Kunkel Law Firm April 2019

APRIL 2019 KunkelCase Files 800-467-5272 • www.KunkelLawFirm.com • GKunkel@KunkelLawFirm.com


Gregory Kunkel, Esq.


Residents of Pennsylvania will face another layer of administrative review in the disability claims process thanks to the Social Security Administration (SSA). The second step in the process is called “reconsideration”and will add an average of four extra months to the claims process. Starting in April, applicants must request reconsideration if the initial claim is denied before they can file a request for a hearing. In 1999, the SSA eliminated the reconsideration step for residents of Pennsylvania and nine other states, but it has now decided to reinstate the process, claiming it wants uniformity across the country. Reconsideration is widely viewed as a useless administrative hurdle that usually results in a“rubber- stamp”approval of the initial decision. In 2017, for example, the SSA affirmed 87 percent of the initial denials of the cases reviewed.

There’s a public health crisis blooming in the corners of high school bathrooms and classrooms, in clouds of mango-flavored vapor exhaled from the mouths of teens. As conventional cigarette use among high schoolers remains at its lowest point in years, overall use of tobacco products among young people has seen a recent uptick as e-cigarettes surge in popularity. Chief among these devices is the Juul, a sleek, discreet e-cigarette shaped like a USB drive. Since it first became available in 2015, the Juul has dominated the e-cigarette market, claiming close to 76 percent of U.S. e-cigarette market share at the end of 2018. It was developed as a safer alternative to smoking for adults, but unfortunately, it has become extremely popular among adolescents in the U.S. According to a 2018 survey conducted by the BMJ,“Juuling,”better known as“vaping,”is now considered a trend among teens, with 1 in 4 high school seniors familiar with the devices, and a little under 1 in 10 reporting recent use. The NewYork Times reports that as many as 3.6 million middle and high school students currently vape. The problem has gotten so widespread that U.S. Surgeon General Jerome M. Adams declared that e-cigarette use among young people has become an“epidemic.” THE RISEOF THE JUUL What to Know About This Teen Epidemic

In the end, reconsideration is another time- consuming procedural trap for people with

disabilities that will further delay the claims process.

As always, our firm is standing by to answer your questions and guide you through the disability process.

The question is how does Juuling work, and what are the risks? How worried should parents be? And, most importantly, what can they do about it?


HOW IS THE JUUL DIFFERENT THAN CIGARETTES AND OTHER E-CIGARETTES? The popularity of Juuls among teens is due to a couple of simple factors. Its attractive and covert thumb drive-like design makes it easy to use without getting caught at school. Plus Juul“juice”comes in fun, appealing flavors, like mango, strawberry kiwi, and mint, making it

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most addictive chemicals in the world. Anxiety, depression, irritability, hunger, and weight gain are all symptoms of nicotine withdrawal — symptoms that pretty much every parent would like to spare their child from. SO, WHAT’S THE VERDICT? It’s clear that Juuling, vaping, and all forms of e-cigarette use are a huge danger to kids. The strategic marketing of Juul specifically seems to have successfully gained them customers for life in our nation’s youth. In 2018, the FDA announced it was cracking down on the illegal sales of e-cigarettes to minors and“kid-friendly marketing and appeal of these products.” If you’re looking to prevent your child from becoming one of the millions of teenage Juul users, simple awareness goes a long way. In one survey, most teen respondents didn’t even realize that Juul pods contain nicotine. The first step to protecting your kids from the dangers of Juul usage is to do your research and have an open conversation with them about the facts.

the smoke and the bad smell —may lower the initial barrier to tobacco use and encourage teens to get started on e-cigarettes like the Juul, regardless of whether or not they would have engaged in tobacco use before. HOW BAD IS IT FOR YOU? Fans of e-cigarettes, especially Juul, often insist their habit is less harmful than smoking traditional cigarettes. But the reality is e-cigarettes have only been available in the American market since 2007. Researchers are only just starting to realize the impact long-term e-cigarette use can have on our health. While Juuls might not as bad for you as traditional cigarettes, they are still extremely toxic and addictive. According to the National Center for Health Research,“The popularity of Juuls among adolescents exposes them to large amounts of nicotine that can have adverse health risks for their physical and emotional development.”At least one study has tentatively linked nicotine to cardiovascular issues, and it’s no secret that nicotine has been proven to be one of the

especially appealing to kids. The vast selection of flavors is one of the company’s major selling points, and their marketing boasts the tagline, “Discover your favorite flavor today.”But the main reason Juul users keep coming back is the same reason smokers reach for a pack of cigarettes: the nicotine itself. Each“pod”is packed with e-liquid that contains 59 milligrams of nicotine per millimeter — a much higher concentration than in other e-cigarettes — in order to mimic the buzz that regular smokers experience from traditional cigarettes. When users inhale, the device vaporizes this liquid, which is then absorbed into the body at a speed comparable to regular cigarettes. Normal cigarettes use freebase nicotine, which can irritate the throat and lungs, but e-cigarettes use nicotine salts, which are designed to go down smoothly. The vapor doesn’t carry the clinging smell of cigarette smoke and disappears almost immediately. According to health experts, the lack of negative traits associated with traditional cigarettes —mainly

Why Exercise Therapy Should Be the First Step in Recovery Amid an Epidemic, PT Helps Curb Opioid Abuse

Studies show that physical therapy may have the potential to dramatically reduce opioid reliance, abuse, and overdose. In one 2017 study published in the Journal of the American Board of Family Medicine, researchers discovered that, in cases where doctors referred patients suffering from low back pain to a PT as a first-line treatment, the odds that the patient ended up needing an opioid prescription decreased significantly. Other studies have also reinforced the same trend for treatment post-surgery: When physical therapy is the first recommendation, patients tend to use fewer opioids and actually spend less on treatment in the long run. The evidence seems clear: If patients follow the recommendations of the CDC and consider physical therapy before taking pills, they substantially lower their risk of dependence on and abuse of prescription drugs. Of course, you should always follow the advice of your doctor, but consider requesting a referral to PT first — it’s just a safer, more consistent, and less expensive option. And who knows? It might just save your life!

Today, a startling number of Americans suffer from opioid addiction. According to a report published in the Annual Review of Pharmacology and Toxicology, more than 4 percent of U.S. adults misused prescription opioids in 2018. Prescription drugs can lead to enough tragic overdoses on their own, but as the physical aspects of addiction set in and prescriptions dry out, addicts desperately turn to more serious drugs like heroin and fentanyl. Opioid addiction is indiscriminate; it can strike anyone of any social class, race, gender, or economic standing. This is one reason the overprescription of opioids over the last two decades, coupled with a more recent flood of street opioids, led to more than 70,000 deaths in 2017. In an effort to stem the tide of opioid-related deaths, the CDC issued a set of new recommendations to doctors in 2016. They questioned the effectiveness of opioids for the management of chronic pain and encouraged physicians to instead focus on physical therapy, cognitive behavioral therapy, and other nonopioid pharmacologic options for long- term intervention.

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Peanuts and Cracker Jacks The Best Opening Days in Baseball History

Baseball’s opening day has been an American holiday of sorts since the Cincinnati Red Stockings threw out the first major league pitch in 1869. To celebrate the start of the 150th season of professional baseball, here are three of the best opening days in baseball history.


On April 15, 1947, an opening-day game changed the course of Major League Baseball. On this day, Jackie Robinson started for the Brooklyn Dodgers, becoming the first African-American player to start for a major league baseball team. Robinson’s historic showing was lackluster, going 0-for-3 at the plate and making a solid showing on the infield at first base, but his mere presence in a Dodgers uniform had already broken history. Despite his nationally-recognized skills — Robinson was named MVP of the MLB farm team league in 1946 — the backlash that followed his rise to the pros, both from fans and teammates, was palpable. Still, as well-known sportscaster Howard Cosell said, “Suddenly, it was a new beginning.”

famous “Murderers’ Row.”With sluggers like Lou Gehrig, Earle Combs, Babe Ruth, Mark Koenig, Bob Meusel, and Tony Lazzeri, it’s no wonder this team went on to win its fifth championship that year.


For decades, no one could match George Herman Ruth. The Great Bambino’s all-time home run record seemed like an impossible feat of strength — that is, until Henry “Hammerin’ Hank” Aaron came along. On opening day, April 4, 1974, Aaron smashed his 714th homer, tying Babe Ruth for the most home runs ever hit and extending the Atlanta Braves’ shutout lead over the Cincinnati Reds. A few weeks later, Aaron surpassed Ruth’s record, prompting a standing ovation from the crowd.


Considered one of the best teams in baseball history, the 1927 New York Yankees started their historic run and 25th season by dismantling the Philadelphia Athletics with a score of 8-3. The slugfest was true to form for the 1927 Yankees, whose players would go on to make up baseball’s

Inspired by Food Network

Take a Break!


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1 pint cherry tomatoes, halved 1/2 teaspoon crushed red pepper flakes 1/2 cup grated Parmesan cheese, ideally Parmigiano- Reggiano Kosher salt, for pasta water and to taste

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12 ounces pasta, ideally fusilli 1/2 pound broccoli florets

2 carrots, shredded

1 yellow bell pepper, cut into strips 1/4 cup extra-virgin olive oil 4 cloves garlic, thinly sliced

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1. In a large pot, liberally salt water and bring to a boil. Add fusilli and cook according to package directions. Add broccoli, carrots, and bell pepper during the last 2 minutes of cook time. 2. Drain the pasta and veggies, reserving 1/2 cup of cooking liquid. Return pasta and veggies to pot. 3. In a large skillet, heat olive oil tomediumheat. Add garlic and cook until translucent and golden, 30 seconds. Add tomatoes, red pepper flakes, and 1 teaspoon salt. Cook until tomatoes are wilted, about 2 minutes. Stir in reserved pasta water.

4. Add tomato mixture to pasta pot, stirring to coat evenly. 5. Divide into bowls, top with Parmesan cheese, and serve.

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One Oxford Centre, 301 Grant Street, Suite 4300 Pittsburgh, PA 15219

INSIDE THIS ISSUE From the Desk of Gregory Kunkel, Esq. PAGE 1 Why 3.6 Million Teens Are Using E-Cigarettes PAGE 1 PT Helps Curb Opioid Abuse PAGE 2 3 Great Opening Days in Baseball PAGE 3 Take a Break PAGE 3 Pasta Primavera PAGE 3 3 Travel Myths Debunked PAGE 4

The Holiday of New Orleans

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Three Travel Myths You Should Stop Believing PARIS ON A BUDGET?

Traveling has many social and educational benefits, but some people have hesitations that prevent them from jetting off on new adventures. Below are three debunked travel myths to give you some ease as you plan your summer vacation! MYTH: VACATIONS ARE EXPENSIVE. Fact: You can travel anywhere on a budget. Tracking flights to score the best deal, setting spending limits, and packing meals are a few ways to save money. Hostels and Airbnbs are great alternatives to spendy hotel stays. Additionally, you don’t have to cross the country to have a great trip. Every state has museums, unique roadside attractions, historical sites, and a booming nightlife. When you know your price limits and what you want to do, traveling can be a fun and inexpensive venture. MYTH: TRAVELING IS DANGEROUS. Fact: If you’re smart about what you do and where you go, traveling can be safe. Go with your gut and only stay somewhere that is approved by travel guides. Visit places you feel comfortable in, and do your research by reading travel blogs, websites, and books to find places that have been vetted by others. Traveling in groups can also be a great way to lower your risk of danger. As long as you plan ahead, you will have a safe trip.

MYTH: JET LAG IS CAUSED BY A LACK OF SLEEP. Fact: While jet lag can make you sleepy, it’s actually caused by a disruption in your circadian rhythm. Our bodies are cyclical, and the circadian rhythm is set by both a natural need for your body to reset and outside forces, such as your job, time zone, and diet. Travel can disrupt this rhythm and routine, which leaves you lethargic during and after your vacation. Sticking to water before and during your flights and staying physically active during and after traveling are great ways to fight jet lag and get back into your normal rhythm. Don’t let these travel myths keep you from seeing the world. Set a budget, go with your gut, and prepare for a shifting rhythm to make your next adventure the best one yet.

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