Social Security Disability

Way back in 1992, after years of disability lawyers complaining about ALJs who showed bias against people applying for disability benefits, the SSA released what they call a “Notice.” This notice described the procedure that they would use to handle these types of complaints. However, the procedure in the notice was considered “interim” rather than “final,” which basically meant that it couldn’t actually be used in practice.

No big deal, right? This is the way the SSA works with new rules. They publish a rough draft, work out the kinks, then release the final version so that it can be used in real cases. But here’s the problem: no final rules were ever published. For the last 20 years, claimants and reps have been able to point to the interim procedures as proof that the SSA knew there was a problem with biased judges, but they still couldn’t do anything about it unless they wanted to file a class action lawsuit against the SSA itself.

Claimants and the attorneys who represent them have complained for years that some ALJs have shown a bias against those applying for disability. And it’s not just that they deny more people than the average – these ALJs seem to actively seek out reasons to refuse benefits time and time again.

Unfortunately, bias such as this has always been hard to prove, and it didn’t help any that the procedures created by the SSA to deal with these kinds of matters were lacking at best. Disability lawyers and their clients were left with one real strategy, but it was always seen as more of a symbol than a real attempt to get justice: file a class action lawsuit. Essentially, they would sue the SSA, claiming that a specific judge had displayed a bias against claimants.

When someone applies for Social Security Disability or files a claim for SSI, there’s a good chance that they’re going to need to provide medical records as evidence on their behalf. It makes sense that the SSA would make this request. After all, they can’t just hand money out to people without proof that there really is a problem, can they?

Unfortunately, the SSA’s request for your medical records isn’t the problem. The fact that some people have to pay an exorbitant amount for them, however, is.

There’s a little-known rule the Social Security Administration has created which basically says you’re required to follow any treatment that might help you get better. If you don’t do this, they’ll deny your claim.

The amusing part about this rule is that in order for the SSA to use it against you, they basically have to argue that you have a valid disability that would be covered. How so?

You need to have an impairment that prevents you from “substantial gainful activity.”
This impairment is expected to stick around for at least a year or lead to death.
In order for you to do any SGA, you need treatment.

These things are practically a laundry list of what you need to

Recently, a Social Security Advocate shared the story of a woman who filed for disability due to her problems with seizures. After having her initial claim denied, she got all her evidence together and had a hearing in front of an Administrative Law Judge. Again she was denied, with the ALJ finding that she was able to do any kind of work.

This time, she took the matter to federal court, outlining the specific Listing that she believed covered her seizures. According to the Listing, someone qualifies for benefits if they still have more than one seizure a month after undergoing at least three months of treatment and that those seizures cause “residuals” that make it more difficult for them to handle activities of daily living. That’s exactly what the claimant was going through, and the Appeals Council agreed and awarded her benefits.

But what if the ALJ presiding over the hearing also rules against you? What then? Well, there’s still a possibility that you can get another appeal, but you have to show the Appeals Council that you have what’s known as “new and material evidence.” How does the SSA define “new and material evidence”? There are …

Every so often, the Social Security Administration makes changes to how various disorders and disabilities should be evaluated in order for someone to qualify for benefits. They proposed specific changes for visual disorders back in 2012, but the revisions didn’t become finalized and made effective until April of this year.

The last time changes like these were made to the way visual disorders should be evaluated was 2006, and these new revisions were put in place due to questions that adjudicators have brought up since that time. Barring any further revisions or extensions, the most recent changes will be in effect for the next 5 years.

Unless you’ve been dealing with Social Security Disability for as long as I have, you probably don’t know much about “allowance rates.” These rates tell us the percentage of people who file a disability claim with the SSA and actually end up getting benefits.

Every year, the government releases a report listing both the percentage of applicants who were accepted to the program nationally and the numbers for individual states and cities with hearing offices. For 2012, the overall national acceptance average was 44.7 percent – less than half. And that’s counting both those who were immediately accepted and people who won their claim after “reconsideration.”

Those numbers might not seem particularly great if you’re thinking about applying, but it’s not all bad news.

If you or a loved one has been trying to apply for Social Security Disability, you already know how long the disability appeals process can take. Most people have to wait for months at the very least, struggling to get by without the benefits they so desperately need, and many end up in this waiting game for a year or longer. Any change designed to speed up the process would be a good thing, right? Maybe – but maybe not.

Back in 2007, the head judge sent a friendly request out to the rest of the ALJs. He asked that they work hard to decide on more cases each year, at least 500 to 700. Many judges, he wrote, were already meeting that number, so it shouldn’t be a big deal.

But what if this push for judges to meet “quotas” means they won’t wait until an important witness for your case is available to testify? Or that they decide before you’re able to track down a piece of helpful evidence from a doctor or previous employer?

As a Social Security Disability attorney, I hear all kinds of questions and concerns from clients and potential clients about the claims and hearing process.

Part of the reason for this is that the SSA doesn’t go out of its way to ensure people have access to the necessary rules and procedures in order to make a claim and fight for their rights. But there’s another reason, too: on some things, the SSA is just plain vague.

For years, the question of the legality of telephone testimony from medical experts (MEs), vocational experts (VEs), and others fell into this latter category. Because SSA rules didn’t specifically address it in one way or another, it was left up to the ALJ presiding over the case to make the call.

Well, no longer. This past June, the SSA finally created a rule to address the issue. The verdict? Telephone testimony is allowed in SSD hearings as long as the side asking to use it gives advance notice to the opposition.