MS Victory

We represent a 38 year old former pharmacy technician from Ozone Park with multiple sclerosis (“MS”).  We filed her application for Social Security Disability (“SSD”) benefits six years ago.  We continued to fight for SSD benefits at all levels of adjudication.  The first administrative law judge (“ALJ”) on the case was Jay Cohen.  Cohen’s decision denying SSD benefits was so transparently defective that when we appealed to federal court, the attorneys representing Social Security immediately asked us to agree to remand the case.

The good news is that the case was finally approved today by a new ALJ.  The bad news is that it took the claimant six years to get approved.  Moreover, as is typical in cases that last this long, it will take many months for her to get paid.  Having said that, the claimant is grateful that we "stuck with her" and finally got her approved.

If you need assistance applying for disability, or help with a claim that you already filed, please feel free to call my office for a free phone consultation.  We have offices conveniently located in Nassau and Suffolk counties on Long Island.

 

 

Cigna Reverses LTD Denial

We were retained by a 59 year old former Director of Engineering from Brooklyn with multiple medical issues, whose long term disability (“LTD”) benefits were terminated by Cigna based on an Insurance Medical Exam (“IME”) by Jeffrey Liva, who makes his living doing IMEs for disability insurance companies.  Cigna paid $6,000 for the Liva IME.  Contrary to the treating doctors, Liva said the claimant could work.

The claimant had an uphill battle because it is virtually unheard of for a disability insurer to reverse a denial after investing thousands of dollars for an IME to say a claimant can work.  We appealed with various diagnostic test reports, and medical and vocational reports, to rebut the Liva opinion, but Cigna failed to respond within 45 days as required under federal law.  Consequently, we sued Cigna, which had the effect of ensuring a favorable standard of judicial review for the claimant.  Today, Cigna finally responded with a letter reversing its decision to terminate the claimant’s LTD benefits.

It took many months to develop the medical and vocational evidence that was submitted on appeal.  Despite the fact that the appeal evidence overwhelmingly demonstrated that the claimant remained unable to work in any full time capacity, it still took actually commencing litigation to obtain the result.

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

State Agency Medical Consultants

At the initial stages of the Social Security Disability (“SSD”) application process, the Social Security Administration relies on doctors who work for each State’s disability determination services (“DDS”) to evaluate the medical evidence.  The DDS doctors, also known as State agency medical consultants, do not examine claimants.  Consultative examiners (“CEs”), who are from private companies that contract with DDS, examine claimants.

DDS doctors usually disregard what claimants’ doctors say, and just focus on what the CEs say, when evaluating SSD claims.  If an SSD application is denied based upon the conclusion of a DDS doctor, then a claimant typically has to wait a couple of years before an administrative law judge (“ALJ”) can hold a hearing on the denied application.  During that delay, claimants can continue to submit updated medical information.  By the time an ALJ has to decide a case, it is likely that the opinion of a DDS doctor has become stale, which is especially true if the claimant provided additional medical evidence during the wait for a hearing.  

We were retained to represent a 52 year old former attorney from Rockville Centre with multiple medical impairments after his SSD application had been denied based on the opinions of the DDS doctors.  We supplied a substantial amount of medical evidence while the claimant awaited his hearing with ALJ Alan Berkowitz, who approved the claimant’s SSD application today.  Notably, ALJ Berkowitz stated that the opinions of the DDS doctors were unpersuasive because they did not review the updated medical evidence

This is an example of why it is so important to retain an attorney who specializes in disability, if you decide to apply for Social Security Disability benefits.   Please call my office for a free phone consultation.  Our Long Island offices are conveniently located in both Nassau and Suffolk counties.

ALJ Berkowitz Reversed Second Time

We represent a claimant from Uniondale with Protein S Deficiency that causes clotting problems, and requires her to elevate her legs most of the day to prevent additional deep vein thromboses from developing.

We filed the claimant’s Social Security Disability (“SSD”) application in 2013, which administrative law judge (“ALJ”) Alan Berkowitz denied.  After the Appeals Council denied review, we appealed to federal court, where we got the ALJ’s decision reversed for a second hearing.  However, the ALJ denied the SSD application at the new hearing by repeating the same mistakes that he made at the first hearing.  This time though, the Appeals Council reversed the ALJ, and ordered yet another hearing. 

Fortunately, the Appeals Council determined that it would be unfair to subject the claimant to a third hearing with the same ALJ, and ordered that the case be reassigned to another ALJ. 

We are a full service SSD office, and represent claimants at all levels of the application and appeal process.  If you find yourself unable Please call us for a free phone consultation.  We have offices conveniently located on Long Island in both Nassau and Suffolk counties.

Some Good News

When someone is approved for Social Security Disability (“SSD”) benefits, or Supplemental Income benefits (“SSI”), accompanying the decision is a guideline for when the claimant’s case should be reviewed.  SSD and SSI are considered temporary disabilities, unless a person has a condition that is expected to end in death within 14 months from the time they stop working.  A review requires the beneficiary to complete paperwork with updated medical information, and to get updated records from their treating doctors to support that they are still disabled, and unable to work full time.  Typically, the older a person is, or the lesser the likelihood of their condition improving, the longer the length of time there is between reviews.  However, under the Trump administration, a new rule was passed to require more frequent reviews, no matter what the age or medical condition of the beneficiary was.  President Biden has withdrawn that rule, which will provide much relief for people who are receiving disability.  There will still be reviews, but not at the ramped up rate that the Trump administration had wanted, which was just another excuse to hurt and disgrace those people who are truly disabled and rely on the little amount of money they received for disability, because they’re medical condition(s) prevent them from being able to work full time.

ALJ Smith Reversed Again

We represent a 23 year old claimant from Huntington with disruptive mood dysregulation disorder whose application for social security disability (“SSD”) insurance benefits was denied by Administrative Law Judge (“ALJ”) Susan G. Smith. The Appeals Council remanded the case to another ALJ after because Smith had failed to conduct a fair hearing.

ALJ Smith made a mockery out of the administrative hearing process because she never intended to consider the claimant’s testimony. The purpose of a hearing is for the ALJ to look fully into the issues and question the claimant. A claimant’s testimony is taken when the objective evidence supposedly fails to substantiate the degree of impairment-related symptoms so the ALJ can consider the claimant’s statements about the intensity, persistence, and limiting effects of her symptoms.

After confirming the information that the claimant had already submitted about her education and past work, the ALJ only asked why the claimant stopped working. The ALJ failed to ask the claimant anything at all about her pain, or inability to work with coworkers, supervisors or the public. In fact, the ALJ failed to ask the claimant anything whatsoever about her physical or mental impairments. In other words, the ALJ had predetermined to reject the claimant’s testimony concerning her symptoms regardless of what she had to say. 

Prejudging is the very definition of bias. ALJ Smith’s disregard for anything the claimant could possibly say demonstrated her prejudging. I asked the Appeals Council to reassign the case to another ALJ if it were not remanded for a calculation of benefits. The Appeals Council chose the latter, and the new ALJ assigned to the case issued a fully favorable decision today.

Survivor Benefits

Most people don't know what they are entitled to receive after a loved one passes away who was collecting Social Security benefits.  This article explains what one should do under those circumstances.