Social Security Disability News

Wednesday, April 2, 2014

Social Security Establishes a Fraud Prevention Unit

The Social Security Administration “SSA” announced this week that it has created a centralized fraud prevention unit in New York City to identify fraudulent activity in the Social Security Disability system nationwide. The unit will initially have 20 disability examiners. They will be tasked with reviewing cases and analyzing current fraud trends to prevent new cases of fraud from happening in the Social Security Disability system. The analysts in this unit are currently re-reviewing the disability medical decisions resulting from recent indictments in Puerto Rico and New York City.

We are pleased to see the development of a fraud unit. Individuals who try to cheat the Social Security Disability system should be prosecuted for taking fraudulent measures to achieve benefits. The actions of these few bad apples affect every truly disabled claimant out there because the exploits by these unethical individuals cause our county, the media and Congress to attack this valuable Federal program.

If you know of someone who is committing fraud in the Social Security Disability System, contact the Social Security Office of the Inspector General at 1-800-269-0271, or visit http://oig.ssa.gov and click on “Report Fraud, Waste, or Abuse.”

In addition, SSA is taking greater measures to protect the identity and private information of the claimants. Since January 2014, SSA is adding security questions to its screening process for callers who are requesting information on a claim. Historically, SSA would ask a caller to verify basic biographical information like birth date, address and phone number. Now SSA is asking callers to confirm the place of birth and the mother’s maiden name of the claimant before revealing any information about the status of the claim to an authorized representative. Thus, Cari and I may be asking you to verify this information with us, so SSA will communicate with us via telephone on your claim.

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.

Wednesday, March 19, 2014

The Differences Between Attorneys and Non-Attorney Representatives

West Coast Disability Law Group, LLP, is a law firm. This means that attorneys who went to law school and passed the California Bar Examination are handling each and every case at our firm. While this may seem obvious to some claimants, please be cautious when deciding who is going to represent you.

There are some companies that employ non-attorney representatives, or advocates, who did not attend law school and/or pass a bar exam to represent their clients. Some of these companies are not open about the fact that you will not be represented by an attorney. This is often alarming to many claimants. We get a lot of last minute calls to represent claimants at their hearings after they discover the people they hired to represent them from other companies are not in fact attorneys or even law firms.

How can non-attorney representatives legally handle Social Security Disability claims you may ask? Both the Social Security Administration and the Veteran’s Administration started programs in which non-attorneys, or advocates, could represent claimants at hearing, and receive the same fee as an attorney for this representation, if they passed a simple multiple choice test. Thus, non-attorney advocates are able to represent claimants in both Social Security Disability and Veteran’s Disability claims at the lower levels of the disability process. If your claim should be denied at the lower levels of the Social Security Disability process and you need to appeal your claim to Federal Court, an attorney can take your claim to this next level. A non-attorney representative cannot represent claimants in Federal Court. Thus, a non-attorney representative can only handle Social Security Disability cases up to a certain level.

Our policy at West Coast Disability Law Group, LLP, is that we only hire licensed attorneys to represent our clients. We feel that a legal education is valuable in any legal arena whether it be in securing Social Security Disability benefits or Supplemental Security Income. Hearings involve making arguments to Social Security Administrative Law Judges and cross-examining expert witnesses like doctors and vocational experts. In our experience, individuals without a legal background have difficulty presenting skillful arguments and effectively cross-examining expert witnesses. Thus, Cari and I believe that the best policy is to let attorneys handle legal matters as this is exactly what they are trained to do.

Whether you decide to hire a non-attorney representative or a lawyer is up to you. However, we recommend asking these questions before you hire anyone:

1. Are you a licensed attorney?

2. What is your experience handling Social Security Disability claims?

3.       How do you determine whether or not you take a claim?
4.       Do you review evidence before taking my case?
5.       Do you have contracts working with any long-term disability companies who may be trying to deny me other types of benefits?

You want to make sure you hire a knowledgeable representative or attorney who is working for you and you alone. These above questions will help you figure out which representative is right for you.

Tuesday, March 4, 2014

Expedited Disability Processing Times for Veterans

The Social Security Administration (“SSA”) announced a new initiative last month that would expedite Social Security Disability claims for veterans who are rated 100% Permanent and Totally (“P&T”) disabled by the Department of Veterans Affairs (“VA”). The new initiative only expedites the Social Security Disability claims process and does not guarantee approval of such benefits. In order to have a case expedited, the veteran must tell SSA that they have a VA disability compensation of 100% P&T and provide his/her VA notification and award letter to SSA. SSA will flag the case for expedited processing.

SSA will still require that the veteran meet SSA’s own definition of disability. However, the veteran will not have to wait the normal average timeframe of 120 to 270 days it takes SSA to process a claim. This expedited process was already in effect for Wounded Warrior claims. Thus, it is an expansion of existing expedited processes that have been applicable to other veteran groups. SSA plans to launch this new process in mid-March.

Thursday, February 13, 2014

The Differences Between State Disability and Social Security Disability

California is a unique state in that we have both a Federal and a State Disability program. State Disability is administered by the Employment Development Department (“EDD”) of California. Social Security Disability is administered by the Social Security Administration, a Federal Agency of the United States.

State Disability is a temporary disability program that provides California workers temporary benefits for up to one year. State Disability can never be extended for more than a year period. In order to qualify for State Disability, you must have had paid into the State Disability Insurance Fund. Some County employees in California do not pay into the State system because they have their own private disability programs through their County employers. In order to apply for State Disability, you must be unable to perform your customary work for at least 8 days before applying. You also must submit your application within 49 days of the date you became disabled or you may lose your benefits. Eligibility for State Disability is dependent on your doctor completing a certification form addressing your disability.

On the other hand, Social Security Disability is a much more complex process. You can apply for Social Security Disability at any time, as long as you have paid enough into the Federal Insurance Compensation Act “(FICA”). Like all insurance programs, Social Security Disability applicants must establish that they were disabled before their date-last-insured (“DLI”) expired. Unlike the State Disability program, your doctors do not fill out a certification form for Social Security Disability. Instead, the Commissioner of Social Security, through his delegated employees at the Social Security Administration, makes the determination as to whether an individual is disabled or not. However, getting your doctor to write a letter of support can be crucial in convincing the Social Security Administration that you are disabled. Social Security Disability benefits can last until you are able to return to work or until the Social Security Administration makes the determination that your disability has ceased.

In spite of the fact that obtaining State Disability benefits is generally easier and has a far shorter procedural process than the Social Security Disability process, Social Security Disability payments are often less than what an individual receives from State Disability. State Disability benefits are paid out biweekly, while Social Security Disability benefits are paid monthly. State Disability and Social Security Disability benefits can offset each other. However, you can file for State Disability and Social Security Disability benefits simultaneously.

Friday, January 24, 2014

The Social Security Administrations Announces New Compassionate Allowances Conditions

The Social Security Administration (“SSA”) announced this month the addition of 25 new Compassionate Allowances conditions to the Compassionate Allowances program. This brings the total number of conditions on the list to 225. Disabilities that comprise the Compassionate Allowance list represent the most serious disabilities that affect individuals. The purpose of the program is to expedite disability decisions, so individuals suffering from these severe diseases receive their benefit decisions as quick as possible. Close to 200,000 people with life-threatening disabilities have received their benefits through this expedited process. The new additions include:

Angiosarcoma
Atypical Teratoid/Rhabdoid Tumor
Chronic Idiopathic Intestinal Pseudo Obstruction
Coffin- Lowry Syndrome
Esthesioneuroblastoma
Giant Axonal Neuropathy
Hoyeaal-Hreidarsson Syndrome
Intracranial Hemangiopericytoma
Joubert Syndrome
Leptomeningeal Carcinomatosis
Liposarcoma- metastatic or recurrent
Malignant Ectomesenchymoma
Malignant Renal Rhabdoid Tumor
Marshall-Smith Syndrome
Oligodendroglioma Brain Tumor- Grade III
Pallister-Killian Syndrome
Progressive Bulbar Palsy
Prostate Cancer - Hormone Refractory Disease - or with visceral metastases
Revesz Syndrome
Seckel Syndrome
Sjogren-Larsson Syndrome
Small Cell Cancer of the Thymus
Soft Tissue Sarcoma- with distant metastases or recurrent
X-Linked Lymphoproliferative Disease
X-Linked Myotubular Myopathy

To see a complete list of all the impairments which qualify for the Compassionate Allowances program, visit this website: http://www.ssa.gov/compassionateallowances/conditions.htm

Thursday, January 2, 2014

How Does The Social Security Administration Determine Disability?

To receive benefits under the Social Security Disability program, you must have a physical or mental impairment (or a combination of impairments) severe enough to keep you from working fulltime in any regular paying job for at least one year or result in death. The test isn't whether or not you can return to your old job, and the test isn't whether or not you have been able to find a job lately. Rather, the test is whether you are capable of doing any job available in the national economy (even if this job involves different skills or pays less than your previous work). By using an extensive set of regulations, the Social Security Administration takes into account your medical condition, age, abilities, training, and work experience in deciding a case.

The Five Step Evaluation that Social Security uses to determine if you are disabled is as follows:

1. Are you working?

If you are working and earning more than the current Substantial Gainful Activity amount (currently $1,070.00 a month), you generally cannot be considered disabled.

2. Is your condition severe?

Your impairment(s) must be expected to last one year or result in death and interfere with basic work related activities.

3. Is your condition found in the list of disabling impairments?

Social Security maintains a list of impairments for each of the major body systems that are so severe they automatically entitle you to disability. If your condition is not on this list, Social Security has to decide if it is of equal severity to an impairment on this list. If it is, the claim is approved. If it is not, Social Security goes on to the next step.

4. Can you do the work you did previously?

Does your impairment prevent you from doing any work that you performed in the last fifteen (15) years? If it does not, the claim will be denied. If it does, the claim will proceed to the fifth and final step of the evaluation.

5. Can you do any other type of work available in the national economy?

Social Security considers your age, education, past work experience, and transferable skills against the job demands of occupations as determined by the Department of Labor. If you cannot do any other kind of work, the claim will be approved. If you can, the claim will be denied.

Monday, December 16, 2013

Misconceptions About Social Security Disability Insurance and Supplemental Security Income Benefits

Cari and I have handled over 2,000 Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”) claims. Throughout our years of practice, we have heard all kinds of misinformation and misconceptions about these benefit programs. Given how frequently we hear incorrect information about SSDI and SSI, we decided to do a blog debunking some of the frequent inaccurate statements we hear.

1. “You have to be off of work for one year before you can file for benefits.”

This statement is very inaccurate. You do not have to be off of work for 365 days before you can apply for benefits. You just have to be able to prove via medical and/or mental health evidence that your impairment (s) will prevent you from working for 365 or more, or that your impairment will result in death.

If you have received a diagnosis and your doctor tells you that you will be out of work due to your impairment and medical treatment for a full year, you should put in your application for benefits immediately. Do no wait for your California State Disability to run out. You can file for both SSDI and State Disability simultaneously.

2. “I have been denied benefits, so it makes no sense to appeal my claim.”

The majority of people are denied at both the initial application level and again during the reconsideration stage regardless of the severity of the impairment. Applying for SSDI and SSI benefits is a game of frustration. Before giving up on your claim, you should consult an attorney if your doctor has indicated that you have a severe impairment that will prevent you from working for a year or more.

3. “I am not looking for permanent benefits. I just want partial benefits.”

The SSDI and SSI programs do not have a partial disability system. You are either found disabled or not disabled. Other areas of disability law like Worker’s Compensation and Veteran’s Service-Connection benefits, do break down disabilities into percentile scales. The Social Security Administration (“SSA”) does not quantify disabilities in this way, however. SSA will either find that you are disabled from all work or that you are capable of performing work in the national economy.

4. “I can never return back to work if I collect SSDI/SSI benefits.”

You can return to work if your condition improves. SSA simply requires that your impairment prevent you from working for a year. If you reach medical improvement after this 365 day period and can return to some type of work, you need to contact SSA and let them know that you are starting to work again. Depending on the level of income that you will be earning at your job, you may still qualify for benefits for a period of time. The crucial thing is that you have to report to SSA that you are returning to work and provide them with a breakdown of your monthly gross income that you will be earning, so they can determine if you are still entitled to benefits.

5. “People are getting rich off of SSDI/SSI benefits.”

No one gets rich off of the SSDI or the SSI program. The average national SSDI payment for November 2013 is $1,129.65. The maximum Federal SSI payment that an individual can receive for 2013 is $710.00. No one receives a windfall from the SSA. People stand to earn a lot more money from working than from collecting SSDI or SSI benefits.

6. “A lot of illegal immigrants are receiving SSDI/SSI benefits.”

We hear this all the time and it is just not true. You cannot collect either SSDI or SSI benefits, unless you have legal Permanent Residence status in the United States. For any immigrant who came to the United States after 1996, you also had to have 40 credits of work performed in the United States to even qualify for SSI. Thus, immigrants who receive SSDI or SSI do so because they have contributed to the United States economy.