I have a case pending in federal court against Unum for wrongful termination of long term disability (“LTD”) benefits. Besides previously approving the LTD benefits, Unum had also approved my client’s benefits under a short term disability plan, as well as under an Individual Disability Insurance policy.
After the court denied Unum’s motion to dismiss, Unum filed a summary judgment motion that asked the court to remand the case to Unum. There are hundreds of reported cases where Unum files motions to affirm its decision to deny or terminate disability benefits. Unum’s seeking a remand is an admission that it knows its decision to terminate my client’s LTD benefits cannot be sustained.
Friday, the court denied Unum’s motion to remand, and ruled that a bench trial with medical witnesses will be scheduled in early January. The court also actually stated on the record that my client will likely prevail at the trial. Norman Bress and Peter Kouros will probably be Unum's witnesses, and possibly Gary Greenhood too. If anyone has information about any of those Unum doctors that they are willing to share, please contact my office.
Saturday, September 8, 2018
Thursday, September 6, 2018
SSA Misinformation
There are a variety of benefits that may be available if you become entitled to receive Social Security Disability (“SSD”) benefits. The Social Security Administration (“SSA”) does not provide those benefits automatically, but requires applications to be filed to receive them. Moreover, either intentionally or unintentionally, the SSA frequently provides misinformation about the availability of these additional benefits.
I represent a claimant who received SSD benefits starting in March 2008, but whose children’s benefits did not start until 2013. The claimant never received a letter from the SSA advising him to file an application for children’s benefits when he was approved for SSD benefits, and proved that he had problems receiving mail at that time. The claimant was also told by the local Social Security that there were no other benefits available for him besides his SSD.
After I obtained a remand from the Appeals Council, I persuaded the ALJ to reverse his original decision. As a result, the ALJ ruled that the claimant was entitled to receive an additional five years of children’s benefits. As the claimant is now gravely ill from his disability, hopefully the decision will provide some solace.
I represent a claimant who received SSD benefits starting in March 2008, but whose children’s benefits did not start until 2013. The claimant never received a letter from the SSA advising him to file an application for children’s benefits when he was approved for SSD benefits, and proved that he had problems receiving mail at that time. The claimant was also told by the local Social Security that there were no other benefits available for him besides his SSD.
After I obtained a remand from the Appeals Council, I persuaded the ALJ to reverse his original decision. As a result, the ALJ ruled that the claimant was entitled to receive an additional five years of children’s benefits. As the claimant is now gravely ill from his disability, hopefully the decision will provide some solace.
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.”
Subscribe to:
Posts (Atom)
