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PERS Disability and Long Term Disability

What is Workers’ Compensation?
Workers’ compensation is an insurance system established to provide injured workers treatment and compensation for injuries sustained at work. All employers in the state of Ohio are required to maintain workers’ compensation coverage. The BWC will assign a customer service specialist to handle an injured worker’s claim. The customer service specialist does not represent the interests of the injured worker, but instead represents the interests of the BWC.

What do I do if I am Injured at Work?
Report your injury to your employer and to the BWC. It is critical that an injured worker immediately report any injury at work, no matter how insignificant it may seem at the time. An injured worker should also immediately seek necessary medical treatment for any injury sustained at work.

What if my Employer is “Self-Insured”?
When an employer is self-insured, it pays for treatment and compensation directly, and does not use the BWC insurance system. Self-insured claims should be handled in the same way all other claims are handled. However, in reality, self-insured claims are often more vigorously defended by the employer.

What Happens if I am Unable to Work as a Result of an Injury?
An injured worker may be entitled to receive compensation if he or she is unable to return to his job while he is temporarily disabled because of an injury at work. A doctor is required to certify that he is unable to perform his regular job and that the disability is temporary. An injured worker must be off work at least eight (8) days to be eligible for compensation.

What if my Employer Treats me Differently Because of my Injury?
In Ohio, an employer may not retaliate or treat an injured worker differently for pursuing a workers’ compensation claim. An injured worker may not be fired, demoted, or discriminated against for filing and pursuing a workers’ compensation claim.

What Other Types of Compensation are Available?
Several other types of compensation are available for injured workers that have sustained permanent injuries. Depending on the facts and circumstances of each case, an injured worker may be entitled to Wage Loss compensation, Permanent Partial Disability, Loss of Use (amputation) compensation, and Permanent Total Disability.

How does one qualify for Social Security Disability or SSI?
You must be determined to be “disabled” as defined by the Social Security Administration. Essentially, you must have medical impairments which preclude your ability to perform the work you have done in the past as well as other work that exists in the economy in significant numbers.

What is the difference between Social Security Disability and SSI?
Social Security Disability benefits are available to those individuals who have worked consistently since age 21, and have worked at least 5 out of the last 10 years.

SSI is essentially Federal Welfare. If you have worked sporadically, or never worked at all, you are still eligible for SSI if you are found to be “disabled.”

Social Security Disability payments are based on your earnings over the years, whereas SSI benefits are capped at $579.00 per month or less if you are receiving support from any other source.

Do you have to be any particular age to qualify for Social Security disability benefits?
No. Even disabled children are eligible for benefits depending on the income of their parents. It does become somewhat easier to obtain benefits for individuals who are over 50 years of age - especially if they have an unskilled labor work history.

Do I have to pay attorney fees if I lose?
No. There is only a fee charged if we are successful in obtaining retroactive benefits. Furthermore, our fee is capped at 25% of your back pay, or $5,300.00 - whichever is less.

How many cases has the firm handled?
The firm has obtained successful results in thousands of cases over the last several years. Our Social Security Disability practice has increased approximately 20% each year for the past five years. We have won cases at the lower administrative level, in front of Administrative Law Judges, and in Federal District Court.

How long does the process take?
Unfortunately, the average processing time in the Columbus region is approximately 24 to 30 months from the date of the application through the date of hearing with an Administrative Law Judge. However, our firm strives to obtain the appropriate evidence as quickly as possible in order to increase the chances of a successful result in less time.

At Agee, Clymer, Mitchell & Laret we represent clients injured from car accidents, injuries at work caused by third parties (not the employer), slip and fall accidents and all other personal injuries. If you are injured at work by a third party (such as an automobile accident as part of your regular job duties) see the section on workers’ compensation claims. Also, contact Agee, Clymer with any other type of personal injuries.

What do I do if I am involved in an automobile accident?
First, call the police. If you are injured in any way seek medical attention. Next exchange information with the other party including the insurance carrier. Remember to obtain the name, address and telephone numbers of any witnesses.

How do I deal with the other party’s insurance company?
Do not give a recorded statement to an insurance adjuster without consulting an attorney. Do not sign anything from an insurance company without consulting an attorney. Finally, do not accept a check from an insurance company without consulting an attorney.

At Agee, Clymer, Mitchell & Laret we represent public employees who are unable to work because of disability or illness. We also represent individuals pursuing a claim for long or short term disability through an insurance policy or other financial institution. If you are a public employee and are unable to perform your usual job, or if you are pursuing a claim for long or short term disability, contact Agee, Clymer for assistance in pursuing a disability claim.

Who is eligible for PERS DISABILITY?
Only individuals who have paid into the PERS fund are eligible to file a PERS disability claim. Typically, only people who work for public employers, state or local government are eligible to file a claim with PERS.

How is “Disability” defined?
In order to be successful on a PERS Disability claim, an individual must show that he or she is unable to perform his or her usual job. PERS will make the initial determination of whether or not one is disabled.

Can an Appeal be filed to the PERS decision?
Yes. However, an applicant has only a limited amount of time to file an appeal and provide new evidence of disability. If you need assistance or if PERS has denied your claim, contact Agee, Clymer.

What is Long term disability?
Individuals who have paid into a private insurance policy to cover them in the event they are not able to work may have a long term disability claim.

Why would I need an attorney?
Occasionally, even though you paid for the insurance policy and your doctor is telling you that you are unable to work, the insurance company still denies the benefits you have paid for. If you are having difficulty obtaining payment on a long term disability policy, contact Agee. Clymer.