The Center for Safe Schools presents: Military Kids!

First Tuesdays online training series.

"Helping Military Kids Cope - Understanding the Deployment Cycle", the first in the series of live, online learning sessions for educators, will be held Tuesday, November 1, 2011 from 10:00 a.m. to 11:30 a.m. (Eastern Time).

Children of parents who are deployed with the military or living at home with veterans experience a range of needs that are not addressed in the traditional school setting. This presentation will help to identify the number and prevalence of military youth in Pennsylvania as well as provide strategies and resources to meet some of those needs. The presentation will address:

1) The prevalence of military families and the unique needs of their children in Pennsylvania;

2) A first hand perspective of the deployment cycle.

3) What a School Liaison Officer is and how to obtain their services when not living on a military base.

This training is offered by the Center for Safe Schools through funding provided Operation: Military Kids! There is no cost to participate. This training has been approved for 1.5 Act 48 credit hours. If you are interested in receiving Act 48 credits, a $5.00 processing fee must be forwarded to our office upon completion of the session. Following the presentation you will be prompted to download an Act 48 form to be completed and returned to this office with a check payable to: CSIU in the amount of $5.00.

To learn more about this session and to register, go to:

www.SafeSchools.info/mission-homefront/professional-development

Pennsylvania Property Tax Rebate/Rent Rebate

If you are receiving SSD or SSI benefits, or are age 65 and older, or a widow or widower age 50 and older, you may be entitled to a Property Tax or Rent Rebate. The income limit for a homeowner is $35,000 per year, and for a renter, it is $15,000 per year. Only half of your Social Security benefits, and/or Railroad Retirement benefits, are considered in determining your yearly income. Eligibility may also be dependent upon other household income.

The maximum standard rebate is $650, but supplemental rebates for qualifying homeowners can boost the rebate to $975. Some homeowners may receive larger rebates than requested based on where you live, income, and/or property taxes. The Department of Revenue will automatically calculate this for you.

The deadline to apply for the Pennsylvania Property Tax/Rent Rebate is December 31, 2011..

You may obtain a Property Tax/Rent Rebate Application Form (PA-1000), and related information online at www.revenue.state.pa.us or by calling 1-888-222-9190.

PBI Model Fee Agreements

Quatrini Rafferty is pleased to announce that its workers' compensation fee agreement has been published by the Pennsylvania Bar Institute (PBI) as a model fee agreement for Pennsylvania attorneys. PBI is a non-profit organization that provides continuing education and informational resources to lawyers throughout the state.

Beware, a Big Headache Is Coming

Spotting Often-Overlooked Clues Like Nausea, Fatigue, Even Yawns May Help Patients Stave Off Attack

By Melinda Beck
THE WALL STREET JOURNAL
Tuesday, June 7, 2011

A migraine is among the most debilitating conditions in medicine—a blinding, throbbing pain that typically lasts between four and 72 hours. There is no cure.

Yet, a few hours or days before the dreaded headache sets in, subtle symptoms emerge: Some people feel unusually fatigued, cranky or anxious. Some have yawning jags. Others have food cravings or excessive thirst.

If migraine sufferers can learn to identify their particular warning signs, they may be able to head off the headache pain with medication or lifestyle changes before it begins, experts say.

"The holy grail of migraine treatment would be to have something you could take tonight to ward off an attack tomorrow," says neurologist Peter Goadsby, director of the headache program at the University of California-San Francisco. At a conference of the American Headache Society last week, he and other experts said these early symptoms may hold clues to what causes migraines in the first place.

Scientists have long known about this so-called premonitory phase, which occurs well before the better-known aura, the flashing lights and wavy lines that about 30% of migraine sufferers see shortly before the headache begins. Yet there have been only a handful of clinical trials treating patients in the premonitory stage—in part because the symptoms are so vague. Still, once patients know what to look for, many can identify some early warning signs."If you ask the average migraine sufferer, 'Do you have any symptoms a few hours before the headache starts?' about 30% will say yes," says Werner Becker, professor of neuroscience at the University of Calgary in Alberta. But given a list of 20 common signs, from changes in mood, appetite or energy to urinating frequently or yawning excessively, about 80% of patients will say, "Oh yes, I've noticed that," he says.

Dr. Becker says one of his patients frequently feels dizzy and loses her appetite about 6 p.m. and knows that an attack is imminent. She finds that taking the migraine drug rizatriptan—usually taken only after the headache starts—can ward it off. "If she doesn't take it, then the next morning, she wakes up with a full-blown migraine," Dr. Becker says.

Sheena Selvey, a 28-year old special-education teacher in Northbrook, Ill., says she knows a migraine is coming when co-workers say her neck muscles have tightened up. She rubs her neck with an essential peppermint oil until she can inject herself with Imitrex, another medication usually used to stop rather than prevent headache pain. She says such steps have helped reduce attacks to two or three times a month from three or four times a week.

Ben McKeeb, a 35-year-old nursing student in Bellingham, Wash., says his wife noticed that his forehead muscles tense up in the shape of a "V" a few hours before his headaches begin. "I can almost always catch that feeling, and if I do all the right things—stay hydrated, stay out of the sun, get plenty of sleep, don't work too hard—I probably won't get one," he says.

Nationwide, about 36 million Americans suffer from migraines. Although some people use the word very loosely, migraines are far more severe than a typical headache, last longer and tend to involve nausea, vomiting and sensitivity to light. Women are three times as likely as men to get migraines, and they've been diagnosed in children as young as 6 months. Migraines cost the country more than $20 billion a year in lost wages, disability payments and health-care bills, according to the American Headache Society, an organization of health-care professionals who specialize in headaches.

As many as half of all sufferers don't seek treatment, in part because they think there is little doctors can do for them. In fact, treatments are proliferating, including over-the-counter pain relievers for mild cases and a class of drugs called triptans typically used to stop migraine pain. For chronic migraines, doctors also prescribe beta blockers, antiseizure medications and antidepressants, but they have significant side effects and help only about 50% of patients about 50% of the time. More drugs are in clinical trials, and non-drug treatments such as acupuncture, massage, biofeedback and transcranial-magnetic stimulation are also showing some promise at alleviating migraine pain.

Doctors used to tell patients to wait until their headache pain was severe to moderate before taking medication. But that's changing. "Now we know the closer we can get to the beginning of the attack, the better the outcome will be," says David Dodick, president of the American Headache Society and neurologist at the Mayo Clinic in Phoenix.

Experts also think that they can learn a lot about the origin of migraines by studying how the body changes in the premonitory phase.

For example, "Many people tell us that they vomit yesterday's food," says Joel Saper, director of the Michigan Head-Pain and Neurological Institute in Ann Arbor. That's a sign, he notes, that their digestion slowed long before they knew a migraine was coming.

Some experts are also re-examining the role of common migraine triggers such as alcohol, chocolate, red wine, aged cheese and caffeine. It could be that physiological changes in the premonitory phase trigger a sensitivity to such foods, rather than the other way around.

"For years, patients would say they got a migraine because they ate chocolate or pizza or a hot dog," says Dr. Saper. "But when you ask why they ate those things, they say, 'I had this insatiable craving....' We need to understand where that craving came from."

Functional-imaging studies of the brain have revealed another tantalizing clue: During the aura phase, a wave of electrical activity sweeps over the outer, furrowed layer of the brain known as the cortex, at a pace of 2 to 3 millimeters per minute. This wave—known as "cortical spreading depression"—activates nerve cells as it goes, and the symptoms sufferers report typically correspond to the area of the brain the wave is passing over. For example, the patient sees flashing lights and wavy lines when the wave is over the visual cortex, and tingling in the hands and feet when the wave is in the motor cortex. Once the wave passes by, the nerve cells become quiet and spent.

Dr. Goadsby and colleagues at UCSF are conducting more imaging studies to determine what brain activity occurs during the premonitory phase.

Experts say migraine sufferers can help themselves and their physicians by keeping a careful log of when their headaches occur, what they ate, drank and did several days in advance, as well as any early symptoms they experienced. They may notice patterns and find their own warning signs.

And even though there is no scientific evidence that taking medication at that early stage will stave off migraine headaches, some experts say it makes sense for patients to avoid their known triggers if a migraine seems imminent.

"If stress seems to be a trigger, cut back on your schedule, try a relaxation technique, don't plan a 12-hour day," says Dr. Becker. "You could potentially stop an attack."

QR Partner, Vince J. Quatrini, Jr., Featured in Pittsburgh Post-Gazette

Rise in disability claims leads to more business, competition

Monday, February 28, 2011

By Zack Needles, The Legal Intelligencer

Social Security disability attorneys across the state said they're busier than ever as the recession-spurred uptick in layoffs has caused a spike in disability claims.

But while the influx of claims has in many ways been good for business, several lawyers the Intelligencer spoke to said it has also been a cause for concern.

For one, some attorneys said they're worried about the potential fallout that could occur if and when the economy right-sizes. But attorneys in the field say the boom itself has also attracted another problem in the form of unwelcome competition from national companies -- not law firms -- that handle claims with paralegals and other nonlawyers, often from out-of-state, without telling their clients.

Unfortunately fortunate

Attorneys said the recent uptick in Social Security disability claims, while profitable for them, partially reflects the country's gloomy job market.

According to statistics on the U.S. Social Security Administration's website, the number of Social Security disability applications filed monthly pre-recession -- prior to September 2008 -- rarely reached 200,000, while the number of post-recession applications routinely topped that figure and often approached 300,000 per month.

In fact, according to the SSA's statistics, the number of monthly applications rose above 200,000 only 14 times between January 1985 and September 2008, while the number dipped below 200,000 only five times between September 2008 and January 2011.

The struggling economy has naturally led to more layoffs, and aging workers with health problems who were just managing to get by at their jobs were, unfortunately, often the first to be let go. What this means is that an increasing number of applications are being filed by people who can qualify for Social Security disability benefits, but likely would not have, felt the need to apply for them had it not been for the recession.

N. Leah Fink, a Social Security disability lawyer with Pittsburgh plaintiffs firm Kunkel & Fink, said there were "a lot of walking wounded" in the national labor force who found themselves unemployed after the economy went south.

"I think that a lot of the workers that were laid off or terminated were part of the group of folks that actually could work with some accommodations," she said.

Vincent J. Quatrini Jr., managing partner of the Greensburg-based workers' compensation and disability firm Quatrini Rafferty, offered the hypothetical example of a 50-year-old steel worker who has remained employed despite struggling with diabetes but is suddenly laid off and unable to find work elsewhere.

"Those are the kinds of people that are now applying for Social Security disability who would have still been in the labor market for several years," he said.

Will the bubble burst?

Eric A. Shore, managing attorney of Social Security disability firm the Law Offices of Eric A. Shore in Philadelphia, said he's seen a "very significant increase" in business over the past three years but admitted he's worried about what might happen to that work when the job market improves.

"I'm afraid of how the pick up in the economy is going to affect us, that's why we opened a personal injury department," he said.

Mr. Shore said he anticipates hiring will improve over the next year, which could possibly even cost him some of his existing clients. "The lifespan of a Social Security case is two years," he explained. "I may have clients ready for a hearing in two years who call me and say, 'Hey thanks for your help, but I don't need this anymore because I was able to get a job.'"

Not all lawyers shared Mr. Shore's apprehension about the future.

Gregory T. Kunkel, also of Kunkel & Fink, said he's not concerned about a dramatic dropoff in business because the aging baby boomer generation is likely to keep up the flow of applications well into the future.

"We have more and more people in that age group," Mr. Kunkel said. "Regardless of the economy, there will still be a large number of disability applications."

Invasion of the nonlawyers

Ms. Fink said a more pressing concern for Social Security disability attorneys is the increased competition they face from national companies that hold themselves out as law firms but routinely send paralegals and other nonlawyers to represent applicants at hearings.

While it's legal for nonlawyers to attend these hearings, Ms. Fink alleged these companies are often less than forthright with clients who believe they're paying for legal representation. Many times, she said, the clients are also unaware that their representative is from out-of-state.

Mr. Quatrini agreed there is a problem with national competitors providing substandard representation to disabled clients. "They get a whole bunch of cases scheduled for one day and they fly in and then fly out of town again," he said. "They haven't met these people, they haven't figured out how they're going to be as witnesses and they haven't prepared them for this emotional day of a hearing."

Zack Needles: zneedles@alm.com or 215-557-2493. To read more articles like this, visit www.thelegalintelligencer.com.

QuatriniRafferty plans to add offices in Downtown Pittsburgh, Latrobe

Premium content from Pittsburgh Business Times - by Patty Tascarella

Date: Friday, January 28, 2011, 6:00am EST

Greensburg-based law firm QuatriniRafferty is expanding for the first time in its 24-year history, opening a Downtown Pittsburgh office in the second quarter and a Latrobe site by early February.

QuatriniRafferty purchased residential space for both — prices weren’t disclosed — but initially won’t be hiring. The offices will be used by existing personnel, said Managing Partner Vince Quatrini.

David DeRose, who specializes in estate law, wills and real estate, will split time between the Greensburg and Latrobe offices. The Pittsburgh office, at 941 Penn Ave., will be home base to Michael Quatrini, Quatrini’s son, who specializes in workers compensation, Social Security disability and veterans disability, all strong growth areas for the firm.

“I like the energy of the city and the close access to the administrative offices where we have our hearings,” Vince Quatrini said.

Other lawyers on staff will use the two newest sites as needed. The firm expects to add secretaries, paralegals and lawyers at both sites starting in 2012, Vince Quatrini said, but couldn’t say how many. All told, QuatriniRafferty employs 33.

QuatriniRafferty can capitalize on better real estate prices and the availability of new and experienced lawyers due to hiring slowdowns at the city’s largest firms in recent years. But the expansion is chiefly driven by the firm’s desire to “provide face-to-face contact with clients,” Vince Quatrini said.

An outlying firm setting up shop in the city is a rarity, said Lori Carpenter, president of Downtown-based recruitment firm Carpenter Legal Search. She couldn’t recall an example in recent years.

“Normally, it’s in the other direction, with a firm based in Pittsburgh looking to the outlying areas,” Carpenter said.

Robert Denney, president of Wayne, Pa.-based consultancy Robert Denney Associates, said QuatriniRafferty’s strategy “makes sense,” but he believes the firm is bucking the national mainstream.

“They’re running counter,” Denney said. “They’re the only firm I’m aware of that’s doing this. Other firms taking advantage of real estate would be redoing the lease or moving to a newer building, not buying in a city’s business district.”

Regardless, QuatriniRafferty has ample room to grow. The space — 2,400 square feet in Pittsburgh and 3,400 square feet in Latrobe — is “huge for one lawyer” to start, Denney said. “The average space today per lawyer has been whittled down to below 600 square feet.”