Thursday, August 16, 2012

If at first …

The Social Security Administration (the “SSA”) has taken various steps to try to reduce the backlog of disability claimants who are waiting for their hearings. Among other things, the SSA now provides online access for attorneys to the eFolders of their clients, whose cases are pending at the hearing offices. EFolder access was intended to save time and money, which it frequently does. However, I have found that evidence that I have submitted fails to find its way into the eFolder way too often.

On a weekly basis, either I have to resubmit records after reviewing an eFolder and learning that a document is missing, or I receive a call from the SSA asking me to resubmit a record that I referenced in another document that managed to make its way into the eFolder. Curiously, it is typically the most salient and supportive documents that fail to find their way into claimants’ files.

On August 13th, in preparation for a hearing on August 20th, I reviewed the eFolder, only to learn that a report from the claimant’s treating eye specialist was missing. I had already submitted the report twice; the second after a prior eFolder review had also revealed that the report was missing. The case was an onset appeal covering the April 10, 2011 to September 1, 2011 time period. The partially favorable decision was based upon a DDS doctor, who said the claimant met a listing based upon a letter from the eye doctor. However, the eye doctor did not say the claimant became disabled as of September 1, 2011; to the contrary, as stated in the missing letter, the eye doctor stated that the claimant became disabled as of March 2011.

I resubmitted the missing report again, and also pointed out that the DDS analyst who denied the case, stated that the claimant became disabled as of September 2011 because that is when the claimant met a listing. I explained that even if true, a claimant does not need to meet a listing in order to be entitled to disability benefits, and that the eye doctor made it clear that the claimant worked beyond her capacity to do so.

The final sentence of my letter was that, “I suspect that if the ALJ had seen the attached that a hearing probably would have been unnecessary.” Apparently, the ALJ agreed because yesterday, I was notified that the claimant’s hearing was cancelled because her onset appeal was being approved.

The eFolder has been a positive step for the SSA. For example, it avoids attorneys having to go to hearing offices to view files, saves the SSA from scheduling and supervising the folder reviews, reduces evidence getting placed into wrong folders, and allows more than one person to access a claimant’s file simultaneously. However, vigilance is still required to ensure that the submitted evidence becomes an exhibit after the eFolder is assembled.

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