John Tucker, Managing Shareholder of Tucker & Ludin, P.A. - The Disability Law Firm - has received an "AV" Rating from Martindale-Hubbell. This rating is based upon confidential peer review surveys completed by members of the legal community that know about the skills and honesty of a particular lawyer.
The AV Rating is the highest a lawyer can receive. Martindale-Hubbell states that the AV Rating "identifies a lawyer with very high to preeminent legal ability," and reflects a lawyer's "expertise, experience, integrity and overall professional excellence."
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
Friday, August 22, 2008
Thursday, August 14, 2008
What is ERISA?
ERISA stands for the Employee Retirement Income Security Act, a federal law passed by Congress in 1974. President Nixon signed ERISA into law after 10 years of study designed to reform the nation's pension system.
Congress ultimately included employer-provided insurance benefits as part of the law. That is why most Short Term Disability, Long Term Disability, and other insurance benefits that are offered by private employers are covered by ERISA. Keep in mind that ERISA applies only to employee benefits provided by private employers. If you work for a government entity or a church, ERISA will not apply to your claim. However, any private employer (even a small company with only one employee other than the owner) that provides employee benefits will be subject to ERISA.
With certain exceptions, ERISA creates one uniform system to administer these group benefit programs sponsored by employers. However, this “uniform system” is far from uniform. The law actually allows employers to establish nearly any type of benefit plan they wish, as long as they provide certain documents to employees and allow for an appeal when benefits are denied.
There are many differences between group benefit cases covered by ERISA and individual insurance claims regulated by state laws. If you or your lawyer do not know those differences and how to handle them, it can hurt your case. ERISA is much less consumer-friendly than state insurance laws, and the insurance companies that administer ERISA plans hide behind its protections to deny many group disability benefit claims that would not be denied if they were individual insurance claims.
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
Monday, August 11, 2008
DISABILITY BENEFIT TIP OF THE WEEK: Offsets
Offsets for Long Term Disability Benefits
Depending on your Long Term Disability ("LTD") insurance plan, your LTD benefits may be adjusted to reflect other income benefits from various sources. These sources can include but are not limited to:
Depending on your Long Term Disability ("LTD") insurance plan, your LTD benefits may be adjusted to reflect other income benefits from various sources. These sources can include but are not limited to:
- Social Security Disability ("SSD") or retirement benefits
- Worker's Compensation
- Veterans Service-Connected Disability or Pension ("VA") benefits
- No-fault auto insurance settlements
- Other employer income
- Any payments from the Railroad Retirement Act
- Any state compulsory benefit act or law
For example, assume Bob is entitled to receive $1000 in LTD benefits and $800 in SSD benefits. Bob's LTD insurance carrier will deduct the $800 from his LTD benefit, leaving him with a $200 net LTD benefit.
In some instances, you may be entitled to a minimum benefit if your LTD is less than your other source of income. For example, if Bob was also entitled to a VA disability benefit of $300 a month, his net LTD benefits would be $0. However, some plans will still give him a minimum monthly payment. This amount will vary according to the plan.
If you are receiving an LTD benefit and have not been approved for SSD yet, your insurance company may estimate your SSD benefit and deduct it from your monthly payment. If they do not, be aware that if you are later approved for SSD and receive a lump sum payment, you will have to pay back the lump sum to the insurance carrier. Your insurance company will then begin deducting your monthly SSD benefit from their payment.
REMEMBER: If you are receiving LTD benefits, READ YOUR INSURANCE POLICY OR EMPLOYER'S BENEFIT PLAN. Know what sources of income the administrator or insurance company may use to offset your benefit. If you receive payments from any of these sources, make sure to tell your insurance carrier. If you do not, they will find out later, and you will have to pay them back!
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
In some instances, you may be entitled to a minimum benefit if your LTD is less than your other source of income. For example, if Bob was also entitled to a VA disability benefit of $300 a month, his net LTD benefits would be $0. However, some plans will still give him a minimum monthly payment. This amount will vary according to the plan.
If you are receiving an LTD benefit and have not been approved for SSD yet, your insurance company may estimate your SSD benefit and deduct it from your monthly payment. If they do not, be aware that if you are later approved for SSD and receive a lump sum payment, you will have to pay back the lump sum to the insurance carrier. Your insurance company will then begin deducting your monthly SSD benefit from their payment.
REMEMBER: If you are receiving LTD benefits, READ YOUR INSURANCE POLICY OR EMPLOYER'S BENEFIT PLAN. Know what sources of income the administrator or insurance company may use to offset your benefit. If you receive payments from any of these sources, make sure to tell your insurance carrier. If you do not, they will find out later, and you will have to pay them back!
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
Monday, August 4, 2008
DISABILITY BENEFIT TIP OF THE WEEK: Filling out Forms
During the initial application process and throughout the life of your claim, your insurance company, the Social Security Administration, and even the Veteran's Administration may require you to fill out various forms. One of the most common forms they will request from you is an Activities of Daily Living form. This type of form has various names, including things like "Claimant Statement," but the common elements are questions about what you can and can't do (i.e., your limitations). Whatever it is called, these kinds of forms are VERY important. Here are some tips for filling them out:
- Be thorough in your responses. Do not give one word answers. For example, if the forms asks, "Do you need help preparing meals?" Do not write simply write "yes." Tell them why you need help. For example: "It hurts to stand long enough to make a meal, so my wife usually prepares them for me."
- Be specific. Do not say, "I cannot sit for a long time." Instead, say something like, "When I sit for more than 20 minutes, my lower back starts to really hurt and I have to stand up and move around." Quantify your answers. "A long time" means different things to different people.
- Give examples of ways your disability has limited your activities. For example, "I only take a shower if I know somebody else is home, because I am afraid I will lose consciousness and fall and no one will be there to help me," or "I went to the grocery store last week but could not finish my shopping because my legs started to hurt too much to continue."
- Avoid absolute statements unless they are always true. Do not say something like, "I cannot sit for more than 20 minutes." Instead say, "It usually hurts when I sit for more than 20 minutes." Insurance companies often get surveillance footage of people making claims. If an investigator gets footage of you driving for 30 minutes without interruption and they have your written statement saying that you cannot sit for more than 20 minutes, they will deny your claim because they think you are lying. Another example might be if you say that you cannot bend at the waist, they might catch you leaning over to check your mailbox.
- List all of your limitations. Most forms do not include a section to list your limitations that are not physical. If you experience fatigue, difficulty concentrating, memory problems and/or irritability, etc., be sure to list those limitations.
-Do not be afraid to attach additional paper if the space provided for your answers is not sufficient.
In general, remember that you are trying to give the person that is deciding your claim a complete picture of your condition. Do not limit your answers simply because there is not much space provided for them. Always be truthful and thorough and it will help build your case from the very beginning.
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
- Be thorough in your responses. Do not give one word answers. For example, if the forms asks, "Do you need help preparing meals?" Do not write simply write "yes." Tell them why you need help. For example: "It hurts to stand long enough to make a meal, so my wife usually prepares them for me."
- Be specific. Do not say, "I cannot sit for a long time." Instead, say something like, "When I sit for more than 20 minutes, my lower back starts to really hurt and I have to stand up and move around." Quantify your answers. "A long time" means different things to different people.
- Give examples of ways your disability has limited your activities. For example, "I only take a shower if I know somebody else is home, because I am afraid I will lose consciousness and fall and no one will be there to help me," or "I went to the grocery store last week but could not finish my shopping because my legs started to hurt too much to continue."
- Avoid absolute statements unless they are always true. Do not say something like, "I cannot sit for more than 20 minutes." Instead say, "It usually hurts when I sit for more than 20 minutes." Insurance companies often get surveillance footage of people making claims. If an investigator gets footage of you driving for 30 minutes without interruption and they have your written statement saying that you cannot sit for more than 20 minutes, they will deny your claim because they think you are lying. Another example might be if you say that you cannot bend at the waist, they might catch you leaning over to check your mailbox.
- List all of your limitations. Most forms do not include a section to list your limitations that are not physical. If you experience fatigue, difficulty concentrating, memory problems and/or irritability, etc., be sure to list those limitations.
-Do not be afraid to attach additional paper if the space provided for your answers is not sufficient.
In general, remember that you are trying to give the person that is deciding your claim a complete picture of your condition. Do not limit your answers simply because there is not much space provided for them. Always be truthful and thorough and it will help build your case from the very beginning.
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
Friday, August 1, 2008
Financial Help While You Wait for Disability Benefits
We often find that our clients are in need of financial assistance while waiting for their disability benefits to be approved. The following is a list of links that may be helpful.
General Resources
http://www.211.org/
http://www.ssa.gov/ – Go to “Find Local Office,” enter in the zip code, then go to “Local Agencies”
Department Children and Families – Medicaid, Discount Drug Card, other services
Prescription Help
RX Outreach
Brevard County
Health Department
Social Services
Citrus County
Health Department
Social Services
Hernando County
Health Department and Social Services
Hillsborough County
Health Department
Social Services
Manatee County
Health Department
Social Services
Orange County
Health Department
Social Services
Pasco County
Health Department
Social Services
Pinellas County
Health Department
Social Services
Polk County
Health Department
Social Services
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
General Resources
http://www.211.org/
http://www.ssa.gov/ – Go to “Find Local Office,” enter in the zip code, then go to “Local Agencies”
Department Children and Families – Medicaid, Discount Drug Card, other services
Prescription Help
RX Outreach
Brevard County
Health Department
Social Services
Citrus County
Health Department
Social Services
Hernando County
Health Department and Social Services
Hillsborough County
Health Department
Social Services
Manatee County
Health Department
Social Services
Orange County
Health Department
Social Services
Pasco County
Health Department
Social Services
Pinellas County
Health Department
Social Services
Polk County
Health Department
Social Services
Copyright (c) 2008 by John V. Tucker and Tucker & Ludin, P.A. All rights reserved. Any content borrowed or referenced from another source is referenced by citation to the original source as noted in the text above.
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