Demystifying

What You Should Know Before You Apply For SSI Disability Benefits For Your Child? The Social Security Administration (SSA) has a created an online factsheet titled “What You Should Know Before You Apply For SSI Disability Benefits For Your Child.” This document outlines the basic requirements for child disability claims. Disabled children may be eligible to receive Supplemental Security Income (SSI) benefits if they are found disabled and their family meets the financial need requirements. In order for a child to be found disabled by the SSA they must have a physical or mental condition(s) that severely limits his or her activities. This condition(s) must last or have lasted longer than one year or is expected to end in death. To file a claim for child disability benefits you can contact the SSA to setup either an in-office interview or phone interview with one of the agents at your local Social Security office.  The phone number to schedule the interview is (800)772-1213. The SSA website also includes a checklist of what is needed for the interview. The interview will consist of gathering information regarding the child’s medical conditions, medical treatment, education history and family’s income.

Under the Social Security Disability and Supplemental Security Income system, a claimant can file on their own. They can do so online at www.socialsecurity.gov, or by calling 1-800-772-1213. However, while a claimant doesn’t need an attorney to file for Social Security Disability or Supplemental Security Income, having an attorney provides a great deal of advantages. A Social Security Disability law firm has attorney’s and staff on hand to help a claimant through every step of the way, from initial filings, appeals, meeting and reminding claimants of deadlines, to representation at a hearing. THE INITIAL APPLICATION: An attorney’s office can help an individual claimant file his initial application. The attorney or professional staff member will work closely with the claimant, trying to find out every doctor source, a work history, dates when the claimant stopped working (or was first bothered by the disabling conditions), and everything else necessary to file the initial application. The office will keep all the evidence of receipt on hand, in case there is any dispute as to when it is received by Social Security. The office will make sure the initial application is as complete and informing as possible, so if there is an opportunity for the claimant to win on the difficult lower levels, that opportunity will not be missed. The attorney office will also send questionnaires out to supportive doctors who are treating you, asking specific and pointed questions about your capacities to do work. While the initial application is pending, we will be cc’d on all your mail from the SSA regarding your claim. This will allow us to give reminders to you as to deadlines for paperwork, or CE appointments, to make sure they are met, and the process goes smoothly. REQUESTS FOR RECONSIDERATIONS (in states where they apply): If a claimant gets denied on the initial application level, the attorney office, in most cases, will also receive the denial letter, and waste no time in reaching out to the claimant. The attorney office will then go over all the necessary facts to file the appeal, and make sure the 60 day filing deadline is met. If, for whatever reason, the attorney office cannot get into contact with the claimant as the 60 day deadline approaches, the attorney office will file protectively online, stopping the 60 day clock for the claimant. We will also maintain all the printouts of the online receipts, to prove receipt by the SSA. If, for any reason, the online appeal process is not available (The US Government can get IT issues of its own), we will file the appeal using US Mail and SSA paper forms. While the request for reconsideration is pending, we will also be serving as reminders to the claimant to meet any paperwork deadlines. During both these processes, if a claimant updates his/her address, or has new medical tests, seeks treatment at a new facility, has a trip to the ER, or a hospitalization, we will be updating Social Security, to make sure they retrieve the medical records for those visits (increasing the amount of evidence for the claim), and making sure the time sensitive mail goes to the right place. HEARINGS: A claimant’s attorney’s office will be cc’d on any denial where the next step is to request a hearing. That office will waste no time in contacting the claimant (or filing protectively if they can’t). The attorney office will go over with the claimant, all the facts necessary for the disability report to accompany the appeal. As the actual hearing date approaches, the attorney office will request medical records from the claimant’s treating sources, to further build the evidence of record. The attorney will prep the claimant for the hearing, letting him or her know everything to expect at the hearing. At the hearing, the attorney will make arguments to the judge, ask questions of the experts, and even ask questions of the claimant, highlighting specific points of information that is beneficial to the claim. If the hearing results in an Unfavorable Decision, the attorney office can then advise the client as to whether the next best step is to appeal to the Appeals Counsel in Virginia, or re-file the claim. If the best next step turns out to be an appeal, the attorney office can help the claimant meet the deadline for the appeal, and, if necessary, write a brief to the Appeals Council, highlighting why a reversal or a new hearing may be the best course of action. One of the most important goals that a Social Security Disability Attorney’s office achieves is keeping the claimant informed every step of the way. They help the claimant know what is going on with the claim, why Social Security is taking an action, or not taking an action, and keeping the claimant informed of their rights. This helps the claimant make well informed decisions during the claim, and ensures a smoother process. While a claimant can go through the process alone, it can be nice to know that a claimant doesn’t have to.

Living in a shelter, medical treatment facility, or a correctional facility may affect your Social Security Disability benefits. Possibly living in a public institution could make a person ineligible for benefits in general. According to Social Security, if you enter a nursing home or hospital (or other medical facility) where Medicaid pays for more than half of the cost of your care, your SSI benefit is limited to $30.00 per month. Some States supplement this $30.00 benefit. Social Security may lower the SSI benefit by any income you may have. However, Section 1611(e)(1)(G) of the Social Security Act provides that Supplemental Security Income (SSI) recipients, who are temporarily institutionalized for medical care can get benefits during the first 3 full months of institutionalization to pay expenses to maintain their home or living arrangement where they may return upon discharge. Social Security refers to benefits paid under §1611(e)(1)(G) as temporary institutionalization (TI) benefits. Often times the answer depends on the type of living arrangement and facility you are living in. For young adults who are age 18 or over and live in a public medical facility where Medicaid is not paying for more than half of the cost of your care, you are not eligible for any SSI benefits. If a child under age 18 enters a nursing home, hospital or other medical facility where Medicaid and/or private health insurance pays for more than half of the cost of care, the child’s SSI benefit is limited to $30 a month (plus any supplementary State payment). Social Security may reduce the SSI benefit by any income the child may have. If a child under age 18 lives in a public facility where neither Medicaid nor private health insurance, either alone or in combination, is paying for more than half of the cost of care, the child is not be eligible for any SSI benefit. An SSI recipient (including an eligible child) may continue to receive benefits (including State supplementation) without interruption based on the full federal benefit rate (FBR) for any of the first 3 full months of medical confinement if for those months the recipient otherwise would be subject to the $30 payment limit, or ineligible due to residence in a public medical institution (payment status NO2). Additionally, the recipient’s admittance must be to a public institution, the primary purpose of which is the provision of medical or psychiatric care, or a public or private Medicaid-certified medical treatment facility.

Most children who leave the foster care systems do not necessarily receive ample preparation and support for the transition to independent living. Foster youth have high risks of being homeless, incarcerated, unemployed, and unskilled. In addition, they are also more likely to experience physical, developmental, behavioral, and mental health challenges. In response to many challenges youth face when leaving foster care, policymakers in many states have taken charge to find means to help the needs of youth in foster care and transitioning out of foster care. Several states are making a comprehensive effort to connect child welfare services with other youth-serving systems, such as workforce development, postsecondary education, mental health, and juvenile justice. These “cross-system” efforts aim to ensure access to and easier navigation of a richer and better coordinated array of services for current and former foster youth. Social Security Administration Regulation SI 00601.011 states disabled youth receiving Title IV-E federal foster care benefits usually cannot become eligible for Supplemental Security Income (SSI) until foster care payments have stopped. Eligibility for foster care payments in most States ends at 18 years of age. Many youth need income support and health services and by applying for SSI this can ease the transition onto independent living.  Social Security Administration accepts SSI applications up to 90 days before the foster care eligibility will end due to age. This is an exception to the general rule of accepting an SSI application in the month before the month of eligibility, as described in SI 00601.010B.3.a. The claimant may file an SSI application if he or she: lives in a foster care situation as defined in SI 00830.410A.1; alleges blindness or disability; appears likely to meet all of the non-medical eligibility requirements when foster care payments terminate; expects the foster care payments to cease within 90 days of the application filing date; and is within 90 days of losing foster care eligibility because of age. (NOTE: If the requirements outlined above are not met or if a claimant in foster care files for benefits more than 90 days before foster care payments end, the claims interviewer should adjudicate the application under the normal application process, documenting the receipt of countable foster care payments. For the application process, see SI 00601.010 and SI 00601.012.) 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.

The attorneys at Greeman Toomey represent Social Security disability claimants across the United States of America. In June 2012 alone, we represented clients at hearings in 15 states: Arizona, California, Georgia, Illinois, Indiana, Kentucky, Michigan, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Texas, and Wisconsin, and across our home state of Minnesota. Nationwide representation means that many of our attorneys are working from the road for days at a time, which would never be possible without the organization and support of our dedicated Minneapolis-based staff. Nationwide representation also means that Greeman Toomey’s attorneys are knowledgeable about nuances between different Federal circuits. Did you know, for example, that a prior decision by an Administrative Law Judge has a different legal effect in the 6th Circuit than in the 9th Circuit? In the 6th Circuit, the cases of Drummond v. Commissioner of Social Security, 126 F.3d 837 (6th Cir. 1997) (http://www.ssa.gov/OP_Home/rulings/ar/06/AR98-04-ar-06.html and Dennard v. Secretary of Health and Human Services, 907 F.2d 598 (6th Cir. 1990) (http://www.ssa.gov/OP_Home/rulings/ar/06/AR98-03-ar-06.html) have been accepted as Social Security Acquiescence Rulings 98-4(6) and 98-3(6). In the 9th Circuit, however, the legal effect of a prior Administrative Law Judge decision is governed by Acquiescence Ruling 97-4(9), Chavez v. Bowen, 844 F.2d 691 (9th Cir. 1988) (http://www.ssa.gov/OP_Home/rulings/ar/09/AR97-04-ar-09.html). This is just one example of a legal difference that stems from the geography of your case. If you have already been denied by an Administrative Law Judge and are looking for representation for a new Social Security claim, make sure your representative knows how to help! For attorneys with the competence to examine your case from every angle and fight for your benefits nation-wide, call Greeman Toomey.

Due to the high volumes of Social Security Disability claims waiting for a hearing by an Administrative Law Judge, the average wait time is between 12-15 months. This can be financially straining for many people pursuing disability claims. Clients frequently ask me if there is any way to speed up this process. The Social Security Administration (SSA) Office of Disability Adjudication and Review (ODAR) will expedite a claim if the claimant is in “dire need.” SSA classifies this as the inability to obtain food, medicine or shelter. In order to request an expedited hearing, please provide a written letter explaining your current financial situation. It is also important to show documentation, such as an eviction or foreclosure notice, to verify your financial need. Utility disconnect or shut-off notice are other examples of helpful documentation. It is very important to show proof of your hardship or SSA may not grant this request. If your request is granted it does not mean that your hearing will take place immediately but rather when the ODAR office is able to fit your claim into their schedule. ODAR offices are typically scheduling hearings two to three months in advance. Successful requests for expedited hearings may speed up the process by several months, potentially alleviating the financial difficulties experienced while awaiting your hearing. For more detailed information regarding this process, click here. (Section B, number 4).

Keeping your Social Security attorney’s office informed of any changes in your medical condition and where you are treating for your conditions is imperative to proving to the Social Security Administration that you are disabled. A large portion of the evidence used to prove your case comes from the medical records obtained from your treating sources. If your attorney’s office is unaware of a source for medical treatment, significant information documenting your disabilities may be missed. To begin with, you should provide your Social Security attorney’s office with a complete list of all physical and mental health clinics and hospitals you are currently visiting and all the ones you’ve seen over the last 12 months. Specifically the names, addresses and phone numbers for all clinics and hospitals are needed. Once this information is provided we do not need to be informed every time you have an appointment for medical treatment at one of these facilities, but inpatient hospitalizations and major changes to your condition should be reported to your case manager. You should also report new diagnoses, scheduled surgeries and any further limitations to your ability to work. It is also very important to keep your case manager informed of any new facilities you treat at once your case has begun. Informing your case manager of any new medical treating sources makes it easier to keep Social Security up to date on your current condition and ensures that the appropriate medical evidence can be obtained in supporting your disability claim. During this process you may have to visit many different clinics and hospitals as part of your medical treatment. Keeping your own detailed list of these providers will ensure that all the appropriate medical records are submitted to help document your disabilities. To learn more about how Social Security decides whether you are disabled under its rules visit: http://www.ssa.gov/disability/determination.htm

The Social Security Administration (SSA) has established different claim processing procedures for claimant’s who are acutely ill. The average claimant is required to wait several months for a decision, while a claimant whom the SSA believes would likely be found disabled may be able to request that the SSA expedite the processing of their claim based on the severity of their illnesses, injuries or conditions. If the claimant’s illness is terminal or they suffer from one the conditions listed on the SSA’s Compassionate Allowance list, their claim should be processed within a matter of weeks. The SSA office handling the claim will flag the application or appeal for faster processing by the Disability Determination Services office which is responsible for making the medical determination.  For a claimant who is waiting for a hearing, the hearing’s office will designate the claim as a critical case. A claimant who has been diagnosed with a terminal illness will be given TERI processing. A claimant who has been diagnosed with a condition on the Compassionate Allowance list will be given CAL processing. To view the current conditions that meet the compassionate allowance designation please click here.  These designations are applicable to both Disability Insurance Benefits (DIB) claims and Supplemental Security Income (SSI) claims. If a claimant has filed an application for SSI and is acutely ill they may be eligible for Presumptive Disability or Presumptive Blindness payments. The payments will be paid to claimant who suffers from a condition or conditions that meet the specific criteria. These benefits will paid for up to six months while the claimant waits for his or her decision. To view the conditions that meet the presumptive disability designation please click here. The SSA may also give special claim processing to a claimant who is suicidal or homicidal. For more information on the processing of these types of claims, please view the SSA’s article “Special procedures for the severely disabled”

The Social Security Administration over the past couple years has given notice to more and more claimants that their hearing is being held via video teleconference. A claimant would go to the office where the hearing is being held and instead of the judge being in person, he/she would be on a video screen. The claimant and the judge can see each other and can have a real-time conversation. The claimant’s representative can be with the claimant, and the expert(s) may be with the claimant, phoning in, or with the judge at a remote location. While this can add convenience and possibly expediency to the adjudication of a claim, it may not be in the best interest of every claimant. First, let’s explore the advantages to a Video Teleconference hearing. Many states, such as Iowa and Minnesota, only have one Office of Disability Adjudication and Review (ODAR), which are Social Security’s formal hearing offices. This requires great expense and effort on the part of many claimants to have to travel several hours, and often have to stay overnight, in order to get to their hearing. Many claimants are homeless or otherwise of limited means, so transportation and such travel may be impossible. As more and more District Offices get outfitted with the technology, these Offices are now able to be a hearing site for many claimants, allowing for greater ease of travel. A claimant in Duluth, MN would have a much easier time getting to the Duluth, MN District Office then the Minneapolis ODAR. The other advantage to a Video Teleconference hearing is that it allows judges from other ODARs to handle claimants from other states. This has allowed judges from the National Hearing Center in St. Louis, MO to perform hearings for claimants all around the country. This allows more claimants to be heard, diminishing the wait time for claimants across the board. For many claimants who have the means to make it to their respective ODAR, and are able to deal with the wait time, a Video Teleconference hearing has several disadvantages. Claimants, experts and the Administrative Law Judge are able to hear one another is through a microphone system or telephone system. If either of these systems breaks down neither the Judge, experts, or claimant will be able to hear one another clearly. Furthermore, the record of the hearing is kept via audio recording, thus, if any audio technology for Video Teleconferencing fails, it will hinder the accurate recording needed for future reference by the claimant, the judge, the representative and, if necessary, the Appeals Council. Furthermore, if the technology breaks completely, the claimant will not be able to have his/her hearing as scheduled, and could cause further delay to a hearing that the claimant waited many months for. In addition, a Video Teleconference deprives claimants of the reassurance of a live, in person conversation. Many claimants may not be able to fully handle, or grasp a live conversation through a video monitor. This could mean that many claimants may not be fully aware that this is the hearing that they have been waiting for, because they are not looking at an in person judge. Finally, several claimants having a Video Teleconference hearing are often times getting a judge from a different Federal Circuit. Social Security is governed by Federal Law, and different regions of the county are parts of different. For instance, St. Louis, MO is in the 8th Circuit, but Eau Claire, WI is in the 7th Circuit. These circuits can have two different standards on several aspects of Social Security Law. Thus, a judge in St. Louis, MO, hearing a case taking place at the Eau Claire, WI District Office may not know or be able to apply to the correct federal standard for the Wisconsin claimant, hindering the claimant’s ability to have a fair hearing. Procedural Due Process, under our Constitution, requires notice and an opportunity to be heard. If the technology and circumstances of a Video Teleconference hearing prevent a claimant from being heard, then the method hinders the government’s obligation under the Constitution, despite its benefits. For many claimants, a Video Teleconference hearing may be ideal to ease the travel burden, and possible ease on wait time for the hearing itself. For other claimants, it can harm their ability to be heard. For the claimants who feel that they are disadvantaged by a Video Teleconference hearing, they can object to the hearing in writing to the ODAR and request a hearing with an in person judge. If ODAR grants the request, the claimant gains all the advantages of an in person hearing, but, in many cases, have a longer wait time for the hearing, and possible longer travel.