by Susan Golden
Claimant 2: State Agency Ineptness
Ms. A applied for SSD benefits on December 19, 2023. She suffers from Post-Covid Syndrome. We also represented her for Long Term Disability benefits, which was approved in two months, based on the same medical evidence that we submitted to Social Security. By the beginning of March 2024, we had submitted to the NY State agency ("DDS"), Ms. A’s medical records and reports from eight doctors, all of whom supported Ms. A’s inability to work fulltime. We filed even more medical support to the Agency than we typically do, because we included an Independent Medical Exam and Functional Capacity Evaluation, both of which supported her disability.
On March 5, 2024, I called Ms. Mohammad, the analyst at DDS who was assigned to Ms. A’s claim. I advised her that we had submitted an overabundance of supportive medical evidence in a timely manner. I purposely did this because DDS considers any medical records more than three months old to be “stale,” and they habitually sit on cases for longer than that in order to claim they don’t have recent records.
I called Ms. Mohammad again on April 3, 2024, since I had not heard back from her, and there still was no decision on Ms. A’s claim. On May 20, 2024, I left a message for Ms. Muhammads’s supervisor, Ms. Flowers-Williams, as I had still not heard back from Ms. Muhammad. Ms. Flowers-Williams did not return my call, but Ms. Muhammad finally did. I told her that I could see Ms. A’s efile via the ERE system, and no work had been done on Ms. A’s case since the end of February. Ms. Muhammad told me she would “get to it.” Two days later, on May 22, 2024, after not looking at the file since the end of February, Ms. Muhammad told me she sent the case to the State agency in-house “doctors” for review. As expected, Ms. A’s case was denied on May 29, 2024, six days after the “doctors” received the claim. In other words, they reviewed 800 pages of medical records in six days. The denial letter lists the medical sources upon which the State agency based their decision. They ignored most of the medical evidence we submitted; not even mentioning half of the evidence we had submitted. Unfortunately, this scenario happens all of the time, and our only recourse is to appeal.
We received a phone call from DDS last week, asking us to submit "updated" records from Ms. A's doctors. When we asked the analyst how long she's had the case, she said since June. So it took her almost 4 months to contact us for updated records, and completely ignored our comments on Ms. A's appeal which stated that the original records we submitted months ago were submitted in a timely manner, and they should make a decision based on those records. We will not play their games. DDS needs to own up to their own delays and ineptness, and make a decision based on the supporting documents. But they will continue to drag this out, and make Ms. A must wait what will be several more months, if not years, before she gets approved.
What is the number one question that I am asked by claimants? “How am I supposed to survive with no income while waiting for a decision?” I have no answer for that because there is no answer! And no one in the SSA seems to care.
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