The Law Offices of Steven Gaechter The Law Offices of Steven Gaechter 2026-06-25T16:02:29Z https://www.gaechterlaw.com/feed/atom/ WordPress /wp-content/uploads/sites/1504022/2024/04/cropped-favicon-gaetcher-x-1-32x32.jpg On Behalf of The Law Offices of Steven Gaechter <![CDATA[Can you get long-term disability benefits for chronic pain?]]> https://www.gaechterlaw.com/?p=51368 2026-06-25T16:02:29Z 2026-06-25T16:02:29Z How can chronic pain limit your ability to work? Chronic pain can qualify for benefits when it prevents you from doing important parts of your job. What matters most is how your symptoms affect your ability to consistently perform the responsibilities your position demands. Depending on your job, pain may make it harder to:
  • Stand or walk for long periods
  • Lift, carry or move objects
  • Sit comfortably throughout the workday
  • Keep up with the pace your position requires
Some people also find that persistent discomfort affects their concentration, decision-making and overall productivity. Over time, those challenges can make it difficult to continue working reliably.

What can help support a chronic pain claim?

You cannot rely on your own description of the pain alone. Medical records can help demonstrate how your symptoms affect your daily activities and your ability to meet the requirements of your job. Helpful evidence may include:
  • Records from your doctors and specialists
  • Notes about your symptoms and treatment
  • Information about restrictions that affect your job duties
Having a clear history of seeking regular treatment helps show that your symptoms continue to affect you despite your efforts to manage them. That information may provide important context when someone reviews your claim.

Why are chronic pain claims sometimes challenged?

Chronic pain claims often face challenges because symptoms do not always appear on a scan or blood test. Unlike some injuries or illnesses, the effects may not show up clearly through testing even when the pain is overwhelming. That does not mean that your condition lacks legitimacy. However, an insurer may ask additional questions or request more information before deciding whether you qualify for benefits. They consider how symptoms affect different people in different ways, which can make these claims more difficult to evaluate.

Next steps

A lack of clear test results does not automatically prevent you from seeking benefits. If chronic pain makes it difficult for you to keep working, understanding what evidence supports your claim can help you prepare a stronger case. Seeking legal guidance may also help you better understand your options and the steps available to protect your rights.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[How insurers value New Jersey ERISA disability settlements?]]> https://www.gaechterlaw.com/?p=51361 2026-06-02T12:46:33Z 2026-06-02T12:26:45Z you look at a New Jersey ERISA disability claim, the settlement value can feel unclear at first. Many parts go into the final number. Because of that, insurers and attorneys usually look at several key details before they reach a range.

What shapes settlement value in ERISA claims?

Under the Employee Retirement Income Security Act of 1974 (ERISA), disability claims follow federal rules that guide how plans review and decide benefits. In simple terms, settlement value depends on how strong your claim looks under the plan rules and your medical records. Insurers also look at your current health and what future benefits may look like if the claim continues. Several key factors often affect value:
  • Medical records showing that you cannot work or have limits at work
  • Plan rules that define disability and explain limits or exclusions
  • Expected benefit length based on your age and health condition
  • Other income sources, such as Social Security disability benefits, that may reduce payments
  • Court-related risks and possible outcomes for each side
Each factor can move the value up or down because both sides may view risk and uncertainty differently.

How do insurers estimate ERISA settlement value?

Insurers often start by adding up the remaining monthly payments under the plan. Then they adjust that number based on what they expect in the future. For example, they may lower the value if they think your health may improve or if the plan limits coverage.

How do attorneys review ERISA settlement value?

Attorneys often take a closer look at how the insurer reads your medical records and the plan rules. They compare that with ERISA standards to see if the decision makes sense. This review often shapes how settlement talks move forward.

How does litigation risk affect ERISA settlement value?

Court risk also plays a role. If either side thinks a judge may see the case differently under federal ERISA rules, the parties often add that risk into the settlement range. In simple terms, more uncertainty can change the final number.

How is the future ERISA disability value calculated today?

The parties usually turn future monthly payments into a single lump sum. This step helps show the value in today’s dollars. It also accounts for time, risk and possible changes in health or income. That estimate may shift if medical records change, work ability changes or other income reduces the total benefit.

Closing thoughts on settlement value

Settlement value in ERISA disability claims often comes from a mix of medical facts, plan rules and financial estimates. Because each case is different, the final range can vary even when cases look similar at first.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[Does your LTD insurer require you to apply for SSDI?]]> https://www.gaechterlaw.com/?p=51354 2026-05-06T17:03:09Z 2026-05-06T17:03:09Z Why does your insurer require an SSDI application? Most LTD policies include an "other income offset" provision. This clause allows the insurer to reduce your monthly LTD payment by the amount you receive from other disability income sources, including SSDI. From the company's perspective, SSDI approval lowers the amount it pays out of its own reserves each month. Your total disability income may stay roughly the same, but a larger share of it comes from the federal government rather than the insurance company. This provision is not unique to any single carrier. It is a standard feature in both employer-sponsored group plans governed by the Employee Retirement Income Security Act (ERISA) and many individual disability policies sold in New Jersey.

What happens if you refuse?

Your LTD policy likely includes a clause that requires you to apply for all available benefits, including SSDI. If you miss the filing window your policy sets, the insurer may act against your claim. In many cases, the company will estimate what SSDI would have paid you and subtract that amount from your LTD benefits anyway. Carriers sometimes call this a "deemed offset" or "constructive offset." It can sharply cut your monthly payment even though you never saw a dollar from Social Security. Some insurers go further and suspend or end LTD benefits entirely for not following policy terms. The result is a loss of income that an SSDI application could have avoided.

How does the SSDI process overlap with LTD?

Filing for SSDI while you already receive LTD benefits can feel redundant, but the two programs use different standards to evaluate disability. Your LTD policy may define disability based on your ability to perform your own job, while SSDI applies a federal five-step process that considers your age, education, work history and medical condition.

Can your insurer reclaim SSDI backpay?

When Social Security approves your SSDI claim, it usually awards a lump sum covering the months starting after your mandatory five-month waiting period up to the approval date. Your LTD insurer will likely claim that this lump sum created an "overpayment" because it was paying full LTD benefits during the same period SSDI should have been offsetting those payments. The math can be confusing. If your LTD benefit is $3,000 per month and your SSDI award is $2,000 per month, the company may seek repayment of $2,000 for each month of overlap, which can add up to a substantial sum depending on how long the SSDI process took.

Which factors should you consider?

The relationship between your LTD and SSDI claims is more connected than it may appear at first. An SSDI denial does not automatically mean your LTD benefits are safe, and an SSDI approval does not mean your total income will increase. You should also pay close attention to your LTD policy's deadlines for filing an SSDI application. Missing these deadlines, even unintentionally, can give the insurer grounds to reduce or cut off your benefits through a deemed offset.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[Common reasons ERISA claims get denied in New Jersey]]> https://www.gaechterlaw.com/?p=51349 2026-04-01T15:19:00Z 2026-04-01T15:19:00Z Filing for benefits under an employer plan can seem simple at first. However, many New Jersey workers receive denial letters that raise more questions than answers. These decisions often come down to small details in paperwork, deadlines or medical proof. Because of that, looking closely at why claims get denied can help you spot where issues may arise and how they affect your case.

Missing pieces that matter

In many cases, denials trace back to gaps in documentation or strict plan rules. Since each claim must meet specific requirements under the plan and federal law, even one missing piece can change the outcome. In fact, surveys suggest roughly one in five insured people receive a denied claim, yet most never appeal those decisions. This highlights how small mistakes can have big consequences. Some of the most common reasons include:
  • Submitting incomplete medical records, such as missing test results or doctor notes
  • Missing filing or appeal deadlines set by the plan
  • Failing to meet the plan’s definition of disability, which may differ from your doctor’s opinion
  • Not following prescribed treatment, like skipping therapy sessions or medications
  • Relying only on a primary care doctor without specialist support for complex conditions
As a result, providing detailed records can help show how your condition limits your ability to work. At the same time, meeting deadlines can keep your benefits application active and eligible for review.

Rules and reviews can trip you up

Even when paperwork seems complete, the wording of the plan can still shape the outcome. In fact, insurers often apply narrow definitions during their review. For example, a plan may require proof that you cannot perform any job, not just your current one. Because of this standard, denials can happen even when you cannot return to your prior role. In addition, insurance companies may rely on file reviews instead of in-person exams. This approach can downplay symptoms or overlook how your condition affects daily tasks. For that reason, building a strong record during the initial claim and appeal stages can make a difference. Working with legal counsel may help identify missing evidence and address issues before deadlines pass.

Turning a no into a maybe

Even after a denial, options may still remain. Filing a timely appeal can reopen the review and allow you to submit stronger evidence. Taking that step may improve your chances of securing the benefits you expected under your plan.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[How to file an SSDI appeal in New Jersey]]> https://www.gaechterlaw.com/?p=51323 2026-02-27T10:07:21Z 2026-02-27T10:00:45Z Request for reconsideration After you receive your disability denial letter, you need to act promptly and file your appeal within the next 60 days. You can do this on your own or with the guidance of a disability lawyer. To prepare your written request, you need to review the details of your denial letter and add more evidence that can help support your claim. These can include your updated medical records, test results and doctor statements. Once you submit your request for consideration to the Social Security Administration, the agency will assign a different examiner to review your case.

Request a hearing with an administrative law judge (ALJ)

If your reconsideration request has been denied, you need to request a hearing with an ALJ. Their office will then send you a notice informing you of your schedule. Make sure to attend your hearing on time. During this process, you will have the opportunity to speak directly with the judge and present your case and evidence. The judge will also be asking you questions about your medical condition and your situation. If the ALJ’s decision rules in your favor, you may start receiving your SSDI benefits. However, if you receive a denial letter from their office, you will need to proceed with the next step.

Appeal the ALJ’s decision with the appeals council

You must file a new review request with the appeals court. The appeals council is a higher body that can reevaluate the ALJ’s ruling on your case and determine whether your appeal is approved or not.

Take your case to federal court

If your appeal is still denied, you can file a lawsuit in the federal district court. This will be your last chance to appeal your case. To help build a strong defense for it, you must hire a lawyer who can advocate for your disability and your rights. While the SSDI appeal process can be emotionally challenging and time-consuming, you need to remember that you are not alone. By reaching out to your loved ones for support and seeking legal help for your appeal case, you can navigate the process with ease and improve your chances of success.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[Will I lose my Supplemental Security Income (SSI) if I work?]]> https://www.gaechterlaw.com/?p=51313 2026-01-30T08:43:29Z 2026-01-30T08:43:29Z How are your benefits vs. income calculated? SSI benefits do not disappear the moment you start working. The Social Security Administration (SSA) uses a formula to reduce your payment gradually based on your earnings. When you work, the SSA does not count the first $65 you earn each month. After that, your benefit decreases by only $1 for every $2 you earn above that threshold. For example, if you earn $500 in gross wages and have no other income, the agency first subtracts the $20 general exclusion and the $65 earned income exclusion, leaving $415. They then divide that remainder in half to determine that $207.50 is your countable income. For residents of New Jersey, the state provides an additional State Supplement payment that is administered directly by the agency. You will receive one combined check each month that includes both the federal benefit and the New Jersey state supplement.

What report must you make to the SSA?

If you work while receiving SSI, you must submit your wage data to the Social Security Administration. This ensures your monthly payments remain accurate. The SSA encourages you to file your earnings for the prior month between the 1st and the 6th of the new month. Doing so during this window ensures your next SSI check is adjusted correctly. You need to notify the agency of all changes, including income and employment status, no later than the 10th day of the month following the change. You can report your wages efficiently using my Social Security online account, the SSI Mobile Wage Reporting app or the automated telephone system. If you cannot use these automated methods, you may mail or fax your pay stubs to your local Social Security office.

What if you do not inform the SSA of the changes?

Failing to submit your earnings on time can lead to serious consequences. The SSA may overpay you, meaning you could owe money back to the federal government. If you do not submit your changes within the required timeframe, the agency deducts $25 from your payment. This penalty increases to $50 for a second offense and becomes $100 for every subsequent failure to report. In more serious cases, knowingly withholding information can trigger a sanction. A first violation of this nature results in a 6 month suspension of payments. If the violation is repeated, you may face a suspension of 12 months for a second offense and up to 24 months for a third offense.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[Does my work history matter when applying for SSDI benefits?]]> https://www.gaechterlaw.com/?p=51306 2026-01-06T15:53:21Z 2026-01-06T15:53:21Z What you need to know about work credits Before the SSA reviews your medical records, it first checks whether you have earned enough work credits to qualify for SSDI. This is how work credits work:
  • You earn one credit for every $1,890 in wages or self-employment income in 2026
  • You can earn a maximum of four credits per year
  • You need a total number of credits that depends on your age, with younger workers requiring fewer than the standard 40
  • You generally must earn at least 20 credits in the 10 years before your disability, though exceptions exist for workers under age 31
If you do not have enough credits, you will not qualify for SSDI regardless of your medical condition. However, you may still be eligible for Supplemental Security Income, which does not require work credits.

How the SSA evaluates your past work

Once you meet the work credit requirement, the SSA reviews your medical condition. If you do not qualify automatically under a specific medical listing, the agency then examines your job history to see if you can still do your previous work. Under a rule that took effect in June 2024, the SSA now reviews only the past five years of your employment history. This update simplifies the application process and recognizes that older work experience may not reflect your current abilities.

How your earnings history shapes your benefit amount

Your work history does not just determine if you can qualify or not. It also directly affects how much you will receive each month if approved. The SSA calculates your benefit using a formula based on your Average Indexed Monthly Earnings. This figure represents your highest-earning years adjusted for inflation. The SSA calculates your average earnings based on the number of years you could have worked, which depends on your age. Unlike retirement benefits, you are not penalized for having a work history shorter than 35 years if you are a younger worker.

Why accurate job descriptions matter for your claim

When you apply for SSDI, you will complete a Work History Report that describes each job you held during the past five years. The details you provide on this form carry significant weight in the decision-making process. The SSA uses your job descriptions to assess whether your disability prevents you from returning to past work. If you describe a job as primarily desk work when it actually required heavy lifting, the examiner might conclude you can still perform that role. Attorneys are able to assist with articulating how your medical condition affects your ability to perform specific job tasks. Legal counsel can also review your earnings record for errors and help your Work History Report reflect the true nature of your employment.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[What is insurance company surveillance?]]> https://www.gaechterlaw.com/?p=51297 2025-12-05T14:53:14Z 2025-12-05T14:53:14Z Why insurers look for inconsistencies When you file a claim, insurance companies conduct surveillance on claimants to ensure their condition of being unable to work. Although rare, some individuals can abuse LTD benefits by committing fraud. That is why their goal is to gather information that contradicts your claim. While surveillance can be intimidating, it does not aim to prove you are committing fraud. The process aims to verify whether your limitations are consistent with your daily activities.

Common forms of surveillance

If your LTD policy is sponsored by your employer, it falls under the Employee Retirement Income Security Act (ERISA). You may have protections under ERISA, but insurers can deny your claim if their investigation reveals fraudulent activities. They have a right to investigate your claim’s validity using these methods:
  • Physical surveillance: An investigator observes you in public or films you in a public area.
  • Social media monitoring: The insurance agents can check your social media accounts to gather evidence.
While insurers can legally investigate you, they must respect the limits of their actions. They cannot trespass on your property, harass you or pretend to be someone else to gain information.

Taking actions to protect yourself

Surveillance can feel alarming, especially when you value your privacy. Instead of hiding from investigators, live your life truthfully. Follow your doctor’s limitations to preserve consistency between your actions and medical records. Additionally, refrain from oversharing on social media and set your accounts to private. The ERISA guidelines on LTD claims are complex. If a video is used to deny your claim, the law limits your time and ability to fight back. An experienced attorney can offer guidance in navigating the legal process.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[Can’t sit for long hours? How it affects an SSDI claim]]> https://www.gaechterlaw.com/?p=51288 2025-11-11T15:00:45Z 2025-11-11T15:00:45Z What counts as “sedentary work” under SSDI The SSA classifies sedentary work as jobs that keep you seated for about six hours during an eight-hour day and require lifting no more than ten pounds. When pain, stiffness or numbness forces you to move frequently or prevents you from sitting for that long, you show that you can’t perform sedentary work at all. Understanding this definition helps you and your doctor describe your condition using the same language the SSA uses when evaluating claims.

How sitting limits can affect your disability claim

When you can’t stay seated for most of the day, you lose the ability to perform many desk-based or light-duty jobs. The SSA weighs that loss heavily in deciding disability. If you’re under fifty and your medical records show limited sitting tolerance along with other restrictions, such as trouble standing, lifting or focusing, you strengthen your argument that full-time work isn’t possible. The clearer your documentation, the stronger your position becomes.

What proof shows your sitting limits

General notes that say “back pain” or “cannot sit long” don’t explain how your condition actually limits you. Ask your doctor to record how many minutes you can sit before symptoms begin, how often you must stand and what happens when you try to stay seated. Keep your own pain log and activity records, then share them during visits so your provider can include those specifics. When your medical notes and personal records align, they create a clear and convincing picture for the SSA.

Put your record to work for you

You give your SSDI claim power when your documentation stays consistent and detailed. Make sure your doctor’s notes reflect what you report day to day, and keep updating your evidence so it shows how your limits affect real work hours. Start organizing those records now, and if you need guidance, talk with a Social Security Disability attorney. Clarity and consistency now can make all the difference later.]]> On Behalf of The Law Offices of Steven Gaechter <![CDATA[Can you work part-time while receiving SSD benefits?]]> https://www.gaechterlaw.com/?p=51281 2025-09-29T15:42:22Z 2025-10-06T15:41:07Z Living with a disability does not always mean you must stop working completely. If you receive Social Security Disability (SSD) benefits, you may be wondering if you can work part time without losing your monthly payments. The Social Security Administration (SSA) has clear rules about this and understanding them can help you plan your future with confidence.

How Social Security defines work activity

The SSA uses the term “substantial gainful activity” (SGA) to decide if you qualify for SSD benefits. In 2025, the SGA limit is $1,620 per month for most people and $2,700 for people who are blind. If you earn more than these limits, the SSA may determine that you are able to work enough to support yourself and you could lose your benefits. If you stay under the SGA limits, you may be able to work part time and keep your SSD benefits. Still, the SSA looks closely at both your earnings and your work activity.

Trial work period

The SSA provides a trial work period that lets you test your ability to return to work without losing benefits. During this time, you can earn above the substantial gainful activity (SGA) limit for up to nine months within a 60-month window and any month you earn more than $1,110 in 2025 counts as a trial work month. You still receive full benefits throughout this period, giving you the opportunity to see if working is manageable without the immediate risk of losing support.

Extended eligibility after trial work

Once you complete your trial work period, you move into a 36-month extended eligibility phase. During this time:
  • You keep receiving SSD benefits for any month your earnings are below the SGA level.
  • If your earnings go over SGA, you do not receive benefits for that month.
  • If your income drops below SGA again, your benefits can start back up without filing a new application.
This extended period gives you flexibility as you figure out how much work you can realistically handle.

What to consider with part-time work

When you take on part-time work while receiving SSD benefits, the SSA looks at more than just your paycheck. Factors that may affect your case include:
  • Type of work: If your job is physically or mentally demanding, it may raise questions about your disability status.
  • Hours worked: Even if your pay is low, working many hours could signal that you are capable of full-time work.
  • Consistency: Regular and steady earnings may be treated differently from occasional or sporadic work.
  • Other income: Non-work income such as investments or gifts does not count toward the SGA limits.

Protect your benefits while exploring work opportunities

You can work part time and still receive SSD benefits as long as you follow the SSA’s rules. Programs like the trial work period and extended eligibility phase make it possible for you to try working again without immediately losing financial support. Keep detailed records, stay within income limits and report your work activity to protect your benefits. Understanding how the rules apply to you is the best way to keep the balance between financial security and meaningful work.]]>