Prudential Approval

We represent a nurse from Manhassett with Lupus and back problems.  We originally persuaded Prudential to reverse its decision that the claimant was able to work as a nurse after we filed an action in federal court.  However, relatively soon thereafter, Prudential challenged whether the claimant was unable to perform any other occupation.

 

At the time of the lawsuit, even though the claimant only needed to establish that she was incapable of working as a nurse, we went out of our way to demonstrate how the medical and vocational evidence submitted supported her being incapable of performing any full time occupation.  We provided Prudential with information from the claimant’s doctors showing that there had been no change in her medical tests, clinical examination findings, or symptoms.  

 

Prudential notified the claimant today that it determined she is unable to be gainfully employed.  If we had not exceeded the evidentiary requirements initially, it is unlikely that Prudential would have concluded that the claimant was disabled from any occupation.

 

Please take note of how important it is to retain an attorney who specializes in disability claims, if you intend on filing for disability.  Our office offers free phone consultations.  We have offices located on Long Island, in both Nassau and Suffolk counties.

Rheumatoid Arthritis

Rheumatoid Arthritis or “RA” is an incurable form of inflammatory arthritis and an autoimmune disease.  When applying for Social Security Disability (“SSD”) benefits, the most expeditious way to establish entitlement to benefits is to show that the claimant meets the criteria under “listing” 14.09.

We represent a 47 year old Vice President of Human Resources from Glen Cove, who was approved for SSD benefits in five months, without requiring a hearing.  There was no written decision because the claimant was approved at an early stage.  However, we were able to access the internal documents from the Social Security file, and learned that the claimant met listing  14.09 because of the effect that the RA had on her hands.  We had submitted a report that focused on how the claimant’s use of her hands were limited, and treatment records that reflected the nodules on them.

The SSD claim process is a lengthy one, especially during the COVID era.  Explaining why the medical evidence supported the claimant meeting the listing significantly expedited her receipt of SSD benefits.   This is why it is so important to have a disability attorney representing you for SSD benefits.  If you are planning on applying for SSD, or have already applied on your own, please call my office for a free phone consultation.  Our offices are conveniently located on Long Island in both Nassau and Suffolk counties.

We Take Care of Our Own?

SSA had two programs available to US citizens who are disabled, Supplemental Income Insurance ("SSI") and Social Security Disability ("SSD").   You need to have enough work credits to apply for SSD, and SSA uses a formula to calculate your monthly benefit based on your earnings.  SSI is a program for people who do not have enough work credits, and who do not have more than $2,000 in their bank account, and meet the financial criteria to be eligible for SSI.  The maximum monthly benefit for SSI is $783 a month.  Who can live on that?  Our country needs to do better, and the SSI and SSD programs need a huge overhaul to meet today's standard of living, and take care of their own citizens, who are unable to work due to a medical condition.

 

Mystery Solved

Sometimes it is unclear why Social Security approves a claimant.  We represent a 32 year old educator from Brooklyn with bipolar disorder, whose supplemental security Income (”SSI”) application was just approved.  We submitted very strong medical opinions along with their treatment records, but that does not usually result in an approval prior to a hearing with an administrative law judge.

We received a notice of award (“NOA”) for the claimant.  However, a NOA explains the benefits to which a claimant is entitled, but does not explain the basis for the decision.  Because Social Security conducts continuing disability reviews ("CDR"), it would help a claimant prepare for that eventuality if the NOA was accompanied with some sort of rationale for the approval.  As the client's attorney, I was able to access his electronic file and review the State agency's notes.  This enabled us to ascertain that the claimant was approved because he met the listing for bipolar disorder, which will prove invaluable when his CDR comes up.

Is the claimant had not retained us, or another disability attorney, he would never have known the basis for his approval.  This is why it is so important to hire a disability attorney if you are thinking of applying for disability.  We have offices conveniently located on Long Island, in both Nassau and Suffolk counties.  Please call our office for a free phone consultation.

More State Agency Deceit

We filed a reconsideration appeal on May 3, 2021.  Just three weeks later, the Stage agency denied the claim without requesting any additional information. The State agency claimed that we refused to allow our client to attend a Consultative Exam (“CE”) because of “a medical condition.”  That claim was deceptive at best.

The State agency concealed that the claimant’s "medical condition" was his cardiovascular heart disease, which resulted in two heart surgeries in February, and two more surgeries in March, when COVID was still raging.  In his condition, the claimant could not risk being exposed to COVID.  To minimize the risk, we offered to have one of his cardiologists perform the CE, who also happen to be the preferred source under the regulations.  His doctors were perfectly willing to perform the CE, but the State agency ignored that offer.

The medical section of our client’s Social Security claim file contains 2,421 pages of records that support his disability from work.  The State agency denied this claim because the claimant did not attend a CE.  We have seen quality control memos rejecting such denials, and reminding the State agency to make a decision on the other evidence in the file.  The State agency failed to do that here.

There were thousands of pages of medical records.  The State agency refused to identify any medical documentation that was purportedly missing.  There was a great deal of documentation regarding our client’s medical conditions, including diagnoses, objective diagnostic test data, operative reports, supportive letters and reports from multiple treating doctors.  There was no need for our client to attend a CE.

Logic dictates that the State agency was too lazy to review the 2,421 pages of medical records. This claim should have been approved.  It is a travesty that it was denied.

We will continue to fight for our client and are confident that the hearing office will give this claim the proper consideration and review.  If you find yourself in need of assistance applying for disability, please contact my office for a free phone consultation.  We have offices conveniently located on Long Island in Nassau and Suffolk counties.