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Spinal Cord Injuries & The Challenges of Obtaining Benefits

October 15, 2012

Scott Mann is a Los Angeles personal injury attorney at the Law Office of Mann & Elias. Mr. Mann graduated from Pepperdine School of Law and for more than 20 years has been helping clients with spinal cord injuries obtain the benefits that they are entitled to.

According to the United Spinal Association, 250,000 Americans are living with spinal cord injuries, with more than 11,000 new injuries occurring each year. These life-changing injuries incur extraordinarily high medical costs, and unfortunately many insurance plans have greatly reduced their realms of coverage for hospital and rehabilitation expenses. After combining the initial hospitalization time in acute care units with the stay in rehabilitation as well as other medical costs like prescriptions, caregiver costs and insurance hikes, the average lifetime costs for paraplegics is $428,000 and $1.35 million for quadriplegics.

If you are part of the two-thirds of Americans living with a spinal cord injury and are unable to work due to your disability, it may seem impossible to face the heaps of medical bills on your own. Health and Accident insurance policies vary. Some only pay for injuries from accidents and natural disasters, while others offer continuous coverage for medical care. If you have a spinal cord injury, getting help with your medical expenses can be difficult and timely. Social Security receives more disability applicants for back problems than any other illness or injury. In fact, applications are up nearly 50% from a decade ago, meaning that disability examiners take great precautions and are very selective when determining who will be granted benefits.

In order to get disability benefits, you must have a medically determinable back impairment such as spinal stenosis, nerve root compression, chronic herniated disc or arachnoiditis. The evaluation process for SSD benefits can take more than 120 days. During this process an evaluator will review medical records, assess proof of diagnosis, review treatments and prescriptions, as well as other details about your specific injury like to what extent you are able to perform job functions. To avoid being quickly overlooked or omitted due to lack of necessity of benefits, it is crucial to attend all doctor appointments and follow your prescribed treatment plan. In the instance that your case is approved, you will not even begin to receive benefits until six months after the date your disability began.

Social Security claims are often denied due to the sheer number of applications they receive. In fact, the government denies more than 75% of claims. The good news is that upon denial of benefits, you are able to reapply to be reconsidered. The bad news is that you have only 60 days to appeal the denial, you must start from scratch and the hearing can take up to 18 months to take place. After all of this time that is precious and crucial to your recovery has passed, the judge may take an additional several months to issue a decision. If your claim is rejected for a second time, the next steps involve the Appeals Council and finally the Federal Court.

Obtaining financial help and applying for disability benefits when you have a spinal cord injury can be a long and difficult road, but with the right information and proper steps you may be able to acquire the proper benefits that you deserve and enjoy relief from your financial burdens.

Do you receive financial help?  Please share your tips or experiences below.

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