Social Security Disability Overpayments

Social Security Disability Overpayments

Social Security disability made $1.3 billion in potentially improper disability payments to people who had jobs when they were supposed to be unable to work. The Government Accountability Office estimated that 36,000 workers got improper payments from December 2010 to January 2013. The numbers represent less than 1 percent of beneficiaries and less than 1 percent of disability payments made during the time frame. But GAO said the overpayments reveal weaknesses in Social Security’s procedures for policing the system.

The Social Security Administration said its accuracy rate for disability payments is more than 99 percent. But the agency noted that even small errors translate into big numbers. More than 8.2 million disabled workers received disability payments in December 2010, a figure that has grown to nearly 9 million. Last year, the agency paid out $137 billion in disability payments.

Before people can receive disability benefits, there is a 5-month waiting period in which they can, in general, earn no more than about $1,000 a month. The waiting period is to ensure that beneficiaries have long-term disabilities. Using a federal wage database, investigators checked whether a sample of disability beneficiaries had worked and earned significant wages during the waiting period, the report said. They found that most of the improper payments went to people who worked during the five months they waited for payments to begin.  Once people start receiving benefits, they can return to work and still get benefits during a trial work period.

Citing a potential weakness, the report said Social Security might not detect a person who worked during the waiting period if the period started in one year and ended in another. For example, if Social Security starts paying benefits in February, the agency might not detect significant wages earned the previous November because they weren’t earned in the same year that benefits were awarded, the report said.

In a written response to the report, the Social Security Administration agency questioned whether GAO overestimated the amount of overpayments. The report comes as the Social Security disability program faces a financial crisis. If Congress doesn’t act, the trust fund that supports the disability program will run out of money in 2016, according to projections by Social Security’s trustees. Congress could redirect money from Social Security’s much bigger retirement program to shore up the disability program, as it did in 1994. But that would worsen the finances of the retirement program, which is facing its own long-term financial problems.

For more information about Social Security disability contact Cary Social Security disability lawyer Kevin Bunn.

WTC First Responders Developing Work Related Cancers

WTC First Responders Developing Work Related Cancers

According to the National Institute for Occupational Safety and Health 1140 people have been diagnosed with cancer related to the attacks on the World Trade Center on September 11th 2001, and that number is expected to grow.  The cancers are traced to in the carcinogens in the air at ground zero.  Tina Engel, an oncology nurse at North Shore Hospital in Queens says she has identified 12 new cases in the last 2 months.  Federal funding is helping patients get biopsies and scans.

Because firefighters, police, EMT’s and other first responders are at particular risk, many of the cancers are work related.  The US Centers for Disease Control has identified about 65,000 people who became sick from 9/11 exposure, many of them first responders.  A Mount Sinai Medical Center study showed that first responders have a 15 percent greater risk of developing cancer than people who were not exposed to the toxic air.  Marty Cervellion , a 63 year old engineer who spent more than 2 months at ground zero following the attacks developed gastroesophageal cancer in 2011.  “It was always in the back of everyone’s mind we were in jeopardy given the contamination down there, but the entire world was calling on you,” he told the Daily News. “It felt so good to serve.  There was no wanting to escape.”

Many workers’ compensation attorneys believe that we will continue to see an increase in work related cancers, which are treated as occupational diseases under NC workers’ comp law.  To recover for an occupation disease in NC the employee must show that their employment placed them at increased risk for developing the condition as compared to the general public and that the employment substantially contributed to the employee contracting the disease.  The challenge is frequently showing that the work exposure contributed to the cancer, particular when other factors such as smoking are present.

Link to Yahoo article.

 

 

Law Students Help Local Kids Mediate Differences

Law Students Help Local Kids Mediate Differences

When East Millbrook school officials started sensing tension among their students they brought in  Professor Jon Powell and the Campbell Law School Juvenile Justice Project which he leads.  The Campbell Law School Juvenile Justice Project is a group of Campbell law students who work with Wake County school children to help them resolve conflicts.  The Project partners with several Wake County middle and high schools and is funded through the Campbell University Norman Adrian Wiggins School of Law.

An anonymous eighth grader at East Millbrook complained that students just  “didn’t get along.”  “It was like he-she said stuff.”  The law school mediators focused on the harm that had been done and how that harm could be addressed in a positive way.  Mediators first talk to the students separately, then together, to help keep a conflict from escalating into a fight.  Professor Powell and the law students’ goal is to get both sides to understand the root of the problems so it doesn’t build up again. “We just worked it out that day” said the eighth grade student.

The Campbell Law School Juvenile Justice Project has dealt with about 80 cases in the last school year.  In the last ten years 95% of the students who completed the mediation didn’t offend again.  A vice principal at East Millbrook said that the students behavior after the program was “calmer, not necessarily best friends but at peace.”

One of the major changes in the practice of law over the past twenty years has been the increased use of mediation to resolve conflicts.  Practically every NC automobile accident, personal injury or workers’ compensation case  that is filed is ordered to mediation.  There are many NC personal injury lawyers who now limit their practice to working as a mediator.  And most NC automobile accident lawyers spend more time in mediation that in trial.

So it’s probably a good idea to start training lawyers in law school to mediate conflict.  And I guess if they can mediate a middle school spat they can mediate anything.

Link to WRAL article.

Should I take a drug test if injured on the job in NC?

Should I take a drug test if injured on the job in NC?

An article in the Smoky Mountain News presents an important NC workers’ compensation question:  Do I have to take a drug test if I am injured on the job in NC, and can my workers’ comp. benefits be denied if I refuse?

According the article, Robert Bradley’s day working at Ghost Town in the Sky amusement park in western North Carolina was like any other until a mock wild west showdown went horribly wrong. Bradley was hit with a piece of shrapnel that exploded out of a gun and buried itself 1.5 inches in his upper thigh. After struggling to find a medic on staff at the amusement park Bradley’s coworkers ended up driving him to a nearby bar parking lot to meet with an ambulance that would take him to the emergency room. At the ER, the doctor flushed out several slivers of an unknown material from the wound. The doctors assumed that the substance was wadding, a material used in place of real bullets. Ghost Town’s workers’ compensation insurance company asked Bradley to submit to a drug test in order to receive workers’ compensation for his injuries. Bradley refused stating that the insurance company was just fishing for a reason to withhold his money. After the accident Bradley lost his job. Bradley says he was fired while Alaska Presley, Bradley’s employer and owner of Ghost Town in the Sky, says Bradley quit. Several other Ghost Town employees quit their jobs at the amusement park in support of Bradley.  So far Bradley has not received either medical or wage replacement benefits from his employer’s workers’ compensation carrier.

This one is a little tricky. First, if an EMPLOYER (not insurance company) has a prior policy of requiring drug testing after an on the job injury, then the employee must either take the test or risk losing his job for violation of company policy. If there is no such policy then the employee is on firmer ground refusing the test. However a refusal or even a positive test is not a valid basis for denying a workers’ compensation claim in North Carolina. If an employer can prove that an employee was actually impaired by drugs when the accident occurred and this impairment contributed to the accident then no benefits are due. A simple drug screen, showing only the presence of a drug, is not sufficient to show that an employee was actually impaired. A test that actually measure the amount of the substance, like a breathalyzer, may be sufficient. The relevant portion of the NC law is reprinted below.

Unfortunately, without regard to the actual law, refusing to take a drug test after an on the job injury in North Carolina may prompt the workers’ compensation insurance company to deny the claim. While a postive test may also draw a denial I generally tell injured workers that if the employer has a clear drug testing policy that it has consistently enforced then taking the test may be best.  The safest route though is to contact an experienced NC workers’ compensation lawyer before deciding whether to take a post-injury drug test.

 

 

 

§97-12. Use of intoxicant or controlled substance; willful neglect; willful disobedience of statutory duty, safety regulation or rule.

No compensation shall be payable if the injury or death to the employee was proximately caused by:

  1. His intoxication, provided the intoxicant was not supplied by the employer or his agent in a supervisory capacity to the employee; or
  2. His being under the influence of any controlled substance listed in the North Carolina Controlled Substances Act, G.S. §90-86, et seq., where such controlled substance was not by prescription by a practitioner; or
  3. His willful intention to injure or kill himself or another.

“Intoxication” and “under the influence” shall mean that the employee shall have consumed a sufficient quantity of intoxicating beverage or controlled substance to cause the employee to lose the normal control of his or her bodily or mental faculties, or both, to such an extent that there was an appreciable impairment of either or both of these faculties at the time of the injury.

A result consistent with “intoxication” or being “under the influence” from a blood or other medical test conducted in a manner generally acceptable to the scientific community and consistent with applicable State and federal law, if any, shall create a rebuttable presumption of impairment from the use of alcohol or a controlled substance.”

The burden of proof shall be upon him who claims an exemption or forfeiture under this section.

 

 

Simpler Hospital Billing Might Help Personal Injury Claimants

Simpler Hospital Billing Might Help Personal Injury Claimants

Starting in June, the mystery shrouding hospital billing in North Carolina will be lessened.  Laws passed by the General Assembly will force hospitals to bill their patients using simple, easy to understand language.  These newly passed laws will help defend the public from misreading or overpaying hospitals for petty or unnecessary charges.   The idea for increasing transparency in hospital billing came alive after the News and Observer and the Charlotte Observer released stories revealing several hospitals misuse of profits.  After these scandals were uncovered, the power of the hospitals in the state began to diminish.

This past year, hospitals across the state took a financial hit due to the greatest Medicaid cuts in history.  The General Assembly denied the expansion of Medicaid to hundreds of thousands of North Carolina residence this year under the Affordable Care Act.  These cuts had the greatest impact on smaller hospitals located in the rural parts of the state where a large number of their patients rely on these federal programs.  These severe cuts in funding forced hospitals across the state to look for new means of income.  The North Carolina Hospital Association is said to have spent almost $1 million on advertisement in an attempt to boost business.

The main goal of N.C. hospitals was to fight a cap on sales tax refunds for non profit hospitals.  The original proposal was to cap the refund at $100,000.  This was quickly shot down by the House and the cap was adjusted to $2.85 million.  To some of the larger hospitals this amount was startlingly small. Many politicians were disappointed and frustrated by the outcome of a $45 million dollar cap on sales tax refunds.  This should not affect any hospitals this year, but hospital lobbyists fear that if the issue is reevaluated in the future, the cap will be set lower.

The most important section of the bill to the public is the more ‘user friendly’ billing system.  Patients will now be more aware of hospital pricing and the cost of all of the services healthcare providers and hospitals provide. Hospitals now have to post the reimbursements for patients from Medicare, Medicaid  and other  insurance providers as well as for patients who are not insured.  These have to be posted in plain view both in the hospitals and on their website. This allows patients to really feel more in control of the care they receive.

This will help NC personal injury and car accident claimants by making the bills easier to understand, especially where the medical provided may have to be reimbursed.

If you have been injured in an auto accident or on the job in NC and have questions about your personal injury claim or NC workman’s comp case please call or email for your free consultation with a North Carolina Personal Injury lawyer.