DO I NEED A LAWYER TO FILE A CLAIM FOR PERA OR MSRS DISABILITY?
You are not required to have a lawyer to file for disability benefits. In fact, if you call or write the Public Employee Retirement Association (PERA) or Minnesota State Retirement System (MSRS), they will send you the forms to complete and file your disability application. Unfortunately, your application will be scrutinized and your benefits will be awarded or denied on the same basis as if you had an attorney.
The more important question is SHOULD you have a lawyer?
If you are a police officer, firefighter or paramedic collectively defined as a "Peace Officer" under PERA you may qualify for Regular Disability or Duty Disability benefits. The criteria to qualify for the two disability benefits are set forth in Minn. Stat. §353.656, Subd. 1, Minn. Stat. §353.01, Subd. 41, and Minn. Stat. §353.031. The difference between procurring a Duty Disability benefit as opposed to a Regular Disability benefit can be hundreds of thousands of dollars worth of additional benefits over a relatively short period of time.
A firefighter, police officer or paramedic may be eligible for Regular Disabilty if his or her disability...........
A firefighter or police officer may also be eligible for PERA Duty
Disability if his or her injury results in a disability that is expected to
prevent that individual from performing his or her normal duties for a period of
at least year, and that the disability is the direct result of an injury
sustained during the performance of duties that are 1) specific to protecting
safety or property, and that 2) present inherent dangers specific to police
officers or firefighters.
Every application is reviewed under the same strict process. Failure to submit a complete application, an application for the wrong type of benefit, failure to file in a timely fashion.
On several occasions, the lawyers at Meuser and Associate, P.A. have been contacted by individuals who have applied for benefits on their own and been denied. While we have been able to successfully procure benefits for a number of clients who were initially denied, there are a number of individuals who we spoke with that we were unable to accept their representation and appeal their denial because it was too late or that had damaged their claim for beneifts so much that we could not recommend trying to salvage.
For example, PERA requires that a member file two Doctor forms in support of their application for either Disability orDuty Disability benefits. These forms appear to be straight forward and simple but are anythign but. The questions can be confusing to your doctor who often completes it in a hurry often times without having throughly reviewed your chart. PERA is very particular in assessing and evaluating claims. If one question is answered incorrectly by your doctor, often times due to the doctor not understanding the question, your application will be denid. Even something as simple as sending in a copy of the form as opposed to the original with an original signature from your doctor will result in a denial.
A brief review of the application reveals that there is no requirement as to what additional medical support is necessary for a successful applilcation. However, both Ron Meuser and Jennifer Yackley of Meuser and Associate, P.A. believe that attaching the appropriate medical support for your application is crucial to a successful award of benefits.
Assume that you are a "Peace Officer" as defined under Minn. Stat. (police, fire or paramedic), age 45 with 22 years of experience. You have a high five of $60,000 annually, $5,000 monthly. You are in a 20% tax bracket. If this individual is awarded disability benefits, he would be entitled to 45% of his high five until he reaches age 55 at which time, the disability benefit is converted to retirement benefits.. The disability benefit is taxable. You would receive $2,250 per month ($5,000 x 45%) less $450 per month in taxes ($2,250 x .20) for a net of $1,800 per month.
If you receive Duty Disability under the same scenario, you would be entitled to 60% of your high five plus an additional 3% for each year beyond 20 years for a total of 66%. This benefit is not taxable and you will be entitled to receive same until age 55 at which time, the disability benefit is converted to retirement. You would receive $3,300 per month non-taxable. Over a period of 10 years the difference in the net amount that you would recover would be $1,500 per month, $18,000 per year and a whopping $180,000 per year!
In addition, if you qualify for duty disability, you may qualify for the Continuation of Health Insurance Coverage under Minn. Stat. 299A.465 which would entitle you to continue on the Employer sponsored health plan as if you were still a member of the department. If you had family coverage at the time of your disability, you would be able to continue under the family coverage at the same rate as you would if you were still a member of the department. This would be through age 65. Assuming, conservatively, that your Employer's share of family coverage is $750 per month, you would receive health care benefits equal to $9,000 per year ($750 x 12 months) through age 65, or in our scenario, $180,000 ($9,000 x 20 years) . That assumes taht health care costs do not go up at all over the next 20 years.
Combining the montly benefit and healthcare costs, the difference benefits would exceed $360,000.
The application process and the law are simply too complex and the stakes too high to apply for Duty Disability benefits on your own.
To schedule a free, no-obligation consultation
with Ron Meuser or Jen Yackley, call Meuser & Associate, P.A. at 877-746-5680 or click here to send us an email.
Wednesday, July 9, 2014
Tuesday, February 19, 2013
To Settle or Not to Settle My Minnesota Workers' Compensation Case
1. Liability/Causation - Has the Employer/Insurer acknowledged that you sustained an injury while in the course and scope of your employment? Do they acknowledge that your current condition/symptoms are causally related to the admitted injury?Whether or not the Employer/Insurer acknowledge liability and/or causation for your injuries is probably the most important factor that plays a role in evaluating your settlement options.
If there is a dispute regarding your right to Minnesota workers' compensation benefits, the Employer/Insurer may denying primary liability or on the basis that your condition is not causally related to your work injury. The most common situation is when the Employer/Insurer acknowledge that you sustained an injury but allege that your current condition is caused by a pre-existing condition or a subsequent injury.
In order to establish causation, or that your condition is related to your work injury, you will generally need a narrative report from your doctor. A narrative report is typically a two-to-three page letter report from your doctor setting forth the manner in which your injury occurred, and offering an opinion as to whether your work injury is a substantial contributing factor to your current condition. Not all narrative reports are the same. The stronger the narrative report, the greater chance you have at succeeding at a full Hearing.
The Employer/Insurer will have utilized an IME (Independent Medical Examiner) to procure an opinion contrary to your claim. Despite the fact that everyone in the Minnesota workers' compensation system, including judges, recognize that an IME is anything but independent, the Employee still has the burden of proof to establish Liability/Causation.
Do let emotions dictate your analysis. Evaluate objectively the strength of your narrative report. Ask your lawyer for an honest evaluation as to Liability/Causation. Too often, an Employee will incorrectly assume that Liability/Causation is clear; that no one could dispute how the injuries occurred. Talk to your lawyer! Even seemingly clear-cut cases involve disputes regarding liability and/or causation. The Employer/Insurer very commonly, and very strenuously, argue that your injury is not work-related.
If you lose on the issue of liability and/or causation at trial, you may very well lose your entire case. Do not underestimate the importance of this issue.
2. Damages - Assuming that you are successful in establishing Liability/Causation, what benefits are you entitled to? First and foremost, you are only allowed to recover those benefits that are specifically allowed for under the Minnesota Worker's Compensation Act. Those benefits include wage loss (temporary total and temporary partial disability), permanency (permanent partial disability) and medical expense reimbursement. The Worker's Compensation Act does not cover pain and suffering, emotional distress, loss of benefits and other intangible losses. Unfortunately, regardless of how much pain you have been in, how long your case has been going on, or how your injuries have affected your life, there is no compensation for these types of losses.
The most difficult aspect of settling a Minnesota workers' compensation case is separating what might be "fair" versus what types of benefits you can prove you are owed. Entitlement to each type of benefit must be evaluated on the strength of your case as it relates to each benefit. For example, you may have a strong claim for temporary partial disability wage loss but a weak case for temporary total disability wage loss.
3. Intangible Factors - What is in the best interest of the Employee? Many lawyers fail to assist their client in evaluating whether to settle and, if so, what type of settlement is in their overall best interest. Sustaining an injury at work, being denied benefits, suffering financial hardship, and undergoing the litigation process can be physically and emotionally exhausting. While a lawyer may ultimately benefit by going a to trial in order to receive additional attorney fees such as Roraff attorney fees, this may not always be in the best interest of the injured worker. For many Minnesota workers' compensation claimants, the thought of remaining in the worker's compensation system for several more years can be daunting.
The key is that you and your attorney objectively evaluate all aspects of your Minnesota workers' compensation claim taking into consideration your injuries, what you have gone through, and what is in your best interest in moving forward. A Minnesota workers' compensation lawyer can help you objectively analyze your case, explore settlement options, and achieve a result that is in your best interest.
To schedule a free, no-obligation case evaluation with a Minnesota workers' compensation lawyer, call Meuser & Associate at 877-746-5680 or click here to send us an email.
Monday, February 4, 2013
Contact Us!
For a free, no-obligation workers' compensation case consultation, please complete the form below and click send! One of our attorneys will contact you as soon as possible to discuss your case.
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