Proposed Changes to SS and Medicare

This article is important for people to read if they are receiving Social Security Disability benefits, or Medicare benefits. Neither of these programs are entitlement programs. They are self funded programs that we, the taxpayers, have paid into. According to this article, we may have our benefits cut. For the people who have SSD cases pending, or are thinking about applying, the proposed budget cuts would have a great impact on the length of time it would take to get their benefits approved.

6 Years for Approval

We represent a claimant from Copiague whose application for Social Security Disability (“SSD”) benefits had been denied after a hearing based on the testimony of a discredited medical expert. Last year, a federal district court judge in New York ordered a new hearing for the claimant. Today, after a six year struggle, the claimant was found entitled to receive SSD benefits back to May 2014. 

While we hope for the best, we always prepare for the worst. That means preparing every case as if it will have to be appealed in court. And when we represent a claimant, we will go to court if necessary. 

Our litigation experience helps us prepare the best possible factual record to present in court, which is important because it is rare when a judge will permit the introduction of new evidence. Litigation experience is also important because you need to understand what the legal theories will be in court in order to know what evidence will be required to support those theories.

It is not easy to find a SSD attorney with litigation experience.  If you want to retain a SSD attorney, who specializes in disability benefits law and has a lot of litigation experience, please contact our office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.  

Harmful Changes to SSD

This article, written by Newsweek, explains how recipients of Social Security Disability ("SSD") benefits may lose their benefits due to a proposed rule change to disability reviews.  

If you need assistance with a disability claim, and are looking for an attorney who specializes in disability, please contact my office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties. 

Age & Disability

Social Security Act was enacted in 1935 to provide economic security when individuals reached retirement age. The idea was that when people become older, they gradually lose the ability to work on a full time basis. It was not until 1956 that Social Security Disability (“SSD”) benefits were added. The reasoning was that many people become unable to work before they reach retirement age, and they need economic security also. 

Age may impacts an individual’s entitlement to SSD benefits in two ways. The older you are, the more likely you have generated a long work history. Also, with the passage of time, the chances increase that a person will sustain an injury or illness that diminishes functionality, especially with progressive medical conditions. 

We represent two claimants whose SSD applications were approved today after hearings. One was a pain specialist from West Hampton Beach, and the other was a stock trader from Commack. Both were 60 years old, and both had long work histories, which the administrative law judge (“ALJ”) found supported the credibility of their complaints and testimony. Both claimants also had orthopedic complaints that were consistent with multiple objective diagnostic MRI and EMG tests. Recent rules and regulations require an ALJ to place greater emphasis on objective evidence. 

Both claimants were looking for a Long Island Disability Attorney and were referred to me by other attorneys.  They are very happy with the outcome of their cases!

Prudential Disability Rating

Over 100 people rated Prudential’s disability insurance at ConsumerAffairs.com. The result – one out of five stars. I have represented countless claimants against Prudential, and agree with that one star rating. Notably, it is not possible to give a zero star rating. 

A nurse from Manhasset with multiple medical conditions, including Lupus, transverse myelitis, and myelomacia, retained us after Prudential denied her application for long term disability benefits. Prudential claimed that the nurse should still be able to perform her job on a full time basis. 

The claimant received her approval today for Social Security Disability (“SSD”) benefits. To qualify for the SSD benefits, not only was the claimant required to show that she was unable to perform her job as a nurse, but also that she was unable to perform any job on a full time basis.  

The claimant initially contacted my office because I am a Long Island Disability Attorney; specializing in both SSD and LTD, with offices in Nassau and Suffolk counties.   The claimant was looking for a Disability Attorney who could handle both her SSD and LTD claims.  We are happy to be able to help her with both.

New Opinion Weighing

The Social Security Administration hopes that eliminating the treating physician rule will substantially reduce the number of disability applications that get approved. 

We represent a 44 year old former mail carrier from Seaford.  She was referred to us by her sister-in-law, a former client whose Social Security Disability ("SSD") benefits were approved a few years ago.  The mail carrier was looking for a SSD attorney on Long Island.  Her back problem was well supported by objective medical data.  However, it was not until a few days after the claimant’s hearing that we finally were able to provide a report assessing her functional limitations from her orthopedist. This case illustrates how at least one administrative law judge (“ALJ”) weighs medical opinions under the new rules. 

The ALJ found the claimant disabled by finding the opinion of the orthopedist and the medical expert (“ME”) persuasive. The ALJ found the orthopedist persuasive because he personally examined the claimant over an extended period of time, his functional assessment was very recent, and the assessment was corroborated by the ME. The ALJ found the ME persuasive because he had full access to the claimant’s medical history. 

While the ALJ found personal examinations, length of treatment, and reviewing all medical records to be important, he did not indicate which were more important. Since both the orthopedist and ME concluded the claimant lacked a sedentary work capacity, the ALJ did not need to say whether he found the orthopedist or the ME more persuasive. There was no indication if personal examinations and the length of treatment was more important than reviewing all the records. 

Had the ME’s opinion contradicted the orthopedist’s opinion, it is possible that the ALJ would have found the ME more persuasive. It seems advisable that when treating sources are asked to provide functional limitations, they should also be given all medical records to review, which should be reflected in their assessments. 

Listings

Meeting a “listing” is one way to establish entitlement to Social Security Disability (“SSD”) benefits. Frequently, all the criteria of a listing may apply to a claimant, but the treatment records may not reflect each criterion. Recognizing the potential applicability of a particular listing, and that some criteria are absent from the treatment records can be overcome. 

I represent a 42 year old graphic designer from Long Island with various back problems. While he received extensive treatment for his back, including lumbar surgery and MRI testing, the records did not reflect that he always met all of the listing criteria. Therefore, we tailored forms for the claimant’s spine specialist to complete that addressed the criteria for listing 1.04, and the response revealed that the claimant did in fact satisfy each element. 

At the hearing, a medical expert (“ME”) testified that the claimant met listing 1.04. Moreover, the ME testified that even if the claimant did not meet or equal the listing, the medical evidence, including the spine specialist’s report, reflected the inability to perform sedentary work. Since the claimant was 42 years old, without the responses to the form we prepared for the spine specialist, the claimant probably would have been denied SSD benefits.  This is another example of why it is so important to retain an attorney who specializes in SSD claims.  If you are thinking about applying for SSD benefits, please contact my office for a free phone consultation. We have offices that are conveniently located in both Nassau and Suffolk counties on Long Island.