Cheryl's Disability Blog


The Relentless Assault against Claimants Continues

In yet another assault on the due process rights of disability claimants, the Social Security Administration has announced that, effective June 2013, experts can appear by phone. Expert testimony, it should be understood, can be critical to the outcome of a case.

In a recent Federal case, the court made clear that a medical expert had to appear in person unless the claimant had prior notice. Moreover, if the claimant objected, expert testimony by telephone could not occur. Edwards v. Astrue (D. Conn. Aug. 10, 2011). Other courts have issued similar rulings.

As SSA disingenuously stated “These final rules address concerns raised in Edwards and other cases.” (emphasis added). SSA’s idea of addressing the due process concerns raised by claimants and upheld by courts is simply to pass a rule that violates these rights on a broad scale.

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Sensationalized NPR story about disability draws criticism

Many of us who represent social security disability claimants (both SSD and SSI), including disability lawyers in Portland Oregon, were dismayed by the recent NPR story that portrayed claimants as greedy and unqualified for the benefits they obtained.

Now NPR has acknowledged the firestorm of criticism that followed a show that was incomplete and misleading at best.  The national association of social security representatives (NOSSCR), of which I am a member, sent an excellent rebuttal.  For NOSSCR’s full statement, go to http://nosscr.org/harmful-allegations-about-social-security-disability-programs-perpetuated-misleading-media-reports.

Here are the highlights:

  • Increase in disability rolls?  This was an expected trend, predicted as far back as 1994, with two very clear factors: the aging baby boomers entering their high-disability years, and women who entered the workforce in the 1970s and 1980s that are now eligible to draw on their own earnings record when they become disabled.
  • Standards for approval?  Eight former SSA Commissioners pointed out in a letter that the standard for disability approval is strict; the majority of applicants are not approved. Disability benefits are only a modest asset that helps beneficiaries live with dignity while unable to work.
  • Lawyers getting rich?  Hardly.  Lawyers are regulated under the Social Security law and prevented from collecting any fee for their work unless they win.  Even then, a legal fee is limited to 25% of past-due benefits, or $6,000 – whichever is lower. In fact, the system unfortunately discourages lawyers from representing claimants who are hit with overpayments or whose benefits are terminated.
  • Social Security benefits contributing to the deficit?  Wrong. SSDI is self-financed by payroll taxes (FICA) and SSI dollars come out of taxes raised, therefore not increasing the national debt. 

“The Social Security Disability Insurance program is an essential component of our American government system, intended to be a social safety net for American workers unable to perform job functions and support their families. These attacks are blatantly one-sided, untrue and threaten the modest benefits that are needed by so many. “

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What is an Alleged Onset Date?

When you apply for social security disability, you’ll be asked what date you say you became disabled.  This date is known as your “alleged onset date” or AOD.  Sometimes the answer is obvious.  Since you cannot be “disabled” and earning over a certain amount (known as substantial gainful activity or SGA), sometimes it’s the date you stopped working.  Other times, such as when you were in a car accident or a work accident and did not work after that, it will be the date of the accident.

For many people, their disability isn’t the result of an accident and occurred over the course of time. Although Social Security employees are willing to suggest an AOD for you, it’s important for you to understand the implications of the AOD.  Among other things, if you’re approved for SSDI as of your AOD, that’s the date from which your two-year waiting period for Medicare will run.

Here are a few examples of how to figure out your AOD:

Example 1

Susan has been working in care facility for 15 years. One day, while lifting a resident into a wheelchair, Susan severely injures her back and neck. Susan is unable to return to work following this incident.

Susan’s alleged onset date for purposes of her Social Security Disability claim would be the date of her accident at work. This would also be the same date she stopped working.

Example 2

Monica has worked as a hairdresser for several years, during which she develops fibromyalgia and chronic fatigue syndrome.  She drops from full-time to part-time.  Unfortunately, she finds that she cannot even continue part-time and quits working.

Monica’s alleged onset date for purposes of her Social Security Disability claim might the date she stopped working at all.  But, it’s worth looking at her earnings to see if her alleged onset date actually could be set at when she went to part-time work.  Figuring that out involves calculating how much she earned part-time to see if it exceeds the allowable amount (known as SGA).  Of course, she will need medical evidence as well.

Understanding how your onset date can affect your case is important.  Your lawyer will explain to you in greater detail why this date is important and how it matters at each level of your case.

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“How Long Do I Have to Wait for the Appeals Council to Make a Decision?”

Add one more frustration to the experience of applying for social security disability – both SSDI and SSI – the length of time it takes to get a decision from the Appeals Council.

The process includes:

1)  Application:  typically in Portland, Oregon, a claimant will wait 4-6 months for a decision

2)  If denied, Request Reconsideration:  typically in Portland, Oregon, a claimant will wait 4-6 months for a decision

3)  If denied, Request a Hearing:  typically in Portland, Oregon, a claimant will wait 15 months for a hearing to be scheduled

4)  If Unfavorable decision, request Appeals Council Review:  typically, a claimant will wait 18-19 more months for a decision

5)  If review is denied; seek federal court review:  typically in Portland, Oregon, a claimant will wait 14-16 months for a decision.

What makes this horrendous wait even worse is that it doesn’t just happen to a few folks.  It happens to a lot of people who will ultimately win their cases, provided they can live that long.

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How Will Sequestration Affect my claim for disability benefits? How will it affect my receiving my payments of benefits?

Sequestration’s mandatory budget cuts are scheduled to take effect today. The press has reported that “Social Security will not be affected.”

This is not completely accurate.

The good news is that payment of benefits will not be affected for those already receiving disability benefits.

However, the sequestration cuts will affect all other aspects of SSA, including the day-to-day operations of field offices.

For claimants, it is likely to mean longer waits in field offices and for the 800-number to be answered, longer waits for initial decisions to be made (estimated at two weeks longer than usual) and longer waits for hearings to be scheduled (estimated at a month longer than usual).

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Cessation of Disability Benefits: How to fight a decision that you are no longer disabled

If the Social Security Administration (SSA) believes that your medical condition has improved or that you now are able to work full-time, they will send you a written notice that says your benefits will stop.

Here are the two most important things to know if this happens to you:

(1) You can fight this decision. The way to do it is by “asking for reconsideration”.
(2) If you want to keep receiving benefits while you fight SSA’s decision, you must request reconsideration within 10 days of getting the notice of SSA’s decision. Otherwise, your benefits will stop.

If you request reconsideration of Social Security’s determination that you are no longer disabled, you have the right to go to an in-person hearing, just like you may have had when you applied for disability in the first place. At the hearing, you can present evidence that you are still disabled, including your medical records, witnesses and a letter from your doctor (highly recommended).

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What happens to my social security disability benefits if I file for bankruptcy?

An area of law that prompts many questions is whether social security disability benefits are protected from judgment creditors, student loan collectors or in bankruptcy situations.  In this post, I will comment on what happens to benefits when a person receiving benefits files for bankruptcy.

Special note:  I am not a specialist in bankruptcy law.  Please consult your own attorney or a bankruptcy law specialist for advice in your individual situation.

Section 207 of the Social Security Act provides that “none of the moneys paid or payable …[under this law]… shall be subject to execution, levy, attachment, garnishment, or other legal process, or to the operation of any bankruptcy or insolvency law.”

A simple reading of Section 207 suggests that creditors cannot obtain your disability benefits.  However, case law indicates that there are potential exceptions, particularly if you receive SSDI benefits rather than SSI benefits. (By law, SSI benefits, even lump-sum payments, can never be taken by a bankruptcy court or creditor.) Two important areas to discuss with your attorney if you receive SSDI benefits are:

  • What happens to lump sum Social Security benefits received prior to filing bankruptcy that have been sitting in your bank account
  • What happens to lump sum Social Security benefits (representing past-due payments from prior months) that come into your bankruptcy estate after you file

In many cases, the single most important thing you can do is to keep careful track of the source of your income.

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How do you know when to apply for disability?

It isn’t always obvious when it’s time to apply for disability. If you have chronic pain, if you have relapsing remitting multiple sclerosis, if you’re having a hard time remembering the simple tasks that your work requires, you may wonder if it’s time.
But how do you know?

Two recent cases made me ponder that question.

The first was that of a hard-working former CNA, who after two decades of caring for other people, realized that she was having a hard time remembering when to give them their medication. She also suffered from chronic pain in her hip, as the result of an old injury from lifting a patient. She dropped from full-time to part-time work but she wasn’t ready to apply for disability. But when her doctor saw signs of early dementia in cognitive tests he gave her, he told her it was time. She applied, was denied, and when we went to hearing, she was immediately approved.

The second is that of a young man in his thirties. He has been diagnosed with multiple sclerosis and the symptoms are causing him to lose every job he has, but only after about a year. He is struggling to remain a working person. When he came to me, still working, we talked a long time about his hopes and plans. It became clear after our conversation that it wasn’t time yet. If the symptoms of multiple sclerosis worsen, he will have no choice. But for now, staying in the work world was the right decision for him.

If you wonder, talk about it with friends, family and above all, your lawyer. Your lawyer can tell you what it takes to win and when a better choice is to keep working.

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Keeping a pain journal just became easier!

I heard about this on the Facebook page of Progressive Rehabilitation Associates and for those of you with smart phones, it’s worth checking out.

Keeping a journal has lots of benefits — from my perspective, it provides excellent evidence when your social security disability hearing date arrives. It’s a long wait but you can be doing this to help your case and yourself.

App: My Pain Diary

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Why are you more likely to win SSI benefits at hearing?

The Congressional Budget Office (CBO) recently issued a report on the Supplemental Security Income (SSI) Program, which is one of two types of disability benefits managed by the Social Security Administration. Looking at the fact that a majority of folks who apply and are denied by Disability Determination Services (DDS) eventually win at hearing, the CBO tried to figure out why. Their conclusion? Four key reasons:

  • More applicants have legal representation at a hearing before an ALJ than they have earlier.
  • In some cases, the medical disorder worsens between the time of the initial application and the time of the appeal hearing.
  • DDS employees have an incentive to deny applications because those results are not as likely to be reviewed by SSA as approvals are. In contrast, approvals handed down by ALJs are not reviewed, and their denials can be appealed first to an Appeals Council and then to the federal courts, although few applicants choose to do so.
  • DDS examiners review only the case file, but ALJs typically meet applicants in person, thus allowing applicants to respond directly to questions. In addition, although it is common for applicants to have lawyers or other representation at the hearings, SSA has no legal representation to advocate against an application at a hearing.

To see the entire report, go to http://www.cbo.gov/publication/43759

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