Monday, May 9, 2016

The 7th Circuit is Fired Up Over Abuses by the SSA

Over the past few years the 7th Circuit Court of Appeals has been issuing sternly worded opinions which are highly critical of the way that the SSA has been handling the disability claims process.  In this era of high denial rates, the opinions of this appellate court, particularly those from Justice Richard Posner, are a sign of hope.  It is not clear yet what immediate impact these opinions are having on the agency but sooner or later things are going to have to change.
Perhaps the most interesting aspect of these decisions is the tone used by the 7th Circuit judges. It is evident that the Court of Appeals is loosing its patience with the Social Security Administration and with the tactics used by many of the ALJ's assigned to hear disability cases. Judge Posner's disdain with the agency is evidenced by the fact that in some decisions he has begun to raise issues on his own without being asked to do so by plaintiff's counsel.  In addition, he has frequently warned the SSA of its repeated use of inadequate vocational expert testimony.  He seems to be so frustrated with the SSA that, at times, his tone has become sarcastic. For example, when a vocational expert testified that there are 1000 sedentary unskilled production worker jobs, 1000 sedentary unskilled information clerk jobs and 2000 sedentary cashier jobs in Wisconsin, Judge Posner said that these numbers "sounded like guesses".  He noted that 1000, 1000 and 2000 were "suspiciously round numbers".  In another case, when an ALJ found that a claimant could perform the supposed occupation of "addresser", Judge Posner question the existence of such a job.  Addresser was identified as a job where someone by hand or by typewriter addresses envelopes and cards. Judge Posner noted: "It's had to believe that, as the vocational expert testified in this case, there are 200,000 people in the United States for who this is a full-time job"... And does anyone use a typewriter anymore?"
In addition to frequently criticizing the SSA for inadequate use of vocational testimony, Judge Posner has also criticized the agency for giving too much weight to a claimant's ability to do home chores such as shopping or taking care of their children.  The 7th Circuit has repeatedly stated that equating house chores with employment tasks is a great misunderstanding because an employee cannot take breaks or ask friends and family for assistance at work.  The 7th Circuit has also been critical of ALJ decisions that find that a claimant is not disabled because he or she has not received constant medical care. The 7th Circuit has correctly explained that claimants usually don't have the money to afford medical services and that denying disability benefits for failure to obtain medical care is not always appropriate.  
Evidently its going to take a while before the SSA gets the message from the 7th Circuit.  As Social Security Disability denials continue to soar, I predict that the number of remands issued by the federal courts is also going to go up.  It is estimated that there were approximately 30,000 Social Security Disability cases remanded last year by the Federal Courts and the Appeals Council.  Eventually, other federal courts will join the 7th Circuit and become critical also of the way that the SSA is massively denying benefits to thousands of disabled Americans.  Its only a matter of time before other judges in the federal court system get fed up with avalanche of unfair disability denials that have begun to clog up their dockets.







Monday, May 2, 2016

May is Lupus Awareness Month!

Do you know that one out of four persons diagnosed with lupus receive disability payments?  As a Social Security Disability lawyer and long term disability lawyer, I urge all of my blog's readers to grab their purple and help advocate for lupus patients.

Lupus Awareness Month is celebrated yearly in May.  Spring is a great time to take action and help raise awareness about this terrible disease.  There are a number of events organized throughout the world and Connecticut.  Here is a list of the most important activities at the local level:

  • Tuesday May 3rd from 10:00 am to 12:00 pm is Lupus Advocacy day at the Connecticut State Capitol.  Educate our legislators about what is like to live with this terrible disease and ask them to take action.  
  • World Lupus Day is May 10th.  Its celebrated everywhere.  Watch the video message from the Global Ambassador for the Lupus Foundation of America Julian Lennon.
  • Join the Walk to End Lupus Now in West Hartford, Connecticut on Sunday, May 15th.  Contact info@lupus.org for information.
  • Put on Purple! Join raise awareness by wearing purple on Friday, May 20th.  Create a group and encourage your friends, family and coworkers to put on purple.  Also use social media to create awareness with the hashtag #PutOnPurple!
  • Join the Lupus Foundation of America Connecticut Chapter at their New Haven County Walk to End Lupus Now on Sunday, September 18th at beautiful Savin Rock Beach  located at 6 Rock Street, New Haven, Connecticut.

Monday, April 25, 2016

Social Security Will No Longer Provide CD's at Disability Hearings

Over past years, the Social Security Administration has provided attorneys with CD's with copies of their client's files.  Just a few days ago, the SSA announced that commencing August 18th it will stop this practice.  From now on, all attorneys must access their client's files electronically using the "Appointed Representative Service" (ARS).  I urge all lawyers who have not registered in the ARS to register as soon as possible.

Beginning August 18th, all Social Security Disability lawyers are going to have to download their clients' files into their own CD's or, download the files into their own laptops and bring the computers into the hearing room.  I'm looking forward to this change.  The current system used by the SSA is not working very well for me.  I find that very frequently the CD's provided to lawyers are not up to date or are broken.  Moreover, the desktop computers available at hearing rooms are awfully slow or freeze in the middle of the hearing.  I have been registered in the ARS for several years and really don't know why I have continued to rely of the CD's provided on the day of the hearing.  I should have started bringing my own laptop to the hearing rooms a long time ago.

I must confess that the only reason why I have not been bringing my own laptop into Social Security Disability hearings is that I don't like having to pass too many items through the metal detectors at Federal Buildings. Social Security hearings are held in Federal Buildings with very tight security and going through this airport type of routine is a real hassle.  

Practice Tip:

For those lawyers who are new to the ARS or are not very skilled using it, here is a great practice tip that I learned from the tech savvy staff at RamosLaw:  Download the client's file into a PDF document.  Use a PDF program that allows you to make bookmarks and comments on the file.  Take notes on the PDF document and flag important exhibits that you can easily refer to during the hearing.  This will enable you make quick references to Exhibits and medical records during your presentation without loosing your train of thought or getting sidetracked by the inability to find an exhibit. 


Monday, April 4, 2016

New Social Security Ruling Eliminates "Credibility" Findings - SSR 16-3p

On March 16, 2016, the SSA issued a new ruling that significantly changes the way that the agency makes disability determinations.  Social Security disability lawyers and their clients should take notice of this considerable change. SSR-16-3p, Evaluation of Symptoms in Disability Claims, supersedes SSR- 96-7p.  For a copy of  SSR 16-3p click here.  This ruling is effective immediately.
SSR 16-3p completely eliminates credibility findings from the adjudication process. Determining whether a claimant was credible or not used to be a central part of the decision process followed by administrative law judges (ALJ's).  Now, credibility cannot be a factor used by the ALJ to decide a case.  At this point, it is too early to tell exactly what effect this ruling will have.  One positive aspect of  SSR 16-3p is that, from now on, ALJ's can no longer put the claimant's character on trial.  Up until this ruling was issued, "character assassination" was frequently used to justify a denial of benefits.  For example, supposed prior bad acts by a claimant, such as a period of incarceration or getting fired from a job, was frequently cited as a reason for denying benefits.
Instead of making a credibility determination, the new ruling requires the ALJ to find out whether the claimant's allegations are "consistent" with the medical evidence and with the statements contained on the record.  If the ALJ finds that the claimant's allegations are not consistent, then the ALJ must explain the specific reasons why the allegations are not consistent.  General statements regarding the consistency of the allegations are not enough.  
One negative aspect of SSR 16-3p is that, from now on, ALJ's cannot make credibility findings based on a claimant's good work record.  On many occasions, I have successfully argued that the allegations of a claimant who has been a good worker, should be given full credibility.  Due to this new ruling, it is uncertain what, if any, importance will a claimant's work record have in the disability determination process.  

Monday, March 28, 2016

Study Suggests Changes to Representative Payee System

As a Social Security Disability Lawyer I have handled many cases in which the relatives of the disabled person have asked that a family member be appointed to manage the claimant's funds.  This request is usually made because the relatives feel that the claimant's disabling condition prevents him or her from adequately managing their benefits.  A person who is appointed to receive and manage the funds of a claimant is called "a representative payee". 
Unfortunately, there appears to be no clear cut rule used to appoint a representative payee.   For example, there are no effective guidelines used to determine whether a person can manage his or her funds or whether the third party being appointed is trustworthy and knowledgeable enough to do the job properly.  Just a few days ago, a study from the Institute of Medicine of the National Academies of Sciences, Engineering and Medicines raised concerns about the manner in which the Social Security Administration is handling the representative payee process.  (For a copy of the report click here.)  
At present time, approximately 3.5 million of the 16 million adults receiving SSDI benefits have a representative payee.  The report found that too few beneficiaries have a representative payee to ensure that funds are used properly.  Other problems were also identified, for example the report found that in some cases beneficiaries who receive both SSI and SSDI have a representative for one program but not the other.  Consequently, the study recommends that new rules be implemented by the Social Security Administration regarding the representative payee program. 

Monday, March 21, 2016

1st Circuit: LTD Denial Letters Must State Time Period to File Suit

Last week, the First Circuit Court of Appeals held that a plan administrator must include the time period for filing a lawsuit in its denial of benefits letter.  In Santana-Díaz v. Metro. Life Ins. Co., 2016 U.S. App. LEXIS 4670 (1st Cir. P.R. Mar. 14, 2016, a disability claimant failed to commence a legal action within the three year limitation period set forth in the long term disability policy.  The final termination of benefits letter sent to the claimant made him aware that he had the right to bring legal action but did not specify the time period to file the lawsuit.  The Court of Appeals held that Defendant MetLife's failure to state the specific time period in the letter violated the requirements of ERISA regulations.  (29 C.F.R. § 2560.503-1(g)(1)(iv)).
Furthermore, the Court held that due to MetLife's failure the comply with ERISA regulations, the three year limitation period was inapplicable to Mr. Santana-Diaz's claim.  The Court of Appeals was not persuaded by MetLife's argument that the plaintiff had received notice of the three year limitation period by receiving a copy of the disability policy.  The First Circuit's decision is consistent with opinions from the Third and Sixth Circuit Court of Appeals.  See Mirza v. Insurance Administrator of America, Inc., 800 F.3d 129 (3d Cir. 2015) and  Moyer v. Metropolitan Life Insurance Co., 762 F.3d 503 (6th Cir. 2014).
Interestingly, in the District of Connecticut, Judge Janet Bond Arterton appears to have issued a decision which is contrary to Santana-Diaz, Mirza and Moyer.  See Heimeshoff v. Hartford Life& Accident Ins. Co., 2012 U.S. Dist. LEXIS 6882, 2012 WL 171325 (D. Conn.Jan. 16, 2012).  (Note that Connecticut is within the Second Circuit Court of Appeals.)  Judge Arterton held that even though the Hartford failed to state in the denial letter that there was a three year limitation for filing a lawsuit, the limitation period applied because it was stated in the summary plan description documents. 

Monday, March 14, 2016

Social Security Presents "CARES" Initiative to Reduce Disability Case Backlog

The number of disability claimants waiting for a hearing before an Administrative Law Judge (ALJ) has now reached 1.1 million.  By the end of 2015, the average waiting time for a hearing was 512 days.  Just a few weeks ago, the SSA's Office of Disability Adjudication and Review (ODAR) unveiled a new plan to help alleviate this backlog.  The plan has been called "Compassionate And REsponsive Service (CARES).  If successful, the SSA believes that CARES will reduce average processing times to 270 days.
One major problem with CARES is that it will only be successful if Congress provides the SSA with the funding needed to implement it.  Nonetheless, even if CARES is implemented, the backlog will not be reduced in the near future.  It is expected the backlog will continue to climb in 2016.
Many a the initiatives of the CARES plan have been used before.  Here is a summary of some of the components of CARES:
  • Hire more ALJ's and ODAR staff.
  • Use Administrative Appeal Judges (AAJ's) instead of ALJ's to decide non-disability cases such as over payment appeals and claims involving retirees and survivors.
  • Expanding the teams of agency lawyers who pull cases from around the country to consider them for favorable on the record decisions.  
  • Have more pre-hearing conferences with senior attorneys from ODAR.
  • Provide "More Robust Case Screening" of cases that have a high probability of favorable decisions.  Apparently, under this part of the plan, cases will be sent back to DDS for additional review.  The SSA has given very few specifics about this part of the plan.
  •  Create more hearing office space, particularly for video hearings.   
  • Allow claimants to file electronic appeals to the Appeals Council. 
Of all the proposals made in the plan, the only one that will make a significant impact is the initiative to have more agency lawyers pull cases from around the country to consider them for fully favorable decisions.  This initiative worked well in the past but for reasons that are not entirely clear, it was discontinued.