Federal Employees – Don’t Handle Reconsiderations On Your Own
Despite our best efforts to inform disabled federal employees about filing for disability retirement, many still are unaware of the obstacles they may face when filing on their own. In particular, many federal employees not only continue to submit their applications on their own, but they also attempt , in the event of denial, to handle their own Reconsiderations. This usually is not a good idea. Here’s why.
First, there is a short timeframe in which to apply for Reconsideration. You have exactly 30 days from the time of denial to appeal to the Merit Board. In that short period, you have three options: 1.)You can have the Merit Board review the claim as is – with no additional medical documentation included in the file. 2.)You can ask for an extension – but be aware that the extension begins based on the day you request it. That means, you’re not really buying yourself a lot more time. 3.)You can ask for the Merit Board to review your file with additional medical documentation. Bear in mind that you are then responsible for getting your treating physician (or physicians) to submit this information. And, you will, no doubt, have to stay on top of the whole process.
Second, if you file on your own and need to apply for Reconsideration, there is a much longer wait for the money that you need to get you through this difficult time. When an experienced federal disability attorney handles your application at the outset, there is a greater chance for a favorable outcome without having to go to Reconsideration. Experienced attorneys know all the tight deadlines, the FERS disability claims process, and the potential obstacles that could hold up your claim. Remember, it is easier to avoid mistakes than to have to correct them.
Third, when you are disabled and facing a challenging time in your life, you should be focusing on recovering and not on obtaining your disability benefits.
If You Have An Employer-Provided Disability Plan, Don’t Handle The Appeal On Your Own
Oftentimes, disabled employees are discouraged from using an attorney to obtain disability benefits available in their employer-provided disability plans. When you have worked for a company for a while, and are comfortable with the people and the environment, you might not view the company’s human resource department or the insurance carrier they use as an “adversary.” However, bear in mind, their primary goal is to save the company and the insurance carrier money. So, you usually are not their first consideration.
Handling your disability claim on your own can lead to all kinds of problems because insurance carriers do not make the disability filing process easy. The likelihood of your claim being denied is greater when you handle it on your own. And, should your claim be denied, the appeals process is even more complicated. You cannot sue for benefits unless you go through the appeals process on an employee benefit claim. That ultimately means the entire experience will take a lot longer, and you will have to wait a lot longer for your disability benefits at a time when you can afford it the least.
Additionally, when you sue for your benefits, the judge most likely will limit the review to your existing claim file (which was complied by the insurance carrier). That means that you will have to do as good a job on your appeal as an experienced disability attorney would do in order to have even a reasonable chance of a successful outcome. And that isn’t very likely.
Finally, if you retain a knowledgeable disability attorney at the outset – when you initially apply for your disability benefits – he or she will help you to avoid making mistakes.
If You Have A Private Disability Claim, Let An Experienced Attorney Handle It
If you have a professional practice or your own your own business, you most likely have an individual disability policy as a safety net. Should you ever have to file a disability claim, it is prudent to retain an attorney experienced in disability law as early as possible in the process – preferably even before you request the claim forms.
First, keep in mind that the insurance carrier is not your friend. Rather, the insurance carrier is a business and its priority is to maximize its profits – often by wrongfully denying claims. As a result, most insurance companies look for a reason to deny claims rather than evaluating whether the claimant actually is entitled to benefits. You will need an experienced attorney in order to protect you from the insurance carrier, and to keep the carrier as close to honest as is possible.
Second, the claim process is fundamentally complicated. There is far more to filing a claim than merely submitting claim forms. When an experienced attorney handles your claim, he or she helps you complete the forms, accompanies you on field interviews or medical exams, reviews and comments on the entire contents of the claim file; submits medical records with a lengthy analysis; and submits vocational and prescription drug information with a detailed analysis.
Without an experienced disability attorney, you could omit pertinent information or persuasive analysis – and that could have an adverse effect on the outcome. Insurance companies have their own in-house attorneys guiding them on how to best “handle” (i.e., deny) your claim. You should have your own attorney advising you.
Finally and most important, an attorney experienced in disability knows the process, the deadlines, and the law. They know how to avoid making a mistake which always is easier than trying to fix one.
Legislative Update . . .
Specter Seeks to Help Disabled Veterans By Keeping Courts Open To Benefits Appeals
Source: specter.senate.gov
Today (Monday, April 12, 2010), Senator Arlen Specter (D-PA) introduced legislation that will help disabled veterans get their benefits by keeping the appeals process open. The Fair Access to Veterans Benefits Act of 2010 would require the United States Court of Appeals of Veterans Claims known as the Veterans Court) to hear appeals by veterans of administrative decisions denying them benefits when circumstances beyond their control – sometimes the very service-related disabilities that entitled them to benefits – render them unable to meet the deadline for filing an appeal.
“The veterans claims process can be extremely difficult to navigate, especially without the aid of a lawyer or when hindered by a mental illness,” said Senator Specter, a member of the Senate Veterans’ Affairs and Judiciary Committees. “My bill will require the Veterans Court to excuse late filing upon a showing by the Veteran of ‘good cause.” This will ensure that veterans have a fair shot to receive the benefits to which they are so justly entitled.”
Established in 1988 by an act of Congress, Veterans Court allows veterans to appeal administrative decisions denying them benefits. Because many Veterans handle their own appeals without the benefit of a lawyer, Congress intended that the proceedings be informal, efficient and fair.
A recent decision by the U.S. Court of Appeals for the Federal Circuit, however, closes the Veterans Court to many deserving Veterans. The court, in Henderson v. Shinseki, ruled against allowing a Veteran to pursue his appeal because he missed a deadline. David Henderson, the plaintiff, suffered from paranoid schizophrenia as a result of his active-duty service in the Korean War. The government denied his benefits claim in 2004 and dismissed his appeal because he missed a filing deadline – by just 15 days. Mr. Henderson asked the Veterans Court to excuse his late filing because it was caused by his service-related disability, a claim his psychiatrist supported under oath. The Veterans Court refused to do so, and a divided Federal Circuit affirmed its decision.
This decision creates, in the words of three dissenting judges, a “Kafkaesque judiciary process in which those Veterans who are most deserving of service-connected benefits will frequently be those least likely to obtain benefits. It is the Veterans who incurs the most devastating service-related injury who will often be least able to comply with rigidly enforced deadlines.”
Senator Specter’s bill would require the Veterans Court to excuse late filings if the Veterans demonstrates “good cause” so that meritorious benefits claims aren’t denied after their day in court. Additionally, the Fair Access to Veterans Benefits Act requires the Veterans Court to reinstate untimely appeals already dismissed as a result of that court’s failure to toll the filing period for good cause. According to a New York Times article, the court dismissed 225 cases similar to Mr. Henderson’s since the 2008 Veterans Court ruling and continues to do so at a rate of two cases per week.
Senate Unanimously Passes Fix For VA Health Care Programs
Source: akaka.senate.gov
Technical legislation would clarify that all VA health care programs meet minimum stands in health insurance reform law . . .
Washington, D.C. . . . The Senate unanimously passed S.3162, a bill to clarify that the health care VA provides to children with spina bifida born to veterans of the Vietnam War and to some veterans who served in Korea during specified times, as well as to children of women Vietnam veterans with certain birth defects, meets the standard of minimum health care coverage required by the Patient Protection and Affordable Care Act.
“This legislation will put to rest any question: veterans’ dependents receiving VA health care meet the new health insurance reform law’s minimum health care coverage standard,” said Senate Veterans’ Affairs Committee Chairman Daniel K. Akaka (D-HI), author of the bill.
This unanimously approved legislation garnered 59 cosponsors during its two days on the floor, before passing the Senate (this afternoon). The bill now moves to the House of Representatives.