Unum LTD Approval

We were able to secure long term disability (“LTD”) benefits for a 47 year old Vice President of Human Resources from Glen Cove. After we took over the case, we advised Unum about the claimant’s various limitations that we were documenting due to the claimant’s rheumatoid arthritis (“RA”) and vocal cord nodules. Unum was unaware that the claimant was required to elevate her legs due to swelling from the RA, and was restricted in her speaking and needing a quiet environment to be heard due to the nodules. Rapidly developing the evidence regarding those limitations led to a quick approval, which was especially difficult in light of COVID. 

Navigating LTD can be very difficult, which is why it is in your best interest to retain an attorney who specializes in disability law. If you find yourself in need of applying for your long term disability, please call my office for a free phone consultation. We have offices conveniently located on Long Island in both Nassau and Suffolk counties.

Federal Court Remand

Even though the Social Security Administration (“SSA”) agreed that the decision of administrative law judge (“ALJ”) Andrew Weiss was indefensible, it took over two years for U.S. District Judge Joan Azrack to remand the decision, which the ALJ issued over three years ago. The complete decision is available on my website.

Form Over Substance

A 54 year old sanitation worker from North Babylon with various orthopedic impairments retained us after his Social Security Disability ("SSD") application was denied. Nothing unusual about the case except that we filed over 2,000 pages of treatment records, much of which were hospital records.  The substance of the file was not unlike many similar claims that were denied by the State agency.  It may be that regardless of the materiality of the documentation submitted, when a very large volume of paper is filed, the State agency feels more confident about the credibility of the claim.

This is another example of why it is important to retain a disability attorney when you apply for SSD.  Even though it may seem obvious to you that you are disabled, you cannot get approved without support from your doctors.  An attorney who specializes in disability can discern what information is needed from your doctors to get your claim approved.  If you are thinking about applying for SSD, please call my office for a free phone consultation.  We have offices conveniently located on Long Island in both Nassau and Suffolk counties.

 

Superior Service at Melville

We have posted blogs about the ineptness of some of the Social Security district offices. But we also like to give credit, where credit is due. I called the Melville district office today regarding a claim that we had recently filed, and was lucky enough to reach Mrs. Craven who works there. Not only did Mrs. Craven fix the mistake that someone else made when processing our client's claim, but she also went out of her way to correct a mistake that was made by someone at the Patchogue district office, who was incapable of correcting their mistake. This is not the first time that Mrs. Craven has helped me, and I hope it won't be the last. She is professional, courteous, and most of all, she knows what she's doing. Problems that pose a particular issue for other representatives she is able to fix in a few minutes. Why can't we expect every SSA representative to perform as well as she. We greatly appreciate Mrs. Craven's knowledge and help, and hope that others can follow her example. Thank you Mrs. Craven.

by Susan Golden

Common Sense

According to Webster’s, common sense is sound and prudent judgment based on a simple perception of the situation or facts. It is astounding how often the State agency exhibits a lack of common sense when evaluating Social Security Disability (“SSD”) applications.

I represent a 59 year old from Freeport, who suffered spine injuries from a motor vehicle accident (“MVA”) on October 11, 2018. The State agency said an MRI from May 19, 2019, supported the claimant’s SSD application, but only found the claimant disabled as of February 19, 2019. 

Common sense dictates that the spine injuries arose from the MVA. Even the administrative law judge was baffled by the State agency’s onset date of February 19, 2019. There was no evidence that the claimant’s condition got worse as of February 19, 2019. There was no medical opinion that could support finding that the claimant was able to work after the MVA. There was no other accident or physically traumatic events between the MVA and onset date.

Navigating Social Security can be very difficult, which is why it is in your best interest to retain an attorney who specializes in disability law.  If you find yourself in need of applying for SSD, please call my office for a free phone consultation.  We have offices conveniently located on Long Island in both Nassau and Suffolk counties.

 

Patchogue Ineptness Continues

We represent a veteran, who was approved in February for Social Security Disability ("SSD") and Supplemental Security Income ("SSI") benefits.  When a person is approved for benefits, it usually takes Social Security ("SS") a while to process and calculate the retroactive and monthly benefits.  It can take even longer when you are approved for both SSD and SSI. However, it has been eight months since our client was approved, and yet he still has not received his retroactive benefits, which he so desperately needs, and he has just started to receive his monthly benefits. 

It would be a gross understatement to say the handling of our client's payments by the Patchogue District office has been a comedy of errors.  Our client's first SSI check was sent to an address where he has not lived for many years, even though SS had the updated address in his file. 

 

To add insult to injury, our client was supposed to have his first monthly SSD check directly deposited into his bank account on October 3, 2020, but on Friday, we learned from the Patchogue District office that the check had been mailed. We asked Patchogue how this could happen becauase we had confirmed our client's bank account information with various people at the Patchogue office multiple times.  Patchogue said that they have two different systems for SSI and SSD, and whoever initially took the updated information, only entered it into the SSI system.  Patchogue also said that whoever updated the address into the SSD system, never updated the banking information.  So once again, we confirmed that Patchogue had the correct banking information and address, so that our client's November check would be direct deposited.  Patchogue told us that our client would receive the check by this past Monday or Tuesday.  

 

Today is Wednesday.  I received a phone call from my client, who was understandably furious.  Even though we confirmed his address with Patchogue last Friday, they mailed his check to the wrong address again!  It's like banging your head against the wall.    

 

Patchogue's mishandling of this matter is utterly reprehensible, incompetent, and unprofessional.  Are they truly that inept at their jobs, or do they just not care?  I am certain that if their paychecks kept getting mailed to the wrong address, then they would be very angry.  

 

Sadly, Patchogue's actions reflect their lack of concern and respect for their constituents, including their Veterans.  Our client became disabled in the line of duty.  Is this really how he should be treated?  I am appalled and disgusted at Patchogue's misconduct.

Common Sense

According to Webster’s, common sense is sound and prudent judgment based on a simple perception of the situation or facts. It is astounding how often the State agency exhibits a lack of common sense when evaluating Social Security Disability (“SSD”) applications. 

I represent a 59 year old from Freeport, who suffered spine injuries from a motor vehicle accident (“MVA”) on October 11, 2018. The State agency said an MRI from May 19, 2019, supported the claimant’s SSD application, but only found the claimant disabled as of February 19, 2019. 

Common sense dictates that the spine injuries arose from the MVA. Even the administrative law judge was baffled by the State agency’s onset date of February 19, 2019. There was no evidence that the claimant’s condition got worse as of February 19, 2019. There was no medical opinion that could support finding that the claimant was able to work after the MVA. There was no other accident or physically traumatic events between the MVA and onset date.

Having an experienced, Social Security Disability attorney is vital when applying for SSD benefits.  Please feel free to call my office for a free phone consultation.  My offices are conveniently located in both Nassau and Suffolk counties on Long Island.

Attorney Needed

Sometimes it undeniably makes a difference having an attorney represent you in connection with your Social Security Disability (“SSD”) benefits. The Social Security Administration's own statistics show that the percentage of claims approved is greater when a claimant is represented by an attorney. I represent a 55 year old from Speonk who worked in computer networking with physical and mental impairments, which shows why an attorney is sometimes is a must. 

After a very heated hearing with a medical and a vocational expert (“VE”), the administrative law judge (“ALJ”) indicated that he would deny the case based on the VE’s testimony. I asked the ALJ if he was relying on the VE’s testimony before or after I pointed out that he originally identified the wrong occupation as the claimant’s past work. The VE admitted that the claimant’s past work was at least a composite occupation comprised of the light one he identified and the physically demanding medium one that I suggested. 

The ALJ then said that it made no difference because the VE identified unskilled occupations that the claimant could perform. I pointed out that the medical-vocational rules would require a finding of disabled. I explained that there was no difference between being limited to unskilled work, and lacking any transferable skills. The ALJ said that if he accepted that argument, then he would approve the claim, but if he did not, then he would require additional information from the treating sources and a supplemental hearing to cross examine the VE. 

The ALJ approved the case yesterday. If I had not accessed vocational databases during the hearing to show the discrepancy in the VE’s testimony, and if I had not pointed out how there was no actual difference between being limited to unskilled work, and lacking any transferable skills, then the ALJ would have denied the case.

Having an experienced, Social Security Disability attorney is vital when applying for SSD benefits.  Please feel free to call my office for a free phone consultation.  My offices are conveniently located in both Nassau and Suffolk counties on Long Island.

The Right Decision

Most people know what strokes are, and how devastating the symptoms can be.  Due to the severe consequences from a stroke, claimants frequently get approved for Social Security Disability (“SSD”) benefits faster compared to other impairments. What do you think would happen to you if you had seven strokes?

 

A truck driver from Howard Beach retained me when he was denied SSD benefits after his sixth stroke. Both the claimant’s neurologist and his stroke specialist provided reports detailing how the claimant was incapable of any type of full time work.  While waiting for his hearing, the claimant suffered a seventh stroke last December, which left him institutionalized without any ability to care for himself.

 

Last December, Gloria Pellegrino, the administrative law judge (“ALJ”) that was assigned to the case refused to approve an OTR.  Because the claimant lost the ability to speak, or use his arms or legs, the claimant’s partner had to testify at a hearing in April, and she described in horrifying detail the extraordinarily limited mental and physical abilities the claimant had even after his sixth stroke. 

 

The ALJ terminated the hearing when the vocational expert (“VE”) started providing testimony that supported the claimant’s position regarding how certain occupations from the Department of Labor (“DOL”) Dictionary of Occupational Titles (“DOT”) were currently performed according to the latest DOL information from O*Net.

 

Despite the overwhelmingly supportive objective medical evidence and opinions from the claimant’s specialists, the ALJ refused to approve the claimant’s SSD benefits, and scheduled a second hearing.

 

The second hearing took place July 13th, and this time a different VE testified.  The VE also identified certain occupations from the DOT in response to a hypothetical question from the ALJ.  When I insisted that the VE describe how he calculated the number of jobs he said existed for those occupations, he said they were from Job Browser.  When I said that told me the source of his numbers, but not how that magic box derived those numbers, the VE could not answer. 

 

Next, I had the VE testify that the occupational descriptions from the DOT that he identified were 40 years old.  After I started questioning the new VE about how those occupations were currently performed according to the latest DOL information from O*Net, the ALJ once again suddenly terminated the hearing.  The VE testified that the O*Net was reliable and current.  The ALJ still refused to approve the claimant’s SSD benefits, and directed me to submit a brief regarding my vocational contentions.

 

On July 16^th, I submitted a nine page brief that detailed the legal and vocational reasons why the ALJ’s reliance on the VE’s testimony was unreliable.  The two primary reasons were the current DOL information showed the occupations the VE identified were no longer performed as unskilled work, and that the VE failed to explain how he calculated his job numbers.  The ALJ still refused to approve the claimant’s SSD benefits.

 

A month ago, I submitted another brief based on Brace v. Saul, 2020 WL 4727345 (7th Cir. 08/14/2020), which held that an ALJ could not accept VE testimony that failed to explain the methodology for job numbers.

 

Today, ALJ Pellegrino approved the claimant’s SSD benefits, and claimed that she rejected all of the arguments in my briefs because the treating specialist stated that the claimant would be off task more than 10% of the time.  If that were true, then the ALJ would have, and should have, approved the OTR last December.

 

Having an experienced, Social Security Disability attorney is vital when applying for SSD benefits.  Please feel free to call my office for a free phone consultation.  My offices are conveniently located in both Nassau and Suffolk counties on Long Island.

 

 

 

Coincidence or Trend?

I represent a 50 year old computer programmer from Fairlawn NJ with neuropathy in his extremities in connection with is claim for Social Security Disability (“SSD”) benefits. The State agency applied the grid rules to issue a partially favorable decision because a transferable skill analysis did not find three jobs to which the claimant’s skills could transfer. Yesterday, the Administrative Law Judge agreed that the claimant was entitled to the remainder of the SSD benefits OTR.

Under the grid rules, a claimant is disabled if they cannot perform a significant range of work. Last week, the Ninth Circuit reversed a
denial of SSD benefits when it ruled that two occupations does not
constitute a “significant range of work.”

It is unclear if the two approvals represent a haphazard convergence of favorable outcomes, or an increased focus on that particular vocational factor. 

Please feel free to contact my office for a free phone consultation if you are looking for an attorney who specializes in disability.  We have offices on Long Island conveniently located in both Nassau and Suffolk counties.

Federal Court Win

Yesterday, District Court Judge Ann Donnelly rejected the decision of administrative law judge (“ALJ”) Sommattie Ramrup, who had denied Social Security Disability (“SSD”) benefits to my client, who was a petition clerk from Brooklyn, and who suffers from depression. 

Judge Donnelly concluded that ALJ Ramrup had cherry picked medical findings as an excuse to substitute her judgment for the opinions of the claimant’s psychiatrists. Judge Donnelly indicated that the claimant met listing 12.04, but remanded the case anyway so the ALJ can “”re-evaluate” the treating psychiatrists’ opinions. Judge Donnelly also indicated that if ALJ Ramrup does not find that the claimant meets listing 12.04, then she must ensure that the hypothetical question she poses to a vocational expert reflects the claimant’s actual limitations.

 

Whether you are thinking of applying for SSD, or have applied on your own and realize you need an attorney who specializes in disability, please feel free to call my office for a free telephone consultation.  We are conveniently located on Long Island in both Nassau and Suffolk counties. 

Waiting for SSD

It seems to be common knowledge that applying for Social Security Disability ("SSD"), and then waiting for a decision, is a very slow process. On a daily basis, clients ask us how are they supposed to support themselves and pay their bills while waiting for a decision from Social Security? Unfortunately, there is no good answer. The more you work, the more Social Security ("SS") will argue that you are not disabled. But even more heart wrenching, and less commonly known, is the amount of people that pass away while awaiting a decision from SSD. Over the years, we have had clients pass away while waiting for their hearing or decision. As we work very closely with our clients, and develop a relationship with them and some of their family members, it is very difficult and frustrating for us when a client passes away. 

The system is broken in so many ways, and has only gotten worse over the last several years. We have no choice, but to continue to wait and hope that SS gets the help and funding it needs, so people's lives are not ruined while they wait for a decision from SS.

State Agency Employee Fraud

HALLEX I-1-3-9 requires an Administrative Law Judge (“ALJ”) to refer a State agency adjudicator suspected of fraud to refer the matter to the Office of Inspector General (“OIG”).

We represent a Social Security Disability (“SSD”) claimant from East Meadow with spine problems. Reports from adjudicators named M. Jackson and M. Censor said the treating physicians were not allowed to do the claimant’s consultative examination (“CE”) because “Prior experience raises a question as to the objectivity, accuracy, or validity of the evidence from the source(s).” 

The adjudicators conspicuously failed to identify the actual name of the medical source or sources whose prior experience was questioned. We contacted the claimant’s medical sources about their prior experience with the State agency, and none of them stated that they have had any prior experience with it. 

Knowingly making a false boilerplate assertion in order to prevent a treating doctor from performing a CE is fraud. I asked the ALJ to issue a subpoena for the attendance of the adjudicator at the claimant’s hearing for cross-examination. Additionally, I asked the ALJ to notify the OIG about the potential misconduct, especially since was no reason to suspect that it had been limited to this one case. 

The ALJ did not make the adjudicator available for cross-examination, and it is unclear if the ALJ referred the matter to the OIG. If anyone waiting for a hearing has a file with similar boilerplate language from an adjudicator, then request that the matter be referred to OIG. Such misconduct should not be overlooked or condoned. 

If you are looking for an attorney on Long Island who specializes in disability claims, please call my office for a free phone consultation.

Judging Disabilities

It is not uncommon for a potential client to say to me, "there's nothing wrong with my neighbor and he's getting disability," or "I know so many people who look fine, and are getting disability." Many people are disabled from diseases that are invisible to others, like mental health disorders, autoimmune diseases, and even certain types of cancers. Social Security ("SS") has a strict definition of disability. Typically, for SS to find you disabled, your doctors need to support that you are unable to work for 8 hours a day at any job, not just your own job. SS decides if you cannot adjust to other work because of your medical conditions, and if your disability has lasted or is expected to last for at least one year or to result in death. To compound matters, their determination is not only based on information that they receive from your treating doctors regarding your limitations and restrictions resulting from your illness, but also from their doctors, who usually default to finding an ability to work. 

You also must have enough work credits to apply for Social Security Disability ("SSD") benefits. If you do not, then you may qualify for Supplemental Security Income ("SSI"), which follows the same medical requirements as SSD, but requires you to meet certain financial criteria to be eligible. 

The bottom line is, just because a person does not look like what you think a disabled person should look like, does not mean that they are not disabled under SS's definition. It is not easy to get approved for SSD or SSI. That is why it is highly recommended that you retain an attorney who specializes in disability and has experience with SS, and statistics show legal representation results in a significantly higher approval rate. Our office offers free phone consultations, and we have offices on Long Island in Nassau and Suffolk counties.

By Susan Golden

Updating Records

Claims for Social Security Disability (“SSD”) benefits have always proceeded slowly, and the pandemic has only compounded matters further. As a result, an SSD claimant can wait close to two years for a hearing. Consequently, medical reports and records can become stale by the time the hearing arrives. 

We represent a 50 year old truck driver from Plainview with knee, back and shoulder problems whose SSD application was filed in 2018. His hearing was transferred to another hearing office, which then rescheduled the date of the hearing. 

The medical evidence that had been submitted would be a year old by the new hearing date. Although complicated by the pandemic, we were able to obtain and submit updated reports. Shortly afterwards, we were notified that the claimant’s SSD application would be approved on the record, and therefore, there was no need for a hearing.

OTRs

The Social Security Administration (“SSA”) began implementing changes in 2009 with administrative law judge (“ALJ”) training, claims assignment, and monitoring, which were designed to reduce the disability allowance rate. Those changes reduced the ALJ and appellate allowance rates. The SSA has continued to change the rules to make approvals more difficult, most notably, by eliminating the treating physician rule. The on-the-record (“OTR”) allowance rate has correspondingly decreased. An OTR allowance can occur when a review indicates that a case can be allowed without a hearing.

Now may be the time to request an OTR. Because of the coronavirus, hearings are being held by telephone. While a claimant can reject a telephone hearing in favor of an adjournment, many of my clients have chosen to proceed with the telephone hearing, rather than wait when an in person hearing can be scheduled.

The logistics of a telephone hearing are problematical. I am located at my home office, the claimant is located their home, the claimant’s witness is located at their home, the ALJ is located at their home, medical and vocational witnesses are located at their homes, and the hearing assistant is located at the hearing office. The potential for chaos and technical issues in obtaining an adequate recording is substantial. That potentiality might be avoided if an OTR is approved.

I have received more OTRs since the start of COVID19 restrictions than I have the last few years. I represent a 21 year old with Autism, whose OTR was approved last Friday, for a telephone hearing that was scheduled today. The evidence was strong, even the State agency psychologists’ opinions were somewhat supportive, even though they had yet to see the extremely supportive reports and records of the treating mental health providers. Nonetheless, absent current circumstances, the ALJ probably would have gone through the motions of holding the hearing, even though he most likely was already persuaded that the medical evidence established the claimant’s entitlement to benefits.

A sheet metal worker from Bethpage, secretary from Farmingdale, and network engineer from Islip Terrace, were also just approved OTR. Absent current circumstances, the ALJs probably would have held the hearings for those claimants too.

If you are thinking about applying for SSD benefits, it is in your best interest to hire an attorney who specializes in disability law.  My office offers free phone consultations.   We have offices on Long Island in both Nassau and Suffolk counties.

Developing The Record

In Social Security Disability (“SSD”) cases, a failure to develop the record is considered to be a lack of a fair hearing. Therefore, to avoid having a decision rejected, an administrative law judge (“ALJ”) is required to develop the record. As a result, many ALJ’s go to extremes to ensure that every possible medical record, regardless of relevance, is part of the file.

It takes a long time to get a hearing. Consequently, the medical records may no longer be current when the hearing takes place. There is a sound way to avoid needlessly protracting the hearing process by insisting that any possible medical evidence be obtained.

A medical expert (“ME”) or a treating physician can opine that updated medical records would be cumulative or unnecessary. We represent a 39 year old with cervical radiculopathy who worked as a massage therapist. By the time the hearing arrived, the records from the claimant’s orthopedist were over a year old.

After the ME testified that the claimant met a listing 1.04, the ALJ asked if the claimant’s condition could have improved subsequent to the orthopedist’s latest records in the file. Since the ME testified that the condition would most likely stabilize or get worse, the ALJ determined that the updated records were superfluous.

If you are thinking about applying for SSD, please call my office for a free phone consultation.  We would be happy to answer any questions you might have.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.

WC IME

A fairly regular question is how much weight should Social Security give to the opinion of a workers compensation (“WC”) doctor. Federal courts usually hold that reports from WC doctors are not substantial evidence because their conflict of interest may have dictated their contents. 

We represent a 49 year old security guard from Levittown with back and cardiovascular vascular problems whose Social Security Disability (“SSD”) application was approved today despite an adverse report from a WC doctor. While we pointed out how federal courts treat WC medical opinions, the administrative law judge (”ALJ”) rejected the WC report on different grounds. The ALJ found that the opinion of the WC doctor was rendered solely for the purpose of determining disability under WC, which used standards and criteria that are different than Social Security. 

It is imperative to address any negative evidence in the file at an SSD hearing, if not sooner. The ALJ might have relied on the WC medical opinion if we had not done so.  

This is another example of why it is so important to retain an attorney who specializes in Social Security Disability when applying for SSD benefits.  If you are considering applying for SSD, please call my office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.

Updating Records

Claims for Social Security Disability (“SSD”) benefits have always proceeded slowly, and the pandemic has only compounded matters further. As a result, an SSD claimant can wait close to two years for a hearing. Consequently, medical reports and records can become stale by the time the hearing arrives. 

We represent a 50 year old truck driver from Plainview with knee, back and shoulder problems whose SSD application was filed in 2018. His hearing was transferred to another hearing office, which then rescheduled the date of the hearing. 

The medical evidence that had been submitted would be a year old by the new hearing date. Although complicated by pandemic, we were able to obtain and submit updated reports. Shortly afterwards, we were notified that the claimant’s SSD application would be approved on the record, and the therefore, there was no need for a hearing. 

If you are planning on applying for disability, or have already applied and are looking for legal representation, please feel free to call our office for a free phone consultation.  Our offices are conveniently located on Long Island in Nassau and Suffolk counties.

NYS OTDA

The New York State Office of Temporary & Disability Assistance (“OTDA”) continues to order Social Security Disability (“SSD”) claimants to be examined by IMA Disability Services for consultative examinations (“CE’s”) under questionable circumstances. 

The regulations state that OTDA may decide a CE is needed, but only “If we cannot get the information we need from your medical sources.” The OTDA ignores the regulations. On a continuing and regular basis, the OTDA orders claimants to go to IMA for a CE without any attempt to obtain any information from claimants’ medical sources. 

We filed an SSD application for a 32 year old salesperson from East Meadow with mental impairments. A few weeks later, the OTDA insisted that the claimant attend an IMA CE, even though we had already provided disability reports and narrative medical summaries and explanations, from the claimant’s psychologist. The OTDA never made any written or oral request for records from the claimant or his doctors, which we also provided. 

We objected to the CE. We asked that the OTDA identify what additional information they contended had not been submitted, and that we would ensure that the claimant’s doctors would provide it. As usual, the OTDA ignored our letter, simply sent another notice that ordered the claimant to attend to the CE. In response, we told OTDA that any CE needed to obtain additional information would have to be conducted by telephone because he has agoraphobia. OTDA said they would see what their doctor said about the agoraphobia. 

We did not hear back from OTDA about the CE. However, the OTDA did approve the claimant’s SSD application. 

This is another example of why it is beneficial to be represented by an attorney who specializes in disability law when you file a claim for benefits. I have helped thousands of clients obtain SSD benefits, many of whom would have been denied. Please feel free to call my office for a free phone consultation. We have offices conveniently located on Long Island in Nassau and Suffolk counties.

Disability Insurance Approvals

Disability insurance companies are working remotely because of the pandemic, which has slowed down the processing of claims. Nonetheless, decisions are getting made. 

We represent a 60 year old finance manager from Glen Cove with cancer whose Disability Insurance (“DI”) application was approved by Mutual of Omaha. We also represent a 55 year old business analyst from North Babylon with back problems whose Long Term Disability (“LTD”) application was approved by MetLife. 

Navigating the claims process is more cumbersome during the pandemic, and requires more effort than usual. Obtaining medical records when doctors’ offices are barely staffed is difficult, and claimants even have trouble being able to schedule appointments. 

It is risky for an insured to try to navigate a disability insurance claim on their own.  While it may seem the insurance company is on your side, they are not.  Please feel free to call my office for a free phone consultation.  We are conveniently located on Long Island in Nassau and Suffolk counties.

What Was DDS Thinking

Sometimes the decision of the State agency adjudicator makes absolutely no sense. I represent a 54 year old school aide from East Meadow who suffered broken legs, neck, shoulder, ribs, arm, and multiple vertebrae with a TBI in a car vehicle accident on August 6, 2016, which was the alleged onset date (“AOD”). A State agency adjudicator named K. Vollmer said the claimant did not become disabled until February 7, 2018, which was the established onset date (“EOD”). 

There was absolutely no evidence that the claimant’s medical condition got worse between the AOD and EOD. Common sense and logic dictate that the claimant’s condition would be worse immediately after the car accident, not two years later. If you ask a Kindergartner if a person would feel better right after a car accident, or two years later, I would bet everything I had that they would correctly answer the latter. 

To make matters even worse, J. Diaz, a second State agency adjudicator, “thoroughly reviewed” the claimant’s file, and nonetheless, concluded that Vollmer was correct. It would seem highly unlikely that two people could independently arrive at the same moronic conclusion. It is more likely that Diaz blindly rubberstamped Vollmer’s decision. 

Thankfully, administrative law judge (“ALJ”) Andrew Weiss ended the travesty. Upon reviewing the file, the ALJ determined that a hearing was not necessary, and approved the claimant’s Social Security Disability benefits. Unfortunately, the claimant had to wait over a year before the ALJ could correct the State agency’s obvious error. 

My client initially applied on her own, believing that she would be approved easily, but was denied almost immediately. She was referred to me by her husband, a former client for whom we obtained SSD benefits. They are both very appreciative because they were unaware that they could appeal the onset date. This is another example of why it is important to retain a disability attorney if you plan on applying for SSD benefits. Please feel free to call my office for a free phone consultation. The office is currently closed due to the pandemic, but we are still able to take phone calls and work remotely. Our offices are conveniently located in both Nassau and Suffolk counties on Long Island.

SSD Backlog

Statistics from the Social Security Administration ("SSA") show that working from home has increased federal employees' productivity, and actually reduced the backlog at the SSA local offices. So even though the employees from the local SSA offices are working from home, they are still processing new applications and appeals.  Unfortunately, the same cannot be said for the State agency, who make the initial decision for Social Security, as they seem to be at a stand still.

COVID-19 Disability

According to a Johns Hopkins expert on lung disease, COVID-19, the disease caused by the new coronavirus, can cause lasting lung damage in at least three ways. 

COVID-19 can lead to acute respiratory distress syndrome (ARDS), a form of lung failure, where patients are often unable to breath on their own and may require ventilator support to help circulate oxygen in the body. People who survive ARDS and recover from COVID-19 may have lasting pulmonary scarring. 

COVID-19 can also lead to sepsis when an infection spreads through the bloodstream, causing tissue damage everywhere it goes. Sepsis, even when survived, can leave a patient with lasting damage to the lungs and other organs. 

Because COVID-19 makes the immune system work hard to fight it, COVID-19 leaves the person more vulnerable to a different disease, which can result in additional lung damage. Permanent lung damage can adversely affect the ability to work. Like any chronic lung disease, the after effects of COVID-19 can result in severe fatigue that precludes even the easiest full time work. 

If you suffer from a respiratory or lung disease, whether it's COVID-19 related or not, and you are unable to work, please feel free to contact my office for a free phone consultation.   

SS Hearings

Social Security ("SS") hearings are normally held at the claimant's assigned hearing office. Due to the pandemic, SS has been giving claimant's the choice of postponing their hearing, or agreeing to a telephonic hearing. SS has announced that they are extending this process through August. If you have a hearing scheduled, you should contact your hearing office to advise them whether or not you agree to a telephonic hearing, or if you want to postpone your hearing.

Some Good News!

This just out! Finally, some good news from the Social Security Administration. The Social Security Board of Trustees has just reported that the Disability Insurance Trust Fund will be able to pay full benefits until at least 2065, not 2035 as they had previously reported.

Medical Consultant C. Levit

According to Social Security, C. Levit is a medical consultant for the New York State agency, who specializes in internal medicine. According to the New York State Department of Health, the only licensed physician in New York with the last name Levit and first initial C, is Charles D. Levit, who coincidentally is an internist. 

I represent a 58 year old from Levittown that used to drive for car services, who applied for Social Security Disability (“SSD”) benefits due to cardiovascular problems. A board certified cardiologist, Thierry Duchatellier, Chief of Cardiology at Mercy medical Center, provided narrative and functionality reports stating that the claimant was disabled based upon the objective diagnostic testing and treatment records, which were also provided. 

Levit reviewed the claimant’s medical records. Levit asserted that the claimant’s medical sources, including Dr. Duchatellier, were not contacted because “Prior experience raises a question as to the objectivity, accuracy, or validity of the evidence from the medical source(s).” Levit failed to identify the medical source or sources whose prior experience was questioned. However, the claimant’s medical sources said they had no prior experience with the State agency. 

I advised the administrative law judge (“ALJ”) that Levit’s boilerplate statement that, “Prior experience raises a question as to the objectivity, accuracy, or validity of the evidence from the medical source(s)” – was fraudulent and defamatory. The statement must be boilerplate because I have seen it in other SSD files. I requested a subpoena for the attendance of Levit at the claimant’s hearing for cross examination, and that the ALJ notify the Agency’s Inspector General about the potential misconduct. 

In this instance, the fraudulent and defamatory was not addressed since the ALJ will be issuing a fully favorable decision. However, such assertions should not be ignored, and in my opinion, claimants should insist on the right to cross examine anyone who makes libelous representations.

COVID19 Impacts SSD

As the COVID-19 pandemic continues, Social Security has had to change some of their procedures regarding Social Security Disability ("SSD") claims. After an SSD claim is filed at the local office, the claim is transferred to the State agency for review. The State agency frequently and erroneously asks claimants to attend a Consultative Examination ("CE"). At this time, the agency obviously cannot send claimants to CEs, so any case they feel requires one will be paused until the shelter in place rules have been lifted.  However, they are still working on claims remotely, as are the hearing offices and the Appeals Council.

Claimants who currently have hearings scheduled will be offered telephonic hearings because the hearing offices are closed. While you do not have to accept a telephonic hearing, Social Security has said they cannot even begin to estimate when an in hearing person will be scheduled.

Prudential Approval

A 55 year old from Manhassett, who worked for Northwell as a nurse, applied for the long term disability (“LTD”) benefits because she could no longer work due to Lupus and back problems. Prudential denied the LTD claim by rejecting all of her treating doctors’ opinions in favor of its in-house doctor. The claimant contacted my office after researching Long Island disability attorneys, and visiting my website.  After her free phone consultation, she retained me to appeal the decision.

I gathered and submitted medical and vocational evidence that rebutted each basis for Prudential’s denial. Just a few days before its deadline for rendering a decision, on a Friday evening, Prudential sent me a medical review by Lucien Parrillo, a well-known insurance industry doctor. No surprise, Parrillo parroted the opinion of Prudential’s in-house doctor.

In just a few days, I managed to submit medical reports rebutting Parrillo’s review. Two weeks ago, when Prudential’s decision deadline expired, I commenced a lawsuit by filing a 37 page Complaint. Last week, Prudential’s attorney asked if I would stay litigation so Prudential could render a belated decision. I declined in order to preserve de novo review. Prudential faxed an approval letter to me today. 

Unfortunately, disability insurers are so driven by their profit motive that they usually do not take LTD appeals seriously until litigation is commenced.

CDC's Response to COVID19

Every day it seems we are getting inundated with so called facts about COVID19. The director of the CDC sets the record straight, explains what we can expect going forward during this pandemic, and provides reasons to be hopeful.

Ehlers-Danlos Syndromes

The Ehlers-Danlos syndromes (“EDS”) are a group of inherited connective tissue disorders. EDS causes joint hypermobility; loose/unstable joints which are prone to frequent dislocations and/or subluxations; joint pain; hyperextensible joints; rupture of major blood vessel walls; and early onset of osteoarthritis. 

We represent a 52 year old former bookkeeper from Northport with EDS. The pain from hypermobility is difficult to establish like any other subjective medical condition where the clinical findings are minimal. However, the clinical and surgical findings resulting from aortic and brain vessel ruptures are distinctly objective. Although the claimant’s joint pain was her primary symptom, I emphasized the ruptures equally as it was more clearly documented. 

The claimant’s disability application was approved today. As I suspected, the decision approving benefits relied mostly on the residual problems from the ruptures. 

If you want to retain a SSD attorney, who specializes in disability benefits law and has a lot of litigation experience, please contact our office for a free phone consultation. We have offices conveniently located on Long Island in Nassau and Suffolk counties.

COVID19 Bill

The COVID19 pandemic is causing a lot of stress and uncertainty when it comes to our finances during this volatile time. The Senate is working on a bill to help financially vulnerable Americans. Hopefully, a bill will be passed shortly. The article published on NBC.com explains why it is better for us if the Senate can agree on increasing Social Security benefits temporarily by $200 per month, instead of suspending employers’ requirement to pay FICA taxes until January. 

We urge you all to stay safe, and continue to perform social distancing. We must all work together to "flatten the curve". We thank all the essential workers who continue to keep us safe.

Kudos to CALJ Wexler

April Wexler is the chief administrative law judge (“CALJ”) of the Long Island Social Security hearing office. CALJ Wexler's efforts to help address the needs of a claimant during the Coronavirus crisis are worthy of mention. 

I represent a 62 year old claimant who lost one kidney to cancer and the remaining one is severely compromised, which makes him highly susceptible to infections.   Even before the Coronavirus, I had arranged for the claimant to testify by telephone from his home. 

Because he can no longer work, the claimant had no income, and had used up all of his savings. As a result, the claimant has been trying to stave off foreclosure proceedings. 

Last week, the ALJ scheduled to hear the claimant’s case had to cancel the hearing due to the Coronavirus.  CALJ Wexler called to notify me that no other ALJ was available to conduct the hearing.  I understood the logistical issues. However, I suggested to CALJ Wexler that it would be worthwhile for her to review the file for an OTR as I explained that there were three very strong grounds to approve the disability application. 

There must be a substantial amount of chaos at the hearing office due to the Coronavirus. Nonetheless, CALJ Wexler not only took the time to review the claimant’s lengthy file, but also called me today to advise me that she was granting the OTR. We thank CALJ Wexler for her exemplary efforts during this crisis.

Our client is overjoyed with his fully favorable decision.  He knows that if he had not hired a disability attorney with decades of experience, then he would not have achieved the same results.  Instead, the claimant would be waiting weeks, most likely months, for a new hearing to be scheduled, and with no guarantee of being approved. 

Please feel free to call or email my office at (888) 572-0861.  Even though both of our Long Island offices are closed, we are working remotely, and are checking our messages frequently.  Please be safe and smart during this pandemic. 

COVID19 Repercussions

We have been receiving many calls from our clients regarding COVID19, and how it will affect their pending cases. The local Social Security offices are closed to the public. The State agency, which makes the initial disability determination, is completely closed. Unfortunately, this means that no work will be done on pending cases, and new cases will not be processed at this time. Since no one knows how long this pandemic will last, no one has any idea how long these work restrictions will remain in place. However, deadlines will be extended for providing documentation, medical information, and submitting appeals. Commissioner Saul released a Press Release yesterday. Part of that release stated:

“We have suspended the following workloads until further notice: 

•We will not start or complete any current medical continuing disability reviews. If you have a medical continuing disability review pending, please do not request medical information from your doctors at this time. We will follow up with you for any medical evidence once the COVID-19 public health emergency subsides. •Where possible, we are suspending our processing and collection of overpayments. 
•We are not conducting organization or individual representative payee accountings. 
 •We will not be able to process a third party requests for information, except from appointed representatives and representative payees."

We will keep you updated as we get new information.  Stay safe, stay healthy.

Coronavirus

We are only having our clients appear at hearings telephonically from their homes. The President has declared a National public health emergency due to the Coronavirus. Similarly, the Governor of New York, Mayor of New York City, and Long Island Counterparts have called in the National Guard, closed schools and health clubs, restricted bars and restaurants from operating, and have taken other measures because of the Coronavirus. Some district office Social Security has been closed indefinitely. 

Because of these extraordinary circumstances, I have been advocating that my clients and I only appear by telephone. Since Social Security hearing experts appear by telephone even when there is no public health crisis, having claimants and their counsel appear telephonically should not pose a problem. Appearing telephonically is obviously required for claimants who are at increased risk, such as those over 60 years of age, with respiratory problems, or with compromised immune systems. 

The telephone appearances will obviate the need to postpone hearings. Since claimants have been waiting years for a hearing already telephonic testimony is more sensible than postponing hearings. Postponing hearings is also an inadequate solution because most claimants are in dire financial straits.

Getting It Right

Sometimes you cannot imagine why a particular disability claim gets denied. I represent a 64 year old from Valley Stream with severe spinal problems that required surgery. He worked for 45 years, and his past work required him to lift and carry up to 100 pounds. His doctors provided tests, treatment records, and functional assessments that precluded all work. Nonetheless, his application for Social Security Disability (“SSD”) benefits was denied.

The case had been assigned to administrative law judge (“ALJ”) Jay Cohen for half a year, and he scheduled the claimant’s hearing for today. ALJ Cohen retired last week, and the case was assigned to ALJ Pecoraro Monday. The case was approved without need for the hearing.

The new ALJ got it right. The medical and vocational evidence was solid, and a hearing should never have even been scheduled. We spent days preparing for the cross examination of the hearing expert. Hope for the best, but prepare for the worst.

It is not easy to find a SSD attorney with litigation experience.  If you want to retain a SSD attorney, who specializes in disability benefits law and has a lot of litigation experience, please contact our office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.

DaTscan

I have posted about Parkinson’s Disease periodically. Periodically, I have also posted that disability claims handlers virtually always want to see objective diagnostic test data before approving benefits. A problem arises when medical impairments are normally diagnosed via clinical examination findings.

From a diagnostic perspective, Parkinson’s is a clinical diagnosis. Claims involving medical conditions like Parkinson’s, which are based on clinical exam findings, frequently get denied improperly for lacking “objective” medical support. Providing medical information from established sources like the Mayo Clinic or the Merck Manual regarding how medical impairments are diagnosed clinically is helpful, but these types of disability claims usually take longer to get approved.

MRI scanning appears normal for Parkinson’s, and thus it would hurt, rather than help the disability claim applicant. However, DaTscan imaging can confirm a diagnosis of Parkinson’s even if the clinical findings are not obviously apparent. In Parkinson’s, there is a steady loss of dopamine transporters in the brain, and a DaTscan can detect dopamine levels in the brain.

We represent a 63 year old former maintenance director from Old Bethpage with Parkinson’s whose disability application was just approved without a hearing. The claim was approved shortly after we submitted the claimant’s DaTscan, which was consistent with Parkinsonian syndrome. 

Our office has been able to obtain SSD benefits for many other disability claimants quickly compared to the national averages.  For the convenience of our Long Island clients, and potential clients, we have offices in both Nassau and Suffolk counties. 

Adult Disabled Child

The Social Security Disability Insurance (“SSDI”) program pays benefits to adults who have a disability that began before they became 22 years old. SSDI is considered a “child’s” benefit because the amount of it is based on a parent’s Social Security earnings record. For a disabled adult to become entitled to this “child” benefit, one of the parents must be receiving Social Security retirement or disability benefits, or have died and have worked enough to qualify for Social Security. 

A minor child can receive benefits when a parent receives Social Security Disability (“SSD”) benefits. After reaching majority, if disabled using the disability rules for adults, a child is eligible to continue receiving benefits on that parent’s record. Disabled Adult Child (“DAC”) benefits continue as long as the individual remains disabled. A child does not need to have worked to get DAC benefits. It should be emphasized that you do not have to be under 22 years of age in order to apply for DAC benefits. 

We represent a claimant whose DAC benefits were approved today, who is currently 33 years of age. We were able to establish that his mental impairments rendered him disabled as of 2008, at which time he was 21 years old.

Knowing the Social Security case law is critical to preparing your claim, and appealing it all the way to federal court if necessary. When retaining a disability attorney to handle your SSD claim, be sure to ask them about the extent of their experience litigating these matters. Please call my office for a free phone consultation. We have offices conveniently located on Long Island in Nassau and Suffolk counties.

State Agency Doctors

Since the last Century, the case law in Social Security Disability (“SSD”) appeals has been crystal clear – the opinions of doctors “who have not personally examined the claimant deserve little weight.” Nonetheless, when an administrative law judge (“ALJ”) wants to deny a case, they frequently rely on the opinion of the non-examining State agency medical consultant as the basis for the decision. 

We represent a 57 year old former controller from Howard Beach with Parkinson’s disease. ALJ Pecoraro, who approved the claimant’s SSD application today, stated that the opinions of the non-examining State agency medical consultants were not persuasive. The ALJ reasoned that because additional evidence was produced after the consultants’ document review, their opinions were not based upon a complete record, and therefore were of little probative value. 

As intimated above, many ALJs are predisposed to deny SSD claims. You can learn if an ALJ is predisposed to deny your SSD claim by checking out their approval rate here. An ALJ with a low approval rate that is predisposed to deny your SSD claim would have found that the opinions of the non-examining State agency medical consultants were persuasive, despite the law clearly being to the contrary. 

Knowing the Social Security case law is critical to preparing your claim, and appealing it all the way to federal court if necessary. When retaining a disability attorney to handle your SSD claim, be sure to ask them about the extent of their experience litigating these matters.  Please call my office staff for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.

SSD Approved in 1 Week

We represent a 60 year old former automotive finance manager from Glen Cove with a very serious medical condition. The good news is that, because our Long Island offices focus exclusively on disability benefit law, we recognized his medical condition would qualify for a rapid compassionate allowance of Social Security Disability benefits based on his meeting a listing. We submitted the objective diagnostic evidence demonstrating that the criteria for the listing and compassionate allowance were satisfied with the application. 

We hope that the immediate approval of SSD benefits will persuade the claimant’s disability insurance carrier, Mutual of Omaha, to act expeditiously to approve benefits too. 

Our office has been able to obtain SSD benefits for many other disability claimants quickly compared to the national averages.  For the convenience of our Long Island clients, and potential clients, we have offices in both Nassau and Suffolk counties.

SS Benefits in Danger

There have been multiple articles and segments on the news in the recent week, warning the American people of the proposed changes to Social Security Disability, Medicare and Food stamps. Because we never know when we might these services, these changes will affect every single one of us.

Proposed Changes to SS and Medicare

This article is important for people to read if they are receiving Social Security Disability benefits, or Medicare benefits. Neither of these programs are entitlement programs. They are self funded programs that we, the taxpayers, have paid into. According to this article, we may have our benefits cut. For the people who have SSD cases pending, or are thinking about applying, the proposed budget cuts would have a great impact on the length of time it would take to get their benefits approved.

6 Years for Approval

We represent a claimant from Copiague whose application for Social Security Disability (“SSD”) benefits had been denied after a hearing based on the testimony of a discredited medical expert. Last year, a federal district court judge in New York ordered a new hearing for the claimant. Today, after a six year struggle, the claimant was found entitled to receive SSD benefits back to May 2014. 

While we hope for the best, we always prepare for the worst. That means preparing every case as if it will have to be appealed in court. And when we represent a claimant, we will go to court if necessary. 

Our litigation experience helps us prepare the best possible factual record to present in court, which is important because it is rare when a judge will permit the introduction of new evidence. Litigation experience is also important because you need to understand what the legal theories will be in court in order to know what evidence will be required to support those theories.

It is not easy to find a SSD attorney with litigation experience.  If you want to retain a SSD attorney, who specializes in disability benefits law and has a lot of litigation experience, please contact our office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.  

Harmful Changes to SSD

This article, written by Newsweek, explains how recipients of Social Security Disability ("SSD") benefits may lose their benefits due to a proposed rule change to disability reviews.  

If you need assistance with a disability claim, and are looking for an attorney who specializes in disability, please contact my office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties. 

Age & Disability

Social Security Act was enacted in 1935 to provide economic security when individuals reached retirement age. The idea was that when people become older, they gradually lose the ability to work on a full time basis. It was not until 1956 that Social Security Disability (“SSD”) benefits were added. The reasoning was that many people become unable to work before they reach retirement age, and they need economic security also. 

Age may impacts an individual’s entitlement to SSD benefits in two ways. The older you are, the more likely you have generated a long work history. Also, with the passage of time, the chances increase that a person will sustain an injury or illness that diminishes functionality, especially with progressive medical conditions. 

We represent two claimants whose SSD applications were approved today after hearings. One was a pain specialist from West Hampton Beach, and the other was a stock trader from Commack. Both were 60 years old, and both had long work histories, which the administrative law judge (“ALJ”) found supported the credibility of their complaints and testimony. Both claimants also had orthopedic complaints that were consistent with multiple objective diagnostic MRI and EMG tests. Recent rules and regulations require an ALJ to place greater emphasis on objective evidence. 

Both claimants were looking for a Long Island Disability Attorney and were referred to me by other attorneys.  They are very happy with the outcome of their cases!

Prudential Disability Rating

Over 100 people rated Prudential’s disability insurance at ConsumerAffairs.com. The result – one out of five stars. I have represented countless claimants against Prudential, and agree with that one star rating. Notably, it is not possible to give a zero star rating. 

A nurse from Manhasset with multiple medical conditions, including Lupus, transverse myelitis, and myelomacia, retained us after Prudential denied her application for long term disability benefits. Prudential claimed that the nurse should still be able to perform her job on a full time basis. 

The claimant received her approval today for Social Security Disability (“SSD”) benefits. To qualify for the SSD benefits, not only was the claimant required to show that she was unable to perform her job as a nurse, but also that she was unable to perform any job on a full time basis.  

The claimant initially contacted my office because I am a Long Island Disability Attorney; specializing in both SSD and LTD, with offices in Nassau and Suffolk counties.   The claimant was looking for a Disability Attorney who could handle both her SSD and LTD claims.  We are happy to be able to help her with both.