CBS News reports this morning that the House Oversight and Government Reform Committee will begin hearings on Thursday, June 27 about the role of administrative law judges in awarding benefits.
Critics of the current disability system point to SSA’s own statistics which show that judges currently approve slightly more than half of the claims brought before them (this is down from a 60% approval rate in 2010). Claims approved at hearings were previously rejected twice by state employees called adjudicators.
Critics also claim that too many judges are approving undeserving cases simply to clear out growing backlogs – the judges complain of quotas – which may delay a hearing date for longer than 12 months.
Others contend that long term unemployed workers claim disability when their unemployment benefits run out [1. This was the premise of a controversial NPR report entitled Unfit for Work: the Startling Rise of Disability in America – see my video about this story here.] Continue reading →
Social Security disability programs are running out of money. As such Social Security executives are looking for ways to reduce the outflow of dollars.
One effort has been to tighten up eligibility standards. Claimant’s representatives throughout the country are reporting that ALJ approval rates are down. When cases are approved, judges are including directives in their decisions for SSA to review approved the approved claimant for medical improvement in one year or three years.
SSA has increased and will continue to increase the number of continuing disability reviews for approved claimants. For years, the CDR program was basically ignored by Social Security – as a result only a very tiny percentage of approved claimants were ever removed from the payment rolls and there was no inquiry into improved medical status. This is changing and I am starting to receive calls from my old clients asking about these continuing reviews. Continue reading →
How should you prepare for a Continuing Disability Review (CDR) or notice of proposed termination? It depends on how vulnerable you are to losing. I received the following question from one of my readers:
I received a letter from SSA saying that they are reviewing my current SSDI benefit and possible to end my benefits due to substantial work between 2004 and now. I would like to have your advisement how I should handle this and what options I can do to keep my SSDI benefits. I only have Medicare insurance and living with AIDS. Also, I am deaf.
My response: Social Security is saying that you engaged in “substantial activity” from 2004 to the present. “Substantial activity” is a term of art and refers to activity that is work or work like activity. Substantial activity can be work for pay, volunteer work, school or other similar activites.
In a CDR context, Social Security is most likely looking at your earnings record. As you know, when you work your employer files copies of all W-2’s and 1099’s generated on behalf of employees. If you were working and your employer was withholding taxes as the law requires there is a written record of your earnings.
I have posted a table on this blog setting out what you can earn and still fall below SGA (substantial gainful activity). Social Security will look at your earnings month by month to calculate how many months you exceeded SGA. You could, in theory, could be asked to repay SSA for each month that you received earnings over SGA and also collected SSDI. Continue reading →
There is no such thing as the “perfect” case. Even the most deserving claimants may end up with a doctor who they don’t like or with whom they do not get along. This is especially true in “pain” cases when narcotic medicines may be prescribed. There are also doctors out there who do not believe in the concept of disability – as far as they are concerned no one is fully disabled and these doctors will not cooperate with a Social Security claimant at all (needless to say, it is helpful if you discover this trait in your treating doctors early enough in your case to find another doctor!).
What about unhelpful medical records? I see this frequently in cases where there was a workers’ compensation case. “Company doctors” often minimize symptoms and generate records indicating that a claimant has the capacity to return to work. Other times I see unhelpful records in cases where my client just did not “click” with his or her physician or psychiatrist.
One of my blog readers wrote me to ask about his obligation to submit unhelpful records in the context of a continuing disability review:
I have been on SSI for 8 years for mental illness. One recently former psychologist would say I was never disabled while my psychiatrist, and my new psychiatrist (the present one is moving) say I am disabled. Continue reading →
In my practice I do not see very many continuing disability review (CDR) cases. If you are not familiar with this term, a “continuing disability review” involves a review by Social Security as to whether an approved claimant remains disabled. For example, there are some medical conditions that can and do improve over time and with treatment. I have been involved in many cases – especially those in which the claimant is in his 20’s or 30’s – when the judge specifically includes in his decision that a particular claimant should be reviewed in 1 year, or perhaps 3 years.
In theory, every Social Security disability case will be subject to a CDR. In reality, because of the current backlog, I rarely hear from my clients that their cases are being reviewed. The few cases that do seem to end up in a CDR typically involve younger claimants.
I am not usually called upon to handle CDR cases because Continue reading →
I don’t get a lot of questions about “continuing disability reviews” (CDR). Here is one that raises an important issue. For those not familiar with the term, a CDR is the process by which Social Security evaluates approved claimants to confirm that they still meet the requirements for disability under Social Security’s rules.
Sometimes, judges will specifically provide for a review in 12 months. The official Social Security disability web sites provides that all cases are to be reviewed every 36 months (although it has been my observation that the 36 month reviews have been performed at random). Although I have not seen any regulations to this effect, I suspect that the cases which are reviewed may be ones where improvement might be most likely. For example, if your approval is based on a condition that could be corrected by (invasive) surgery, your case might be flagged for review.
You should also understand that disability attorneys like me rarely get involved in CDR cases. Why? Continue reading →