SSDI: The truth behind media and political mischaracterizations

The Social Security Disability Insurance (SSDI) program is an integral part of the Social Security system that provides vital economic security to workers and their families. SSDI provides modest but essential coverage that American workers earn, and protects against the economic devastation that often accompanies life-changing disability. Unfortunately, recent media coverage (including recent opinion pieces in The Hill) has painted a highly inaccurate picture of this program, in an effort to encourage damaging changes that would hurt people with disabilities.

Eligibility criteria for the SSDI program are extremely strict and only people with the most significant disabilities qualify for benefits. An applicant must prove with medical evidence the inability to engage in “substantial gainful activity” (defined as earning less than $1,070 monthly in 2014), due to a physical or mental impairment expected to result in death or last for at least one year. Most applicants are denied; only about 40% are approved, a fact which belies claims that there is a “systematic bias” toward approving applicants who are not actually disabled.

People with disabilities turn to the program as a last resort, often having attempted to continue working after it is no longer healthy to do so and having spent down their savings before applying. There is no evidence that people are leaving the labor force to receive SSDI. While it is true that SSDI applications increased during the recent economic downturn, approval rates also declined. website uptime . In fact, the current approval rate is the lowest it has been in 40 years.

Growth in the SSDI program has long been predicted by the Social Security Chief Actuary and is due almost entirely to two demographic factors: the aging of the baby boomers and women entering the workforce. According to the SSA, program growth has peaked and is projected to level off.

The SSDI program is complex so it is not surprising that many applicants choose to retain a representative, given the importance of the outcome. Having an experienced professional provide assistance is valuable for people with disabilities. Representatives help ensure that applicants provide SSA with all relevant medical evidence and help the agency make the right decision as early in the process as possible. SSA’s policies and procedures to regulate representatives do a good job of dealing with the very small number of representatives who violate the rules.

Notably, Congress has not uncovered any evidence of fraud in the SSDI program beyond the cases SSA itself uncovered, after several years of investigation. Nor has Congress found any evidence that people who should not be eligible are wrongly approved. Senator Coburn has been quoted on the topic and appears to mischaracterize what his 2012 investigation actually found. That investigation reviewed only 300 appeals decisions from just 3 counties, and his staff questioned the quality of about 25% of the written decisions but did not claim the decisions were wrong. In fact, the investigation did not find that a single individual was approved who should have been denied.

The Social Security Administration does a good job of identifying potential fraud in the program, despite its woefully inadequate recent funding levels and resources. SSA’s administrative budget is only about 1.4 percent of benefits paid out each year. However, Congress has provided nearly $1 billion less than requested over the past three years. SSA’s program integrity work has suffered too, receiving $421 million less than authorized over the last two years. The result? SSA has lost more than 11,000 employees since 2011 – a heavy blow to the agency’s ability to serve the American people.

If Congress is serious about protecting the integrity of this program, it should start by providing SSA with adequate funding to do so. It should enact H.R. 4090, the Social Security Fraud and Prevention Act of 2013, introduced by Representative Xavier Becerra (D-CA) earlier this year. It would provide SSA with dedicated mandatory funding for program integrity activities, strengthen fraud detection activities, and increase penalties for people convicted of exploiting the program.

The SSDI program does not need significant changes. It has provided economic security to workers who become disabled, and their families, for more than 50 years. But Congress does need to enact legislative changes to secure the future of Social Security and prevent cuts for SSDI beneficiaries in 2016. A rebalancing of the Old Age Survivors Insurance and Disability Insurance trust funds through reallocation of the payroll tax going into each of the funds, approved by Congress multiple times in the past, would account for demographic shifts and solve short-term funding gaps. This program is a key piece of our national social insurance infrastructure and it needs to be kept strong for current and future generations.

Silverstone is executive director of the National Organization of Social Security Claimants’ Representatives. Previously she served as staff attorney for NOSSCR for more than 20 years.
The article can also be accessed on The Hill’s site: http://thehill.com/blogs/congress-blog/healthcare/215601-ssdi-the-truth-behind-media-and-political-mischaracterizations

APPLYING FOR SOCIAL SECURITY DISABILITY

There are three ways to apply for Social Security Disability Benefits. You can apply online at ssa.gov. An application made this way will be for SSDI benefits only. If you want to apply for SSDI and SSI benefits you can call your local office and set a time for them to take your application over the phone. This can be very time consuming. Finally, you can go to the Social Security Office and apply in person.

When applying, it is important to understand the difference between SSDI and SSI. A very basic explanation would be that SSDI are benefits you receive from working and paying taxes. If you have enough paid in (credits) you get the benefits. If you have not paid in enough, you will not receive SSDI. However, you may receive SSI benefits. SSI does not require you to pay into the Social Security system to get benefits. Simply put, SSI is a from of benefit that can be received if you have little in the way of assets and no income. You cannot apply for SSI online.

At the application stage, you should have the following information available; proof of age and SS number; list of employers covering the last 15 years; W2 or tax returns for the past 10 years; names and addresses of your doctors; a list of medicines; and any medical records you might have.

You will also be given a follow up “interview” by the Social Security Office. This interview is used to confirm information provided on your application and to get additional information which may have been omitted.

If you need help with your application, call us, we will answer your questions. If you want to file an SSDI application, we can come to your home and help you complete the process online.

2013 Changes to Workers Compensation Benefits: More money; Less medical treatment.

Beginning July 01, 2013, the Maximum Workers Comp benefit is $525 per week (raised from $500 per week). The maximum Temporary Partial Payment is now $350 per week.  That’s good news.  The bad news is our Legislature has now capped the amount of medical treatment an injured worker can receive from “life time” benefits to 400 weeks. The only exception to this is for injuries that are deemed “Catastrophic” under 34-9-200.1(g). This restriction on medical benefits limits the amount of medical treatment the insurance company is required to provide. Thus saving them a lot of money. Most injuries do not require treatment lasting longer than 400 weeks, but those who need continuing treatment and MEDICATIONS, will surely feel the effects of the change.

Social Security Case Approvals

The latest Social Security case approval statistics are out. In Georgia the approval rate for cases heard by a Judge is 48%. 16% of cases are dismissed without a decision. 36% are denied. Nationally, 46% are approved. 18% are dismissed and 36% are denied.

From asking for a Hearing to actually appearing in court takes on average 13.3 months in Georgia and 11.7 months nationally.

Expect the wait times to increase due to more applications and fewer Social Security employees to handle the increased workload.

With long wait times and less than a 50% chance of winning, it’s important that your case is thoroughly prepared and argued. I’m proud to say that our dismissal rate is much lower than average and our win rate is much higher than average.

Am I eligible for disability benefits?

Most folks want to know what their chances are of getting disability benefits. There are a lot of factors that are considered when deciding if someone gets benefits or not. Social Security considers age, education, work background and the nature of your disability that keeps you from working. Your impairment must be “severe” and have lasted or expected to last at least 12 months.

Statistically, according to Associate Social Security Commissioner Arthur Spencer, only 33% of initial claims are allowed. Claims that are denied at application are then appealed and “reconsidered”. About 9.5% of cases are granted at this stage. dns information . domain name owner . Next is the Court hearing.

Some Judges only award 20% of their cases. Some award 80%. For 2013, a little less than 50% of claims were granted at the Hearing level.
Contrary to what you hear and see on the news, trying to get Social Security Benefits is not as easy as just applying and waiting for a check to arrive. As you can see, it’s much harder to get Social Security Disability than most people think.

Why is my case taking so long?

Getting through the Social Security Disability process can take several years from application to Hearing to Award even longer if appeals are made after a Hearing. Why does it take so long? In a recent Federal Court complaint the following provides a brief but accurate summary of why claims are bogged down.

The review and adjudication of disability claims by the Social Security Administration (“SSA” or “Agency”) is a system in crisis. The United States Supreme Court has recognized that the SSA disability hearing system is “probably the largest adjudicative agency in the world.” Approximately 3.3 million disability claims are filed each year, a 57% increase since 1990. Over the last five years, SSA disability workloads have grown significantly due to, among other factors, an aging Baby Boomer population reaching their disability-prone years and the Great Recession of 2008 with its lingering high unemployment. Congress has responded to these demographics by making matters worse. site information . As the most recent SSA Commissioner finally conceded on his departure in February 2013, the SSA has simply not gotten the necessary resources from Congress to address this rising number of disability claims. The chronic lack of resources has had a multiplier effect on the time required to resolve claims, with disability claimants being forced to wait a year or longer for their claims to be decided.

How can an attorney help with my Social Security case?

If you have been denied your Social Security Benefits, you should speak to an attorney. An experienced Social Security attorney can help in several ways. First, your attorney should help in developing medical evidence. This includes gathering medical reports and making sure the Judge has the reports to aid in deciding your case. Second, hiring an attorney will give you an advocate in the court room. Several theories of disability may be presented to the Judge which give the Judge more ways to find you disabled and rule in your favor. Your attorney should inform you on how the court proceeding will take place and what to expect. Third, an attorney can explain the disability process so that you understand where your claim is and how it is progressing. This is very important because most Social Security claims take months and sometimes years and the frustration with the system can be a lot to deal with on your on.

There are many other reasons to contact an attorney if your benefits have been denied. These will be discussed later. But do keep in mind that you have 60 days to appeal a denial. So if you are denied and you think you may want to speak with an attorney, don’t delay!

Injured on my job. What do I do first?

If you are injured while working at your job, you need to report the injury as soon as possible to your supervisor. Georgia law requires that notice of an injury be given to the employer within 30 days (although there are a few exceptions to this rule). In my practice, I’ve noticed that the cases which are denied most often because of “notice” are those cases where a worker is injured one day and reports it the next. Even worse is when someone gets hurt on Friday and reports the injury on Monday morning. I see this all the time where someone gets hurt on Friday and thinks they will rest over the weekend and feel better on Monday. But when you are still hurting on Monday, it can present a problem. This time gap gives the employer and their insurer the argument of “how do we know the injury didn’t happen over the weekend?”. ask ausiello . Although we usually are able to secure benefits for our clients who are in this situation, it takes time and often filing for a hearing in court. Don’t take chances. apache web server If you are hurt, report it. Get the medical attention you need.

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