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SSD for School Custodian

An application for Social Security Disability (“SSD”) that I filed 5 months ago for a 55 year old school custodian with spine problems and depression was approved today. Presumably, this is a perfect example of the importance that vocational evidence plays in SSD cases.

There are various factors and presumptions that are made when evaluating SSD applications. One consideration is the age of the applicant, for which there are several categories. Had the claimant been one year younger, then he would have fallen into a different age classification, and his SSD application may not have been approved.

Another vocational factor concerns the physical demands of the claimant’s past work. As a school custodian, the physical demands of the claimant’s past work placed it into a “medium” or even more strenuous category. Had the claimant’s past work been less strenuous, then his SSD application probably would have been denied.

There are other vocational factors that can have a determinative affect on an SSD application. That is why it is very important to ensure that the vocational evidence is properly provided when applying for SSD benefits. Incorrectly describing past work or omitting relevant information can result in having the application denied initially, which should be avoided given the increasingly long waiting time for a hearing.

28 Months For Approval

Recent efforts in Congress to derial Social Security Disability(“SSD”) have been well documented. Carolyn Colvin, the Commissioner of the Social Security Administration, said that if Congress does not shore up the SSD Insurance Trust Fund, then it would be a “death sentence” for beneficiaries. According to a recent Wall Street Journal article, Democrats attribute the problem to an increasing and aging population, and Republicans attribute the problem to non-disabled workers who became unemployed during the economic downturn.

As a result of Congressional pressure on the SSA, the approval rate for disability claims cases has dropped the last five years in a row, from 63% to 45%. Various measures have been taken to reduce approvals, and budgetary issues are resulting in a marked increase in hearing waiting times. Some people believe the delays are designed to hurt the cash flow of attorneys who represent the SSD claimants. Earlier this month, Law 360 noted that Binder & Binder is seeking a $6 million loan to avoid liquidation because the slowdown in social security disability and veterans’ benefits has sapped its cash flow.

Unfortunately, claims of rampant applicant fraud remains unfounded, and the overwhelming vast majority of applicants cannot work on a full time basis. Just as justice delayed is justice denied; delaying SSD benefits is unjust. I represent a 64 year old bus driver whose SSD benefits were approved yesterday after 28 months. The claimant had several physicians who all concluded the claimant was disabled, and their opinions were supported by tests and clinical records. Even the SSA medical expert at the hearing agreed with the treating physicians. It would not have taken 28 months to decide this case five years ago.

SSD With No Hearing

The problem of long waits for Social Security Disability (“SSD”) appeals is nothing new. Recently, however, I have written about how the waiting time to have an SSD appeal heard by an administrative law judge has reached an all time high. The increased waiting time should provide even greater incentive to try to get approved at the initial decision level.

I represent a 51 year cook with back, hip, and hand problems, whose SSD application was approved today at the initial level. Many claimants with similar impairments do not get approved initially. Was there anything different here? Yes.

The claimant ensured that we received everything that we requested in support of the application. All medical tests, pharmacy information, treatment records were promptly obtained, and all agency and representative forms, and functionality reports were completed and submitted expeditiously. As a consequence, the State agency never even requested a consultative examination.

State Agency Analyst Lied

One of my client’s eFolder became available today. The eFolder contained one document that said my client did not comply with requests to have a consultative examination (“CE”), and the other said that my client did not keep the CE appointment. Both documents were written by J. Nimrod, a State agency analyst. Nimrod is a liar.

My client appeared for his CE. In fact, he has videotape showing that he complied with the CE request, and kept the CE appointment. The videotape is concrete proof that Nimrod lied when representing in writing that my client neither complied with the CE demand, nor kept the appointment.

Nimrod and other analysts habitually fail to follow the rules. Nimrod and his ilk have made it a habit of lying about claimants supposedly not appearing for their CE. These so-called analysts know that there is no rule precluding claimants from taping a CE. Consequently, the analysts blatantly lie when a claimant appears for a CE with a videorecorder, and claim that they never showed up.

It is difficult to have any respect for the State agency when its employees destroy its integrity through flagrantly fraudulent misrepresentations.

Social Security Backlog

One of the first questions potential claimants ask me is how long will it take to get my Social Security Disability (“SSD”) claim approved. My answer used to be, an average of 7 months for the initial decision, and another 6 months to a year if the claim is initially denied.

The answer now is quite different. As reported in the Washington Post, SSD claims now take an average of 109 days at the initial application. The denial rate is 68%. In New York, the claim is appealed and transferred to the Office of Adjudication and Review, where it takes an average of a year before a decision is made. If the claim is denied at a hearing by an Administrative Law Judge, the next step in the appeal process is with the Appeals Council. The decision at this level takes an average of 374 days.

Quite simply, as the Washington Post reported, the entire system is backlogged with over 1 million cases. The more cases, the longer the wait. The current wait for a decision on SSD benefits is at an all time average high of 435 days.

If you are thinking about applying for SSD, or have a claim currently pending, you must be prepared to wait quite a long time for a decision.

Social Security Backlog

One of the first questions potential claimants ask me is how long will it take to get my Social Security Disability (“SSD”) claim approved. My answer used to be, an average of 7 months for the initial decision, and another 6 months to a year if the claim is initially denied.

The answer now is quite different. As reported in the Washington Post, SSD claims now take an average of 109 days at the initial application. The denial rate is 68%. In New York, the claim is appealed and transferred to the Office of Adjudication and Review, where it takes an average of a year before a decision is made. If the claim is denied at a hearing by an Administrative Law Judge, the next step in the appeal process is with the Appeals Council. The decision at this level takes an average of 374 days.

Quite simply, as the Washington Post reported, the entire system is backlogged with over 1 million cases. The more cases, the longer the wait. The current wait for a decision on SSD benefits is at an all time average high of 435 days.

If you are thinking about applying for SSD, or have a claim currently pending, you must be prepared to wait quite a long time for a decision.

Chronic Fatigue Syndrome Renamed

While the symptoms associated with Chronic Fatigue Syndrome (“CFS”) are well documented, disability claims based upon it are denied at a high rate, due in large part to the stigma of its being an imaginary illness. The Social Security Administration even promulgated a specific ruling to evaluate CFS after concerns that the condition was not being taken seriously.

Yesterday, the Institute of Medicine, which guides the federal government on important medical issues, emphasized that CFS is real, needs to be taken seriously, and recommended that this disorder be renamed Systemic Exertion Intolerance Disease (“SEID”). Renaming CFS to SEID is intended to prevent dismissing the complaints of people with the disease, and hoped to lead to a greater effort about its causes and possible.

The Institute of Medicine stated that there is no reason for skepticism about the serious nature of CFS, in particular, “the misconception that it is a psychogenic illness or even a figment of the patient’s imagination.”

Go Figure

The amount of time that disability claimants are waiting for hearings has increased dramatically. As a result, the backlog is about a million cases, for which the Social Security Administration (“SSA“) blames budgetary problems.

Ironically, many applications pending at the initial level have been decided much quicker than usual. Historically, it took the State agency 6 to 7 months to render a decision. However, recent decisions have taken significantly less time. The last couple of months I have had applications denied in only 2 or 3 months; some even without nonmedical development or requests for consultative examinations. On the other hand, today I had two more applications approved, one 3 months, and the other 4 months, after being filed.

Is this all simply an odd coincidence? Faster decisions by the State agency results in even more claims waiting for hearings. A cynic might say that the backlog is purposely being increased in order to make a case for increasing the SSA budget.