Railroad Retirement Disability Success Stories
M was a 38 year old AMTRAK police officer who was struck by a car in the line of duty. Although his primary injuries were not that severe, the accident exacerbated a congenital condition that M had, causing severe nerve irritation of his spinal cord due to displacement of his skull. As a result of his injury, M suffers chronic headaches, upper extremity pain and cognitive difficulties.
M filed a claim for Disability benefits from the Railroad Retirement Board. Unfortunately, while he had worked for the Railroad long enough to get regular Disability benefits, he had not worked long enough to get occupational disability---that is, Disability benefits due to his inability to do his own job.
M came to Insler & Hermann for assistance in his claim after the Railroad Retirement Board denied his benefits, based on their determination that while he was unable to perform the duties of a railroad police officer, he could perform other jobs. We filed an appeal and requested the Board’s records. On review we noted that although M had told the Board about several treating sources, those records were not in the file. Furthermore, the material in the file focused only on the relatively benign findings directly related to the accident---not the catastrophic consequences that had come about as a result of the injury.
Gabriel Hermann joined M at a hearing before a Railroad Retirement Hearing Official at which time M detailed how, as a result of the exacerbation of his congenital condition, he cannot sleep for more than a few hours per night, has chronic headaches that do not subside for days at a time, and cannot concentrate or help care for his children. Soon after that hearing, M was notified that he was awarded three years’ of Railroad Retirement benefits, totaling past due benefits in excess of $60,000.
C is a 53 year old rail car cleaner who worked for MetroNorth for over 25 years. She injured her wrist and suffered a spinal cord injury while transporting garbage, yet when she filed her claim for Railroad Retirement Benefits, her claim was denied. She filed a Request for Hearing before a Hearing Official on her own, but then asked Insler & Hermann to review her file and assist her at her hearing.
During the file review, we noticed that while C’s impairments were correctly identified and she was noted to have physical difficulties, the claims examiner for the Railroad Board had misapplied the guidelines for establishing disability for an individual over age 50. Since C was over age 50 and had been doing unskilled work cleaning railcars for over 15 years, if it was determined that she was unable to perform more than sedentary work, she should have been found disabled automatically. Unfortunately, the claims examiner somehow had concluded that a rail cleaner was a “skilled” job, and that was why the claim initially had been denied.
Insler & Hermann brought this discrepancy to the attention of the Hearing Official, who immediately approved C’s claim. C received a lump sum payment of over $25,000 and has a monthly annuity in excess of $2500 on which to live.
L came to us at age 52 after a long career working for Metro North and then, later on, for Putnam County. As a result of complications following hip surgery, L was unable to continue to work for the County as a worksite supervisor and job coach due to an increased risk for repeatedly dislocating his hip if he continued working.
Although he had not worked for the Railroad for many years, L had sufficient years of service to be eligible for Railroad Retirement Benefits, but since he did not have 240 months of service (20 years), it was necessary to show an inability to work in any capacity. However, because he was over age 50 at the time his disability began, we were able to argue that since he was unable to perform his own job, and the maximum exertion he could manage was at a sedentary job, he was eligible for Disability. We filed L’s claims on his behalf and provided documentation showing that he couldn’t work. Within 5 months, the Board approved his claim, granting him monthly benefits of $1350.
J actually contacted our office to inquire about Supplemental Security Income benefits. He told us that he had been denied SSI because he had had assets that exceeded the maximum permissible under SSI. After reviewing his Social Security earnings record, we noted that although we could make a strong case for him to receive SSI, in fact he had sufficient years of service to be eligible for Railroad Retirement Disability benefits. A claim was filed with the Railroad Retirement Board with the two issues of disability and onset date pending.
While J had some earnings even after the alleged onset date of his disability, we were able to convince the Hearing Officer that his post-onset earnings did not exceed the threshold for Substantial Gainful Activity and that he was thus eligible for disability from a date well before the date initially established by the Board. Incredibly, although the hearing Officer wrote up in his determination that J’s post-onset earnings were not substantial gainful activity, the effectuation branch of the Board insisted for 6 months that they could not pay him from the date of his disability due to his post-earnings income. After we finally convinced the appropriate supervisors that J’s post-onset earnings should not be counted, they released an additional $20,000 above J’s initial lump sum payment of $8,000.