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VA Announces Final Community Care Regulations Under MISSION Act.

VA Announces Final Community Care Regulations Under MISSION Act.

Veterans Community Care Program

The new Veterans Community Care Program replaces the Veterans Choice Program, which expired June 6, 2019 and was immediately placed into law on the same day. The  U.S. Department of Veterans Affairs (VA) announced the publication in the Federal Register of two final regulations as part of its new Veterans Community Care Program under the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act of 2018.

The MISSION Act strengthens the VA’s ability to deliver trusted, easy to access, high-quality care at VA facilities, virtually through telehealth, and in Veterans’ communities. The law makes several improvements to VA care.

A key component of the MISSION Act is a new urgent care benefitthat provides eligible Veterans with greater choice and access to timely, high-quality care. With urgent care, Veterans have a new option for care for the treatment of minor injuries and illnesses, such as colds, sore throats and minor skin infections. The benefit is offered in addition to the opportunity to receive care from a VA provider, as the VA also offers same-day services.

The VA also published the final regulation for the Veterans Community Care Program governing how eligible Veterans receive necessary hospital care, medical services, and extended care services from non-VA entities or providers in the community.

The VA previously published an interim final rule for Veterans Care Agreements (VCA) on May 14, 2019. The VA may use VCAs to order care when not otherwise feasibly available through the VA’s contracted network. VCAs are intended to be used in limited situations. The VA will purchase most community care for Veterans through its contracted network as part of its strong partnerships with third-party administrators. Currently, these administrators are TriWest Healthcare Alliance and Optum Public Sector Solutions.

The VA is implementing improvements to its community care program as required by the VA MISSION Act. Veterans can find detailed information on urgent care eligibility, community care eligibility and MISSION Act implementation at www.missionact.va.gov.

Call Us Today

This is good news for our Veterans seeking healthcare. However, if you are a disabled Veteran and having trouble receiving your benefits, know that Jan Dils, Attorneys at Law, is always on your side. If you’d like to know more about what our firm can do for you, call us today at 877-526-3457 for a free consultation. If you’d rather talk at a later time, fill out this form so our team can contact you at your convenience.

3 Forms You Should Know About When Applying for Social Security Disability

3 Forms You Should Know About When Applying for Social Security Disability

Social Security Disability (SSD) and/or Supplemental Security Income (SSI)

Once you file an application for Social Security Disability (SSD) and/or Supplemental Security Income (SSI), the Social Security Administration will send your claim to a state agency, known as Disability Determination Services (DDS). This is the department that will make a medical decision on your claim. While your claim is at DDS, you will receive various forms to complete and return. Below, we will explain the three most common forms:

1. Adult Function Report (AFR)

This form is also known as the Activities of Daily Living report. In this form, you are asked to describe your daily activities as well as how your daily activities are affected or limited by your disabilities. Sometimes there will be a third-party AFR that a family member or peer is asked to fill out as a witness to the disability you face daily. These forms are to showcase the way an illness or disability impairs daily living and should be filled out completely with nothing left blank. There will be questions such as, “How often do you go outside?” and “Do you prepare your own meals?”

2. Work History Report (WHR)

This form asks you to describe all the jobs you have held within the past 15 years. It will ask for details regarding job descriptions such as how often you would be standing, walking, bending, lifting, sitting, carrying and whether you were in a leader or management position. We broke down the work levels in a previous blog – https://jandils.com/3-ways-social-security-defines-work/. This form is how Disability Determination Services classifies the jobs you had before becoming disabled or while being disabled. The older the claimant, the more important this form becomes – especially after the age of 50. The Work History Report helps to determine if there is any skill that would possibly be transferable to another occupation that is doable with your disability. It’s important to be detailed and thorough while describing your past work.

3. Pain Questionnaire

Seems pretty self-explanatory, right? Well, it is. The pain questionnaire asks you to describe the pain you feel daily. Some of the details requested include location, severity and frequency of the pain. The questionnaire will also ask what can help the pain, if anything, as well as what makes it significantly worse.

Accurately completing these forms is an extremely important step in your pursuit of disability benefits. Our office has 25 years of experience reviewing and completing these forms. If you need help completing the DDS forms or are thinking about applying for SSD or SSI, our team at Jan Dils, Attorneys at Law, is here to help you. If you’d like a free consultation, call us today at 877-526-3457 or visit jandils.com. If now is not a convenient time to talk, fill out this form so we can call you at a better time.

 

3 Ways Social Security Defines ‘Work’

3 Ways Social Security Defines ‘Work’

There are five levels of work that the Social Security Administration uses to judge whether an individual can perform the range of sedentary, light, medium, heavy or very heavy work. This judgment is based from an exertional point of view – exertion being effort needed to complete a given task. Below we will break down three of these five forms of work that are most common.

Sedentary Work

Sedentary work is work that involves lifting no more than 10 pounds at once. It can occasionally involve carrying or lifting items such as ledgers, small tools and docket files. While a sedentary job is defined as one that involves a lot of sitting, it also involves some walking and standing to carry out job duties. Usually, this involves standing or walking for up to two hours throughout an eight-hour work day and sitting for six hours of an eight-hour work day.

Light Work

Light work jobs require frequent lifting or carrying objects that weigh 10 pounds and occasionally lifting or carrying objects that weigh up to 20 pounds. Jobs that fall into this category require a bit more standing and walking than sedentary jobs, usually six hours of standing and/or walking.

While performing a job in this category, one might be able to sit for small increments between walking and standing with a total of no more than two hours of sitting in an eight-hour work day. An example of a job that falls into this category would be a cashier, bagger or machine operator.

Medium Work

Jobs in this category require the ability to lift 25 pounds frequently and no more than 50 pounds occasionally. Similar to the requirements of light work, one would have to be able to stand or walk for six hours out of the eight-hour work day and sitting up to two hours of an eight-hour work day. Use of hands is necessary, though the use of fingers directly for fine activities is not. In a medium-level job, there is typically more stooping involved due to the frequent moving of objects. They recommend a decent flexibility of knees and torso for the level of activity required for jobs in this category. Some examples are construction workers, plumbers or electricians.

Call Us Today

Being accurate in describing your past work is vital to the success of your claim, especially if you are age 50 or older. It’s one of the many reasons why so many people turn to Jan Dils, Attorneys at Law. If you’d like to know more about what our firm can do for you, call us today at 877-526-3457 for a free consultation. If you’d rather talk at a later time, fill out this form so our team can contact you at a time that is best for you.

Identifying Nursing Home Neglect

Identifying Nursing Home Neglect

You have a thousand things on your plate. As you are stuck in this whirlwind of life, your parent or grandparent is beginning to need more and more help with the activities of daily living. Putting him or her in a nursing home is one of your options, but how can you be sure the patient will be cared for properly? We have some tips for keeping your loved one safe and the signs of neglect.

First, we should define nursing home neglect, which is different from nursing home abuse. Neglect is defined as lack of care, or subpar care for an elderly person that can harm the patient. Identifying nursing home neglect warning signs can be very difficult, but here are a few of the most common:

  • Dehydration / Malnutrition
  • Lack of nursing home staff involvement
  • Unusual changes in behavior
  • Poor hygiene
  • Unexplained injuries
  • Unsanitary living conditions

In some cases, there won’t be any physical changes identifiable, so you will need to pay close attention to any behavioral changes. If living conditions seem dangerous or unsanitary, there may be cause for concern as to nursing home neglect. Taking pictures when bringing a loved one to a nursing home for the first time is highly recommended; taking subsequent pictures over a period of time is also suggested to ensure he or she is receiving the best care.

If you suspect your family member is being mistreated or neglected by a caregiver, you may have a Personal Injury case on your hands. Jan Dils, Attorneys at Law, has a team who deals exclusively with Personal Injury cases with great knowledge and experience and in nursing home neglect. If you have concerns, we have answers. Please do not hesitate to contact us for a free consultation. You should never have to worry about the care your loved one receives.

Round Up

Weeds Aren’t the Only Thing to Watch Out for this Spring

As spring continues and summer approaches, there will be gardening and lawn care taking place in neighborhoods everywhere. Among the most common annoyances during these activities are the pesky weeds that grow and sprout around flowers and plants. For many years a common go-to for help with these pests was Roundup Weed Killer. It seemed to really get the job done well, and people loved its reliability.

What many people didn’t know was the pesticide and herbicide glyphosate, present in Roundup, is a probable human carcinogen. That is, at least, according to the International Agency for Research on Cancer, which is a branch of the World Health Organization. It may be the most commonly used pesticide in all of America, as it is used on corn, cotton, and soy bean farms everywhere. You should think twice about where and from whom you buy your produce.

Bayer, recent buyer of the Roundup brand, disputes the argument. Yet lawsuits are being pursued by dozens of individuals who have developed Non-Hodgkin’s Lymphoma, Large B-Cell Lymphoma and T-Cell Lymphoma, along with a handful of other cancers. There are cases coming up left and right connecting this carcinogen to the diseases victimizing many farmers.

This spring think twice before coating your pastures, home gardens and lawns with this chemical. Instead, try a few of these alternatives: natural horticultural vinegar, saturated steam weed control, electric weed eaters, and so many more. Make a difference in your health and your neighborhood by trying to practice safer weed removal.

In addition to your own personal household use, if you have been diagnosed with Non-Hodgkin’s Lymphoma and have used a glyphosate product (i.e., Roundup or Eraser) in any of the following occupations: agriculture, barge operation, farming, forestry, groundskeeping, landscaping, pesticide and herbicide application, professional gardening, trucking or transportation, please contact our Personal Injury Team at Jan Dils, Attorneys at Law, for a free consultation. Call us at 877.526.3457.

IVC Filters

IVC Filters

Have you ever heard of your Inferior Vena Cava? It is often shortened into the acronym IVC, and is the largest vein in your body. Its primary duty is to carry blood from the lower half of your body up to your heart and lungs ¾ a very, very important job for just one vein. This vein is crucial to our human functioning.

Are you familiar with an IVC Filter? Many people get IVC Filters to help avoid clotting in their veins. This could be compared to a different form of blood thinner for those who may not be able to use more traditional treatments. These filters help prevent blood clots from moving through the veins and into the lungs or heart area.

Two types of patients at risk are those with venous thromboembolic (VTE) disease, more specifically pulmonary embolism, also known as PE. Many of the victims of VTE are hospitalized patients who are prone and still for most of their days. Blood can begin to clot and potentially travel through the veins. With PE, clots can cause chest pain and potential death if they get in the way of blood flow to the lungs. The highest period of risk to develop VTE is after a major surgery or injury, or after cancer, a heart attack or heart failure.

The procedure to insert the IVC Filter is not invasive, meaning there is just a small insertion point that does not need stitching up afterwards. The filters can go in through the neck or through the groin and be placed using a catheter. If inserted through the neck, it is said you should be fine within a day of the operation. If inserted through the groin, it is recommended that you avoid driving, climbing stairs, and lifting heavy objects for up to two days.

Over the last ten years, there have been countless Personal Injury lawsuits due to the ineffectiveness of these filters and their possible outcomes. They are known for puncturing veins, flipping or tilting, being irremovable, fracturing or failing, and can potentially cause internal bleeding, clotting, stroke or death. Though these filters may have their benefits, they have more of a chance to injure clients than help them.

If you have had an IVC Filter implanted and have suffered an injury caused by it, you may have a potential Personal Injury case on your hands. We have helped many clients with these cases. If you want to know more about this subject, call us today for a free consultation. Our toll-free number is 877-526-3457. If you would prefer to correspond with us electronically, you can also fill out the form below and we will contact you during our business hours.

Social Security Disability

The 5 Levels of Your Social Security Disability Claim

Many people file for SSDI (Social Security Disability Insurance) daily. This can be a saving grace for those who need help financially but cannot find work that is accommodating to their disabilities. The length of the process can be trying and very intimidating. It will take a different amount of time for everyone, but the typical timeline that is followed through all applications is broken down here to ease the minds of those who are new to this process.

SSDI

Initial Level

On average, it takes about three to six months for a decision to be made after the initial application is filed. During this time, Disability Determination Services (DDS) works on the claim. The DDS, which are fully funded by the Federal Government, are State Agencies that make the initial determination as to whether a claimant is disabled or blind under the law.

Your claim will be assigned to a Disability Examiner who will request and evaluate medical evidence with the assistance of doctors. At this time, you will likely receive questionnaires to obtain more information, such as any limitations of your daily activities, a description of your past work, specific details pertaining to location and severity of your pain, as well as specific information regarding seizures if you have been diagnosed with epilepsy.

If there isn’t enough information within your own medical records to allow DDS to make a fair decision, DDS may require you to attend a consultative exam. You are not responsible for paying for this exam. You will receive an appointment notice that informs you of the date, time and location of the scheduled exam. It is important for you to keep this appointment or contact the disability examiner if you need to reschedule. It’s also important to note that failure to attend could lead to a denial for insufficient evidence.

Most initial decisions are denials, but the good news is that these can be appealed within 60 days of the date on your denial letter.

Reconsideration Level

Also known as the Recon Level, this step also takes about three to six months for a decision to be made after the request for the reconsideration has been filed. Your claim will again go to DDS, but it will be assigned to a different Disability Examiner. This level will seem familiar as it mimics the initial level. DDS will request and review any updated medical evidence. They may send you additional forms to complete and may send you for a consultative exam if needed.

Again, most reconsiderations are denied as well. To appeal the reconsideration denial, the next step would be to request a hearing before an Administrative Law Judge (ALJ) within 60 days of the date listed on your reconsideration denial letter.

Hearing Level

This is the third level of the claims process. Once the Request for a Hearing before an Administrative Law Judge (ALJ) is made, the claim will be sent to the OHO – Office of Hearing Operations. At this point, the DDS will no longer be working with your claim. It can take anywhere from 15 to 24 months from the date the hearing is requested to receive a scheduled hearing date.

Many hearings take place via video with the ALJ who is likely in another city. The decision is generally made after the hearing and told to the claimant through letters mailed to them and their representative.

There are three possible outcomes: Fully Favorable, Partially Favorable or Unfavorable. SSA estimates that approximately 50% of disability awards are granted at the hearing level by an ALJ.

Appeals Council

After receiving a decision from the ALJ, you have the option to appeal their decision for 60 days following the date on the decision notice. This is known as a Request for Review of Hearing Decision/Order. The Appeals Council (AC) is given the responsibility of processing appeals of less than fully favorable ALJ decisions. They can also review any decision on its own motion. This includes fully favorable decisions as well.

This level of appeal doesn’t have a set timeline, but they generally issue decisions within 90 days to 18 months.

Federal District Court

This is the fifth and final level of the claims process. The Federal District Court (FDC) is where claimants can take their cases if they do not agree with the decision made by the AC. The next step would be to file a civil suit; the appeal must be filed within 60 days of the date listed on the AC decision.

In this situation, the civil action is filed in the District Court of the United States for the judicial district in which the claimant resides. If they do not reside within any such judicial district, the civil action must be filed in the United States District Court for the District of Columbia.

Again, there is no general timeframe for a claim at FDC.

Since 1994 we’ve helped thousands of people get the Social Security benefits they deserve. Our firm is focused on customer service, and we strive to keep our clients informed at every level.

If you’d like to know more about our services, or if you’d like a free consultation, call us today at 877-526-3457 or visit jandils.com. If you can’t talk now, fill out this form so we can call you at a better time.

Motorcycle Accidents

Sometimes All of the Safety Tips in the World Cannot Protect a Motorcycle Driver

Motorcycle accidents, though not necessarily more frequent than any other types of personal injury accidents, are more likely to result in serious injury or death. And while they are like other vehicle accidents in some ways, the unique factors inherent in motorcycles and motorcycle riding, injuries resulting from motorcycle accidents, and liability issues surrounding them can be very different from car accidents.

In the vast majority of these accidents, the car strikes the motorcycle from the front 78 percent of the time. The car strikes the motorcycle from the rear only 5 percent of the time.

Motorcyclists are most in danger of an accident when a car is making a left-hand turn. About 42 percent of all traffic accidents involving a car and motorcycle involve a car turning left.

Motorcycle Driver

Lane splitting (driving between two lanes) is perhaps the next most common cause of an accident. If a collision occurs while a motorcycle is lane splitting, whether the motorcycle or car is at fault depends on whether lane splitting is permissible in that state, the views of the police officer and judge on lane splitting, and the actions of both the driver of the car and motorcyclist prior to the accident.

There are times when a driver of a car is negligent or reckless and causes injury to a motorcyclist, but the motorcyclist also did something that contributed to the crash. In such cases, the vehicle driver might raise the motorcyclist’s conduct as a defense to the negligence claim. In some states, such a defense, if proven, might reduce the amount of the motorcyclist’s recovery. In others, the motorcyclist’s behavior might prevent the motorcyclist from getting any monetary recovery at all.

Get In Touch With Us

Once the insurance companies get involved, the victim is at a huge disadvantage. Insurance companies will limit the amount paid out on claims. What should you do if you are injured in a motorcycle accident? It is always better to consult with a knowledgeable motorcycle accident attorney as soon as possible. At Jan Dils, Attorneys at Law, a first consultation is always free. We won’t let the insurance companies cause you even greater pain and suffering.

What’s the difference between Punitive and Compensatory Damages

When you’re involved in a car accident, you have to deal with a lot. You’ll likely have medical treatment to worry about, you’ll probably have to find a new car, and there’s a good chance you’ll be looking for an attorney. And of course, you’ll probably be dealing with an insurance company that’s not on your side. The last thing you’ll want to do is figure out confusing Personal Injury terminology.. Two terms that can be particularly confusing are punitive and compensatory. But, as we will explain here, they are less complicated than they may seem.

Punitive damages. Punitive damages are intended to punish someone for something they did wrong. Punitive damages are often well-known. If you’re over 30, you probably remember the case of the elderly woman who sought millions of dollars for spilling hot coffee from McDonald’s on herself. That was absurd, right? Actually, no. There is a lot of misinformation about this case, even to this day. The incident occurred in 1992, and there are still people who believe that the plaintiff, Stella Liebeck, was just money hungry. In reality, the restaurant was found to be negligent, and Stella offered to settle the case for $20,000 to cover the cost of her medical bills. After going back in forth with the lawyers representing McDonald’s, the case went to trial. McDonald’s was found to be negligent, and the jury awarded Stella Liebeck 2.7 million dollars in punitive damages to punish them for what they did wrong.

If you’d like to read more about the infamous McDonald’s lawsuit, read our in-depth blog here.

Punitive damages are intended to punish and also, in some cases, create change. It’s safe to say that after this lawsuit, McDonald’s paid more attention to their coffee temperatures. The thing to remember, though, is that the plaintiff was originally seeking just $20,000 to cover her medical bills. The jury awarded more than she was seeking.  The original amount requested, $20,000, would be considered compensatory damages.

Compensatory damages. Often referred to as “actual damages,” compensatory damages are intended to compensate an individual for an actual loss. Compensatory damages are separated into two categories: economic and non-economic damages.  They can include property damage, economic loss, or injuries. Economic damages refer to compensation for objectively verifiable monetary losses such as past and future medical expenses, loss of past and future earnings, loss of use of property, costs of repair or replacement, the economic value of domestic services, and loss of employment or business opportunities. For instance, if you’re involved in an accident and the other individual damages your car, he or she may have to pay for the damage to your car. This would be a form of economic compensatory damages. If the individual caused $5,000 worth of damages to your car, he or she would have to pay that amount. (In most cases, their insurance company would be paying for the damage.)

Non-economic damages refer to compensation for subjective, non-monetary losses such as pain, suffering, inconvenience, emotional distress, loss of society and companionship, loss of consortium, and loss of enjoyment of life.

Here are some examples of Non-Economic damages:

  • Pain and suffering – physical distress caused by an injury, including aches and pains, scarring, permanent or temporary limitations on activity.
  • Emotional distress – emotional distress caused by a physical injury, physical contact, sexual harassment, libel, or slander.
  • Loss of consortium – being deprived of the benefits of a normal family relationship due to an injury or death caused by the acts of another. Also referred to as “loss of companionship,” this may be the inability of a spouse to provide the same love and affection, comfort, society, or sexual relations as he or she did before the injury.
  • Defamation – the intentional communication, whether written or spoken, of false information that harms the reputation of a person or entity.
  • Loss or impairment of physical or mental capacity – the loss of a person’s ability to physically care for himself, or to think clearly or make decisions for himself.
  • Loss of enjoyment of life – loss of a person’s ability to participate in and enjoy the activities and pleasures of life as experienced prior to the injury.

If you want to know more about compensatory damages, call us today for a free consultation. Our toll-free number is 1-877-526-3457. If you’d rather communicate electronically, fill out this form so we can contact you at a better time.

How Insurance Rates Differ Based On Where You Live

On November 9th, 2018, I was driving home from work to change clothes before attending a Veterans charity gala. I live in a rural part of Parkersburg, WV. My house is far from the city streets, and difficult for most people to find. Around 7:00 p.m., the sky was dark and some snow flurries were just starting to fall. That’s when my 2005 Chevy Malibu decided it no longer wanted to operate. My car chose a really inopportune time to give up. I was approaching the crest of a hill less than a mile from my house when the engine shut off. My car wouldn’t start, and I had to navigate backward down a dark winding hill with no power steering and no backup camera. I was stranded for about 90 minutes. The tow truck driver arrived and charged me $100 to tow my car one mile to my home. Needless to say, I didn’t make it to the charity gala that evening.

The next day, my sister took me to a local car dealership where I purchased a new 2018 Mitsubishi Outlander Sport. I was so happy to have a new, reliable car. The dealership told me they would contact my insurance agent the following week. I didn’t expect a major change because I haven’t had an at-fault accident or a moving violation since 2006. I had full coverage insurance on my Malibu because I work for a personal injury law firm, so I know how important quality insurance coverage is for all motorists. I was surprised to learn that my monthly rates went up $45 per month. My new car is not fancy. It’s not a sports car, and it doesn’t have all of the expensive equipment that can make premiums go up. So, what’s the deal?

I found out that one of the problems is something I can’t do much about. I live in West Virginia. As of December 2018, West Virginia has the 20th highest insurance rates in the nation. We’re not the worst. That distinction goes to Michigan. But we’re not the best either. Vermont has the cheapest insurance rates in the nation. Ohio has the 2nd best rates in the nation. I’m sitting at the Jan Dils, Attorneys at Law headquarters in Parkersburg, WV. If I walked out the front door and turned right on Market Street, I’d be in Ohio after a quick walk. It doesn’t seem fair that a few blocks and a river are keeping me from better insurance rates. But the reality is that your zip code plays a big part in determining your insurance premiums. One of the reasons insurance rates in West Virginia are so high is that our state has a lot of rural roads and a large population of wildlife. A lot of motorists in West Virginia collide with wildlife–specifically deer. Each year, West Virginians rank among the top in the nation for deer collisions. This can cause all of our rates to go up because insurance companies are paying a lot of money to repair cars that collide with deer. Insurance companies are going to assume that a West Virginian is more likely to collide with a deer than someone who lives in New York City.

So why is Michigan so expensive? According to Forbes, Michigan is more expensive than other states because it employs a unique no-fault car insurance system. Also known as personal injury protection or PIP insurance, no-fault insurance is a type of car insurance coverage that helps pay for your and your passengers’ medical bills if you’re injured in a car accident, regardless of who caused the accident. (source: geico.com) Because this type of insurance covers you and the other individuals involved in the accident, regardless of who was at fault, it is more expensive.  It’s a higher level of coverage that is mandatory in some states and optional in others.

Other factors for insurance cost include age, gender, car location, and driving record. While my increased insurance rates are upsetting, I am happy to have good coverage. Working at a personal injury law firm, I’ve learned that cut-rate insurance rates may seem appealing, but their lack of coverage can be detrimental, especially if you’re injured by an uninsured motorist. Pay close attention to your rates, and be aware of what your insurance does and does not cover.

If you want to know more about this subject, call us today for a free consultation. Our toll-free number is 1-877-526-3457. If you’d rather communicate electronically, fill out this form so we can contact you at a better time.

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