by Susan Golden
At the beginning of this year, the total wait time for a Social Security Disability ("SSD”) hearing was at an all time high of 511 days. Fast forward to today, and that wait has increase by another 84 days, bringing the total wait time to an average of 595 days.
As I discussed in a previous blog, due to the federal government hiring freeze and budget cuts in federal spending, SSD is backlogged with cases. There are not enough administrative law judges, attorneys or staff to handle these claims in a timely manner.
If you are in dire need, and cannot wait two years for a hearing, then we recommend calling your Congressman or Senator to lobby on your behalf. You can also try calling your local TV news stations, like "7 On Your Side." The public needs to know how disabled people are being treated. These people worked their entire lives, and would give anything to be able to continue to do so. Nobody wants to get SSD instead of working since SSD only provides a fraction of what they were earning. No one should have to live for 2+ years without any income, and in danger of losing everything, because of bureaucratic delays.
Tuesday, August 22, 2017
Thursday, August 17, 2017
SSA Medical Experts
When an Administrative Law Judge (“ALJ”) schedules a hearing for a Social Security Disability (“SSD”) claimant, a medical expert (“ME”) may be asked to testify.
According to the case law, an ME’s job is “to explain complex medical problems in terms understandable to lay examiners, not to assess plaintiff's impairments.” Nonetheless, ALJ’s almost always ask the ME for an assessment of the claimant’s restrictions and limitations, which more often than not, support the ability to work on a full time basis. Consequently, the credentials of the assigned ME should be investigated promptly in order to prepare for the ME’s cross-examination.
I represent a 49 year old former nurse with fibromyalgia and arthritis, whose SSD application was remanded by the Appeals Council for a new hearing for a vocational expert (“VE”). On remand, the ALJ held a hearing with a VE. Afterwards, the ALJ submitted interrogatories to an ME, named Gerald Galst. I advised the ALJ that unless he was prepared to issue a fully favorable decision, then I wanted a supplemental hearing to cross examine the ME.
I investigated ME Galst’s background, and submitted information from about ten websites where he was referred to as a cardiologist, which I used for the cross examination. After using a few of the exhibits, and Galst admitting that he was a cardiologist, that he didn’t treat fibromyalgia or arthritis, the ALJ went off the record and stated that he agreed the claimant should be found disabled.
By making it clear that the ME was a cardiologist, and did not practice as an internist, it would have been extremely difficult for the ALJ to accept the ME’s opinion over the opinion of the treating rheumatologist.
According to the case law, an ME’s job is “to explain complex medical problems in terms understandable to lay examiners, not to assess plaintiff's impairments.” Nonetheless, ALJ’s almost always ask the ME for an assessment of the claimant’s restrictions and limitations, which more often than not, support the ability to work on a full time basis. Consequently, the credentials of the assigned ME should be investigated promptly in order to prepare for the ME’s cross-examination.
I represent a 49 year old former nurse with fibromyalgia and arthritis, whose SSD application was remanded by the Appeals Council for a new hearing for a vocational expert (“VE”). On remand, the ALJ held a hearing with a VE. Afterwards, the ALJ submitted interrogatories to an ME, named Gerald Galst. I advised the ALJ that unless he was prepared to issue a fully favorable decision, then I wanted a supplemental hearing to cross examine the ME.
I investigated ME Galst’s background, and submitted information from about ten websites where he was referred to as a cardiologist, which I used for the cross examination. After using a few of the exhibits, and Galst admitting that he was a cardiologist, that he didn’t treat fibromyalgia or arthritis, the ALJ went off the record and stated that he agreed the claimant should be found disabled.
By making it clear that the ME was a cardiologist, and did not practice as an internist, it would have been extremely difficult for the ALJ to accept the ME’s opinion over the opinion of the treating rheumatologist.
Unum Loses
I represent a plaintiff who sued Unum after it terminated her long term disability (“LTD”) benefits. ERISA required Unum to render a decision in 45 days. Unum said that it could wait indefinitely beyond the 45 days because it was waiting for information from one of the claimant’s doctors. Rather than waiting, my client sued Unum. Unum then moved to dismiss the case, arguing that Plaintiff had to wait for Unum to make a decision.
In McFarlane v. Unum, U.S. District Court Judge Abrams rejected Unum’s argument, and denied its motion to dismiss. That decision can found on my website in the Resources tab drop down menu for Court Decisions. The bottom line is that disability insurers cannot claim that they are waiting for information as an excuse to act in a dilatory manner. Also as a result of the decision, Judge Abrams will review Unum’s decision de novo, meaning it will not be given any deference.
In McFarlane v. Unum, U.S. District Court Judge Abrams rejected Unum’s argument, and denied its motion to dismiss. That decision can found on my website in the Resources tab drop down menu for Court Decisions. The bottom line is that disability insurers cannot claim that they are waiting for information as an excuse to act in a dilatory manner. Also as a result of the decision, Judge Abrams will review Unum’s decision de novo, meaning it will not be given any deference.
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