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The New York Disability Law Blog

Information and Help for Disabled Individuals with Workers' Compensation, Social Security Disability and Construction Accident Claims

Craig Rosasco in Newsday on Farmingdale Village Trustee Election

Posted in Firm News & Events

Turley, Redmond, Rosasco & Rosasco Partner Craig Rosasco is making his final push this weekend to win his election for Farmingdale Village Trustee.  See yesterday’s Newsday article about Craig Rosasco and the current Farmingdale Village Trustee incumbents.

Craig and his family will be out in force this weekend knocking on doors in the Village to hear what residents have to say.  Please remember to vote for Craig Rosasco as Farmingdale Village Trustee at Farmingdale Village Hall this Tuesday, March 18, 2014 on Row “B”.   Thanks.

Craig Rosasco Announces Run for Farmingdale Village Trustee – Vote March 18, 2014

Posted in Firm News & Events

Craig Rosasco, the Managing Partner of our firm’s Garden City office, has announced that he is running for Trustee in the Village of Farmingdale, Long Island, where he lives.  Craig is no stranger to Farmingdale and has been a “Daler” his entire life.  The election will take place on March 18, 2014 at Farmingdale Village Hall.

He has also launched a new website for his election at www.CraigRosascoDaler.com .  On the website, Craig says it is “Time for a New Start in Farmingdale” given the most recent difficulties that have faced the Village.   He also pledges to “keep taxes low and preserve the quality of life in Farmingdale Village”, while “facing the new challenges in the Village head on”.

Needless to say, all of us at Turley, Redmond, Rosasco & Rosasco, LLP  are proud of Craig and he will have the firm’s full support in this important race.  Like other partners in the firm who have held leadership positions in their communities, whether through Lions, Rotary Club or their churches, Craig’s community involvement is part of the firm’s strong belief in “giving back” to our neighbors.

Good luck, Craig!

How To Fill Your Prescription Under Workers’ Compensation

Posted in Medical Care and Prescriptions, NY Workers Compensation Claims, Uncategorized

If you have been injured on the job, you may require medication in order to heal and cope with pain. As you would expect, your medications will have to be filled by a pharmacy; but if you have filed for Workers’ Compensation  for your work-related injuries or illnesses, there are specific guidelines in which to have those prescriptions filled.

The following is a simple breakdown of the process in having your prescriptions filled by a pharmacy under Workers’ Compensation Law:

  • Filling Medications: You have a right to obtain medications that are needed for your work-related injury or illnesses under Workers’ Compensation Law. However, it is important to note that the law enables only insurance carriers and those who are self-insured to choose the pharmacies that you will be able to use in filling your prescription. In order for your prescription to be covered by the insurance carrier, you must use the designated pharmacy.
  • Insurance Carriers:  Under Workers’ Compensation Law insurers can choose the establishment in which your medications are to be filled. This includes pharmacies, mail-order pharmacies and pharmacy networks. Your insurance carrier will have to make you aware of the establishment they have chosen via written documentation. Under Workers’ Compensation Law, all insurance carriers are required to provide you with the name and location of the pharmacy. They must also disclose any other stipulations to having your medications filled. Insurance carriers are to assign a pharmacy that is in reasonable distance to you or that offer mail order service.
  • Insurance Carriers Controverts Claims: Under Workers’ Compensation Law, an insurance carrier or self-insured employer does not have to pay for your prescriptions or medical care if they have  contested the claim. Should your claim be recognized as work-related, then the carriers or self-insured employer will have to pay for medical treatment and medications.  In the event that your claim is controverted and the assigned pharmacy will not fill your prescriptions, you are able to use a pharmacy of your choice.
Attorney Bill Turley talks about reimbursement of medical expenses. 

  • Your Current Prescriptions:  Your insurance carrier cannot stop you from receiving the medications that you are currently taking. Under Workers’ Compensation Law, insurance carriers can only decide where your prescriptions will be filled, not what prescriptions you are allowed to take. If an insurance carrier denies payment for a specific drug your doctor has prescribed for your work-related illness or injury, then the Workers’ Compensation Board will make a decision in the dispute.
  • Reimbursement of Prescription Costs: There is no set time frame for which your carrier has to reimburse you for the cost of your prescriptions. However, under Workers’ Compensation Law, the carrier does have to pay any undisputed portion of any claim within 45 days of receipt, unless a claim is disputed. If a claim is disputed, the insurance carrier must still pay any undisputed portion of the claim within 45 days. They must also notify you that the claim is not being paid and the reason why.

Should you need more information about prescriptions under Workers’ Compensation Law or assistance in filing your Workers’ Compensation claim, contact us toll-free at 1-877- NY-DBLAW for a free claim evaluation.

$21.4 Million Alleged Social Security Disability Fraud by Lawyer and Retired Police in New York

Posted in Disability Pensions, Labor News, NY Workers Compensation Claims, Social Security Disability, Zadroga 9/11 Compensation Fund Claims

Today is a terribly sad day for all disabled retired New York police officers with integrity who have legitimate psychological disabilities related to their heroic service during and after the 9/11 tragedy. As reported in the NY Times and other media outlets across the globe, one lawyer and certain police  “facilitators” have allegedly been engaged in this disability scam since 1988 (one year before I graduated from law school)!

It is also a sad day for the overwhelming majority of New York Disability lawyers with integrity. The lawyer who allegedly orchestrated the decade’s long scam, Raymond LaVallee, was a person I never met despite being a Social Security disability lawyer myself for over 22 years.  I never saw him at local or national Social Security Bar Association events or seminars.  Like many such alleged fraudsters, he appears to have slithered in the isolated murky waters that often accompany those who live to scam – rather than live to serve.

This is still a breaking story and I will have much more to say about this shameful scheme in the coming days on this blog.  For now, I will head out to teach my first class tonight of “Protective Legislation for Workers” at St. John’s University School of Law.  As you can see from the attached syllabus, Protective Legislation for Workers – Spring 2014, I will be teaching law students about representing clients vigorously, but ethically, in Social Security disability claims, while sadly acknowledging the relatively few bad apples in our midst who tarnish all our reputations.

Workers’ Compensation Cash Benefits – What are the different types?

Posted in Construction Accidents, NY Workers Compensation Claims, Uncategorized

If you have been injured on the job, you may be entitled to Workers’ Compensation cash benefits.  Under the statute to injured workers, there are 3 types of workers’ compensation cash benefits that may be relevant to your particular work related injury.

 

Workers' Compensation Cash Benefits

 

The following is a simple explanation of each workers’ compensation cash benefit that you may be eligible for:

Cash Benefit for Lost Wages: If you are partially or totally disabled for more than 14 days, then you are entitled to workers’ compensation cash benefits for your lost wages.  You will receive an amount based on your average weekly wage (including overtime) for 52 weeks prior to the date of your work related injury. The Workers’ Compensation Board uses the following formula to determine your cash benefit:

2/3 x average weekly wage x % of disability = weekly benefit

If you are unable to return to work due to your injury, then you may be able to get benefits for future lost wages as well. If you return to work, and your injury causes you to earn less than what you were making prior to the injury, then you may also be entitled to reduced earnings benefits.

Schedule Loss of Use Award: This particular workers’ compensation cash benefit, also known as an SLU, will give you an award based on an injury to extremities such as a toe, arm, leg, foot, finger, and other body parts.  You are awarded based on the diminished use of the particular extremity. If you cannot recuperate the same ability of that body part, then it is considered a permanent disability in which you may be compensated for. A medical exam by a doctor is required to determine the percentage of loss to the particular extremity that has been injured.

Section 32 Settlement: This workers’ compensation cash benefit offers a lump sum compensation for your injuries as well as the cost of future medical care for the injury. With a Section 32 Settlement you cannot file a future claim should problems persist after you receive your award.  This is not for everyone and you should consult an attorney to ensure that this type of workers’ compensation cash benefit is the right choice for  you.

For more information, Senior Partner Craig Rosasco talks about these 3 types of workers’ compensation cash benefits in the video below.

 

 

Should you need more information or assistance in filing your Workers’ Compensation claim, contact us toll-free at 1-877- NY-DBLAW for a free claim evaluation.

Angela Luongo, a Paralegal at Turley, Redmond, Rosasco and Rosasco, contributed to the writing of this post.

 

Who is an “Employee” Under Workers’ Compensation Law?

Posted in NY Workers Compensation Claims, Uncategorized

The New York State Workers’ Compensation Board (WCB) has specific guidelines which are used to determine who is considered an employee under New York State Workers’ Compensation Law (WCL). Under this law, all “employees” must be covered under a workers’ compensation insurance policy by his or her employer in order to be protected and receive benefits should they be involved in an accident on the job. The Workers’ Compensation Board defines an employee as an individual who provides services to a for-profit business. If the services provided by an individual do not meet the definition of an “employee” under workers’ compensation law, then the individual may be considered an independent contractor.

Workers' Compensation

Employees will usually fall under the categories of day laborers, leased employees, borrowed employees, part-time employees, unpaid volunteers (including family members) and most subcontractors. There are grey areas however, and other factors may be relative in determining whether or not an individual is considered an employee under the law.

A workers’ compensation judge will make the final decision on whether or not an individual is an employee or independent contractor at a hearing due to a work-related accident or illness under the following workers compensation law guidelines.

Who controls the work performed? – A person or organization who directs the individual to how the work is to be completed indicates that the job is being performed by an employee. A person may be an independent contractor if he/she controls the way a task will be completed or if he/she works under his/her own operating license.

Is the nature of the work the same as employer? – If an individual performs work that is also the same type of work as the employer , then he/she may be considered an employee. For example, if a commercial painting company hires an individual to paint buildings, then that person would be considered an employee. On the other hand, if an auto mechanic is hired to repair a vehicle for a limousine company then he would be considered an independent contractor.

How does the employer pay the individual? – If a business has an individual on an hourly, weekly, monthly, (etc.) payment schedule, or the employer withholds taxes and other benefits such as unemployment insurance or a 401K, then that suggests that the individual is an employee. If someone is paid through a 1099 or W-2, neither is considered to be a factor in determining whether or not the person is an employee under workers’ compensation law. Payment made for performance of the task as a whole may indicate the task is being done by an independent contractor.

Is the equipment and material provided by the employer? – If a business provides the equipment and materials needed to perform the job task, then the individual will be considered an employee. For example, a bricklayer supplies all the necessary tools for an individual to complete the job.

Does the employer have the right to hire and fire individual? – If a business has the right to hire or fire an individual that is performing the work, then that suggests that the person is an employee. Obviously, an independent contractor can be terminated from his contract if the work performed is not up to the standards of the hiring business, however, as mentioned above, under workers’ compensation law, an independent contractor has control over how the work is to be performed and completed.

Should you need more information or help in filing a workers’ compensation claim, contact us toll-free at 1-877- NY-DBLAW for a free claim evaluation.

Angela Luongo, a Paralegal at Turley, Redmond, Rosasco and Rosasco, contributed to the writing of this post.

Appealing an Unfavorable Decision for Social Security Disability Benefits: Statistics Show the Road Gets Tougher

Posted in Social Security Disability

social security disability benefits

 

Recently the Appeals Council of the Social Security Administration (“SSA”) released its summary of requests for review from the 2013 fiscal year. Requests for review are appeals of decisions issued by Administrative Law Judges (“ALJ”) or dismissals by claimants for Social Security or Supplemental Security Income benefits.  Of nearly 176,000 requests for review, a whopping 77% of requests were denied review by the Appeals Council. Once denied by the Appeals Council, an individual can possibly start an entirely new claim for benefits, which means losing years of potential benefits; or can appeal to United States District Court, which can become costly and time consuming. 17% of requests for review were remanded back to an ALJ for further consideration, 4% were dismissed by the claimants, and less than 2% were fully reversed and given a favorable decision by the Appeals Council.

These statistics emphasize the importance of an attorney when filing for Social Security Disability benefits. An individual who files an appeal to the Appeals Council is likely to get denied review almost 80% of the time. The key is being in the best position to win at your ALJ hearing, so the Appeals Council can be avoided altogether. If denied at hearing, the path to Social Security Disability benefits becomes increasingly more difficult. An experienced attorney can put you in a more advantageous position, and can assist you before it’s too late.

A recent client of Turley, Redmond, Rosasco and Rosasco, appeared unrepresented at her ALJ hearing in Jericho, NY. She was denied benefits by the ALJ even though she had significant spinal impairments. She retained our firm when looking to appeal her unfavorable decision. We fully reviewed her file, met with her personally and drafted a legal brief stating our reasons why the ALJ’s decision was incorrect as a matter of law. The Appeals Council granted our request for review and remanded (one of the 17% of requests for review that was remanded) the claim back to the original ALJ who did not find in the client’s favor originally. We represented her at her hearing and she was approved for benefits and received over two years of Social Security Disability benefits retroactively in addition to ongoing lifetime benefits. It is outcomes such as this that reveal how useful a skilled attorney can be in a Social Security Disability claim.

A loss at hearing is not the end of the road; in order to be one of the 17% of cases that is granted a remand by the Appeals Council, it is imperative to know the law, the Social Security Regulations and what to look for in an ALJ’s decision. An experienced attorney can help better situate you for an appeal to the Appeals Council. If you or someone you know has any questions regarding Social Security Disability, contact Turley, Redmond, Rosasco and Rosasco at 631-582-3700.

 

9/11 Workers’ Compensation Registration Re-opens: Governor Cuomo Signs Bill

Posted in NY Workers Compensation Claims, Zadroga 9/11 Compensation Fund Claims

Last week Governor Cuomo signed an important new bill that re-opened 911 workers’ compensation registration and disability pensions for Ground Zero workers. The new registration deadline is set for September 11, 2014, but re-opens registration and filing for previously denied claims. Therefore, any 9/11 worker who was previously denied workers’ compensation because they failed to register timely, will now have a second shot at establishing a claim before the New York State Workers’ Compensation Board. In addition, the filing of new workers’ compensation claims will have an impact on pending 9/11 Victim Compensation Fund claims. It is strongly suggested that you speak to a workers’ compensation lawyer knowledgeable in 9/11 claims as soon as possible. Feel free to contact Turley, Redmond, Rosasco and Rosasco with any questions.


Registration preserves the right for workers who participated in the rescue, recovery and clean-up efforts at Ground Zero to be able to file a future claim should they become sick with a 9/11 related illness.The revised  bill now allows for vested members in eligible pension retirement systems to participate in 9/11 workers’ compensation registration regardless if they had subsequently left service. The registry  known as the WTC-12 or the WTC Notice of Participation for pension systems, for example, The New York City Employee Retirement System (NYCERS) or the New York City Police Pension Fund (NYCPPF). If you have already filed a WTC-12 or WTC Notice of Participation, you do not have to re-register. You can view the full press release from Governor Cuomo here. 

Angela Luongo, a Paralegal with Turley, Hansen & Partners contributed to the writing of this post.

Queens New York Social Security Disability Judge Bias Class Action Settlement Approved by Court

Posted in Disability Pensions, Health Info, Labor News, Social Security Disability

 

 

There are unfortunately many Americans who fell for the recent “one-sided” 60 Minutes piece by Steve Kroft about how easy it is to get disability benefits from Social Security  For those who want to know the reality of how tough getting disability benefits can really be,  you should read the attached Padro vs. Astrue (Colvin) Queens NY Social Security Judicial Bias Class Action decision from the Chief Judge of the US Federal District Court in New York filed today, October 18, 2013.  Much credit goes to the lawyers for the plaintiffs, the Urban Justice Center and pro bono counsel Gibson Dunn led by Jim Walden for their “David vs Goliath” like victory.

Essentially, the settlement in Padro v.  Astrue (Colvin) grants over 4000 New York disability claimants who were unfairly denied benefits by five rogue judges in Queens, NY the right to new hearings before different and independent judges.  It also forces the five errant ALJ’s to undergo remedial re-training on Social Security law and proper procedures for conducting fair hearings.   Finally, all future decisions by these five judges will be monitored by a special unit within the Social Security Administration for 30 months.

So there Mr. “Disability is Easy to Get” Kroft -  stick this decision in your pipe and smoke it!

For more background on Padro v. Astrue and judicial bias against claimants, see my prior blog posts and the New York Times story that broke it all here.  The important thing is that now over 4000 disabled claimants will now be given the opportunity for fair hearings by new, independent law judges.

Hopefully, the five offending  judges have learned a valuable lesson - intimidation and bullying of disabled claimants appearing before you will no longer be tolerated either by the Social Security Administration (your employer) or New York Social Security disability attorneys.    I am pleased to report that a few of the five ALJ’s have seemingly turned over a new page.  Let’s hope it stays that way.

What is the NY Workers’ Comp Claims Process?

Posted in Construction Accidents, NY Workers Compensation Claims, Uncategorized

Most people don’t go into work and say “I think I will get injured today. Yeah that’s what I’ll do! At two thirty, I’ll be the victim of a horrible accident and spend months or even years undergoing a grueling and expensive recovery process“.   As such, many people are not prepared when serious work accidents do strike.  Recovery may take a very long time and result in a lot of financial stress and anxiety. That being said, it is important to understand the New York Workers’ Compensation claims process ahead of time so you are prepared.

To better understand these workers’ comp procedures, let’s use a   hypothetical New York construction site accident. This construction worker is “Steve”:

Workers' Compensation

Let’s say Steve (who is only hypothetical and not based on any particular real-life individual) is a construction worker.  He goes to his job site every day and works very hard.  Then one day Steve falls off this steel beam on the construction site landing on the ground 20 feet below:

His leg appears broken and he is in severe pain.  What’s the first thing Steve should do?

That’s right! He should obtain any necessary emergency medical attention immediately.  But what else should he do?  Steve should notify his supervisor of his injury and the circumstances surrounding it if he is not already aware. This should be done in writing within 30 days or as soon as possible.

Also, Steve should file a claim by filling out official New York State Workers’ Compensation Board  form C-3 as soon as possible but no longer than two years of the accident or within two years of when it became apparent that the injury or illness is work-related. This form should be sent to the NY Workers’ Compensation Board online or mailed to the appropriate WCB district office.

Within 48 hours of  falling off the steel beam, Steve’s Doctor should perform a preliminary medical exam and mail official WCB Form C-4 (Doctor’s initial report) to the WCB District Office, the employer and/or the employer’s insurance company, Steve, and Steve’s NY workers’ comp attorney.

The employer must also report the injury to the New York Worker’s Comp Board and his insurance company within ten days of the injury using official WCB Form C-2, Employers’ Report of Injury.

Within 18 days of receiving form C-2 and a proper medical report (C-4) and if the claim is not “controverted” (contested), Steve should begin receiving cash workers’ compensation benefits for his lost wages.  If the insurance company is not making payments, they would have to inform the NY Worker’s Compensation Board, as well as Steve and his NY workers’ comp lawyers Turley Redmond Rosasco & Rosasco, LLP.   The insurance company would also have to provide a good reason for disputing the claim if this was the case.

If the insurance company “accepts” the claim, Steve receives benefits every two weeks.  If these were to be stopped or modified, the insurance company would have to fill out form C-8.6 (Form Notice That Payment of Compensation Has Been Stopped or Modified) and send it to the Workers’ Compensation Board.   Every 45 days, Steve’s doctor will also submit progress reports to the Workers’ Compensation Board.

If Steve had not filed a claim or informed the employer of is on-the-job injury, he would have been giving up extremely valuable cash and medical benefits under the New York State Workers’ Compensation Law.  Fortunately, this was not the case. Good luck Steve! We’re all pulling for you!