Category Archives: social security

SOCIAL SECURITY DISABILITY: THE TRUTH BEHIND MISCHARACTERIZATIONS BY POLITICIANS AND THE MEDIA

Today’s post comes from guest author Jay Causey, from Causey Law Firm.

A thought-provoking article about the Social Security Disability (SSD) program appeared in the August 25, 2014 edition of The Hill, a newspaper published for and about the U.S. Congress. The article was authored by Barbara Silverstone, Executive Director of NOSSCR, the National Organization of Social Security Claimant’s Representatives. Ms. Silverstone’s complete article can be accessed on the The Hill’s website.

Ms. Silverstone dispels with factual data some of the myths currently being peddled by certain members of Congress and media outlets. Ms. Silverstone points out the eligibility criteria for SSD are extremely strict, and the burden is on the person applying for benefits to prove, with medical records – not mere assertions, the severity of his or her disabling condition(s). Only about 40% of applications are approved, a fact that belies the claim there is a systematic bias toward approving applicants who are not actually disabled. The current approval rate is the lowest it has been in 40 years.

Ms. Silverstone notes that recent Congressional investigations into allegations of fraud have not identified any cases of fraud beyond those that the Social Security Administration itself has uncovered. She discusses, in particular, the 2012 investigation of Senator Coburn. His staff reviewed about 300 appeals decisions, but failed to identify a single individual who was approved for benefits that should have been denied. Congress complains that the Social Security Administration does not do enough to identify potential fraud in the program, but at the same time Congress has cut Social Security’s budget, providing about $1 billion less than requested over the past three years! As a result, Social Security has lost more than 11,000 employees since 2011. This inevitably has impacted the agency’s ability to serve the American people in many aspects of its operation.

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“Lamestream Media” Enables Right-Wing Talking Points About Social Security Disability

– – Screen Shot from Fair.org

Today’s post comes from guest author Jay Causey, from Causey Law Firm.

     Just in time for a scheduled meeting of the Senate Committee on Governmental Affairs to discuss the status of the Social Security Disability program (SSDI) on October 7th, on Sunday, October 6, CBS’ popular “news” show, 60 Minutes, aired “Disability USA” – a sensationalized program full of misleading and largely anecdotal information designed to convince viewers the program is riddled with fraud and on the brink of collapse.  If you watched this program, and it is your sole source of information about Social Security Disability, you know essentially nothing about the actual operation of the program.  You heard not a single word from disability recipients, their advocates, or from officials who administer the program, none of whom were invited to participate in the 60 Minutes piece.

…the 60 Minutes segment focused on some fraud in the program in one impoverished area of the country in order to paint disability recipients generally as the undeserving poor, slackers and frauds.

     First, listening to the program you might not have understood that the average monthly benefit of about $1100 is not tax-payer money but earned credits for money paid into the system by the disabled worker.  Then, in terms of the “shocking” growth of the disability rolls you heard CBS’s Steve Kroft and Senator Tom Coburn, R-Oklahoma natter on about, you didn’t hear that the statistical growth of the program is a direct function of the increase in population over the past 30 years, the aging of the baby-boomer population into their higher disability years, the entry of women into the work force in greater numbers, and similar demographic factors.  Finally, you likely came away from the program thinking that qualifying for SSDI is a cakewalk, when the actual standards for disability result in denial of two-thirds of all applications, only 10% of those denials being reversed on appeal, and an overall figure of about 41% of applicants ultimately qualifying.

     Completely ignored in this puff-piece for the right wing (Coburn is the lead Republican on the Senate Subcommittee for Investigations and has a long-standing, well-documented hostility to Social Security) is the shifting of responsibility for disability from workers’ compensation systems, where it properly belongs, to the Social Security Disability program because of the rollbacks in coverage and benefits in states’ workers’ comp programs across the country, all driven by right-wing and corporate interests.  So, while SSDI faces potential exhaustion of its funds in the next few years (although this can be – and in the past has been – remedied by shifting funds from the Social Security old-age program), the liability insurance industry, which includes workers’ compensation carriers, is enjoying record profits over the last two years.

     Similarly unmentioned was the impact of the worst economy in decades, shrinking the ability of disabled workers to find less physically challenging work.

     As is typically the case with these types of “news” pieces, the 60 Minutes segment focused on some fraud in the program in one impoverished area of the country in order to paint disability recipients generally as the undeserving poor, slackers and frauds. CBS could have moderated the potential negative impact of its program by including interviews of SSA program officials or of spokespersons from some two dozen national disability advocacy organizations who asked to be heard on this show.  It shamefully chose to ignore all such requests, and has diminished itself accordingly as a news organization.

 

 

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THE TRUTH ABOUT CHEATIN’ AND LYIN’

Today’s post comes from guest author Susan C. Andrews, from Causey Law Firm.

     You hear it all over the place these days: there are lots of people out there who lied and cheated to get Social Security Disability (SSD) benefits. I’m here to tell you that is a myth. You don’t have to drill down very far to find out differently. I should know, from where I sit, as an attorney who handles SSD cases. Where I sit most days is in front of a big pile of medical records—I mean HUNDREDS of pages of medical records, all belonging to the same person. You see, some of my clients have just one great big medical issue—like cancer, or Multiple Sclerosis, or Parkinson’s, and many of my clients have multiple medical problems. Either way, they have spent more time in doctors’ offices and hospitals than any of us would ever choose to do.

 There is a mistaken notion floating around out there that a person can just waltz into Social Security, claim to be disabled, and voila—he’s granted benefits!

     There is a mistaken notion floating around out there that a person can just waltz into Social Security, claim to be disabled, and voila—he’s granted benefits! Nothing could be further from the truth. The burden of proof is on the claimant (the person claiming benefits) to show that he or she is disabled from engaging in substantial gainful activity (SGA) for a period of at least 12 continuous months. More about SGA in a bit. That proof starts with medical records, and diagnoses made by doctors. Self-diagnosing just doesn’t cut it, even if you’ve read up on your condition all over the internet, and you’re absolutely positive you know what’s wrong with you! Sometimes we get calls from people who do not have health insurance, and even though they have a serious medical condition, they have been unable to access much in the way of health care. Sadly, some of those folks who should be able to qualify for benefits do not, because they simply do not have the necessary treatment records to document the seriousness of their conditions.

     As mentioned above, Social Security’s definition of disability is the inability, due to one or more medical impairments, to engage in substantial gainful activity for a period of at least 12 continuous months. Social Security defines SGA in part by a dollar figure that usually goes up a little every year. In 2013 it is $1,040. Social Security looks at a person’s GROSS earnings, not net earnings or take-home pay. So if I’m able to gross $1,040 or more per month, I can engage in substantial gainful activity and I do not qualify for SSD. This concept is important especially for individuals with progressive conditions.

     Take, for example, a person diagnosed with Parkinson’s. One famous example is the actor Michael J. Fox. His Parkinson’s affects his functioning, but he is still working. Many people with progressive conditions continue to work for some time after receiving their diagnosis. At some point, progression of the disease may force some of them to go to part-time work. When the hours worked decrease, their earnings may no longer qualify as SGA. Or—and I see this a great deal in my practice—some people begin to have more bad days than good days, and work performance is impacted. There are days so bad that they really have no choice but to call in sick. Then this begins to happen more frequently than a couple of days a month. In my experience, at that point most employers become very unhappy campers. Not only are the employees taking sick leave faster than they are accruing it, they can’t tell their employers ahead of time which days they will wake up with an exacerbation of symptoms that keep them in bed, or at least in their bathrobe, all day.

     Which brings me to my final point: Many of my clients look okay to the casual passer-by. Take the guy with a serious heart problem. Well sure, if I followed him around for half a day, I’d see that he can barely exert himself without getting out of breath. But if I just passed by, he might look fine. And the day he spends at home in his bathrobe because he can hardly catch his breath—I’m not going to see him at all when he’s having one of those really lousy days. His condition may be largely invisible.

     To sum it up, I’d say there’s a bit of wisdom in being slow to judge. Thank goodness we take our good health for granted—it’d be a miserable existence if I spent too much time worrying about getting sick before it actually happened. But, of course, serious illness can strike any of us when we least expect it. And on the other side of that defining moment, the world can look a whole lot different.

 Photo credit: Gemma Grace / Foter / CC BY-NC

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Media Portrays Social Security as an Avenue to Benefits for the Unemployed – WRONG! It’s Not That Simple…

The Social Security Administration turns down many worthy applicants when they first apply.

Today’s post comes from guest author Susan C. Andrews, from Causey Law Firm.

     There is a lot in the news these days about the Social Security Disability Program, with some pundits suggesting people are getting on benefits simply because they are unemployed, or because they claim to be injured or ill when in fact they are able-bodied and fully capable of working. Every day, all day, I work with people filing for Social Security Disability benefits. So I work with the program’s rules – yes, there are rules for deciding these cases – it is not enough just to claim to be disabled. And I come face to face with individuals who are struggling, sometimes with a major health issue such as cancer, or rheumatoid arthritis, or Multiple Sclerosis. Other folks have multiple health problems that have combined to force them from the labor market. All of them have medical records, often reams of them, documenting diagnoses, chronicling surgeries and other treatment regimens. This is one big thing I think the general public does not know: a person must have one or more diagnoses from a qualified physician that could account for the symptoms and limitations he or she is reporting to Social Security. There must be convincing medical documentation. Much of my day is spent obtaining and reviewing the medical records of my clients, and ensuring that the decision-makers at Social Security also see them.

…the medical condition must be not only serious, but also prolonged.

     Many people are not familiar with Social Security’s definition of disability or the program’s rules, so they do not realize that the disabling medical condition or conditions must be serious enough to have prevented the person from working for AT LEAST 12 continuous months. If the individual has not yet been out of the labor market for a period of at least one year, it must be very clear that this will be the case. In situations where there is doubt about this, Social Security typically turns down the claim. I have had callers who have been unable to work for a few months while going through chemotherapy treatment for cancer, but have been able to get back to work in less than one year. They do not qualify for Social Security Disability benefits. So the medical condition must be not only serious, but also prolonged.

     One broadly held belief about Social Security Disability is, in fact, true: The Social Security Administration turns down many worthy applicants when they first apply. It is necessary to appeal (the first appeal is called a Request for Reconsideration). Often, a second denial follows. Then it is necessary to request a hearing in front of a judge. For a person who is too sick to work, not feeling well, and home alone trying to navigate this system, it can be daunting. One of the joys of my practice is our capacity to lend support to such individuals, to take the reins of the case and drive it forward, so my client can concentrate on taking care of herself or himself while I and my staff handle the legal stuff.

     We are able to offer representation to people at any stage in the process, including initial application. We are happy to talk with callers who are weighing their options, and simply need information in order to know whether to apply for benefits in the first place. There is no charge for such calls, so do not hesitate to contact us if you have questions about Social Security Disability.

Photo credit: Thomas Hawk / Foter.com / CC BY-NC

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