In order to qualify for Social Security Disability (“SSD”) benefits a claimant must have acquired enough work credits, which are earned by paying taxes into the Social Security systems. Work credits expire after a period of time. The Date Last Insured (“DLI”) is the day when the work credits expire. A claimant must establish that he became disabled before the DLI.
Some claimants are under the misperception that they are precluded from obtaining SSD benefits if they fail to apply before the DLI. A claimant can apply well after the DLI, and still be approved for SSD. I filed an SSD application last April for a 55 year old former salesperson whose DLI expired at the end of 1999. I received her SSD approval today.
When the claimant contacted me she had been led to believe that she was not eligible for SSD benefits because her DLI had expired in 1999. The claimant will now start receiving her monthly SSD as well as SSD benefits back to April 2009.
Monday, February 28, 2011
Multiple sclerosis
Multiple sclerosis (“MS”) is a chronic, often disabling disease that attacks the brain, spinal cord, and optic nerves. When applying for Social Security Disability (“SSD”) benefits, the best strategy is to provide evidence that shows the claimant meets the MS “listing.” If the criteria of the MS “listing” are met then the applicant is presumed to be disabled, and no further medical or vocational development is required. Since MS is usually treated by a neurologist it would be best to obtain an opinion from a neurologist that the claimant meets the criteria under the 11.09 listing for MS.
I represent a 54 year old former attorney whose SSD application was approved in less than three months, and shortly after I submitted medical evidence from the claimant’s neurologist showing that the 11.09 criteria were met. The claimant was not even asked to be examined by a Social Security doctor.
If a hearing has already been scheduled, showing that a claimant meets a listing is important because it makes it significantly more difficult for an Administrative Law Judge to deny the claim, or for the denial to be sustained on appeal. Moreover, it is also likely that an attorney advisor would approve an on-the-record request for a fully favorable decision if shown that the medical evidence meets a listing.
I represent a 54 year old former attorney whose SSD application was approved in less than three months, and shortly after I submitted medical evidence from the claimant’s neurologist showing that the 11.09 criteria were met. The claimant was not even asked to be examined by a Social Security doctor.
If a hearing has already been scheduled, showing that a claimant meets a listing is important because it makes it significantly more difficult for an Administrative Law Judge to deny the claim, or for the denial to be sustained on appeal. Moreover, it is also likely that an attorney advisor would approve an on-the-record request for a fully favorable decision if shown that the medical evidence meets a listing.
Expediting Disability Benefits
The attorney-advisors who work in the Social Security hearing offices can help you avoid the long wait for a hearing on your Social Security Disability (“SSD”) appeal if they approve your on-the-record (“OTR”) request for a fully favorable decision. I just returned from being out of the country for a week, and found that attorney advisors from Jericho, New York and Topeka, Kansas had approved two OTRs.
Preparing an OTR requires summarizing the medical and vocational evidence, and explaining why the Social Security rules and regulations show that a hearing is not needed to approve disability benefits. The Kansas OTR involved a 48 year old woman who had worked with the mentally disabled, who has cervical radiculopathy. The Jericho OTR concerned a 51 year old former jewelry sales representative with neck and back impairments as well as carpal tunnel syndrome. I have found that since Social Security has started using templates to write their decisions that an OTR request does not need to be long; it just has to focus on the most salient pieces of evidence in the record.
A claimant should want their attorney to submit an OTR whenever possible because it could result in receiving benefits many months, even years, before a hearing would take place. The expedited awarding of disability benefits not only improves the claimant’s cash flow sooner and avoids the stress of a hearing, but may also result in a reduced attorney fee. The SSA regulation authorizing attorney advisor decisions is set to expire August 10, 2011.
Preparing an OTR requires summarizing the medical and vocational evidence, and explaining why the Social Security rules and regulations show that a hearing is not needed to approve disability benefits. The Kansas OTR involved a 48 year old woman who had worked with the mentally disabled, who has cervical radiculopathy. The Jericho OTR concerned a 51 year old former jewelry sales representative with neck and back impairments as well as carpal tunnel syndrome. I have found that since Social Security has started using templates to write their decisions that an OTR request does not need to be long; it just has to focus on the most salient pieces of evidence in the record.
A claimant should want their attorney to submit an OTR whenever possible because it could result in receiving benefits many months, even years, before a hearing would take place. The expedited awarding of disability benefits not only improves the claimant’s cash flow sooner and avoids the stress of a hearing, but may also result in a reduced attorney fee. The SSA regulation authorizing attorney advisor decisions is set to expire August 10, 2011.
Saturday, February 19, 2011
Radiculopathy
Radiculopathy or radiculitis is any disease of the spinal nerve roots or cord, whose typical symptoms include pain, numbness, tingling, and weakness. When the evidence shows that a spinal condition is causing radicular symptoms a disability claim is usually approved.
When applying for Social Security Disability (“SSD”) benefits, if a claimant’s spine condition compromises the nerve roots or spinal cord, resulting in pain, range of motion and motor strength loss, and either reflex or sensory loss, then a claimant should be found presumptively disabled under listing 1.04, making the claimant’s functionality irrelevant. Usually, a treating doctor’s opinion that a claimant meets listing 1.04 is needed to have an SSD application approved at first instance. However, there are exceptions when the evidence is crystal clear.
I represent a 56 year old former appliance repairman whose SSD application was approved shortly after I submitted the claimant’s neck and back MRI reports. I had made sure to submit treatment records that had described various spinal impairments and radicular symptoms that met listing 1.04, yet the claim sat for several months. Then, just a couple of weeks after I submitted the MRI reports, which undeniably revealed spinal conditions that impinged and flattened the nerve roots and spinal cord, the SSD application was approved.
Even though a treating doctor’s listing 1.04 opinion was not submitted, medical records were submitted that clearly evinced all of the criteria of the listing. The claimant was not asked to be examined by a Social Security doctor, which is how Social Security normally assesses a claimant’s functionality. Therefore, it appears that listing 1.04 was found to apply. By understanding what information regarding the claimant’s spine conditions should be submitted it greatly expedited the claimant's receipt of SSD benefits.
When applying for Social Security Disability (“SSD”) benefits, if a claimant’s spine condition compromises the nerve roots or spinal cord, resulting in pain, range of motion and motor strength loss, and either reflex or sensory loss, then a claimant should be found presumptively disabled under listing 1.04, making the claimant’s functionality irrelevant. Usually, a treating doctor’s opinion that a claimant meets listing 1.04 is needed to have an SSD application approved at first instance. However, there are exceptions when the evidence is crystal clear.
I represent a 56 year old former appliance repairman whose SSD application was approved shortly after I submitted the claimant’s neck and back MRI reports. I had made sure to submit treatment records that had described various spinal impairments and radicular symptoms that met listing 1.04, yet the claim sat for several months. Then, just a couple of weeks after I submitted the MRI reports, which undeniably revealed spinal conditions that impinged and flattened the nerve roots and spinal cord, the SSD application was approved.
Even though a treating doctor’s listing 1.04 opinion was not submitted, medical records were submitted that clearly evinced all of the criteria of the listing. The claimant was not asked to be examined by a Social Security doctor, which is how Social Security normally assesses a claimant’s functionality. Therefore, it appears that listing 1.04 was found to apply. By understanding what information regarding the claimant’s spine conditions should be submitted it greatly expedited the claimant's receipt of SSD benefits.
Saturday, February 12, 2011
Expediting Disability Benefits
When a person becomes disabled and can no longer work the loss of income can result in severe financial hardship. For many claimants, it is critical not only to obtain disability benefits, but to do so quickly. When seeking Social Security Disability (“SSD”) benefits, having a thorough understanding of the medical and vocational evidence, and their interplay with the rules and regulations, can lead to an expedited approval.
I represent a 51 year old former jewelry sales representative who was approved for SSD today without a hearing after I submitted an on-the-record (“OTR”) request for a fully favorable decision. An Attorney Advisor can approve an OTR when the evidence in the file shows that a hearing is unnecessary. While the clerks at the State agency who make the initial disability decisions may not fully comprehend the applicable rules and regulations, Attorney Advisors do.
The claimant’s primary problem was neck and back spine problems. The evidence I submitted to the State agency included MRIs and EMGs with positive findings, and a report from the claimant’s neurologist that specified why the claimant could not perform sedentary work. No new evidence was submitted to the hearing office, where the OTR was reviewed by the Attorney Advisor.
Under applicable rules, when a claimant’s relevant past work is non-sedentary, and the claimant is over 50 years old, that person must be found disabled even if capable of sedentary work if there are no transferable work skills. Although I did not proffer a report from a vocational expert, I was able to aver in the OTR that no reported case had ever found that a jewelry sales representative has transferable skills. Therefore, I argued that a regulation known as Medical-Vocational Rule 201.14 required finding the claimant disabled. The Attorney Advisor assigned to the OTR agreed, and the claimant’s SSD application was approved.
The argument for applying Rule 201.14 was probably critical. Without the argument, it is likely that the Attorney Advisor could have decided that whether the medical evidence supported the inability to perform sedentary work was a close question, which an Administrative Law Judge would need to resolve.
I represent a 51 year old former jewelry sales representative who was approved for SSD today without a hearing after I submitted an on-the-record (“OTR”) request for a fully favorable decision. An Attorney Advisor can approve an OTR when the evidence in the file shows that a hearing is unnecessary. While the clerks at the State agency who make the initial disability decisions may not fully comprehend the applicable rules and regulations, Attorney Advisors do.
The claimant’s primary problem was neck and back spine problems. The evidence I submitted to the State agency included MRIs and EMGs with positive findings, and a report from the claimant’s neurologist that specified why the claimant could not perform sedentary work. No new evidence was submitted to the hearing office, where the OTR was reviewed by the Attorney Advisor.
Under applicable rules, when a claimant’s relevant past work is non-sedentary, and the claimant is over 50 years old, that person must be found disabled even if capable of sedentary work if there are no transferable work skills. Although I did not proffer a report from a vocational expert, I was able to aver in the OTR that no reported case had ever found that a jewelry sales representative has transferable skills. Therefore, I argued that a regulation known as Medical-Vocational Rule 201.14 required finding the claimant disabled. The Attorney Advisor assigned to the OTR agreed, and the claimant’s SSD application was approved.
The argument for applying Rule 201.14 was probably critical. Without the argument, it is likely that the Attorney Advisor could have decided that whether the medical evidence supported the inability to perform sedentary work was a close question, which an Administrative Law Judge would need to resolve.
Videoconference Hearings
The Social Security Administration allows attorneys and experts to appear at hearings via teleconference or telephone in order to reduce costs and increase scheduling flexibility. Teleconferencing is also used to redistribute workloads so that while a claimant may attend a hearing at the local hearing office, the Administrative Law Judge ("ALJ") may appear via video from another hearing office.
Many claimants have relied on Nationwide Social Security Disability (“SSD”) practices to represent them because they cannot find local representation. Those Nationwide practices sometimes send disability representatives to hearings who are not attorneys. Moreover, those Nationwide practices have claimants deal with non-attorneys throughout most of the process, and a great many claimants never see or speak with an attorney until a hearing.
Telecommunication appearances eliminate the need to rely on Nationwide disability practices. I had SSD hearings this week in Washington State and Wisconsin. For the Wisconsin hearing, the claimant went to the Madison, Wisconsin office, the ALJ appeared from Milwaukee, Wisconsin office, and I appeared at the Queens, New York office. I had previously obtained SSD benefits for the claimant’s uncle, who was also from Wisconsin, without ever having to make an appearance there. Both claimants were able to communicate with me directly without having to rely on non-attorneys
Many claimants have relied on Nationwide Social Security Disability (“SSD”) practices to represent them because they cannot find local representation. Those Nationwide practices sometimes send disability representatives to hearings who are not attorneys. Moreover, those Nationwide practices have claimants deal with non-attorneys throughout most of the process, and a great many claimants never see or speak with an attorney until a hearing.
Telecommunication appearances eliminate the need to rely on Nationwide disability practices. I had SSD hearings this week in Washington State and Wisconsin. For the Wisconsin hearing, the claimant went to the Madison, Wisconsin office, the ALJ appeared from Milwaukee, Wisconsin office, and I appeared at the Queens, New York office. I had previously obtained SSD benefits for the claimant’s uncle, who was also from Wisconsin, without ever having to make an appearance there. Both claimants were able to communicate with me directly without having to rely on non-attorneys
Tuesday, February 8, 2011
Federal Court Decision
National Organization of Social Security Claimants' Representatives (“NOSSCR”) is an association of attorneys who represent Social Security Disability and Supplemental Security Income claimants. The latest edition of NOSSCR’s Social Security Forum, chose my decision in Sergenton v. Astrue, 714 F.Supp.2d 412 (E.D.N.Y. 2010) for publication in its “Selected Cases” section.
Sergenton held that the Social Security Administration had to pay attorney fees because ALJ Rothman acted unreasonably. After losing the report of the claimant’s doctor, which was the basis for the federal court remanding the case, ALJ Rothman refused to contact the doctor or consider the replacement report I submitted from the doctor.
Sergenton held that the Social Security Administration had to pay attorney fees because ALJ Rothman acted unreasonably. After losing the report of the claimant’s doctor, which was the basis for the federal court remanding the case, ALJ Rothman refused to contact the doctor or consider the replacement report I submitted from the doctor.
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