Your Disability Benefit: It Is What It Is

The following article was authored by Quatrini Rafferty attorney A. Tereasa Rerko and originally published in our newsletter, the Legal Update.

Quite often, I am asked how much monthly income a person will receive if they are approved for Social Security Disability (SSD) benefits. My answer is always, "It depends." What it depends upon is your individual earnings history. Monthly SSD benefits are similar to snowflakes: no two are exactly alike. Even if your neighbor or relative is working for the same employer and making similar wages, the calculation of your SSD benefits may not be the same.

SSD benefits are calculated using your unique work history, which includes your earnings for all jobs that you have worked during your lifetime. At the time you are determined to meet the disability requirements of SSD, your benefits will be computed using that work history. The Social Security Administration (SSA) looks at not only how much was earned, but when the income was earned. That income is then subjected to a complex formula to calculate your disability benefit amount.

It is always a good idea to check your earnings history on file with the SSA for accuracy. As long as your earnings history recorded by the SSA is correct, there is really no way to increase the monthly disability benefit amount. However, if your earnings history is not complete or accurate, then the calculations used to determine your monthly benefit amount will be incorrect. We suggest that you make any corrections to that record as soon as possible. To obtain a copy of the earnings record that SSA has on file, a simple request form needs to be completed. To obtain that form, contact your local SSA office, go to http://ssa.gov/, or contact our office.

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Tribune Democrat: School Closure Hearing Delayed

GREENSBURG — A hearing scheduled today in the ongoing battle over a school near New Florence has been canceled.

The hearing – on the preliminary objections filed by Ligonier Valley School District in response to a lawsuit by a citizens group seeking to keep the school open – had been scheduled in Westmoreland County Court before Judge Gary P. Caruso. The citizens group, Save Our Rams Education, filed a lawsuit against the district in May.SORE is seeking an injunction to block the planned closure of Laurel Valley Middle-High School. The district plans to send those students to its other middle and high schools in Ligonier in the fall.

One of the objections the district had was that the lawsuit did not contain enough details, said district Solicitor Dennis Rafferty. The citizens group filed an amended complaint that contains more details, putting a halt to today’s hearing and causing the process to start over again, he said.

The school district believes the amended lawsuit still doesn’t contain enough details and expects to file another preliminary objection, Rafferty said. A hearing on the objections probably will be held in July, he said.Judge Gary P. Caruso has scheduled Aug. 2 and 3 as the dates for the hearing on the injunction request.

http://tribune-democrat.com/local/x657339812/School-closure-hearing-delayed

QR Partner Dennis B. Rafferty Quoted in the Tribune Democrat

School hearing slated

Citizens group, district at odds over Laurel Valley closing

Frank Sojak fsojak@tribdem.com

GREENSBURG — A Westmoreland County judge has scheduled a hearing June 22 on the preliminary objections the Ligonier Valley School District has filed in response to a lawsuit by a citizens group seeking an injunction to block the closure of the Laurel Valley Middle-High School near New Florence.

Dennis Rafferty, school district solicitor, filed the objections Tuesday at the Westmoreland County Courthouse in Greensburg.

On May 10, the citizens groups, Save Our Rams Education, filed a lawsuit that asks a judge to overturn the board’s April 19 decision to close the school.

Rafferty said the hearing on the objections was scheduled for 2:45 p.m. before Judge Gary P. Caruso.

If the case is not settled then, the judge scheduled Aug. 2 and 3 as the dates for the hearing on the injunction, he said.

Rafferty said he will be assisted at the court proceedings by the Pittsburgh law firm of Anderson and Price, whose services were obtained through the Pennsylvania School Boards Association.

The citizens group is being represented by Gary J. Matta, a Pittsburgh lawyer.

Rafferty said one of the preliminary objections is that the district should not be prevented from closing the school.

Another objection is that in addition to the school district, the lawsuit

names all board members who voted

to close the school and the superintendent.

“We’re contending that they should not be named in the suit because they have immunity under Pennsylvania law,” Rafferty said.

No other points are being addressed specifically, he said.

One of the points being raised by the citizens group in the lawsuit is that students will be forced to undergo long and arduous bus trips over dangerous roadways.

Rafferty said that Pennsylvania law says that school boards can make decisions on closing schools so long as they take all relevant factors into consideration.

So even though there is no question that there will be long bus rides, the bus rides were

factors that were taken into

consideration by the board, he said.

“In spite of that, they still felt it was in the best interest of the district and taxpayers to close the school,” he said.

Another point raised in the lawsuit is that sending Laurel Valley middle and high school students to the Ligonier Valley Middle School and Ligonier Valley High School will create serious overcrowding.

Rafferty said the same analysis for the bus rides applies to each point the citizens group raises in the lawsuit.

Dennis B. Rafferty Featured in Pittsburgh Tribune Review Article

By Jewels Phraner
LIGONIER ECHO
Tuesday, June 8, 2010

A Westmoreland County judge will hear arguments June 22 in a case involving the decision to close Laurel Valley Middle/High School.

The Ligonier Valley school board voted 8-1 in April to close the complex in the northern end of the district.

Shortly after the decision, 13 district residents filed a complaint against the district, the eight board members who voted in favor of the plan and Superintendent Christine Oldham. Director Victor Sansing voted against the closing.

District Solicitor Dennis Rafferty said the hearing is scheduled for 2:45 p.m. before Judge Gary P. Caruso.

If the case is not decided at that time, an injunction hearing is scheduled Aug. 2 and 3, he said.

The citizens' complaint alleges the school board acted illegally and violated public trust. It also alleges the decision to close the school was arbitrary, capricious, done in bad faith and "motivated by reasons unrelated to providing quality education."

The citizens are represented by Pittsburgh attorney Gary Matta.

Rafferty will represent the district, along with attorneys John Smart and Lee Price of Pittsburgh's Andrews & Price. Rafferty said Smart and Price's services were obtained through the Pennsylvania School Boards Association.

The district responded to the complaint June 1, arguing that the plaintiffs do not meet the burden of proof established in previous court cases.

According to the district's response, courts historically have chosen not to interfere with decisions of governmental bodies unless officials have acted in bad faith, abused their power or acted capriciously or fraudulently.

The district's decision to close the school is neither arbitrary nor capricious, Smart contended.

"Arbitrariness and caprice are not to be confused with bona fide differences of opinion, allegedly unwise acts or asserted mistakes in judgments," the district said in its response.

Residents opposing the closure filed for an injunction that would stop the district from moving forward with the closure.

The group says that unless the district stops proceeding with the plan to move Laurel Valley students in grades six to eight to Ligonier Valley Middle and students in grades nine to 12 to Ligonier Valley High schools, the district will cause "immediate and irreparable harm."

The district argued that no such injunction is required.

"To the contrary, (the district) will suffer harm if the preliminary injunction is granted," Smart stated in his response.

A Summary: Long-Term and Short-Term Disability

The following article was authored by Quatrini Rafferty attorney Brian Patrick Bronson, Esq. and originally published in our newsletter, the Legal Update.

As an employee you may be entitled to various employee benefits from your employer. These benefits may include health insurance, family medical leave, short-term and long-term disability benefits , and sickness and accident benefits. However, these programs can be confusing at the time when you need them most — when you have suffered either an injury, illness, or accident that prevents you from returning to work. The last thing on your mind at this point in time is getting through the required paperwork before you concentrate on your own recovery. However, this is the time that you need to be most diligent in protecting the benefits to which you may be entitled through your employment.

Your employer is not required to carry short-term and long-term disability benefits. However, many employers do provide these benefits. Unlike workers' compensation, short-term and long-term disability benefits are not limited to “work-related” injuries . These benefits cover any type of disability regardless of the cause.

You should be aware of the coverages provided by your employer and the terms and conditions of your particular benefits. Short-term and long-term disability benefits may be covered by a contract that the employer has entered into with an insurance company on behalf of all eligible employees. The terms of these contracts can vary drastically from policy to policy in terms of duration of benefits, definition of disability, deductible sources of income, and rehabilitation incentives. You should obtain a copy of your disability policy. Federal regulations require employers to provide copies of these policies within 30 days of a written request. You may also have been provided with an employee manual or Summary Plan Description (SPD). These documents can be very helpful in explaining your rights to employee benefits.

Employee benefits such as short-term and long-term disability are regulated by the federal government through a complex scheme of laws pursuant to the Employee Retirement Income and Security Act (ERISA). ERISA sets forth strict deadlines regarding all aspects of the processing of these claims that both you and the insurance company must follow. If you fail to file your claim or appeal of benefits denial timely, you may lose your right to sue your employer in court. If you have already filed a claim or an appeal and have not heard anything from the insurance company, you should not allow time to pass without knowing the deadlines that apply in your particular case. ERISA is complex and difficult to thoroughly discuss in this article; however, you must be vigilant in protecting your right to employee benefits.

If you have questions or concerns regarding your short-term and long-term disability benefits, please contact Brian Patrick Bronson at our Greensburg or Latrobe offices at (888) 288-9748 or www.qrlegal.com.

- Quatrini Rafferty -

Social Security Administration Announces Approval/Denial Numbers for Hearing Offices

The Social Security Administration recently released information on the number of favorable and unfavorable awards for 2009 at the regional hearing offices. Quatrini Rafferty attorneys actively try social security cases in front of the judges from each office.

This data includes social security disability (SSD) and supplemental security income (SSI) hearing results through December 2009. Out of the 860 decisions issued through the Pittsburgh Hearing Office, 538 were favorable awards (this includes fully favorable and partially favorable decisions) and 322 were denials.

The Johnstown Hearing Office (including hearings held at remote locations such as Latrobe, Dubois, and Altoona) awarded 549 cases while denying 247.

The Cranberry/Seven Fields Hearing Office issued 660 awards and 385 denials.

Finally the Morgantown, WV hearing office awarded 426 cases while denying 286.

http://www.ssa.gov/appeals/DataSets/03_ALJ_Disp.

- Quatrini Rafferty -

UPDATE: COBRA Continuation Coverage Assistance Under ARRA

In February and October 2009, the Quatrini Rafferty blog authored posts detailing COBRA assistance through the American Recovery and Reinvestment Act of 2009 (aka: Stimulus Bill.) This is intended as a follow-up. The following article was posted on the U.S. Department of Labor's website:

The American Recovery and Reinvestment Act of 2009 (ARRA), as amended on December 19, 2009 by the Department of Defense Appropriations Act, 2010 (2010 DOD Act) provides for premium reductions for health benefits under the Consolidated Omnibus Budget Reconciliation Act of 1985, commonly called COBRA.

Eligible individuals pay only 35 percent of their COBRA premiums and the remaining 65 percent is reimbursed to the coverage provider through a tax credit.

To qualify, individuals must experience a COBRA qualifying event that is the involuntary termination of a covered employee's employment. The involuntary termination must occur during the period that began September 1, 2008 and ends on February 28, 2010. The premium reduction applies to periods of health coverage that began on or after February 17, 2009 and lasts for up to 15 months.

For more information, visit the Department of Labor's website:

http://www.dol.gov/ebsa/cobra.html

- Quatrini Rafferty -

Social Security Administration Adds 38 New Diagnoses to Compassionate Allowance List

The Social Security Administration maintains a Compassionate Allowance List (CAL) as a way to quickly identify medical conditions that will likely qualify for disability benefits, lessening the wait time for a decision.

When Social Security receives a claim that alleges a condition listed on the Compassionate Allowance list, the case is marked as expedited. While a favorable decision is not guaranteed based on the condition being listed on the CAL, it may decrease the wait time a claimant typically faces. If Social Security is not able to make a favorable decision after examining the case under the CAL guidelines, it will then be processed as a non-expedited claim.

As of March 1, 2010, Social Security has expanded the initial CAL to include 38 new medical conditions. The 38 new Compassionate Allowance conditions are:

1. Alstrom Syndrome
2. Amegakaryocytic Thrombocytopenia
3. Ataxia Spinocerebellar
4. Ataxia Telangiectasia
5. Batten Disease
6. Bilateral Retinoblastoma
7. Cri du Chat Syndrome
8. Degos Disease
9. Early-Onset Alzheimer’s Disease
10. Edwards Syndrome
11. Fibrodysplasia Ossificans Progressiva
12. Fukuyama Congenital Muscular Dystrophy
13. Glutaric Acidemia Type II
14. Hemophagocytic Lymphohistiocytosis (HLH), Familial Type
15. Hurler Syndrome, Type IH
16. Hunter Syndrome, Type II
17. Idiopathic Pulmonary Fibrosis
18. Junctional Epidermolysis Bullosa, Lethal Type
19. Late Infantile Neuronal Ceroid Lipofuscinoses
20. Leigh’s Disease
21. Maple Syrup Urine Disease
22. Merosin Deficient Congenital Muscular Dystrophy
23. Mixed Dementia
24. Mucosal Malignant Melanoma
25. Neonatal Adrenoleukodystrophy
26. Neuronal Ceroid Lipofuscinoses, Infantile Type
27. Niemann-Pick Type C
28. Patau Syndrome
29. Primary Progressive Aphasia
30. Progressive Multifocal Leukoencephalopathy
31. Sanfilippo Syndrome
32. Subacute Sclerosis Panencephalitis
33. Tay Sachs Disease
34. Thanatophoric Dysplasia, Type 1
35. Ullrich Congenital Muscular Dystrophy
36. Walker Warburg Syndrome
37. Wolman Disease
38. Zellweger Syndrome

http://www.socialsecurity.gov/compassionateallowances/newconditions.htm


If you have been diagnosed with one of the conditions listed on the CAL, please contact the Quatrini Rafferty Social Security Department at either our Greensburg or Latrobe office at 1-888-288-9748 or at our website www.qrlegal.com.

- Quatrini Rafferty -

WC Benefits And Retirement Benefits Don’t Mix

The following article was authored by Quatrini Rafferty attorney Peter J. Gough and originally published in our newsletter, the Legal Update.

Every so often the Pennsylvania courts issue decisions which result in attorneys rushing to contact their clients with advice. Now is one of those times. We want you to be aware of a change in the law which could result in the loss of your workers' compensation benefits.

The Commonwealth Court of Pennsylvania recently issued two decisions, both of which involved injured workers who were receiving workers' compensation benefits at the same time they were receiving pensions and/or Social Security retirement benefits. The Court concluded that if the injured worker receives a pension or Social Security retirement benefits, that worker is presumed to have been voluntarily removed from the work force - in other words, "retired." For that reason, that worker will not be entitled to workers' compensation benefits.

In the first case, the Court held that an injured worker who accepts a pension is not entitled to workers' compensation unless that worker establishes that a) he or she is actively seeking employment, or b) the work-related injury forced him or her to retire from working any job in the entire labor market and not just from performing the pre-injury job.

A short time later, the Commonwealth Court made life even harder for injured workers. In the second decision, the injured worker applied for and received a disability pension. Then, he testified during his workers' compensation case that he did not actively seek employment for a period of time after receiving the pension. The Court again found that the injured worker had retired during the time that he did not actively seek work. Thus, he was not entitled to workers' compensation wage loss benefits.

Moreover, the Court laid out in detail what injured workers must do to demonstrate that they are not retired. Simply put, the Court said that searching the internet or newspaper ads for jobs is just "window shopping" and does not constitute a true job search. To show a good faith effort to find employment, one must prove that job applications were submitted.

What this means is that injured workers who are currently receiving benefits and who are receiving, applying for, or considering taking pensions and/or Social Security retirement benefits must be actively looking for work on a regular basis in a meaningful manner. These workers have to read the classifieds and then contact potential employers about the jobs. The worker must keep a diary or calendar detailing the jobs they looked into, the employer's name, when they applied, with whom they spoke, and any other important details.

Further, injured workers must never describe themselves to their physicians, employer, co-workers or anyone as "retired" or "resigned."

In sum, an injured worker who is considering retirement must be cautious.

The best way to deal with this is to see a workers' compensation attorney at QuatriniRafferty before applying for retirement, pension or Social Security benefits. To have attorney Peter J. Gough and the Quatrini Rafferty Workers' Compensation department evaluate your Pennsylvania Workers' Comp Claim, contact our Greensburg or Latrobe office at 1-888-288-9748 or at our website www.qrlegal.com.

If you are already receiving workers' compensation and retirement benefits, start applying for jobs, keep the diary, and see your Quatrini Rafferty attorney as needed.

- Quatrini Rafferty -

Quatrini Rafferty Announces New Practice Area: Veterans' Disability

The attorneys at Quatrini Rafferty are pleased to announce a new, full-time practice area: Veterans' Disability. QR attorneys Brian Patrick Bronson and Michael V. Quatrini were recently certified by the U.S. Department of Veterans Affairs to represent members of the armed services who suffer service connected disabilities or diseases.

In short, Veterans' Disability is available to members of the armed services who suffer physical or psychological injuries or diseases while on active duty. This even includes injuries or diseases that were made worse by active duty military service.

The amount of the monthly benefit depends on the degree of disability. In certain instances, additional benefits are payable where there is a loss of limbs, a spouse/children/dependent parent, or a seriously disabled spouse.

• Applying for Benefits

The process for obtaining benefits is similar to Social Security Disability. The veteran submits an application, through our office, outlining his or her injuries, and detailing the connection between the injuries and a particular event during their time in service.

A specific description of the precipitating event is critical, along with medical evidence supporting the connection between the event and the injury. Official military documentation of the event is very beneficial to the claim, as are testimonies from fellow services mates. We will also need discharge or separation papers (DD214 or equivalent). It should be noted that disability benefits are not available for those who were discharged under dishonorable conditions.

Some conditions, depending on the dates and locations of your active duty, are eligible for "presumptive" status, meaning that the VA process presumes that active duty service caused these conditions. It is then up to the VA to disprove the connection. These include, but are not limited to, Lou Gehrig's Disease (ALS), Hodgkin's disease, prostate cancer, diabetes mellitus (Type 2), chronic lymphocytic leukemia, chronic fatigue syndrome, and fibromyalgia. Prisoners of war, for any length of time, can receive presumptive status for psychosis, anxiety, post-traumatic osteoarthritis, heart disease, stroke and a few other medical complications.

Once the application is complete it is submitted to a local office for review. The local office makes a decision as to whether the claim is (1) service connected, and if so, (2) the percentage of disability assigned to the injury.

• The Appeal

Where the local office either denies the claim (i.e. saying the injury is not service connected) or assigns a low, or zero, percentage of disability to the condition(s), the claim can be appealed to a Veterans Law Judge at the Board of Veteran' Appeals. This must be done within one year of the initial decision.

There is some bad news:the average wait time for a hearing is 971 days.

Prior to the hearing, we will meet with the veteran to review the initial decision, the veteran's file and collect additional, updated medical evidence.

• The Hearing - Veterans' Law Judge at the Board of Veterans' Appeals

Again, similar to the Social Security Disability process, the hearing will involve testimony from the veteran concerning the disability - how is happened, how is it limits the individual, etc.

After the hearing, the BVA can do one of two things: they could affirm the Regional Office's denial of your claim. Or, they can reverse the decision made by the Regional Office and grant you benefits.

Should the BVA affirm the denial of your claim, the next appeal would go to US Court of Appeals for Veterans Claims.


To have attorneys Brian Patrick Bronson or Michael V. Quatrini evaluate your Veterans' Disability claim, contact our Greensburg or Latrobe office at 1-888-288-9748 or at our website www.qrlegal.com.