Social Security Disability News

Wednesday, August 14, 2013

How Does the Supreme Court's Defense of Marriage Act Ruling Affect SSDI and SSI Benefits?

We have been getting a lot of questions about how the Unites States Supreme Court’s decision regarding the Defense of Marriage Act (DOMA) will affect Social Security Disability (“SSDI) and Supplemental Security Income (“SSI”) benefits for same-sex partners. As most of you are aware, on June 26, 2013, the Supreme Court held that Section 3 of DOMA is unconstitutional as it deprives same-sex spouses equal protection under the Fifth Amendment.

What this now means is that same-sex spouses, and their children, are able to file claims for various types of SSDI benefits, including Disabled Widow’s/Widower’s benefits, Disabled Adult Children benefits, Survivor benefits, and Children’s benefits. In order to file a claim, however, the following conditions must be met:

The same sex couple must have a legally valid marriage. Couples in civil unions will not be qualified at this time.
The couple, and their children, must reside in a state that recognizes same-sex marriages.

While the Supreme Court’s ruling opens the door for same-sex spouses, and their children, to SSDI entitlement, the impact on SSI benefits could have the opposite effect. As SSI benefits take into account the income of a spouse to determine eligibility, same-sex spouses may find that their SSI benefits are reduced or discontinued.

To read the Supreme Court’s decision in entirety, please visit the link below:
http://www.supremecourt.gov/opinions/12pdf/12-307_6j37.pdf

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.

Friday, August 2, 2013

Social Security Disability Time Frames

We often get asked, “How long does the Social Security Disability (“SSDI”) process take?” The honest answer is it varies by jurisdiction. Unfortunately, the weak economy, budget cuts, and the fact that the baby-boomer generation is at retirement age, have all negatively affected the time frames of the SSDI process.

There are five potential stages that an individual may go through in the SSDI process, including the initial application, reconsideration, hearing, Appeals Council, and Federal Court levels. The majority of individuals will be required to attend a hearing in front of an Administrative Law Judge (“ALJ”).

After filing an initial application, it will take the Social Security Administration 120 to 270 days to make a decision, or approximately 4 to 9 months. If denied, these same time frames are applicable at the reconsideration stage, though we do get a majority of the reconsideration determinations back within 180 days, or 6 months. If you are denied at the reconsideration stage, you must request a hearing. At the hearing level, it takes SSA anywhere from 236 to 547 days to schedule a hearing (National Ranking Report By Average Processing Time dated 4/26/13). Keep in mind, the time period that a claimant will wait to have a hearing scheduled is in addition to the time frames at the initial application and reconsideration levels.

Below are the time frames for the local Southern California SSA hearing offices, which are technically known as the Office of Disability Adjudication and Reviews or “ODARs” (National Ranking report dated 4/26/13):

Los Angeles Downtown = 275 days

Orange = 305 days

San Bernardino = 309 days

Moreno Valley = 322 days

Long Beach = 328 days

Pasadena = 330 days

Los Angeles west = 340 days

Santa Barbara = 358 days

Norwalk = 428 days

San Diego = 475 days

As you can see, the time frames associated with the hearing level are varied. After a hearing is held, it will take an Administrative Law Judge anywhere from 30 to 90 days to make a decision, or 1 to 3 months. If the claim is awarded, it can take the local SSA office up to another 90 days, or 3 months, to process the monthly benefits. Retroactive benefits can take the local SSA offices longer to process.

If the claim is denied, however, an individual must file an appeal with the Appeals Council in Falls Church, Virginia. On average, it will take the Appeals Council anywhere from 12 to 36 months, or 1 to 3 years, to rule on the claim. If denied, the only option left is to file a claim to Federal Court. Appeals to Federal Court can also take anywhere from 12 to 36 months, or 1 to 3 years, to receive a determination.

We recognize that these time frames can be shocking. However, it is important for every claimant to come up with a plan to support himself/herself, while he/she applies for these benefits, as the Social Security process has some significant timeframes associated with it.

For more information on the Social Security Disability process, please visit our website at http://www.westcoastdisability.com/The-Social-Security-Disability-Claims-Process/

Tuesday, July 23, 2013

The Consultative Examination

Clients often call us with questions concerning a letter they receive indicating that they have been scheduled for a “Consultative Examination”. Most clients want to know what the exam is and if they have to attend. Clients are also curious as to who has scheduled this exam and what doctor they will be seeing. Here is some basic information and insight about Social Security medical exams.

What is the Consultative Examination?

A fairly high percentage of individuals who file for either Social Security Disability benefits or Supplemental Security Income benefits will be required to go to a medical examination by the Social Security Administration. Social Security Disability exams are called Consultative Examinations (“CE exam”). CE exams can be physical in nature, psychological (IQ testing), or psychiatric in nature. They can also include ophthalmological exams, blood work, and the taking of x-rays. The Disability Office that schedules your exam also pays for the CE exam and any necessary tests. The exam is scheduled with a doctor closest to your home zip code, so it is important that you always notify your attorney when you move or change addresses.

Why is a Consultative Examination being scheduled in my case?

Sometimes your medical records don’t say as much about your condition as you might think they should. For example, your doctor’s notes might only say that you complained of low back pain and you were prescribed a pain medication. In other instances, your medical records are hand written and impossible to read, or information from your doctor may be incomplete. In some cases, clients have not been to see a doctor recently. Limited documentation such as this does not give the disability examiner reviewing your case sufficient information about how your condition limits your ability to function and work.

CE exams are requested by disability examiners (examiners handle initial disability applications) and also by Administrative Law Judges at the disability hearing level. The purpose of these exams is to obtain additional medical information and documentation for an adjudicator (a disability examiner or a judge) to arrive at a decision. Disability examinations that are scheduled by a disability examiner or a disability judge are mandatory and failure to attend can result in a decision based on existing evidence, or the closure of a case for failure to comply. However, if you miss a scheduled exam and have a valid reason for this happening, an examiner will usually allow for the examination to be rescheduled.

Who performs the exam?

CE examinations are performed by independent physicians and psychologists who have contracted to examine disability claimants and provide written reports afterwards. The doctors who perform these exams are not Social Security doctors. They are not employed by the Social Security Administration, rather they are independent contractors who are paid for their services. In addition to performing an examination, physicians and psychologists who perform CE exams are required to submit the written results of an examination. Please keep in mind that Social Security CE exams are not for the purpose of rendering medical treatment or making the decision on your claim. The purpose of these exams is to provide a recent snapshot of your conditions and various limitations.

How long does the exam take?

One of the most common complaints among our clients who have gone to CE examinations is that the duration of the exam was only 5-10 minutes. The length of the exam will vary depending on the type of exam a claimant is sent to. Examinations for physical allegations can be relatively brief (10-15 minutes is not abnormal), while a mental exam can take considerably longer due to the nature of psychological or psychiatric testing.

What should I do to prepare for the exam?

Being required to go to a medical exam by Social Security is no cause for alarm. Getting an appointment letter for a CE examination means, at the very least, that your claim is actively being worked on.

Here are some important tips to keep in mind when attending your CE examination:

Arrive a few minutes early for the exam. If you show up late, the doctor may refuse to see you, and the exam would have to be rescheduled. This can add further delay to the processing of your claim.
If you have children, leave them with someone during your exam so that you will be able to give the doctor your full attention.
When you go to the exam, always bring a government issued picture ID, like a driver’s license.
Take any medications or pill bottles with you to the exam, and any necessary braces, canes, eyeglasses, or hearings aids that you use.
Have someone go with you to the examination and observe.
Takes notes during and after the examination. How long did the doctor see you? What questions were asked? Were any tests performed?
Cooperate to the best of your ability during the exam. The doctor may ask you to do something that is uncomfortable. Not trying or refusing to do something the doctor asks, can make a difference in how your disability is viewed.
Be honest and don’t pretend to be better or worse than you are.

Friday, July 19, 2013

The Differences Between Social Security Disability ("SSDI") and Supplemental Security Income ("SSI") benefits

If you thought SSDI and SSI were the same Social Security programs, you are not alone. Frequently, our clients use the terms interchangeably, but in fact, each program is quite different. Both programs are administered by the Social Security Administration. They also both require that an individual prove that he/she is unable to work due to a physical or mental impairment(s), or a combination of impairments, for 365 days or more to establish entitlement. If you are granted either one of these benefits, you receive health insurance and cash benefits. However, that is where the similarities end between these two programs. Below is a description of each program and its unique features to help you understand the fundamental differences between the two entitlement packages.

Social Security Disability benefits

Often referred to as SSDI or Title II benefits, Social Security Disability benefits are calculated based on what you have paid into the Social Security system. You must have worked a sufficient amount of “quarters” to be entitled to these benefits. There is a 5 month waiting period from the onset date of disability that must toll before you are entitled to these benefits. After you have been found disabled for a full 24 months on a Title II application, you will also receive Medicare benefits. The maximum amount of retroactive benefits you can receive in regards to a Title II claim, is one year prior to the initial application date.

Supplemental Security Income

Often referred to as SSI or Title XVI benefits, the Supplemental Security Income program is designed to operate as a “needs based” program. To qualify, your countable resources cannot exceed more than $2000 as an individual and $3000 as a couple. Owning one automobile, one house, and one wedding ring will not disqualify you from this program. The Federal payment amount is $710 for an eligible individual and $ 1066 for an eligible couple for the year 2013. There is no waiting period for Supplemental Security Income as is required for Social Security Disability benefits. Supplemental Security Income eligibility also entitles you to Medi-Cal in the state of California, sometimes referred to as Medicaid in other states. The earliest benefits can begin in a Title XVI case is from the date of application.

For more information on SSDI and SSI benefits, visit our webpage at http://www.westcoastdisability.com/Practice-Areas/

Tuesday, July 9, 2013

Parkinson's Disease - Not a Joking Matter

When Cari and I started our Social Security Disability blog, I doubt either one of us would have thought we would ever mention the name of Kanye West in it. Unfortunately, we are mentioning it now and not in connection with a positive story.

Kanye West is no stranger to controversy. At a minimum, he is known for being brash, outspoken, and arrogant , though I am sure some of you reading this could substitute some better adjectives that may more accurately describe this man. In fact, I think President Obama’s remark that Kanye West is a “jackass” is likely appropriate. However, I understand that in the entertainment world shock value sells and that there is often the perception that there is no such thing as “bad publicity.” As long as it is harmless, I have no problem with it. I usually can just ignore it.

Occasionally, however, a celebrity or public figure does something that is so offensive that it warrants discussion and while I am hesitant to call further attention to this (ummm…let me choose my word carefully) “jackass,” I am going to do so to address a larger issue – the insensitivity that certain people have to those with profound disabilities.

Kanye West recently released a new album called “Yeezus.” In the song entitled “On Sight,” West describes how he gets a woman “shaking like Parkinson’s.” Full disclosure… I am editing the exact phrase he uses because this blog is G-rated, but let’s just say he uses a more offensive term than the feminine noun “woman” but that would require a whole other blog to address this lyrical choice.

What I want to address in this blog is his insensitivity towards the Parkinson’s Disease community by making a casual and distasteful reference to getting a woman trembling like she has Parkinson’s Disease. It makes me wonder if West is just grossly insensitive to those who suffer from this progressive and debilitating disease OR is he just completely ignorant to all the trials and tribulations that people with Parkinson’s Disease go through on a daily basis?

I prefer to think of people as being ignorant opposed to apathetic. Stupidity breeds confusion, while apathy to others in dire situations is an indication (to me at least) that you are devolving as a human. Thus, I am just going to hope that Kanye West simply doesn’t understand how serious and devastating Parkinson’s Disease can be.

For our clients who deal with it every day, you know exactly what I am talking about. For those of you out there who have never known someone with Parkinson’s, let me tell you that experiencing tremors is just one of the many symptoms that people with Parkinson’s must deal with. While tremors are often a hallmark of Parkinson’s Disease, other physical symptoms include rigidity, bradykinesia, balance issues, and gait immobilization. People with Parkinson’s Disease can have difficulty with communications and suffer from word-finding and aphrasia. A host of cognitive and mental health issues can accompany a diagnosis of Parkinson’s Disease, including depression, concentration and memory issues, and in its advanced stages, dementia. Parkinson’s Disease is incurable, and while there are medications out there to manage the symptoms, Parkinson’s is progressive in nature. For more information on Parkinson’s Disease, please visit our website at:

http://www.westcoastdisability.com/The-Social-Security-Disability-Claims-Process/Impairments-Physical/Parkinson-s-Disease.shtml

Additionally, the America Parkinson’s Disease Association (“APDA”) has a wealth of information and support for the Parkinson’s Disease community. Here is a link to their website:

http://www.apdaparkinson.org/

I happen to think it would be beneficial for Kanye West to visit with one of the local APDA chapters, so he can understand why the Parkinson’s Disease community was outraged by his poor choice in lyrics. As a disability advocate, I can’t help but take offense when a life altering disease is discussed glibly and in what appears to be a poor attempt at a comedic lyric. It isn’t creative. It isn’t shocking. It just makes you a bigger jackass.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.

Monday, June 17, 2013

In The News...

Last week was a very interesting week in terms of news worthy items that are pertinent to the disability community.

The Supreme Court ruled that isolated human genes cannot be patented. The Supreme Court did distinguish human genes from DNA molecules engineered by people, which would still be eligible for patent. This case was getting a lot of media attention, ever since actress, Angelina Jolie, announced that she underwent a preventative double mastectomy due to the fact that she was a BRCA gene carrier, a gene that predisposes one significantly to breast and ovarian cancer.

The problem has been that BRCA testing is not widely affordable to the general public due to the fact that a company called Myriad Genetics had been awarded a patent for BRCA1 and BRCA 2 genes in the 1990s. This patent essentially eliminated a competitive market for BRCA testing. The hope with this new ruling is that other companies will increase their research into BRCA gene testing and come up with more affordable ways for all women to effectively screen themselves for BRCA genes.

On a different note, Cari and I have become aware of a new documentary that was created to help end the stigma and misperceptions of mental illness. The documentary entitled A New State of Mind: Ending the Stigma of Mental Illness was funded by California’s voter approved Mental Services Act and profiles the stories of individuals who have fought to overcome the stigmas and misconceptions associated with mental illnesses. The documentary is narrated by actress, Glenn Close.

It is estimated that one in four people suffer from a mental illness. In spite of this significant statistic, mental illnesses are one of the least understood disabilities by the general public. Unfair stereotypes overshadow the many successes that people with mental illnesses are able to achieve. This documentary seeks to highlight the individuals and organizations fighting to end discrimination against people with mental illnesses.

Here is a link to the documentary:

http://www.eachmindmatters.org/great-minds-gallery/view-the-film/

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at info@westcoastdisability.com or call us at (800) 459-3017.

Friday, June 7, 2013

What Does It Mean to Be Disabled?

The concept of disability can be both abstract and confusing. The term “disabled” is personal in nature and means different things to different people. However, when it comes to being deemed “disabled” in the legal sense, it doesn’t take long to realize that there are various definitions and standards depending on which governmental or private entity is evaluating the application for disability.

Disability benefits come in many forms. While Cari and I only handle Federal Social Security Disability Insurance and Supplemental Security Income claims, disability benefits are also available through the State of California, the Worker’s Compensation system, the Veteran’s Administration, and private insurance companies. What many people are surprised to learn is that every single one of these types of benefits comes with its own unique definition of disability.

Some of these programs focus on whether an individual can perform his or her past work. Other programs focus on whether an “average” individual with the same impairments could perform work. Some of these programs look at whether an individual is prevented from working for a short period of time, while other programs focus on a more long-term definition of disability. Social Security’s definition can be more complex, however.

Social Security finds that a person is disabled if this person has a physical or mental impairment, or a combination of both, which prevents this person from working for at least 365 days, or the impairment(s) is expected to result in death. Additionally, SSA is not just concerned with whether an individual can perform his or her past work. SSA also looks at whether a person has transferrable skills to perform other work, and depending on the person’s age, whether this individual could perform unskilled work in the national economy. Finally, SSA also considers an individual’s age and education when assessing a claim.

While these factors are important to the Social Security Administration, other disability plans have different criteria to consider. Thus, it is always important to keep in mind the standards that you must meet for the particular disability program you are applying for.