Tag Archives: Morrison And Nicholson Family Law Offices
Senate Committee Reveals Trouble with the Quality of Disability ALJ Decisions
Senate Committee Reveals Trouble with the Quality of ALJ Decisions
A recent article in the Washington Times discussed the increasing stress that the Social Security Disability system is operating under and how that stress has led to troubling problems affecting millions of Americans.
Investigators working for a Senate subcommittee examined hundreds of cases in which disability benefits were approved and found that those making the decisions frequently ignored warning signs such as incomplete or inconsistent information. Senators have said this review demonstrates the need for an overhaul of the existing system. One Senator said that the decisions from some administrative law judges (ALJs) were so bad that the final verdict seemed almost entirely arbitrary.
Though the first phase of this investigation involved looking over applications that were approved but should not have been, the Senate committee says it will next turn its attention to those cases that were denied and may have been denied wrongfully. Those in charge say they worry that they will discover the system is not helping many of the people it was designed to protect.
For its part, the Social Security Administration says it has work to do to fix problems in the system. However, they claim that outlier decisions occur far less often than they used to and the decisions of many ALJs are affirmed with much more regularity then ever before.
That may sound good, but problems still abound. The massive report showcased one ALJ from Oklahoma who has issued more than 1,000 decisions each year since 2006. Judge W. Howard O’Bryan Jr. peaked in 2008 with 1,846 decisions and regularly approved 90 percent or more of the claims. This compares to an average ALJ approval rate of about 60 percent. The investigation revealed that his decisions were notable only for their “poor quality” and how Judge O’Bryan often regurgitated the same boilerplate language in each case decision.
One case that apparently prompted the investigation, involved a man living as an adult “baby,” meaning he slept in an adult-sized crib and wore diapers. The man was collecting disability benefits despite having demonstrated carpentry skills and his ability to work with a reality TV show and a website for other adult “babies.”
The case of the adult “baby” highlighted another problem according to the Senate subcommittee and that is how out of date the list of jobs given to ALJs are. The list has not been updated since the 1970s and excludes many computer-related jobs that some people (possibly other adult “babies”) with disabilities might be able to perform.
If you think you may be entitled to Social Security Disability benefits and have questions, call The Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation today.
Source: “Judging of disability claims flawed, Senate study finds,” by Stephen Dinan, published at WashingtonTimes.com.
Posted in Social Security SSD/SSI
Tagged abuse of the system, administrative law judges, ALJ, ALJ decisions, approval rate of disability claims, bad ALJ, Cleveland disability attorney, congress review of ALJ decisions, denial of benefits, disability fraud, how to handle your hearing before an ALJ, SSA, virginia disability lawyer
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Chronic Heart Failure and disability
Chronic Heart Failure
Chronic heart failure (CHF) is a potentially lethal condition where the heart cannot pump a sufficient amount of blood, which can then cause blood to accumulate in the vessels leading to the heart and can cause congestion or accumulation of fluid in various parts of the body. The precise part of the heart that fails impacts the damage caused. For instance, if the left chambers of the heart fail, blood backs up into the lungs, causing lung congestion. If the right chambers of the heart fail, blood backs up into the legs and the liver, causing congestion and swelling, called edema. CHF is usually accompanied by an enlargement in the size of the heart.
Symptoms of heart failure can be mild or moderate, including shortness of breath, fatigue, and weakness, especially with exercise. CHF can also cause heart palpitations and dizziness. Treatment of CHF can be very difficult and involves rest, proper diet, and a variety of medications.
The Social Security Administration (SSA) will evaluate whether a patient with CHF qualifies for disability under its listing for “chronic heart failure” which appears as listing 4.02. To qualify for disability benefits under the SSA’s listing for chronic heart failure, you must have been diagnosed with severe continuing heart failure despite being on heart medication. It is important to note that the SSA’s listing does not require that you have fluid retention at the time of evaluation to begin receiving disability benefits, but your medical records should show that you have suffered some fluid retention at some point in time. More specifically, the following typically must be shown to meet a disability listing:
• Your medical records must show the following evidence of either systolic or diastolic heart failure.
- Systolic failure: the heart’s ejection fraction (the percentage of blood pumped out of the heart with each heartbeat) is 30% or less during a normal period, or the heart’s left ventricular end diastolic dimensions are larger than 6.0 cm.
- Diastolic failure. thickness of left ventricular wall septum 2.5 cm or larger on imaging, an enlarged left atrium 4.5 cm or larger, and normal or elevated ejection fraction during a normal period.
To receive benefits under the listing, you must also be able to demonstrate one of the following symptoms:
• Inability to perform an exercise tolerance test (ETT) at a workload equivalent to 5 METs or less
• If an exercise tolerance test would be too risky, persistent symptoms of heart failure that very seriously limit your daily activities are required to be shown, or
• At least three episodes of heart failure and fluid retention within the past 12 months, requiring emergency room treatment or hospitalization for at least 12 hours.
If you think you may be entitled to Social Security Disability benefits and have questions, call The Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation today.
How much does SSI pay per month?
How much will your Supplemental Security Income (SSI) checks pay each month? Well, it varies as some states award additional income to the base amounts listed below. That being said, here are the amounts for 2012. Keep in mind that these amounts change each year in conjunction with the cost of living adjustment (COLA).
Social Security Administration SSI payout amounts for 2012:
| Recipient | Unrounded annual amounts for— | Monthly amounts for 2012 | |
|---|---|---|---|
| 2011 | 2012 a | ||
| Eligible individual | $8,095.32 | $8,386.75 | $698 |
| Eligible couple | 12,141.61 | 12,578.71 | 1,048 |
| Essential person | 4,056.93 | 4,202.98 | 350 |
| a The unrounded amounts for 2012 equal the unrounded amounts for 2011 increased by 3.6 percent. | |||
Payment reduction
Remember, these payouts are lowered depending on your countable income each year. If you are thinking of applying for disability benefits click for a free consultation or call 1-800-596-1533.
Does my income affect my child’s ability to qualify for Social Security Benefits?
How much income can parents have before their children no longer qualify for Supplemental Security Income benefits?
Disabled children can qualify for benefits under the Supplemental Security Income (“SSI”) program, which is administered by the Social Security Administration, depending: (1) on the nature of their disabilities; (2) on how much income they have (if any); and (3) on their available resources. Children’s “available resources” include the income (and assets) of their parents and guardians. Therefore, many parents and guardians of disabled children wonder how much income they can have before their children no longer qualify for SSI benefits.
The Social Security Administration (“SSA”) defines a child as someone who is not married; is not head of a household; and is under age 18, or is under age 22 and regularly attending school. This discussion only applies to SSI benefits for disabled children, as the SSA defines the terms “disabled” and “children.”
1. Nature of disability. According to the definition established by the applicable laws and regulations, a child is “disabled” if the child “has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months.” In other words, a child is disabled for purposes of SSI benefits if the child has a very serious medical condition that will last (or has lasted) for at least one year. For example, a child who suffers from cystic fibrosis could qualify for SSI benefits. A child with a minor broken leg, but who did not otherwise have a serious medical condition, would probably not qualify.
2. Child’s income (if any). In terms of a child’s income, a child may not earn more than $1,000.00 per month from employment and still qualify to receive SSI benefits (in 2011; the limit on a child’s total monthly income changes every year). On the other hand, a child who is unemployed, or who is employed but earns less than $1,000.00 per month (in 2011), would meet the income limit.
3. Income and resources (i.e. assets) of parents or guardians. The determination of a child’s eligibility to receive SSI benefits also takes into account
Income, in this context, comes in two varieties: “earned income” and “unearned income.” Earned income consists of “wages from employment, net earnings from self-employment, certain royalties and honoraria, and sheltered workshop payments.” Unearned income consists of money received from other sources, “such as Social Security benefits, pensions, state disability payments, unemployment benefits, interest income, and cash from friends and relatives.” Some income is exempt and does not count toward the applicable limits. The following chart illustrates the income limits currently applicable in many (but not all) circumstances.
|
Number of Ineligible Children in Household |
All Income is Earned |
All Income is Unearned |
||
|
One Parent in Household |
Two Parents in Household |
One Parent in Household |
Two Parents in Household |
|
|
0 |
$2,821 |
$3,495 |
$1,388 |
$1,725 |
|
1 |
$3,158 |
$3,832 |
$1,725 |
$2,062 |
|
2 |
$3,495 |
$4,169 |
$2,062 |
$2,399 |
|
3 |
$3,832 |
$4,506 |
$2,399 |
$2,736 |
|
4 |
$4,169 |
$4,843 |
$2,736 |
$3,073 |
|
5 |
$4,506 |
$5,180 |
$3,073 |
$3,410 |
|
6 |
$4,843 |
%5,517 |
$3,410 |
$3,747 |
By “resources,” the SSA essentially means property. For instance, resources include bank accounts, cash, life insurance, real estate, stocks, U.S. savings bonds, vehicles and other property belonging to a child’s parents or guardians that could be exchanged for cash and used for food or shelter. Some resources, such as a home, household goods and personal effects, and money in pension funds, are exempt and do not count toward the applicable limits. Currently, the applicable resource limit (for non-exempt resources) is $2,000 for a single parent or guardian, and $3,000.00 for a couple.
To summarize: A disabled child’s eligibility for SSI benefits depends upon the nature of the child’s disability, the amount of income that the child earns (if any), and the income and resources available to the child—including resources available through parents and guardians. Regarding the resources of parents and guardians, the limits vary from case to case depending on the circumstances. The income limits listed in the foregoing chart, and the resource limits discussed above, might or might not apply in a specific situation because of the many rules and regulations, as well as exemptions, that govern SSI eligibility for disabled children. If you are the parent or guardian of a disabled child and would like to learn more about SSI eligibility, then talk with a lawyer with experience dealing with Social Security issues.
Can I draw early social security retirement and disability at the same time?
Can I draw early retirement benefits from Social Security and receive Social Security Disability Insurance benefits at the same time?
Lately, a number of my clients have asked me whether they can receive early retirement benefits from Social Security and, at the same time, also receive Social Security Disability Insurance (“SSDI”) benefits. Believe it or not, the answer is “yes” in many cases. Suppose that Susan B. Anthony, who is currently 62 years old and lives in Troy, Ohio, worked for 30 years at the Spacely Sprockets factory in Wilmington. She has leukemia, and as a result of her condition, she had to stop working on June 1, 2010. At that time, she did not apply for SSDI benefits. Now that she has reached age 62, she would like to begin drawing early retirement benefits from Social Security. She also wants to apply for SSDI benefits.
Normally, were Susan to elect to draw early retirement benefits, the amount she would receive would be reduced by 25% compared to drawing benefits at full retirement age. For example, if Susan would have received a monthly retirement benefit of $1,000.00 had she retired at age 66 (the full retirement age for someone born in 1949), then her monthly early retirement benefit would be $750.00. If she were married, then her spouse’s benefit would be reduced by 30%. Furthermore, Susan’s monthly benefit would not increase once she reached full retirement age—the 25% reduction would be permanent.
In Susan’s case, however, she stopped working as the result of her disability. Because her disability forced her to stop working before she reached full retirement age (again, Susan is currently 62; her full retirement age would have been 66), Susan could effectively receive her full retirement benefit if her application for SSDI benefits is approved.
Assume that Susan began drawing her early retirement benefits shortly after her 62nd birthday, which was July 1, 2011. She then applied for SSDI benefits. On her application, she listed June 1, 2010, as the date on which her disability began. A decision on an application for SSDI benefits usually takes several months, and can sometimes take longer. Suppose, therefore, that the Social Security Administration approves Susan’s application for SSDI benefits on December 1, 2011, and that it determines that Susan’s disability began on June 1, 2010.
In this scenario, Susan would be paid her SSDI benefits retroactively from January, 2011, through July, 2011—when she started receiving her early retirement benefits. Then, for August, 2011, through December, 2011, Susan would be paid the difference between her early retirement benefit, which she already received, and her full retirement benefit. From December, 2011, onward, Susan would receive SSDI payments in the amount of her full, monthly retirement benefit. Effectively, because Susan’s early retirement was the product of her disability, the Social Security Administration treats her as if she had stopped working at her full retirement age.
Keep in mind that the foregoing example only applies when the Social Security Administration approves an application for SSDI benefits. For instance, had her application for SSDI benefits had been denied, Susan would have received only her reduced, early retirement benefit.
In addition, the amount of Susan’s monthly benefit would also have been different had the Social Security Administration determined that her disability began on a later date. Had the Social Security Administration determined that Susan’s disability began on September 1, 2011, then Susan would be treated as if she retired two months early (i.e. full retirement age less, less two months). In other words, if the date on which Susan’s disability officially began (as determined by the Social Security Administration) came before the date on which she stopped working, then she would be treated as if she had stopped working at her full retirement age. On the other hand, if the date on which her disability officially began came after the date on which she stopped working, then she would be treated as if she had retired early.
Drawing Social Security early retirement benefits and receiving SSDI benefits at the same time is possible. For some, this is the best option. For others, waiting until full retirement age to begin drawing benefits is the best option. If you have questions about early retirement and SSDI benefits please contact the Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation.
