Sadistic IMA Conduct

The Free Dictionary defines harassment as the systematic actions of a group, including threats and demands, whose purpose may be merely to gain sadistic pleasure from making someone fearful or anxious. That definition applies to the manner in which IMA Disability Services (“IMA”) treats Social Security Disability (“SSD”) claimants. 

For many years, my clients have advised me that the consultative examinations (“CEs”)  performed by IMA contain findings that could not have been made. Consequently, because of IMA’s dishonest conduct, I have advised claimants to videotape their CE. There is no rule prohibiting an SSD claimant from videotaping their CE, and there is a rule permitting workers compensation (“WC”) claimants to videotape examinations. 

I represent an SSD claimant who appeared at IMA for a CE. IMA told him that WC claimants can videotape exams, but not SSD claimants. When my client showed IMA that the letter scheduling the CE did not prohibit videotaping the CE, IMA said that their policy is to prohibit the taping, and therefore, IMA refused to perform the CE. 

IMA refused to explain why the same person could tape the exam if he were seeking disability benefits from WC, but not SSD. There is absolutely no rational[NO e] or legitimate reason to treat the same person differently just because the source of IMA’s funding is different. Therefore, logic dictates that the purpose of IMA’s systematic inconsistent and arbitrary actions is to gain sadistic pleasure from making SSD claimants fearful or anxious.

IMA Disability Services

Apparently, the Social Security Administration ("SSA") automatically sends notices to Social Security Disability ("SSD") claimants that they have been scheduled for a “consultative examination” ("CE") regardless of what the medical evidence indicates. 

I represent a 58 year old delivery driver whose SSD application was approved today without ever being denied at any level. What is baffling is that the claimant was sent letters on two different occasions for a CE, each of which stated that “It will be necessary for you to be examined by the Specialist named below.” The so-called specialist was “IMA Disability Services.” The letters also stated that “You must keep this appointment at the time and date indicated below.” 

I had objected to the CE because, among other things, the claimant had submitted medical evidence from his treating doctors that clearly supported his inability to work in any capacity. The SSA obviously agreed because it approved SSD benefits without a CE. The question is, why are letters being sent to SSD claimants stating that it is “necessary” for them to be examined by IMA, and that they “must” attend the CE, when it obviously is not true?

A Padro Success

The Padro class action provides certain disability claimants who had hearings with Queens ALJs new hearings. I represent a 40 year old pharmaceutical territory manager whose Social Security Disability (“SSD”) was denied by ALJ Fier, despite evidence from several treating doctors that her physical and mental impairments rendered her totally disabled. The claimant alleged that she became disabled in 2008, and her date last insured (“DLI”) was 12/31/13. 

The claimant was given a new hearing under the 2014 Padro settlement agreement. The new ALJ had medical and vocational experts testify at the hearing. I supplied new medical reports, which post-dated the DLI. The new ALJ found the claimant was disabled because she met a listing based on one of the new reports I obtained. With that exception, the ALJ approved the claimant’s SSD benefits essentially based upon the same evidence that that had been presented to ALJ Fier.

Disability for Breast Cancer

According to the Centers for Disease Control and Prevention, cancer is the No. 2 cause of death in Americans, second only to heart disease. Even when diagnosed early and attacked with the latest treatments, cancer still has the power to kill. Unfortunately, many survivors are unable to recover fully from the disease, and have difficulty completing the very tasks that they so ably performed before being afflicted with the disease.

I represent a 59 year old property manager, which is a job that requires standing and walking most of the day, and lifting up to 20 pounds. The claimant has breast cancer; a MUGA scan revealed malignant neoplasm. Her application for Social Security Disability (“SSD”) benefits was approved by an administrative law judge (“ALJ”) on-the-record. Consequently, the claimant did not need to appear for a hearing. 

The claimant submitted a report from her internist that provided a less than sedentary residual functional capacity (“RFC”). Even if the claimant had a sedentary RFC, the medical-vocational rules would require finding the claimant disabled. Nonetheless, the ALJ approved the claimant's OTR on the grounds that her cancer qualified as a compassionate allowance. 

The MUGA scan was significant because the courts have held that the opinion of a treating physician is entitled to controlling weight where that opinion is based upon electrodiagnostic testing. In addition to the MUGA scan, an ultrasound revealed suspicious abnormalities, and then a biopsy revealed infiltrating ductal carcinoma.

Continuing Disability Review

After the Social Security Administration (“SSA”) determines that an individual is disabled, it is required to perform a review periodically to see if that person remains disabled. That review is called a continuing disability review (“CDR”). The purpose of the CDR is to determine if a person's medical problems have improved. 

The SSA has implemented many policies recently in an attempt to try to decrease the number of people receiving disability benefits. Increasing funding to do CDRs is one of the SSA’s new tactics. In other words, the SSA hopes that CDRs will determine that disability claimants have improved so their Social Security Disability (“SSD”) benefits can be terminated. Not surprisingly, the SSA is over employing the CDR process. 

I represent a 52 year old fire department dispatcher with back problems, multiple sclerosis (“MS”), and fibromyalgia, whose SSD benefits were approved today. The back impairments and MS were so severe that the SSA’s medical expert concluded each medical condition met a listing. Nonetheless, even though the claimant’s herniated discs and other back problems, and brain lesions are permanent conditions, the decision approving SSD benefits recommends CDR in 12 months because improvement is expected. 

The claimant’s orthopedic and neurologic back problems are progressive in nature. While they may not get worse within 12 months, they are permanent will not improve. There is no medical evidence anywhere that MS is curable. It appears that the SSA is simply taking steps to increase the number of CDRs regardless of the facts.

CIGNA Reverses LTD Termination

I represent a former Senior Director of Program Management whose microvascular ischemia forced him to stop working when he was 62 years old. I was retained after CIGNA terminated the long term (“LTD”) disability benefits, despite the fact that its own medical peer reviewer agreed with the claimant’s cardiologist that it would be dangerous for the claimant to continue working. 

CIGNA terminated the LTD benefits on the grounds that the claimant had the functional capacity to work. CIGNA completely disregarded the fact that it had previously reversed its original decision to deny LTD benefits after conceding that the claimant had to stop working to avoid the effect that work stress had on his microvascular ischemia. Without any written explanation, I received a check today, indicating that CIGNA had admitted that, once again, it was irrelevant whether the claimant could physically perform the work. 

CIGNA and other disability insurers have shown an increasing tendency to deny and terminate claims when claimants are over 62 years of age. Apparently, insurers are increasingly taking the position that since relatively few benefits remain, they hope many claimants will not fight the termination, or that there will not be enough at stake for an attorney to accept the case. CIGNA may be right. 

I agreed to represent this claimant because I had handled his claim in the past. I knew in advanced that my fee would not be worth the effort. Had I not previously represented the claimant, I may not have agreed to take his case. The problem is that without an attorney, I suspect that CIGNA would not have reversed its decision, and reinstated LTD benefits.

Disability Hearing Witnesses

The ostensible purpose for an Administrative Law Judge (“ALJ”) holding a hearing is to assess the credibility of the claimant who is seeking Social Security Disability (“SSD”) benefits. One way to bolster a claimant’s credibility is by developing work history evidence. Another way is by having a witness corroborate the claimant’s testimony. 

The Social Security rules require that evidence be considered from non-medical sources, such as: spouses, parents, caregivers, siblings, other relatives, friends, neighbors, and clergy. When an ALJ fails to discuss hearing testimony from these witnesses in a decision denying SSD benefits, the decision must be reversed. 

I represent a 28 year old corrections officer whose unfavorable ALJ decision was rejected today by the Appeals Council. The order from the Appeals Council noted that the ALJ claimed he gave appropriate weight to the testimony of the claimant’s girlfriend, but in fact, failed to indicate the specific weight accorded it. 

I advise every claimant to bring a witness to testify at their hearing. Besides bolstering the claimant’s testimony, because ALJ’s routinely ignore lay witness testimony, it provides an additional solid ground for appeal.