Demystifying

Demystifying, SSA, SSDI

How will the possible government sequester affect the Social Security Administration?

According to a report issued by the Senate Appropriations Committee the possible sequester cuts would have significant impact on the Social Security Administration (SSA) and the processing of disability claims. The sequestration is set to occur in seven days if Congress does not act. Across the federal government, $85 million in automatic spending cuts will begin. The Senate report states that the SSA would be forced to reduce its staff by about 5,000 employees. The SSA would also need to furlough their entire staff, 65,000 employees, for a six week period of time to absorb the drastic budget cuts. A furlough is an unpaid leave. It is also expected that 15,000 state employees at the Disability Determination Services (DDS) agencies will also be furloughed. The DDS agencies process disability applications and Request for Reconsideration appeals for the SSA. Due to the decreased SSA and DDS staff, average processing times of claims will increase. Currently the average processing time for an initial application is 111 days. This is expected to climb to 180 days which will increase the number of backlogged claims these offices are already experiencing. For more information on the how the pending sequestration will affect the federal government and the SSA, check out the Federal Times article “Report: Federal furloughs, downsizing if sequestration cuts happen.”

Demystifying, SSA, SSDI

Survivors Benefits: Death and Divorce

The loss of the family member is devastating, emotionally and financially. Social Security can help by providing income for the families of workers who die. According to Social Security, 98 of every 100 children could get benefits if a working parent dies. And Social Security pays more benefits to children than any other federal program. Many people do not realize that the value of survivors insurance under Social Security has the potential to have more value than your individual life insurance. When you die, certain members of your family may be eligible for survivors benefits. These people include widows, widowers (and divorced widows and widowers), children and dependent parents. A widow or widower may be able to receive full benefits at full retirement age. The full retirement age for survivor is age 66 for people born in 1945-1956 and increases to age 67 for people born in 1962 or later. Of course, reduced widow or widower benefits can be received as early as age 60.  A widow or widower can receive benefits at any age if she or he takes care of the deceased’s child, who is receiving Social Security benefits, and younger than age 16 or disabled. Unmarried children who are younger than age 18 (or up to age 19 if they are attending elementary or secondary school full time) can also receive benefits. Children can receive benefits at any age if they were disabled before age 22 and remain disabled. If you are divorced and your prior spouse of 10 years or more dies, then upon death you can collect benefits upon the prior spouse’s tax records. Your former spouse, however, does not have to meet the length-of-marriage rule if he or she is caring for the decease’s child who is younger than age 16 or who is disabled and also entitled based on the deceased’s work history. The child must be your deceased spouse’s natural or legally adopted child. Benefits paid to a surviving divorced spouse who meets the age or disability requirement as a widow or widower will not necessarily affect the benefit rates for other survivors getting benefits on the worker’s record. However, if you are the surviving divorced mother or father who has the worker’s child under age 16 or disabled in your care, your benefit will affect the amount of the benefits of others on the worker’s record. If you have questions or feel that you are eligible to receive Social Security Disability Insurance benefits call Greeman Toomey PLLC today at (877) 332-3252 for more information

Demystifying, SSA, SSDI

Supplemental Security Income (SSI) Benefits for Premature Children

Social Security provides Supplemental Security Income (SSI) disability benefits to certain infants born with low birth weight whether or not they are premature.  A child weighing less than 1200 grams (about 2 pounds, 10 ounces) at birth can qualify for SSI based on low birth weight provided the infant’s family meets the SSI’s income requirements.  A child weighing between 1200 and 2000 grams (about 4 pounds, 6 ounces) at birth and considered small for his or her gestational age also may qualify. Children from birth up to age 18 may qualify for Supplemental Security Income (SSI) benefits. Children must meet Social Security’s definition of disability for children and the parents and child must have low income and few resources. SSI for your child can certainly help pay for your child’s hospital stays, other medical bills, or child care for your premature baby. Newborns over 1,200 grams may qualify for SSI depending on their gestational age. Listed below are the gestational ages and birth weights provided by Social Security that may qualify a child for Supplemental Security Income benefits: 37-40 weeks — Less than 2000 grams (4 pounds, 6 ounces) 36 weeks — 1875 grams or less (4 pounds, 2 ounces) 35 weeks — 1700 grams or less (3 pounds, 12 ounces) 34 weeks — 1500 grams or less (3 pounds, 5 ounces) 33 weeks — 1325 grams or less (2 pounds, 15 ounces) If the newborn weight is equal to, or less than, the specified amount, based on the newborn’s gestational age, the newborn may qualify for SSI benefits. However, generally benefits are terminated by age 1 for babies who are receiving SSI payments due to their low birth weight, unless Social Security determines their medical condition is not expected to improve by their first birthday and Social Security will schedule a review for a later date. If you have questions or feel that you are eligible to receive Social Security Disability Insurance benefits call Greeman Toomey PLLC today at (877) 332-3252 for more information.

Demystifying, SSA, SSDI

Social Security Disability and Child Support

The federal Office of Child Support Enforcement estimated that more than $100 billion in ordered child support went unpaid in 2009. About $53 million of this unpaid amount was owed to the government due to a lack of public assistance reimbursements. These numbers have influenced governments to more arduously go after child support payments from the parents responsible to pay it so taxpayers are not left holding the bag to make-up nearly 50 percent of the missing funds through public assistance support. There are many parents out there who owe child support, but can’t afford to pay it because they are unable to work due to a disability. It’s important to know that even though you may be entitled to Social Security disability payments, you may not be off the hook from paying child support. Disabled workers who qualify for the Social Security Disability Insurance (SSDI) program have paid into Social Security their entire working lives. Because the amount payable to these disabled workers is based on their earnings history SSDI recipients can have a portion of their benefits seized if they owe back child support. The Supplemental Security Income (SSI) program is different. Because SSI is based, not on earnings history, but on economic need for low income people, these funds cannot be seized for child support payments. This program is basically a public welfare benefit similar to foods stamps and other public welfare benefits. As the amount of unpaid child support increases, government officials will continue to ramp up enforcement by garnishing payments and even locking up those who are not meeting their child support obligation. A recent NBC News article reinforces the possibility that government officials are using jail as an option to enforce child support laws. Check out this article for more information.

Demystifying, SSA, SSDI

Ask a Case Manager: I lost at my hearing! What are my options now?

If you are denied at the hearing level you will receive a Notice of Decision – Unfavorable from the Social Security Administration (SSA) Office of Disability Adjudication and Review (ODAR). If you receive a Notice of Decision – Unfavorable you have two options: one is to file an appeal with the Appeals Council or to file a new claim. At Greeman Toomey, if a client is denied at their hearing, the attorney who represented you at the hearing will review the decision and your file to determine what is the best course of action. The appeal with the Appeals Council is called the Request for Review of the Hearing Decision/Order (SSA 520). This request must be filed within 60 days of the date of the decision. It is important to note that if the hearing decision is not appealed that decision is made final. The Appeals Council will review your decision to determine if the Administrative Law Judge made the correct decision at the time of the hearing. This review can take can take over a year to process. The Appeals Council has three different options. It may be decided that the decision was incorrect and you are in fact disabled. It may be determined that more information is necessary and your claim will be returned to the ODAR office for another hearing. Or the Appeals Council may deny your Request for Review. Unfortunately, we most often see that the Appeals Council denies the Request for Review. For some of our clients, it may be in their best interest to file a new claim. If this is the option that you choose, there is a 65 day waiting period from the date of the decision before filing your new application. Because the hearing decision will have been made final, when refiling the earliest you can allege disability is the day after the judge’s decision. The processing time for the new claim will be similar to your previous claim. For additional information regarding the processing of these claims please refer to this earlier blog post.

Demystifying, General Info, SSA, SSDI

New Social Security measures at the hearing office: Do they actually help claimants?

When a claimant, who is treating for his/her conditions is about to go to a hearing, often times their file is filled with hundreds of pages of sensitive medical information about them that will aid the judge in the evaluation of the claim. The Office of Disability Adjudication and Review wants to make sure a claimant’s privacy is maintained throughout the process, so they keep close guard as to who can see a claimant’s electronic file for review for a hearing. The policy has been that a claimant and a representative have to check in with the guard at the front gate and get screened prior to entry, then, the claimant or representative checks in with the front desk and requests a CD by providing information about the claimant (last name, first four numbers of claimant’s social security number). However, in the past couple months Social Security has also decided to encrypt the CDs of electronic evidence. In order for a claimant or representative to access CDs of the claimant’s medical evidence, the day of the hearing, the person must also enter into the computer the first four letters of the claimant’s first name, the pound sign, and the last four digits of their Social Security number. This may seem simple enough to a lot of claimants, and seem like a sensible security measure, however, it can block a lot of claimants from reviewing a file they need to review prior to their hearing. Many people are claiming disability due to conditions that affect their ability to think and carry out multi-step tasks. For many, as a result of depression, anxiety, the effects of constant pain or other conditions, they cannot carry out even simple two or three step tasks. By adding these security measures, Social Security has effectively added multiple steps to a claimant accessing an electronic folder. This is further complicated by the fact that a claimant cannot see the letters and numbers they are typing in, as they are typing in the password (as part of the encryption effort). Claimants with learning disabilities may need to see exactly what they are typing, or else they may not be able to complete the necessary task to access their own file. This process also assumes computer literacy amongst claimants, although many claimants have little or no knowledge about how to use a personal computer. The Office of Disability Adjudication and Review has staff members ready, willing and able to assist a claimant in accessing their electronic file. The staff is friendly and helpful when asked. However, this failsafe to protect the claimant’s ability to access his/her file only works if the claimant is capable of asking for help when needed. Many of the same conditions that affect a claimant’s memory (depression, anxiety, learning disability, etc.) can also affect their ability to socially function even on the most superficial levels. This includes asking for help when needed. This means that many claimants with severely debilitating mental conditions will NOT be able to access the evidence being used at their hearing, as they cannot carry out the now more complex tasks to access the file, and cannot ask for help when needed. Social Security conducts hearings on whether a claimant is disabled as part of the claimant’s Constitutionally guaranteed right to notice and an opportunity to be heard under the 5th Amendment’s Due Process clause. It can be argued that if a claimant cannot access the evidence being used at their opportunity to be heard, then they may not have been properly noticed under the law. This will also hinder the claimant’s ability to be ready for the hearing and be able to address all the issues to the best of his/her ability. A change to remedy this situation would occur at the Congressional level or the Commissioner’s level. If this situation is of interest to you, and you wish to speak out, you can write to your US Congressperson or US Senator.  

Demystifying, Legal News, SSA, SSDI

Disability Benefits for Wounded Warriors

Disabled military service members and veterans may be eligible for expedited processing of their claims. This special claim processing is reserved for military service members who become disabled while on active military service on or after October 1, 2001. This designation applies whether the disability occurred while in the United States or on foreign soil. This Social Security Administration (SSA) law is outlined in HALLEX I-2-1-40 Critical Cases section. This also provides information for the SSA employees on how to process these types of claims. If you are or were an active military service member and became disabled on or after October 1, 2001, it is important to bring this to the SSA’s attention as screening for this expedited processing can sometimes be missed. The expedited processing applies to both claims for Disability Insurance Benefits (DIB) and Supplemental Security Income (SSI) claims. In order to qualify for DIB benefits you must have paid enough in to the SSA, recently enough to be insured. To determine if you qualify you can call the SSA and ask for your date last insured; to qualify for the DIB benefits you must be found disabled prior to this date. If you have not paid enough into the SSA system recently enough you may still qualify for SSI benefits. SSI is a benefit program based on financial need. To read more about the Wounded Warriors program please view the SSA’s article called “Disability Benefits For Wounded Warriors.”  

Demystifying, SSA, SSDI

Why does Social Security Disability Take So Long?

The most asked question by anyone who has ever gone through the Social Security disability process has to be “why does it take so long?” In reality, it’s an easy question to answer, but not as easily accepted. Most of the people who apply and are awarded benefits for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) face an approximate wait time of up to two years, depending on what part of the country they live in, before claims are ultimately decided. The main reason for this is that the majority of SSDI and SSI applicants have to appear at a hearing before an Administrative Law Judge before benefits are awarded because Social Security denied them on two previous attempts to acquire benefits. The Office of Disability Adjudication and Review (ODAR) in Minneapolis, the Social Security office that schedules and administers hearings, has up to 10,000 cases on any given day that are waiting to be scheduled for a hearing. The number of cases waiting to be scheduled for a hearing in other jurisdictions varies. Because there are this many cases waiting to be scheduled in Minneapolis it takes 12 to 15 months before a hearing will be held because there not enough judges to hear all the requests for hearings in a timely manner. Other jurisdictions face wait times between 8 and 20 months for hearings. If you are someone who is waiting 12 to 15 months for a hearing that means you have already been denied SSDI or SSI on two previous occasions, which results in you having spent up to 10 months on this process before you even have chance to request a hearing. With this knowledge it’s easy to see why Social Security disability cases can drag on. It is true that not everyone who applies for SSDI or SSI have to go to a hearing before they are approved. About 25 percent of applicants are approved on initial application and another 10 percent or so are approved after their first appeal. Even if you are approved at one of these two levels the process can still take several months. You may know someone who didn’t have to wait a long time before they were approved, but these people are the exception to the rule. If you have to go to a hearing before an Administrative Law Judge for your SSDI or SSI case, you have a lot of company. This link explains the appeals and hearing process.

Demystifying, Legal News, SSA

Ask a Case Manager: I got a letter about the Virtual Screening Unit. What's that?

As a case manager, I am always glad to hear when one of our client’s gets selected for the Virtual Screening Unit (VSU). This can potentially speed up the processing time of your claim and get the benefits you deserve in your hands faster. The VSU is a program developed by the Social Security Administration (SSA) to reduce the backlog of claims waiting for a hearing. Claims selected by the VSU are claims currently waiting for a hearing at one of the SSA Offices of Disability Adjudication and Review (ODAR). If your claim is selected by the VSU, an attorney adjudicator will review your file in an effort to determine if a fully favorable decision can be issued without having a hearing. A fully favorable decision means that SSA agrees that you are disabled and agrees to the exact date that you alleged onset of your disability. At Greeman Toomey, if one of our client’s receives a VSU notice, we update their file immediately. You will receive a phone call from one of the members of our medical records staff to confirm we have requested records from all the appropriate medical sources. Once received we will submit all of these records to the attorney adjudicator the at the VSU. We would also want to make contact with your supportive doctors. If you are treating with a doctor for your physical or mental health conditions and believe that doctor would be supportive of your claim, we have a special form we will ask them to complete regarding your conditions, restrictions and limitations. Also if you have any supportive documents in your possession that have not already been submitted to SSA please provide our office with copies. After reviewing the information submitted, the attorney adjudicator may try to make a decision within the next 7-14 days. Sometimes the adjudicator may need some clarification regarding your medical information. An example would be when a specific condition was diagnosed or a treatment plan was prescribed. The adjudicator may also request additional information regarding your past relevant work, such as a job description or confirming whether previous employment was full time or part-time. If a fully favorable decision cannot be issued, your claim will be sent back to the appropriate ODAR office. Claims returned to the ODAR office go back in line in their original order, not causing any delay in the scheduling of your upcoming hearing. Should you have any questions please feel free to contact your case manager at (612) 332-3252 or toll free at (877) 332-3252.

Demystifying, SSA, SSDI

Medical Expert Interrogatories

A prior blog post entitled “Medically Equaling Analysis at Step Three of the Sequential Process” discussed the importance of having an updated opinion from a Medical Expert. If additional medical evidence obtained after the State agency physician reviewed the claim suggests that a medical equivalence may be reasonable, an Administrative Law Judge (ALJ) must obtain an updated medical opinion from a Medical Expert. This requirement may be satisfied by either having a Medical Expert present during a hearing to testify, or by obtaining his or her opinion through interrogatories (i.e., a set of written questions). HALLEX I-2-5-44 outlines what an ALJ must do when the ALJ receives a Medical Expert’s response to his or her interrogatories. When the ALJ receives a Medical Expert’s response to his or her interrogatories, the ALJ must: Provide a copy of the response to the claimant and the representative and notify them of the right to comment, submit further relevant evidence, propose additional interrogatories to the ME, and request a supplemental hearing with opportunity to question the ME at the supplemental hearing. If the claimant requests a supplemental hearing, the ALJ must grant the request, unless the ALJ receives additional documentary evidence that supports a fully favorable decision. Questioning a Medical Expert is an essential part of a Social Security disability attorney’s job. Therefore, understanding the procedures and rules surrounding Medical Expert interrogatories is imperative.

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