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What is the difference between SSD benefits and SSI?

Whether you were born with a disability or acquired one in life due to an injury or an illness, living with a disability can be very challenging for residents in West Virginia and elsewhere. It is not only difficult to carryout daily activities, but it can be hard to maintain a job and even pay for all the medical expenses required to address any arising health concerns from the disability suffered. Such a condition can make it impossible or nearly impossible for the individual and the person’s family to meet all their financial requirements and basic needs. Thus, a person living with a disability is likely to apply for Social Security Disability to help offset these financial burdens.

What is the difference between SSD benefits and Supplemental Security Income? The Social Security Administration runs both of these programs, and both programs provide benefits to individuals based on the disability the person is suffering from and certain factors that make them eligible for each program.

SSD benefits are provided through Social Security Disability Insurance, which is based on prior earnings. The taxes workers pay into the Social Security Program finances SSDI; however, to be eligible to receive SSDI benefits, a worker must earn a sufficient amount of credits. Credits are based on the taxable work that is insured for Social Security purposes. Those eligible for SSD benefits include those that are blind, disabled workers, widows or widowers of disabled workers or adults that have been disabled since childhood.

On the other hand, SSI disability benefits are awarded based on the financial needs of the adults or children applying for them. This includes those that are blind or disabled, have limited income and researches, meet the living arrangement requirements of the program or other eligible factors. Unlike SSDI benefits, SSI benefits are financed through general revenues.

No matter a person’s age or cause of a disability, those living with a disability are likely to endure financial issues due to the medical expenses and life adjustment related to the disability suffered. Therefore, it is important to understand what Social Security programs you qualify for and what steps you need to take to recover any benefits you are entitled to.

What is the appeals process for SSD benefits?

For those suffering a disability in West Virginia and elsewhere, it can be difficult to meet all the financial responsibilities required of an individual or a family. In some cases, a serious or permanent disability can make it difficult or impossible to work, thus, making it challenging to make an income to cover living expenses. In these matters, an individual will likely seek Social Security disability benefits; however, not all applicants are approved. In these cases, an applicant may want to exercise the person’s right to appeal a denied application for disability benefits.

What is the appeals process for SSD benefits? Following a denial, an applicant has 60 days to make a written request for an appeal. The appeal process is made up of four levels. The first level is reconsideration, which is followed by a hearing by an administrative law judge. The third level is a review by the Appeals Council and the final level is a Federal Court review.

Reconsideration is a complete review of an applicant’s claim. Someone who did not take part in the first decision completes this review. At this level of review, all evidence submitted when the original decision was made plus any new evidence will be looked at. This process can normally be conducted without the need for an applicant being present.

When an applicant disagrees with the decision made at reconsideration, the person may ask for a hearing. An administrative law judge that had no part in the original decision or the reconsideration of the claim conducts this. It is usually advantageous to attend the hearing because this could assist with the explanation of the applicant’s case.

If an applicant does not agree with the decision made at the hearing, could the person can request for a review by the Social Security’s Appeals Council. During this process, the Appeals Council looks at all of the requests made for review; however, a request might be denied if the Council believes the hearing decision was correct. If a case is reviewed, it will either be decided by the Appeals Council or returned to an administrative law judge for further review.

If an applicant disagrees with the decision of the Appeals Council or the Appeals Council decides to not review an applicant’s case, the person may file a lawsuit in a federal district court.

The appeals process can be lengthy and complex; therefore, it is imperative that applicants fully understand what options are available to them. This will help them better protect the person’s rights and interests in the matter. 

What does state law have to say about discrimination in workers’ comp cases?

Recently, we spoke about a lawsuit recently filed by a West Virginia worker who alleged that his employer routinely discriminated against employees who attempted to exercise their right to workers’ compensation. West Virginia law, to be sure, prohibits employers from discriminating in any fashion against present or past employees due to their receipt or attempt to receive workers’ compensation benefits. Here we wanted to take a brief look at what state law says on the matter on two important points: health insurance and termination.

With respect to health insurance, employers are not allowed to cancel the policy, decrease participation on behalf of the employee or his dependents, or decrease the employee’s coverage during the time an employee is receiving workers’ compensation benefits for a temporary disability. That being said, an employee is allowed to change insurance carriers, or reduce or cancel medical coverage, so long as other employees in the same class are treated the same.  

When it comes to termination of an injured employee who is receiving or seeking to receive workers’ compensation benefits, it is simply prohibited. State law specifically prohibits employers from terminating injured employees while they are off work and receiving temporary total disability benefits. The only situation where this would be permissible is when there is a separate dischargeable offense, which generally refers to misconduct unrelated to the injury or absence.  


car accident

West Virginia researcher says male pedestrians at higher risk than women

New research shows that men are two times more likely to suffer fatal injuries in a pedestrian accident than women. A researcher with the West Virginia University School of Public Health an Injury Control Research Center spearheaded the study. Researchers looked at data recorded in the United States 2008 and 2009. Worldwide, more than 1.2 million people are killed in traffic accidents and in the United States 12 percent of all traffic fatalities involve a pedestrian.

Some studies have previously suggested a higher risk of death for male pedestrians. However, few studies reportedly have been conducted that have looked deeply into the associated factors that may increase the risk of death, according to the lead researcher from West Virginia.

In seeking to discern what may lead to the apparent higher risk of death for men, the researchers looked to see whether distance traveled could be a factor. However, research shows that on average males and females walk about the same distances each day overall. But data earlier studies have suggested that males seemed to have had a slightly greater risk of death when involved in a pedestrian accident.

The recent study showed that men are roughly 2.3 times more likely to be killed in a pedestrian accident when compared to their female counterparts. The lead researcher says that more scientific inquiry is needed to explain the greater apparent risk.

While the research focused solely on fatal injuries, it is important to note that any pedestrian can be at risk for serious injury. People are no match for an automobile or other form of vehicle. Although the studies suggest that men can be at higher risk, women are obviously not safe in an accident.

While the speed of the vehicle in any pedestrian accident can be a factor in the degree of injury a victim may suffer, it is also important to note that other hazards exist for pedestrians.

The impact of the vehicle can cause broken bones, internal injuries, head injuries and more. Similarly, the accident victim can be thrown into other objects that can cause serious injuries or death, such as the pavement, curbs, road signs and other hazards near an accident scene.

Wait for hearing for applicants appealing denied SSD claims

When individuals in West Virginia and other states across the country are unable to work because of an injury, illness or disability, this can be very problematic and life impacting for the individual. While Social Security disability benefits are available to those suffering from serious disabilities, those filing for benefits may not receive them following their initial claim. In fact, many are initially denied and will have to appeal this decision if they seek to collect SSD benefits.

A denied claim requires an applicant to go through the appeals process; however, this process is not always quick and often causes an applicant to make numerous appeals until they reach a favorable decisions or run out of options. However, due to a substantial drop in the Social Security Administration’s staffing, this has caused a major backlog in those attempting to appeal a denied claim.

In fact, recent data suggests that 1.1 million applicants are waiting an average 543 days for the person’s appeal at the hearing level. This wait is related to the staffing at the SSA dropping. According to the Center on Budget and Policy Priorities, there was a 14 percent staffing drop since 2010. That amounts to a loss of 1,989 workers who are no longer able to process disability claims.

This staffing shortage is a growing problem, especially for those appealing their denied claims. In fact, there are also staffing challenges in the appeals stage due to a shortage of administrative law judges available to hear disability claims. Due to these shortages, those applying for SSDI can roughly expect a 30-month wait to just receive a hearing.

While the SSA has released a plan to address these issues, it is projected that the problems of backlogs will not be resolved until the summer of 2020. Whether people are waiting for an appeal, waiting to hear a decision or are working on a SSD application, it is important to take the time to be fully aware of their rights and options. This will help progress the process when the time comes to act on a decision made by the SSA.