After years of promising to do so, the Social Security Administration issued its long-awaited ruling on how to evaluate disability claims for people with fibromyalgia. Prior to the issuance of this ruling, social security claimants had to make arguments under other, vaguely related disorders like Chronic Fatigue Syndrome or pain disorders. SSR 12-2p will provide some clarity for claimants, attorneys, and administrative law judges.
Interesting piece from Forbes magazine about the potential impact of the Affordable Care Act on people with disabilities. The article makes the rather dubious claim that once the ACA is fully implemented, people with disabilities who are currently covered by Medicaid will leave the public health market in droves because they would not be ‘held back’ from working full time and/or finding insurance in the private market due to pre-existing health conditions. However, it also points out that prior to the passage (and recent Supreme Court affirmation) of the ACA, persons with disabilities who had an interest in attempting to work more than part-time were loath to make an attempt for fear of losing their eligibility for SSI and Medicaid.
Earlier last week the Education Department proposed new rules to revamp its program for forgiving federal student loans of borrowers who become disabled. While the proposed reforms would not use Social Security disability findings as a basis for discharging loans – as many student borrowers’ advocates had hoped – they would streamline the application process and improve communication with borrowers. As of 2008, the standard for discharge of student loans is full disability for at least five years. Check out the full article here.
Click this link for Congressional Testimony by the Honorable D. Randall Fry, President of the Association of Administration Law Judges. He makes some more than fair points: noting the immensely short time judges have to review cases that are often hundreds of pages long, and that Administrative Law Judges have to do an immense balancing act protecting the interest of justice, the treasury and the claimant. However, the suggestion that having a government attorney present at each hearing to oppose the claimant is not a solution. It will only cause more spending withing the system to pay for the extra attorney at each hearing. Furthermore, many claimants don’t go into a hearing represented, and many of those claimants lack the capacity to be able to successfully argue their case opposing a government attorney. Social Security Disability hearings are designed to be NON-ADVERSARIAL. The system is overburdened, but adding adversity to the claimant is not the solution.
At present there are 113 medical conditions that qualify for ‘compassionate allowance’ status; an additional 52 conditions will be added in August 2013. Compassionate Allowances (CAL) include medication conditions that Social Security purportedly identifies and targets early in the process for expedited processing. The full list of conditions can be found here, and it includes Early Onset Alzheimer’s, some cancers, and several congenital birth defects. On July 13, 2012, the Social Security Administration announced that Huntington’s Disease would be added to the compassionate allowance list by the end of the year. Huntington’s Disease is a genetic disorder passed from parents to children that causes physical symptoms including jerking motions in the extremities and an unsteady gait – it also results in mental impairments including psychosis and dementia. The disease is progressive and there is no known cure.
Try going the better part of two years without the ability to earn a living and having no income to speak of. Many times this is exactly what someone who is going through the Social Security process is faced with. Because it can take a long time before an applicant is approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) most of those who apply experience financial distress. If you can’t work because of your disabilities how someone with no income would pay their rent and keep their utilities on is anyone’s guess. Fortunately, for those who are able to, Social Security will allow applicants to work on a part-time basis while they are going through the disability process and even after they are approved for disability benefits. It is important to know specific rules if you are working and applying for Social Security disability. It may seem like a contradiction for someone who is claiming to be disabled to go back to work or to continue working, but many people have no other choice. Working, especially on a part-time basis, does not necessarily mean you are not disabled. Many people have physical or mental health disabilities that prevent them from working at a full-time level, or what Social Security considers to be a Substantial Gainful Activity (SGA). In 2012 Social Security has set SGA at $1,010 gross income (before taxes) per month. Anyone who earns more than this through work-related activity runs the risk of disqualifying themselves from being eligible for SSDI. That means that Social Security will not even consider whether you are disabled because you do not meet the technical requirements of the program set forth by Social Security. Applicants who are applying for SSI face even stricter income limitations as all household income and most assets can disqualify someone from being eligible for SSI. It’s also important to know that even if you go back to work full-time, when going through the disability process, your case will probably not be dismissed unless you earn more than $1,010 (gross) per month for a continuous sixth-month period. Be sure to keep your legal representatives informed of your work activity, specifically your case manager, if you are a client of Greeman Toomey. If you show that you are attempting to work, but are unable to sustain that work because of your disabilities, it’s generally not a negative when it comes to the Social Security process.
A couple of thoughtful responses to Congressman Allen West’s controversial comments that Social Security is akin to modern-day slavery can be found here and here.
Comments by Florida Congressman Allen West – comparing Social Security Disability benefits to ‘modern, 21st century slavery’ – are generating lots of chatter on the internet. Congressman West does not explain how, exactly, an insurance policy that American taxpayers have paid into through their own earnings is somehow analogous to forced labor secured by threat of violence. He has since attempted to retract his controversial comments.
The Wall Street Journal published this article last November discussing how the Social Security Administration (SSA) is cutting costs generated by the doctors employed to review cases. Per the article, the doctors are receiving less money per case reviewed, have been pressured to review an incredibly large number of cases, and are reviewing cases outside of their medical specialty. The article provides a clear example of what can happen when medical experts are overworked and are asked to review conditions outside of the specialty: Mr. Bunn’s claim based upon a neurological condition typically found in older individuals was denied due to an opinion provided by a pediatrician despite two supportive opinions provided by Mr. Bunn, leading to a claim that was eventually resolved by an Administrative Law Judge over two years later and after much financial hardship.
On June 27, 2012 the House Ways and Means Committee Subcommittee on Social Security held hearings on the Social Security Disability appeals process. I’m linking to two interesting statements, one from the Consortium for Citizens with Disabilities, and one from the president of the Association of Administrative Law Judges. I found the disparate opinions between the two groups fascinating – both have similar complaints about the system, but they come to diametrically opposed conclusions about how to fix it. (Sound familiar, Congress?) Some interesting facts from the statements: 70% of SSDI beneficiaries are 50 years old or older. 66% have a high school education or less, and 33% did not finish high school. As of May 2012, the average wait time for a hearing was 353 days. The SSA has closed 160 remote hearing site locations and laid off 9,000 employees in the last three years. In 2011, the nationwide allowance rate approving disability claims was 58% (four points lower than in 2010.) Administrative law judges are instructed to spend no more than 2 ½ hours on each individual case, each of which includes – on average – over 600 pages of medical records. Judges are encouraged to meet a quota of up to 700 decisions per year. Stay tuned for new developments. If you have opinions, share it with your representatives. Contact information is available here.
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