In addition to SSD claims, our office handles Railroad Retirement Board claims. Injured or disabled employees of a railroad can apply to the Railroad Retirement Board (RRB) for disability. The RRB administers the program and some of the benefits and procedures mirror the Social Security Administration's disability program and benefits. For railroad employees there are several benefits that the worker or his dependents should look at in terms of eligibility.
Social Security Disability and SSI claims often deal with physical ailments and their effects on a person's ability to do work. The Social Security Administration determines whether the person seeking benefits can perform his/her past work and whether other work exists considering his/her residual functional capacity, i.e. what the claimant can still do despite her physical or mental impairments. What is an exertional level?
Unfortunately, the news for Social Security Disability and SSI claimants waiting for a hearing continues to worsen in terms of wait times for hearings and percentage of people awarded disability. Just a few months ago, in May of 2014, I posted the latest information on wait times and approval rates. Things have worsened since then!
Often Social Security Disability claimants are confronted with a dilemma after receiving an unfavorable decision from an administrative law judge following a hearing. Does the claimant appeal to the appeal council, which can take a long time and is often unsuccessful, or file a completely new application? Years ago, a claimant could do both. However, the Social Security Administration passed SSR 11-1p in 2011 forcing claimants to choose between appealing or filing a completing new claim under most circumstances. I previously discussed these issues, but now there have been some clarifications by the SSA.
Workers' Compensation claims in Tennessee for injuries such as hearing loss and carpal tunnel will become vastly more difficult after July 1, 2014. As discussed previously, injuries arising out of or in the course and scope of employment in Tennessee on or after July 1, 2014 are going to be treated substantially different under the "reformed" Tennessee Workers' Compensation Act. An example of a substantive change, would be the definition of injury. Tennessee Code Annotated section 50-6-102 injury definition for accidents on or after July 1, 2014.
Often in workers' compensation claims, when the claim involves mental injuries, psychologists are offered by the insurance companies for treatment. Psychologists are not entitled to give a finding of causation under the act. As the Supreme Court stated in its unreported decision Shelby v. Highways, Inc, 2003 Tenn. Lexis 413 (May 13,2003), "the trial court cannot base a finding of causation solely upon the opinion of a psychologist." Id. at *12 (citing Cigna Property & Cas. Ins. Co. v. Sneed, 772 S.W.2d 422 (Tenn. 1989». The Shelby Court indicated that the holding does not preclude inclusion of all of a psychologists' testimony, but does preclude the psychologist from making statements regarding causation of any given injury. It is well established jurisprudence in the state of Tennessee that causation may only be proven by medical expert testimony, and in Rapier v. Jones Blair Paint, 2002 Tenn. Lexis 428 (Sept. 27,2002), the plaintiffs even conceded that "a psychologist is not competent to render an opinion as to causation and permanency of an injury in workers' compensation cases." See also McCaleb v. Saturn Corp., 910 S.W.2d 412 (Tenn. 1994) and (Argonaut Ins. Co. v. Williams, 580 S.W.2d 784 (Tenn. 1979) (both holding that causation and permanency of injury must be established by expert medical testimony). Tennessee courts have clearly stated that "while a clinical psychologist may have valuable testimony to offer, such testimony is not competent in a workers' compensation case on the issues of causation or permanence of medical impairment." Skelton v. Robertshaw Controls Co., 1998 WL 740855 (Tenn. Workers Compo Panel Oct. 26, 1998). Further, the Tennessee Supreme Court in Freemon V. VF Corp, Kay Windsor Div., 675 S.W.2d 710 (1984) expressly held that a psychologist was not a medical doctor and was not qualified to establish permanence in a workers compensation case.
Social Security Disability claimants should know that on April 3, 2014, the Social Security Administration published Social Security Ruling (SSR) 14-1p, "Evaluating Claims Involving Chronic Fatigue Syndrome (CFS)" rescinding SSR 99-2p. SSR 14-1p is effective April 3, 2014. For the full text, go to SSA's website. Pertinent parts follow below:
Sometimes in workers' compensation claims, the injured worker has pre-existing problems or conditions. Often the employer or workers' compensation insurance company will deny the claim based on those pre-existing conditions or illnesses. An employer cannot escape liability when an employee, upon suffering a work-related injury, incurs disability far greater than if the employee had not had pre-existing medical conditions. Kellerman v. Food Lion, Inc., 929 S.W.2d 333, 335 (Tenn. 1992); Rogers v. Shaw, 813 S.W.2d 397 (Tenn. 1991).
A person can qualify for Social Security Disability or SSI benefits if he suffers from Crohn's disease or inflammatory bowel disease. Crohn's disease. The Social Security Administration (SSA) follows a step-by-step evaluation to determine if someone is medically qualified for disability benefits. At the third step of the process, the SSA looks to see if the person has an impairment or several impairments that meet or equal a "listing." The listing is as follows:
People applying for Social Security Disability or SSI are waiting longer to have their cases heard and fewer cases are being approved. The national average processing time for claims before the Office of Disability Adjudication and Review is up to 392, which is an increase of 10 from February of 2014, and up from 372 in December of 2013. Nationally, the average approval rate is 44% (down from 46% since December of 2013). In Tennessee, the average processing time is 419, which is up from the 407 days in February of 2014 and 388 days in December of 2013 with 49% of cases being approved. The approval rate has dropped from 50% in February of 2014 and 53% in December of 2013.