I represented a former police officer at a Social Security Disability hearing in New Haven, Connecticut, which was nearly a 100 miles away from my office. The SSA refused to reimburse my travel expenses based on an antiquated rule.
The SSA stopped reimbursing attorneys to prevent situations where an attorney from New York could get reimbursed for travel to a hearing in Hawaii. The rule makes sense in that situation. However, I requested to appear via video conference, which the SSA refused to allow. If the SSA refuses to allow an attorney to appear via video conference, the way they allow experts and claimants, then the SSA should be required to pay the attorney's travel expenses.
There is no rule requiring an attorney to appear in person, nor should there be because the attorney does not provide sworn testimony. Moreover, refusing to pay travel expenses when an attorney has offered to appear by video is contrary to the SSA's pushing video appearance for experts in the name of efficiency. The refusal to pay expenses in these circumstances curtails a claimant's right to counsel of his choice, and favors nationwide companies for whom travel is far less of a burden.
I would love to hear the SSA's explanation for why an ALJ has the right to insist that an attorney appear in person when the ALJ has no qualms about allowing experts to do so.
Friday, February 17, 2012
Tuesday, February 14, 2012
Disability Benefits For Carpenter
Disability benefit claims usually result in a battle of the medical experts where your doctor says you cannot work and their doctor says you can. Having other doctors corroborate your doctor’s opinion will help insure that your doctor’s opinion will be accepted over their doctor’s opinion.
When applying for Social Security Disability (“SSD”) benefits you might be able to succeed ultimately with only one supporting treating physician. However, experience has shown that in most cases your claim will be denied initially if you have only one supporting doctor.
I represent a carpenter who became unable to work when he was 49 years old due to neck, back and shoulder problems. His application was approved today without ever being denied. The claimant is being treated by a physiatrist, which is an appropriate specialist for the claimant’s impairments. Instead of simply relying on the opinion of the claimant’s physiatrist, I secured opinions from the claimant’s pain management specialist and chiropractor too.
While the claimant may have been able to receive SSD benefits without the concurring medical opinions, stacking the deck in the claimant’s favor minimized the chances of his having to file an appeal. While the chiropractor is not a medical doctor, the frequency and extended duration of his treatment rendered his opinion regarding the severity of the claimant’s condition important. By presenting three medical opinions to support the claimant’s application, it took far less time than usual for the claimant to start receiving SSD benefits, which gave him critical cash flow now that he lost his working income.
When applying for Social Security Disability (“SSD”) benefits you might be able to succeed ultimately with only one supporting treating physician. However, experience has shown that in most cases your claim will be denied initially if you have only one supporting doctor.
I represent a carpenter who became unable to work when he was 49 years old due to neck, back and shoulder problems. His application was approved today without ever being denied. The claimant is being treated by a physiatrist, which is an appropriate specialist for the claimant’s impairments. Instead of simply relying on the opinion of the claimant’s physiatrist, I secured opinions from the claimant’s pain management specialist and chiropractor too.
While the claimant may have been able to receive SSD benefits without the concurring medical opinions, stacking the deck in the claimant’s favor minimized the chances of his having to file an appeal. While the chiropractor is not a medical doctor, the frequency and extended duration of his treatment rendered his opinion regarding the severity of the claimant’s condition important. By presenting three medical opinions to support the claimant’s application, it took far less time than usual for the claimant to start receiving SSD benefits, which gave him critical cash flow now that he lost his working income.
Friday, February 10, 2012
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (“CTS”) is the name given to the nerve damage from entrapment of the median nerve. CTS causes paresthesia, pain, numbness, and other symptoms in the distribution of the median nerve, which includes the fingers. According to the National Institute of Health (“NIH”), CTS is common in people who perform repetitive motions of the hand and wrist, most commonly, typing on a computer keyboard. Other causes include: sewing, driving, assembly line work, painting, writing, use of tools, sports such as racquetball or handball, and playing some musical instruments. The NIH says that CTS is a costly and disabling occupational illness.
I represent a claimant who was just approved for long term disability (“LTD”) benefits under a group disability policy issued and administered by Liberty Mutual. In the approval letter, Liberty said that LTD benefits were approved because the claimant was unable to do his own occupation, and that the claimant was required to apply for Social Security Disability (“SSD”) benefits.
Most group LTD policies require filing for SSD, and then will reduce the LTD benefit by the amount of the SSD. Moreover, the failure to apply for SSD will result in the insurance company deducting the estimated amount of the SSD from the LTD benefit. Many insurance companies refer claimants to their SSD company, which is a bad idea. Because SSD companies get their clients from the LTD carriers, they perceive the insurance company as their real client.
In some circumstances, it may be possible to get SSD benefits while conceding the functional ability to sedentary or light work, or even medium work in rarer circumstances. However, most group LTD policies require claimants to prove they cannot do any occupation after 2 years. Since the SSD company is beholden to the referring insurance company, the SSD company does not bother to argue that the claimant cannot do sedentary or light work, and while enabling the claimant to get SSD benefits, sets the claimant up to have his or her LTD benefits terminated.
I represent a claimant who was just approved for long term disability (“LTD”) benefits under a group disability policy issued and administered by Liberty Mutual. In the approval letter, Liberty said that LTD benefits were approved because the claimant was unable to do his own occupation, and that the claimant was required to apply for Social Security Disability (“SSD”) benefits.
Most group LTD policies require filing for SSD, and then will reduce the LTD benefit by the amount of the SSD. Moreover, the failure to apply for SSD will result in the insurance company deducting the estimated amount of the SSD from the LTD benefit. Many insurance companies refer claimants to their SSD company, which is a bad idea. Because SSD companies get their clients from the LTD carriers, they perceive the insurance company as their real client.
In some circumstances, it may be possible to get SSD benefits while conceding the functional ability to sedentary or light work, or even medium work in rarer circumstances. However, most group LTD policies require claimants to prove they cannot do any occupation after 2 years. Since the SSD company is beholden to the referring insurance company, the SSD company does not bother to argue that the claimant cannot do sedentary or light work, and while enabling the claimant to get SSD benefits, sets the claimant up to have his or her LTD benefits terminated.
Thursday, February 9, 2012
SSD Approved in Two Months
I represent a 55 year old former truck driver with a bad back whose application for Social Security Disability (“SSD”) benefits was approved after two months. The severity of his back condition was bad, but no more so than many other claimants with failed back surgery who seek SSD benefits. It was the presentation of the vocational evidence that made the difference.
If a claimant is unable to “communicate in English,” then special rules apply that make it easier to obtain SSD benefits. The question is what does communicating in English mean? Even if a person has a limited ability to speak and understand English, if also unable to read and write English, then that person could qualify for SSD benefits under special rules that would preclude benefits for a person with the same medical circumstances who were literate.
In light of the above, it is important to make sure that a claimant is able to read and write in English. If not, it should be made clear to the state agency when initially applying that the claimant lacks the ability to do so, and to spell out the implications of being unable to read and write when submitting medical evidence. The result should be a quicker approval than usual.
If a claimant is unable to “communicate in English,” then special rules apply that make it easier to obtain SSD benefits. The question is what does communicating in English mean? Even if a person has a limited ability to speak and understand English, if also unable to read and write English, then that person could qualify for SSD benefits under special rules that would preclude benefits for a person with the same medical circumstances who were literate.
In light of the above, it is important to make sure that a claimant is able to read and write in English. If not, it should be made clear to the state agency when initially applying that the claimant lacks the ability to do so, and to spell out the implications of being unable to read and write when submitting medical evidence. The result should be a quicker approval than usual.
Monday, February 6, 2012
Reflex Sympathetic Dystrophy
Yesterday’s Newsday had an article about a person’s ordeal with Reflex Sympathetic Dystrophy (“RSD”), also known as Complex Regional Pain Syndrome (CRPS). According to the National Institute of Neurological Disorders and Stroke, symptoms include crippling pain, burning sensation, skin color, temperature, and sensitivity changes, sweating and swelling. And according to the International Research Foundation for RSD/CPRS, the incurable condition affects over a million Americans.
Because RSD/CRPS affects so many people, the Social Security Administration (the “SSA”) promulgated a special rule for it. The rule notes that conflicting evidence is not unusual in cases of RSD/CRPS, and that its chronic pain and medications can affect an individual's ability to maintain attention and concentration, which obviously can interfere with one’s ability to work. The rule also discusses how third-party information, including Information from nonmedical sources such as neighbors, friends, relatives, clergy, past employers, rehabilitation counselors, or teachers is important.
When applying for disability benefits it is important to understand the nature of RSD/CRPS in order to present a case that properly explains how it limits the ability to work. When applying for disability benefits from the SSA make sure that your attorney is aware of the special rules that apply for RSD/CRPS.
Because RSD/CRPS affects so many people, the Social Security Administration (the “SSA”) promulgated a special rule for it. The rule notes that conflicting evidence is not unusual in cases of RSD/CRPS, and that its chronic pain and medications can affect an individual's ability to maintain attention and concentration, which obviously can interfere with one’s ability to work. The rule also discusses how third-party information, including Information from nonmedical sources such as neighbors, friends, relatives, clergy, past employers, rehabilitation counselors, or teachers is important.
When applying for disability benefits it is important to understand the nature of RSD/CRPS in order to present a case that properly explains how it limits the ability to work. When applying for disability benefits from the SSA make sure that your attorney is aware of the special rules that apply for RSD/CRPS.
Monday, January 30, 2012
Veterans Medical Source Statements
Medical Source Statements that describe a claimant’s functional restrictions and limitations are crucial to any type of disability claim, as it is the effect of a medical condition, not its mere diagnosis, that actually counts. For example, in POMS DI 22505.007, the Social Security Administration (“SSA”) discusses the importance of obtaining a functionality assessment from the claimant's treating doctor because he or she should have the most knowledge about the claimant’s impairments.
Because the SSA usually does not request functional assessments from claimants’ doctors, the claimant must do so. Historically, it was very difficult to obtain functional assessments for claimants who were treated through the Veterans Health Administration (“VHA”). However, that changed when the VHA issued a directive on October 29, 2008, 2008-071, which requires it to assist veterans with completing forms for various benefits, specifically including Social Security Disability (“SSD”) benefits.
A veteran retained me after his application for SSD benefits was denied. Citing the VHA directive, I was able to secure a functional assessment from the claimant’s treating physician at the VHA. With the addition of the VHA Medical Source Statement containing the claimant’s functional assessment, the SSA approved the claimant’s SSD benefits.
Because the SSA usually does not request functional assessments from claimants’ doctors, the claimant must do so. Historically, it was very difficult to obtain functional assessments for claimants who were treated through the Veterans Health Administration (“VHA”). However, that changed when the VHA issued a directive on October 29, 2008, 2008-071, which requires it to assist veterans with completing forms for various benefits, specifically including Social Security Disability (“SSD”) benefits.
A veteran retained me after his application for SSD benefits was denied. Citing the VHA directive, I was able to secure a functional assessment from the claimant’s treating physician at the VHA. With the addition of the VHA Medical Source Statement containing the claimant’s functional assessment, the SSA approved the claimant’s SSD benefits.
Wednesday, January 25, 2012
Disabled by Schizophrenia
Many people are under the misperception that schizophrenia is a disease where the person has a split or multiple personality. According to the Mayo Clinic, schizophrenia is a group of severe brain disorders in which people interpret reality abnormally, and may result in some combination of hallucinations, delusions and disordered thinking and behavior. Importantly, the Mayo Clinic points out that the ability of schizophrenics to function normally and to care for themselves usually deteriorates over time.
When applying for disability benefits, the question is has the schizophrenia deteriorated the claimant’s ability to function in a work setting. A 41 year old college graduate, who had been a shoe salesman for nearly a quarter century, retained me after his application for Social Security Disability (“SSD”) benefits had been denied on the ground that he could “perform simple low level jobs.” Social Security agreed that the claimant could no longer work as a shoe salesman, but identified three other jobs from the Dictionary of Occupational Titles that he purportedly could perform.
Before preparing to attack Social Security’s conclusion that the claimant could perform the three identified occupations, I decided to investigate if the evidence would demonstrate that the claimant met the “listing” for schizophrenia. If a claimant meets a listing, then Social Security must find that the claimant is disabled without needing to determine if the claimant has the functional ability to work.
The records in the claimant’s Social Security file appeared to show the claimant met the criteria of the listing for schizophrenia. Rather than making a legal argument explaining why the claimant met the listing, I provided the listing criteria to the treating psychiatrist, and asked for his medical opinion as to whether or not the claimant met the listing. Since the psychiatrist did opine that the claimant met the listing, I requested a fully favorable decision on the record (“OTR”), which was approved.
The OTR was particularly advantageous to the claimant. Besides reducing his attorney fee, the OTR also enabled the claimant to avoid the stress of a hearing. Moreover, knowing that he would be approved for SSD benefits mitigated the likelihood of the claimant’s condition deteriorating even further.
When applying for disability benefits, the question is has the schizophrenia deteriorated the claimant’s ability to function in a work setting. A 41 year old college graduate, who had been a shoe salesman for nearly a quarter century, retained me after his application for Social Security Disability (“SSD”) benefits had been denied on the ground that he could “perform simple low level jobs.” Social Security agreed that the claimant could no longer work as a shoe salesman, but identified three other jobs from the Dictionary of Occupational Titles that he purportedly could perform.
Before preparing to attack Social Security’s conclusion that the claimant could perform the three identified occupations, I decided to investigate if the evidence would demonstrate that the claimant met the “listing” for schizophrenia. If a claimant meets a listing, then Social Security must find that the claimant is disabled without needing to determine if the claimant has the functional ability to work.
The records in the claimant’s Social Security file appeared to show the claimant met the criteria of the listing for schizophrenia. Rather than making a legal argument explaining why the claimant met the listing, I provided the listing criteria to the treating psychiatrist, and asked for his medical opinion as to whether or not the claimant met the listing. Since the psychiatrist did opine that the claimant met the listing, I requested a fully favorable decision on the record (“OTR”), which was approved.
The OTR was particularly advantageous to the claimant. Besides reducing his attorney fee, the OTR also enabled the claimant to avoid the stress of a hearing. Moreover, knowing that he would be approved for SSD benefits mitigated the likelihood of the claimant’s condition deteriorating even further.
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