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.

SSA on the Hotseat

The House Ways and Means Committee held a thearing on October 26, 2023, to question the acting assistant deputy commissioner of operations from the Social Security Administration ("SSA") about the decades old systemic problems that affect millions of Social Security Disability ("SSD") applicants.  If you ever applied for SSD benefits, or know someone who has, then you probably already know about these problems.

The SSA is supposed to help people who are eligible for SSD benefits when they become too ill to work.  However, the application process is antiquated, customer service is almost non-existent, the wait time to speak to someone on the phone averages 35 minutes, and the wait time for a decision is ridiculously long.

Some of our clients retain us after they have applied on their own, and they realize that trying to navigate the SSA's system is extremely stressful and difficult.  We take that burden off of them and make certain that the SSA has no direct contact with them.  Our clients would rather be working than applying for SSD, but due to any number of medical conditions, cannot work on a full-time basis.  But trying to stay afloat while the SSA makes a decision is almost impossible for many of our clients.  We have had clients pass away while waiting for a decision, and the SSA just does not seem to care.  The SSA simply blames the delays on backlogs and lack of staff.

David Camp, interim chief executive of the National Organization of Social Security Claimants’ Representatives, also testified at the hearing.  He explained how changing some of the SSA's rules and regulations, which are ineffective and old, could reduce the wait time for a decision, and free up the State agencies' analysts to work more efficiently.  These common sense changes could make a huge difference in many people's lives.  Of course, the members of the Ways and Means Committee would have to agree to continue to fund the SSA, because any cuts to their budget would be detrimental for anyone that is trying to obtain SSD benefits.

 

Medical Investigating

Attorneys representing claimants seeking Social Security Disability (“SSD”) benefits frequently will attack an administrative law judge (“ALJ”) for failing to credit the claimant’s subjective complaints.  Attorneys need to listen their clients as well.

We represent a 55 year old claims adjuster from Franklin Square, who asked us to seek SSD benefits due to mental impairments.  When preparing the claimant for his hearing, he complained about neck and hand pain.  We immediately advised him to see a neurologist, who performed EMG testing, which yielded abnormal results.

The ALJ disregarded the claimant’s physical impairments when denying the case.  Shortly thereafter, in light of the abnormal EMG, the neurologist sent the claimant for an MRI of his cervical spine.  The MRI revealed shockingly severe findings.

When appealing the ALJ’s decision, we submitted the MRI.  The Appeals Council remanded the case to the ALJ in near record time.  The same ALJ approved the claimant’s SSD application today based primarily on the physical impairments.

Our client, who suffers from extreme anxiety, was so grateful to us for being successful in getting his claim approved.  We are glad we were able to relieve one burden from his shoulders.  Please call our office if you are looking for an experienced disability attorney to help you apply for Social Security Disability benefits.  We have offices located on Long Island in Nassau and Suffolk counties, and offer a free phone consultation.

 

COLA Increase

It's the time of the year again when Social Security announces the COLA ("Cost of Living Adjustment").  This year the COLA is 3.2%.  The SSA has estimated that anyone receiving benefits can expect an increase of about $50 beginning in 2024.

More ALJs Needed

We represent a 58 year old from Fair Lawn, NJ, with mental and physical impairments, who requested a hearing with an administrative law judge (“ALJ”) on September 7, 2022.  The good news is that ALJ Dina Loewy from the Jersey City hearing office approved Social Security Disability (“SSD”) benefits today OTR.  Unfortunately, it took 13 months to obtain the OTR.

The average wait time for a hearing at the Jersey City office is 13 months, which is better than most hearing offices.  For example, the average wait time for a hearing at the Long Island hearing office is 16 months.  Consequently, the Long Island hearing office has been transferring SSD appeals to other offices, like Albany and Hartford, which have average hearing waits of 14 and 13 months respectively.

It is not a secret that ALJs are under pressure to increase the number of cases they adjudicate in order to reduce the hearing wait times.  An internal memo from last year from the Deputy Communications Commissioner for Social Security, said that years of inadequate funding resulted in the agency  being unable to " keep up with the demand for service and our annual fixed cost increases."  According to the memo, Disability Determination Services (“DDS”), which assesses disability claims, experienced "historically high attrition as workloads become less reasonable with fewer staff."

It would seem to be in everyone’s best interest if the number of ALJs and State agency representatives could be increased.  The SSD safety net was designed to help workers at the most vulnerable point  of their careers.  Workers paid into the system for the explicit purpose of receiving some limited financial assistance just in case they become disabled.  Workers should not have to wait a year for the DDS to render a decision, and if denied, then wait over another year for a hearing with an ALJ.

If you are thinking about applying for SSD, you should retain an experienced disability attorney to represent you.  The process of applying is not a simple one and can cause a claimant a lot of undue stress.  Our offices are located in Nassau and Suffolk counties on Long Island.  We offer a free phone consultation.