Friday, January 23, 2009

Scheduled Injuries the latest way to figure benefits

Anyone who hurts their arm, leg, hand, foot at work is often shocked to learn that in Colorado there is a separate way to figure their permanent impairment benefits. So unless it can be considered a whole person injury by a judge or it results in a possible claim for permanent total disability Colorado law says it is paid by using the "schedule" for the injury. The problem is that these injuries are treated as not as important so they are paid lower benefits. At least that is how Colorado law makes it out. It is ironic but some people lose their trade and have a horrific drop in earning ability but insurers pay following the schedule. Roughly for every one percent of your arm or leg that you are permanently impaired means $500 for you. So ten percent of your arm is about $5000.00. You can figure this out yourself by looking at the chart here. You multiply the doctors rating by the number of weeks in the chart by the amount shown based on your date of injury. I assure you if your entire arm were to be amputated or useless the permanent benefit would be under $52000.00. Again there are exceptions. Also much more can be considered in a settlement but insurers relish the low payouts. I've said this before...Colorado should abolish this terrible way of calculating a permanent injury. Imagine a carpenter who can no longer grasp a hammer and do his job. His earnings loss over his lifetime could be enormous even if he goes to work in another field. Or, consider the fellow who plays a musical instrument and makes good money but loses his trade because of the work injury. The problem with the schedule is that it completely disregards your pre-injury earnings and pays a flat amount even when you lose your trade/occupation. I can say if the injury affects both arms or hands or both legs we do seek to make it a bigger case whenever possible. There are variables where even a small injury can mean a major claim but this is not true for everyone. In contrast if you hurt your back it can mean much higher benefits because the permanent figures do use your wage rate and your age. These variables often make the calculation much higher.

Friday, January 16, 2009

Social Security Administrative Law Judge History

Each judge in the Social Security disability system has a track record. These records are maintained by the Social Security Administration but were only recently opened to public viewing. The link right here is to the site that deserves much credit for forcing the records to be open for anyone. If you know the name of your judge you can type it in and find out his decision making percentages for the last 3 years. Of course these are but statistics but I have researched a few of the local Judges. Judge Ball issues favorable decisions at the hearing stage 62% of the time, Judge Maddigan 68%, Judge Musseman 48% and Judge Shaffer 70%. What it does suggest is that seeking a hearing after you have been denied can give you a decent chance for a fair decision. These Judges do not just approve the denials so many receive.

Friday, January 09, 2009

Reduced Aid to Needy Disabled

I guess I am always surprised when the disabled are treated as worth so little. They are often helpless physically and financially but to hit on them to save money seems way out of line. As reported in the Coloradoan the benefit called Aid to the Needy Disabled in Colorado has been reduced effective January 1st to no more then $200 a month. This is not Social Security Disability but is some assistance for the disabled while they perhaps wait for Social Security disability benefits. I researched this a bit and it seems about ten years ago the benefit went from $229 to $239 a month. To roll back benefits in this area seems incredible to me. Surely in these economic times there are other places to save then cut benefits for those most vulnerable.

Sunday, January 04, 2009

Impairment vs. Disability in Workers Comp

A number of years ago Colorado joined most of the other states in changing permanent disability to permanent impairment. With respect to permanent disability unless you are totally disabled your benefits are limited to what is called impairment. You receive a "rating" from an authorized doctor or a Division IME doctor and unless overturned your benefits are based on this impairment rating. This amounts to the medical people deciding on your legal benefits by determining your impairment. While the judge can decide which rating is correct it is still a function of anatomical damage in almost all cases. The older historical basis of determining your loss of earning capacity was discarded. So let's say you are hurt and lose your trade and it means a true loss of future earnings over your life. The amount you'd receive is still based on the rating although for whole person injuries the formula does include an age factor and a wage factor. Still it is not an individual assessment of your loss of a job or trade. What Colorado and most other states did was say that physicians must use the American Medical Association Guides that are published to perform the rating. In Colorado we use the AMA Guides 3rd edition revised. This is old. They are now publishing the AMA Guides 6th edition. Is this edition better for injured workers?'s worse. Any edition of the Guides will say that it is not trying to determine disability only damage to the body or psyche. In the real world it is used to determine benefits in what used to be a legal question of disability. Also in my opinion the editorial board assembling the Guides are largely composed of doctors who are not really claimant oriented. The 6th edition seems to now be diagnostic based rather then measurement based on your individual range of motion. Claimant lawyers are highly critical of this and also well aware that the ratings coming out from this are often much lower then the 5th edition. Colorado has stayed with the 3rd edition revised but my concern is that all such impairments are artificial ways of paying benefits. The whole concept of paying for your disability has been hijacked by this impairment rating process. No one seems to care if you lose your trade. All these "reforms" did was to remove permanent disability issues and replace them with artificial ways of calculating benefits. I do understand that insurers wanted to save money but for that we have caps or limits in total benefits. What they did to the purpose of workers comp has always bothered my sense of fairness in compensating injured workers. The only exception is when you are totally disabled. Then the rating is less important and consideration is given to your age, education and lack of employability. I am including an excellent link to an audio discussion that interviews the prime proponent of the 6th edition and also a claimant's attorney. It is long but quite a listen. That link is here. Additionally a crtical review was written and put at the LexisNexis website here.

Saturday, January 03, 2009

Wondering About Social Security Entitlement?

I came across a simple website run by the government that lets you answer some
multiple choice questions to see what, if any, Social Security entitlements you might be eligible for. It's pretty basic but it is very simple to use and may give you some insight as to what programs may be there for you. You do not post any personal identifying information. It is just a tool to see what pertains to you. If you want to talk with a representative at your local SS office (rather then use online resources) you should call them at (719) 574-9279 to see if you need an appointment. Often the office visit can take a while. Should you wish to apply much information is needed such as the names/addresses of your doctors and employers for many years. Also be aware that when you describe the jobs you've done do not be incomplete or inaccurate. Realize that disability in its simplest sense means that you are no longer employable. So if you can physically/mentally do one or more of the jobs you've done in the past 15 years on a sustained basis then you're not disabled. If you've done very easy work then they can wonder why you cannot do it again. Needless to say an attorney is often needed since denials are common. Also in this area your doctor can be very important to itemizing your problems and restrictions. Anyway click here for the eligibility tool.