Fast SSD Approval

We represent a 59 year old carpenter with shoulder and hand problems, whose Social Security Disability (“SSD”) benefits were approved in less than three months. Given the cutbacks to the agencies processing SSD claims, the quick approval was somewhat unusual. 

With the claimant’s help, we were able to obtain and submit treatment records, diagnostic tests, and a narrative report that supported the claimant’s application. The narrative report included restrictions and limitations that described the claimant’s functionality, symptoms, treatment, and supporting objective findings. Consequently, the claimant was not asked to undergo a consultative examination, which frequently is the basis for denying SSD applications.

Vocational Experts

At a Social Security Disability (“SSD”) hearing, an administrative law judge (“ALJ”) can ask a medical expert, vocational expert (“VE”), both, or neither to testify. In some circumstances, it may be advisable for a claimant to retain their own VE. 

I represent a 37 year old former case manager for the State Court system with migraines, neck and back problems, and mental impairments, whose SSD application was approved today, largely because she had retained a VE. I had advised the claimant to retain a VE for two reasons. First, many ALJs find it difficult to account for migraines. Second, the claimant also filed a NYSLERS claim, and that entity does not use VEs when evaluating claims. 

There are relatively few VEs locally who are familiar with the SSD process, and many of them also work for Social Security Administration (“SSA”), which was true for the VE that the claimant retained. After bringing the VE’s report to the attention of one of the staff attorneys at the SSA hearing office, he advised me that he would recommend an OTR, which the ALJ approved today. 

The ALJ’s decision gave great weight to the opinions of the claimant’s orthopedist and neurologist, who had provided diagnostic tests and treatment records to support their opinions. However, that is not unusual, yet very few cases now get approved OTR. The ALJ’s decision also gave great weight to the VE’s opinion that there was no work that the claimant could perform full time. That distinction indicates that it was the reason why the ALJ found an OTR was justified.

Disability & Medicare

It is important to remember that after you become eligible for Social Security Disability (“SSD”) benefits, you can also receive Medicare. Since many claimants get their health insurance through their employers, which terminates after they stop working, Medicare becomes vitally important. 

The lack of health insurance can also affect your ability to obtain SSD benefits. I represent a 58 year old claimant from Florida for his SSD claim. He had been a carpeting foreman and had developed shoulder and ankle problems. His internist, podiatrist, and orthopedist provided reports to support the SSD application. 

The State agency asked if the claimant was going to have surgery on his shoulder. I advised the State agency that the claimant could not afford to have the surgery because he had no health insurance. Shortly thereafter, the claimant’s SSD benefits were approved. 

When SSD benefits are approved, you are automatically enrolled in Medicare after you get SSD benefits for two years. The two parts of Medicare that you receive are hospital insurance and medical insurance.

IMA Disability Services

Don’t believe everything you hear; especially when it comes from IMA Disability Services (“IMA”).

I represent a 58 year old construction foreman, whose job was very heavy work. He had rheumatoid arthritis and carpal tunnel syndrome, which prevented him from continuing to work. As usual, the State agency directed the claimant to attend a consultative examination (“CE”). 

I advised my client to videotape the CE. Two weeks ago, he went to the IMA office in Bohemia with his wife, who was videotaping the entire CE process with her cell phone. He was taken for an x-ray before the physical examination. Before the x-ray was taken, an IMA representative told the claimant that he was not allowed to record the CE. When the claimant insisted that he had the right to videotape his own exam, he was told that the CE would not proceed and to leave. 

As the claimant was leaving IMA, he was told that he would be back the next week. The claimant never returned to IMA, and he received his Social Security Disability (“SSD”) check in the mail today.

NYSLERS & SSD

When applying for disability benefits, the Social Security Administration (“SSA”) is required to consider evidence from other governmental agencies. While a decision from another agency awarding disability benefits is not binding on the SSA, the SSA can find such a decision to be very persuasive. 

I represent a 52 year old former teacher with back, knee, shoulder, and mental impairments. In May 2017, the SSA was given a report from the treating orthopedist that concluded the claimant could not work, and that report was supported with treatment notes and MRI test data. In October 2017, the SSA was given a report from the treating spine surgeon that concluded the claimant could not work, and that report was supported with treatment notes, surgical reports, and MRI test data. In December 2017, the SSA was given a report from the treating psychiatrist, which concluded that claimant could not work. Despite well supported opinions from three different specialists, the SSA did not approve SSD benefits. 

Two weeks ago, the SSA was provided with proof that NYSLERS found the claimant unable to work. Today, we learned that the SSA approved the claimant’s SSD benefits. While the NYSLERS approval was not binding under the regulations, the SSA must have found it to be convincing.

Help for SSD Benefits?

Some politicians on the Ways and Means Committee actually understand how claimants are being adversely affected by the Social Security Administration's ("SSA's") lack of funding. The wait times for hearings at the SSA have so greatly increased, along with the wait times for receipt of benefits, that Ways and Means might actually try to do something about it. Those politicians are urging the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and related agencies Chairman, to increase funding to the SSA to help combat the backlog, which is negatively affecting millions of disabled workers.

Vocational Experts

At a Social Security Disability (“SSD”) hearing, an administrative law judge (“ALJ”) can ask a medical expert, vocational expert (“VE”), both, or neither to testify. In some circumstances, it may be advisable for a claimant to retain their own VE.

I represent a 37 year old former case manager for the State Court system with migraines, neck and back problems, and mental impairments, whose SSD application was approved today, largely because she had retained a VE. I had advised the claimant to retain a VE for two reasons. First, many ALJs find it difficult to account for migraines. Second, the claimant also filed a NYSLERS claim, and that entity does not use VEs when evaluating claims. 

There are relatively few VEs locally who are familiar with the SSD process, and many of them also work for Social Security Administration (“SSA”), which was true for the VE that the claimant retained. After bringing the VE’s report to the attention of one of the staff attorneys at the SSA hearing office, he advised me that he would recommend an OTR [9/20/17], which the ALJ approved today. 

The ALJ’s decision gave great weight to the opinions of the claimant’s orthopedist and neurologist, who had provided diagnostic tests and treatment records to support their opinions. However, that is not unusual, yet very few cases now get approved OTR. The ALJ’s decision also gave great weight to the VE’s opinion that there was no work that the claimant could perform full time. That distinction indicates that it was the reason why the ALJ found an OTR was justified.