PRACTICE AREAS:
WORKER’S COMPENSATION & SOCIAL SECURITY:

WORKER’S COMPENSATION

If you have had an accident at work, even a minor one, you should consult with an attorney. Even if it seems the insurer is processing your claim correctly, or you do not think you can afford a lawyer, it is always a good idea to talk with one. A consultation with a Guinn & Dalton attorney is, at the very least, a risk-free way to learn about whatever options might pertain to your claim.

A claim is never too small too old or too simple for Guinn & Dalton to consult with you about your options. Initial consultations are always free and if you retain an attorney and nothing needs to be corrected on your claim, the attorney is not paid. Additionally, there is no obligation to sign-on after the initial consultation and you are welcome to take time afterwards to make a decision.

Following are the types of workers’ compensation issues the attorneys at Guinn & Dalton can help you resolve:

Denial

If any aspect of your claim has been denied, do not assume the denial is correct. Insurers may deny claims and conditions with little evidence to support their decision. An attorney can review your file at no charge and offer advice about the strength of the evidence. Even previous denials based on some evidence can be, and frequently are, overturned. If you disagree with a denial, you will have to appeal it - usually by requesting a hearing. Appeals can be complex, as there are many different types of denials, each with its own appeal procedure. An attorney can make sure any denial you receive is appealed correctly and in a timely fashion.

If an attorney represents you at hearing on a denial and wins, the attorney’s fee is paid by the insurer - not by you. If you do not win at hearing, you will not have to pay the attorney a fee.

Notice Of Hearing

For nearly all denials, you will have to produce medical reports in support of your claim. Your doctor’s chart notes or work releases, by themselves, are almost never enough to win. An attorney can advise and assist you in obtaining the medical reports you need, in order to present the strongest case possible.

Even if your hearing is coming up in a few days, it is not too late to talk to an attorney. In fact, talking to an attorney quickly may enable you to postpone the hearing and/or prepare your case more completely.

Notice Of Acceptance

The insurance company does not have to accept every diagnosis presented. Just because your claim has been accepted does not mean that the insurer has accepted the correct conditions––and it is very important that they do. The benefits you receive generally flow from the condition accepted. An attorney can help you navigate the law on these issues and work to obtain all benefits for your work injury.

Time Loss

If you are unable to work because of your injury, the insurer will owe you temporary disability benefits (these are called time loss). As time loss benefits are often your only income while hurt, these benefits are extremely important. There are rules the insurer has to follow regarding when and how often they pay, as well as how much. There are also rules that you have to follow in order to qualify for these benefits. Both insurers and workers often make mistakes in this arena. Our attorneys can help you avoid making errors and correct the insurer’s oversights that could cost you critical income when you need it most.

Notice Of Closure

The amount you receive for disability, if any, involves a complex calculation. If you have received a Notice of Closure (NOC), do not assume that the awarded disability is correct. An attorney can help you assess whether the awarded amount is adequate and give you the advice you need to weigh your options, should you want to challenge the award.

A Notice of Closure also awards other benefits, including periods of authorized time loss, which require a thorough review. Our attorneys can help with this analysis.

Vocational Assistance

An injured worker could be eligible for retraining. The eligibility requirements involve a detailed analysis of your medical records and the wage received at injury, among other factors. Should vocational training be denied, you can still challenge the denial. Even if you have received a Notice of Eligibility, the training offered may be insufficient. An attorney may help by obtaining an eligibility evaluation and denial revocation, while procuring sufficient training.

Settlement

A settlement involves giving up potential workers’ compensation benefits in exchange for monetary compensation. It is important to know that settlement of a workers’ compensation claim is not like settlement of a personal injury case or other civil disputes. Not all workers’ compensation claims settle, and settlement is not the only way to receive money on your claim. If you have been offered a settlement amount and are wondering how it compares to the worth of your claim, you should consult an attorney.

Reopening a Claim

An injured worker is still entitled to benefits after claim closure. You may be entitled to time loss benefits, medical benefits, vocational benefits and permanent disability benefits long after your actual injury and initial claim. Your entitlement to reopening a claim involves a complicated analysis of the medical evidence, the age of your case and your work status. Depending on the nature of the injury and the conditions the insurance company have accepted, an injured worker may be entitled to benefits for life. An attorney can help guide you through these complexities and ensure that you receive the post-closure benefits you are entitled to by law.

DISABILITY & SOCIAL SECURITY

Generally, if you are not working and have a severe impairment that has lasted or will last for 12 months or result in death, and if this impairment either meets a certain listed level of severity, or prevents you from being able to perform any work that exists in substantial numbers in the national economy, you meet the medical requirements for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.

The nonmedical requirements generally relate to for how long and until how recently you or someone else have paid into Social Security, or to your current financial situation. If you have questions regarding whether you might meet these requirements, you should consult an attorney.

Following are the types of disability and Social security concerns the attorneys at Guinn & Dalton can help you address:

Proof

You will be required to prove that you are disabled. This means that you will need to obtain a detailed medical opinion that contains specific information based on a highly specialized set of legal standards. Your doctor’s chart notes will almost never be enough. Even a letter from your doctor stating you are disabled will not carry your burden. Our attorneys can help you obtain a legally sufficient opinion from your doctor.

Representation

If we represent you for your Social Security claim, you are found disabled and there are back-due benefits owing on the claim, our fee will generally be 25% of those back-due benefits, subject to certain caps. If we represent you and you do not prevail, you do not pay us a fee. If you are not sure you need representation, one of our attorneys will discuss your claim with you at no charge, and with no obligation to retain us.

Initial Application

The decision to apply for SSDI or SSI benefits is a serious one, and one that you should discuss with your doctor, your family and an attorney. While it is not necessary to talk to an attorney before you have filed, even a brief discussion can be very helpful in making your application as strong as possible.

Notice Of Disapproved Claim

If your initial claim has been denied, it is extremely important to consult an attorney. Most claims are denied at the initial level, and often for reasons that have little to do with the actual severity of your impairment. However, simply requesting reconsideration without submitting additional expert evidence to your file will almost certainly result in denial at the next level—and a two-year wait for a hearing before a judge. Our attorneys can help you take advantage of the limited time available to improve your application for the reconsideration process, and give you the best possible chance to avoid the frustrating delay between reconsideration and hearing.

Notice Of Reconsideration

If you have been denied at the initial level and again at reconsideration, you will likely have to wait two years for a hearing before an administrative law judge. However, there are occasionally ways to accelerate the process, and our attorneys can help you determine if they are available in your claim.

Hearing

If your claim goes to hearing before an administrative law judge, you will have a chance to explain your impairment to a judge in ways that the written record cannot. You should absolutely, without exception, retain an attorney to represent you before the SSA at the hearing level. Our attorneys can prepare you for hearing and help you obtain the evidence you need to prevail before the judge.

Appeal

Just because you have lost at hearing does not mean that the SSA made the correct decision. Judges often make decisions that are not supported by sufficient evidence to withstand review from the Appeals Council or Federal Court. Our attorneys can help you determine whether your decision is one that is likely to be overturned on appeal.

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