In this case, my friend's mother was married to a gentleman who had applied for benefits in the early 2000's.  He had been denied at his first hearing, then appealed and ended up before a judge a second time for a second hearing.  Shortly after the second hearing (but before a decision was made) he passed away.

Because of the more then 7 year pendency of his claim the past due benefit amount was substantial – over $115,000.  The question – who gets the money.

According to Social Security law (Code of Federal Regulations, Title 20, Section 404.503(b)), the surviving spouse would be the primary beneficiary if she/he was living in the same household as the claimant at the time of death.  If the surviving spouse does not qualify, the surviving children collect.  If there are no children, the parents of the deceased collect.  If there are no parents, the surviving spouse who was not living with the claimant at the time of his death, and so forth.

Note that the funds do not go into the deceased claimant's estate – they are payable directly to the spouse or other beneficiary.

I previously published a blog post about how I won a case for a deceased claimant.  Prior to proceeding I submitted form HA-539, a Notice Regarding Substitution of Party Upon Death of a Claimant.  Individuals eligible to receive benefits must complete and submit form SSA-1724, which is a form entitled Claim for Amounts Due in the Case of a Deceased Beneficiary.

Post from: Social Security Disability Blog

Who Collects Past Due Benefits if a Claimant Dies Before a Disability Decision is Issued

I own a condo in central Florida.  My parents live in north Florida near the Georgia border.  I plan on moving to Macon, Georgia (Macon is about 100 miles south of Atlanta in the middle of the state).   Should I file now?  Should I file now and use my parent's address?  Should I wait until I move to Macon to file?

Here are my thoughts: I would advise you to file now and to use your current address as your home address.  If you are concerned that your mail may not get forwarded you can use your parent's (permanent) address.  In general it is not a good idea to wait to file.  If you wait you may lose the right to claim some of your past due benefits, or in a worst case scenario, your coverage for Title II benefits could run out.  If you are not working, and expect to be out indefinitely, I generally advise potential clients to file sooner rather than later.

Now – what about the location where you would file?  At the initial and reconsideration level of appeal, your case will be processed by a State Agency adjudicator.  Adjudicators follow fairly rigid protocols and I have not seen any documentation to suggest that an adjudicator in one state is more or less likely to approve a claim than an adjudicator in another state.  Those statistics may exist but I have never seen then.

The initial and recon appeal will eat up between 6 months and a year, by which point you would presumably be in Macon.  When you move you would notify Social Security and your file may be transferred to a State Agency adjudication office nearer to where you live.  Then again, it might not be transferred.  I think it is certainly possible that filing an address change, thereby triggering Social Security to move your file could add to a delay in the processing of your case, but my experience has been that the State Agency adjudicators are expected to complete their evaluation within a set period of time.  I don't know that having the file moved will significantly add to a delay.  This is especially the case now that Social Security disability files are electronic – physical files are no longer involved so transferring a case is an electronic process.

The biggest wildcard when you change venues will involve the hearing offices.  Some hearing offices house judges who approve very few cases.  Other hearing offices tend to trend more favorably to claimants.   On the other hand the tendencies of the specific judge assigned to your case are much more important than the hearing office statistics.  You can research statistics about the ratios of approval by specific judges.  Local lawyers who practice in a particular hearing office can also be a good source of advice.

Ultimately I don't know that I would spend a lot of effort "judge shopping."  If you have a good case with compelling medical evidence and support from a treating physician, you stand a good chance at winning, while weak evidence will not convince even a judge who tends to favor claimants.  Further, if you ask Social Security to change your hearing office venue at the last minute you will face  delay as hearing calendars are often filled months in advance.  If you hire one lawyer for location 1, then switch, you may end up paying more than 25% of your past due benefits as lawyer 2 will want to be  paid.

At the very least, if you are thinking about hiring a lawyer in central Florida, let  him or her know about your possible move – you want to make your case less complicated, rather than the other way around.

Post from: Social Security Disability Blog

Does It Matter Where I File My Application for Benefits if I Plan on Moving?

1. you will be approved
2. you will be denied
3. your case will be continued to another date for a supplemental hearing
4. the judge will issue a "partially favorable" decision

Over the past couple of years I have noticed an increase in the number of partially favorable decisions I am receiving.  I think this is because my clients, especially low income clients, do not have access to regular medical care and judges are using consultative exam reports to move the alleged onset dates.

Here is an example of what I mean:  a couple of weeks ago, I tried a case before a judge who is generally considered to be very reluctant to approve cases.  At the time of the hearing my client was a month shy of her 52nd birthday.  She had a 10th grade education and past work as a short order cook.  She alleged disability due to uncontrolled diabetes, numbness in her feet and hands, vision issues and pain.

She last worked 3 years previously, when she was 48 years old.

In reviewing this case, I saw it as a "grid rule" case.   Grid rule 201.10 provides that a 50 year old claimant with less than a high school education, semi-skilled work but no transferable skills who was limited to sedentary work due to an exertional limitation would qualify for disability.

My client had very little money and had last seen a doctor almost 2 years previously.   In addition to the older medical records, there was a consultative examination report from February, 2008 that supported my argument.  My client turned 50 in October, 2007.

At the beginning of the hearing, I advised the judge that we were prepared to amend our onset date to my client's 50th birthday in October, 2007.

I just received the decision and what did the judge do?  He issued a partially favorable decision, approving my client as of February, 2008 – the date of her consultative examination.   I think that any reasonable observer would recognize that my client's condition did not change between October and February.  The net result is only 2 months of past due benefits – but that means about $1,500 to my client.

In my view, the judge's actions were absurd and perhaps a little mean spirited.  During the hearing he made it known that he was not happy with the claimant's pack a day smoking habit (he noted that if she saved the money she spent on smoking she could afford to visit her doctor).

The point here is that when you don't find a way to go to your doctor, or enlist the help of a treating doctor to identify your work limitations, you may find that your judge will pick a date later than the onset date you alleged.  In fact, I know many judges who will always choose onset dates that correspond with a particular medical report.

I think that tying an onset date to the date of a medical report can be a logical choice but such a practice should not be applied mechanically as it was in this case.

You need to be aware of this tendency and make every effort to develop a thorough and convincing medical evidence file so you won't be subject to what could be the arbitrary choices of your judge.

Post from: Social Security Disability Blog

Onset Dates, Consultative Exams and Cynical Judges

In June of this year, the New York Times published an article about the Lifeline program entitled Providing Cell Phones for the Poor.

The program specifications vary from state to state – and associated programs may provide subsidies for electricity and other utilities.  You can find out what is available in your state by a simple web search – I typed "Lifeline + cell phones + Georgia" into Google and the search result documented a number of carriers offering the service.

Thanks to Wisconsin disability lawyer Don Chewning for blogging about this important benefit to SSI recipients.

Post from: Social Security Disability Blog

SSI Recipients May Be Eligible for Free Cell Phones and Free Minutes

When Georgia Congressman John Lewis set reduction of SSA’s disability case backlog as one of his top priorities, the Atlanta North processing time for claims was the worst in the country at 828 days, and in Atlanta proper it was 750 days.  He noted that “people are waiting years for benefits they deserve, some are even dying while waiting. This is simply wrong…Somehow the richest, most powerful nation in the world must find a way to meet the needs of these Americans. They have suffered enough. They should not suffer at the hands of their government.”

Mr. Lewis testified before the Budget Committee, and urged his colleagues on the House Ways and Means Committee to give SSA the funds needed to hire more Administrative Law Judges and disability claims staff.

Last month, Social Security Commissioner Michael Astrue announced that for the first time in a decade, the agency ended its fiscal year with fewer pending disability hearings than in the previous year.  It closed FY 2009 with 722,822 pending hearings – a reduction of more than 37,000 cases from its 760,813 hearings pending at the start of the fiscal year.  Processing time for cases also improved over the same period, dropping from an average of 514 days in FY 2008 to 491 days in FY 2009.

“Our backlog reduction plan is working, and progress is accelerating,” Commissioner Astrue said.  “Even in the face of a significant increase in our workloads as a result of the worst recession since the Great Depression, we have reduced the hearings backlog for nine consecutive months.  Thanks to the efforts of thousands of hardworking Social Security employees and the additional funding we received from President Obama and the Congress, we have exceeded our backlog reduction goal for this year.”   Click on the link to see SSA’s recent news release discussing these developments.

Despite Commissioner Astrue's positive spin on the statistical improvement, in real life I am still seeing delays of 2 to 3 years.  We are seeing some cases processing through the case very quickly and I suspect that these fast tracked cases have something to do with making the statistics look better.

We have also seen thousands of cases shifted from the Atlanta North hearing office to Atlanta and from Atlanta to Columbus and Macon.  These temporary fixes may result in a short term improvement in the statistics related to delays but only time will tell if the recent backlog improvement is a true trend.

We are also seeing increasing delays in the processing of hearing decisions following the hearings.  I have several cases in my office that I tried in March in which a hearing decision has not yet been issued.   The hearing offices advise us that they do not have enough staff to help the judges.

I do think that Commissioner Astrue is making the backlog a priority in his office and I applaud him for his efforts.  Moving a large bureaucracy like SSA is not an easy task and I wish him the best of luck in this undertaking.

Post from: Social Security Disability Blog

SSA’s Disability Case Backlog Reduced for First Time in a Decade

This question concerns itself with your capacity to perform work or work-like activities.  Other factors like the job prospects in your town, your transportation issues, etc. are not relevant.  As I tell my clients – imagine that a chaueffer driven limo will pick you up each morning and take you home each night – can you reliably fulfill the demands of an entry level job?

Far too often, disability claimants hurt their chances greatly by giving the "wrong" answer to this ultimate question.   In a future post I'll print out some examples of "good" answers to this question but today I want to focus on the wrong way to answer.

My colleague, Dallas disability attorney Stan Denman has graciously allowed me to reprint his take on this topic, which I think should be essential reading for all disability claimants and their lawyers.   As a claimant you must take the time to understand how the disability process works and what the judge needs to hear.   If you get the answer to this "ultimate" question wrong, you will not be approved.

Here are Stan's Five "Case Killers," in no particular order:

Top Five Bad Answers to Question: WHY CAN'T YOU WORK?

In no particular order of "badness", here are the top five"case killing" responses to the Administrative Law Judge Question: "Why can't you work?"

2. "My long-term disability insurance company told me to file for social security disability"

This can be an easy mistake to make. Again, the ALJ wantsto know why you think you cannot work. Most long-term disability carriers require those that are on claim for long-term disability benefits to file for social security disability, because the insurance company can reduce the monthly benefit they pay in the amount of the social security disability benefit. So it is true that most LTD recepients may file at the suggestion of their insurance company. But this answer makes you look like the insurance company is leading you around by the nose, motivated not by a belief that you are in fact disabled but rather simply going along with the insurance company.

3. "My unemployment insurance ran out"

This is a real case killer, because it makes you look like you are just working the system.

4. "I don't have a car/way to get to work"

Social security disability benefit eligibility has nothing to do with whether you have reliable transportation, or even if your impairment keeps you from driving. Now, if you have an impairment that means you can't drive you have to talk about how that impairment would keep you from working once you are at the job. How you get there is irrelevant.

5. "They eliminated my job/they outsourced it to Mexico," etc.

Unfortunately, the issue is not whether you job is available. The issue is whether you could perform the job, whether it is in fact in existence. A little strange, I know, but….

Here are a couple more that I can add:

6. "My doctor said that I am not able to lift more than 5 lbs. or sit for more than 3 hours"

The judge can read your medical record and what your doctor said.  You are the claimant – what do you think and why?

7. "I can't stand for long periods of time, sit for too long or lift very much.  There is no way I could do any kind of work."

When you testify you must be specific  Generalizations like "too long," "too much" or "not very much"  or "I don't know I have never tried" don't help.  Before the hearing you need to prepare specific answers about how long you can stand, how far you can walk, how much you can lift, etc.  Your lawyer can give you a breakdown of these "exertional" activities.   Answer questions about exertional activities using pounds, feet, and specific times.

8. "If somebody would give me a job where I could work alone and sitting down, I probably could work"

If you say this, you are basically saying that you can perform a simple, sit-down type of job.  At the very least your testimony should be consistent with the notion that there is no full time work you can do.

Post from: Social Security Disability Blog

The WRONG Answers to the Question: "Why Can't You Work"

At Social Security hearings, judges often call vocational witnesses to classify your past relevant work.   Generally Social Security is concerned with your past relevant work over the past 15 years.  Short durations jobs of less than 3 months are usually considered unsuccessful work attempts (UWA) and don't count as past relevant work.

Vocational witnesses identify both the "exertional level" of your past relevant work as well as the "skill level" of that work.   Jobs are classified exertionally as:

• sedentary
• light
• medium
• heavy
• very heavy

More explanation about what these exertional levels mean – page on this blog;  post from Colorado disability lawyer Tomasz Stasiuk

Jobs are classified by skill level as:

• unskilled
• semi-skilled
• skilled

Vocational experts use a resource called the Dictionary of Occupational Titles (D.O.T.) to classify the exertional and skill level of every job that (in theory) exists in the national economy of the United States.  You can read the D.O.T. online by clicking on the link.

The D.O.T. classification of your past work can also be important in a determination as to whether you meet a grid rule.  I have also described how I use the grid rules in cases on my Georgia Social Security web site.

While you are not expected to know how the Dictionary of Occupational Titles works, it will help if you discuss ahead of time with your lawyer how you should describe your past work.   For example you may have had a job title that suggests a particular job, whereas the work you actually performed represents a different job in terms of the D.O.T.

Post from: Social Security Disability Blog

Understanding How Social Security Classifies Your Past Work

I presented all three to our judge, and the judge decided to approve based on….(you'll have to read the case study to find out).

Not surprisingly the judge looked very favorably on my client's long, consistent work history.  The judge even put on the record his opinion that my client would never have stopped working but for his medical issues.  As I note in the case study, the medical record in this file was a little sparse – but a solid work history can go along way to greatly enhance a claimant's credibility.

One of the arguments I had at the ready (although I did not have to use it) was the "frequent restroom break" problem associated with a drug called Lasix, that helps clear fluid from the bodies of patients with congestive heart failure.  Many of my clients are surprised to learn that I often win cases on the work performance problem of needing to go to the restroom several times an hour.   Although excess restroom breaks don't sound like a medical issue, the practical import of this problem is excess missed time from work.

Post from: Social Security Disability Blog

Heart Disease Case Study Posted

Are there any circumstances when an alcoholic or drug abuser might still qualify for disability?

You may be surprised to learn that the answer to this question is "yes."   If the alcoholic or drug user can prove that he/she has a mental or physical condition that leaves that claimant unable to work, and that this other condition exists independently of the alcohol or substance abuse, he/she can win.  In such a case, the claimant' s disability would remain even if substance abuse was absent from the picture.   Such a distinction can be difficult to prove, but it can be done, especially if the claimant has a long treatment record from a treating physician and that physician is prepared to go  on record drawing those lines.

Similarly, I have won a couple of cases on behalf of alcoholics who have severe liver disease arising from drinking.  In one case in particular, I remember seeing blood chemistry test results that clearly documented liver failure in an individual who continued to poison himself with alcohol despite the very negative health implications.

On the other hand, Social Security judges will look much more sympathetically on a case filed by an active alcoholic or drug abuser if the claimant is making a sincere effort to treat the addiction.

Post from: Social Security Disability Blog

Can an Alcoholic Ever Qualify for Disability?

Here is an example:  Tom applies for SSDI benefits in March, 2008, alleging an onset date of January 7, 2008.  Tom's case is denied administratively and he appears at a hearing in August, 2009 and the judge issues a favorable decision issued on September 2, 2009.

Tom will become eligible for SSDI benefits as of July, 2008.  This is because SSDI imposes a five month waiting period on payment of benefits.  January, 2008 does not count in this 5 month period because it is a partial month, so the waiting period includes February, March, April, May, and June, 2008.  Tom's eligibility, therefore, begins as of July, 2008.  His Medicare, however, does not kick in until July, 2010.  This is the 24 month Medicare delay.

Why is there a 24 month delay in starting Medicare?   According to a recent article in the Dallas-Ft. Worth News:

When Congress extended Medicare coverage to people with permanent disabilities in 1972, it also established the waiting period. Lawmakers added the wait to hold down the cost of the new government benefit, avoid overlapping with private insurance and make sure Medicare would be available only to people whose disabilities were long-lasting.

However, as a number of public interest groups point out, the private insurance landscape has changed significantly since 1972.   Far fewer disabled persons have coverage, meaning that disabled citizens who are deemed "disabled" by Social Security may have to forgo medical care and treatment for up to two years.

Of course, the primary obstacle in efforts to eliminate or reduce the 24 month waiting period is money. Eliminating the wait would cost the federal government $6.8 billion the first year and $110 billion through 2019, according to the Congressional Budget Office.  With record deficits already in place it seems unlikely that Congress will take steps to add to the shortfall.

In Social Security disability cases, therefore, your onset date is critically important because it will determine your eligibility for Medicare.  The further back in time you can push your onset the sooner you become eligible for Medicare.

Post from: Social Security Disability Blog

24 Month Waiting Period for Medicare Benefits in Approved SSDI Cases Causes Hardship