Social Security Disability SSI : The Worst Advice I've seen yet

Here's an excerpt from an article that, essentially, is a recommendation against representation. I think I may have mentioned this article once before, but the advice on it is flawed enough that it is certainly worth mentioning once more:

"Instead of having an attorney represent you, bring other qualified individuals to speak on your behalf. This can include your doctor, social worker, and family members."

The author of this article may have a bias against attorneys and non attorney representatives. I don't know, but the advice he's pitching is nothing less than ludicrous.

1. Getting a social worker to show up at a disability hearing would be about as helpful as having my dog with me in traffic court.

2. Getting a doctor to appear at a disability hearing would be just as useful---having an M.D. confers no knowledge or insight regarding how to win a disability claim or how the social security administration's disability programs work. In fact, most doctors, despite the fact that they are routinely asked to support their patient's disability claims with records and statements, remain AMAZINGLY IGNORANT of what is needed to document a claimant's allegations of disability (for any doctors who may be reading: functional restrictions and limitations).---But the most ludicrous aspect of this fine parcel of advice...is the mere thought that you could even get a doctor to show up at a hearing for you, short of a $2000 inducement.

3. Family members to provide representation? Sure, your family members are probably capable of providing a sound argument in favor of a disability allowance, based on a solid knowledge of medical and vocational issues as they apply to disability adjudication? Why would I even think to doubt that? Good grief!

Here's the link to the article. The title is "Social Security Disability and SSI: How to Win Your Appeal". However the title should be "How not to win you disability claim"

Advice that is not recommended but posted to illustrate that bad advice abounds on the internet





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Can you afford a lawyer for a social security disability claim?

Here's a post from another blogger. In the post, Jonathan mentions that he received an approval for disability on his first try without the need for representation. He also mentions having a friend who is thinking of hiring an attorney for a social security claim; however, the friend is of the opinion that he cannot afford to hire an attorney.

Regarding Jonathan's success with his own claim, yes, some claimants are fortunate enough not to be put through the ringer of the disability evaluation process. Roughly, thirty percent, in fact. But...nearly seventy percent of all social security disability and SSI claimants are not so fortunate and must face the prospect of throwing in the towel, or filing appeals.

Regarding Jonathan's friend and his concerns, no, it doesn't cost a disability claimant a single dime to find and obtain representation. Disability lawyers and non attorney representatives work on a contingency basis, meaning they get paid a fee only if the claimant's case is won. The fee is currently equal to 25% of a claimant's back pay, with a cap of $5300 (as of 2006).

Jonathan is right, of course, to advise his friend to get treatment for the purpose of documenting his condition. When it comes to disability cases, everything boils down to reviewing a claimant's medical records.

A helping hand





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Disability Denied

I've been around social security disability and SSI disability claimants in several capacities over a number of years (caseworker, disability examiner, advocacy) and the conclusion I've reached is that the majority of disability applicants do not want to file for disability benefits. They file for disability benefits because they have to. In other words, because their medical or mental condition has made it impossible for them to work and earn enough money to support themselves.

Individuals who file for SSD and SSI benefits and enter the disability evaluation process do so with a fair amount of despondency and anxiety. And, unfortunately, most have their disability denied, and their trepidation validated. Depending on the state in which you live, the rates of denial at the initial claim level can be as high as seventy percent or more.

Why does this happen? Why do so many individuals with valid claims have their disability denied, particularly when so many of them stand a greater chance of being approved for benefits at a later point in the process (that is, if they follow the appeal process -- for more information, visit this page: Social Security Disability Appeals) ?

The answer is multifaceted, without a doubt; however, part of the reason for such large denial rates has to do with the "culture of denial" that exists at the various state agencies that process social security disability and SSI disability claims for the social security administration. These are the agencies (normally referred to as disability determination services or the bureau of disability determination) in which disability examiners gather the medical records of applicants and render decisions on their claims. These are also the agencies in which disability examiners work under a subtle (and sometimes not so subtle) pressure to deny more disability claims than they approve.

In these agencies, the quality-control focus on continually analyzing whether a disability determination should have been a denial instead of an approval has led to certain patterns of behavior that have long since become SOP, and virtually etched in granite.

Put another way, the ranks of unit supervisors at the various disability determination services (each state has at least one DDS, some states have several) have been inclined, and motivated, for many years to deny many good claims for disability benefits. And this inclination is so pervasive (and, let's be honest, twisted) that it is not unheard of for DDS unit supervisors (who, incidentally, have no medical training whatsoever) to challenge the very physicians who are assigned to their units as medical consultants.

Some would categorize this as outrageous chutzpah, that a DDS unit supervisor (i.e. a state employees with zero medical expertise) would challenge and override a physician whose job is to assist and validate the decisions of disability examiners. But it happens all the time (not by actual order, but definitely via pressure and coercion, i.e. strongarming).

And it is clear evidence as to why "social security disability reform" may not be nearly so effective as its architects project and anticipate. Because as long as the culture of denial remains rooted at disability determination services, no shell games (substituting federal review for DDS reconsiderations) or wishful-thinking-alterations to the system (quick disability decision units, which, under current supervisors, are not likely to move disability cases any faster than they currently move) will have any substantial impact.

Unfortunately, this is where SSA's top level management falls shortest, simply because for all they do know, at a very basic level (the level at which initial disability claims are received and processed), you have to wonder if they really know much about how the disability system actually works.




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Application for Disability - SSD and SSI applications

Many individuals who are effectively disabled (unable to perform the work requirements of their current jobs, past jobs, or any other job) wait quite a while before they decide to contact the social security office and file an application for disability. In fact, some potential claimants never seriously consider filing for disability benefits until their funds are exhausted and their disabling condition has become even more severe.

Why do some people wait so long before applying for disability? There are many answers to the question. For some, delaying filing may reflect the hope that their condition will improve, making a return to work possible. For others, a delay in filing may have a bit to do with hearing from others how difficult the (social security disability) system is. Such scenarios are understandable, of course. The mere prospect of not being able to work and earn a living is fatiguing, in and of itself.

However, waiting too long to file an appeal, or in this case an application for disability benefits can be harmful to an individual's well-being. What is "too long" in this instance? Too long can be defined as waiting beyond the time that you have become disabled and unable to work. In other words, when you can no longer go to your job, or can no longer work and earn a certain minimal amount (social security refers to this as substantial gainful activity), you should immediately file an application for disability. And you should not hesitate to do this, because the application and appeal system can take an incredibly long time to get through.

This brings us to other questions, of course, such as how to file an application for disability and how long such an application takes to process. How to file for disability is fairly simple (though, it can be somewhat confusing, depressing, and intimidating). You simply contact the social security administration (by contacting your local social security office--try to avoid the 1-800 number as it tends to be the source of a fair amount of bad information) and inform them that you wish to file a disability claim. Once you've performed that simple act, the process will be set in motion.

What happens after you've requested an application? An interview appointment date will be set. Your interview can be done over the phone, or in person at the social security office. What happens after an interview has been conducted and an application has been filed? You wait, for several weeks, or, perhaps, several months, for a disability claims examiner (at a state agency that handles disability claims for the social security administration) to gather all your medical records and make a decision on your case. If the decision is an approval, of course, then you should begin receiving benefits shortly (shortly is a relative term---sometimes it can take weeks to get into benefit receipt status and months to receive your backpay). If the decision is a denial, you have the choice of starting over with a new application for disability, or filing an appeal (typically, the better choice).

How long does it take to get a decision on an application for disability? This is a nebulous question because the answer varies with each and every social security disability claim. There are no deadlines on SSD cases (unlike medicaid) so an application for disability may take thirty days, three months, six months, or beyond a year. In most cases, a decision will take close to the average that's spouted by most claims reps (claims reps are the individuals who take disability claims at the social security office). But that doesn't always happen.

If you are denied for disability, of course, you probably want to consider getting representation for your claim, though you are entitled to obtain help at any stage of the process, even after you've just applied for social security disability or SSI disability, or before a disability hearing is scheduled to take place.




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Social Security Disability and the Mental Health Treatment Study

From Don Lavin's Blog:

"My employer, Rise, Incorporated, recently joined a national research project that will study the impact of providing integrated mental health treatment and evidence-based employment practices (EBPs) for Social Security Disability Insurance (SSDI) recipients. This project is entitled the Mental Health Treatment Study (MHTS) and it will officially begin on July 1, 2006. MHTS is funded by the Social Security Administration (SSA) and will host more than 20 demonstration sites serving approximately 1,500 SSDI recipients from multiple geographic regions of the United States."

Read Don's Post here: Many roads, one destination




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Who makes the Social Security Disability decision ?

Actually, the answer to this question depends on the level your claim is at. If your social security disability or SSI disability claim is being processed at the intial claim level, the decision will be made by a disability examiner who works at the state agency that handles medical evaluations for the social security administration in your particular state (in most states, this agency is known as either the bureau of disability determination or disability determination services). If your claim is being heard (or already has been heard) at a disability hearing, the decision will be made by an administrative law judge.

Of course, decisions by examiners are not nearly so absolute as decisions made by judges.

Disability examiners process SSDI (social security disability insurance) and SSI disability claims by gathering a claimant's medical records and analyzing them to see if the claimant meets the social security administration's disability approval standards. In the course of processing a claim, an examiner will read a claimant's records and compose a synopsis, or write-up, that reflects the examiner's recommendation (approval or denial) for the case. The examiner will then typically consult with either a medical or psychological consultant (an M.D. or a Ph.D.) who is assigned to his or her processing unit.

After the consultation is completed (and many cases will require a consultation with both types of consultants), a decision on the claim will be finalized and the case file will be reviewed by either the examiner's supervisor or the assistant supervisor (sometimes known as a case consultant)...for "more finalization". In other words, if one of these indvidual's has an issue with the examiner's conclusions, the examiner may have some additional work to do.

However, once the claim finally makes it through the supervisory gauntlet, it can begin to make it's way out of the state agency and back to the social security office. That is...if the file is not intercepted by quality control. If a regional quality control office "selects" the file for review, a claimant may have to wait several more weeks before learning what the decision on their claim is.

By marked contrast, when a federal administrative law judge makes a decision on a social security disability or SSI disability claim, the decision is simply the decision. Of course, if the decision is a denial, this may be appealed. But unlike the system in which disability examiners adjudicate disability claims, there is no one present to "second guess" the judge. Examiners, by comparison, are often second guessed by their unit consultants and supervisors as well as by quality control staff.




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How much does it cost to hire a social security disability attorney?

Individuals who provide representation services on social security disability and SSI disability claims (either a disability attorney or a non attorney representative) are not paid upfront. Quite the reverse, they are paid on contingency -- meaning a claimant does not pay a fee until a case has been won...regardless of how long the case takes (and this, unfortunately, can take years).

This, of course, poses a tremendous advantage for disability claimants because it allows virtually any disability claimant to find representation, provided, of course, that their case has merit.

How much does it cost to hire an attorney or a non attorney representative? Representatives are paid by receiving a percentage of a claimant's disability back pay and this percentage is currently twenty-five percent. In other words, if a claimant's case is won and the claimant's back pay amounts to $20,000, the attorney or non attorney who handled the claim would be entitled to receive $5000 as the fee.

Is a representative's fee capped at a certain limit? Yes, it is. Though an attorney or non attorney rep can receive 25% of a disability claimant's backpay, the total fee cannot exceed a maximum amount. In 2006, the maximum allowable fee was $5300.

Can an attorney or non attorney representative receive any compensation other than the fee that is specified by the social security administration? Yes, and this will vary from representative to representative. Many reps will charge for the cost of gathering a claimant's medical records and for the cost of obtaining statements from a claimant's doctors (yes, doctors do charge for this, and some doctors charge quite a bit).

Such costs are completely normal and valid, of course, and the representative is simply advancing expenses upfront with the understanding that the costs will be repaid when representation has been concluded (note: unlike the fee, which is paid ONLY if a case is won, reimbursement for the cost of records is often required win or lose---thankfully, the cost of records does not usually exceed two hundred dollars).

What an attorney or non attorney advocate may decide to charge for other expenses should be clearly spelled out in the fee agreement. For this reason, a person who is pursuing social security or SSI disability benefits should read their fee agreement before signing with a particular rep. Because when it comes to incidentals, not everyone charges the same thing. Remember, though: the fee itself is non-negotiable as this is dictated by thesocial security administration.




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Social Security Back Pay

Social security back pay is exactly that. It's what social security "owes you back" after your claim has finally been approved. Back pay, of course, is a huge issue for social security disability claimants since most claimants go months and even years with no source of appreciable income.

How far back can social security disability back pay go? The answer is not quite as clearcut as one might think. One way to answer the question is to say that social security disability benefits can be paid back to the date of application and up to 12 months retroactive to this date. However...title II (a.k.a. social security disability) benefits are subject to something akin to an "elimination period" (a term that generally applies to private disability policies---and, in fact, social security disability is considered by the government to be a form of insurance). In the case of SSD benefits, this is called the five month waiting period, meaning that no matter when your disability is considered to have begun, the social security administration will essentially remove five months of your benefits from you (it's worth noting that the five month waiting period does not apply to SSI disability claims).

In the prior paragraph, the phrase "when your disability is considered to have begun" was used, because though a claimant may potentially receive social security backpay back to the date of application (and even 12 months prior to the date of application), whether or not a claimant actually receives benefits from this far back will depend on the claimant's established onset date.

The EOD, or established onset date, is the date that a claimant's disability is determined to have begun, based on the claimant's medical records. In many cases, a claimant's medical records will establish an onset date that is fully favorable in relation to the date that was claimed on the disability application. But this is not always the case.

Back pay can seem to be a fairly complex issue, depending on a number of factors such as when a claimant's disability onset date is determined and when the claimant applied for disability. And adding to the complexity is the fact that claimants who are approved for disability benefits and who filed prior disability applications (meaning prior to the application they were actually approved for) can sometimes, if the medical record warrants, have their prior cases reopened for the purpose of receiving a larger backpayment. And this is certainly the type of instance in which having qualified representation can make a definable difference in the benefit-award outcome of a case. Because an experienced representative will typically attempt to establish the earliest and most favorable onset date for a social security disability claimant.




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Social Security Disability SSI : Psychological and other mental testing

I came across someone else's blog and the individual was commenting on the fact that her mother was sent to a consultative examination (a CE exam) for her social security disability application. The exam was a psychological CE, designed to gauge a client's mental status and level of psychological functional limitations.

The blogger indicated that the exam took 2 1/2 hours to complete. Not every psychological CE may take this long, but there's no question that the mental exams scheduled by social security are not at all like consultative physical exams---not when it comes to the time element (it is extremely common to hear a disability claimant state that their physical consultative exam took only ten minutes).

A claimant who is required to attend a psychological exam would probably find it beneficial to get a decent amount of sleep the night before because if it seems apparent to the psychologist administering the exam that "best effort" was not given, the exam results may be considered invalid. That, of course, amounts to a waste of time for everyone, including the disability claimant.

Here's another tip: never try, for whatever reason, to deliberately manipulate the results of a psychological exam, because the individuals who administer such examinations are fairly expert at detecting this and will, typically note in the exam report any attempt to influence the outcome of the test.




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Social Security Disability Appeal - Tips on the Appeals Process

The point of this post is to illustrate a few insights as to why it is better to follow the social security disability appeals process, versus starting over with a new disability application. And to do that, let me relate a recent experience.

I was speaking to someone the other day who, like me, is a former disability examiner for social security disability and SSI claims. The question that came up was: "What's the biggest unique you ever saw on a new file?"

Ok, I better explain what I mean by this. Unique numbers refer to how many times a disability claimant has filed for social security disability or SSI disability. My answer was 22. My friend had actually seen one as high as 25.

Now, what does all of this mean? Well, here it is: When a person files a claim for SSD or SSI and gets denied, they have three choices: 1. give up completely (and many people do), 2. file an appeal and follow the appeals process, and 3. start over with a brand new application for social security disability or SSI.

If a person decides to start over with a new claim (usually, this is a terrible choice), then you add one to their total unique number. So, for the person whose unique number was 22, this meant that they had filed close to two dozen times.

What's wrong with this? Well, it's not really productive. A person who chooses not to file a social security disability appeal and instead chooses to begin a new claim will, typically, be denied again. And if they keep starting new claims versus filing an appeal...they will, most likely, be denied over and over and over (get the point?) again.

The reason why a social security disability or SSI claimant should nearly always (I say "nearly always" because there are a limited number of situations in which a new application is the best route, but this is a very limited number of situations) file an appeal is this: ultimately, you want your disability claim to be reviewed at a disability hearing, held by an administrative law judge who specializes in adjudicating social security disability and SSI claims. But...the only way to get to such a hearing is by requesting an appeal after a disability application has been denied. And, of course, after that first appeal (known as a reconsideration or review) has been denied, a claimant may request their second appeal, the appeal that actually leads to a hearing in front of a judge.

How long does the appeal process take? Assuming that a claimant does not get approved on their first appeal (the reconsideration or review), and has to appear at a hearing, the appeal process can easily take over 2 years. And, certainly, this sounds impossibly long, both from a medical and financial standpoint. However, enduring the appeal process is preferable by far to never being aproved for disability benefits and I woould gather to say that the person who had filed 22 times had probably put several years into the process...with nothing to show for it.




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SSI Benefits - How to apply for SSI Disability

What are SSI benefits? This is a fairly common question for individuals who are considering filing a claim for disability benefits. SSI stands for supplemental security income and is mandated by title 16 of the social security act.

SSI disability benefits exist to provide coverage to those individuals who were never insured and eligible for social security disability benefits, as well as individuals who were once insured for SSD benefits but whose coverage has lapsed (due to insufficient work credits in recent years). This, of course, includes disability applications that are filed for minor age children.

SSI disability benefits are unlike social security disability benefits in that the monthly benefit amount is capped to a maximum, though the maximum may be adjusted periodically to account for inflation (with social security disability, the amount you receive each month is based on your earnings record and this, too, may be adjusted for inflation).

SSI benefits also differ from social security disability benefits in that a claimant's eligibility to receive benefits may be affected by their assets. To remain eligible to receive SSI benefits, a claimant cannot have more than $2000 in countable assets (such as vehicles other than one's primary mode of transportation and real property other than one's primary residence). And, of course, the reason for this is that SSI is considered a need-based program.

Lastly, SSI benefits may be distinguished from social security disability benefits in this fashion: in most states, an SSI benefits recipient will also be eligible to receive medicaid (I say most because though most states have medicaid, not every state does), which provides for a certain number of doctor visits and filled prescriptions.

Do you apply for SSI benefits any differently than you file for social security disability benefits? No. The application process for SSI benefits is the same and is indistinguishable.

If your claim for SSI benefits is denied, you have the right to file an appeal, and if that first appeal is denied, you have the right to request a hearing before an administrative law judge (generally, your chance of winning SSI benefits at a hearing will be approximately 40% without represenation, and 60% with representation).




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Reasons to Apply for Disability

There's only one reason to apply for disability. And the reason is...that an individual is limited enough by their condition, or various conditions (mental, physical, or both), to the extent that they can no longer work, either at one of their past jobs, or at any other form of work deemed suitable by the social security administration (based on a claimant's age, work skills, past work requirements, current level of restrictions, and level of education).

That's one way to answer the question. Another way to address the issue, however, is to say this: You can apply for social security disability or SSI disability benefits and potentially win your case no matter what your diagnosed condition is. To some, this may sound strange, but, because of the way the social security administration evaluates and adjudicates disability benefit claims, the specific condition a person has is not nearly as relevant as the limitations that are caused by a claimant's condition.

For example, if disability claimant A files on the basis of having had a heart attack, but claimant A has not had resulting functional restrictions sufficient enough to prevent a return to work, claimant A will probably not be approved for disability benefits. On the other hand, if claimant B has osteoarthritis and the medical evidence demonstrates that claimant B will be unable to return to his former work, or perform any other form of suitable work, then claimant B will probably be approved for disability benefits.

So, in answer to the question, "What are reasons to apply for disability?", the answer is that literally any medical, psychological, or psychiatric condition may qualify you for disability benefits, as long as the condition sufficiently limits your ability to work.

However, on a final note, it should be stated that, according to social security's definition of disability, the inability to work at a former job or perform any other form of suitable work must persist for at least a year, or be be projected to last for at least one year.




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Getting Disability - Social Security Disability and SSI

Getting disability benefits. There are literally tons of questions associated with this two word sentence. If you're searching for information online regarding social security disability or SSI disability, of course, there's a more than fair chance that you're looking for either 1. basic information about how to file an application or an appeal for disability benefits, 2. information regarding representation, or 3. tips and advice to enhance your prospects for winning benefits.

This particular post will point out a few informational tidbits that may provide insight for individuals who are just starting a claim or are considering filing an appeal.

A. Getting disability benefits established can take a fairly long time. And by that I mean a very long time. What do I mean by a very long time? Unfortunately, up to three years or longer. Yes, you may be one of the luckier ones and have your claim approved at the initial application level in under six months (though, even an approval at that level can still take a year or longer--it always varies). But 70% of all claimants are initially denied, and for these individuals getting disability benefits approved usually means starting a series of appeals that results in a hearing before a judge (fortunately, when we say "series" we mean only two appeals).

B. Getting disability from the social security administration can involve an extraordinary amount of anxiety and stress. And for several reasons. First, as we've already stated, the process is typically long and drawn out. But, as a consequence of that, many social security disability and SSI claimants, perhaps most, will experience severe financial hardship. And a third source of disability claim-related stress has to do with the fact that, for long periods of time, a claimant will simply have no idea what is happening with their case (ideally, the social security administration should provide periodic updates to claimants regarding the status of their case, but this does not happen--meaning you should call the social security office, disability determination services, or your representative, attorney or otherwise, whenever you need to know what is happening what your claim).

C. Getting disability benefits won at any level can be hampered significantly if you don't supply social security (and by "social security", I mean either the claims rep at the social security office or the disability examiner at disability determination services who is working on your medical evaluation) with the information they need. "Information", of course, includes a wide spectrum. For instance, when you complete your disability application, you need to make social security aware of your medical sources of treatment, including the names of your doctors and the dates you've been seen. When you file an appeal, you need to provide social security with updated information regarding your medical treatment. In other words, if you've been back to see one of your doctors recently or you've had some form of testing done, indicate this. And if you've been to a doctor, hospital, or clinic that social security is not aware of, then definitely indicate this on your appeal form so these medical updates can be gathered and added to your file (although, it should be stated that at the hearing level, social security will not perform any additional development---this will generally be up to you or your attorney or non-attorney representative).

If you haven't filed for social security disability or SSI disability, reading this post may make you feel somewhat depressed. Learning just a little about how the SSD and SSI evaluation system works can have that effect. However, if your medical or mental condition is preventing you from working, you should file a claim for benefits ASAP, simply because the process does take so long. And if your claim proceeds to the hearing level (most claimants who are denied at the application level must appear at a disability hearing before a claim for benefits can be approved), then you should seriously investigate finding representation to maximize your chances of winning benefits.




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Can you receive Social Security Disability (aka SSDI and SSD) and SSI also ?

Actually, you can receive both social security disability benefits and SSI benefits both at the same time, though this is not something in which you really have any choice. In brief, here's how it works. When you file for disability benefits, either online or by visiting your local social security office, you do simply that---you file an application for disability. The category from which your benefits may, ultimately, be drawn, though, will be determined by social security.

If you have earned enough work credits to qualify for social security disability benefits (that is, if you have insured status), then your disability application will be for SSD, or social security disability.

If you do not have enough work credits (and this may be the case for 1. minor children, 2. individuals who worked, but never became insured due to insufficient credits, and 3. individuals who were once insured for social security but have lost their coverage), then your disability application will be for SSI, or supplemental security income.

However, there is a third category and that category is called a concurrent claim. A concurrent disability claim exists when a person has coverage, or insured status, for social security disability, but, due to their earnings record, is expected to receive a small disability benefit (less than the full SSI monthly benefit). For such individuals, a concurrent claim for both social security disability and SSI may possibly be filed.

The thinking behind concurrent claims is that a person who qualifies for social security disability should be able to receive a benefit amount no less than the amount currently received by SSI disability beneficiaries---assuming, of course, that one meets the requirements of both the social security disability (title II) and SSI (title 16) programs.




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The Canadian Approach to Health Care....

The Canadian approach to health care seems to have some advantages. At least that's what you can infer from an associated press article written by Michael Stobbe and appearing on Newsday.com on 5/30/06.

Excerpts:

"Universal coverage makes it easier for more Canadians to get disease-preventing health services, she said."

"And nearly twice as many Americans said there were medicines they needed but couldn't afford (9.9 percent versus 5.1 percent)."


Maybe there is some appeal to living in the Great White North, eh?




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Social Security Administration to Speed Disability Payments to Recipients?

If you can believe it, an election-year bill in Congress reportedly and allegedly contains funding for this.

From the article by Richard Cowan, writing for Reuters:

"Regula (republican congressman from Ohio) said his bill also would add $184 million next year to help the Social Security Administration speed disability payments to recipients."

No details, unfortunately, on how they plan to put this designated funding to use for this purpose. But, who knows--all kinds of things happen in election years.




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The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

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The difficulty in reaching Social Security Claims Reps versus the need to protect them

Attorney Charles Hall has an excellent blog (Social Security News) but I have to disagee with something he said on a recent post: Protecting Social Security Employees.

In the post, Mr. Hall comments about an SSA notice of proposed rulemaking (NPRM) that would enable social security field office personnel to refuse to give out the desk phone numbers of claims reps.

He states "It is a little hard to figure out why Social Security employees would need to fear domestic violence when they are at work. It is so difficult to get through to any individual Social Security employee on the telephone that it would be almost impossible to make harrassing telephone calls to any SSA employee. Almost all SSA offices now have security guards to protect employees on the job.

Well, the reason it is so hard to get a claims rep on the line has a bit to do with the fact that they are literally being overworked with too many claims to process and too many daily appointments (I know what I'm talking about here---SSA's approach to agency turnover is to turn over the extra workload to remaining staff...and they are going to have a meltdown when retirements begin to really hit). But it also has to do with the fact that there are so many people constantly calling.

Let me state, I fully understand why claimants call the social security office as much as they do. They have requests for information and they are ENTITLED to receive answers. But the fact of the matter is, SSA does not staff their offices appropriately, and for this reason claimants, attorneys (meaning their staff personnel), and non attorney representatives often have difficulty reaching claims reps or getting them to return calls.

Social Security Disability and SSI disability claimants should be able to get information and answers from the social security office, but, ultimately, the blame for their inability to do so lies squarely at the feet of SSA management and congress which funds the agency. And it is extremely doubtful that the social security administration's approach to staffing field offices will change at any time in the near future. In fact, with record federal deficits and debt, it's damned unlikely that it will.

But it's not the fault of the claims reps who work in field offices. And it's undertandable that SSA would want to protect their claims reps and likewise protect their ability to get some work done. Unfortunately, the fact that it is currently so difficult to reach claims reps by phone is evidence in itself that claims reps would be deluged with calls if they were made more accessible to the public.

Finally, regarding phone harassment and the need for on-site security: Yes, they do receive a fair amount of harassment (again, it is fully understandable as to why people are often upset, considering how slow the system operates) and, yes, there is, unfortunately, a need for security personnel (you know, it's always the one bad apple).




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

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Bipolar Disorder, ECT, Social Security Disability

Here's a post from another blogger that I'd like to recommend, simply because reading and listening to other people's stories is didactic, particularly if you suffer from the same affliction.

The blogger is an attorney with Bipolar Disorder who is on ECT (electroconvulsive therapy). His claim for LTD benefits has been denied and he is currently in the process of pursuing social security disability benefits.

As he states, the ECT has been extremely helpful in treating his bipolar disorder; however, not surprisingly, he's suffering memory deficits. This is essentially the situation with my brother-in-law, who has been on out-patient ECT for about 2 years. In his case, the memory problems seem to be cumulative; that is, the longer the electroconvulsive therapy continue the worse his memory problems seem to get. In fact, just remembering how to get the movie theater he has gone to a few dozen times is a no-can-do. Hopefully, that won't be the case with this blogger. My brother-in-law does say, though, that even with the memory impairment, he's very glad he's received ECT, because the alternative (manic episodes, depression, and constant thoughts of suicide) was much worse.

Overwhelmed






Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

---

Looking forward to those golden years...Gulp! (retirement ain't what it used to be)

This is a depressing article, but there are several statistics that offer some food for thought.

Retired Seniors find little Security

Some of the stats that seemed especially depressing to me were as follows:

1. For about 7.7 million Americans older than 65, Social Security is the sole source of income, according to the Social Security Administration.

2. Many seniors -- nearly 3 million nationwide -- are turning to food banks to help stretch their budgets.

3. The U.S. Department of Agriculture said one in five low-income households with elderly members had difficulty affording food in 2004.

4. 35 percent of U.S. heads of households have never had a pension plan.


This is a loose tie-in to all of this, but the way our nation's demographics are headed (an older population with fewer young workers), I find it difficult to believe that we are not headed toward some form of socialized medicine at some point. I mean, how can it be avoided? My own in-laws are middle-middle income retirees, but even with health insurance, pensions, and a home that's free and clear, they get eaten alive by medication costs.

Of course, this is not how any of us idealize our retirement years. But for many, if not most of us, the reality is that, not long after we retire we begin to physically fall apart (and for some of us, this happens well in advance of retirement age). And, then, what we've managed to accumulate through savings and, hopefully, wise decisions, immediately becomes endangered.

Is this the American dream? To look forward to spending our last score of years minimalized? No, it's not. But it's why I expect we'll see some fairly profound changes to our society in the next twenty years or so. It will simply be unavoidable when so much of the electorate falls into the senior citizens category.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

---

Just when you think it can't get worse on disability benefits

Sometimes when I write a post, I'll mention the devastating financial aspects of filing for social security disability or SSI, because, as we all know, it's difficult to subsist without some form of income, and applying for disability benefits can be an incredibly long process.

However, even for those who do get approved, life is still no cakewalk. Let's face it, a disability check doesn't go that far. And being on disability means living a very limited life that, doubtless, is composed of bill juggling and all the stress and anxiety that comes with that.

Here's a post from another blogger who, without a doubt, is having it very rough. Just When You Think It Can't Get Worse! . As you'll notice, David's concerns include taking care of basic needs (such as food and utilities), the continuation of his medical coverage, and speculating about the possibility of returning to work.

Regarding the work issue, this is something that many individuals (whether they're considering filing for disability, have already filed for disability, or have been approved for disability) find themselves pondering...despite the fact that their condition causes a significant amount of pain and is easily aggravated.

However, returning to work on a limited basis can be a dangerous proposition for someone who receives disability benefits, particularly when it comes to maintaining medical coverage.

Related posts:

Social Security Disability SSI and the Health Insurance Issue

Social Security Disability Benefits and being scared shitless

Working while collecting Social Security Disability or SSI - It may not be worth it

If you already receive social security disability or ssi benefits, can you work ?

Social Security Disability and SSI: working while taking meds





Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

---

Disability Blogs and Disability Claimants

If you do a search on google's blog search (www.blogsearch.google.com -- still in beta, I believe) for the phrase "disability blogs", you'll find a number of references to individual disability blogs and lists of disability blogs. Visting a few of these blogs you'll find that some are focused on specific issues, some are used by their authors for catharsis, some are quite humorous, and some, to quote Rocky Balboa, just "fill gaps".

Unfortunately, most of these are of little to zero interest to most social security disability and SSI claimants.

"What!", exclaims the chorus of offended disability bloggers. "How dare you say such a thing!".

I dare.

Here's why: The vast majority (majority means most, though not all) of individuals who are in desperate need of being approved for disability benefits (I say desperate because when you have no income, no healthcare, no access to prescriptions and some possibility of losing your home, you're pretty desperate) care little about disability culture issues, disablism, ablism, or any one individual's desire to rant about this, that or the other thing (don't get me wrong, I certainly enjoy a good rant myself and also periodically enjoy reading other people's rants). Quite the opposite, they're looking for fairly specific information of a practical nature versus issue orientation.

Having said that, though, I can certainly recommend a number of the "other" types of disability blogs. Here are just a couple examples.

Disabilities Unlimited
(interesting writing and fairly informative)

The 19th Floor
(well written with a good sense of humor, such as the phrase for one
blog post "Because You Can Never Have Too Many Lawyers")











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
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---

Social Security Disability SSI Application and Hearing Tips: Describing your work

If you ask a social security claims rep (claims reps are the individuals who take your application for either social security disability or SSI) which part of the application interview takes the longest amount of time to complete, they'll likely tell you it has to do with getting a breakdown of the physical activities attached to a past job. In other words, how much time was spent sitting, standing, etc.

This part of the interview may be akin to pulling teeth simply because most claimants have never taken the time to think about the time-portions of their work day that were consumed by certain physical activities. Frankly, other than for the purposes of completing a disability application or answering questions at a hearing, why would anyone think about this?

But this type of information is relevant to a disability claim and important. Why? Because whether or not you are approved for disability benefits will likely depend not only on your physical and mental limitations, but also on the requirements of your previous jobs.

Remember: Eligibility for social security disability or SSI disability has very little to do with the names of your conditions, but, rather with---

1. What you are still capable of doing even with your condition (your residual functional capacity).

2. Whether or not your limitations will allow you to return to your past work (this is why it's important to know what you actually did on your past jobs)

3. Whether or not your limitations will allow you to perform a suitable type of other work.

According to one claims rep I know, disability claimants tend to minimize the demands of their previous jobs. But you should never do this, not when you file for disability benefits and certainly not when you appear at a disability hearing.

When it comes to describing your pain, symptoms, physical limitations, and mental limitations, NEITHER MINIMIZE NOR EXAGGERATE, but, rather, give honest and well-considered answers.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
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---

Who's that old guy?

Just the odd post here. I was sitting in a Barnes and Noble bookstore (usually pretty nice places with decent snacks, plenty of room, and, most importantly, wireless internet access). While tapping out a different post for this blog, I saw a fairly old soldier enter the store. Judging by his appearance, he was probably about 50. What's the significance of this? Well, if you have any familiarity with the U.S. army, you know that 99 heads out of a 100 will be reasonably young. Whether enlisted, warranted, or commissioned, most soldiers enter service between the ages of 18 and 24. And even if they remain in service for 20-22 years, they're still relatively young when they get out. That being the case, it's always noteworthy to see a soldier in uniform who has some years on him. In such cases, if he's enlisted, there's a possibility he's a Sergeant Major or perhaps even a Command Sergeant Major. If he's commissioned, you may be looking at a general, or a full colonel at the least. Of course, even in the civilian world, gray hair on a male confers a certain amount of status (a social phenomenon that many women have noticed and find quite irritating). But, in the military, being of a certain age and bearing a fair amount of gray confers even more. It is a signal of probable rank. No wonder a couple of the younger guys in the cafe seemed to adjust their seat position just a bit when the "old guy" walked by.




Additional information on Social Security Disability at www.disabilitysecrets.com










Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

---

Social Security Disability SSI: What is an on the record decision ?

"On the record decisions" occur after a request for a hearing before an administrative law judge has been made. And they happen in two basic ways. In some instances, a hearing office staff attorney will initiate an on the record review of a case that is pending a hearing date. In other instances, an attorney or non attorney claimant's representative will request an on the record review.

First off-- What is an on the record decision? Well, there's only kind of on the record decision and that's favorable. If an OTR review is done and no decision is made to pay a claim based on such a review, the hearing request process will continue to move forward, meaning that the claimant will still eventually be granted a hearing date.

Second-- Why are requests for on the record reviews made? When it's fairly apparent, based on a review of medical evidence, that a claimant's condition is disabling according to social security standards.

Favorable decisions that result from on the record reviews are, without question, wonderful news to disability claimants, because, in many cases, they can eliminate months of unnecessary waiting for a disability hearing. On the flip side, of course, on the record approvals display in full view the failures of SSA when it comes to properly adjudicating disability claims---because if a claimant's case is strong enough to be approved "on the record", why was it denied at the prior level (the first appeal step)?




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

---

Social Security Disability SSI: Two is (may be) an unlucky number

Earlier this evening, I was in a convenience store and the customer in front of me at the checkout register was asked by the cashier, "Are you sure you don't want to get something else?" Two pepperoni flavored slimjims were on the counter. For a second, the customer, a slightly disheveled-looking gentlman in his early thirties wore a blank look. Then, in the tradition of Eureka!, a realization flashed across his face. He said to the cashier, "You are so right. Thank you for reminding me. That is definitely an unlucky number.

For a moment as I watched this exchange, I wonder if I had suddenly been transported to a land of voodoo and superstition. Two is an unlucky number? I'd never heard of it. But, apparently, both parties ahead of me had. I watched the man select his third slim jim to ward off any potential ill-fatedness wrought by the purchase of only deux slimjims.

The purpose of this post: simply to relate this little anecdote. The tie-in? Well, in one sense, two can be an unlucky number in social security disability and SSI cases (you may sense that I am reaching, but I really do have a point). If you are not approved for benefits on your initial application, chances are likely that your claim will be denied on the first appeal as well.

Ok, perhaps this post is a bit lame. But it is, unfortunately, true that if you are denied on your social security disability or SSI application for benefits you will probably, at some point, need to appear at a hearing before an administrative law judge before you claim can be approved. That's not to say you can't get approved on your first appeal. But, typically, only 15-20 percent of those appeals get approved.

Now, has anyone else heard of two being an unlucky number?











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

---

How hard is it to find a lawyer or representative for a social security disability or SSI claim?

Believe it or not, though there are plenty of disability attorneys and non attorney representatives (non attorneys are allowed to provide representation on social security disability claims, which is a very good thing since many non attorneys are former SSA claims reps, DDS examiners, nurses, etc, and these individuals are often ideally suited to providing top notch disability claim representation) out there, it is sometimes difficult to find a representative who will take your case.

Over the last few years, I've probably spoken to several hundred individuals who informed me that several reps had declined taking their case (in fact, some claimants end up contacting legal aid after a number of attorneys or non attorneys have declined to offer representation). Why does this happen? Well, for several reasons.

1. Some disability reps will shy away from taking children's cases.

2. Some disability reps will avoid SSI claims (although with SSI withholding now, there should be less of this), preferring to take only title II (social security disability) claims, or even claims that are concurrent (meaning there is a social security disability and an SSI claim).

3. Some disability reps will deliberately screen their potential new clients to achieve a caseload that is skewed toward individuals who are fifty and over.

Why do some reps avoid taking such claims? To achieve caseloads for which the probability of winning averages 90 percent or higher. However, to quote one practitioner I've known for several years, "Where's the challenge if you're only taking slamdunks?". He also had this to say, "You're not helping people if you automatically screen out certain types of cases."

Despite this, a social security disability or SSI disability claimant will usually be able to find representation, though in some instances, it may just require making a fair number of phone calls.


related post: Come one, Come all ! -- Reps who take any and every Social Security Disability or SSI case -- a good or bad thing?




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
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---

Social Security Disability SSI and Bad articles

(as with so many posts on this blog, the point of the post comes at the end)

I came across an article on bipolar and, since my step-son, brother-in-law, and mother-in-law all have bipolar disorder (still don't think there's a genetic component to this condition?), I decided to take a look. But after a second, I realized it was mainly a promotional article for someone's guide to winning social security disability benefits.

I won't mention the name of the author or the name of the publication. I won't even mention the fact that the publication (an E-book) is written by a chiropractor (oops) or the fact that the social security administration does not accept records from chiropractors since chiropractic records are not considered medical evidence.

Having said that, it is possible that this individual's publication is potentially useful. The fact that chiropractors are not medical doctors should have no bearing on the ability to provide information that is helpful to disability claimants. Medical training, though potentially helpful, is simply not relevant to social security disability and SSI claim adjudication. In fact, even disability examiners who make initial claim decisions and decisions on reconsiderations have zero medical training (they are trained to read medical records and adjudicate in the SSA environment).

So, the fact that a chiropractor would put together a guide to winning disability benefits does not seem quite so strange. What does strike me as strange is that a chiropractor has assembled a guide to winning social security disability benefits for bipolar patients. When I think of chiropractors, I think of manipulation and adjustments, not psychiatry or counseling...But, perhaps this chiropractor has some knowledge of this condition (perhaps via a family member or through personal experience) and also SSD and SSI claims apart from the practice of chiropractic. Who knows.

Now, the point of this post. The review/promotional article (whatever it is) states that this e-book is "the perfect compromise: a far greater amount of help and support for disability claim success than the claimant would ever get at a local Social Security office. . .without the substantial expense of a personal advocate."

Oh, boy. That's an interesting line. And it demonstrates a great disconnect in logic. For starters, individuals who work at social security field offices do not have advocacy as part of their assigned duties. And to state that an e-book is a great fill-in if you don't want to hire an attorney or non-attorney disability representative is a preposterous statement (Believe it or not, some people think they're doing themselves a favor by going to a hearing unrepresented; that is, until they get a denial notice and realize that maybe, just maybe, they should have gotten representation---don't get me wrong: you can win without a representative...but your chances of winning without representation go down considerably).

Anyway (handily referencing the title of this post), that is definitely a bad article.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
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---

Social Security Disability SSI: How can you win a case if you don't have health insurance and can't get seen by a doctor ?

This really has to be one of the worst problems that claimants who are filing for social security disability and/or SSI disability benefits have to face.

The way the disability system is setup, a disability claims examiner or a disability judge will often have difficulty approving a claim for ongoing benefits if a claimant or the claimant's representative cannot produce recent medical documentation. How recent? This varies, per the adjudicator and often varies according to the types of impairments that a claimant presents with (i.e. the prognosis and outlook for some impairments is not likely to change). Generally, though, the last dated records an adjudicator examines should probably not be older than 2 or 3 months.

However, this is a problem for a sizeable percentage of individuals who are pursuing social security disability and SSI claims. And this blog excerpt expresses the frustration that disability applicants feel:

My lawyer told me it wasn't worth it, they'd go by what the judge said. Her advice was now that I live in California get new doctors who document every little symptom even better. Of course with no insurance and the only way to get into the ability to pay neuro clinics, that is proving to be nearly impossible so far.

How do you go to a doctor on a regular basis when you no longer have health insurance? In most cases, you can't. True, sometimes a physician that you have a treatment history with will continue to see you, but, more and more, doctors are turning away patients who have lost their insurance. This leaves disability claimants in the position of having to go to emergency rooms (which often provide a deplorable level of care), health departments, and free clinics (which often are very limited in their resources).

Unfortunately, there don't seem to be any easy answers out there regarding this scenario that so many disability claimants find themselves in (my own personal opinion is this: with American demographics leaning heavily toward an aging population, some form of socialized medicine is probably inevitable--obviously, laissez faire economics and the free market are not "cutting it"). But...this makes it so much more important to maximize one's chances from the beginning of the social security disability and SSI process. How do you do this? Well cover this in a following post.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Attorneys - what you should know
The purpose of the Social Security Disability SSI medical exam
Application for social security disability
Disability for Diabetes

---

Are you automatically denied for Social Security Disability or SSI when you first apply with an initial application ?

I've probably heard a hundred variations of this granule of commonly accepted wisdom regarding social security disability and SSI. Generally, the comments go something like this:

"Well, I expected they would deny me since they always do the first time"

"I know they never approve you on your first application, that's why you have to keep filing over and over until you get it"

"Is there a rule where they have to turn you down first before they can approve you?"

Point of fact: there is no SSA rule that dictates that title II (social security disability) or title 16 (SSI, or supplemental security income) disability claims must be denied on the first application, or X number of times before a claim can eventually be approved.

Why has this become folklore? Because so many cases do get denied at the intial application level. According to federal statistics, in 2003 about 63 percent of all initial claims were turned down. That, of course, is a national statistic which is an average. In some states, denial rates were 70 percent and over for that year. In fact, in the state of Mississippi, in 2003, nearly 73 percent of initial claims were denied.

Accentuating this myth, certainly, is the fact that claimants who filed their first appeal (now called a reconsideration, in future years to be called a review) were denied at even higher rates (yes, denial rates on first appeals are generally higher across the country).

Nonetheless, it is not standard operational procedure for disability claims to be turned down at the initial application level, or at any level. It is simply a depressing reality of the SSA disability system.

The thing to keep in mind is this: if you are filing for social security disability or SSI, you stand, on average, about a 30 percent chance of being approved on your initial claim. If you are denied on your initial claim, you should definitely file an appeal. Your first appeal, however, will stand an 80-85 percent chance of being denied. But, if your pursue your claim to the point where you can have your case presented to an administrative law judge at a disability hearing, you will a much better chance of being approved for benefits.

1. Without representation, you will have a better than 40% chance of being approved.

2. With attorney or non attorney representation, you will have a better than 60% chance of being approved.

So, if your claim is denied, it does not mean that your claim is without merit and it does not mean that you will never receive disability benefits. What it will mean, though, is that you will be more likely to win your claim if you follow the appeals process and, at some point, obtain qualified representation.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
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---

Expediting the Social Security Disability and SSI application process

Again, this is from the same press release that was mentioned earlier (a couple of posts back) with regard to veterans benefits.

" The goals of the Commission, once CNA has conducted its data collection
and analysis, are to improve outreach, expedite the SSDI application and
examination process, and to explore federal certification, which could lead
to a single disability exam for all veterans."

I hate to put it this way, but this sounds like a bunch of malarkey. Unless congress wants to amend the social security act and create a separate social security disability and SSI disability evaluation track for veterans, good luck on such "goals". Simply put, SSDI and SSI claims fall entirely under the purview of the social security administration and this is not likely to ever change, nor is it likely that social security disability and SSI claims for veterans will ever be handled in any way, shape, or form any differently than such claims are handled for civilians.

In fact, under the new SSDI - SSI system that will receive it's trial run in the social security administration's boston region (most of the new england states)on 8/1/06, there are provisions for attempting to move cases faster by identifying those claims for which it is "obvious" that a claimant's condition is "disabling".

But this notion of quick disability decision units is not likely to have more than a neglible effect on the process, if that, simply because, from the standpoint of disability claims examiners, there is no such thing as an obvious state of disability; meaning, you still have to request medical records and read them before you can actually know what's wrong with a claimant and whether or not they qualify for benefits. And that's exactly how the process works now.




Additional information on Social Security Disability at www.disabilitysecrets.com










Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
Disability for Bipolar Disorder

---

Does everyone hate PDF files, or is it just me?

In this regard, I really doubt it is just me. Listen, I have a fairly fast PC with plently of memory and I use a cable modem. Nonetheless, everytime I click on a search engine link without realizing that the link is to a PDF (I believe the acronym stands for portable document file), I feel sick as soon as I realize what I've done. Why, you ask? Well, if you've ever clicked on a PDF, I shouldn't have to explain, because you are acquainted with the experience of having your computer freeze up while the acrobat reader program loads. While this is happening, of course, you can't tab over to something else to "ride out" out the wait and you might as well forget about using the back button on your browser which will be rendered temporarily useless.

I hate PDF files with a passion. Not just because of what I've just said, but also due to the fact that these stupid things are HARD TO READ. And scrolling through multi-page PDF stuff is no picnic.

Guess what? I'll bet you the price of a hamburger that when claimants or disability reps want a copy of the file to view...it will probably be on PDF. Can you imagine having to try to view a quarter inch to one inch thick file this way. I guess paper, which allowed you to easily take notes and flip forward and back...was just too old fashioned.

Maybe files won't be on PDF, but I bet they will be. Because that's the smartest thing that the federal government can think of. And, of course, they're not that smart. And if that's the case, how many judges and reps will just start printing paper copies anyway.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
Disability for Bipolar Disorder

---

Paul Gleason has died at age 67

People from my generation (funny the way that sounds, almost as if I have some age on me) remember Paul Gleason from the movies Trading Places and, especially, from The Breakfast Club.

According to this BBC News article (original source: US character actor Gleason dies ), he died from a rare form of lung cancer, one linked to asbestos.

Asbestosis and mesothelioma are both linked to asbestos exposure. Regarding the latter of the two, mesothelioma (in most cases, it takes the form of pleural mesothelioma, a cancer of the protective lining of the lungs) is basically a death sentence. Typically, patients who receive the dreaded diagnosis survive little more than a year.

How do you get mesothelioma? Well, the medical community speculates that nearly any level of exposure to asbestos fibers can lead to an individual developing the disease. And the incubation period for this illness can be as long as 40 years.

Interesting note: Mr. Gleason was a minor league ball player before he turned to acting.











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
Disability for Bipolar Disorder

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Social Security Disability SSI and Veterans Benefits - the effect of the web

Recently, it became known that the implementation of an offset, with regard to veterans benefits and disability benefits from the social security administration, was under consideration. The news spread like wildfire, of course, among websites and blogs that have an interest in (and keep a watchful eye over) such issues.

Well, according to a May 24, 2006 press release (source: http://www.vetscommission.org), "In a show of hands vote of 11 to 2
at its May 19th public meeting, the Commission agreed to adopt a motion to
clarify that there would be no mention or question of an offset of VA or
SSDI benefits and to limit data collection from the Social Security
Administration and SSDI in several key ways."

Apparently, the "trial balloon" that was floated regarding a possible offset met fairly stiff wind resistance from a number of sources. And those who disseminate and pass information along using various internet conduits (personal websites, article submissions, blogs, forums) most likely (I have no doubt myself) played some role in this.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
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Filing a Social Security Disability or SSI appeal online

If you need to file a social security disability or SSI disability appeal, you can do it the standard paper route. Just make sure you 1. request the appeal within 60 days of the date of your last denial, 2. submit the paperwork within the 60-day time frame alloted to you (it's actually 65 days since the social security administration allows you an extra five days for mailing time), and 3. certainly make sure that you keep a copy of everything you submit for yourself (when it comes to paper, SSA has this nasty habit of either not receiving what you've sent, losing it, or claiming to have lost it).

Paper appeals will probably always be an option for SSD and SSI disability claimants, simply because, though most people are now online, there will always be a percentage of the population that is not. Also, since applying for disability benefits and filing disability appeals can be an extraordinarily long process that exacts a heavy financial toll on claimants (not having income for a year or more can have this effect), claimants who could previously afford the cost of internet connectivity may not have this option at a later date.

But, claimants who are net connected may wish to consider filing their disability appeal online. What advantage would there be in this? Well, let's examine how the process used to work and how it currently works.

Social security claims reps used to receive all appeals on paper (...since that was the only option available). Now, though, since SSA has moved into the electronic age, disability appeals become part of a claimant's electronic file. This is completely automatic if a social security disability or SSI disability appeal was filed online because, by default, it becomes part of the electronic file. However, appeals that are sent in on paper have to be manually entered by social security claims reps.

Social security claims reps HATE THIS.

Why? Here's why. When claims reps are in the position of transferring into the computer all the information that is recorded on a handwritten paper appeal, they have to do exactly that. They have to record everything, exactly as the claimant wrote it. No matter what the claimant wrote, how much the claimant wrote, or HOW the claimant wrote it (some people write book length answers to questions and some people, like myself, have handwriting that looks, at best, like drunken chicken scratch).

This presents a nightmare for a claims rep, a nightmare that did not exist when all appeals were filed on paper, but which now exists because paper appeals must be manually entered by claims reps into the SSA electronic folder system.

So, what happens when an appeal is received on paper at a social security field office versus being submitted online? Well, having some knowledge of human behavior and the fact that most people will tend to avoid tasks that require more work (and which piss them off), I would hazard to say that paper appeals...tend to get less TLC from claims reps, i.e. they don't exactly receive "high priority status" (this has also been relayed to me by field office personnel who, for obvious reasons, will remain unnamed).

So, if you have the inclination and the ability, you might want to consider filing your social security disability or SSI appeal online.

And, if you are an attorney or non attorney representative for disability claimants, you really should be filing your appeals online, simply to get your appeals out of the DO or FO faster and on to the state agency (in most states, known as DDS, or disability determination services).




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
Disability for Bipolar Disorder

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People with developmental disabilities can't change - or can they ?

"It belies the myth that people with developmental disabilities can't change"

This is a quote from a documentary on Kim Peek, the individual on whom the title character, Rain Man, was based. Kim is, of course, an autistic savant with extraordinary memory abilities, to the extent that he remembers nearly every fact he is exposed to. And Kim's abilities are so impressive that there may only be about 50 people on the planet whose cognitive talents approach his.

Interesting facts about Kim:

1. Until his early thirties, he was classified as mentally retarded.

2. He has agenesis of the corpus callosum, meaning that the thick bundle of nerve tissue that connects the two hemispheres of the brain in most people does not exist in Kim's brain.

3. Kim has a very limited ability to understand metaphors. So, if you were to say to him, "Get a grip on yourself", he would take the statement literally and begin to grab himself.

4. Give Kim any date in history and he can instantly tell you on which day of the week the date occurred.

5. Unlike most savants who seem to specialize in one area (such as an extraordinary ability to replicate music or draw), Kim seems to soak up data...about nearly anything and everything.

The documentary on Kim (on science channel) was fascinating. But I have to admit, after watching the incredible talents of a savant being demonstrated, I was surprised to hear him described as developmentally disabled. Of course, he certainly is. At 52, he must rely on his father to help him with basic activities of daily living, such as brushing his teeth. But, it just shows that the term developmental disabilities includes a bit more than we commonly conceptualize.

The quote, by the way, is a reference to the fact that, though Kim is now fairly social, at the time Rain Man was being produced he had difficulty even looking another person in the eye. Now, he addresses people in numbers great enough to fill lecture halls.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
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Social Security Disability or SSI and more than one medical problem

It is actually somewhat rare for a disability application to list only one physical or mental impairment. In most cases, an applicant will cite more than one condition whose symptoms contributes to their state of disability.

Does it affect your disability claim if you have more than one medical problem ? I've come across this particular question more than once so I thought I would address it.

From from the standpoint of a disability examiner (disability examiners work in the state agencies that handle initial ssd and ssi disability claims for the social security administration), whether an applicant lists one condition or several makes no real difference at all.

This is simply because the way SSA disability claims are decided, the emphasis is on what a claimant is still capable of doing despite the limitations that are caused by their condition (or conditions). Therefore, what a claimant has, i.e. diagnosed medical problems, is not the overriding factor in the the evaluation process.

And, of course, since disability examiners and the social security disability system itself are intently focused on the concept of residual functional capacity, what a disability examiner looks for when reviewing medical records has more to do with objective signs of limitations versus names of conditions. And this information is then translated into an assessment that is labeled as RFC, or residual functional capacity.

Now, you may have noticed the mention of the word "objective" and if you've read this blog before you may recall the assertion that was made regarding objectivity. In essence, the statement was that the social security disability and SSI disability decision-making process is not objective, but, instead, subjective.

How do you turn objective evidence into subjective decision-making? Basically, the same way a referee makes a call in a game. What happens during a play is objective. How the referee sees it and calls it, though, is subjective. In other words, though a disability claimant's medical records may be objectively stated, how the records are interpreted depends on the reviewer. And this, of course, is one of the chief problems of disability adjudication: there is a huge disconnect between cases that are decided at DDS and cases that are decided at disability hearings.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Applying for disability on the basis of Back pain
If your condition is disabling, file for disability as soon as possible
Doing a disability appeal - you should appeal if your claim is turned down
Bipolar Disorder and disability benefits from the social security administration

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Social Security Disability and SSI: working while taking meds

I thought I would start off this post with a little jingle (to the tune of Simon and Garfunkel's "sounds of silence").

Hello back pain my old friend
You're hear to urk me once again
Because I lifted and while leaning
I heard a pop and started screaming
And the pain that was planted in my brain
Still remains
Within the L5-S1 area of lumbar degenerative disc traumatic violence

Ok, I guess we know now that a song writer, even in the tradition of Weird Al Yankovic (what's he up to these days, I wonder), I shall never be.

Point of this post? I am once again beset with significant back pain. Not the kind that people file for disability for, of course, but back pain of the moderately painful sort. And, once again, I am taking pain meds. And once again, the effect of the meds is such that they make me just a wee bit less than fully lucid.

The thought occurred to me: it's a shame that social security disability - SSI claims examiners aren't trained to take this into consideration (and trust me on this, they aren't and don't). Because if you have significant back pain and you're forced to take analgesics or narcotic analgesics, the meds can definitely affect your ability to concentrate and process information. And this can certainly affect job performance and even one's ability to do a job.

Personally, when I take flexeril, I'm out (as in groggy and not with it). Today, I didn't even take flexeril, but just the actual pain meds. Well, in some cases (everyone reacts to meds differently, that's why we have so many), even those are enough to detract from one's ability to engage in daily job-related functions.

But, the fact (imo) that disability examiners fail to plug such variables into the equation when "concocting" a claimant's residual functional capacity rating is not surprising. After all, the system gives relatively little consideration to pain, as well.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
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Rheumatoid Arthritis and the increased risk of cancer from certain drugs

Liz Szabo of USA today writes in a recent article about the increased risk of cancer from the drugs remicade and humira. Both drugs are used to treat rheumatoid arthritis, an autoimmune disorder and inflammatory disease. According to her headline, the additional cancer risk posed by the use of these drugs is small; for every 154 patients who take the drugs, 1 patient may develop cancer within six to twelve months. True, that's less than one percent and these drugs are truly needed by patients with rheumatoid arthritis, crohn's, and psoriasis. But here's to hoping that medical research can develop even better drugs to decrease the cancer risk. Because, personally, I'd hate to be the one out of 154 who wound up the unlucky lottery winner.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
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Social Security Disability SSI, Bipolar, Alzheimer's and Schizophrenia

A short piece by Michelle Healy of Wire Reports states that four and a half million Americans have alzheimer's, that this number could exceed sixteen million by mid-century, and that half of all people over 85 will develop alzheimer's. Developing alzheimer's is a scary proposition, no doubt.

Reading the article, though, made me think of two other conditions, bipolar disorder, and schizophrenia. Both of these conditions are progressive as well. And from the standpoint of arresting further damage, medication compliance is very important.

Compliance with meds (taking one's meds as prescribed), though, is a big problem for disability claimants. Many claimants who had health insurance coverage when they initially filed for disability benefits no longer have such coverage at some point in the process. And, without it, they find it extremely difficult (and often impossible) to:

1. Get prescriptions filled.

2. Obtain needed medical treatment.

Without a doubt, this can be a bad situation for a person whose condition, mental or physical, is deteriorative in nature. Medications can be vital for arresting continued declines. For disability claimants, though, a lack of health coverage presents a double whammy since medical record documentation is needed to prove one's state of disability. And, of course, those records aren't generated if you can't go to the doctor.

It's very common, of course, for disability claimants to go to an ER for treatment, or to county services, the health department or a local free clinic. But I doubt many would argue that the level of care received in such places can take the place of an established, ongoing patient-doctor/therapist relationship. And the medical records that are generated in this manner tend to be "thin".




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
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Social Security Disability SSI - Reapplying is NOT the same thing as appealing

A woman in texas posted on her blog that her 62 year old husband who has rheumatoid arthritis and a heart condition has been unable to get approved for disability benefits. She's even planning to build him a wheelchair ramp and get him portable oxygen. That's how bad his condition is.

You can make all the structural changes to the disability system that you want, but unless you do something to get rid of decision-making like this, I'm not really sure how much good it will do.

The new plan being instituted by the Social Security Administration Commissioner is touted by SSA as the kind of reform that will get rid of bonehead decisions that deny 62 year olds with very significant health issues. And the plan calls for quick decision units whose mission will be to work on disability cases that are "obvious". However, as every individual who ever worked on a disability claim knows, disability claims are not obvious.

What do I mean by this? That even if you send a case to a quick decision unit, the examiners will still have to order the medical records and apply the same evaluation process to the claim. So, what does that change? NOTHING.

And how do you identify a case that should go to a quick decision unit anyway? Will someone at the social security office do this? Quess what? They're not trained to do that. They take claims. They don't process them. They don't read and evaluate medical records.

The commissioner's plan to make the social security disability and SSI disability system more equitable is smoke and mirrors. If you really wanted to FIX the problem (And they don't. They're simply trying to make it more difficult for people to get approved and in future posts we'll deal with that), you would spend the required amount of money it would take to put more warm bodies into the system. For the social security disability system, that means more disability examiners, more social security field office claims reps, more hearing office support staff, etc.

And you'd also have to alter the quality review process on cases so that there is not an institutional bias toward denying claims. That's actually the most important item on a reform "hit" list. Hiring more warm bodies would push cases faster so people with disabilities wouldn't have to go broke and file for bankruptcy while they wait on the benefits they are entitled to. But to make sure that ridiculous decisions become a thing of the past---for that you have to get rid of some problems that have become institutionalized. In other words, fix a system that punishes disability examiners for making too many approvals on disability cases. *Note: regarding bankruptcy, please remember that this is the same administration that thinks that average citizens should not be entitled to bankruptcy protection while the Donald Trumps of the world can file for bankruptcy protection every other month (which I think he does).

Oh, here's the point I was actually trying to make on this post. The woman in her blog stated "He said he will keep reapplying every 60 days".

Remember: filing new applications is NOT the same thing as appealing a denial. In almost all cases, unless you received a "technical denial", you need to appeal when you've been denied.

Related posts:

Should you appeal a disability denial ? How do you do it ?

Appeals for social security disability and SSI

Changes to the Social Security Disability and SSI Disability system that disadvantage claimants

How many Social Security Disability and SSI claimants do not file an appeal ?




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
Disability for Bipolar Disorder

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The purpose of the Administrative Law Judge in Social security disability and SSI cases

There are, no doubt, many thousands of stories out there about disability judges who were terse, rude, judgmental (no pun intended) and who simply made bad decisions on claims brought before them. And I would not argue with any of them.

However, the fact remains: every claimant who goes before an ALJ has been denied on an initial social security disability or SSI claim and on a first appeal. And roughly half of all claims that are taken to disability hearings...are won by claimants and their representatives.

Because of this, I think it is reasonable to say that the ALJ (administrative law judge) serves as an equalizer, of sorts. At this point, you may be thinking of the old TV show, starring Edward Woodward (he was better in Breaker Morant, by the way). But it's true, without a doubt.

When I was a disability examiner, we used to speak about the great differences in approval rates; that is, cases approved at DDS and cases approved at hearings offices. Unfortunately, most examiners were of the mind that ALJs approved far too many claims (which recon examiners had denied).

However, in my opinion, the examiners who thought this way suffered from tunnel vision. They were unable to view the system in ways other than those related to their job function.

The truth is, how you look at a disability claim and how you look at the person filing the claim probably depends a great deal on whether you actually meet the person.

Disability examiners do not meet the indivduals whose claims they are deciding. Disability judges do. To an examiner, a claimant is a file, a job, a performance statistic for one's annual evaluation. And to some extent, this may be true of judges. But judges meet the individuals whose fate they decide. And because of this, for at least a few minutes, the file has a face.

(Remember, disability evaluation is not an objective process. It is subjective and statements to the contrary are wishful thinking at best, and lies at worst---if it was objective, judges would not be overturning so many prior denials)




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
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SSI Appeal

A while back I came across this question: "I know how to file an appeal for social security disability, but how do I file an SSI appeal".

The question this individual asked points to a somewhat common misunderstanding about the disability programs that are mandated by the social security act and operated by the social security administration.

First, I'll just cut to the chase: How do you file an appeal for SSI disability? The same way you file an appeal for social security disability. There is no difference. In fact, when it comes to processing a disability claim with the social security administration, there is no difference whatsoever between SSI and social security disability.

Now, if you're thinking to yourself "Wait, I was told that social security disability and SSI are two separate programs", yes, they are two separate and distinct disability programs. Social security disability (also known as SSD, SSDI, RSDI, DIB, and title II benefits) is for individuals who have worked and earned enough quarters of coverage to be insured for...you guessed it, social security disability benefits. SSI, on the other hand, provides disability benefits to individuals who either 1. never worked and earned enough coverage quarters for SSD, or 2. were once covered for SSD via their earnings, but, whose coverage has lapsed (which can happen if you've not worked in a long time). , The definition of SSI, of course, means that this is also the social security administration's disability program which provides disability benefits for minor children.

Are there other differences between SSI and SSD? Yes, individuals who are approved for SSI will typically, depending on the state in which they reside, receive medicaid benefits while those who are approved for social security disability will receive medicare benefits two years after their date of entitlement. Also, SSI, since it is a needs based program, is subject to asset limitations (you cannot have more than two thousand dollars in countable assets) and the income of a spouse of an SSI applicant / recipient will count to some extent (this is called "deeming") when it comes to determining eligibility.

Obviously, SSI and social security disability are separate and distinct programs. However, none of that makes a difference when you file an appeal. Why? Because when you originally file for disability, you are simply doing that: filing for disability.

From an application standpoint, the distinctions between SSI and SSD are chiefly for the purpose of deciding which category to put your claim in. But, aside from that, the differences are hardly worth noting (i.e. SSI and SSD claims are processed the same way, evaluated the same way, handled the same way---nothing changes).

So, back to the question with which we began: How do you file an SSI appeal? Answer: the same way you file a social security disability appeal. You simply contact the social security office and let them know (assuming you have just received a notice of denial) that you need to file an appeal. At that point, they will send you the appropriate appeal forms which you will complete and return to them. If you have an attorney or non attorney handling your case, by all means have them do your appeal for you. Lastly, you also have the option of filing your SSI appeal online, though your attorney or non attorney representative can do this for you as well.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
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Should you appeal a disability denial ? How do you do it ?

Should you appeal a disability denial? It's a valid question. Individuals who have been involved in the disability system for quite a long time, either as claims examiners, SSA claims reps, and attorney and non attorney claimant's representatives, might be tempted to handle this question in a brusqe manner. However, what many disability insiders sometimes loose sight of is the fact that for every claimant who has initiated their first disability claim, the system is not only complex and hazy, but entirely new to them.

So, to answer the question, should you appeal a disability denial?, the answer is: yes, in almost all cases you should definitely file an appeal. And here's why.

If you choose not to file an appeal following a disability denial, you will (assuming you wish to further pursue your social security disability or SSI claim) be forced to apply again, that is, file a brand new application. This is, in almost all cases, a mistake since a new SSD or SSI disability application will simply be sent back to the same agency that issued the prior denial. In most states, this agency, which handles medical determinations for the social security administration, is known as DDS, or disability determination services. And the individuals who work on disability cases there are known as examiners. By filing a new claim following the receipt of a denial, your application will be sent to DDS again, probably to a different examiner, but the decision you receive will very likely be the same: a denial.

Amazingly, many individuals choose to file brand new social security disability and SSI disability claims over and over versus doing an appeal. And, predictably, their cases are turned down over and over (and over).

The best course of action following a denial on a claim is to appeal. Why? To ultimately get your case out of the hands of DDS (which has a culture of denying disability claims) and into the hands of an administrative law judge at a disability hearing. Statistically, more than 40% of individuals who go to disability hearings unrepresented win their claims. This fact alone makes it obvious that a disability claimant who has gotten a prior denial should do an appeal. However, individuals who go to disability hearings with representation (in the form of an attorney or non attorney representative) have a greater than 60% chance of winning social security disability or SSI disability benefits.

...But you can only get to a hearing if you follow the appeal process which, ultimately, will put your case in front of a judge. Should you file an appeal if your claim has been denied due to medical ineligibility? Yes, without a doubt.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
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One of the inherent problems of disability claim adjudication

Let me just start this post by saying this: social security disability and SSI disability claim adjudication is not an objective process. It it was, you wouldn't see such remarkable differences in decisional outcomes for claims that are decided at DDS (disability determination services) and claims that are later decided at the hearing level. In fact, when I was a disability examiner, we used to joke that if you had a case you really wanted to get approved, but were fairly certain that your unit's medical consultant and/or supervisor just wouldn't go for it, you needed to find some way to send it to another unit's doc for an RFC. Because the truth was, some medical consultants were more (or less) likely to lean toward approvals. Sometimes, this was the result of laziness on the part of the medical consultant (i.e. doctors who never bothered to read an examiner's writeup and who simply signed anything put in front of them). And sometimes this simply amounted to a difference of opinion.

However, because the social security disability - SSI system is not entirely objective and somewhat subjective in nature, human emotional dynamics can sometimes exert an influence. Here's an excerpt from another blogger's post. This was an individual who had filed on the basis of cancer and whose case had been denied (sadly, this is not an isolated occurrence -- I can remember the case of a person with brain cancer who later died who was denied on his initial application and on his first review before being approved for a judge). Fortunately, the claimant's case was heard by an administrative law judge who may have been able to relate to the claimant's medical condition in a personal way.

The judge that we'd been assigned was just coming back off of leave and my case was the first one he was due to handle. I'm sad to say that the reason why the judge had been on leave was because his brother had suddenly died of cancer. He took a look at my files before my attorney was going out to call me in before him. He read a few of the reports and closed it back up. He told the attorney not to bother bringing me in to testify because he couldn't deal with going through the rigamarole just to approve the case. He was a bit upset that the case had to get all the way to this step before it was approved given the fact that there had been no guarantee that I'd even survive long enough to make it to the hearing.


Regarding empathy or the lack of it in the system, here's a somewhat related post from this blog: The least empathetic cog in the Social Security Disability evaulation system .




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
Social Security Disability SSI Degenerative Disc Disease and Back pain
File for disability
Disability appeal information
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To those who wish to make it harder for disabled individuals

...if you could walk in their shoes for just a day or so. Living on disability is obviously no walk in the park.

This is from someone else's blog, and I think it makes the point very clearly to those who find it budgetarily vital to make the social security disability system even more hostile and deny even greater numbers of claimants:

"I am on social security disability for a lower back problem and chronic fatigue syndrome and I live on 600.oo a month which is not much. I am a single woman and I live in an apartment in washington state with two cocker spaniels and a cat. I am tired of living on disability and not being able to pay off all of my bills and take trips and buy a home or new clothes or anything else I want to do in my life. I would love to have more money than I know what to do with and get off social security forever. To not be embarrassed when someone ask me what I do for a living. To leave money for my family when something happens to me. To be able to meet new people and make new friends."





Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
How much can I earn and still receive Disability benefits ?
File for disability

Disability status
Disability back pain

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If you are turned down and denied for disability

If you've been turned down for disability, that is, if your claim for social security disability or SSI benefits has been denied, you should probably file an appeal and do it as soon as possible.

I say probably because there are a limited number of instances in which it may be better to start over with a new disability application. For instance, if you received a technical denial (The type of denial that occurs when your medical records were not even evaluated. To use an example, if you were denied because you were working at the time you filed a claim).

However, the types of situations in which it would be preferable to complete a new disability application versus filing an appeal are fairly limited. In most cases, a claimant will maximize the chances of eventually winning benefits by following the appeal route.

How quickly should you file your appeal if your claim has been turned down? As s-o-o-n as possible. The social security administration will allow you 60 days in which to get your appeal paperwork submitted. But, obviously, your appeal cannot be processed and worked on...until it has been submitted and received. So, by all means, get the appeal forms sent in ASAP.

Is it necessarily a bad sign if your disability case gets denied? No, in fact the majority of all individuals who file for disability benefits are denied on their initial application. And an even higher percentage of those same individuals are turned down on their first appeal. Once a case gets to a hearing before a federal administrative law judge, however, the chances of winning are nearly half and half without representation, and better than sixty percent with representation.

In other words, if your disability claim is turned down, it does not mean that you will not eventually receive an approval for benefits. You may simply have to wait a very long time to receive your monthly benefits and whatever backpayment you are entitled to receive.

Unfortunately, many claimants make the assumption that their social security disability or SSI disability claim will be approved soon after they apply and plan with this assumption in mind. This can, in certain instances, be detrimental in a financial sense (and sometimes it can simply have disastrous consequences). Instead of doing this, an individual pursuing a disability claim should:

1. "Play it safe" by assuming that their claim will be denied on the initial application and on the first appeal

2. And make financial plans accordingly.

In other words, planning for the worst case scenario may leave you better prepared and even pleasantly surprised in the event your claim is approved earlier in the process.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
How much can I earn and still receive Disability benefits ?
File for disability

Disability status
Disability back pain

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The purpose of the Social Security Disability SSI medical exam

A fairly high percentage of individuals who file for either social security disability or SSI disability benefits will be required to go to a medical examination by the social security administration. Unfortunately, many, if not most, disability claimants do not understand the purpose of such an exam, why it has been requested, or who the medical examiner conducting the exam really is.

First of all, let's deal with proper terminology. Social Security Disability medical exams a.k.a. SSI medical examinations are actually called CE exams. CE stands for consultative examination.

Who schedules CE exams and what is the purpose of a CE examination? Consultative examinations are requested by disability examiners (examiners handle initial disability applications) and also by administrative law judges at the disability hearing level. The purpose of such an exam is typically to obtain medical record documentation in situations where:

1. Additional information is needed to properly adjudicate a claim (for instance, for a respiratory allegation, a breathing test may be needed, or a claimant with arthritis may be sent to an xray exam if xray reports are not available in the claimant's own records).

2. Disability claimants simply have not been to a doctor recently (examiners, in particular, need recent medical evidence in order to determine if a claimant's disability exists in the "here and now").

In either case, the scheduling of a "social security medical examination" implies that additional information is required for an adjudicator (a disability examiner or a disability judge) to arrive at a decision. And, typically, the implication is that an approval will not be possible without obtaining additional records (consultative examination reports count as medical record documentation).

Who performs social security medical exams? These examinations are peformed by independent physicians and psychologists who have contracted to examine disability claimants and provide written reports afterward. In other words, despite the assumptions of many, the doctors who perform such exams are not social security doctors. They are not employed by SSA, but, rather, are independent contractors who are paid for services that are rendered. Consultative exams, of course, can be physical in nature, or psychological (IQ testing) or psychiatric in nature.

How long does a consultative exam last? This can depend on the type of exam a claimant is sent to. Examinations for physical allegations can be relatively brief (fifteen minutes is not abnormal), while a mental exam can take considerably longer due to the auditing nature of a psychological or psychiatric examination.

Here are a few other points to keep in mind regarding CEs, or consultative examinations:

1. Social security medical exams are not for the purpose of rendering medical treatment.

2. Disability examinations that are scheduled by a disability examiner or a disability judge are mandatory and failure to attend can result in a decision based on existing evidence---or the closure of a case (for a failure to comply).

3. Physicians and psychologists who perform consultative exams are generally required to submit the results of an examination within ten days of the date of an examination.

4. A CE exam is often the final step in the processing of a disability claim (as regards the gathering of medical records).

In short, being required to go to a medical exam by social security is no cause for alarm. Quite the contrary, it signals that every attempt is being made to make a decision on a claim and that the possibility of an approval exists.




Additional information on Social Security Disability at www.disabilitysecrets.com











Other Posts:
How much can I earn and still receive Disability benefits ?
File for disability

Disability status
Disability back pain

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Appeals for Social Security Disability - Disability Appeals Process

Most individuals who decide to finally file a claim for social security disability or SSI benefits (I say finally because many claimants think about filing for benefits but delay the decision to file for quite some time) know very little about how the system works. In fact, many individuals who work in social security field and district offices know relatively very little about how the disability system works (this is because the social security office takes the disability application, but does not process it --- this is handled by a disability examiner in a state-level agency whose function is to render medical decisions on disability cases).

Naturally, then, a person who is filing for disability benefits may be partially or completely unaware of their appeal rights and the social security disability appeals process.

In essence, this is how the disability appeals process works: Disability applicants whose claims are denied at the initial application level have to right to request an appeal within sixty days of the date of their denial. This appeal is essentially a review or reconsideration of the decision that was made on the initial application.

Typically, this review results in the same decision; that is, another denial. Disability claimants who are denied on this review are entitled to request a second appeal within sixty days of the date of this denial and this appeal is known as a request for hearing before an administrative law judge. The chances of winning benefits rise substantially at this appeal (even more so for claimants with representation), which is good news for claimants.

Unfortunately, the time required to get to a hearing can be extraordinarily long (from the time a hearing has been requested until the time a hearing date is set can take as long as two years). And, of course, this does not take into consideration the length of time that the first appeal step may require (the first appeal can take as little as a few weeks or as long as several months). Obviously, appeals for social security disability and SSI claims can be very drawn out and taxing (both mentally and financially).

Despite these realities, however, the appeals process will, typically, yield better opportunities for approvals to claimants who have been initially denied (versus filing a brand new ssd or ssi claim and starting over from scratch).

Important things to remember about the Social Security Disability and SSI appeals process:

1. If you are requesting an appeal, do it quickly to keep your case moving through the system as fast as possible.

2. If you have had additional medical treatment or have been seen by new medical treatment sources, be sure to report this information when you submit your appeal paperwork.

3. If the appeal you are requesting is for a disability hearing, seriously consider getting representation so your case may be adequately and properly prepared prior to your hearing date.

4. After submitting your appeal paperwork (if you did not file electronically), make a follow up call to the social security office to make sure they received it.




Additional information on Social Security Disability at www.disabilitysecrets.com











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