Tuesday, August 28, 2018
SS Retirement Benefits
This article gives great advice regarding getting when and how to get the most out of Social Security retirement benefits.
Monday, August 20, 2018
Pain Management Support
I represent a 58 year old former security officer with hip, shoulder and back impairments, whose Social Security Disability (“SSD”) application was approved without a hearing. What distinguished this case from the countless other SSD applications based on orthopedic impairments is the support from pain management physicians.
The claimant had seen more than one pain management specialist, whose treatment records were provided. Just as importantly, we submitted reports detailing the claimant’s functionality. Those records and reports objectified the effects of the claimant’s pain.
The Social Security Administration (“SSA”) views the opinions of treating physicians with skeptically, which is why the SSA withdrew the rule that gave the opinions of treating physicians greater weight than the SSA doctors. I had numerous Administrative Law Judges (“ALJ’s”) and SSA medical experts tell me that they do not care what treating doctors say because they will say anything to help their patients. ALJ’s reject SSD applications by asserting claimant’s complaints of pain lack credibility and are inconsistent with the objective medical record.
No medical specialist is in a better position to opine about the effects of a claimant’s subjective complaints of pain than a pain management specialist, which makes it more difficult for the SSA to deny a claim. Moreover, logic dictates that the SSA will find complaints of pain more credible when a claimant sees the need to treat with a pain management specialist.
The claimant had seen more than one pain management specialist, whose treatment records were provided. Just as importantly, we submitted reports detailing the claimant’s functionality. Those records and reports objectified the effects of the claimant’s pain.
The Social Security Administration (“SSA”) views the opinions of treating physicians with skeptically, which is why the SSA withdrew the rule that gave the opinions of treating physicians greater weight than the SSA doctors. I had numerous Administrative Law Judges (“ALJ’s”) and SSA medical experts tell me that they do not care what treating doctors say because they will say anything to help their patients. ALJ’s reject SSD applications by asserting claimant’s complaints of pain lack credibility and are inconsistent with the objective medical record.
No medical specialist is in a better position to opine about the effects of a claimant’s subjective complaints of pain than a pain management specialist, which makes it more difficult for the SSA to deny a claim. Moreover, logic dictates that the SSA will find complaints of pain more credible when a claimant sees the need to treat with a pain management specialist.
Wednesday, August 15, 2018
Social Security Scam
We received a phone call today from a former client who was very upset because he had received a voice mail from Social Security accusing him of fraud. Fortunately, before returning the call, he called me. I advised my client that Social Security would never leave a message like that. I urged him to call his local Social Security office to advise them of the phone call, which obviously was a scam. Do not ever respond to such a call, and contact your local Social Security office if you have any questions.
Wednesday, August 1, 2018
More Trouble for SSD
The denial rates for Social Security Disability ("SSD") benefits have been increasing for several years now. Nonetheless, in order to invigorate that trend, the Trump Administration has changed the rules governing the hiring of Administrative Law Judges ("ALJ's"). Instead of going through a competitive interviewing process based on experience, the new executive order makes it easier for Presidential appointed Agency Heads to hire new ALJ's directly. This fosters the selection of ALJs who are predisposed to deny SSD benefits, which is a goal of the Administration. More denials means more appeals, choking the already backlogged system with more claims, and increasing even further the amount of time that people will have to wait for a favorable decision.
Tuesday, July 24, 2018
Recording A CE
Regardless of what the medical records reveal, the State agency tells a Social Security Disability (“SSD”) claimant to go for consultative examinations ("CE”). CEs almost invariably contain fraudulent findings. For example, the CE report will say that the claimant had no trouble getting on and off the exam table, when the claimant only sat in a chair. This has been happening for many years.
To guard against fraudulent findings, I advise my clients to video record the CE, which are performed by IMA. Because there is no law, rule, or regulation that prohibits a SSD claimant from recording the CE, IMA claims that it is against their policy. However, in IMA offices, they have signs stating that claimants can record their exams, so their “policy” is specious at best.
I represent a 52 year old former teacher for the deaf whose SSD application was approved by an ALJ today. The State agency had denied the claim on the grounds that the claimant refused to attend the CE. The claimant testified that when the IMA doctor saw the claimant’s spouse recording the exam, the doctor threw a fit, left the exam room, and refused to return. The claimant further testified that she never refused to answer any question or submit to an exam by IMA. If the reports of IMA doctors actually reflected what transpired during their exams, then there would be no reason for IMA’s “policy.”
To guard against fraudulent findings, I advise my clients to video record the CE, which are performed by IMA. Because there is no law, rule, or regulation that prohibits a SSD claimant from recording the CE, IMA claims that it is against their policy. However, in IMA offices, they have signs stating that claimants can record their exams, so their “policy” is specious at best.
I represent a 52 year old former teacher for the deaf whose SSD application was approved by an ALJ today. The State agency had denied the claim on the grounds that the claimant refused to attend the CE. The claimant testified that when the IMA doctor saw the claimant’s spouse recording the exam, the doctor threw a fit, left the exam room, and refused to return. The claimant further testified that she never refused to answer any question or submit to an exam by IMA. If the reports of IMA doctors actually reflected what transpired during their exams, then there would be no reason for IMA’s “policy.”
Friday, July 20, 2018
COPD
Chronic obstructive pulmonary disease (“COPD”) is a progressive disease that makes it hard to breathe. COPD symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. The symptoms of COPD are progressively worsening and persistent breathlessness on exertion, eventually leading to breathlessness at rest.
Because a claimant is initially symptomatic upon exertion, the more strenuous a claimant’s job is, the sooner that person is likely to become unable to perform it. Thus, a laborer in the construction industry is much more likely to be found disabled soon after the onset of COPD, compared to a receptionist who spends most of the day sitting.
I represent a 55 year old floor tiler whose Social Security Disability (“SSD”) claim was approved today. His job required him to carry 100 pound boxes of tiles and sacks of grout. The administrative law judge (“ALJ”) found it credible that the level of exertion to perform the tiling work was precluded by the COPD. Had the claimant’s work required mostly sitting, then the ALJ would not have found the COPD to be disabling until it had progressed to the point where little exertion resulted in symptoms.
Because a claimant is initially symptomatic upon exertion, the more strenuous a claimant’s job is, the sooner that person is likely to become unable to perform it. Thus, a laborer in the construction industry is much more likely to be found disabled soon after the onset of COPD, compared to a receptionist who spends most of the day sitting.
I represent a 55 year old floor tiler whose Social Security Disability (“SSD”) claim was approved today. His job required him to carry 100 pound boxes of tiles and sacks of grout. The administrative law judge (“ALJ”) found it credible that the level of exertion to perform the tiling work was precluded by the COPD. Had the claimant’s work required mostly sitting, then the ALJ would not have found the COPD to be disabling until it had progressed to the point where little exertion resulted in symptoms.
CE Boondoggle Continues
For many years, I have been describing how virtually every single
State agency examiner who processes applications for Social
Security Disability benefits insists that claimants must attend consultative examination “CE”s. Almost every CE is scheduled in violation of
the Social security rules and regulations, and results in a waste of time and
taxpayer money. By demanding a CE, the State agency is saying it does not
believe what the treating doctor says. Notably, ALJ Kilgannon just said the
same thing during a hearing last week, which shows that the
aforementioned concept is not limited to the State agency.
I represent a 54 year old former carpenter with knee, neck, back, and shoulder impairments. On May 21, 2018, the State agency told the claimant he had to attend CEs for his knee and depression. Ignoring my May 23, 2018 letter detailing why a CE was improper, the State agency rescheduled them on May 31, 2018.
When the State agency sent a reminder letter about the CEs on June 1, 2018, we faxed a letter advising the State agency that the claimant neither has, nor claimed, a mental impairment. Nonetheless, on June 14, and 15, 2018, the State agency sent additional letters to remind the claimant about the CEs. After a series of calls, the State agency finally agreed that a CE was not needed to address a mental impairment.
The good news is that the claimant’s SSD benefits were approved last week without a hearing. The bad news is that the attempt to compel the claimant to submit to a mental CE must have delayed the processing of the application. There was nothing in the application regarding a mental impairment. There was no medical record regarding any mental problem. No psychotropic medication was prescribed for the claimant.
Did the State agency fail to review the file properly when scheduling the mental CE? Does the State agency or its examiners have an undisclosed incentive to schedule needless CEs? I suspect we will still be asking these questions for the unforeseeable future.
I represent a 54 year old former carpenter with knee, neck, back, and shoulder impairments. On May 21, 2018, the State agency told the claimant he had to attend CEs for his knee and depression. Ignoring my May 23, 2018 letter detailing why a CE was improper, the State agency rescheduled them on May 31, 2018.
When the State agency sent a reminder letter about the CEs on June 1, 2018, we faxed a letter advising the State agency that the claimant neither has, nor claimed, a mental impairment. Nonetheless, on June 14, and 15, 2018, the State agency sent additional letters to remind the claimant about the CEs. After a series of calls, the State agency finally agreed that a CE was not needed to address a mental impairment.
The good news is that the claimant’s SSD benefits were approved last week without a hearing. The bad news is that the attempt to compel the claimant to submit to a mental CE must have delayed the processing of the application. There was nothing in the application regarding a mental impairment. There was no medical record regarding any mental problem. No psychotropic medication was prescribed for the claimant.
Did the State agency fail to review the file properly when scheduling the mental CE? Does the State agency or its examiners have an undisclosed incentive to schedule needless CEs? I suspect we will still be asking these questions for the unforeseeable future.
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