Wednesday, April 21, 2010

Deceptive SSA Notices

The Office of Temporary & Disability Assistance (the “State agency”) is responsible for making the initial decision on Social Security Disability (“SSD”) claims in New York. The State agency sends letters to SSD applicants stating that he or she “must keep the appointment” to be examined by a “specialist” from IMA Disability Services (“IMA”). The letters are frequently followed by phone calls from IMA threatening that the application will be denied if the claimant fails to appear for the appointment.

As a legal matter, it is untrue that a claimant “must keep the appointment.” The truth is that most claimants do not need to be seen by a doctor from IMA. The rules provide that a claimant cannot be compelled to attend a consultative examination (“CE”), such as the IMA exam, without first seeking the particular information from the treating physicians, or asking them to clarify any alleged inconsistency in the medical evidence. However, the State agency sends the letters for the IMA CE without complying with the rules.

As a factual matter, it is also untrue that a claimant “must” attend the IMA CE. Many times, even after insisting that a claimant must attend an IMA exam, and after threatening to deny a claim if the applicant refuses to attend, SSD benefits are approved anyway. I represent a 59 year old former nurse whose SSD application was approved today six weeks after she was told that she must attend an exam by IMA.

There are countless other reasons why most demands for a claimant to attend a CE violate the rules. Not surprisingly, since IMA makes enormous amounts of money from performing thousands of CEs, they try to make claimants believe that they have no right to refuse to attend a CE. Therefore, letters insisting that a claimant attend a CE should be objected to in writing, preferably citing the regulatory basis for the objections.

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