Monday, July 24, 2017

Fast SSD Approvals

I represent a former road technician from Florida, and a former electrician from New York, who were approved today for Social Security Disability benefits in less than three months and less than fours months respectively. The primary complaint of both claimants was back pain, they were both over 55 years old, and neither performed sedentary work.

As usual, Social Security directed that their doctors examine the claimant, and those examinations were avoided. The treating specialists were cooperative, and promptly provided supporting reports and records. It is unclear if the approvals are indicative of a directive for approving “GRID” cases, or merely a coincidence.

Monday, July 17, 2017

Video Representation

I represent a former nurse whose claim for Social Security Disability (“SSD”) benefits was approved today by an Administrative Law Judge (“ALJ”) from Albany. I had requested to appear via video at the Long Island hearing office with the ALJ and the claimant appearing in Albany. 

When the Albany hearing office scheduled this matter for a hearing, it insisted that I appear in person at the Albany hearing office. The Albany hearing office claimed that I had asked for a hearing at the Long Island hearing office, which was false. To compound matters further, the Albany hearing office stated that the claimant signed a Video-opt-out, and failed to mention that Form HA-55 specified that I wanted to appear by video teleconference at the hearing, which was also untrue, and could be confirmed by reading the document. 

Considering that experts frequently appear via telephone, I requested that I appear at the claimant’s hearing, via Long Island ODAR's videoconferencing. I explained that the claimant’s right to the counsel of her choice should not be denied because she had to leave Long Island because she could no longer afford to live there after becoming disabled. After contacting the ALJ directly, he agreed to allow me to appear from the Long Island hearing office via videoconference. 

When I was retained, the claimant resided on Long Island. However, because her disability prevented her from earning a living, she was forced to relocate to the Albany area where the cost of living was more affordable. Having to relocate is not uncommon, and a claimant should not have to discharge their attorney of choice because of financial reasons. Kudos to ALJ Arthur Patane for recognizing that plight.

Wednesday, July 5, 2017

Treating Doctor CE

The Social Security Administration (“SSA”) invariably sends notices to applicants seeking Social Security Disability (“SSD”) benefits stating that they to attend a consultative examination ("CE”). In New York, claimants are told they have to be examined by a doctor from Industrial Medical Associates (“IMA”). However, the SSA’s program operations manual system (“POMS”) states that a claimant’s own medical sources should be asked to perform the CE for the back problem. 

When my clients get notices for an IMA CE, I advise the State agency about the relevant POMS, and offer to have the claimant’s doctor perform the CE and provide a detailed written report. To ensure there is no issue regarding the quality of the report, I tell the State agency to specify exactly what they would like the report to include, and to provide me with the same information they send to IMA when asking it to conduct a CE. 

Several disability analysts have recently agreed to allow claimants’ doctors to perform CE in lieu of IMA. In each instance the claim has been approved. One of those cases involved a 49 year old former Director of a State agency whose primary impairments are Lyme disease and fibromyalgia. Both conditions are frowned upon by the State agency, which invariably denies SSD applications based on those conditions. Nonetheless, shortly after the claimant submitted the CE report from her doctor, the SSD application was approved.

Monday, July 3, 2017

Investigating DDS Doctors

I represent a 54 year old Social Security Disability (“SSD”) claimant with chronic asthma and prostate cancer, who not only worked full time as a detective, but also worked 20 hours a weekend as a bus driver. In a prehearing memorandum, I argued that the claimant’s work history alone should warrant approving the SSD application because the claimant’s work ethic shows that he would have continued working if he were physically able. 

The claimed earned over $100,000 annually, so he had no incentive to exaggerate his condition in order to receive a third of his salary in SSD benefits. The claim file exceeded 1,500 pages of medical records when I was retained to handle the claimant’s appeal. I provided reports from the two pulmonologists, urologist, and internist that detailed the claimant’s inability to perform even sedentary work. Even though my prehearing brief explained that if the claimant were capable of sedentary work, he still would still have to be found disabled in accordance with the medical-vocational rules, and the Police Pension Fund found the claimant disabled from his past work as a detective, I was told that the ALJ still felt a hearing was necessary. 

A month before the hearing, the only evidence adverse to the claimant’s SSD application was the opinion of the State agency doctor who never examined the claimant. I supplied websites in which the State agency doctor identified himself as a nephrologist, and the claimant did not have a kidney problem. I asked the ALJ again to review my prehearing letter. 

I was advised today that a hearing will not be required. It apppears that ALJs do not review prehearing briefs until shortly before the hearing. If you believe your case is very strong, then submit a prehearing brief explaining why the vocational and medical evidence precludes the need for a hearing. The ALJ may agree.

Friday, June 23, 2017

Work History

Earlier this year, Ingrassia v. Colvin, 2017 WL 908195 (E.D.N.Y. Mar. 6, 2017), held that an ALJ erred by failing to evaluate the Social Security Disability (“SSD”) plaintiff's long work history of approximately 25 years when making a credibility assessment. 

I represent a former carpenter with back problems who has a 40 year work history. When the ALJ asked if I had any opening remarks, I focused on the claimant’s 40 year work history. The hearing was brief, and the claimant’s SSD application was approved today. The ALJ’s decision stated that the claimant could do light work, even though the doctors said that sedentary work was not possible. However, the ALJ still concluded that the claimant could not work. 

A claimant should always discuss their work history even though an ALJ will limit questions to the last 15 years. A claimant with a good work history is entitled to substantial credibility when claiming inability to work. Common sense dictates that a person with a long work history would continue working because of their strong work ethic if physically and mentally able. Most ALJ’s accept that premise.

Auxiliary Benefits

There are various types of additional, or auxiliary benefits that might be available when you become entitled to receive Social Security Disability (“SSD”) benefits. For example, if you are entitled to SSD benefits, then you are also entitled to receive benefits for your minor children, which is typically about half your SSD benefit. 

Frequently, the Social Security office will not always contact a claimant about children’s benefits after learning that a claimant will be receiving SSD benefits. Children’s benefits are not provided automatically; the claimant must file an application for them. If filed timely, the children’s benefits will start when the SSD benefits start. If an application for children’s benefits is not filed promptly, they may have a later start date than the SSD benefits. 

I represent a claimant who received SSD benefits starting in March 2008, but whose children’s benefits did not start until 2013. I was retained to see if it were possible to obtain additional children’s benefits. 

The claimant never received a letter from Social Security advising him to file an application for children’s benefits when he was approved for SSD benefits, and he had proof that he had problems receiving mail at that time. Moreover, the claimant testified that he went to the local Social Security office shortly after securing SSD benefits, he was specifically told that there were no other benefits available. 

In 2014, the claimant learned that he should have been receiving children’s benefits, and he filed an application for them. The application was approved. However, the general rule is that children’s benefits, like SSD benefits, can only be paid 12 months prior to the application’s filing. Therefore, the claimant only received children’s benefits as of 2013. The claimant appealed, but an ALJ denied the request for an earlier onset. 

I filed an appeal that argued because the claimant had been misinformed about his entitlement to children’s benefits, he was entitled to a March 2008 onset. The Appeals Council reversed the ALJ’s decision, and ordered a new hearing, to address the claimant’s misinformation argument. Unfortunately, this is a situation that could have been avoided if the claimant had retained an attorney experienced in Social Security. While an attorney is never required, one is usually advisable.

Thursday, June 15, 2017

Prehearing Brief

I represent a 54 year old Social Security Disability (“SSD”) claimant with chronic asthma and prostate cancer, who not only worked full time as a detective, but also worked 20 hours a weekend as a bus driver. In a prehearing memorandum, I argued that the claimant’s work history alone should warrant approving the SSD application because the claimant’s work ethic shows that he would have continued working if he were physically able. The claimed earned over $100,000 annually, so he had no incentive to exaggerate his condition in order to receive a third of his salary in SSD benefits. 

The claim file exceeded 1,500 pages of medical records, when I was retained to handle the claimant’s appeal. I provided reports from the two pulmonologists, urologist, and internist that detailed the claimant’s inability to perform even sedentary work. Even though my prehearing brief explained that if the claimant were capable of sedentary work, he would still have to be found disabled in accordance with the medical-vocational rules, and the Police Pension Fund found the claimant disabled from his past work as a detective, I was told that the ALJ still felt a hearing was necessary. 

A month before the hearing, the only evidence adverse to the claimant’s SSD application was the opinion of the State agency doctor who never examined the claimant. I supplied websites in which the State agency doctor identified himself as a nephrologist, and the claimant did not have a kidney problem. I asked the ALJ again to review my prehearing letter. 

I was advised today that a hearing will not be required. I suspect that ALJs will not review prehearing memos until shortly before the hearing. If you believe your case is very strong, then submit a prehearing brief explaining why the vocational and medical evidence precludes the need for a hearing. The ALJ may agree.