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Administrative Law Judges conduct Social Security hearings in order to determine whether applicants are eligible for Social Security Disability (SSD) or Supplemental Security Income (SSI).  Often, claimants are denied benefits once, or potentially two times.  While the hearings are informal, they can include various professionals, including an attorney, a vocational expert, a medical expert, and a court reporter.

gavel

The purpose of a hearing is for the claimant to testify regarding their need for benefits.  They must show that they are disabled, as defined by law.

Typically, the judge asks questions of the claimant in order to understand the case.  When an individual is represented by an attorney, the attorney may ask questions that elicit a response providing the judge with important details.  A representative, such as an experienced disability lawyer, can help provide complete and helpful answers at a disability hearing.

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Workers’ compensation judges make the ultimate determination on a witness’ credibility. When a decision has been appealed, Pennsylvania courts analyze whether there has been an error of law. A reviewing court cannot assess a determination of credibility. However, appellate courts in Pennsylvania may analyze whether there has been an error of law or whether the judge made  a “reasoned decision.”

justice

Courts have explained that it is difficult to determine what is a “reasoned decision” made by a workers’ compensation judge.  The Commonwealth Court of Pennsylvania had analyzed a decision by a WCJ and determined, in that particular case, that the judge had not provided a reasoned decision. There, the WCJ had found that the testimony of a treating physician was not convincing.  Instead, the WCJ found the expert witness provided by the workers’ compensation insurance carrier was more credible.  The WCJ had decided that the employee’s treatment for severe trauma, including thoracic, lumbar, and rib fractures, was not reasonable and necessary.  In this particular case, the reviewing court remanded back to the WCJ to explain his reasons for determining credibility. The court held that simply because an opinion was “not convincing” was not acceptable, in terms of providing enough information, for the Court to determine whether there was a sufficient basis for the finding.

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According to the Pennsylvania Department of Transportation, alcohol use and speeding contribute to the majority of car accidents throughout Pennsylvania. Alcohol-related crashes remain a major safety issue, and in 2014, there were 10,550 crashes due to impaired drivers.  Statistics also indicate that in 2014, alcohol-redrunk drivinglated deaths were 28% of the total traffic deaths. Statistics also indicate that the majority of alcohol-related deaths take place between 8:00 p.m. and 4:00 a.m., with the majority of these fatal crashes occurring on the weekend.

The public health concern regarding drunk driving continues to remain high. For those accident victims suffering physically and emotionally from the effects of a drunk driving accident, Pennsylvania law provides a means to recover compensation.  In many cases, the driver will be charged by the state and face criminal proceedings. But victims of drunk driving collisions can file a separate personal injury claim to recover costs for medical treatment, as well as expenses related to pain and suffering and loss of income due to the accident.

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Pennsylvania workers’ compensation laws provide benefits to those who suffer injuries in the course and scope of employment.  Often, industrial accidents lead to physical injuries that are compensable.  The definition of “injury” is critical to an injured employee’s claim for benefits. Significantly, an “injury” under the Pennsylvania Workers’ Compensation Act may manifest in different ways.  Physical injuries are one form of harm, but the Act provides compensation for mental harm, as well as suffering due to a disease.

chemical exposure

According to Pennsylvania workers’ compensation laws, medical conditions stemming from diseases can be compensable when they are caused or aggravated at work.  After filing a workers’ compensation claim, injured employees may set forth testimony to support their argument that exposure to conditions at work caused the disease. In some cases, there need not be a more obvious proof of exposure. Witness testimony may be enough to support a petition for workers’ compensation benefits.

Recently, the Commonwealth Court of Pennsylvania held that the term “injury” includes “hurtful or damaging effect(s) which may be suffered by anyone.” In the case at hand, the issue was whether the widow of an employee who had allegedly been exposed to harmful chemicals at work could receive compensation following the death of her husband.  Her husband had worked as an electrician for his employer, at a plant, and had been diagnosed with metastatic bladder cancer, eventually passing away.

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Individuals suffering from medical conditions that prevent them from working are encouraged to apply for Social Security, since the law requires the Administration to consider the combined effects of these conditions when determining eligibility.  Federal law mandates that Social Security take into consideration the combined effects of impairments when they make headachea decision about whether an individual qualifies for benefits. Applicants are encouraged to list all of their medical conditions, including minor ones, when applying for disability.

As the Social Security Administration completes its five-step evaluation process, they will look at the combined effects of your medical problem. In some cases, the combined effects of mental, emotional, or physical impairments may be disabling, even if the separate conditions may not be.  The critical element for Pennsylvania residents applying for Social Security is to communicate to their medical care providers all of their symptoms.  This allows for a complete record before the SSA.

According to the law, the first step is to determine whether an individual can engage in substantial gainful activity. If so, the individual will be deemed capable of work and not disabled. The second step in the evaluation process focuses on assessing impairments that may affect the ability to work.  Severe impairments substantially interfere with the ability to perform work-related tasks, both physical and mental.  These can include walking, bending, lifting, following directions, and communicating with supervisors and co-workers. Non-severe impairments are those that are not disabling on their own but can exacerbate symptoms of other conditions that may lead to a determination of disability.

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Fatal car accidents may be caused by a variety of factors and lead to either a sudden death accident or an eventual death fatal accident.  Throughout Pennsylvania, surviving family memberhighway accidents or dependents of the person who passed away may face medical bills, funeral expenses, and other accident-related costs. By pursuing a wrongful death claim against the person who caused the accident, they may recover compensation for their losses.

According to Pennsylvania law, when an individual is fatally injured due to a wrongful act, intentional conduct, or negligence, there may be a legal action to recover damages.  According to the statute, the “right of action,” or the ability to bring this claim, exists for the benefit of surviving spouses, children, or parents of the deceased.  The law specifically states that these individuals need not reside within the Commonwealth.  Additionally, if there is no person eligible to recover damages, the personal representative for the deceased can bring an action to recover damages.

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Workers’ compensation provides benefits for employees injured in the course and scope of employment.  Employers that maintain workers’ compensation insurance are generally protected, or immune, from personal injury lawsuits filed by their employees.  In other words, in exchange for giving up their right to pursue a civil claim against their employer, employees are provided lost wages and accident-related medical costs through a no-fault system.

shattered windshield

As a no-fault system, the Pennsylvania Workers’ Compensation Act entitles employees to assistance in the form of compensation and benefits, regardless of who was at fault for causing the underlying accident and injuries.  There are numerous rules and requirements in order for a workers’ compensation claim to be accepted, including properly reporting the injury to the employer.  In many cases, initial claims are denied by the employer or their insurance carrier but can be appealed.

Third-Party Claims May Provide Another Form of Recovery

When a third party, rather than your employer, causes your workplace injury, you may pursue a claim against them for the damages.  For example, if a defective power drill at work caused your injuries, you may bring a claim against the manufacturer of the saw. Third-party claims are legal claims against non-employers who may be responsible for work-related injuries. There are various situations in which an employee may have an appropriate third-party claim against an individual or entity, including equipment malfunctions, car accidents, and errors by outside contractors.

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Pennsylvania law provides for damages to individuals who have successfully shown the legal fault of an individual or entity in a civil lawsuit. As a plaintiff in a personal injury lawsuit, an injured individual may recover compensation for past and future harm related to the underlying accident or incident. Damages, in the form of monetary compensation, are available to plaintiffs who prove the elements of their legal claim, whether it is negligence, premises liability, or products liability.

accident

Damages sustained in an accident are often grouped into different categories, including economic damages, non-economic damages, compensatory damages, and punitive damages. Compensatory types of damages serve to put the plaintiff in the position they would be had the accident not occurred. Punitive damages are intended to deter conduct and to punish a defendant for outrageous, reckless conduct.

As the first step in a personal injury case, the complaint is used to notify the defendant of the action and to set forth information concerning the case. The plaintiff would provide information on the type and severity of the injuries sustained and name the parties against whom relief is sought. Additionally, the complaint lists the allegations as well as the damages set forth by the plaintiff.

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Social Security Disability benefits or monthly Supplemental Security Income benefits are provided by the Social Security Admicalculatornistration to help individuals who cannot work due to an illness, injury, or mental condition.  While the program provided by the Social Security Administration provides monthly benefit payments, helping the financial situation faced by disabled individuals, there may be remaining challenges for recipients. Some Social Security Disability beneficiaries cannot manage their financial affairs and are appointed a representative payee to help them.

A representative payee receives the beneficiary’s payments and ensures that the beneficiary’s basic needs are met.  In some cases, family or friends serve as representative payees.  The Administration determines whether a beneficiary requires a representative payee. In some cases, an administrative law judge or disability examiner may recommend a representative payee, or the beneficiary can request a particular person.

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Social Security Disability benefits exist for individuals with severe heart conditions that prevent them from working.  Congestive heart failure, recurrent arrhythmias, and coronary artery diseases are examples of some conditions that may qualify an individual for benefits, under the “Blue Book” Listings of Impairments.  The Blue Book is officially called “Disability Evaluation Under Social Security.” Criteria listed in the Blue Book will entitle claimants suffering from that disabling condition to Social Security Disability benefits. When individuals suffer from a condition specifically patientlisted in the Blue Book, this inclusion does not guarantee they will be approved for benefits. However, it does demonstrate that the individual has suffered a disabling condition for a period of time that qualifies the individual for consideration by the Social Security Administration.

Heart conditions listed in the Blue Book are found in Section 4.00, described as disorders that affect the proper functioning of the heart or the circulatory system.  These impairments may be congenital or acquired, and the listings describe cardiovascular impairments based on symptoms, laboratory findings, and functional limitations.

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