Lupus

About 1.5 million Americans have Lupus according to the Lupus Foundation of America. Because the Social Security Administration (“SSA”) recognizes that Lupus frequently can prevent a person from being able to work, it created a listing for it. Claimants with Lupus can receive Social Security Disability (“SSD”) benefits even if they do not meet the criteria for the listing. 

I represent a 59 year old former administrative clerk with Lupus whose SSD claim was approved today, without the need for a hearing. We submitted a report from the treating rheumatologist that cited RNP and ANA antibodies as the laboratory test data that supported his opinions. A staff attorney from the hearing office then asked us for that objective medical evidence, we provided copies of the test results. Thereafter, the staff attorney advised us that she would recommend having SSD benefits approved.

SSD Delays

If you Google Social Security Disability (“SSD”) delays, you will find countless articles about the record long waiting time to get a hearing with an Administrative Law Judge, or about how thousands of people are dying while they wait for their SSD benefits.  Claimants frequently ask me what they can do to minimize their wait time.  My answer is that they should visit their doctors to ensure that they provide the necessary test results, treatment records, and opinion reports and forms that I advised.

I represent a 59 year old house cleaner with back and neck problems, whose SSD application was approved today in less than five months.  While the majority of my clients are in their 50’s with musculoskeletal problems, few get approved in less than five months.  The only thing that was really different here was that the claimant promptly provided all of the medical information that I suggested was needed to support her claim.

The SSD process takes much longer than it should.  Because claimants can no longer work and have no income, most cannot afford the usual delay involved.  It helps to be proactive.  While we always request documentation, doctors obviously are more responsive to information requests from their patients, than they are to us.

WC Medical Opinions

Many people file both Workers Compensation (“WC”) and Social Security Disability (“SSD”) claims. During the SSD application process, the Social Security Administration (“SSA”) frequently obtains the records and reports of the WC doctors. How much weight does the SSA give to the opinion of a WC doctor? 

Last year, in an SSD appeal, a federal district court judge rejected the opinion of a WC doctor because he failed to specify if the claimant could sit for 6 hours a day. The district court judge reasoned that the SSA administrative law judge (“ALJ”) was not permitted to speculate about the claimant’s capacity to remain seated based on the WC medical reports, and had a duty to procure medical evidence that specifically discussed the claimant’s capacity to sit for six hours and to stand and walk for two hours. 

What happens if a WC doctor addressed whether or not a claimant could sit for 6 hours a day? In New York, it has long been recognized that when reviewing a SSD claim, the opinions of WC doctors are entitled to little weight. Federal court judges have discounted reports from WC doctors on the grounds that self-interest may well have dictated their contents, and they should not be permitted to constitute substantial evidence. 

Despite the aforementioned, ALJs frequently seek to deny SSD benefits by elevating the opinions of WC doctors over the opinions of treating doctors. 

I represent a 46 year old former cement truck driver whose SSD application was approved today. Despite the fact that two treating orthopedists and a treating pain management specialist specified that the claimant lacked the ability to perform sedentary, the ALJ insisted that the claimant provide the report from the WC doctor. 

The claimant’s WC case was closed a few years ago after he received a lump sum settlement. However, I was able to obtain, and submit, the WC doctor’s report to the ALJ a couple of weeks after the hearing. I enclosed the report with a cover letter that included the citations and greater explanation concerning the relevant case law briefly mentioned above. I contended that there was no reason to defer to the opinion of the WC doctor because the ALJ already had medical evidence from the treating doctors that specifically discussed the claimant’s inability to sit for 6 hours a day. 

The ALJ, who was from the Virginia hearing office, approves as many SSD claims as he denies. Regardless of where the ALJ is located, because the claimant resides and would appeal to federal court in New York, New York case law would apply to the appeal. Considering that my client was under 50 years of age, I suspect that the ALJ would have denied the SSD application based on the WC doctor’s opinion if I had not provided the cover letter explaining how New York courts have treated WC medical opinions.

Government Targets the Disabled

In another cruel and unusual twist, the Trump Administration has given states the power to require people on Medicaid to "participate in a work program or other form of approved “community engagement” in order to retain their health benefits." By doing this, it puts the disabled in an "in-between” position, which will lead to more people being disability benefits and even death.

Another SSD Myth Busted

I have written several blogs regarding some of the myths about people who apply for Social Security Disability ("SSD") benefits.  One of the biggest myths is that these people are lazy, and just want to sit home and collect SSD benefits.  The truth is that most of those people would much rather be working than sitting at home, and having to rely on SSD benefits, which pay only a fraction of what they had been earning.  Here on Long Island,  SSD benefits rarely cover the most basic necessities. These people are like you and I, have worked hard their entire lives, paid into Social Security, and became disabled for a multitude of reasons beyond their control.  Even with doctors supporting their claims, and their years of employment attesting to their credibility, they are too often denied SSD benefits.  We have no right to judge them.  If these people have enough work credits, then they are eligible for SSD benefits.  If they do not, then they may eligible for Supplemental Security Income (“SSI”).  So unlike what the government would have you believe, no one is getting benefits that they are not eligible to receive.  Nonetheless, the government has been taking affirmative steps to increase the SSD and SSI denial rates, while allowing the waiting times for hearing to hit a record high.

The Truth About SSD

"Social Security is a pay-as-you-go system with current workers contributing to older Americans." However, while cutting taxes, the government spouts the need to cut funding to Social Security and Medicare due to budget deficits and annual dept, when in reality this is not even close to the truth.

SS Benefits 101

Many clients that call us have no idea that they could have applied for Social Security Disability benefits. This article explains who is eligible, and what steps need to be taken to apply for these benefits.

Increase in SS Denials

It's pretty much common knowledge that the denials for Social Security Disability benefits have increased exponentially over the past several years. What may not be common knowledge is that our government has directed the Social Security judges to deny as many claims as possible, even when the law supports the merits of the claim.