Frequently Asked Questions About Injury and Disability
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What is a Consultative Exam?
When you apply for Social Security Disability Insurance benefits (SSDI), the Social Security Administration (SSA) will decide whether you qualify for benefits. They could schedule a consultative exam to help them make a decision on your claim. This is a medical examination that is scheduled by the SSA with a physician that they choose. This is a physical or mental examination that they will use when deciding whether you are unable to work due to your medical condition.
When Could You Be Required to Attend a Consultative Exam?
Whether the SSA will schedule a consultative exam will depend on your disability and the evidence you submit to support your application. Examples of when this exam may be required include:
- Additional medical information is needed that is not included in your medical records.
- There are gaps in your medical treatment, or you have not been treated by a doctor for a while.
- The SSA cannot obtain your medical records from your doctor for a reason beyond your control, such as your physician’s death or refusal to supply them.
- There are inconsistencies in your medical records.
- The SSA needs specialized medical evidence to decide your claim.
- You could experience a change in your medical condition in the future that may affect your ability to work.
Importance of Attending Your Consultative Exam
You must attend your CE Exam if the SSA requests that you attend one. If you fail to attend your exam, the disability examiner could determine that you are not being cooperative and deny your application.
Who Performs a Consultative Exam?
Your treating physician can conduct a consultative exam. Often it is performed by an independent doctor hired by the SSA. These doctors do not work for the SSA.
What Happens at a Consultative Exam?
The purpose of your exam is not to treat you. It is to determine how serious your disability is.
The extent of your consultative exam will depend on your disability and the questions that the SSA has about how it affects your ability to work.
However, there are specific rules on how long your exam should last. Here are some requirements that should be followed:
- A general physical exam should be for at least 30 minutes.
- A musculoskeletal or neurological examination should take at least 20 minutes to perform.
- A psychological exam should last at least 60 minutes and a psychiatric exam should last for at least 40 minutes.
- Other types of examinations are required to be for at least 30 minutes.
Once the exam is completed, the physician would submit a written report to the SSA.
Who Pays for a Consultative Exam?
The SSA will pay for a consultative exam and any diagnostic tests associated with it. You should not be charged for these services.
Are you considering filing for SSDI? Does the SSA require you to attend a consultative exam? Call our Roswell office to schedule a free consultation with our experienced Social Security disability lawyers who can help you obtain the SSDI benefits you are entitled to.
What to Do If the SSA Requests a CE Exam
A cumulative medical exam can be a quick procedure, but it can have a big impact on your SSDI application. It is important to remember that the doctor performing it does not work for the SSA, but is being paid by them. Here are important tips on how to handle your exam:
- Be polite and respectful during your exam.
- Expect to be asked about your symptoms by the examining doctor. You want to give him short answers and include concrete examples.
- You should be truthful when discussing your illness or medical condition. Do not exaggerate or downplay the symptoms that you are experiencing.
Retain an Attorney Immediately If You Receive a Notice of a CE Exam
One of the most important first steps you should take if the SSA notifies you of a CE Exam is to retain an experienced disability attorney. Your attorney can give you advice on how to best handle your exam and ensure that you receive the SSDI that you deserve. Call the Injury and Disability Law Center today to schedule a free consultation to learn how our skilled lawyers can help you with your SSDI claim.
Do I need an attorney to appeal a Social Security disability denial?
If your application for Social Security Disability Insurance benefits (SSDI) is denied, you do not have to hire a lawyer to file your appeal. However, if you want to win your case, your best strategy would be to retain an experienced Social Security disability attorney. Here are three reasons why having a lawyer represent you in your appeal will increase the chances of success.
Reason #1: Gathering Your Medical Documents
Your attorney will review your entire file and all the medical documents you provided that support your application. They will be able to identify gaps in your medical history and will be able to obtain the medical records you need to file with the Social Security Administration (SSA) to support your claim quicker than you could. They will also contact your doctors and have them write a written opinion that explains fully what your disability is and how this prevents you from working.
Reason #2: Understanding of Law and Procedures
A knowledgeable attorney will know how to file your appeal properly. They will also understand the rules and procedures that must be followed so that your appeal proceeds quickly and smoothly.
Reason #3: Preparing You for Your Hearing
One of the biggest benefits of having an attorney is that they will be with you at your hearing for your appeal. Some of the ways an attorney can help you include:
- Trial preparation. They will prepare you for the questions that the administrative judge will ask you at your hearing.
- Evidence. They would be certain that all your medical records, doctors’ opinions, and other evidence that supports your claim of disability are presented at your hearing.
- Witnesses. They will identify all the expert witnesses you need, such as a physician, and any other witnesses who can help you prove your disability and will prepare them to testify at your hearing.
- Cross-examination. A vocational expert would most likely testify on behalf of the SSA. After the administrative law judge questions this expert, your lawyer can effectively cross-exam them about their findings and show how they are inaccurate. They would also cross-exam any other witnesses presented on behalf of the SSA.
Was your application for SSDI benefits denied? Call our office to schedule a free initial consultation to learn how our skilled Social Security disability lawyers in Roswell can help you.
How long does it take to settle a car accident claim?
If you are thinking about filing a claim for compensation for your injuries in a car accident, you will want to know how long it will take to settle your claim with the negligent driver’s insurance company. Unfortunately, each case is different. Some can settle in a few months, while others can take a year or longer to resolve.
Factors That Affect How Long it Will Take You to Settle Your Auto Collision Case
The insurance company could offer you a quick settlement in an effort to pay you less than the true value of your claim. However, it is rarely in a car accident victim’s interest to accept the insurance company’s first or second offer. Here are some factors that affect the time it takes to settle these claims.
Seriousness of Your Injuries
If you suffered serious injuries, you would be entitled to your past and future medical expenses, lost wages, and pain and suffering in your settlement. You need to wait until you reach your maximum medical improvement, which is the stage where you fully recover or recover as much as you will, before settling your case.
Why is this important? You cannot know how much you should receive in future damages until you reach this stage in your recovery.
Who the negligent driver’s insurance company is can have an impact on how long it will take to resolve your claim fairly. Some larger insurance companies will fight harder and longer to reduce the amount they pay car accident victims.
In addition, if you suffered long-term injuries, the value of your claim will be greater. The insurance company will raise even more disputes in an effort to deny your claim or pay you less than you deserve by wearing you down.
If there are true questions about who was at fault in causing your collision, it could take longer to convince the insurance company of their liability. You may have to collect additional evidence or hire an expert witness to resolve this dispute.
If the insurance company refuses to be reasonable or the statute of limitations, which is the deadline to sue, will expire soon, you will need to retain an experienced car accident lawyer. While you may still settle your case before it goes to a jury trial, it could take longer to resolve it if you must litigate your case.
Do you want to know how these factors could affect your claim? Do you need help negotiating your settlement? Call our Roswell office to schedule a free consultation with our skilled car accident legal team to get your questions answered and learn why we are the right injury attorneys for your case.
How are grid rules used to determine Social Security disability eligibility?
If you are applying for Social Security Disability Insurance (SSDI) benefits, it can be easier to get your application approved by the Social Security Administration (SSA) if you are 50 years old or older. The SSA considers it harder for older applicants to learn new job skills or move to a different type of work. If the SSA decides that you can no longer perform your former job duties, they will use grid rules to determine if you are eligible for benefits.
How the Grid Rules Work
The SSA refers to the additional difficulty an older worker has switching to a new type of job as a vocational adjustment and uses grid rules to determine these applicants’ claims. The SSA considers a number of factors that are applied to grids the SSA developed in deciding whether someone qualifies for benefits. The following factors are considered.
The SSA divides applicants into the following age groups: younger individuals (aged 18 through 49 years old), individuals approaching old age (50 through 54 years old), advanced age (55 years old or older), and approaching retirement (60 years old or older). It is easier for an older individual to get approved by the SSA under the grid rules.
Individuals who have a lower educational level are more likely to have their application for SSDI approved. The SSA divides educational abilities into the following levels:
- High school graduation or higher with additional training for skilled work
- High school graduation or higher with no additional training for skilled work
- Limited education, which is generally completing l1th grade or lower
- Inability to read and write
Past Work Experience
The SSA considers an individual’s prior work experience under the grid rules. Jobs are grouped into these classifications: unskilled, semi-skilled, and skilled. It is easiest for unskilled workers to qualify for SSDI using the grids.
Transferable Work Skills
The SSA will take into account whether semi-skilled or skilled workers have job skills that would transfer to other types of employment. Applicants who have more transferable job skills will have a harder time getting their application approved.
Residential Functional Capacity
A person’s residential functional capacity (RFC) is their ability to do work on a full-time basis. In determining what a person’s RFC is, the Social Security Administration will use medical evidence, such as from the applicant’s doctor, as to their ability to stand, walk, lift, push, and carry. RFC is divided into these categories:
- Sedentary work
- Light work
- Heavy work
- Very heavy work
Individuals classified as heavy work or very heavy work will be more likely to qualify for SSDI under the grid rules.
Do you have questions about your eligibility for SSDI under the grid rules? Do you need help appealing a denial of your application? Start a live chat or call our Roswell office to schedule a free consultation with our experienced Social Security disability lawyers.
Am I entitled to Medicare if I am getting SSDI benefits?
If you are approved for SSDI benefits, you also qualify for Medicare. However, you are not are eligible for Medicare right away. Here, you can learn how this complicated waiting period for benefits works.
How Long Is the Waiting Period for Medicare?
There is a two-year waiting period after the first month you are eligible for your monthly SSDI payments before you can receive Medicare. However, not everyone who applies for SSDI has to wait two years before being entitled to Medicare. Here is how the waiting period rules work:
- The two-year waiting period for Medicare starts running from the date you start receiving your monthly SSDI benefits. The date when you are eligible for SSDI payments is the date of your disability plus a five-month waiting period.
- If it takes you a long time to get your SSDI application approved, which is common, you may have already gone through much or all of the two-year waiting period for Medicare during the application and appeal process.
- Because the Social Security Administration (SSA) only pays 12 months of retroactive SSDI benefits, the earliest date that you can qualify for Medicare is one year after you apply for SSDI.
Exceptions to the Two-Year Waiting Period for Medicare Eligibility
Currently, there are two exceptions to the rule that you must wait two years before receiving Medicare. You may be entitled to Medicare immediately in these situations:
- End-stage renal disease with kidney failure. If you need ongoing dialysis or a kidney transplant due to end-stage renal disease, you can obtain Medicare coverage the third month after you begin dialysis.
- Amyotrophic lateral sclerosis (ALS). You are eligible for Medicare as soon as you are eligible for SSDI if you suffer from ALS.
Do you need help figuring out when you qualify for Medicare? Are you filing your SSDI application? Call our Roswell office or start a live chat to schedule your free consultation today with our experienced Social Security disability legal team to get your questions answered and learn how we can help you.
How much does it cost to hire a Social Security disability attorney?
When you are applying for Social Security Disability Insurance (SSDI) benefits, you are more likely to get your application approved by the Social Security Administration (SSA) if you are represented by an attorney. However, you may be concerned that you cannot afford to pay a lawyer when you are not working because of your disabilities. Here’s why you do not need to be worried about this.
How Lawyers Charge Their Fees in Social Security Cases
Social Security disability attorneys charge their attorney fees on a contingency fee basis. Under this type of agreement, you would not owe any up-front attorney fees. Here’s how payment of the fees works:
- You would only owe attorney fees if you win your case. If you do not receive SSDI benefits, you would owe no attorney fees.
- Your lawyer cannot charge you more than 25% of your back pay or $7,200, whichever is less.
- Your attorney will be paid their attorney fees out of your back pay award before you receive your payment.
Retainer Agreements in SSDI Cases
Your lawyer must enter into a written retainer agreement with you, stating how much you will be charged. They must also file a petition with the SSA to obtain approval of the fee agreement. Once the SSA approves it, they will pay the attorney fees directly out of the backpay award.
How Costs Are Charged in Social Security Disability Insurance Cases
In addition to the attorney fees you will owe, you must also pay the costs associated with your case. These costs can include copying costs for your medical records and reports from your physicians.
Some lawyers will require you to pay these extra costs as they are incurred while others will pay them and get reimbursed when they are paid their attorney fees. Your retainer agreement should spell out how you must pay these costs.
Experience Matters When Selecting Your Attorney
While the attorney fees you will owe is a consideration when hiring a lawyer, it should not be the only factor you consider. You need an experienced Social Security disability lawyer who has a track record of success if you want to win your case.
Are you applying for SSDI benefits? Do you need to file an appeal? Call our Roswell office to schedule a free consultation to learn how we can help you.
What should I do to prepare for my Social Security disability hearing?
If your application for Social Security Disability Insurance (SSDI) is denied by the Social Security Administration (SSA), you will need to file an appeal and attend a hearing. Providing a good testimony at your hearing will be crucial to getting your SSDI application approved. Here are five tips on how to prepare for it.
What You Will Testify to at Your Hearing
Understanding what you will need to testify about can help you as you prepare for your hearing. You will need to answer questions about the following:
- Your medical conditions that have caused you to become disabled and the symptoms you experience
- Limitations in your physical and mental conditions caused by your disability
- Your medical treatments and medications for your medical condition
- Your education and training
- Your work history
- Your day-to-day activities and how your disabilities have affected your ability to do them
Five Tips to Prepare for Your Hearing
Being prepared for your hearing is essential if you want to win your appeal. Here are five ways you can get ready for it:
- Review your file. You need to review your application, your medical records, and any correspondence with the SSA. This will help you to remember what you have told them about your disability and issues in your case that you will need to address at your hearing.
- Prepare a cheat sheet. You can bring documents to your hearing that will help you remember all the important details about your disability. Collect these documents, such as your application, medical records, and notes to yourself regarding common questions you can expect to be asked.
- Provide recent medical records. It is important that the administrative law judge has all your current medical records when deciding your case. Submit any up-to-date medical documents with the SSA before your hearing so that they are in your file and can be reviewed by the judge at your hearing.
- Obtain a written doctor’s statement. One crucial type of evidence you will need is your doctor’s statement about your medical condition and how it affects your ability to work. Even if you filed this statement when you applied for SSDI, you should obtain a more recent one from your physician once you receive the notice of your hearing from the SSA.
- Retain an attorney. The best way that you can ensure that you are fully prepared for your hearing is to retain an experienced Social Security disability lawyer. They can help you file your application correctly, provide the SSA with all the medical records and other evidence they need, prepare you for your hearing, and attend it with you.
Do you need assistance preparing for your Social Security disability hearing? Call our Roswell office to learn how our skilled Social Security disability legal team can help.
When does a Veteran qualify for Special Monthly Compensation?
You may qualify for VA disability benefits if you suffer from a disability that was caused while you were in the Armed Forces. The Veterans Administration considers some medical condition more serious and may award you Special Monthly Compensation (SMC), which can result in you receiving a significantly higher monthly disability payment.
When Are Veterans Eligible for Special Monthly Compensation?
Special Monthly Compensation is a benefit that certain Veterans, their spouses, surviving spouses, and parents may qualify for. It is paid to Veterans who have special circumstances, such as the need for personal care at home, due to the nature of their disability. Here are situations when a Veteran may qualify for these benefits:
- Aid and attendance. A Veteran who needs daily supervision by a family member, home nurse, or home personal aide because his disability is so serious may qualify for these benefits.
- Loss of use. If a Veteran has the loss of use of a body part and it is severe enough, he may be entitled to SMC. The use of the body part must be no better than if it was amputated and the Veteran used a prosthesis.
- Permanently bedridden. A Veteran who cannot get out of his bed due to his service-connected disability can qualify for SMC benefits.
- Blindness. If the Veteran suffers from vision loss, and it meets the VA’s definition of blindness, the VA may consider their condition debilitating enough to pay them Special Monthly Compensation.
- Homebound. Veterans qualify for these payments if their disability is so severe that they cannot leave their homes and will not be able to for the rest of their lives. An individual may also be considered homebound if they cannot leave a hospital or other care facility.
Some disabilities that can qualify a person for SMC include:
- Loss of a foot or hand or use of this body part
- Paralysis or immobility of a joint
- Blindness in one or both eyes
- Deafness in both ears
- Loss or loss of the use of a reproductive organ
- Inability to communicate with others through the use of speech
- Loss of or loss of use of the buttocks
- Loss of tissue in one or both breasts because of radiation treatment or a mastectomy
If you qualify for SMC benefits, the VA is supposed to automatically pay you the additional monthly payment you are entitled to. However, this does not always happen..
Let our experienced VA disability legal team help you file your application and ensure that you and your family receive all the disability payments you deserve. Call our Roswell office to schedule a free consultation today to learn more about how we can help you.
What should I do if my SSDI check is late?
If you are eligible for SSDI benefits, you will receive a monthly disability payment. The Social Security Administration (SSA) no longer mails out checks and instead will directly deposit your payment into your bank account. While payments are usually paid on time each month, on occasion, your payment could be late. Here’s what you need to do to report a late payment so you get paid.
When You Should Expect to Receive Your Check Every Month
When your initial application is approved, it could take a few months for you to receive your first payment, especially if you are also receiving back pay. The SSA sends out monthly payments on a schedule based on your date of birth. Here is their current schedule of payments:
- Your payment will be on the second Wednesday of the month if you were born on the 1st through the 10th.
- Your payment will be on the third Wednesday of the month if you were born on the 11th through the 20th.
- Your payment will be on the fourth Wednesday of the month if you were born on the 21st through the 31st.
There are exceptions to these rules. If you started receiving disability payments before 1997, you should receive your payment on the 3rd of the month. If your payment date falls on a holiday, your payment would be made the day before the holiday.
Why Your Payment Could Arrive Late
Your payment might be late for a number of reasons, such as:
- You changed your bank or had a change of address and did not notify the SSA.
- The bank account used by the SSA to make your payment changed.
- If the SSA office that is responsible for processing your payment has a slower process, it may take longer for you to receive your check.
What to Do If Your SSDI Payment Is Late
If you are worried that your payment was stolen, you should contact the SSA immediately. Otherwise, they request that you wait at least three business days after the date you should have received your check to contact your local office or call them at 1-800-772-1213 (TTY 1-800-325-0778) on Monday through Friday from 7:00 am to 7:00 pm.
You should receive your first payment within 90 days of being approved for benefits. If you do not get it within this time period, contact your Social Security disability lawyer if you have one or the SSA.
Should I accept a quick settlement of my car accident case?
If you were injured in a car accident caused by another driver, you are probably worried about how to pay your medical bills and your living expenses while you are off work recovering from your injuries. You may be tempted to accept the insurance company’s offer of a quick settlement to get your money and get on with your life. However, here are three reasons this could be one of the biggest mistakes you could make in your case.
Reason #1: A Quick Settlement Is in the Insurance Company’s Interest
If the insurance company offers you a settlement soon after you file your claim, it is important to understand why they are doing this, which is to save money. They will most likely start negotiations by making a low-ball offer of far less than you deserve in hopes that you will accept a quick settlement.
Reason #2: You Will Have to Sign a Release
When you settle your claim with the insurance company, you will have to sign a release before receiving your payment. By signing this legal document, you acknowledge that this is a full settlement of your case, and you waive your right to any further compensation for your injuries. If you later discover that your injuries are more serious than you originally thought, you would not be able to reopen your claim and obtain more money.
Reason #3: You Do Not Know the Seriousness of Your Injuries
Under New Mexico law, you are entitled to both past and future medical expenses, lost wages, and pain and suffering from the negligent driver. You cannot know how much your claim is worth until you reach your maximum medical recovery. This is the stage in your medical treatment where you have fully recovered or recovered as much as you can, and your doctor can give you a final prognosis.
It could take you months or longer to reach this stage in your recovery. It is important to wait until you reach your maximum medical recovery to settle your claim because you cannot know what future medical treatments you will need and whether you can return to work until you reach this point in your treatment.
What You Should Do If the Insurance Company Offers You a Quick Settlement
If you receive a settlement offer from the insurance adjuster, you should not make any decision on accepting it until you have retained an experienced car accident attorney. You should never agree to settle your case or sign any documents without first consulting with a lawyer to ensure that your legal rights are protected.
The legal team at The Injury & Disability Law Center is here to advise you of your options and fight for all the compensation you deserve. Call our Roswell office or start a live chat to schedule a free consultation today.