What Benefits Are Your Survivors Able to Recover?

workers-compensation-apply-when-a-worker-diesIn New Jersey, after a job-related injury, you can apply for disability and medical benefits under the state’s workers’ compensation system. If your injury keeps you from working, either temporarily or permanently, you’ll be able to pursue disability benefits, either for the time you are out of work, for a set period of time (if your injury is permanent), or even for the rest of your life, in certain situations. But what happens if you are killed in a workplace accident or die from an occupational disease?

Under New Jersey law, the surviving spouse and natural children who were in a worker’s household at the time of death qualify as dependents and are entitled to receive a death benefit after a worker is killed or dies because of a work-related cause. As a general rule, the benefits will be 70% of the worker’s average weekly wage (AWW) for the past 52 weeks. That benefit amount is divided among the dependents. Other relatives or dependents may also seek death benefits, but must prove actual dependency to the workers’ compensation board. A minor child will be considered a dependent until age 18, unless in college or physically/mentally disabled, when benefits may be available for a longer period of time.

In addition, the workers’ compensation insurance company or the employer must pay up to $3,500 in burial or funeral expenses when a worker dies from a job-related cause.

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At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured workers throughout New Jersey. For a free initial consultation, contact our office online or call us at 856-200-8989.

We handle all workers’ compensation claims on a contingency basis. We won’t charge you attorney fees if we don’t recover compensation for your losses.

The Four Levels of a Social Security Disability Appeal

If you suffer from an injury or illness that makes it impossible for you to work for at least 12 months, you can seek benefits through the federal Social Security Administration. Unfortunately, even if your claim seems clearly to fall within the guidelines established under the law, your application may be denied. If so, though, you still have options. Here are the four levels through which a Social Security disability claim appeal will travel.

Reconsideration

The first step you can take after the denial of an Social Security disability claim is to ask for a reconsideration. This is generally a matter of formality, as, in most states, you cannot move any further up the appeals process unless you have asked for a reconsideration. The reconsideration is conducted by a claims examiner at Disability Determination Services, and is more often than not denied.

A Social Security Disability Hearing

If, as most often happens, your request for reconsideration is denied, you can ask for a hearing before an administrative law judge. The judge will fully review your claim, as well as any new medical evidence you may have, and will render a decision based on all testimony and evidence presented. The judge may take testimony from a vocational expert regarding whether you have the capacity to work in a comparable job. Though the Social Security disability hearing offers the best chance of the reversal of a denial of benefits, it can take a long time to schedule a hearing.

The Disability Appeals Council

If your claim is rejected by the administrative law judge, you still have options. You can ask the Social Security Appeals Council, a group of more than 50 appellate judges, to review the findings of the administrative law judge to determine if any errors were made.

An Appeal in Federal District Court

The final avenue of appeal in a Social Security disability case is to the federal district court. You must file your appeal within 60 days of the decision by the Appeals Council. Technically, though you are appealing the decision of the administrative agency, your filing in federal court is in the form of an initial civil complaint. Federal law prohibits the filing of a lawsuit against the Social Security Administration, so you must name the Social Security commissioner as defendant. Once you have filed a complaint in federal district court, you have the right to appeal through the federal court system, to the U.S. Court of Appeals and ultimately to the U.S. Supreme Court.

Contact the Law Office of Taylor & Boguski

At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured people throughout New Jersey. For a free initial consultation, contact us online or call us at 856-200-8989.

When You Cannot Work Because of Injury or Illness

Obtaining Benefits through the Social Security Administration

Handicap parking spaceWhen you are unable to work because of injury or illness, you can look to private or employer-sponsored disability insurance. But you are not without options if you don’t have this type of coverage. Regardless of your age, if you meet the requirements, you can receive payments under a Social Security disability insurance or Supplemental Security income claim.

Qualifying for Social Security Disability Insurance (SSDI) Benefits

To be eligible for SSDI payments, you must first show that you are disabled. For purposes of eligibility, the Social Security Administration defines a disability as a condition that keeps you from being gainfully employed for at least one year. In addition, because payments for SSDI claims come from tax receipts, you must have enough “work credits” to qualify. While the number of credits generally depends on your age and when you became disabled, as a general rule, you must have worked at least some part of the five of the last ten years before your disability claim is filed.

The Benefits under an SSDI Claim

Once your application is approved, you will receive payment of benefits based on your personal earnings record, with average payments ranging from $1,000 to $1,400. For the first two years during which you receive benefits, you may be eligible for Medicaid, based on your total income. However, after two years, you will automatically qualify for Medicare, regardless of how old you are.

Supplemental Security Income (SSI)

The Social Security Administration operates the SSI program as well, but it’s based primarily on financial need, and is generally funded in a cooperative program between state and federal government. To qualify under the federal guidelines, you must:

  • Be blind, disabled or over the age of 65
  • Be a citizen of the United States or meet strict requirements related to permanent residence, asylum or refugee status
  • Fall below the income guidelines
  • Own a minimal amount of property
    • Contact Us

      At Taylor & Boguski, we bring more than 70 years of combined legal experience to injured people throughout New Jersey. For a free initial consultation, contact our office online or call us at 856-234-2233.

Residual Function Capacity and Social Security Disability Claims

The Social Security Administration (SSA) must know what you can and cannot do on a job before it makes a decision on your disability claim. The SSA will take into account both the extent of your disability and your capability or functionality in coming to a determination in your specific case.

Evaluating Your RFC

If you have a medical condition that does not fit into one of the SSA’s List of Impairments, then they will have an evaluation performed to determine what your functional capacity and limitations are and whether you can return to the work you used to do. This evaluation will determine what is called your residual functional capacity (RFC).

Generally, a disability claims examiner will work with a medical consultant who will review your medical records, including physician’s notes about your functional capacity and limitations. They will then make a decision about the type of work you can perform and the type of restrictions that may limit the work you do.

RFC and Strength Limitations and Impairment

The RFC will look at strength-related limitations that include your ability to:

  • stand
  • sit
  • lift
  • carry
  • walk
  • push
  • pull

Once your ability to exert has been defined, your RFC will be assigned to a certain category of work.

The RFC and Work

Depending on your ability to exert and your limitations, the RFC will determine whether you can reasonably perform various types of work, including:

Sedentary work. A restriction to sedentary or seated work means that a person has been determined to have the ability perform a job sitting, with the occasional requirement to walk or stand. The person will also be able to lift no more than 10 pounds at time.

Light work. A person who has been restricted to light work has been evaluated as able to lift up to 20 pounds on occasion and 10 pounds frequently. The job can also require frequent standing and walking with the ability to push and pull arms and legs.

Medium work. A person assigned to this RFC can lift up to 50 pounds at a time and carry frequently 25 pounds.

Heavy work. A person assigned to this RFC category can lift up to 100 pounds at a time and frequently carry up to 50 pounds.

Very heavy work. A person who has been evaluated into this category can lift weights of more than 100 pounds and frequently carry 50 pounds or more in your job.

A claim may generally be turned down your RFC determination means you are capable of performing work in one of the above categories. However, the SSA must also take into account whether you have other types of limitations, called non-exertional limitations. The exertional and non-exertional limitations are combined to come to a determination. Your age may also play a role in this determination if you are considered an “older” person.

RFC and Other Factors That Limit Your Work Ability

Non-exertional factors that are taken into account include your ability to:

  • stoop, climb, crawl, or crouch
  • use hands and fingers to reach, move, or handle things
  • talk, see, or hear
  • focus or concentrate
  • remember or understand instructions
  • function around noise, dust, or other environmental issues
  • work effectively out of depression, anxiety, or nerves

As you can see, the SSA claims disability process is extremely complicated. Combing exertional and non-exertional impairments to win a Social Security Disability Claim can be done, but you need to know how to do it. An experienced disability attorney can evaluate your case and help you understand how to tailor an effective approach to achieve your goals.

Contact an Experienced Social Security Disability Claims Attorney in New Jersey

Find out how we can help you effectively navigate the SSD claims and RFC evaluation process. We encourage you to arrange a free case evaluation with an experienced attorney at Taylor and Boguski, in Mount Laurel, NJ. Please call 800-404-5299 or 856-234-2233 or contact us online.