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Social Security Disability Again the Subject of Congressional Inquiry

Social Security disability costs too highCBS News reports this morning that the House Oversight and Government Reform Committee will begin hearings on Thursday, June 27 about the role of administrative law judges in awarding benefits.

Critics of the current disability system point to SSA’s own statistics which show that judges currently approve slightly more than half of the claims brought before them (this is down from a 60% approval rate in 2010).  Claims approved at hearings were previously rejected twice by state employees called adjudicators.

Critics also claim that too many judges are approving undeserving cases simply to clear out growing backlogs – the judges complain of quotas – which may delay a hearing date for longer than 12 months.

Others contend that long term unemployed workers claim disability when their unemployment benefits run out [1. This was the premise of a controversial NPR report entitled Unfit for Work: the Startling Rise of Disability in America – see my video about this story here.] Continue reading →

How to Coordinate Social Security Disability with Social Security Retirement Benefits

Social Security retirement and SSDIA number of my Social Security disability clients are in their late 50’s or early 60’s and they have questions about the impact of disability payments on Social Security retirement payments and vice versa.

I never felt comfortable offering advice about this issue because it falls into the area of financial planning, which is not my area of expertise.  As a Social Security disability lawyer, I focus on representing claimants who have applied for disability benefits.  Once those benefits are awarded, my representation ends, although I am happy to make referrals to professionals in other areas.

I did run across an interesting article about the disability/retirement planning issue on a web site called InvestmentNews.com, which is written for the benefit of financial advisers.  A columnist on that site, Mary Beth Franklin, publishes a regular blog called Retirement 2.0 and her June 6, 2013 column entitled How to mesh Social Security disability and retirement strategies is worth a read. Continue reading →

Disabling Traumatic Brain Injuries Can Arise from a Single Concussion

Concussions have been in the news lately because stories about retired football players who are fighting cognitive loss, memory issues and severe depression that arises from brain injury. Athletes like football players and boxers often experience multiple concussions over many years, but damage to the brain can occur even after a single concussion.

Not All Head Injuries Carry the Same Significance

Scientists who study concussions and their aftermath have determined that not all head injuries are the same.  Medical researchers in Europe studying brain injury in unhelmeted soccer players report that It turns out that a head trauma from an angular blow causes significantly more damage than a straight on blow to the head.  It turns out that an angular blow causes twisting of the brain stem and more tearing of delicate nerve fibers.   [1. Click here to review the abstract to a report in the British Journal of Sports Medicine entitled “Brain loading in concussive head impacts: implications for injury prevention.”] Continue reading →

New Information Available About Social Security’s Work Incentive Programs

ticket to work programSocial Security disability programs are running out of money.   As such Social Security executives are looking for ways to reduce the outflow of dollars.

One effort has been to tighten up eligibility standards.   Claimant’s representatives throughout the country are reporting that ALJ approval rates are down.   When cases are approved, judges are including directives in their decisions for SSA to review approved the approved claimant for medical improvement in one year or three years.

SSA has increased and will continue to increase the number of continuing disability reviews for approved claimants.  For years, the CDR program was basically ignored by Social Security – as a result only a very tiny percentage of approved claimants were ever removed from the payment rolls and there was no inquiry into improved medical status.   This is changing and I am starting to receive calls from my old clients asking about these continuing reviews. Continue reading →

Your Lump Sum Payment for Past Due Benefits may be at Risk from Child Support Collection Companies

auxiliary benefitsRecently the Social Security disability lawyer discussion group on LinkedIn contained an interesting thread about child support issues.  Child Support and Social Security disability matters tend to draw a lot of attention from both custodial and non-custodial parents, so I try to write about any developments I note in this area.

The poster on LinkedIn reported that she represented a claimant who was a non-custodial parent who owed several thousand dollars in past due benefits.  The child support collection office (state not named) had apparently contracted with a private collection agency.  The collection agency notified Social Security about the child support lien and the minute that the past due benefit award was issued, it was grabbed by the collection agency.  Child support claims are one of the few types of claims that can garnish SSDI (but not SSI) benefits – see the federal statute here.

One of my colleagues, attorney Erin Schmidt from Cleveland, Ohio added a very salient point to this discussion.  Collection agencies do not account for auxiliary benefits.  Since auxiliary benefits (which can amount to 25% of a disabled claimant’s monthly benefit amount and are paid in addition to the claimant’s benefit), a favorable decision could result in the payment of thousands of dollars to the auxiliary. Continue reading →

Genitourinary Impariment Listing URL Updated

The Social Security Administration has changed the URL for Listing No. 6.00 – Genitourinary Impairments.   This is a change to the syntax of the Bluebook [1. http://www.ssa.gov/disability/professionals/bluebook].

Previously, the URL read as follows:

http://www.ssa.gov/disability/professionals/bluebook/6.00-Genito-Urinary-Adult.htm

This is now a dead link.

The updated link now reads:

http://www.ssa.gov/disability/professionals/bluebook/6.00-Genitourinary-Adult.htm

I am not sure why SSA decided to get rid of the dash between “genito” and “urinary” but it did.  If you had bookmarked the old link, now is the time to update it.

Absence of Political Influence Costs Social Security Disability Claimants

Tom CoburnI have no doubt that a significant percentage of disability claimants denied by Social Security judges do have significant medical or mental health problems that would prevent them from performing competitive work.  Why, then, are these honest but unfortunate men and women receiving denials when they should be receiving fully favorable decisions?

This is a very unsettled time in the world of Social Security disability and there are forces in play that you as the claimant and me as the claimant’s attorney cannot control.

On one hand, we have a President and Congress who are intent on expanding our nation’s social safety net.  Whatever your political leanings, there can be no doubt that the federal government has committed itself to spend trillions of dollars in various social programs.   Politicians of both parties assure us that Social Security and Medicare are sacred and that we will not balance our budget on the backs of seniors and the poor.

At the same time, Congress regularly holds hearings to identify instances where disability claimants have defrauded the system, or where judges have approved 99% of cases brought before them.  I recently highlighted the efforts by Oklahoma Senator Tom Coburn to crack down on fraud and inefficiency in the disability decision making process.  You can view that video here.

The press regularly reports that the disability trust fund will run out of money in 2016 “unless something is done.”  Here is an example of one such article from the Washington Post. Continue reading →

How do I Win for a Medical Condition that Cannot be Seen on a Diagnostic Test

fibromyalgia difficult to diagnoseI get a lot of questions about fibromyalgia and other medical conditions that rely on subjective reporting by patients.  These cases are definitely getting more difficult to win.  Here is a question sent to me by a blog reader that describes an increasingly typical situation:

I'm 41 yrs old and have been suffering for many years with narcolepsy and fibromyalgia.  My sleep disorder actually falls between narcolepsy and idiopathic hypersomnolence.  My family and myself are falling apart because of my disabilities. I've applied for disability in the past and was denied. I'm applying again and wanting to ask you how do i go about applying to prove my disability since its been denied in the past?  How much weight does testimonials from family and friends carry?  How much weight does a signed letter from my doctor saying, i can't work/drive its unsafe, carry?

I am not surprised that you have had a difficult time with Social Security.  As you probably know, Social Security defines disability in terms of your capacity to work a simple, entry-level type of job.  Basically you have to prove that the symptoms of your medical condition or conditions are so intrusive, that you cannot work at any job, full time.

As the person claiming disability you have to prove that you are unable to work – you do this by submitting medical records, and, even better, a functional capacity form completed by your doctor that identifies specific activity limitations.

Continue reading →

Will I Win my Case? I have been Waiting a Long Time and I am Scared

advice about Social Security disability case

Every month, I receive requests for my opinion from concerned and anxious disability applicants about whether a case is good enough to win.   Usually a hearing has been scheduled and the claimant is looking for some reassurance.

The question below is a good example of this type of question.   I am happy to help my blog readers any way I can but I hope you can understand that I can't intelligently answer questions like these because I have no way of knowing what is contained in the medical record.  Further, it would not be appropriate to offer legal advice on a blog, especially to a person who has a lawyer.  I would point out that in my view, a claimant's testimony is less and less important relative to the medical record documents in one's case file.

I am going in December with my attorney for my first meeting with a judge. I have degenerative disc disease, fibromyalgia, arthritis in hands, sleep about 3 hours a night, can't lift anything above 10 pounds, severe low back pain for past four years I have not worked. Can't sit or stand for over 15 to 20 minutes at a time my back has stabbing, burning pain and sometimes runs down back of legs. My right hand will now go to sleep when ever it want to. I have had 17 facet shots under an x-ray machine and probably 35 x rays that show nothing. What is your opinion on this case will I win 100 percent and since I waited 2 years without work before I filed is there maybe a possible way to figure out what I may end up with to live off of? Anything you can tell me will be much appreciated. Is there any books that I can read to help me with this? It is very scary. I was also turned down 3 times by 3 different doctors when I did have insurance to get an MRI which I think I really need in this case.

As far as whether a particular person will win or not, here is what I would say:

  • do you have support from a treating doctor in the form of a functional capacity evaluation or a narrative report describing activity limitations.   Social Security judges are trying to decide whether you have the capacity to perform a simple, entry-level, "warm body" job – has your doctor identified specific areas of functioning where your reliability is less than acceptable.  If you do not have this type of support from a treating doctor, you are going to have an uphill battle.
  • have you been treating regularly with one or more doctors and are there medical reports and diagnostic reports (such as MRI's, CT scans, etc.) in your file that document your compliance with treatment and lack of success with treatment?
  • is there any evidence in the file to suggest that you are malingering or drug seeking? – these can seriously damage your case
  • assuming you are represented by counsel, what does your attorney think?  Can he explain to you the argument he intends to present to the judge and does he feel that the evidence describes serious limitations that impact your reliability at a job?
  • ask your attorney to tell you the truth – if your case is weak, is there anything you can do to make it stronger?   Obviously, you will win if the judge accepts everything you say about your pain, discomfort, physical and mental limitations – the question: does the medical evidence support what you say?

Can Vocational Witness Testimony Predict the Outcome of Your Hearing?

SSDI hearing decisionsOver the past couple of years, Social Security has changed its procedures to offer less information to claimants and their lawyers.  Staring in January, 2012, for example, SSA began deleting the name of the judge from hearing notices.  Thus, when I meet with my client to prepare for an upcoming hearing, I cannot speak to the likes and dislikes of a particular judge because I do not know who that judge will be.

It is my understanding that the purpose of this particular change was to prevent “judge shopping” whereby a lawyer might tell his client to move rather than appear at a hearing before a judge who rarely grants cases.  It seems to me that claimants and the entire disability adjudication system benefit more by having their lawyers better prepared than SSA benefits from rare instances of judge manipulation.

Another change I have noticed involves SSA directives discouraging judges from announcing their decisions.  In years past, judges would sometimes announce favorable decisions in cases where the evidence was clear.  Now, judges rarely announce their decisions directly even if all of the evidence and testimony points towards a favorable decision.

From my clients’ perspectives, of course, this mystery is extremely frustrating.  Imagine waiting 2 years to get a hearing, then to discover that it may be another 6 weeks before a decision is announced. Continue reading →

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