Tag Archives: prison and social security disability checks
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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Rheumatoid Arthritis and Social Security Disability
Rheumatoid Arthritis
Rheumatoid arthritis is a disease that causes damage to joints, organs, and bodily systems due to inflammation of joint tissues. While inflammation is usually a response by a person’s immune system to disease or infection, the immune system of someone suffering from rheumatoid arthritis attacks the person’s healthy joints, causing pain, stiffness, and swelling in the joints. As the disease progresses, it causes difficulty in engaging in even ordinary activities, this includes things as simple as walking, standing, getting dressed and personal grooming.
Rheumatoid arthritis is not the same as osteoarthritis or other forms of arthritis. Instead, it is an autoimmune disease, which causes the body’s immune system to mistakenly turn on otherwise healthy tissue. Physicians diagnose rheumatoid arthritis by a physical examination, followed by blood tests to detect abnormalities and then by using body scans or bone scans to examine the effect of the disease on the person’s joints.
Symptoms of rheumatoid arthritis include pain and swelling of the joints that cause them to be tender to the touch, red and puffy hands, fatigue, fever, weight loss, and morning stiffness. Generally the smaller joints are affected first, followed by the larger joints and even the neck. Sadly, there is no cure for rheumatoid arthritis and doctors work to slow down the progress of the inflammation.
To be approved for Social Security Disability benefits due to rheumatoid arthritis or other inflammatory arthritis, you must may meet the requirements found in Listing 14.09 of the Blue Book.
These requirements say that claimants must have a three-month history of constant joint pain, swelling and tenderness that involves multiple major joints. These joints are defined as the hip, knee, shoulder, ankle, elbow, or hand and wrist. In addition, joint inflammation, swelling, and tenderness must be found upon physical examination by a doctor, despite attempts at treatment. You must also have considerable restriction of joint function. Finally, all these symptoms must be expected to last for at least twelve months.
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.
Posted in Social Security SSD/SSI
Tagged autoimmune, disability benefits, fatigue, fever, hip pain, inflammation, inflammatory arthritis, joint pain, knee pain, osteoarthritis, pain, RA, rheumatoid arthritis, SSA, ssdi for joint pain, ssi for arthritis, swelling, tenderness, weight loss, wrist pain
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Will my social security disability judge (ALJ) look at my Facebook account?
The Importance of Social Media in Social Security Disability Claims
Before the advent of the Internet, investigators had a much harder job. Collecting information, verifying statements and making sure everything added up is a lot more difficult without the help of Facebook, Twitter, Instagram and other social networking services. The rise of these websites has encouraged people to post a plethora of personal information about themselves online for anyone to access. It’s important to understand that friends and family are not the only people taking notice. While this information is primarily useful in the personal injury context, it can be equally valuable when it comes to Social Security Disability claims.
Disability benefits exist to offer support due to those unable to work due to a debilitating condition. Would a quick look through your social media profiles indicate that you deserve such benefits? Better hope so, because it could spell disaster for your case if you’re claiming a terrible back injury yet have pictures plastered across Facebook of your recent tango lessons or bungee jumping adventure.
Investigators and judges use social networking websites and could conceivably check up on what you’ve been doing while you’re claiming injury. And it’s not just your profile that could cause problems, being tagged in a photograph by a friend who does not have privacy settings on a Facebook page can also spell trouble. While this article should not be read as encouraging deception, disabled parties should be aware that anything posted online is not 100% private.
The following are some suggested steps for ensuring that your online footprint remains as small and as private as possible.
1. Immediately make your profile “private,” and set all privacy settings to the highest level.
2. Remember to not discuss your accident, injuries or treatment, including any prescribed medication, on ANY social networking sites.
3. Avoid discussing recent activities you’ve engaged in, physical exertion, abilities and limitations, or any other information that may bear on what you can and cannot do because of your condition.
4. Be sure you know everyone who is your “friend.” Do not accept friend requests from people you do not personally know.
5. Review your friend list and block anyone you are not 100% sure you trust. Investigators could pose as a friend or get information from others who are to gain access to potentially incriminating information that could negatively affect your claim.
If you think you may be entitled to Social Security Disability benefits or have questions, call The Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation today.
Which medical records are the best for winning my disability claim?
What kinds of medical records do you need for your disability claim? Before you can begin collecting disability benefits, the Social Security Administration requires that you prove that you are unable to work. The best evidence of this is, obviously, medical documentation. Medical evidence can take many different forms. These can include notes, mental health records, blood work, imaging studies, as well as a multitude of other reports. If you have timely, accurate, and sufficient medical records that come from your treating physician, you will greatly increase your chances of being approved for disability benefits. Each of these qualifiers – timely, accurate, and sufficient – has specific, SSA definitions.
Timely records are those that are relevant to your current medical condition. If you are attempting to claim disability for something that occurred last year, medical records from ten years ago would not be considered timely. Deciding what is timely falls within the purview of the treating physician. The nature of the ailment or condition is one factor in determining the timeliness of the records. If the condition is recurring or continuous, older records regarding the ailment or condition may be timely. If, on the other hand, the condition is one that resolves itself quickly or one that changes, older records may be less relevant and therefore not timely. The doctor knows best in these kinds of situations.
Accurate records are those that properly describe your condition according to acceptable medical sources. The Social Security Administration only accepts medical opinions from certain types of health care providers: (1) licensed physicians; (2) osteopaths; (3) optometrists; (4) podiatrists; and (5) speech pathologists. If the records or opinions do not come from one of these five kinds of health care providers, it may not, in many cases serve as acceptable medical source of evidence to the Social Security Administration. It is important to keep in mind that evidence from lay-persons, chiropractors and the like will be considered by the administration, however, these records will likely not carry as much weight as opinions from the aforementioned sources.
Finally, sufficient records are those that contain enough information for the disability judge to make a determination about your eligibility from those records alone. To be frank, the Administration wants to see that you have been treated for this condition prior to filing for disability. The treating physician’s notes and opinions carry the most weight with the Administration.
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.
Can I receive Medicare or Medicaid benefits at the same time as I receive Social Security disability benefits?
Attorneys such as John T. Nicholson who practice Social Security law often hear questions about whether someone could receive Social Security disability benefits at the same time as Medicare or Medicaid benefits. In general, someone who satisfies all of the relevant eligibility requirements can receive Social Security disability benefits and Medicare or Medicaid at the same time. Whether anyone in particular could receive these benefits, however, would depend upon the specific circumstances.
The Centers for Medicare & Medicaid Services (“CMS”) has administrative responsibility for Medicare and Medicaid. Medicare is
a national health insurance program serving U.S. citizens (and permanent residents) who have reached at least age 65, as well those younger than 65 who have certain disabilities, permanent kidney failure or amyotrophic lateral sclerosis (“ALS,” commonly known as Lou Gehrig’s disease). Medicare comes in four types.
1. Part A (hospital insurance). Medicare Part A helps to pay for the cost of inpatient care in hospitals and skilled nursing facilities—including care in critical access hospitals, but excluding custodial and long-term care in nursing facilities. Although the other types of Medicare usually require payment of a monthly premium, payroll taxes and self-employment taxes cover premiums for Medicare Part A in most cases.
2. Part B (medical insurance). Medicare Part B helps to pay for the cost of doctors’ services and outpatient care; in addition, it helps to pay for the cost of some of the services provided by physical and occupational therapists, as well as some of the cost of home health care. Those whose Medicare Part A premiums are covered by payroll or self-employment taxes may enroll in Part B. Coverage under Part B generally requires payment of a monthly premium.
3. Part C (Medicare Advantage plans). Those insured under Medicare Parts A and B can choose to enroll in a Medicare Part C, or “Medicare Advantage,” plan. Medicare Advantage plans, which must be approved by Medicare, are offered by private insurers. The coverage provided under these plans must be at least as good as what Medicare provides, but coverage otherwise varies from insurer to insurer. Medicare pays private insurers a specified amount each month for every Medicare Advantage member. Coverage under Medicare Advantage requires payment of a monthly premium for Medicare Part B, as well as a monthly premium for the private insurer.
4. Medicare Part D (prescription drug coverage). Medicare Part D helps to pay for the cost of prescription drugs. Those insured under Medicare Part A, Medicare Part B or Medicare Part C (Medicare Advantage) may choose to enroll in Part D. Medicare Part D generally requires payment of a monthly premium.
Medicaid is two programs that provide disability benefits: Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”). SSDI provides benefits to insured workers with disabilities, or in other words, those who: (1) have been employed for at least five of the last ten years; (2) have paid FICA (“Federal Insurance Contributions Act”) taxes; and (3) have a “disability” as the Social Security Administration defines the term. A disability, for purposes of Social Security, is a serious medical condition that lasts (or has lasted) for more than a year and prevents someone from being gainfully employed. In addition, SSDI will provide benefits to the disabled children of insured workers, so long as the children became disabled before they reached the age of 22, as well as to the disabled surviving spouses of insured workers who have died.
SSI, on the other hand, pays benefits to disabled adults and children who have little or no income, or other financial resources. The program also provides benefits to adults without disabilities who are age 65 or older and whose financial means fall within the applicable limits.
Someone who receives SSDI benefits, or who is eligible to receive SSDI benefits, is also eligible to receive Medicare at the same time. Eligibility for Medicare begins after a waiting period of 24 months from the first date of eligibility for SSDI. For those with kidney disease who are on dialysis, however, the waiting period is reduced to three months from the date on which they began receiving dialysis. Medicare eligibility begins immediately for those with a terminal illness expected to cause death within six months, as well as for those with ALS. Those over age 65 are generally not eligible to receive SSDI benefits.
Likewise, eligibility for SSI and Medicare is also possible. Those under age 65 can receive SSI and Medicare benefits at the same time as long as they satisfy the eligibility requirements of both programs. For those age 65 and over, eligibility for Medicare is essentially automatic, and they can receive SSI benefits if their financial means are within the limits established under the Social Security Administration’s rules.
Eligibility for Medicaid often varies according to state law. In Ohio, children up to age 19; families with children under age 19; pregnant women; those with disabilities; and those over age 65 are eligible to receive Medicaid benefits if they meet certain financial requirements. Ohio residents under 65 who qualify for Medicaid can receive SSDI benefits, as well, if they qualify for SSDI under the rules of the Social Security Administration. Those over age 65 are usually not eligible to receive SSDI benefits.
Medicaid and SSI are similar programs inasmuch as they serve those with limited financial means. Ohio residents who have qualified to receive SSI benefits under the Social Security Administration’s rules can also qualify to receive Medicaid benefits if they qualify based on the rules established by the Ohio Department of Job and Family Services.
Although the receipt of benefits through all four of these programs is technically possible, the eligibility rules can be complicated—especially for receiving benefits from multiple programs at once. Furthermore, applications for disability benefits are often denied at first. If you think that you might be eligible to receive Social Security disability benefits, or if your application for benefits has been denied, then you should speak with a lawyer, like John T. Nicholson, who focuses on Social Security law.
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