Fraudulent CE's

Social Security constantly sends claimants to Consultative Exams ("CEs"), even when the claimant has supporting medical documents from their own treating doctors.  Social Security's own rules specify that the treating provider is the preferred source, and a CE only needs to be scheduled if a claimant does not submit medical documents from their own doctors.  Nevertheless, Social Security almost always ignores their own regulations, and schedules unnecessary CE's for the claimants to attend.  Unfortunately, most of the time, this is not in the claimant's best interest.  The companies that Social Security hires to perform the CEs, and the doctors who perform them, routinely commit fraud.  If you do attend a CE, it is vital that you note everything that the doctor does and does not do, and the length of the exam.  You should bring someone with you to the CE who can be a witness at a hearing if you do get denied based on the CE.

 

SSA - Is Anyone Listening?

by Susan Golden

The Social Security Administration ("SSA") has problems.  Serious problems.  Years and years of backlogged claims, analysts who don't give a damn, inexperienced employees, and Judges who don't follow the rules.  Unfortunately, we have had claimants pass away, while waiting for a decision on their Social Security Disability claim.  And there are thousands of people across the country who are dying before their claims have been decided. 

We have a client who passed away almost four years ago.  He left behind a wife and two children.  He filed for Social Security Disability benefits on December 5, 2017.  His case, which was supposed to be expedited, went before Judge Carlton at the Bronx Hearing Office on April 12 2019, who erroneously denied the claim, and who took months to make the decision; September 26, 2019 to be exact.  We appealed his case to Federal Court.  On January 29, 2021, a Federal Court Judge made the decision to remand the case back to Judge Carlton for a new hearing.  We immediately sent a letter to Judge Carlton, reminding him the that the claimant had passed away, and that the case was supposed to be expedited, and asked that the hearing be scheduled right away.  The remanded hearing wasn't held until June 9, 2022.   At the hearing, we reminded Judge Carlton that there were no new records to submit because the claimant had passed away.

It's been well over four months since the hearing, and not only has the Judge not made a decision on the claim, he has not even LOOKED at the case since the hearing.  We have spoken to supervisors at the Bronx Hearing Office, mailed and faxed letters to the Chief Administrative Law Judge of the Bronx Hearing Office, and have had the claimant's wife call her local congressman's office.  There has been NO movement at all.  How is this even possible?  The answer is, there are no consequences or repercussions for Judge Carlton, the Bronx Hearing Office, or the SSA.  The way this case has been handled is a disgrace and a travesty.  And it's not the first one and it won't be the last.  No one deserves to be treated like this.  Is anyone listening??

 

 

Cost of Living Increase

It is almost that time of the year again when Social Security announces the cost of living adjustment ("COLA") to Social Security checks for 2023.  This year, due to inflation, those receiving Social Security benefits could see as much as an 8.7% increase to their Social Security checks.  Experts' predictions on the amount of the COLA have been fluctuating over the past several months, but one thing they all seem to agree on is that it will be one of the largest increases in more than 40 years.  It would also be the highest increase anyone currently receiving benefits has ever received.

Unconscionable Delays by ALJ

by Susan Golden

It is a well known fact that the process of applying for Social Security Disability ("SSD") benefits and waiting for a decision, can take months, or even years.  You cannot continue to work if you want to apply for SSD, yet, you're expected to live without income and wait, while the system slowly churns.

Social Security's excuse for their long delays  in processing a claim has always been that they are understaffed and backlogged.  While this in part may be true, the bulk of the delays seem to be due to a simple lack of caring. While there are many concerned and committed workers at the SSA, they seem to be more of a rarity, as a lot of the more experienced employees retire.  So many cases are delayed simply because a file sits on someone's desk for days, weeks and even months.

We represent a claimant who applied for  SSD benefits on December 5, 2017.  The claimant became unable to work a fulltime job on June 15, 2016, and contacted us in December of 2017, seeking our services. Unfortunately, he passed away 3 months before his initial hearing.  He left behind a wife and two children, who were his world.  Five months after his hearing, his claim was denied by ALJ John Carlton at the Bronx hearing office.  This is an unusually long period of time for a Judge to take to make a decision.

We appealed the claim at the Appeals Council ("AC") and it was denied three months later, in December of 2019.  We subsequently filed suit in Federal Court, and the case was remanded for another hearing. The order was signed and issued by Federal Court Judge Ronnie Abrams on July 6, 2021, and sent back to the AC to process and send back to the hearing office.

It then took the AC an unusually long six months to send a letter to AlJ Carlton, advising him that our claimant's case had been remanded for further proceedings.  Two weeks later, we sent a letter to ALJ Carlton, reminding him that the claim was supposed to be expedited, even though the AC didn’t treat it as such, and asked that the hearing be scheduled.

Our client's remanded hearing was held on June 8, 2022, six months after we requested ALJ Carlton to have the hearing scheduled, and almost a year after Judge Abrams issued her decision for a remand.

Four months have passed since the June 8th hearing, and ALJ Carlton has not made a decision.  In fact, he has not even looked at the case.  We have called the Bronx hearing office on a number of occasions to ask why this is so.  We were simply told the case is with the ALJ, and there is nothing they can do.  In the beginning of August, we sent a letter to ALJ Carlton, on behalf of our claimant's wife and children, asking him to please make a decision on the case, as there was no new evidence to submit since the claimant has been deceased since prior to the original hearing in April of 2019.

Regrettably, our request has fallen on deaf ears, and has been completely ignored.  Our claimant's wife is understandably angry and upset at the way her husband's case has been handled, and feels that their children deserve to be treated with dignity and respect.  The delays in this case have been unconscionable.

This week, we sent a letter to Chief Judge Selwyn S. Walters, at the Bronx hearing office, respectfully asking him to speak with ALJ Carlton, to avoid any further delays, and to ask him to make it a priority to make a decision on this case.

Podiatrists

Do not underestimate the importance of podiatrists.  when applying for Social Security Disability (“SSD”) benefits.  The Social Security regulations specifically state that podiatrists are acceptable medical sources for purposes of establishing impairments of the foot.  Claimants frequently overlook podiatrists with foot problems when they are not the primary impairment.

We represent a 56 year N.Y.P.D. detective from North Carolina who had been found disabled because he needed kidney dialysis.  After recovering from a kidney transplant, the Social Security Administration (“SSA”) conducted a hearing during a continuing disability review (“CDR”).  The SSA reinstated benefits yesterday.  However, the CDR found that the claimant was disabled based on the claimant’s foot problems from diabetes, not any renal impairment.

Regardless of whether a foot problem is your primary impairment, your podiatrist’s records and disability opinion should be sought.

CE Boondoggle Continues

Time to discuss again the needless demands the State agency makes for a Social Security Disability (“SSD”) claimant to attend a consultative examination (“CE”).

Since the last Century, virtually every CE notice I have received has violated the Social Security regulations.  Demanding a CE means the State agency refuses to believe what the treating doctors say.  The CEs have delayed claimants’ receipt of SSD benefits, wasted taxpayer money, and wasted the time of administrative law judges.  To make matters worse, the State agency has insisted on CEs throughout COVID.

I represent a 47 year old former clerk from Glen Cove with multiple sclerosis (“MS”), bladder cancer and depression.  Despite supportive reports and records from the claimant’s urologist, neurologist and psychiatrist, the State agency denied SSD benefits because the claimant, with a compromised immune system due to cancer, would not attend a CE.

The case was approved today without a hearing.  As soon as an attorney from the Social Security Administration received the case, it was approved OTR.  The four demands for the claimant to attend a CE obviously were unnecessary.

Does the State agency have an unwritten regulation that requires they insist that every claimant attend a CE?  Doubtful.  More likely, the State agency examiners are too lazy or too busy to read the file.  Therefore, the examiners want to disregard all the medical evidence in the file, and just want to rely on what the CE says.