NADR Q2 Newsletter

NADR 20TH Anniversary & Celebration Networking Weekend The Vinoy St Pete, Florida - 9/10-9/13

SECOND QUARTER 2020

IN THIS ISSUE:

3

A NOTE FROM THE PRESIDENT

4

WORKER’S COMP OFFSET ARTICLE

8

NETWORKING AGENDA

10

CONFERENCE RECAP

11

ROUNDTABLE OVERVIEW

12

NADR TALKLIST RULES

CONTENTS

NADR NEWSLETTER SECOND QUARTER 2020

IN THIS ISSUE 3

A NOTE FROM THE PRESIDENT

4

WORKER’S COMP OFFSET ARTICLE

8

NETWORKING AGENDA

10

CONFERENCE RECAP

11

ROUNDTABLE OVERVIEW

12

NADR TALKLIST RULES 12

A NOTE FROM THE PRESIDENT ALJs making rational decisions and the new Social Security bill that was recently introduced in Congress. So, let’s grow our professional outreach through service.

Greetings NADR colleagues I first want to thank those of you that have the confidence that I am suited for the office of NADR President. Although, I’m not completely overwhelmed, I am intrigued by the potential opportunities and challenges of the next two years. I have served on the Board of Directors with three outstanding former Presidents and I hope to be as successful as each of them in navigating all of the issues.

Please reach out to me with your ideas (gcates@musedisability.com) or stop me at the networking event or annual conference. I want to know what you are thinking and what we can do as an organization to grow our positive reputation.

Those of you that know me well, understand that I am a collaborator, more than anything else. Thus, I am asking for each of you to collaborate with me to make NADR the best organization of its kind. Any business success that I have achieved has been by putting service first. This has resulted in a relatively successful 40+ year career in advocating for the disabled population. Based on this model, I am asking each of you to be of service to NADR. I am asking that each of you provides one hour per month (12 hours a year) in service to NADR. I don’t care how… post a positive story on Facebook, send an email, share a success story on the Forum, encourage a fellow professional, tell someone or some group about NADR, volunteer on a committee or at a conference, write your Congressional Representative or any other method you choose. I enjoy creativity and tangential thinking. So, surprise NADR with your service ideas. Over the next 24 months, I’d like for many more citizens outside of NADR to know about what we do and why. We have weathered some significant set backs in recent years. But I hear some positive things happening… support to overturn the appoints clause, NADR NEWS

Stay well, friends.

Greg

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SECOND QUARTER 2020

WORKER’S COMP OFFSET NOTES AND MINI REFEERENCE GUIDE WC Offset Notes and Mini Reference Guide

My office procedure when filing an initial SSDI claim that involves WC is to provide the following to SSA at the initial step: 1) 2) 3) 4) 5) 6) 7) 8)

SSA 1696 Fee Agreement SSA 827 SSA 1709 with Section I completed and signed Printout of payments to date * Signed copy of any Lump-Sum settlement, if applicable Any medical records, IME’s, FCE’s, in claimant’s possession A short narrative, if needed, as to the current status of the claim

This will usually save several months of back and forth mailing with the Field Office before the claim is forwarded to the DDS office for a medical determination. * Some states, Washington as an example, have a website where a claimant can review their claims, payments, medical records and other documents. These sites are a gold mine for payment records and medical records. If I have a client in one of these states I schedule an in-office appointment and review everything in the work comp file. I print any and all records that may be pertinent to the SSDI claim.

Information needed in order to determine whether or not a claimant would be subject to offset if granted SSDI benefits.

PIA - Primary Insured Amount. You will probably have to contact SSA directly for that figure. I will usually call the FO with the client present and request PIA and Fam Max (if applicable).

Work Comp periodic payment amount - This is the amount your client (or potential client) receives from the work comp surety. Checks are usually biweekly. Most claimants will be able to tell you when payments started, stopped or changed.

ACE - Average Current Earning Calculating an ACE: Highest single year within 5 years of injury, divided by 12, multiplied by .8.

Or Highest 5 years of earnings, divided by 60, multiplied by .8.

Use whichever formula is most beneficial to claimant.

NADR NEWS

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SECOND QUARTER 2020

WORKER’S COMP OFFSET NOTES AND MINI REFEERENCE GUIDE (CONTINUED) Add the monthly work comp amount to the PIA amount. If the amount is less than the ACE amount, there shouldn’t be an offset. If the amount is greater than the ACE amount, the claim would be subject to offset. Please remember that most WC claims will go through a cycle of payments, non-payments, reinstatement of payments, settlement, or something along those lines.

If language is not incorporated into a LSS, then SSA will prorate any settlement into the future.

It is very important that the WC attorney review potential settlements and outcomes before advising a client on LSS. In most cases it is very beneficial to incorporate proration language to avoid offset.

If a client is unrepresented in their work comp claim, I will repeatedly suggest that they seek counsel and offer to provide a list of local WC attorneys. If they are already represented, I will do everything I can to make sure there is regular communication with that office. Here are a couple of sample emails I have sent to referring attorney’s.

Dear [WC Atty]: I just received the WC payment info on the [client] matter. Here are the figures to date.

ACE = $2,580 (High year 2014 $38,700) PIA 2017 = $1185 PIA 2018 = $1209 PIA 2019 = $1243 TII Application date 6/12/18. Earliest possible payment date if found disabled = 6/2017.

ACE ($2580) - PIA (1243) = $1337 If we are successful at hearing, [client] should be able to receive up to $1337/mo in prorated benefits prior to an offset being triggered.

Based on SSA website figures, [client] has a life expectancy of 24.5 years, or 294 months. *I typically enclosed a printout of earnings showing my work in calculating the most beneficial ACE; a copy of the life expectancy calculator; and PIA info, if available.

Here is an example of an email where the attorney forgot to notify my office of a lump sum settlement, and failed to incorporate offset language.

Dear [WC Atty]: I just received a copy of the signed LSS from [client]. Since the LSS did not contain proration language, here is an estimated breakdown of TII disability benefits.

Gross settlement Excl. Fee expense NADR NEWS

$50,000 (12,500) 5

SECOND QUARTER 2020

WORKER’S COMP OFFSET NOTES AND MINI REFEERENCE GUIDE (CONTINUED) Net Settlement Excl. Future Medical

$37,500 (10,000)

Amount subject to offset

$27,500

POMS DI 52150.050

$27,500 divided by $392.40 (amount of last periodic payment, rounded to nearest dime POMS DI 52150.060 (D)(3)(d) = 70.08 weeks). Start date for proration is day after the day of the last periodic payment (6/15/18). 29 weeks would be the balance of 2018, and remaining 41 weeks would end this week. (POMS DI 52150.060 (D)(2)(b)).

Based on these figures, it is my belief that she will not be eligible for her full SSA disability payments until next month. SSA is running their calculations today.

I’ve been given two PIA’s by SSA. I am assuming that one is 2018 amount, and the other 2019. $1265 and $1301.

Her ACE is $2487. $392.40 x 4.3 = $1687.70 work comp per month. 2018 PIA $1265 plus $1687 work comp = $2952. Her ACE is $2487, so she would be subject to offset for the balance of 2018 (29 weeks). $1301 PIA plus $1687 WC would be $2988, ACE is $2487, so she will be in offset through next week (41 weeks).

Found disabled as of 9/2017, DOI. Received weekly WC of $392.49 through 6/14/18. Her application was not filed until 5/2019, so benefits cannot start prior to 5/2018. Medicare should start Feb 2020.

(Side note on this case. She had contacted SSA to inquire about a monthly benefit amount while still thinking she would be able to return to work. That call took place in 9/2018. We were able to get this deemed a protected filing date which resulted in additional benefits).

Samples of offset language incorporated into Lump Sum Settlements: “The parties acknowledge that they have disputes over the extent of Claimant’s disability, which would continue for his lifetime, as well as other issues. Claimant alleges, for purposes of Social Security, that he is entitled to prorate the amount of this Lump Sum Settlement over his lifetime.

Claimant alleges that his preset life expectancy is approximately 25 years, and that for proration purposes, for Social Security, the sum of $130,000, less attorney fees of $32,500 and costs of $4,225.54 is $93,274.46, and that $93,274.46 should be prorated over the Claimant’s life expectancy, which would factor into a weekly benefit of $71.74 over his 25-year life expectancy”. and “It is Claimant’s contention that she suffered permanent partial disability following an accident that occurred on 12/29/14. At the time of the injury, Claimant was age 58.5 years old. Claimant asserts her life expectancy is presently 86.3 years. As such, she had an additional life expectancy of about 27.8 years after the date of her accident. Claimant’s life expectancy was extrapolated from the official website of the Social Security Administration: NADR NEWS

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SECOND QUARTER 2020

WORKER’S COMP OFFSET NOTES AND MINI REFEERENCE GUIDE (CONTINUED) (https://www.socialsecurity.gov/oact/population/longevity.html). As full settlement of any and all claims listed above for workers’ compensation benefits, Claimant has agreed to accept and surety has agreed to pay a lump sum of $73,714.00 new money, including the leaving of her future medical costs open. This lump sum amount is compensation for permanent disability which will affect Claimant for the rest of her life. Claimant assets her remaining life expectancy is presently about 298.8 months. Therefore, the total new money lump sum of $73,714.00 less attorney’s fees of $18,428.50 will result in a net lump sum settlement to the Claimant in the amount of $55,285.50. Claimant further asserts that the net lump sum payment of $55,285.50 to Claimant represents payment to the Claimant of about $185.02 per month for the 298.8 months of the Claimant’s remaining life expectancy, as calculated according to the official website of the Social Security Administration”.

Basic Reminders: Remind ALL clients, in writing, that SSA needs notified ASAP if there are changes in work comp payments. This includes starting, stopping, entering into a LSS, or rulings by the Industrial Commission/Labor and Industries. I typically make this, in bold, in the first paragraph of a closing letter.

When providing SSA with a copy of a Lump Sum Settlement, make sure it is signed by all parties and date stamped! Unsigned or unapproved copies will not be accepted by SSA. POMS references: DI 521 - Workers’ Compensation/Public Disability Benefit Offset Most referenced in my practice DI 52120 - State Specific WC Procedures DI 52150 - Factors in computing WC/Public Disability offset DI 52110.000 - WC Payments that May Cause Offset DI 52105.015 - Payments Not Considered WC DI 52150.065 - Subsequent Addendums (I typically provide a copy to those that contact my office and request assistance in “fixing” a LSS they negotiated themselves).

NADR NEWS

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SECONDS QUARTER 2020

NADR Networking Weekend & 20th Anniversary Celebration in the “Sunshine City” September 10-13, 2020

NADR NEWS

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FIRST QUARTER 2020

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NADR NEWS

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9

SECONDS QUARTER 2020

A NOTE CONFERENCE RECAP officially declared the spread of the virus a pandemic.

From Capturing our Vision to Changing our Vision – NADR Continues to be Resilient…

My team (Julie, Jane, Deb and I) were biting our finger nails leading up to the Puerto Rico Conference. There were already a handful of people who were going to have to cancel their trip and stay home due to Coronavirus concerns. The March Board meeting was upon us and we knew we had to present the facts of the matter as plainly and unbiased as we could.

It was still unbelievable to me that we were about to present information that would result in a total cancellation of our 20th Anniversary Conference & Celebration. This conference had been the main topic of conversation between us for nearly 10 months. I wish the membership at large could have been on that call! What an amazing show of responsibility and concern for the safety and well-being of our members and their families. I have taken courses on emergency response preparedness and the importance as the Executive Director (for lack of a better title) to be confident, know the chain of command, understand who on the team is permitted to speak to the media, be prepared to field calls from loved ones of conference attendees…and the teachings from these courses were swirling in my head as I listened to the discussion of the Board on that call. For once in ten years, I was actually relieved that I, in fact, had no vote. As each person was called upon to cast their vote for pressing forward with or cancelling the conference it became clearer and clearer to me, that everyone else was putting themselves in the same mental position. Ultimately, none of us could imagine a scenario where we were hosting 200+ of our colleagues, friends & NADR family, on an island, during what looked to be the beginnings of a global pandemic. NADR officially cancelled the conference on March 10th, 2020 – I believe just two days before the World Health Organization NADR NEWS

Pivot…

I’m swinging on the front porch of our Spring Break beach house rental not even a week later. Everything has been shut down around us and we were essentially sheltering in place.

The phone rings and it’s Julie. We had received an email earlier in the day from Michael Wener talking about a “virtual” conference registration he had seen. Immediately Julie starts talking about all the ways in which this “could really work.” Right then and there the Virtual Conference Series: Changing the Vision was born. I have to say thank you, thank you, thank you to everyone involved in the planning and participation of the Virtual Conference. It surely didn’t hold a candle to sipping Pina Colada’s on the beach with all our NADR buds, but it absolutely reminded me that this is one heck of a professional organization with a spirit like none other!

It’s because of the members that this organization is what is it. Beautiful beach resort or home office desktop Zoom meeting – we are NADR! I can’t thank you all enough for that.

Until we meet again, please be well!

Eva Sirman, CAE NADR Association Manager

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SECOND QUARTER 2020

A NOTE ROUNDTABLE OVERVIEW We started a thing! Back in April, NADR member Shay Guess posted on our Facebook Group page that he missed the face to face conversations and round table discussions with conference attendees while lamenting the Puerto Rico conference cancellation. If you haven’t attended an NADR event, we frequently offer “Round Table” sessions in which we have small groups discuss various topics related to representation. This benefits attendees because not only do they get to meet and connect with fellow colleagues, but they also learn what’s working for others. When we saw Shay’s post, we knew we could fill this void utilizing Zoom. We quickly assembled a small team of moderators, including Carletta Griffin, Karen Lauridsen, Dorene Carney and Shay Guess. This team came up with the topics that they wanted to lead during their round tables and we scheduled a different topic for every Tuesday and Thursday in May. The sessions were completely free to attend, but we limited attendance to just 10 participants so that we could have face-to-face discussion.

months, it was so good to see each other face-to-face and work through issues together. Attendee and member Kerie Stone offered praise for the program, “The sessions provided the perfect combination of work-related information and socialization. They also served as a reminder that NADR members are always available to each other. I feel I was able to receive help and advice and I was also able to help our colleagues, so the sessions have been a total win-win for me.”

NADR Secretary, Cliff Berkley, was instrumental in creating this opportunity. Berkley commented, “I find the Round Table sessions as a unique opportunity for our members to collaborate in an intimate environment. Utilizing video conferencing in a small setting provides an excellent platform to exchange ideas, learn new practice methods and stay connected with our wonderful members.”

NADR is planning on offering more virtual Round Table sessions and continues to find ways to increase membership engagement and value. Stay tuned for more Round Table dates in the future!

The topics were all well-received and most of the sessions were registered to max capacity.

The moderators did a fantastic job at facilitating a relevant conversation and providing helpful resources for the attendees. After missing the conference and being in isolation for several

NADR NEWS

Julie Phelps

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SECOND QUARTER 2020

NADR TALKLIST RULES & GUIDELLINES NADR TALKLIST RULES & GUIDELINES Purpose of NADR’s Talklist The purpose of the NADR Talklist is to facilitate professional discussion and the exchange of information among members related to the practice of all aspects of Social Security Representation.

General Guidelines on NADR's Talklist Use These are not laws meant to inhibit or limit discussion but are created to instill civility and protect NADR. The NADR Board of Directors has the authority and responsibility to impose sanctions. Egregious violation of the guidelines may result in suspension or termination of Talklist privileges.

Content Acceptable content may include topics related to NADR business and all aspects of Social Security Representation including, but not limited to, rules, regulations, laws, medical, legal, vocational, and ethical issues as well as advertising issues, methods for best practices, remuneration concerns, form completion, education, and legislation. While it is administered by NADR, the views and opinions expressed on the Talklist by its subscribers are not endorsed or approved by NADR or any of its representatives.

Respect For Subscribers The Talklist is intended as a forum for respectful, professional discussion. Attacks on any individual, group, business, or institution are strongly discouraged, including comments that would reasonably be interpreted as disparaging, defamatory, abusive, profane, threatening or offensive. Agreeing to disagree or continuing private debates off the Talklist are examples of appropriate ways to end a discussion.

Violations & Complaints Talklist guideline violations and complaints should be directed to the current Talklist Moderator or a Board Member (see http://www.nadr.org/?page=BoardofDirectors). This should be done off the Talklist.

Upon receipt of a valid complaint the Talklist Moderator will issue a private e-mail warning to the member accused of violating the rules and provide a copy to the Board President.

If the offense continues, the Board President has the authority to give a 5 day “cooling off period” with immediate removal of talkist privileges for the short 5 day period. Upon reactivation of talklist, if the offense is repeated or other rules are violated, then the full Board can vote for removal of the member’s talklist privileges indefinitely.

NADR NEWS

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SECOND QUARTER 2020

NADR TALKLIST RULES & GUIDELLINES (CONTINUED)

Announcements promoting events, webinars, educational opportunities, products or services Promoting and posting of an announcement or solicitation for events, webinars, educational opportunities, products or services, may be allowed but they must be approved by the board of directors and/or the talklist monitor prior to being posted to ensure it complies with talklist rules concerning products or services that compete with NADR offerings. This applies to events hosted by an individual member of NADR or any other entity. Failure to seek approval prior to posting may result in a 5 day suspension of talklist privileges. Further violations may result in being placed on moderation for 6 months or suspension from the talklist indefinitely.

Solicitation of NADR members The talklist is to be used as described above in the section titled “Purpose of NADR’s Talklist”. Solicitation of members, either by means of public announcement or private message, for products, services, contributions, or donations as well as recruitment is prohibited and grounds for removal from the talklist.

Using the members directory for solicitation is strictly prohibited. The information is only posted for the members to contact other members and for the general public to seek a representative in their area.

Job Postings Any requests for employment, whether for full time, part time or contract work, including but not limited to representation, brief writing, case review, etc., should only be posted in the Career Center on the NADR.org website, and are inappropriate on the Talklist.

Claimant Privacy No claimant’s names, SSN’s, or any other personally identifiable information may be posted to the list. If you are looking for referrals for a claimant, please post the case description and area and wait to send their name and contact information to responders in a private email.

Identification & Signatures Postings without the author’s name are not allowed. Subscribers must always provide personal identification via a brief signature line or lines. Please limit signature lines to 3 or 4 lines maximum.

Commercial Advertising NADR prohibits members from advertising products and/or services that directly compete with products and/or services NADR provides. Discussion of tools and products which NADR NEWS

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SECOND QUARTER 2020

NADR TALKLIST RULES & GUIDELLINES (CONTINUED)

assist in the improvement of representation of clients is a vital part of the Talklist, however, and is permitted as long as these products and tools do not directly compete with products or services NADR provides.

Re-use of Postings NADR asks that postings to the Talklist not be re-posted or forwarded to other e-mail lists or individuals without the express permission of the posting’s author. This includes the initial author, anyone referenced in the e-mail item, and any authors or others referenced in the historic material that is sometimes included below the most current messages.

Further, when matters are of a particularly sensitive nature, NADR asks that you discuss such with a board member.

NADR NEWS

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SECOND QUARTER 2020

NADR TALKLIST RULES & GUIDELLINES (CONTINUED)

NADR Talklist Netiquette The following guidelines are basic online discussion etiquette that will keep the Talklist a respectful, civil and easy to use.

Responding to Talklist Posts Remember, replying to a Talklist message posted at talklist@talklist.nadr.org is posted publicly on the Talklist. If your intent is to reply directly to the poster (or to any other individual), be sure to enter just the intended recipient(s)’ email address. Double checking the “To:” line can prevent embarrassment.

Subject Lines Specific topics should be clearly noted in posting subject lines. If a subscriber makes a Reply-posting that reflects a substantial departure from the topic of a previous posting, a new more descriptive subject should be inserted to replace the original and identify a new thread. Check the subject line for relevance to the content of your post before you hit the send button.

“Off Topic” Subject Lines Subjects that are not specifically related to SSA representation but are of interest to the membership should be preceded by OT (Off Topic). Continuation of such dialogue may be most appropriate via private email.

Quotes of Previous Messages “Quote smartly.” Quoting previous messages can help provide context to your reply. It is preferable that replies include the most relevant part of the previous messages in the discussion thread. It is also preferable that parts or all of any previous messages that are no longer relevant to the thread be deleted. Responses should be added above the previous posting’s content.

Single Phrase Replies Single phrase replies to the entire Talklist such as “Thank you” and “I agree” are discouraged. It is preferable that such responses be sent directly to the intended recipient(s), rather than to the entire Talklist. (You can easily cut and paste the poster’s e-mail address into the “To:” field for any direct reply.)

Special Formatting

NADR NEWS

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SECOND QUARTER 2020

NADR TALKLIST RULES & GUIDELLINES (CONTINUED)

It is preferable that a plain text font be used for postings, with traditional black text on a white background. Colored backgrounds and text is discouraged, as is the use of special fonts or the extensive use of italics, bolding or capitalization.

Abbreviations & Acronyms Avoid use of abbreviations and acronyms that are not commonly known to SSA representative practitioners.

Requests For Reference Material, etc. & Responses Whenever possible, it is preferable that requests made of another subscriber for articles or other materials (including the requester’s contact information) be sent directly (privately) to the intended recipient rather than to the entire Talklist. Likewise, the responder should respond directly to the requestor.

Virus Warnings & Internet Information Usually, it is inappropriate to use the Talklist for forwarding information about virus alerts or other internet-related information. If a subscriber wishes to disseminate what he or she believes to be critically useful information please forward to a current board member for review and approval before posting.

While You Are Out Please avoid using “auto reply” or “away message” e-mail functions that will cause replies to the Talklist which may be generated in your absence. This results in an automatic reply being sent to the entire NADR Talklist membership. Subscribers wishing to avoid Talklist email messages during an absence, should temporarily unsubscribe from the Talklist by contacting the NADR National Office; contact the NADR National Office when wishing to re-subscribe.

5/12/2020 NADR Board of Directors

NADR NEWS

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SECOND QUARTER 2020

FEDERAL COURT PRACTICE

Disability Law Is All We Do! • NATIONWIDE APPEALS • FEDERAL COURT • APPEALS COUNCIL • LONG-TERM DISABILITY

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NADR NEWS

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SECOND QUARTER 2020

NADR NEWS

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SECOND QUARTER 2020

NADR NEWS

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SECOND QUARTER 2020

nADr MentorInG GUIDe (For Mento r

s and Ment

ees)

Board of Director s 2014-2015 President Robert McDowell Elizabethtown, KY Vice President Steve Skinner Redding, CA

Mentor Guide Sub-Committee, Earline

Secretary Philip Litteral Ashland, KY

Marchand, and the following folks on her

Treasurer Michael Wener Memphis, TN

Committee for their hard work on the production of the NADR Mentoring Guide.

Directors-at-Large Karen Starr Grand Rapids, MI Greg Cates Memphis, TN

Please consider signing uptio as a Mentor or a NADR Na

Patty Sexton Wauna, WA

Mentee after

Barbara Manna Pittsburgh, PA

nal Office PO Box 96503 #3 0550 Washithrough reading the guidelines. ngton, DC 2009 0-6503

We are hopeful that this will be another

NADR National Offi ce Administrators Eva Sirman 202-822-2155 eva@nadr.org Julie Phelps 202-822-2155 admin@nadr.or g

NADR PO Box 96503 Washington, DC 20090-6503 Phone: (202) 822 -2155 Fax (972) 245-67 01 Web Site: www.n adr.org

NADR NEWS

NADR would like to thank the chair of the

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invaluable NADR member benefit.

Mentor Guide Sub-Committee Earline D. Marchand Carol Balderee Sherrell Rodgers Steven Gragg Brandy Bowdry Dedra Wood SECOND QUARTER 2020

a Sirman 2-822-2155 a@nadr.org

lie Phelps 2-822-2155 min@nadr.org

ADR

Box 96503 ashington, DC 20090-6503 one: (202) 822-2155 x (972) 245-6701 eb Site: www.nadr.org

BOARD OF DIRECTORS 2019 - 2020

President C. Greg Cates, EdD., ADR Memphis, TN

Vice President Michael Wener, ADR Memphis, TN

Secretary Clifford Berkley, ADR Fullerton, CA

Treasurer Christopher Mazzulli, ADR Baltimore, MD

Director At Large Kelly Blad, ADR Cook, MN

Director At Large Melissa Smith, ADR St. Louis, MO

Director At Large Meredith Marcus

Director At Large Sherrell Rodgers

Director At Large Carl Groves

NADR News is published by NADR and is the property of the National Association of Disability Representatives. Copyright 2016, NADR. The articles appearing in the NADR News do not necessarily reflect the opinions of NADR. The accuracy and content of each article is the responsibility of the individual writer.

NADR NEWS

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SECOND QUARTER 2020