Disability Synergy

The Social Security Administration is required to consider the combined effect of all your medical impairments when determining if you are disabled.  Thus, even if none of your impairment renders you disabled, you can still be found disabled by the combined impact of all them.  We represent a 56 year old financial planner from Manhasset with cervical radiculopathy and Crohn’s disease that illustrates the aforementioned synergistic principle.

The claimant’s application for Social Security Disability (“SSD”) benefits was denied by the State agency.  When the case proceeded to a hearing, the administrative law judge (“ALJ”) sounded surprised when the medical expert testified that the claimant’s severe Crohn’s disease would pose no limitation on her ability to stay on task and avoid sick days.

The ALJ issued a fully favorable decision today.  Among other things, the ALJ accepted the treating physician's opinions  that the claimant would be absent from work more than three times per month, and would be off task greater than 20% of the workday, which would preclude all work.  He accepted these opinions without asking the Vocational Expert, assigned to the hearing, to testify, after my intense cross examination of their Medical Expert.

Only an experienced disability attorney would know how to navigate the hearing in order to obtain the approval of the claim.  Please call my office for a free phone consultation if you are considering applying for disability benefits.  Our offices are located on Long Island, in Nassau and Suffolk counties.

Too Long

We represent a 55 year old construction worker from St. James with hip and spine impairments, whose Social Security Disability (“SSD”) benefits were approved today, six months after we filed his application.  While we are glad that we were able to obtain SSD benefits without the need for a hearing, six months was still too long a time for the approval.

Based on the claimant’s work history, age and education, he was entitled to SSD benefits under the medical-vocational rules even if he were physically able to perform “light work.”  Light work is more strenuous than sedentary, desk work.

The claim file contained close to 1,500 pages of medical records.  There were plenty of objective diagnostic test results that showed the claimant would be unable to stand and walk for the requisite 6 hours a day to perform light work.

Social Security has many excuses when we challenge their delay tactics.  The undeniable fact is that if we do not constantly call the local office, and the Stage agency analyst handling our clients’ claims, the delays would be much longer.  Do not accept their perpetual cycle of delays.  Call our office for a free phone consultation, whether you are considering applying for SSD, or if you applied on your own and realize that you need an experienced disability attorney to navigate the administrative process.  Our offices are located on Long Island in Nassau and Suffolk counties.

 

LTD Benefits Reinstated

We represent a claimant whose long term disability (“LTD”) benefits were denied by Lincoln Life.  After we filed suit Fredrich v. Lincoln Life and Annuity Co. of N.Y., 2022 WL 1537162 (E.D.N.Y. 05/13/2022)  Lincoln approved LTD benefits on June 22, 2022, and paid past due benefits.  However, last month, Lincoln terminated the LTD benefits.  We requested the claim file, and began gathering medical and vocational evidence for the appeal.

When I reviewed the claim file, I found notes dated February 28, 2023, from the Lincoln claim handler who terminated the LTD benefits.  Her notes stated that a peer review dated February 27, 2023, supported the claimant being disabled from August 1, 2020 to present and ongoing, and that the claim would be re-evaluated in three months.  Therefore, I sent a letter to the Lincoln claim handler on March 9, 2023, asking why she terminated benefits if the file was not even due to be reviewed for another three months.  Perhaps more importantly, I asked what medical tests, exam findings, and symptoms, did Lincoln contend changed after June 22, 2022, which Lincoln believes shows the claimant was no longer disabled.

I received a call today from Lincoln’s LTD Manager.  After reading the March 9, 2023, the LTD Manager agreed that the claimant remained disabled, and advised me that Lincoln was reinstating LTD benefits.  While the claimant had already incurred some costs in obtaining updated reports, he was happy to receive an expeditious reversal of the termination.

This is the second time in a week where an insurance company reversed its adverse disability decision, and we obtained a favorable outcome for our clients' LTD claims.  You need an attorney representing you when navigating the LTD claim and appeal process.  Lincoln would not have reversed itself if the claimant had been unrepresented.  Call our office for a free phone consultation.  We are located on Long Island, with offices in both Nassau and Suffolk counties.

 

Hartford Settles

Nearly three years after commencing an action against Hartford to recover long term disability (“LTD”) benefits, and a few months after getting Hartford to start paying monthly LTD benefits, we have an agreement in principle to settle the remaining cause action in connection with a buy-out of the claimant’s future benefits.

Disability insurance companies, like Hartford, are notorious for deciding to deny LTD claims before they have even started reviewing a claim, and for terminating benefits without a medical reason, they just want to avoid paying the claim anymore.  The disability insurance companies only care about their profitability.  They do not care about claimants, which is why you need an experienced disability attorney to represent you for your LTD claim.   Our office offers a free phone consultation with offices located on Long Island in Nassau and Suffolk counties.

Witnesses

Many people seeking Social Security Disability (“SSD”) benefits do not include third party support statements when applying, or have third parties testify at hearings.  Having witness attestations should not be overlooked.

We represent a 57 year old Financial Vice President from Queens Village with spine impairments.   The claimant had two SSD applications that were denied before we were retained.   The good news is that we succeeded in getting the claimant’s third application approved on-the-record without a hearing.  The bad news is that the ALJ would not reopen the prior applications, which resulted is a substantial loss of benefits.

One difference in the third application was a report from the claimant’s friend, which the ALJ specifically considered in accordance with Social Security Ruling (SSR) 16-3p.  Specifically, he considered the personal observations in terms of how consistent those observations are with the claimant's statements about their symptoms as well as with all of the objective medical evidence in the file. Third party statements are not evaluated using the same criteria as medical source statements; however, they were considered to complete the narrative of the claimant's subjective complaints in accordance with accordance with and 20 CFR 404.1520b(c) and 416.920b(c).

The claimant made the right decision when he realized that he needed to retain an experienced disability attorney after filing on his own, and being denied twice.  We cannot emphasize enough the importance of  his decision.  Please feel free to call our office for a free phone consultation if you are considering applying for SSD benefits.  We are located on Long Island with offices located in both Nassau and Suffolk counties.

 

 

 

Dire Need

According to Social Security, a dire need situation exists when a claimant alleges any of the following circumstances:

• The claimant is without food and is unable to obtain it.
• The claimant lacks medicine or medical care and is unable to obtain it, or access to necessary medical care is restricted because of a lack of resources.
• The claimant lacks shelter (e.g., without utilities such that their home is uninhabitable, homelessness, expiration of a shelter stay, or imminent eviction or foreclosure with no means to remedy the situation or obtain shelter).

Absent evidence to the contrary, accept a person's allegation that the person does not have enough income or resources to meet an immediate threat to their health or safety.  HO employees will err on the side of designating the case critical.

Despite the above, many requests to have a claim classified as a dire need case are ignored by the assigned analyst.

We represent a 58 year old with multiple foot, spine and wrist problems from Valley Stream who worked as an electrician.  We were able to obtain strong evidence from the claimant’s pain management specialist.  The claimant qualified as a dire need case because his utilities were being shut off.  However, the case was languishing because the analyst was holding dire need status hostage.

The analyst refused to tag the case as a dire need because he wanted to the claimant to attend a consultative examination (“CE”) with IMA. We had to escalate the matter above the analyst’s head, who claimed there was nothing he could do.  We succeeded in getting the supervisor to expedite the case, which was approved in about 10 days, without the need for a CE.

The claimant is so happy that he retained us, and that we had the experience and knowledge to do what was needed to get his claim expedited.   This is just another of many reasons why you should retain an experienced disability attorney to represent you if you plan on filing for Social Security Disability benefits.   If we hadn't known what to do, our claimant's case would still be sitting there.

If you are planning on applying for Social Security Disability benefits, please call our office for a free phone consultation at (888) 572-0861.  Our offices are conveniently located in Nassau and Suffolk counties on Long Island.

 

DDS Laziness

We represent a 49 year old financial advisor from Plainview with residual problems from a stroke, whose Social Security Disability (“SSD”) benefits were approved today without a hearing, but with little help from the State agency. 

Since the claimant was under 50 years of age, there was little need for vocational information, because transferable skills were not an issue. Nonetheless, the State agency repeatedly held the claim up by requesting more details about the claimant’s work duties than they do in other cases. 

To compound matters further, we submitted thousands of pages of medical and hospital records detailing the stroke sequelae. The records documented hemiparalysis, balance issues, fatigue, foot drop, among other things. Nonetheless, the State agency kept sending requests for the claimant’s brain scans – which we confirmed each time had already been submitted. Then it became obvious to us what the problem was. 

We went through the records that were in the State agency’s electronic folder for the claimant. We pulled out the brain scans, and resubmitted a second time. SSD benefits were approved shortly thereafter. In other words, the State Agency representative refused to review the medical records because they were so voluminous, so we had to do their job for them. 

It is vital to have an experienced disability attorney represent you if you plan on applying for SSD benefits. From the moment we file our client’s application, we stay on top of the representative(s) handling your claim. For example, when we submit medical evidence directly into our client’s efile, we receive a confirmatory receipt. However, we consistently find that when we check the efile a few days later, the evidence we submitted is not there. The State agency analysts' stock answer is that it’s the “system’s” fault. It’s a constant game of submitting evidence, checking to make sure it shows up in our claimant’s file, and then calling the State agency when we don’t find the evidence in the file. 

The bottom line is that most of the analysts at the State agency do not do their jobs. It could be that they are lazy, stupid or they just don’t care. If you want to maximize your chances of being approved for SSD benefits, then you need to retain an experienced disability attorney. We have been handling disability claims since the last Century. Please call our office for a free phone consultation if you plan on applying for SSD benefits. We have offices located in both Nassau and Suffolk counties on Long Island.