All posts by Lauri Watkins

Social Securtiy

Social Security Fears? An Open Letter to Our Clients

We’ve been hearing from clients, both current and former, about the proposed changes to Social Security – and what we are hearing is fear. Our clients have been found too disabled to work under very stringent definitions of disability, but are now hearing that their already strained incomes may be cut – or taken away entirely. 

They are scared.

And they are looking to us for assurances – assurances that, unfortunately, we cannot give. 

We cannot promise our clients that their benefits won’t be cut.

We cannot promise our clients that their Medicare won’t be further compromised – that even fewer doctors will accept it, that fewer procedures will be covered, that the medications they need to survive and function won’t drop off the allowed formulary, that block grants will limit how much treatment they can receive in a given time frame, regardless of need or urgency.

All we can do is tell them what we do know – and, more importantly, we can remind them that they have a voice.

Please feel free to share our note with your clients or friends. Modify it to suit your needs and jurisdiction. And, please, think about our clients: when you vote, and when you voice your concerns to your legislators.

Dear Client:

First of all, no changes to Social Security have been made yet. Many things are being proposed, but budgets are subject to numerous changes before they are approved, and even once approved, they are subject to additional changes as they are implemented.  And implementation doesn’t usually happen overnight – it takes place over years.

It’s true that cuts to Social Security Disability, Medicaid, and Medicare are all being discussed. However – cuts to these programs have been discussed every budget cycle for the past several decades!  But nothing has actually happened yet.

At this time, we recommend that people:

  • Pay attention. You’re right that some changes are being talked about – be aware of what, and how that might affect you.
  • CONTACT YOUR LEGISLATORS. This is the most important thing! Whether your Senators and Congressional Representative share your party or not, they are still responsible for YOU as their constituent. Tell them that you rely on these programs, and how you would be affected by any changes. Tell them by whatever means you can: call, email, write, show up in person if at all possible. As we have seen on several recent legislative proposals, even deeply party-line legislators can be convinced to vote down proposals that their constituents have made clear are not in their best interests.
  • Don’t panic. Yes, these changes can sound scary – but remember, nothing has actually happened yet. It’s not a bad idea to make some contingency plans – could you reduce your living expenses? Can you start saving a little bit each month, to have a cushion against potential future needs? Are there any opportunities for you, within your limitations, to bring in some bit of income, just in case? – but beyond that, anything is just speculation. Panic makes it harder to advocate for what we need, so try to keep unproductive dwelling on “what if” to a minimum!
  • PLAN TO VOTE, in every single upcoming election. Watch what the politicians and candidates DO, not what they say! If they have voted to cut your benefits, they are not really looking out for you, and we all need representatives that truly work FOR us – not against us!

If you are receiving combined benefits through both Social Security and Workers’ Compensation, any changes to the Disability program will be at least somewhat mitigated, as your Workers’ Compensation benefits should increase to offset at least some of the loss in Social Security income, up to your maximum time-loss benefit. The possible impact on your Medicare is much harder to predict – we can’t say what will happen, when nothing has yet passed!  

Our firm does not handle Social Security cases, and does not plan to do so. However, we are in close contact with our colleagues who still do, and we still participate in advocacy work for these programs, as we are aware of the need our clients have for them.  Should changes take place that will affect our Workers’ Compensation clients, we will review the impacts and keep in touch.

Photo credit: Thomas Leuthard via Foter.com / CC BY

Defense Base Act

NYT: What if PTSD Is More Physical Than Psychological?

There’s exciting new science about blast injuries in war zones – but of course, even as the military begins confronting it, the contractors with Defense Base Act claims get dumped into a civilian health care market that has no idea what they’re looking at, diagnosed with PTSD, and told to deal with it.

By ROBERT F. WORTH, New York Times

JUNE 10, 2016

In early 2012, a neuropathologist named Daniel Perl was examining a slide of human brain tissue when he saw something odd and unfamiliar in the wormlike squiggles and folds. It looked like brown dust; a distinctive pattern of tiny scars. Perl was intrigued. At 69, he had examined 20,000 brains over a four-decade career, focusing mostly on Alzheimer’s and other degenerative disorders. He had peered through his microscope at countless malformed proteins and twisted axons. He knew as much about the biology of brain disease as just about anyone on earth. But he had never seen anything like this.

The brain under Perl’s microscope belonged to an American soldier who had been five feet away when a suicide bomber detonated his belt of explosives in 2009. The soldier survived the blast, thanks to his body armor, but died two years later of an apparent drug overdose after suffering symptoms that have become the hallmark of the recent wars in Iraq and Afghanistan: memory loss, cognitive problems, inability to sleep and profound, often suicidal depression. Nearly 350,000 service members have been given a diagnosis of traumatic brain injury over the past 15 years, many of them from blast exposure. The real number is likely to be much higher, because so many who have enlisted are too proud to report a wound that remains invisible.

Daniel Perl is continuing to examine the brains of blast-injured soldiers. After five years of working with the military, he feels sure… that many blast injuries have not been identified. “We could be talking many thousands,” he said. “And what scares me is that what we’re seeing now might just be the first round. If they survive the initial injuries, many of them may develop C.T.E. years or decades later.” 

For years, many scientists have assumed that explosive blasts affect the brain in much the same way as concussions from football or car accidents. Perl himself was a leading researcher on chronic traumatic encephalopathy, or C.T.E., which has caused dementia in N.F.L. players. Several veterans who died after suffering blast wounds have in fact developed C.T.E. But those veterans had other, nonblast injuries too. No one had done a systematic post-mortem study of blast-injured troops. That was exactly what the Pentagon asked Perl to do in 2010, offering him access to the brains they had gathered for research. It was a rare opportunity, and Perl left his post as director of neuropathology at the medical school at Mount Sinai to come to Washington.

Perl and his lab colleagues recognized that the injury that they were looking at was nothing like concussion. The hallmark of C.T.E. is an abnormal protein called tau, which builds up, usually over years, throughout the cerebral cortex but especially in the temporal lobes, visible across the stained tissue like brown mold. What they found in these traumatic-brain-injury cases was totally different: a dustlike scarring, often at the border between gray matter (where synapses reside) and the white matter that interconnects it. Over the following months, Perl and his team examined several more brains of service members who died well after their blast exposure, including a highly decorated Special Operations Forces soldier who committed suicide. All of them had the same pattern of scarring in the same places, which appeared to correspond to the brain’s centers for sleep, cognition and other classic brain-injury trouble spots.

Then came an even more surprising discovery. They examined the brains of two veterans who died just days after their blast exposure and found embryonic versions of the same injury, in the same areas, and the development of the injuries seemed to match the time elapsed since the blast event. Perl and his team then compared the damaged brains with those of people who suffered ordinary concussions and others who had drug addictions (which can also cause visible brain changes) and a final group with no injuries at all. No one in these post-mortem control groups had the brown-dust pattern.

Perl’s findings, published in the scientific journal The Lancet Neurology, may represent the key to a medical mystery first glimpsed a century ago in the trenches of World War I. It was first known as shell shock, then combat fatigue and finally PTSD, and in each case, it was almost universally understood as a psychic rather than a physical affliction. Only in the past decade or so did an elite group of neurologists, physicists and senior officers begin pushing back at a military leadership that had long told recruits with these wounds to “deal with it,” fed them pills and sent them back into battle.

If Perl’s discovery is confirmed by other scientists — and if one of blast’s short-term signatures is indeed a pattern of scarring in the brain — then the implications for the military and for society at large could be vast. Much of what has passed for emotional trauma may be reinterpreted, and many veterans may step forward to demand recognition of an injury that cannot be definitively diagnosed until after death. There will be calls for more research, for drug trials, for better helmets and for expanded veteran care. But these palliatives are unlikely to erase the crude message that lurks, unavoidable, behind Perl’s discovery: Modern warfare destroys your brain.

Read the full article at the New York Times site.

Photo credit: A Health Blog via Foter.com / CC BY-SA

Community

Causey Law Firm is Proud to Support Lowell Elementary School!

Causey Law Firm was a proud supporter of Lowell’s BIG EVENT, a gala fundraiser held on April 2.  The first event of its kind for Lowell, the BIG EVENT brought together businesses, parents, faculty, staff, and supporters from all over the city to raise money for one of Seattle’s most unique public schools.

Lowell Elementary School is located in Seattle’s Capitol Hill neighborhood, and serves children in grades K- 5, plus a medically fragile pre-school.  Its student population draws not only from Capitol Hill, but east all the way to the water, encompassing Belltown, downtown, and all points in between.  This swath of the city draws students from every imaginable demographic, encompassing the children of Seattle’s new technorati, longtime Seattleites, immigrant families, and families experiencing homelessness.  Nearly 40% of the student population at Lowell is comprised of children who are medically fragile, have special needs, or are enrolled in the District’s Vision Impaired program. In addition, Lowell is a Title 1 school where more than 50% of the children are eligible for free or reduced lunch.

And Lowell serves them all. 

This population provides a unique set of strengths as well as challenges, and the Lowell PTA has made a focus of reaching out to the wider community of both the neighborhood and the city in order to support and celebrate Lowell. 

Causey Law Firm not only had the honor of being a sponsor of the event, we also were lucky enough to bid on and win a set of Hot Sculpted Glass nesting bowls by local glass artist Martin Blank!  Our cell phone photography does not do them justice.  We thank Martin and all the other participants and sponsors of the event.

Congratulations to Lowell, Partners at Lowell School (PALS) PTA, and fundraising chair Grace Kim for an excellent event and some impressive fundraising for Seattle’s kids – and thank you for letting us take part!

Social Security

Social Security Basics: “How long do I need to be off work?”

If you, or a loved one, are diagnosed with a severe or aggressive condition, you may qualify to be immediately approved!

     One question that I am asked frequently by folks considering applying for Social Security Disability is “How long do I need to be off work?”  This question is based on a slight misunderstanding of the Social Security rules.  Your medical condition, or combination of conditions, that prevents you from working must have lasted or be expected to last a minimum of one year, (or be expected to result in death), in order for you to qualify for Social Security Disability.  That year does not need to have passed, in order for you to file your application.  If your condition is not expected to get better, or if a long course of treatment is planned that would take you out past one year, then you can file your initial application.  If there is clear medical evidence that you will be unable to work for at least a full year, there is no need to wait for the year to elapse before starting!

If you have not been off work for an entire year, but your condition is expected to last at least that long, you should apply right away.

      If your condition is not expected to get better, or if a long course of treatment is planned that would take you out past one year, then you can file your initial application.  If there is clear medical evidence that you will be unable to work for at least a full year, there is no need to wait for the year to elapse before starting!

     If you have not been off work for an entire year, but your condition is expected to last at least that long, you should apply right away. Benefits can’t begin until you have been disabled for five months, and an initial application usually takes 3-5 months (sometimes longer) to process, so the sooner you file your application, the sooner you may get your benefits.

     Of course, Social Security may deny your claim initially anyway, in which case you should appeal the decision.  We have had several clients who hit the one-year duration mark while we were in the appeals process.  A Social Security claim can take up to two years (sometimes longer) from the initial application until adjudication at a hearing, so the sooner you start, the better.

     If your diagnosis is terminal, Social Security will make every effort to expedite the processing of your claim.  I find it heartening that we don’t receive many inquiries for assistance from people with terminal conditions; I take this to mean that Social Security is doing the right thing and approving them right away.

     Social Security has a list of conditions that are automatically approved, called Compassionate Allowances Conditions – if you, or a loved one, are diagnosed with a severe or aggressive condition, you may qualify to be immediately approved!  Check the following list at Social Security’s website:

http://www.ssa.gov/compassionateallowances/conditions.htm

     When you file your application, be sure to point out that you believe your condition is on the list.

     I also receive calls with a variation on this question, from folks who are still working: “How can I get my Social Security started, so I can stop working?”  This call is not from people who are attempting to somehow ‘game’ the system, but rather folks who have been told by their doctors that they should stop working, or people who know that their work activity is exacerbating their medical conditions – but who can’t afford to stop working without a guarantee of income.  Unfortunately, this is one of the many Catch 22s of the Social Security Disability world – there is no way to get your benefits started up, until you stop working*. 

     One of the first things that Social Security will do, when you file your application, is look up your recent and current earnings.  If you are still working at a level considered above SGA (Substantial Gainful Activity), then they will not even order your medical records.  The fact that you are working, proves that you can – whether or not your doctor has said that you shouldn’t, whether or not you are in pain, whether or not working is causing your condition to get worse.

     Please, do not hesitate to contact us if you have questions about Social Security Disability.

 

*There is a level of earnings under which Social Security doesn’t count your income against you; this level is called “Substantial Gainful Activity”, and it can vary from year to year. In 2013, earnings under $1,040 per month are considered less than Substantial Gainful Activity, though any earnings will cause Social Security to more closely scrutinize your claim (considering, for example, whether you could perform your currently part-time job on a full-time basis, etc.).  A year-by-year look at the Substantial Gainful Activity amounts can be found at http://www.ssa.gov/oact/cola/sga.html

 

Photo credit: Viewminder / Foter.com / CC BY-NC-ND