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Disability Alphabet Soup: Sorting Through the Maze of Legal Abbreviations

  • Published: 2010-10-28 (Rev. 2013-06-02) - Contact: Lewis B. Insler, Esq.
  • Synopsis: If you are disabled and cannot work you may be entitled to benefits from a number of different sources.

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"If you can return to work but need accommodations to do so, your employer may be required to provide those under the ADA (Americans with Disabilities Act)."

LTD, SSD, SSI, ERISA, STD. The list goes on. ADA, MVA, FMLA, SPD, MSA, WC, PI, not to mention no-fault. And what is the difference between Medicare and Medicaid

Most of these abbreviations won't get you many points in a Scrabble game, but anyone dealing with a disability had better know what they mean and, more importantly, how they interact.

If you are disabled and cannot work, you may be entitled to benefits from a number of different sources. If your disability is expected to last a year or more, you may be eligible for SSD (Social Security Disability) if you have worked regularly, or SSI (Supplemental Security Income) if you have not. Both of these programs are administered by the SSA (Social Security Administration).

To supplement their public benefits, many people also have LTD (Long Term Disability) or STD (Short Term Disability) policies either privately or provided by an employer or other group. The group policies are often called ERISA (Employee Retirement Income Security Act) policies, named for the Federal law that regulates them.

If your disability results from an on-the-job injury you might also be entitled to WC (Workers' Compensation). Though WC and SSD combined cannot exceed 80% of past income, they may not come anywhere near that amount for a high earner, which is why having an LTD policy is so valuable.

Most plans offset the LTD you receive by the SSD and sometimes even the no-fault or WC, but you have to check your policy or SPD (Summary Plan Document).

Under most policies, receiving SSD does not guarantee that the LTD carrier will pay you. However, in 2004 the nation's largest LTD carrier, UnumProvident, signed an MSA (Multi-State Agreement) with 48 of the 50 states, agreeing to place great weight on a favorable SSD determination.

In addition to the benefits already mentioned, additional benefits are available to civil servants under their state ERS (Employees Retirement System), and to Railroad employees under the RRB (Railroad Retirement Board).

If you were injured in an MVA (Motor Vehicle Accident), in many states you may receive No-fault insurance payments for up to 80% of your wages for up to three years. No-fault benefits can be offset by WC, STD and even LTD, though more often, the LTD offsets for the No-fault! If a third party caused the accident, there may be a PI (Personal Injury) case as well. If the PI is settled, the WC may stop, but if your SSD is being offset because of the WC (because the total of your SSD and WC cannot be greater than 80% of your past earnings) then not only might the offset end, you may actually be entitled to additional SSD when the WC is paid back from the PI case! That is because once you pay back WC, the SSA rightly considers that you never received it and there should not have been an offset in the first place.

If the PI is settled or tried to a verdict, you may continue to receive SSD, which is not asset dependent, but not SSI---unless an SNT (Special Needs Trust) was created for the proceeds. The settlement of your PI case may mean the end of Medicaid if you were receiving SSI, but not Medicare, which begins 30 months after the date deemed by Social Security that your disability began.

COBRA (Consolidated Omnibus Budget Reconciliation Act) is the Federal law that requires employers with over 20 employees to give you the opportunity to pay on your own for the benefits that you were formerly receiving. COBRA benefits last up to 30 months from the date you stop working.

Thankfully, not every disability lasts a year or more, which is a prerequisite to receiving SSD and SSI. If you are employed by a company with greater than 50 employees you are covered by the FMLA (Family Medical Leave Act), which allows you to take up to 12 weeks of unpaid leave while protecting your job and all benefits during a serious illness or injury. During the time that FMLA is unpaid, you might be eligible for WC, STD or some other accrued time from your employer.

However if your disability exceeds the FMLA, your employer is not required to hold your job for you unless it is protected by a CBA (Collective Bargaining Agreement), or by law in the case of civil servants.

If you can return to work but need accommodations to do so, your employer may be required to provide those under the ADA (Americans with Disabilities Act). The details of that are beyond the scope of this article, but I wanted to get yet another disability acronym into the soup! No doubt you are confused by all of this. We've just scratched the surface and every claim has its own set of factors that makes it different from your friend's or relative's. This jumble of information isn't even clear to a lot of lawyers, and my office is continually fielding calls from other attorneys to help sort out this alphabet soup. If you need help understanding your rights, contact a good SSD attorney for guidance. Don't give up, and good luck!

Insler & Hermann LLP concentrates in claims for Social Security Disability and Long Term Disability. With over 50 years of legal experience, we focus our practice exclusively on Disability claims - www.nymetrodisability.com







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