A Message from Karl Osterhout About Food Waste and 412 Food Rescue

I know that we here at OBL talk a lot about 412 Food Rescue, but it’s really just because there is so much to talk about! So much food waste (amazing amounts wasted!) even while so many folks face a constant (and often losing) battle to feed themselves and their kids! But Leah Lizarondo and her amazing team, often called the “Uber for food recovery,” has an amazing web platform and community-based system which makes it incredibly easy to help, using their “Food Heroes” app! Not only have they already helped redirect over 9 million meals from over 2300 food retailers, by the currently operating in six cities, Leah’s plan is to create a global movement that reaches 100 cities by 2030! And not only that, Vital Voices has honored Leah as one of their 2020 Global Leadership Award honorees for her amazing work. Please take the time, especially as we enter into the time of year when family and community and food are virtually synonymous, to listen to this brief video of Leah explaining her vision for making the world a better place.

One of the things I frequently think about when I think of 412FR is that Leah’s vision is one that really transcends politics; in this time when everything is so oppositional and stressful in the world from a political point of view, I enjoy reflecting on the vision like hers that can unite us all – after all, what is there to disagree within the plan to get food from people who are going to throw it away anyway into the hands of people who don’t have enough?

Advice to Our Clients Applying for Disability from OBL Paralegal, Tracy Riggins

“Tracy the Paralegal that I worked with was incredible, and very attentive and responsive to all of my requests and many phone calls and questions. She is AWESOME.” – M.E.

“Tracy is one of the paralegals that was with me from the beginning to the end. She was full of vital information pertaining to my case and would return my calls and emails right away. Tracy was courteous and professional even when I was frustrated at times.” – R.B

Our clients are consistently happy with the service they receive from our paralegal extraordinaire, Tracy Riggins, and for good reason…SHE IS AWESOME! Tracy works with our clients who are applying for Social Security disability at the administrative level and is known for her thoroughness and excellent communication.

Tracy explains what her role is and gives advice to our clients:

I am with the clients from the time the application gets filed until the day a decision from an ALJ comes through.  I answer any questions they have about paperwork they receive from Social Security, help guide them in filling it out if needed, and update Social Security with any updates they have during the initial and reconsideration stages.

During the hearing stage, I am there to make sure we have all the information we need to prepare a good case at the hearing.  I ask the clients to call me with any major changes, new providers, and any change to their work.  I gather all medical records that are received and submit them to SSA.

I am the main point of contact for all 3 stages of the process. If I do not have the answer, I will get it for you.

Things to remember and to make sure that are done in a timely matter are:

• • • Update our office with any new provider, new diagnosis, or major change in condition
    • Fill out any paperwork sent to you in a timely matter
    • Update us with an address or phone number change. If we cannot get a hold of you, we cannot prepare your case properly.
    • Stay in treatment. It may be difficult with lack of insurance or money, but consistent treatment is VERY important in a Social Security case.

Osterhout Berger Disability is so thankful to have Tracy on our team! She is the best and that is what our clients deserve!

Announcement: Shay Guess Joins the OBL Team!

Osterhout Berger Disability Law is expanding! We are thrilled to announce that Shay Guess, an experienced and skilled representative based in northern Mississippi, has joined the OBL team.

Shay has 8 years of experience in Social Security disability applications, appeals, and ALJ hearing representation. He passed the difficult EDPNA national exam administered by the Social Security Administration in 2015 demonstrating professionalism and competence. OBL Managing Partner, Karl Osterhout, met Shay years ago at a conference held by the National Association of Disability Representatives (NADR) and shares his excitement: “I am deeply impressed with Shay both as a person and as a highly dedicated Social Security rep. He is very aggressive in pursuing his client’s claims before Social Security judges, utilizing his own experiences and very effectively utilizing the training sessions that are provided throughout the year and at our annual conference. I could not be more thrilled to add him to our team.”

Shay cares deeply about helping individuals in his community and looks forward to utilizing OBL tools and resources to win disability cases for his clients. Shay adds, “I am teaming up with OBL for some of the same reasons I am working as a Disability Representative today. This team cares about the practice of disability law; they push for excellence in the outcome of the decisions; they don’t waiver in their approach; and at the end of the day, it’s still about the client and what is in the client’s best interest. I am looking forward to the challenges and the difference we can make in someone’s life that needs the best in their corner fighting for them.”

Our clients in Mississippi will find that working with Guess will be a pleasant and compassionate experience and we are so excited about this addition to our team!

Medicare Options For the Disability Recipient

One of the greatest benefits of receiving Social Security Disability is that recipients are eligible to draw Medicare benefits early. This helps them maintain medical care and treatment. Our office thinks it’s important to help our clients through this confusing process. Our in-house licensed health insurance agent works with our clients to clearly explain what to expect and options available to them. Medicare includes Part A (hospital insurance) and Part B (doctor coverage). However, it is not full coverage nor does it include prescription drug coverage.

To supplement the charges that Medicare doesn’t pay, you will need to choose between three options:

• Enroll in a Part D prescription drug plan. This plan will have a monthly premium but will provide coverage for prescription drugs. It’s important to confirm that the plan covers your specific medications! The benefit of this option is that you can see any doctor without having to worry about networks. The downside is that this does not offer any medical coverage and you are still responsible for what Medicare doesn’t cover (20% of Part B medical charges).

• Enroll in a Medicare Advantage plan. These plans typically have very low monthly premiums that range from $0-$100 but many include prescription drug, dental, vision, and hearing coverage as well as many other extras. These plans allow you to pay smaller copays for each medical service instead of the higher Medicare coinsurance. The downside is that they are offered through private insurance carriers and are HMOs or PPOs, meaning it could be difficult to stay with your treating physicians because of network issues.

• Enroll in a Medigap policy. These plans work with Medicare Part A and B to cover what Medicare doesn’t, but do not require you to stay in a network. This may be a good option for someone who has frequent medical appointments or needs to see specific doctors. The monthly premiums are higher on these plans and depend on the state you live in. Some states do not offer Medigap to individuals under 65. Pennsylvania does offer these plans and the premiums are not any higher than they are for individuals at retirement age. This option does not include prescription drug coverage or dental, vision or hearing. Premiums for those benefits would be additional.

There are plenty of Medicare agents out there who know which option to push before they even speak to you. Medicare enrollment is not a one-size-fits-all approach. Everyone has unique healthcare needs and should explore all of these options to see which makes the most sense to them. We are happy to help our clients navigate Medicare enrollment and supplemental options so that they get the best healthcare coverage for them.

To speak with someone about your Medicare options, please complete this short form:

LTD Application Tip: Do Not Use Regular Mail!

It costs more money in the short run, but please consider submitting any information to your LTD company, whether it is the application, medical evidence, or other evidence, by some sort of certified mail or (if you can afford it) overnight mail that will provide you with documentation that the information you sent was received. As we discuss in one of the recent articles we filed on our website, LTD companies have been known to “lose” or “forget about” information that claimants send to them.

For more great LTD application tips, download our free E-Book below:

The Adversarial Nature of LTD Claims; Insurance Companies Lookout for Themselves!

Claims for LTD benefits are adversarial cases, where the employer and/or insurance company has claims adjusters, doctors, vocational experts and other experts who provide evidence against the worker’s interest. So, even though the “HR person” at the company may be, in fact, a very nice person, this should not lull the worker into forgetting that, in the end, the employer/insurance company will always look out for itself first.

The process for applying for LTD benefits requires strict adherence to the time frames established in the Department of Labor’s regulations, and all evidence and all medical and vocational opinions should be submitted with the application, if possible. If the LTD claim is denied, the claimant has 180 days to file an appeal; this may seem like a long time, but the last chance to submit evidence is when this appeal is filed. If the claim is again denied after the appeal, the worker’s last chance is an appeal to a federal district court.

Because of the strict procedural deadlines, the need to submit evidence in a timely fashion, and the need to develop a persuasive narrative establishing that the worker is “disabled” based on the law and the evidence, it takes very careful, long term, strategic planning to anticipate the legal arguments and medical opinions that will be brought to bear against the worker. In other words, a worker who thinks they may be entitled to LTD benefits, in our opinion, needs to be guided from the very beginning by someone knowledgeable and dedicated to solving the difficulties of the disabled worker.

What You Need to Know About the Long Term Disability Application Process

You should expect the application process to take between four to six weeks. In order to apply, you will need to submit the application, documentation of your income and a signed release that authorizes your insurance company to obtain copies of your medical records. After you submit the documents to your insurance company, you should be contacted to schedule a phone interview and a paramedical examination.

On the date of your exam, a technician will complete a home visit, take your blood and urine samples and measure your vital signs, height and weight. The results will be sent to the insurance company. Your phone interview will be conducted at the scheduled time. You should be prepared for the questions by getting copies of what to expect from your insurance broker. You should make certain that you have your doctor’s contact information handy in case you need it during the phone interview. The interviewer will ask you questions about your health condition and your lifestyle.

The next step will either be the submission of your information to underwriting for final approval, or the company may instead request that you submit to a functional capacity evaluation or an independent medical examination. It is a good idea to talk to your long-term disability lawyer before attending either an FCE or an IME – we have helped countless clients through this process, and would be honored to do the same for you. Companies often use these types of assessments to provide them with reasons to deny your claim. If your case is sent to underwriting for approval, you should expect to be notified of its approval within two to four weeks. If you are denied, you will receive a denial letter in the mail.

Read more about filing for Long Term disability HERE

Do’s and Don’ts of Long Term Disability Appeals

It is important for you to understand what you should and should not do for your long term disability denial appeal. When you receive your denial letter, you should request a copy of your policy and of your file from the company. The file should contain all of the medical records that the company reviewed in making its decision. It should also include surveillance video, outside doctors’ reports, internal notes and other information that the company relied on to deny your claim.

If you have been approved for social security disability or workers’ compensation, submit evidence that you are receiving benefits as evidence of your disability. You should also supplement your record and submit written reports from your treating doctor and your former employer if you are able to do so. Getting written statements from others who can state how your disability affects your daily life can also be helpful. Finally, make certain to get help from an experienced long term disability attorney.

There are several things that you should avoid doing during your appeals process. You should never send in your appeal without reviewing your policy and your file first. Make certain that the job description accurately portrays the essential tasks of your job, and don’t rely on a description that is generic. Limit communication with your insurance company via telephone. Instead, insist that everything is in writing. Don’t rely on the regular mail to submit documents and send them via certified, return-receipt mail. Don’t miss any of your deadlines because you may be permanently barred from pursuing your claim further if you do. If you have mental or physical disabilities, it is likely that you may need to get an experienced attorney’s help and should avoid representing yourself on your appeal.

While receiving an appeal of your long term disability claim can be disheartening, you may be successful on appeal. With the help of an experienced long term disability attorney like our team at Osterhout Berger Disability Law, it is possible that you may win approval during the internal appeals process without needing to file a lawsuit. If your claim is ultimately denied, then you will have the ability to file a civil complaint in federal court to try to recover the benefits you should rightfully be awarded.

Learn more about Long Term disability benefits HERE