changed in your life from before the wreck to after the wreck.
Once you know the answers to these questions, then the attorney can begin to place an appropriate range of values for your case.
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HOW DO PERSONAL INJURY ATTORNEYS GET PAID?
Most personal injury attorneys work on a contingency fee basis. This means the attorney does not charge you anything to start your case and will also most likely advance any costs necessary to pursue your case. In the event a recovery is made, and only when a recovery is made, the attorney will then receive a percentage of the amount of money recovered as attorney’s fees for his or her services.
The Florida Bar limits the amounts attorneys may charge for personal injury contingency fees in Florida. For case values less than one million dollars, the fees are limited to 33.3% if no lawsuit is filed; 40% if a lawsuit is filed and the defendant files an answer, and potentially an additional 5% if the case has to go on appeal for one reason or another. As with everything, there are some variances to the fees charged and they can be less, but this is a general overview.
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CAN I CANCEL MY CONTINGENCY FEE CONTACT AFTER I SIGN?The Florida Bar requires that each contingency fee be in writing and the contract must state that the client has three business days to cancel the contract. At Syfrett, Dykes & Furr, our first and foremost goal is to keep the client satisfied. As a result, if the client desires to leave for any reason and no recovery has been made or offered, the client’s file will be copied for them at no charge and the appropriate parties will be notified that we are no longer counsel on the case. Fortunately, this is a circumstance that occurs very rarely.
One of our goals is to educate our clients about the contingency fee contract, how the attorney’s fees and costs will be paid at the end of the case, and how long the process is expected to take. One of the main reasons for client dissatisfaction is they feel there is a lack of communication with their attorney. To improve client satisfaction, we start at the beginning by thoroughly discussing the case process and we also provide a written handout that gives our clients an overview of a typical personal injury case with a time frame for how their case will likely progress.
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