My short wish list for the new year – hopes both big and small!

1.  I wish that SSA would make a client’s file available to me from the moment I represent them instead of limiting the availability to after I file the Request for Hearing.

2.  I wish that the hearing office could get out from under the backlog of cases awaiting hearings so that my clients could obtain a resolution on their claims.

3.  I wish that medical researchers could find a cause and cure for MS – this group of people represents a large part of my practice.  Through my practice and my work with the North Florida MS Society, I see firsthand the devastation this disease causes.

4.  I wish that the hearing office would stop sending my corrupted discs so that I could review the files I need to review.

5.  I hope that my clients know how much time I spend thinking about them individually and how much I want to prevail in each one of their cases.

Merry Christmas to All!

December 24, 2014

I am grateful that I am able to continue to do the work that I do despite the increasing difficulty in getting claims paid.  I am grateful for the clients who put their trust in me and my office with what may be the most important thing going on in their lives.  Lastly, I am grateful that I am able to help my clients obtain the benefits they need to support themselves and their families.

I wish you all a very Merry Christmas and I hope the new year brings you better health and a successful resolution to your disability claim.

 

Faces and Facts of Disability

December 17, 2014

One of the most common criticisms that I hear about the disability programs is that they are full of fraud.  While there is fraud within the disability programs and every large program, it is not nearly as prevalent, in my opinion, as people imagine.  The constant criticism of the disability process has resulted in a smaller percentage of people being awarded benefits.  Thus, it is more difficult to receive benefits today than ever before. Claim approval rates have been on steady downward trends for decades with no signs of bottoming out. Some Judges approval rate for claims is in the teens, meaning more than 80 of 100 claims the Judge sees are denied.

One significant factor, even among the administrative law judges, is a loss of focus on the good this program does for many American workers. Recently, the SSA released a video that show some of the faces that the disability programs help. It provides facts about the program and how it is essential to help our citizens that are less fortunate.

I hope you will watch the short video and thoughtfully consider who the program is designed to help, and how important it is to those individuals.

http://www.ssa.gov/disabilityfacts/

 

SSA has increased the number of medical continuing disability review (CDR).  Beneficiaries have a statutory right to continue to receive monetary benefits and Medicare pending the appeal if the review is based upon a “medical CDR”.  Benefits pending appeal are not available if benefits are terminated due to earnings above the substantial gainful activity level (which are knows as “work CDRs”).

Beneficiaries may be deterred from requesting continuation of benefits pending appeal because if the ultimate decision is that the medical cessation is upheld, the benefits paid pending appeal will be considered an overpayment.  It is important to note that the regulations specify that waiver of recovery of the overpayment will be found so long as the appeal was made in “good faith”.  Good faith is assumed unless the individual fails to cooperate with the processing of the appeal.

To receive benefits pending appeal, the beneficiary must file the appeal and request benefits pending that level of appeal within ten days of receipt of the notice of cessation.  Although SSA presumes the notice was received five days from the date on the notice, it is strongly advised to go to the Social Security District Office as soon as possible and make the appeal in person.  GET A RECEIPT DOCUMENTING THAT YOU WANT BENEFITS CONTINUED.

The Social Security Administration has issued final policy decisions for processing claims involving non-marital relationships such as civil unions, domestic partnerships or reciprocal beneficiary relationships.  As of August 2014, the major policy decisions regarding same-sex couples are:

1.  Spouses of Retired Workers.  SSA is processing claims for spouses of retired workers if the couple is married and currently domiciled in a state that recognizes same-sex marriages.

2.  Surviving Spouses.  SSA has authorized the processing and payment of some surviving spouse and lump sum death payment claims for same-sex married couples.  The policy on surviving spouses benefits and the lump sum death payment take a similar approach as the previous instructions for retired workers (meaning the couple was married and at the time of the wage-earner’s dean, he or she was domiciled in a sate that recognized same-sex marriage).  SSA is required to look to the law where the insured worker lived at the time of death.

3.  Non-marital legal relationships such as civil unions and domestic partnerships.  SSA will consider the claimant to be the number holder’s spouse if the sate of the number holder’s domicile would allow the claimant to inherit a spouse’s share of the number holder’s personal property if the number holder died without leaving a will.  Under these circumstances, we will treat the couple’s relationship as a marital relationship.

Claims representatives at the SSA will review pending claims and appeals that were based upon an allegation of non-marital legal relationship.  To be “married” for eligibility purposes, SSA must determine if the non-marital legal relationship was valid in the place it was established and it qualifies as a marital relationship using the laws of the number holder’s domicile.

 

SSA is urging anyone who is a potential beneficiary to apply now.  If a policy not yet been determined for certain situations, claims will be held and processed after SSA issues further instructions.  It is expected that SSA will issue further policy when the U.S. Supreme Court decides the underlying constitutional issue.

 

%d bloggers like this: