What is Social Security Disability?

Posted on February 9, 2020 by admin
Social security disability claim on a wooden table.

Social security disability claim

 

Social Security Disability or SSDI benefits provide you with a monthly income after you have been unable to work for 12 months. The crucial difference between SSDI and SSI relates to the number of years you worked full-time for five of the last 10 years. If you had FICA taxes withheld for five years during that ten-year span, you can apply to qualify for SSDI funds. If you weren’t able to work for that span at a W-2 job, you can still qualify for SSI or Supplemental Security Income, as well as state benefits depending on laws in your state.

Qualifications

To qualify for SSDI, you must be facing severe, long-term, total disability. Total disability means that you can’t hold a full-time job. Long-term means that the condition is expected to last for at least a year. Anything you’re currently earning will need to be reported. In 2020, if your income is more than $1,260 per month for sighted people and $2,110 for non-sighted (statutory blindness) people, your application will not be accepted.

How Do I Apply?

You can make your Social Security disability application online. You’ll also send in a Medical Release Form so that SSA can collect your medical records. Take care to review the Adult Disability Checklist to make sure you have all your documentation in order. Finally, if you’re not comfortable working on the computer, you can apply via telephone or TTY. You can also visit your local Social Security office in person to ask for application help. It’s a good idea to call and set up an appointment for this assistance. What you put on the application is important. You may think that you have a slam dunk case for disability but more than 65% of initial claims are denied. You should consider hiring a Social Security disability attorney before you decide to file the application.

How Long Must I Wait?

The initial decision usually takes between four and six months. The process can take longer if Social Security needs additional information and sometimes they wait to see how well your treatment works to make sure your condition will last at least 12 months before making a decision. Once approved, you may receive a back payment of benefits and ultimately a monthly payment. For SSDI there is a 5 month waiting period that begins the month after the month you were found disabled and you can be paid nor more than 12 months prior to the day you applied. For SSI benefits generally begin with month you applied. Be aware that if you are disabled, any income you make and the income of your spouse may raise your income high enough that you have to pay taxes on your SSDI income. Once you apply for SSDI, be ready to apply for state benefits as well to make sure that you have some cash coming in to help you stay afloat.

What If I’m Denied?

There are four levels of appeal after a denial. After the first denial, you can request a reconsideration of your application. You are allowed to submit new evidence to show that the initial decision was not correct. If you are denied at reconsideration, you can then ask an administrative law judge to hold a hearing on your disability application. Hearings are complicated legal proceedings and it is generally advisable that you have an attorney help you with the hearing. If the judge denies your claim you can appeal to the appeals council. The appeals council will review the judge’s decision to see if any mistakes were made. If the appeals council decides not to review your claim you can then file a lawsuit against the Social Security Administration in the United States Federal District Court. Understand that none of these are fast and that you may have to wait for years for your disability benefits. For example, just getting in front of an administrative law judge takes about two years or more.

What Does a Denial Mean? 

Many first-time applications are denied. Don’t be defeated by a denial. Be ready to connect with someone at the Social Security office to help you make another submittal and pick up any new information you may have omitted in your first submittal. Understand that the Social Security Administration wins if you give up on benefits you’re entitled to. Keep fighting.

How Can a Lawyer Help? 

Your Social Security disability application can be filed with the help of an attorney. If you get a denial and you don’t have an attorney you can hire an attorney who can help you appeal the denial. Attorneys help with getting the best information to the Social Security Administration and with building the best case possible.

The attorneys for Social Security disability at Barnes Disability Advocates help clients file applications and appeal denials. We have an experienced team of professionals that can assist you through every part of the disability process, from applying for benefits, to conducting a hearing before an Administrative Law Judge, to appeals to the Appeals Council and in the Federal Courts.

We can assist clients with all types of disabilities, including disorders like depression, anxiety, bi-polar disorder, PTSD, schizophrenia, and intellectual disability and physical disabilities like back pain, breathing disorders, heart conditions, cancer, arthritis, headaches, neck pain, COPD, skin disorders, and seizures. We even help with more difficult conditions like fibromyalgia, chronic fatigue syndrome, and rare or unusual diseases and conditions.

Can My Doctor Help?

Your doctor can assess your Residual Functional Capacity to determine whether or not you can hold a job. This assessment is critical in qualifying for your Social Security disability benefits because it establishes your specific work-related limitations in basic work activities. Your Social Security disability application will need to demonstrate that you are incapable of maintaining any form of employment moving forward. 

Working with a Social Security disability attorney during the initial application process can lessen your chance of being declined and having to fight through an appeal. However, even with a Social Security disability lawyer, your application might be rejected. However, this shouldn’t mean you should give up. With the right guidance, you can get your application reviewed and approved to help you support yourself and your family.

Get results with Barnes Disability Advocates starting today!

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Recent Commentary in “The Hill”

Posted on August 27, 2014 by Jay

The following commentary was recently published in “The Hill.” There has been much inaccurate information about the Social Security Disability program in the media. This comment by the Executive Director of the National Organization of Social Security Claims Representatives provides a counterpoint to those reports with accurate and reliable information.

SSDI: The truth behind media and political mischaracterizations

The Social Security Disability Insurance (SSDI) program is an integral part of the Social Security system that provides vital economic security to workers and their families. SSDI provides modest but essential coverage that American workers earn, and protects against the economic devastation that often accompanies life-changing disability. Unfortunately, recent media coverage (including recent opinion pieces in The Hill) has painted a highly inaccurate picture of this program, in an effort to encourage damaging changes that would hurt people with disabilities.

Eligibility criteria for the SSDI program are extremely strict and only people with the most significant disabilities qualify for benefits. An applicant must prove with medical evidence the inability to engage in “substantial gainful activity” (defined as earning less than $1,070 monthly in 2014), due to a physical or mental impairment expected to result in death or last for at least one year. Most applicants are denied; only about 40% are approved, a fact which belies claims that there is a “systematic bias” toward approving applicants who are not actually disabled.

People with disabilities turn to the program as a last resort, often having attempted to continue working after it is no longer healthy to do so and having spent down their savings before applying. There is no evidence that people are leaving the labor force to receive SSDI. While it is true that SSDI applications increased during the recent economic downturn, approval rates also declined. In fact, the current approval rate is the lowest it has been in 40 years.

Growth in the SSDI program has long been predicted by the Social Security Chief Actuary and is due almost entirely to two demographic factors: the aging of the baby boomers and women entering the workforce. According to the SSA, program growth has peaked and is projected to level off.

The SSDI program is complex so it is not surprising that many applicants choose to retain a representative, given the importance of the outcome. Having an experienced professional provide assistance is valuable for people with disabilities. Representatives help ensure that applicants provide SSA with all relevant medical evidence and help the agency make the right decision as early in the process as possible. SSA’s policies and procedures to regulate representatives do a good job of dealing with the very small number of representatives who violate the rules.

Notably, Congress has not uncovered any evidence of fraud in the SSDI program beyond the cases SSA itself uncovered, after several years of investigation. Nor has Congress found any evidence that people who should not be eligible are wrongly approved. Senator Coburn has been quoted on the topic and appears to mischaracterize what his 2012 investigation actually found. That investigation reviewed only 300 appeals decisions from just 3 counties, and his staff questioned the quality of about 25% of the written decisions but did not claim the decisions were wrong. In fact, the investigation did not find that a single individual was approved who should have been denied.

The Social Security Administration does a good job of identifying potential fraud in the program, despite its woefully inadequate recent funding levels and resources. SSA’s administrative budget is only about 1.4 percent of benefits paid out each year. However, Congress has provided nearly $1 billion less than requested over the past three years. SSA’s program integrity work has suffered too, receiving $421 million less than authorized over the last two years. The result? SSA has lost more than 11,000 employees since 2011 – a heavy blow to the agency’s ability to serve the American people.

If Congress is serious about protecting the integrity of this program, it should start by providing SSA with adequate funding to do so. It should enact H.R. 4090, the Social Security Fraud and Prevention Act of 2013, introduced by Representative Xavier Becerra (D-CA) earlier this year. It would provide SSA with dedicated mandatory funding for program integrity activities, strengthen fraud detection activities, and increase penalties for people convicted of exploiting the program.

The SSDI program does not need significant changes. It has provided economic security to workers who become disabled, and their families, for more than 50 years. But Congress does need to enact legislative changes to secure the future of Social Security and prevent cuts for SSDI beneficiaries in 2016. A rebalancing of the Old Age Survivors Insurance and Disability Insurance trust funds through reallocation of the payroll tax going into each of the funds, approved by Congress multiple times in the past, would account for demographic shifts and solve short-term funding gaps. This program is a key piece of our national social insurance infrastructure and it needs to be kept strong for current and future generations.

Silverstone is executive director of the National Organization of Social Security Claimants’ Representatives. Previously she served as staff attorney for NOSSCR for more than 20 years.

The article can also be accessed on The Hill’s site: http://thehill.com/blogs/congress-blog/healthcare/215601-ssdi-the-truth-behind-media-and-political-mischaracterizations

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Can Disability Benefits Be Garnished?

Posted on July 22, 2013 by Jay

Social Security benefits have long been protected from garnishment by creditors.  However, the Social Security Administration has bee pushing to have all beneficiaries receive their deposits through direct deposit.  In fact, Social Security now requires direct deposit.  The problem is that creditors can get garnishment orders for any money that is in a bank account and they end up freezing beneficiaries’ access to their money.

Social Security has recently issued new regulations designed to protect beneficiaries from these garnishments.  These rules do not apply garnishments for child support.  However, these rules will provide significant relief to individuals who have other debts because they prevent creditors from freezing essential benefits when they are deposited in checking or savings accounts.

The rules, which became effective on June 28, 2013, provide that financial institutions must conduct an investigation when they receive a garnishment order.  The institution is required to review the account history for the two months prior to the day the institution received the order and determine whether any Social Security deposits were made.  If deposits were made the institution must make the lesser of the total Social Security deposits made during that two month period or the balance in the account on the day of the review available for “full and customary access.”  Any new deposits must also be available. The new rules also prohibit the institution from charging a fee for the garnishment unless a non-Social Security deposit is made within five business days of the investigation.

For more specific information about the garnishment rules go to http://www.fms.treas.gov/greenbook/guidelines_garnish0311.pdf.

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Hearing Office Reassignment

Posted on June 24, 2013 by Jay

The Social Security Administration has reassigned the Southern Utah geographic area (the area served by the St. George Field Office) to the Las Vegas hearings office.  This change means that the judges hearing Southern Utah cases will be coming from the Las Vegas office rather than the Salt Lake City office.

Social Security has not released an official explanation for the change.  However, Social Security has made reducing the hearings back log a priority and that is probably the main reason for the change.  The Las Vegas hearing office had an average wait time of 351 days with a pending case load of 2,200 cases in March of 2013.  The Salt Lake City office had an average wait time of 366 days with a pending case load of 3,523 cases.  The latest numbers released by SSA since the reassignment show that these two hearings offices now have very similar wait times (353 days for Las Vegas and 359 for Salt Lake City) and similar pending case loads (2,959 for Las Vegas and 3,162 for Salt Lake City).

Both offices have 6 administrative law judges but due to health problems not all of the Salt Lake judges can travel to St. George for hearings.  Our information from the Las Vegas hearings office is that all six of the Las Vegas judges will travel to St. George on a rotating monthly basis and will do a week of hearings when they come.  It appears that this change is going to result in shorter waits for hearings in the Southern Utah area, which generally sees longer wait times than average for those wanting an in-person hearing.

This is not the first time this sort of reassignment has taken place in Southern Utah.  In the last 10 years the Southern Utah area has been assigned to the Las Vegas, Pheonix, and Tuscon hearing offices at different times.  None of those changes were permanent.  Social Security has indicated that this change will be permanent.

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Social Security Disability: Politics & Reality

Posted on May 21, 2013 by Jay

As a Social Security disability attorney one of the questions I am asked most often is about how I can sleep at night knowing that I represent people who don’t really deserve benefits or who are purposefully scamming the system.  Lately, it seems that those questions have increased in frequency and intensity.  The Social Security disability system seems to be under attack at the grass roots level.  In fact, these recent attacks prompted a unified response from 5 past Commissioners of Social Security, an unprecedented response and indication of the importance of the current debates.  (You can view the letter here.)

I can assure you that I have never had someone come to me and tell me that they want to get benefits even though they can physically and mentally work.  Most people who come to see me tell me that they have worked all their life for the benefits they are applying for and they deserve the benefits and they deserve to be treated fairly by the Social Security Administration.  I agree.

Two recent publications provide very good, accurate, complete, and verifiable information that goes directly counter to the direction most of the political debate seems to be moving in.  In this article I provide a brief synopsis of those publications and links so that you can access them to view the facts for yourself.  Please pay attention to the details.  The Social Security disability system is a benefit of last resort for millions of Americans and the continuation of the benefit has real, life and death, consequences for the people who need those benefits.  Don’t make decisions without understanding how the benefits work, who is getting them, and what the social consequences are.

The first publication is by Kathy A. Ruffing, a Senior Fellow at the Center on Budget and Priorities.  She provided testimony before the Subcommittee on Social Security Committee on the House Ways and Means Committee.  You can find find a transcript of her testimony by clicking here or going to http://www.cbpp.org.

Ms. Ruffing makes the following key points about the disability program:

  • Demographics explain most of the growth in the award of disability insurance benefits.  The main factors contributing to these demographic changes are that baby boomers have aged into the years when people are most likely to be disabled, more women are qualifying for disability benefits, and Social Security’s full-retirement age has risen to 66.
  • While demographics is the main driver in the growth of the disability insurance awards, other important factors include legislative changes, changing workplace requirements, rising cost and declining availability of health insurance, rising retirement age, and the economic downturn.  However, these factors are easily overstated when compared to the demographic issues.
  • The disability eligibility criteria are stringent.  To be eligible a person must be insured, meaning they must have worked enough to qualify.  The person must have a severe impairment, a simple diagnosis is not enough.  The person must be unable to perform substantial work, a standard that means they can’t be able to earn more than $1040 per month.  Finally, the person must wait at least 5 five months after the disability began before benefits start.
  • The typical disabled worker is over 50 and has severe mental, musculoskeletal, circulatory, or other impairment.
  • Recipients of disability receive modest benefits.  The average monthly benefit in December of 2012 was just $1,130.  Comparison to pre-disability earnings showed that disability benefits replaced only 50 to 55 percent of earnings.
  • Few beneficiaries could earn enough to support themselves by working.  Even though disability beneficiaries are allowed to work as long as they don’t earn more than SSA’s threshold, currently $1,040, only 12 percent of beneficiaries do.  Only 4 percent have their benefits terminated because of a return to work and more than 25% of those begin receiving benefits again once they stop working.  Even applicants that are denied for disability benefits fair poorly in the labor market with 47% showing no earnings in the two years after application and those working achieving a median income of only $10,000.
  • Certain proposed changes to Social Security Retirement programs would have enormous impact on the disability program.  For example, raising the retirement age would result in more people being disabled since older workers are far more likely to be disabled and the payments to disabled workers are higher than payments to retired workers.
  • SSA’s administrative funding, the money used to operate SSA’s programs, is not adequate and has resulted in significant delays in claim processing and an inability by SSA to conduct continuing disability reviews.

The second publication is by the National Organization of Social Security Claimant’s Representatives.  It was submitted to the Subcommittee on Social Security House Committee on Ways and Means on March 20, 2013.  You can find the full article by clicking here or going to http://www.nosscr.org.

  • In 1984 Congress unanimously enacted the Social Security Disability Benefits Reform Act of 1984.  This Act sought to resolve multiple issues in the disability evaluation process that had led to a crisis and near collapse of the disability system.  This act provided several changes to the disability evaluation system including:
  • Mental Impairments are evaluated under the same basic definition of disability as all other impairments, i.e. a person with mental impairments must be unable to engage in substantial gainful activity by reason of a medically determinable impairment.
  • Multiple Impairments should be considered in combination.  Prior to the Act SSA only evaluated the effect of individual impairments so that people with multiple severe conditions that didn’t precisely meet the criteria would be found ineligible even though they were unable to work.  Now SSA considers those impairments and their effect on employment in combination.
  • SSA must evaluate the effect of pain.  Prior to the act disability decision makers had no clear rules for evaluating subjective symptoms like pain.  However, as a result of the Act SSA has set procedures that require that a person establish by objective medical evidence a condition that could result in the pain or symptoms.  If that is done, then SSA must consider the pain in evaluation of disability.

These publications provide valuable information about the disability program that should help policy makers better evaluate the effect of proposed decisions on one of the most vulnerable segments of our nation.

Some of the conclusions from these publications are obvious.  First, the disability program is not in trouble because of fraud or malfeasance.  In fact, the disability program is serving the population it was designed to serve, people who are unable to work at a sufficient level to support themselves.  Second, the disability definition is very strict and is being strictly applied by SSA.  However, one of SSA’s biggest challenges is getting enough money to properly administer its programs.  An increase in funding of certain programs, i.e. continuing disability reviews, could significantly decrease the overall cost of the program.  Third, Social Security beneficiaries receive only very modest benefits and enrollment in the disability program generally results in a drastic decrease in a person’s standard of living.  Fourth, the disability program is not a replacement for welfare but is instead serving the group of Americans it was intended to serve.

Hopefully, the points from these publications will help you to better understand the disability program and its impact and importance in our society.

 

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Costs of Requesting Medical Records

Posted on April 30, 2013 by Jay

Many people wonder how much it will cost them to get copies medical records they need to support their claim for disability.  These costs are determined by state laws, which can vary widely.  Here is a synopsis of the rules that apply in Utah, Nevada, and Arizona.

Utah law allows a health care provider to charge a reasonable fee to cover the health care provider’s costs in responding to the request for medical records.  However, that cots cannot exceed $20 for locating the records.  A provider may also charge up to 50 cents per page for copies of the first 40 pages and 30 cents per page after that.  Utah providers are also allowed to charge postage and sales tax costs to the party requesting records.

Nevada law prohibits a provider from charging for medical records for a Social Security disability case for the first request as long as the requesting party provides documentation of the claim for disability benefits.  A provider is allowed to charge up to 60 cents per page for a second copy of the request for records to support the same claim but no administrative fees can be charged.

Arizona allows providers to charge a reasonable fee for production of records.  There isn’t much guidance about what a reasonable fee is.

The Federal HIPAA law allows health care providers covered under the act to impose reasonable, cost-based fees.  The fee can include the cost of copying (supplies and labor) and postage if the requesting person wants the records mailed.  The provider can also charge for a summary or explanation of what is in the records if the requesting party asks for one.  However, under HIPAA a health care provider cannot charge for the costs associated with searching for and retrieving requested medical records.

Our preference is to allow Social Security to request and pay for records as much as possible.  A claimant can always get a copy of those records from SSA at a later date.  However, SSA will generally request records covering the period for a maximum of 1 year prior to the date disability began or one year prior to the filing date.  If you have older records that are important to your claim you should request those records on your own.

Many health care providers will provider their patients with a free copy of their records upon request.  Many providers now make their records accessible at any time through patient portals.  Be careful with these requests because providers may give you summaries or withhold important information or notes unless you specifically request them.

With this information you should be able to get all the necessary medical records to help support your claim for disability.

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Decline in Service at SSA

Posted on April 23, 2013 by Jay

Social Security is unable to provide necessary services to the public on a timely basis.  According to Acting Commissioner Carolyn Colvin, who recently testified at a hearing before the House Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.  Her written testimony was presented as the effects of sequestration begin to be felt at Social Security.

Acting Commissioner Colvin’s comments included pictures showing long lines outside field offices and packed waiting rooms inside.  She noted that during the week her testimony was presented 12,000 people had to wait more that 2 hours to be served at local offices.  That wait time has tripled over the last 4 months.  Many pepple are already aware that field offices have significantly reduced the hours they are open to the public, opening at 9:00 am, closing at 3:30 pm, and closing on Wednesdays at 12:00 pm.

The problems even extend to wait times for Social Security’s 800 number.  The busy rate for the number has increased from 4.6 percent to 15 percent.  The average wait time for getting a call answered has increased from 3.5 minutes to 7.5 minutes.  SSA consolidated 41 field offices, closed 490 contact stations, and is foregoing plans to open eight new hearing offices.  All of this means that SSA and its employees is increasing unavailable to do business with the public.

Congress has frequently expressed displeasure at SSA’s inability to improve the status of continuing disability reviews (CDR’s).  Congress criticizes SSA for failing to keep up with scheduled CDR’s.  Considering SSA’s funding problems, Acting Commissioner Colvin indicated that this will continue to be a problem.  She noted that actual appropriations by Congress have not achieved the level of actual funding authorized by congress.

One of the most significant areas of delay is at the hearing level.  The average processing time for hearings hit an all time high of 532 days in August of 2008.  Through SSA’s efforts of hiring new Administrative Law Judges (ALJ) and improving productivity that number fell to a low of 340 days in October of 2011.  However, since then the wait time is increasing again to an average wait time now of 382 days.  Because of funding shortfalls SSA expects that the wait time will increase further.  While SSA’s need for additional ALJ’s is great Acting Commissioner Colvin does not expect that SSA will be able to hire new ALJ’s until the second half of fiscal year 2014.

The average wait time in the Salt Lake City hearing office, the office that serves Southern Utah, is now 370 days.  Our experience for the Southern Utah area is that the wait time is about 440 days for cases that actually have a hearing.  Both of these numbers are significant increases (at least 40 days greater) over the wait time from last year.

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Reaction to This American Life Story, “Trends with Benefits”

Posted on March 25, 2013 by Jay

The National Public Radio program This American Life ran an hour long story on Saturday investigating the “rise” in disability benefit recipients over the last couple of decades.  You can find the complete story here http://www.thisamericanlife.org/radio-archives/episode/490/trends-with-benefits.

We found this story both insightful in some respects and very misleading and incomplete in others.  Social Security is an effective social program. The Social Security Disability Insurance (SSDI) and the Supplemental Security Income (SSI) programs provide vital and much-needed economic security and access to health care for individuals whose impairments are so severe that they cannot work.   Discussion of issues surrounding disability are vitally important to our national interests but they are often used for political purposes that don’t serve the public interest.

Although the report seemed to indicate that just about anyone could get disability, only individuals with the most significant disabilities are eligible for SSDI benefits. Only around 40 percent of those who apply for benefits are eventually approved, ensuring that only those who meet the strict requirements are found eligible.  We have respresented individuals with brain cancer, near complete paraplegia, severe seizures disorders, blood disorders, and countless others who clearly meet the criteria for disability but are denied benefits anyway.  Almost all of our clients are so financially devastated by their disabilities that they lose all their possession, their marriages, and suffer further declines in their health.

The SSDI beneficiary populations receiving benefits are very diverse. Some are terminally ill, with about one in five male SSDI beneficiaries and one in seven female SSDI beneficiaries dying within the first five years of receiving benefits. Nearly 70% of SSDI beneficiaries in 2010 were age 50 or older and nearly 1 in 3 was age 60 or older.

Research and analysis of the disability program by the Center on Budget Policy Priorities shows that today’s percentages of people on disability compares similarly to numbers from the 1970’s and earlier.  Meanwhile, SSI recipients as a percentage of the population has actually declined.  The indications from this research are that the primary driver in the increase of people on disability is the aging population.  Follow this link to see the complete report http://www.cbpp.org/cms/?fa=view&id=3818.

These numbers also show that while economic downturns do increase disability applications they do not necessarily result in higher awards.  Today’s workplace is arguably more stressful because jobs require more skill and are less secure than ever, making transition from low skilled manual jobs to other work nearly impossible.  Ms. Joffe-Walt noted in her story about one person that she interviewed that it might just be possible that where she lives there are no jobs that a person can do while sitting.  This comment drives home the fact that many Americans simply do not understand the difficulties many of the disabled face in providing for themselves.

We encourage you to listen to the report from NPR but make sure to do some additional ready so that you more fully understand the problems we face in regards to our fellow disabled Americans.

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What to do when you are scheduled for a consultative exam

Posted on March 20, 2013 by Jay

What should you do when you receive notice from Social Security that you are scheduled for a consultative exam?  Social Security often schedules these exams when it determines that your own medical records are not sufficient to determine whether you are disabled.  SSA schedules your exam with one of its regular doctors.  Although these doctors aren’t employed by Social Security they do a lot of work for them and they are regularly provided training by the state disability determination services.  Although your claim can be denied for lack of cooperation if you refuse to attend you do have options when it comes to which doctor you see.

First, Social Security is required to contact your doctor to get additional information it needs before scheduling you for a consultative exam.  Unfortunately, Social Security does not often do this.  If you are scheduled for a consultative exam and you would rather see your doctor you should talk to you doctor about doing the exam.  Social Security will pay for the exam, though at a reduced rate.  If you doctor agrees then you should contact Social Security at the number on the consultative examination notice and let them know that your doctor is available for the exam and you would rather have your doctor do the exam.

Next, you should review the notice for the consultative exam carefully.  There are several reasons why you can legitimately object to a particular exam.  These include your having seen the doctor before, language barriers, inconvenient office location (e.g. no elevator, long-distance travel), and religious observances (e.g Sabbath Day or religious holidays).  The details for objecting to consultative exams are found in 20 C.F.R. § 404.1519j.

Before the exam you should also gather all testing reports relevant to your disability so that you can bring them with you.  Social Security will often neglect to send the consultative examiner essentially testing such as MRI reports, x-rays, vision testing, and blood work.  If you bring these with you the consultative examiner will at least have the opportunity to review the reports during your exam.

At the exam, you should take accurate notes immediately after or during the exam to note the tests performed, the length of the exam, and any unusual events or circumstances.  My clients often tell me that a consultative examiner did not perform an exam that was reported in their results so it is important that you document at the time of the exam what actually happened.  These notes should include everything you did including what chair you sat in, what you lifted or carried during the exam, and interactions with the staff.  You can bring a witness to the exam if you would like and have that person make a similar record of what happened.  Assume that you are being observed at all times.  Doctors will often observe you as you enter and leave the building as well as your behavior in the waiting room.  Recently, SSA has used its own investigators to observe claimant behavior before and after exams.  They may even make contact with you pretending to be investigating some other crime in the area or follow you before or after the exam to observe your activities.  Just be aware that you are probably being watched.

After the exam you should obtain a copy of the exam and review it with your doctor.  Social Security sends a release form with the consultative examination notice that allows you to have a copy of the results sent to you doctor.  Reviewing it with your doctor can provide both you and your doctor with valuable information about your medical conditions and will help you understand if there were any problems with the exam.  If you find problems you should make sure to write them down and if possible have your doctor write them down in your treatment notes.

One last note; some consultative examiners ask you to sign a document indicating that you are satisfied with the exam.  You should not sign any such document.  You won’t know if you are satisfied with the exam until you have reviewed the report.  There is no requirement that you sign any document so you should not do it even if the doctor insists.  Even if the doctor refuses to examine you should still not sign the document.

These suggestions will help you to have the best experience possible with a consultative exam but don’t expect that a consultative exam will be helpful to your disability case.  More often than not these exams are inadequate.  The best approach is for you to see a primary care provider on a regular basis and thoroughly discuss your impairments with that provider.

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How Will Sequestration Effect Social Security Disability Claims

Posted on February 28, 2013 by Jay

Although it has been widely reported that the sequestration will have no effect on Social Security there is more to the story.  The sequestration does not effect payment of benefits but it does affect Social Security’s administrative budget.  These cuts will affect SSA’s day-to-day operations at all levels according to a Fact Sheet released by SSA.

According to the Fact Sheet both district office and hearing office operations will be negatively impacted.  The result will be longer waits in field offices because of hiring freezes and the loss of an estimated 5,000 current employees.  Claimants trying to get information through the 1-800 number will also face longer wait times, perhaps as much as 30 minutes.

Wait times at the hearing level could increase by nearly a month, increasing an already overwhelming wait.  Thus, the sequestration would virtually erase the minimal gains in reducing the backlog Social Security has made over the last couple of years.  Social Security has indicated that it will try to avoid furloughs but they still remain a possibility.

The sequestration takes effect at midnight tonight.  Virtually no progress has been made on avoiding the sequestration.  SSA does have some time before the effects will of the sequestration will be felt but a quicker resolution would obviously be more beneficial.

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