Interesting News Story About How Disability Claims Are Processed
 

Hi Everyone.
This news story about how disability claims get processed is interesting. It explains that the Government policy is to deny most claims with the idea that if the claim is legitimate, the person filing the claim will be willing to go through the difficult appeals process. Most of us in the system already know this. But it is interesting to see the Government lay it out, and clearly state that they systematically put legitimate claimants through hell as part of their process. Just thought some of you may want to see it.
Bernclay- :holysheep:

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Spike In Disability Claims Clogs Overloaded System
By Stephen Ohlemacher, Associated Press
May 10, 2010

WASHINGTON – Nearly 2 million people are waiting to find out if they qualify for Social Security disability benefits. It will be a long wait for most, even if they eventually win their cases.

The Social Security system is so overwhelmed by applications for disability benefits that many people are waiting more than two years for their first payment. In Ohio, Michigan, Minnesota and other states, the wait can be even longer.

the rest here -
http://hosted.ap.org/dynamic/stories...MPLATE=DEFAULT

it's just wrong aint it!
 

those that really need it cant get it and those that dont get in:eek:

I can see in some of those states with really high unemployment, the reason. People know its a hassle, and keep working. But if there is no work, well------- I can't blame them. You have to eat some how.

And I am considering applying for it myself, so I am in no way condeming those who do.

I didn't interpret the article the same way the OP did. Just saying...

Agreed. From the article cited at the top of the thread:

The Social Security commissioner, Michael J. Astrue, says the delays are unacceptable, particularly for people who have paid payroll taxes for years to support the system and now are unable to work because of debilitating medical problems. Astrue has had some success in reducing a case backlog that has plagued the system for years. But a spike in new applications, linked to the economic recession, threatens to swamp the system again.

* * *

"The most important thing we can do to improve the disability process is to make the right decision as soon as possible," Astrue said at a recent congressional hearing. "Certainly, I'm not happy with the accuracy of the system, even though it is getting better."

His goal is to clear the backlog of appeals hearings by 2013. "It takes longer to fix something than it does to break it," he said.

Then too, check out the following press release from the Social Security Administration, dated March 2, 2010, Social Security Hearings Backlog Falls to Lowest Level Since 2005:

Michael J. Astrue, Commissioner of Social Security, today announced that the number of disability hearings pending stands at 697,437 cases -- the lowest level since June 2005 and down more than 71,000 cases since December 2008, when the trend of month-by-month reductions began. In addition, the average processing time for hearing decisions has decreased to 442 days, down from a high of 514 days at the end of fiscal year (FY) 2008.

“We have decreased the number of hearings pending by almost 10 percent over the last 14 months and cut the time it takes to make a decision by nearly two and a half months. This remarkable progress shows our backlog reduction plan is working,” Commissioner Astrue said. “With ongoing support from the President and Congress as well as the efforts of our hardworking employees, I am confident the hearings backlog will continue to diminish.”

Social Security has actively addressed the hearings backlog and increased the capacity to hold more hearings. The agency hired 147 Administrative Law Judges (ALJs) and over 1,000 support staff in FY 2009, and has plans to hire an additional 226 ALJs this year. The agency now has four National Hearing Centers to help process hearings by video conference for the most hard-hit areas of the country. The agency also has aggressive plans to open 14 new hearing offices and three satellite offices by the end of the year. The first of these offices was opened in Anchorage, Alaska on February 19, 2010.*

http://www.socialsecurity.gov/presso...og-0310-pr.htm


Finally, here in California, while the Feds pay 100% of the cost of the state determination system, those employees - along with all other state workers - have been forced by Arnold to take unpaid furloughs every other week. The net effect being that in the interest of preserving a sense of equality among state workers who have been given what works out to a 10% pay cut, even SSD evaluators who's salary is paid by the federal government are being furloughed! And although a couple of superior judges have ruled the process illegal, those judgments have been stayed pending appeal, a process that could take years. See, generally, Order Granting Writ of Mandate http://media.sacbee.com/smedia/2009/...ffiliate.4.pdf and Appellate court issues second furlough decision http://www.sacbee.com/static/weblogs...ents_Container and Supreme Court leaves seven furlough cases in lower courts http://www.examiner.com/x-36269-San-...n-lower-courts.

I would think that if the current administration was in favor of a policy that delayed disability determinations for years, it would be backing the Terminator on this one, but it isn't. See, Social Security Administration Praises Court Ruling on "Illegal" Furloughs in California - Asks Governor Schwarzenegger to Accept Ruling and Congress to Increase Oversight, January 4, 2010 http://www.socialsecurity.gov/presso...urlough-pr.htm and Furloughs in Federally-Funded Benefit Programs: Backlogs Build and California Compensates with Overtime and Hiring, A Report for the Senate Rules Committee December 22, 2009 at page 6:

Federal Disability Benefits

Disability Determination Service Division of the state Department of Social Services Federal Official Calls California Furloughs “Ridiculous”

U.S. Social Security Administration officials have harsh words for the furlough of state workers who administer two of their programs to aid disabled people.
Regional Commissioner Peter Spencer, based in Richmond, called it “a no-brainer,” “ridiculous” and “an anti-stimulus action.”

“Congress and the President gave us additional funding to process disability cases to stimulate the economy,” he said, “and the state’s actions counteract the intent of the legislation and hurt the state’s economy.”

“It’s money that they are losing,” Spencer said of the governor’s office. “It does not save them a cent.”

The governor’s furlough order covers the doctors, analysts and clerical staff of the Disability Determination Service Division of the Department of Social Services. These workers evaluate applicants for two programs:

• The Supplemental Security Income program, which in California pays an average of $612 a month to people who are aged, blind or disabled and have little or no income; and

• the Social Security Disability Insurance program, which in California pays an average of $947 a month. Both programs help people who are so disabled they cannot work for a year or longer.*

http://www3.senate.ca.gov/deployedfi...20programs.pdf

Bottom line: this is just yet another clean up operation following years of (at best) indifferent neglect under the prior administration. Sort of like how the Department of the Interior's Minerals Management Service gave a free pass the blowout preventer now used in all deep water oil wells, including the Deepwater Horizon. Oil spill investigators find critical problems in blowout preventer, May 11, 2010, Washington Post:

While Congress probes the accident, a board of federal officials is also investigating. In a hearing in a hotel ballroom near New Orleans, Michael Saucier, a regional supervisor for the Minerals Management Service, said the beleaguered federal agency that oversees offshore drilling learned in a 2004 study that fail-safe systems designed to shear through steel pipes could fail in some circumstances. But he said MMS did not check whether rigs were avoiding those circumstances.

The hearing provided the spectacle of one federal agency drawing embarrassing admissions out of another. Some of the toughest questions came from Coast Guard Capt. Hung Nguyen, co-chair of the investigating board. He raised the 2004 study that found that blowout preventers did not have the power to cut ultra-strong pipe joints.

Nguyem also asked Saucier how the MMS ensures that blowout preventers function. Saucier said for that, the government relies heavily on industry designs and oil company tests.

"Manufactured by industry, installed by industry, with no government witnessing oversight of the installation or the construction, is that correct?" Nguyen asked.

"That would be correct," Saucier said.

http://www.washingtonpost.com/wp-dyn...T2010051102889


Mike

* Public document; no copywrite asserted.

Mike, I'm so impressed with all your knowledge, I was wondering if you knew anything about SSI? I was raising our kids most of our marriage, my oldest is 30 and my youngest is 25 we have been married 33 years. I was told that because my husband is employed I am not eligible, they think he makes too much money (thats a joke) I was once told by someone that you can still get SSI even if you are married with a spouse who is employed. I did get medicaid for my medical, but it's medicaid with share of cost. I had to go that route because my insurance company dropped me and we went through to much of our personal finances. This was originally a wc case, but got so sick of running thru their hoops, that I finally decided it was time to settle. This all started in 1986 and I settled in 2002. I have already applied once and was turned down, do I need a lawyer to even start over or should I just forget about it? I would really appreciate your advise. Thank you in advance. Your friend Wendy

Follow up to my original post
 

Hi Everyone.
I am not sure how my original post was interpreted, but it was not meant to be a comment about a particular administration. I have been disabled over the span of 3 presidential administrations (towards the end of one, all through the second, and now into the present third) and have had difficulty with the disability process throughout. I am not going to get into being for or against any particular administration sine that really wasn’t the point.

The parts of the article I was referring to were these.

“ … Two thirds of claims are denied … Most people will drop their claims … The appeals process can take two years or more ...” “The system is designed to weed out malingerers. It has to be that way to prevent the fraudulent, frivolous claims from getting into the system.”

They say that most people drop their claims because they are faking their disability. But many people drop their claims because they can’t handle the stress of the process since they are in extreme pain.

My point is that you must have the strength to go through the appeals process to have a good chance of eventually getting benefits. Many of us suffering from intensely painful disabilities don’t have the strength for this process. This means that by default, if you are legitimately disabled (I am), you will most likely need to hire an expensive lawyer (I did). Even with a lawyer the process is extremely stressful and a very physically painful experience for someone with CRPS. Also many of us simply can’t afford a lawyer. Depending on your specific situation, the lawyer fee is not always percentage based, and not always paid after the fact.

I was injured in front of 30 witnesses, I was picked up off the floor and taken directly to medical treatment. From that point on I accumulated a steady flow of undeniable medical documentation that is now in a folder 2 feet thick. I have never had any doctor (including government doctors) dispute or deny my condition. Despite all of this, I still had to go through a torturous and painful disability process that lasted years and cost me tens of thousands of dollars. After wining my completely unnecessary legal battle, I was then forced to take legal action of my own in order to regain the money that I had been wrongfully forced to spend. I did all of this and won every time.

Why did all of this happen? Why was I forced into a completely unnecessary legal process when I had mountains of documentation and testimony proving my legitimate disability. The reason was because “The system is designed to weed out malingerers”. That may sound good on paper, but the reality is that in order to reduce their annual payout, the government will do whatever works to reduce the disability payout. And the fact is, that the government has found that if you put disabled people through enough stress and expense, they will voluntarily drop their legitimate disability claims, and the annual disability payout is then reduced.

The only reason for the entire unwarranted legal mess I was forced into was to try to make me give up my claim voluntarily. This is not my opinion. I had an excellent lawyer who had worked on the government side of the disability process for years. The lawyer explained to me why and how all of these things were being done. Without that guidance and insight I do not think I would have been able to endure the stress of the entire process. Had they succeeded in forcing me to give up my legitimate claim, I would almost certainly be dead by now, since I would not have been able to afford the resources to treat my extremely painful and debilitating CRPS.

By contrast, if you are a “malingerer”, and you are perfectly healthy, and you have years of experience defrauding the welfare system, you will have no problem whatsoever navigating through this process and ending up with disability benefits. The malingerers are the only ones who have the strength to endure the process. It is not painful for them since they are healthy. It is not stressful for them since they actually have nothing to lose and will be fine if they get denied.

The end result is that you have malingerers getting disability since they are healthy enough to handle the process, you have tens of thousands of legitimately disabled people not getting disability since they are too disabled to handle the process, and you have a government that really doesn’t care since their annul disability payout has been reduced.

I know it’s a bit much, but it’s the truth. I hope this may have been helpful to anyone who is dealing with the process. God Bless You All.

Bernclay- :holysheep:

Ssi
 

Dear Wendy -

Thanks for the compliment. Truth is, the only thing I really know is how to access databases, a skill I picked up in countless hours of online legal research when I was practicing law. That, and what I've managed to retain in my long term memory; and the business about Arnold just stuck in my craw, so to speak.

As far as SSI, I know next to nothing about it because I have a private disability insurance policy that I was lucky to be talked into buying way back when policies were so boadly written they almost ended up driving some of the major carriers into receivorship. Those payments don't effect SSD but are counted as income under SSI, and put me over the limit for SSI from the start.

What I was able to find offhand was a website on SSI maintained by the SSA, What You Need To Know When You Get Supplemental Security Income (SSI), which includes the following:

If you have income other than your SSI, you must tell us about it. And you should tell us if the amount of your other income increases, decreases, or if the income stops. Usually, changes in your income in a month will affect your SSI payment two months later.

You also should tell us about changes in the income of other family members living with you. For example:

If you are married, tell us about any change in your husband’s or wife’s income, including any change in the amount of his or her Social Security benefits. (If you also get Social Security benefits, you do not need to tell us when you get a Social Security benefit increase.)

If you have a child younger than 18 who gets SSI and lives with you, tell us about any change in:

The child’s income;
Your income;
Your husband’s or wife’s income; and
Income of any child in your home who is not getting SSI.

Also tell us if:

A child in your home who is not getting SSI gets married; or
A child who is working or who is age 18 to 22 starts or stops attending school full time.
What we count as income
Under SSI, income includes cash, checks and other things you get that can be used for food or shelter. Here are examples of income:

Wages from your job, whether in cash or another form;
Net earnings from your business if you are self-employed;
The value of food or shelter that someone gives you, or the amount of money some gives you to help pay for them;
Department of Veterans Affairs benefits;
Railroad retirement and railroad unemployment benefits;
Annuities, pensions from any government or private source, workers’ compensation, unemployment insurance benefits, black lung benefits and Social Security benefits;
Prizes, settlements and awards, including court ordered awards;
Proceeds of life insurance policies;
Gifts and contributions;
Support and alimony payments;
Inheritances in cash or property;
Interest earned, including interest on savings, checking and other accounts;
Rental income; and
Strike pay and other benefits from unions

Items that do not count as income

The following items are not income:

Medical care and services;
Social services;
Money from the sale, exchange or replacement of things you own (though the money may count as a resource if you retain it until the next month);
Income tax refunds;
Earned Income Tax Credit payments;
Payments made by life or disability insurance on charge accounts or other credit accounts;
Proceeds of a loan;
Bills paid by someone else for things other than food, clothing or shelter;
Replacement of lost or stolen income; and
Weatherization assistance.

Some things we normally count as “income” will not reduce your SSI payment. For example, under certain conditions, home energy assistance provided by certain home energy suppliers is not counted as income. Food, clothing, shelter or home energy assistance provided free or at a reduced rate by private nonprofit organizations also is not counted. Even though these items may not count, you should still tell us about them.

* * *

If your name is on any bank account with another person, you must tell us about the account, even if you do not consider the money to be yours. You must tell us about the account, even if you do not use the money or account. If someone wants to add your name to an account, check with us first. If the money is not really yours, or if it is for a special purpose like your medical expenses, we can tell you how to set up the account so it will not affect your SSI.

If you (or your husband or wife) buy, sell or become the owner of any real estate, a car or personal property, you need to tell us.

http://www.ssa.gov/pubs/11011.html#8b

Now, not only am I no longer a practicing attorney, but I never knew anything about SSI in the first place. Reading what's on the website, my naked guess is the big thing you would have to be concerned with, regarding your husband's income, is "The value of food or shelter that someone gives you, or the amount of money some gives you to help pay for them." That and any money in joint checking accounts, etc. And why they want to know about when "your husband or wife . . . buy[s], sell[s] or become[s] the owner of any real estate, a car or personal property," escapes me, unless it's just so they can do background checks on whether you personally hold any interest in those assets.

That said, bear in mind this is just a website maintained by the SSA, and as such is simply its version of the applicable laws, regulations and court holdings. As such, you should really consult counsel who is knowledgable in these areas. Sorry I can't be more helpful.

Mike

Here's my issue with the above, the government has not "clearly stated that they systematically put legitamate claimants through hell as part of their process" in this article.

The Social Security Commisioner states in the article:

"The most important thing we can do to improve the disability process is to make the right decision as soon as possible," Astrue said at a recent congressional hearing. "Certainly, I'm not happy with the accuracy of the system, even though it is getting better."

If only Sookie Stackhouse was available as an ALJ. :p

I've already written about how I feel about the SS process in the SS forum, so I'm not going to do so again here.

Not true. By federal law, Attorney's fees for SSI/SSDI claims are capped at 25% of backpay or $6000, whichever is less.