Monthly Archives: October 2013

Ketamine Therapy: Wonder Drug for RSD/CRPS and Depression?

Today’s post comes from guest author Kristina Brown Thompson, from The Jernigan Law Firm.

Lately there’s been a lot of buzz surrounding a drug known as ketamine. Some workers’ compensation patients with chronic, neuropathic pain [i.e. Complex Regional Pain Syndrome (CRPS) and Reflex Sympathetic Dystrophy (RSD)] are lauding ketamine as a new wonder drug and a few pain clinics are now prescribing ketamine therapy to treat certain pain conditions when other treatment is not effective. Yet, ketamine is by no means a new drug. Developed in the 1960s, ketamine has typically been used as a pediatric anesthetic or by the military in emergency surgery situations (think Vietnam). It’s a serious medication and is typically administered intravenously in the clinic.

Clearly, ketamine is a potent drug. Not to mention that it’s a derivative of Phencyclidine (“PCP” or “Angel Dust”). On the street, ketamine is called “Special K” and is highly sought for its hallucinogenic side effects. Yet, now it’s being prescribed in certain contexts for treatment of major depression and chronic pain conditions (i.e. CRPS/RSD) and being hailed by some as an effective treatment modality where others have failed. 

The press surrounding ketamine lately has largely been optimistic. Last year, NPR broadcast a piece on Talk of the Nation featuring ketamine. The program discussed ketamine’s potential as a fast-acting drug to relieve major depression, particularly when other medications were no longer effective. A few months ago, Time ran an online article entitled “Club Drug Ketamine Lifts Depression in Hours.” Based on the title alone, what depression sufferer wouldn’t want to try ketamine? The article reported that “[a]fter receiving a single intravenous (IV) does of ketamine, 64% of patients reported fewer depression symptoms within one day compared to 28% of those given midazolam – an anesthetic drug that was used as a control.” Even CBS News ran an article earlier this year stating that “[k]etamine may be quick, effective treatment for untreatable depression.” 

RSD patients and pain clinics are reporting similar fast-acting pain relief stories. One patient reported that ketamine therapy reduced her pain to a manageable 5 out of 10, on a pain scale of 1 to 10 with 10 representing the most amount of pain imaginable (see article). Another patient who had full-body CRPS had undergone several pain treatment modalities. She had tried Bier blocks, spinal blocks, and a spinal cord stimulator. Nothing relieved her pain. However, after about a year on the ketamine treatment program, she was able to mow her lawn for the first time in ten years. 

Ketamine is a controversial topic in the medical community. There is not much research on the long-term effects of ketamine use. Some say that chronic use of ketamine may cause verbal, short-term memory and visual memory loss. Some research indicates that the effects on the brain are irreversible. Currently not many clinics are offering ketamine therapy. Clearly the potential benefits could be tremendous and RSD/CRPS treatment could be revolutionized. However, as with any form of therapy, patients should discuss the benefits and risks carefully with their doctor.

 

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Why The Republicans Should Not Cut Food Stamps

Facts about food stamps. Click on this image to see it full size.

Today’s post comes from guest author Paul J. McAndrew, Jr., from Paul McAndrew Law Firm.

I write about a debate now occurring in Congress in which the GOP is threatening millions of American families, including 200,000 Iowa households.  The debate is over food stamps, now known as the Supplemental Nutrition Assistance Program (“SNAP”).

To understand the problem, we need only review the survey-report issued by the Department of Agriculture on September 4.  (Alisha Coleman-Jensen, Mark Nord, Anita Singh, “Household Food Security in the United States in 2012”).  The report shows that nearly 49 million Americans lived in “food insecure” households last year.  This means family members lack consistent access to adequate food throughout the year.  In short, 49 million Americans (over 16 times the Iowa population) went hungry for long periods in 2012.  Worse, children were found to be hungry in 10% of all U.S. families with children.  The agency found that hunger rates since the 2007 recession are much higher than before. 

Many people have a misunderstanding of this hunger; many think the hungry are the same persons who are homeless.  In fact, in most cases the hungry are persons who work at low-paying jobs or are disabled from work.

The GOP (mostly the House GOP) wants to cut food stamps.  Yet, food stamps have been the centerpiece of our country’s safety net for the poor.  Benefits are adjusted for income.  Recipients can use SNAP benefits only for food, notwithstanding Rep. Steve King’s assertion that he knows food stamps are used for bail and tattoos.  Nearly 48 million Americans now receive food stamps (about 15% of the approximately 314 million Americans), at an annual cost to us of about $80 billion.

No matter what Congress decides, food stamps expenditures will be reduced in November, when a provision in the 2009 stimulus bill expires.  House Republicans, however, propose Continue reading →

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We Support Brandworkers

Attending the 2013 Brandworkers Awards Dinner

On Wednesday October 16, several members of our firm attended the Annual Brandworkers’ Dinner held at the Angel Orensanz Foundation in NYC. Brandworkers was founded in 2007 by retail and food employees who identified a need for an organization dedicated to protecting and advancing their rights. The organization was launched based on a simple principle: that working people themselves, equipped with powerful social change tools, were uniquely positioned to make positive change on the job and in society.

By empowering retail and food employees with social change tools, Brandworkers’ Focus on the Food Chain and Legal Defense-Plus programs have recovered close to $1 million in unpaid wages and compensation for discrimination; improved working conditions for hundreds of workers; and have helped workers develop as powerful social change leaders.

We look forward to continuing our  support of their mission!

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THE TRUTH ABOUT CHEATIN’ AND LYIN’

Today’s post comes from guest author Susan C. Andrews, from Causey Law Firm.

     You hear it all over the place these days: there are lots of people out there who lied and cheated to get Social Security Disability (SSD) benefits. I’m here to tell you that is a myth. You don’t have to drill down very far to find out differently. I should know, from where I sit, as an attorney who handles SSD cases. Where I sit most days is in front of a big pile of medical records—I mean HUNDREDS of pages of medical records, all belonging to the same person. You see, some of my clients have just one great big medical issue—like cancer, or Multiple Sclerosis, or Parkinson’s, and many of my clients have multiple medical problems. Either way, they have spent more time in doctors’ offices and hospitals than any of us would ever choose to do.

 There is a mistaken notion floating around out there that a person can just waltz into Social Security, claim to be disabled, and voila—he’s granted benefits!

     There is a mistaken notion floating around out there that a person can just waltz into Social Security, claim to be disabled, and voila—he’s granted benefits! Nothing could be further from the truth. The burden of proof is on the claimant (the person claiming benefits) to show that he or she is disabled from engaging in substantial gainful activity (SGA) for a period of at least 12 continuous months. More about SGA in a bit. That proof starts with medical records, and diagnoses made by doctors. Self-diagnosing just doesn’t cut it, even if you’ve read up on your condition all over the internet, and you’re absolutely positive you know what’s wrong with you! Sometimes we get calls from people who do not have health insurance, and even though they have a serious medical condition, they have been unable to access much in the way of health care. Sadly, some of those folks who should be able to qualify for benefits do not, because they simply do not have the necessary treatment records to document the seriousness of their conditions.

     As mentioned above, Social Security’s definition of disability is the inability, due to one or more medical impairments, to engage in substantial gainful activity for a period of at least 12 continuous months. Social Security defines SGA in part by a dollar figure that usually goes up a little every year. In 2013 it is $1,040. Social Security looks at a person’s GROSS earnings, not net earnings or take-home pay. So if I’m able to gross $1,040 or more per month, I can engage in substantial gainful activity and I do not qualify for SSD. This concept is important especially for individuals with progressive conditions.

     Take, for example, a person diagnosed with Parkinson’s. One famous example is the actor Michael J. Fox. His Parkinson’s affects his functioning, but he is still working. Many people with progressive conditions continue to work for some time after receiving their diagnosis. At some point, progression of the disease may force some of them to go to part-time work. When the hours worked decrease, their earnings may no longer qualify as SGA. Or—and I see this a great deal in my practice—some people begin to have more bad days than good days, and work performance is impacted. There are days so bad that they really have no choice but to call in sick. Then this begins to happen more frequently than a couple of days a month. In my experience, at that point most employers become very unhappy campers. Not only are the employees taking sick leave faster than they are accruing it, they can’t tell their employers ahead of time which days they will wake up with an exacerbation of symptoms that keep them in bed, or at least in their bathrobe, all day.

     Which brings me to my final point: Many of my clients look okay to the casual passer-by. Take the guy with a serious heart problem. Well sure, if I followed him around for half a day, I’d see that he can barely exert himself without getting out of breath. But if I just passed by, he might look fine. And the day he spends at home in his bathrobe because he can hardly catch his breath—I’m not going to see him at all when he’s having one of those really lousy days. His condition may be largely invisible.

     To sum it up, I’d say there’s a bit of wisdom in being slow to judge. Thank goodness we take our good health for granted—it’d be a miserable existence if I spent too much time worrying about getting sick before it actually happened. But, of course, serious illness can strike any of us when we least expect it. And on the other side of that defining moment, the world can look a whole lot different.

 Photo credit: Gemma Grace / Foter / CC BY-NC

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Misclassification – Department of Labor Recovery

Today’s post comes from guest author Leonard Jernigan, from The Jernigan Law Firm.

The U.S. Department of Labor has recovered more than $1 million in back wages and liquidated damages for 196 employees of Bowlin Group LLC and Bowlin Services LLC out of Ohio and Kentucky. Bowlin Services installed cable for Insight Communications, a cable, telephone and Internet provider in Kentucky. The defendants misclassified 77 employees as independent contractors and violated the Fair Labor Standards Act (FLSA) by denying these workers access to critical benefits, including minimum wage, overtime, family and medical leave, unemployment insurance, workers’ compensation and failing to maintain accurate payroll records.

Misclassifying employees negatively impacts our economy, generating losses to the U.S. Treasury, Social Security and Medicare funds, state unemployment insurance, and state workers’ compensation funds. It also leads to unfair competition because businesses that play by the rules are at a disadvantage.

This problem has become so acute in Tennessee that last month the legislature passed Senate Bill 833, which has been signed into law and imposes penalties on construction companies for misclassifying workers in an attempt to evade workers’ compensation premiums. A Tennessee study in 2012 revealed losses of up to $91.6 million in workers’ compensation premiums. North Carolina has identified the problem but has yet to take any action. Until states aggressively prosecute misclassification, this fraud will continue.

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Disability, USA? A Different Point of View About Social Security Disability Benefits

imageYou may have seen a recent report on 60 Minutes regarding the Social Security Administration’s disability program.  If, after watching that report, you became concerned that either a) Social Security would soon run out of money, or b) Social Security was paying disability benefits to either outright frauds or those who just aren’t disabled, I wouldn’t blame you.  That’s not because those things are true, but because this “report” was extremely biased and inaccurate.  The truth is that Social Security is well-funded and will be able to pay benefits well into the future, if not indefinitely.

It’s true that applications for Social Security disability benefits increase when the unemployment rate goes up.  What’s not true, however, is that otherwise healthy people are drawing a disability check during bad economic times.  The Center for Retirement Research at Boston College recently published a report that concluded that applications for benefits did rise when the unemployment rate went up, but that most of these “extra” claims were denied.  Those who were approved tended to be older individuals working physically demanding jobs whose bodies were just worn out after years of hard labor.

Applications for disability benefits have increased recently, and a large part of that increase can be attributed to the fact that Americans are simply getting older.  One of the consequences of getting older is that your body doesn’t work as well as it used to, and you become much more likely to get a chronic disease such as diabetes.  It’s no surprise that disability applications will increase as more and more Americans enter the most disability-prone category of their lives.

People might worry that this increase in applications means that Social Security will soon run out of money to pay benefits.  60 Minutes didn’t do anything to allay those fears, stating several times that the trust fund is going broke in the next few years.  The disability trust fund currently only receives a fraction of the amount collected in payroll taxes, with the vast majority going to the retirement trust fund.  There is a simple fix for this problem – the government can either give more of each dollar to the disability fund, or transfer some money from the retirement fund to the disability fund.  In fact, this has been done several times, but with the money going from the disability fund to the retirement fund.  Social Security is well-funded and in no danger of going broke – don’t let anyone tell you otherwise.

60 Minutes also made it appear that disability benefits are there for anyone who applies, with no need to present any medical documentation to back up their claims.  Those who have been through the process know that this is just false.  The standard of disability for Social Security’s program is extremely high.  Only those who are truly disabled – and who have the documentation to back it up – are awarded benefits.

There are some people who try to game the system and get benefits that they are not eligible for.  Due to Social Security’s strict standards, most of these people are denied benefits in the first place.  For those that do resort to fraud, Social Security has an investigative unit dedicated to finding these individuals.  Once caught, they face stiff penalties, including restitution and jail time.

Despite what 60 Minutes would have you believe, Social Security’s disability program is well-funded, and only pays benefits to those who can prove they deserve them.  Don’t be fooled by sensationalistic programs designed to mislead rather than inform.

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Overpaid Disability Benefits by Social Security: Now What?

Today’s post comes from guest author Roger Moore, from Rehm, Bennett & Moore.

What can I do if the Social Security Administration (SSA) says I have been overpaid disability benefits?

This is a very common problem, unfortunately. There are a number of factors that cause these issues to come up so frequently.

First, the rules about how much one can make differ, depending on what type of disability benefit is received. Social Security Disability Insurance (SSDI) recipients can earn over $1,000 per month without jeopardizing their monthly benefit. But almost every dollar earned by Supplemental Security Income (SSI) recipients can affect the amount of their monthly benefit, as this benefit is partially based upon a recipient’s financial situation. These amounts can change over time.   

Second, there are many different rules about when you can earn money from working above what is called the substantial gainful employment level and not jeopardize your continued entitlement to disability benefit. It’s difficult to summarize all of the circumstances, yet alone know all of the rules, for a claimant. What’s more, simply providing the SSA your wages doesn’t absolve you from having to repay overpayments. The SSA doesn’t look at this information on a regular basis. Years later, you may get a “Dear John” letter advising you that you were overpaid thousands of dollars. 

Finally, you may simply get wrong or bad information from someone when you meet with or speak with the SSA. It’s important to document when you spoke with the person and who that person was. If possible, get them to put their advice in writing. 

When faced with an overpayment, there are two things you should always do. First, Continue reading →

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What Football Can Teach White-collar Employees About Layoffs, Severance

Today’s post comes from guest author Jon Rehm, from Rehm, Bennett & Moore.

With football season upon us, I would like to use football to explain some common situations that employees face.

I get a lot of calls from white-collar professionals who have long careers with a company but then are laid off a few months after a new boss is hired. This happens a lot in football when a general manager/athletic director replaces a head coach and the head coach fires the previous coach’s assistant coaches. White-collar employees in middle-management positions are essentially the equivalents of assistant coaches in football. In the world of football, it is assumed that a new head coach can bring in his new assistants. The same assumption holds true in the business world.

Assistant coaches are oftentimes “bought out” of their employment contracts. Sometimes white-collar professionals have employment contracts, but more often than not they do not. Sometimes professionals are offered severance agreements, but unless there is an employment contract, that severance is not a buyout. Employers are also under no obligation to offer severance. If severance is offered, that doesn’t necessarily mean that an employer wrongfully terminated the employee.

Of course, no employee can be terminated because of age, disability, sex, race, nationality, or in retaliation for engaging in a protected activity like filing for workers’ compensation or filing with OSHA. But even if there is some appearance of wrongful motivation on behalf of the employer, the employer can still defeat a potential lawsuit if they have a legitimate business reason for terminating the employee. Going back to a football analogy, if the new head coach wants to switch an offensive or defensive scheme, they have the right to hire the person they choose. The fact the new hire might be less effective than the old hire is not a decision that a court will second guess in a wrongful termination. Sure, if there is something else wrongful going on, it is something a court or a jury could consider, but in a case where there is a recent change in management, employees will have difficult time overcoming the assumption that the new boss just wants to “put in their team.”

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