Claimants frequently omit information concerning some medical problems because they say it is not the main problem. That is a mistake, especially when applying for Social Security Disability (“SSD”) benefits. Social Security has a rule that requires
considering the combined effect of all of a claimant’s impairments without regard to whether any such impairment, if considered separately, would be of sufficient severity.
I represent a 49 year old legal secretary with physical and mental impairments from an accident, whose SSD benefits were approved today without a hearing. I submitted reports from the claimant’s pain management specialist and orthopedist regarding the physical impairments, and reports from the claimant’s psychiatrist and therapist regarding her mental impairments.
Most cases with severe physical or mental impairments still require a hearing before SSD benefits are approved. While the claimant probably would have been approved based upon either her physical or mental impairments after a hearing, developing the record for both impairments facilitated a decision without one. The goal is not simply to win, but to do so as quickly as possible.
Friday, May 27, 2016
Thursday, May 26, 2016
Lymphedema
Lymphedema refers to swelling that generally occurs in the arms or legs, which is usually caused by the removal of, or damage to, your lymph nodes. The swelling occurs from a blockage in your lymphatic system that prevents lymph fluid from draining well, and the fluid buildup leads to swelling and frequently causes pain and reduced mobility. According to webmd, elevating the swollen arm or leg can help drain lymph fluid from the affected limb.
I represent a 51 year old former art director with lymphedema whose Social Security Disability application was approved today. A key reason for the approval was the opinion of the treating physician, who opined that the claimant should elevate her leg hourly, which the vocational expert said precluded work. The Administrative Law Judge gave great weight to that doctor’s opinion, and accepted the vocational expert’s opinion.
I represent a 51 year old former art director with lymphedema whose Social Security Disability application was approved today. A key reason for the approval was the opinion of the treating physician, who opined that the claimant should elevate her leg hourly, which the vocational expert said precluded work. The Administrative Law Judge gave great weight to that doctor’s opinion, and accepted the vocational expert’s opinion.
Friday, May 20, 2016
Significant Weight Suffices
Social Security Administration (“SSA”) regulations require Administrative Law Judges (“ALJs”) to assign weight to all medical opinions. ALJs must also discuss the factors explaining the level of weight assigned. The question arises, if your doctor’s opinion supports your disability claim, then how much weight does an ALJ need to assign that opinion for you to win?
An ALJ gives controlling weight to an opinion if it is well-supported by medically recognized clinical and laboratory diagnostic techniques, and is not inconsistent with the rest of the medical evidence. That requires the ALJ to approve disability benefits. However, what happens if the ALJ gives less than controlling weight to your doctor’s opinion, can you still win your case?
The answer is yes. Frequently, ALJ’s give great or greatest weight to treating physician opinions when they approve disability benefits. I represent a 38 year old former administrative assistant and stockbroker whose Social Security Disability application was approved today after the ALJ gave “significant weight” to the opinions of four treating specialists.
An ALJ gives controlling weight to an opinion if it is well-supported by medically recognized clinical and laboratory diagnostic techniques, and is not inconsistent with the rest of the medical evidence. That requires the ALJ to approve disability benefits. However, what happens if the ALJ gives less than controlling weight to your doctor’s opinion, can you still win your case?
The answer is yes. Frequently, ALJ’s give great or greatest weight to treating physician opinions when they approve disability benefits. I represent a 38 year old former administrative assistant and stockbroker whose Social Security Disability application was approved today after the ALJ gave “significant weight” to the opinions of four treating specialists.
Thursday, May 19, 2016
Cancer Claims
The Social Security Administration (the “SSA”) tries different types of initiatives and programs on a regular basis. Usually, those programs reduce the number of claims being approved. For example, the SSA virtually eliminated the authority of staff attorneys to write OTRs, and the SSA increased the number of claims approved by ALJ’s for review.
The SSA may have another initiative currently. The SSA seems recently to be approving cancer claims more rapidly. In fact we had two more such claims approved today. While compassionate allowances, which include many cancers, are always supposed to be expedited, that has frequently not been the case.
The SSA does not automatically approve cancer claims. However, bringing it to the attention of the right people at the SSA should expedite its resolution, especially if there is presently a focus on such claims.
The SSA may have another initiative currently. The SSA seems recently to be approving cancer claims more rapidly. In fact we had two more such claims approved today. While compassionate allowances, which include many cancers, are always supposed to be expedited, that has frequently not been the case.
The SSA does not automatically approve cancer claims. However, bringing it to the attention of the right people at the SSA should expedite its resolution, especially if there is presently a focus on such claims.
Combined Disabling Conditions
Claimants frequently omit information concerning some medical problems because they say it is not the main problem. That is a mistake, especially when applying for Social Security Disability (“SSD”) benefits. Social Security has a rule that requires considering the combined effect of all of a claimant’s impairments without regard to whether any such impairment, if considered separately, would be of sufficient severity.
I represent a 49 year old legal secretary with physical and mental impairments from an accident, whose SSD benefits were approved today without a hearing. I submitted reports from the claimant’s pain management specialist and orthopedist regarding the physical impairments, and reports from the claimant’s psychiatrist and therapist regarding her mental impairments.
Most cases with severe physical or mental impairments still require a hearing before SSD benefits are approved. While the claimant probably would have been approved based upon either her physical or mental impairments after a hearing, developing the record for both impairments facilitated a decision without one. The goal is not simply to win, but to do so as quickly as possible.
I represent a 49 year old legal secretary with physical and mental impairments from an accident, whose SSD benefits were approved today without a hearing. I submitted reports from the claimant’s pain management specialist and orthopedist regarding the physical impairments, and reports from the claimant’s psychiatrist and therapist regarding her mental impairments.
Most cases with severe physical or mental impairments still require a hearing before SSD benefits are approved. While the claimant probably would have been approved based upon either her physical or mental impairments after a hearing, developing the record for both impairments facilitated a decision without one. The goal is not simply to win, but to do so as quickly as possible.
Sunday, May 8, 2016
Deceptive Insurance Practices
New York has a General Business Law (“GBL”) that imposes liability for deceptive business practices in the conduct of any business, trade, or commerce. GBL 349 has three elements: 1) the conduct must be consumer-oriented; 2) the conduct must be misleading; and 3) the plaintiff must be injured as a result of the deceptive act or practice. GBL 349 permits recovery of up to three times the plaintiff’s damages, and a court can also award attorneys’ fees.
The courts have upheld GBL 349 claims involving many different types of economic activity, and that includes conduct by disability companies. Claimants whose benefits under individual disability policies were wrongfully denied have commenced actions alleging that the disability insurer violated GBL 349.
I represent a 60 year old client who had to stop working as a foreign exchange broker after more than a quarter century following his sixth lumbar back surgery. The Social Security Administration and Reliance Standard quickly found the claimant was disabled from any full time occupation, let alone his own occupation.
Met Life found the claimant disabled from his own occupation, but then refused to pay additional benefits after a few months. I filed an action against Met Life that included a cause of action for GBL 349 violations. Met Life moved to dismiss the claim, arguing that it did not apply where a plaintiff sought benefits under a disability insurance policy. Specifically, Met Life argued that the complaint was merely a private dispute. The court rejected Met Life’s argument on the grounds that the claimant had stated claims that affected the public in general. Therefore, the court held that the claimant had properly stated a cause of action for GBL 349 violations, and denied Met Life’s motion to dismiss.
The courts have upheld GBL 349 claims involving many different types of economic activity, and that includes conduct by disability companies. Claimants whose benefits under individual disability policies were wrongfully denied have commenced actions alleging that the disability insurer violated GBL 349.
I represent a 60 year old client who had to stop working as a foreign exchange broker after more than a quarter century following his sixth lumbar back surgery. The Social Security Administration and Reliance Standard quickly found the claimant was disabled from any full time occupation, let alone his own occupation.
Met Life found the claimant disabled from his own occupation, but then refused to pay additional benefits after a few months. I filed an action against Met Life that included a cause of action for GBL 349 violations. Met Life moved to dismiss the claim, arguing that it did not apply where a plaintiff sought benefits under a disability insurance policy. Specifically, Met Life argued that the complaint was merely a private dispute. The court rejected Met Life’s argument on the grounds that the claimant had stated claims that affected the public in general. Therefore, the court held that the claimant had properly stated a cause of action for GBL 349 violations, and denied Met Life’s motion to dismiss.
Monday, May 2, 2016
Cyclic Vomiting Syndrome
According to an article in the Journal of Child Neurology, cyclic vomiting syndrome (CVS”) is a gastrointestinal disorder that is “characterized by severe discrete episodes of nausea, vomiting, and lethargy.” CVS is a fairly common, disabling, predominately childhood condition that has increasingly been seen in adults in recent years.
I represent a 49 year old former truck driver with CVS whose Social Security Disability (“SSD”) application was approved today five months after it was filed. The claimant had been treating with a gastroenterologist for this chronic condition since 2012. The claimant was missing about three days a month due to the CVS, which most vocational experts would say makes a person unable to sustain employment. However, even if CVS does not require a person to miss an entire day, it renders a person off task too often to be able to perform full time work on a sustained basis.
I represent a 49 year old former truck driver with CVS whose Social Security Disability (“SSD”) application was approved today five months after it was filed. The claimant had been treating with a gastroenterologist for this chronic condition since 2012. The claimant was missing about three days a month due to the CVS, which most vocational experts would say makes a person unable to sustain employment. However, even if CVS does not require a person to miss an entire day, it renders a person off task too often to be able to perform full time work on a sustained basis.
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