IMA

The Social Security regulations identify the limited circumstances when a person seeking Social Security Disability (“SSD”) benefits should be sent for a consultative examination (“CE”).  However, upon receiving an SSD application, the knee jerk reaction of our State agency is to tell a claimant they must go to Industrial Medicine Associates (“IMA”) for a CE by an unnamed person, for an unspecified reason.

One of our former clients, an insurance representative from Brookhaven, came back to us after a continuing disability review (“CDR”) resulted in her SSD benefits being terminated.  When we appealed, the State agency sent the usual demand for a CE by IMA.  We explained why the CE would be inappropriate, and the State agency specified what additional medical information was needed, which we supplied from the claimant’s specialists.  Shortly thereafter, the claimant’s SSD benefits were reinstated.

Even though our client had not needed our services for over 10 years, she knew she could contact us to help her again, and was confident that we could get her benefits reinstated.    Needless to say, she is very happy and grateful that we were able to help her again.

Unconscionable DDS Delays

 by Susan Golden

There used to be a time, years ago, when it seemed like the State agency representatives actually did their jobs.  Now those representatives, including supervisors, are far and few between.

We represent a 59 year old videographer from Floral Park, who suffers from severe arthritis in both of his hips, as well as severe anxiety and depression. We filed his application for Social Security Disability ("SSD") benefits in October of 2022.  In January of 2023, we alerted Social Security that our claimant was in dire financial need, and was in danger of losing his home.  If someone is at risk of being homeless, or having their utilities turned off, Social Security is supposed to expedite the claim.  When the application is dire need, instead of the usual 6-7 months to make a decision, Social Security is obligated to prioritize the claim, and make a decision as quickly as possible.

It took more than a year before our claimant's SSD application was finally approved.  It is absolutely horrific that a claim that was supposed to be expedited, was not a priority to anyone at the Stage agency; not to the analyst handling the claim, not to the analyst’s supervisor, not to the supervisor’s supervisor.  We did our job by providing the State agency with all of the medical and vocational evidence necessary to make a quick decision.  They simply did not do their job.

We have access to the claimant’s efile, just as the analysts at the State agency do.  We upload the evidence electronically into the efile, and can view that evidence just as the analyst and supervisor's handling the claim can.  However, the State agency analysts let cases sit in limbo for months, and then claim that the medical evidence we submitted, which was timely when we submitted it, is “stale” or “not current enough.”   The State agency told us that they consider any records more than three months old to be “stale.”   However, they fail to return our calls.  When they finally do call us, they claim they cannot see the evidence we submitted, even though we can see it in the same efile.  Alternatively, they purposely delay returning our calls, and/or responding to our letters, for over three months so they can claim the evidence is too old.  It is a vicious cycle, with no consequences or repercussion for their intentional mishandling of disability claims.

In this case, we submitted a letter four times from the claimant’s landlord that the claimant was in danger of being evicted for not paying his rent.  The first letter was submitted in January of 2023, a year ago.  We submitted letters from the claimant's utility companies that his water and electricity were being turned off.  We repeatedly escalated the matter, calling supervisor after supervisor, going up the ladder, trying to find someone who would do something!  Even after we reached a supervisor who seemed willing to help, it still took another month for our claimant's SSD benefits to be approved.

Our claimant is very appreciative that we fought for him and were successful in obtaining his SSD benefits.  We will continue to fight for our clients, and hope that we can put pressure on Social Security to change their broken, outdated system, and hire people who actually care about doing their job.

Transferable Skills

 There are two parts to every disability benefit claim – the medical evidence and the vocational evidence. It literally can pay to know the vocational rules when seeking Social Security Disability (“SSD”) benefits.

We represent a 55 year old automobile mechanic from Centerport, who had a stroke.  The Social Security rules classify a 55 year old as a person of advanced age.  The vocational rules were outcome determinative in his case because the claimant lacked transferable skills.

Transferability refers to acquired work skills, not to aptitudes and attributes that are more properly characterized as qualities necessary and useful in nearly all jobs.  An automobile mechanic is classified as skilled medium work.  The case law has repeatedly reported testimony from vocational experts that an automobile mechanic does not have any transferable skills.

The claimant was a high school graduate.  Under the Grid Rules, a person of advanced age, who is a high school graduate, with no transferable skills, must be found disabled even if capable of performing the physical demands of light work.

The treating neurologist limited the claimant to sitting for 8 hours, and standing/walking for 4 hours, in an 8 hour day, and occasionally lifting up to 9 pounds.  As that opinion was supported with a brain MRI that confirmed chronic infarcts with multiple intercranial stenosis, the Administrative Law Judge accepted the opinion.  Since the claimant could not lift 20 pounds, not stand and walk for 6 out of 8 hours, he could not perform light work.   Therefore, he was found disabled under the Grid rules.

It is important to retain an experienced, disability attorney who has extensive knowledge about Social Security's rules, both medical and vocational.   If you or someone you know is considering applying for SSD benefits, please call our office for a free phone consultation.  Our offices are located on Long Island in both Nassau and Suffolk counties.

Quick SSD Reversal

We were retained by a 45 year old Education Director after her Social Security Disability (“SSD”) application was denied.  She had to stop working due to Yao’s Syndrome.

Yao’s syndrome is a relatively new rheumatic condition, which is not well understood.  Having successfully obtained SSD benefits for other claimants afflicted with Yaos, we knew what clinical and opinion evidence to submit to win approval.  Fortunately, we secured the SSD benefits in a few months, without the claimant having to attend a hearing.

If you are thinking about applying for disability benefits, please contact our office for a free phone consultation at (888) 572-0861.  We have offices located on Long Island in both Nassau and Suffolk counties.

QC Reviews

The Social Security Administration (“SSA”) routinely conducts “quality reviews” of decisions from the State agency.  The SSA insists that the reviews are random.  However, since the last Century, every time one of my client’s decisions has been pulled for review, the State agency decision was an approval of Social Security Disability (“SSD”) benefits.  Moreover, every colleague I know has also expressed that their clients have never had a disapproved decision reviewed.

We represent a 54 year old teacher from Port Jefferson Station with diabetes and mental impairments.  The State agency approved SSD benefits three days after we submitted very supportive reports from the claimant’s psychiatrist and therapist.  Nonetheless, it took a month and a half to obtain the approval because the decision had been pulled for quality review. 

 There is zero justification for quality reviews.  The fact that only awards are reviewed reveals that their purpose is not to attempt to improve that quality of the State agency decisions.  Rather, their purpose is to try to find some means to reverse the approval.  Just as the SSA is being called upon to eliminate the reconsideration stage of the hearing process, the SSA should also eliminate so-called quality reviews.

 

Insurance Scam

Insurance companies do whatever they want to make money.  Even if you have been paying into a plan, and then find yourself in need of filing a disability claim, the number one concern of the insurance companies is profit.  They don't care about you, they care about the bottom line.  They've already "denied" you before they even see your claim.  They will act like they're your best friend, and then stab you in the back.

Retaining an attorney for a long term disability claim is vital if you want to have a much better chance of being approved.  We have decades of experience with all of the insurance companies, and know how they operate.  We also have an extremely high rate of success.  Please call our office for a free phone consultation.  We have offices on Long Island in both Nassau and Suffolk Counties.

by Susan Golden

 

 

Winning Hands

 Most unskilled sedentary jobs require good use of both hands and the fingers; i.e., bilateral manual dexterity (“BMD”). Fine movements of small objects require use of the fingers; e.g., to pick or pinch.  Most unskilled sedentary jobs require good use of the hands and fingers for repetitive hand-finger actions.

For over 40 years, the Social Security Administration (“SSA”) has recognized that BMD is necessary for the performance of substantially all unskilled sedentary occupations.”  In fact, SSR 83-14 provides that a limitation to unskilled sedentary work with an additional loss of BMD  is significant and, thus, warrants a conclusion of disabled.

Vocational experts (“VEs”) routinely testify that claimants who lack bilateral manual dexterity are precluded from performing any sedentary occupations.  However, the fact that a VE had to testify at a hearing means that the State agency denied the claimant Social Security Disability (“SSD”) benefits two times.

We represent a 59 year old nurse from Syosset with many diverse impairments, including carpal tunnel syndrome and a trigger finger.  After we submitted records and a report detailing the claimant’s lack of BMD, the State agency approved SSD benefits, just three months after we filed the application.  No doubt, the approval was based on the claimant’s lack of BMD. Regardless of what impairments claimants may have, they should take care to obtain reports that detail the functional limitations and restrictions they may have in using their hands.