Puerto Rico Needs Your Help! The SSA Must Consider Accepting More On the Record Requests from Puerto Rico

I must take a break from my weekly Social Security Lawyer postings and ask all of my readers to donate generously to the people of Puerto Rico. The Island is going through a terrible humanitarian crisis in the wake of Hurricane Maria. Below, I will provide a list of some charitable organizations that are collecting funds for the victims of the disaster. 

In the next few days, I also would like to contact my Social Security Lawyer colleagues at the National level to see if we can lobby the Social Security Administration to consider accepting more on the record requests (OTR's) from the victims of Hurricane Maria. I believe that the disaster will increase the case backlog in Puerto Rico and that holding in-person hearings is going to be extremely difficult.  

Here is a list of organizations seeking donations for Puerto Rico:

Fondos Unidos de Puerto Rico
P.O. Box 191914
San Juan, PR 00919
tel: (787) 728-8500
fax: (787) 728-7099
http://www.fondosunidos.org/

Caritas Puerto Rico
201 Calle San Jorge
Esquina Baldorioty de Castro
San Juan, Puerto Rico 00902
P.O. Box 8812, San Juan, Puerto Rico 00910-0812
787 300-4953
www.caritas.pr

Fundación Comunitaria de Puerto Rico
1719 Ave. Ponce de León
San Juan, PR 00909-1905
787-721-1037
https://www.fcpr.org/

Hurricane Maria Children's Relief Fund
Save the Children
501 Kings Highway East, Suite 400,
Fairfield, CT 06825
https://secure.savethechildren.org/site/c.8rKLIXMGIpI4E/b.9535647/k.A2B9/Hurricane_Maria_Childrens_Relief_Fund/apps/ka/sd/donor.asp

Maria & Irma: Puerto Rico Real-time Recovery Fund
ConPRmetidos
1511 Ave. Ponce de León Suite K, La Ciudadela
San Juan P.R. 00909
Phone:787-773-1100
https://www.generosity.com/emergencies-fundraising/maria-irma-puerto-rico-real-time-recovery-fund

New Social Security Ruling Regarding Sickle Cell Disease (SSR 17-3p)

Some Social Security Rulings (SSR's) can be of great assistance to Social Security Disability Lawyers when they encounter a case with a medical condition that is frequently misunderstood or difficult to understand.  This is the case with SSR 15-1p, which deals with interstitial cystitis, and SSR 12-2p, which deals with fibromyalgia. 

Just last week, the Social Security Administration (SSA) published a new ruling regarding sickle cell disease (SSR 17-3p)  For a copy of this new ruling click here.  This ruling gives social adjudicators and judges important background information on sickle cell disease and sets forth how cases involving this condition should be evaluated.  Hopefully this ruling will provide a more consistency in the decision making process.

Sickle cell is the most common inherited blood disease in the U.S..  It is believed that approximately 100,000 Americans have sickle cell disease.  Despite its prevalence, this condition is not always easy to evaluate due to its many different manifestations and complications.  

One of the important aspects of SSR 17-3p is that it instructs adjudicators to evaluate sickle cell disease under the following hematological disorder listing: 7.05, 7.17 and 7.18.  The new ruling also recognizes that sickle cell can impose exertional as well as non-exertional limitations on a claimant. For example, a person with sickle cell may have pain, fatigue and shortness of breath.  The condition may also cause difficulty in maintaining concentration or have difficulty completing tasks due to pain acute pain crises.

The Social Security Administration has indicated that the effective date of this ruling is September 15, 2017, and that the SSR will apply to new applications filed on or after September 15, 2017.  This means that SSA will use this ruling on and after 9/15/17 in any case in which SSA makes a determination or decision. SSA expects that Federal courts will review SSA’s final decisions using the rules that were in effect at the time SSA issued the decisions. If a court reverses SSA’s final decision and remands a case for further administrative proceedings, SSA will apply this SSR to the entire period at issue in the decision it make after the court's remand.

RamosLaw's Long Term Disability Lawyer Video Reaches 18K Views

At RamosLaw, we believe that disability lawyers should take full advantage of social media to inform and educate the community that they serve. 

Social media has given lawyers a platform to reach communities that historically have had very little access to legal representation.  In the past, disabled individuals who were denied coverage by disability insurers such as Cigna, MetLife, Unum, the Hartford and many others, didn't know who to turn to when their benefits were denied or stopped.  Many of them would go unrepresented and some didn't know how to, --or simply couldn't--, advocate for themselves.  Disability insurers were aware of this, and took advantage of claimants who were unrepresented or were represented by lawyers who didn't have any experience working in ERISA cases.  

Now, thanks to the availability of information on the web, disability claimants have much more information available to them.  Moreover, they know that there are lawyers throughout the Nation that can represent them without any up front legal fees.

These are just some of the reasons why our office's video has has had so many views on YouTube. Please take a look at our video, comment, like it and share it:

   

For more information regarding our practice please visit www.LongTermDisabilityAppeals.com

Social Security Failed to Send Due Process Notifications

Last week, Social Security issued a message advising its lawyers and staff that due to an apparent gross error it had failed to notify claimants and beneficiaries of certain adverse decisions, such as denial and cessation of disability benefits notice letters.  For a copy of the "Emergency Message" click here.  According to the message, it looks as if the error in sending the notices happened between September 2016 and March 2017.

As stated in a previous post, a claimant generally has 60 days to file an appeal when he or she receives a letter from social security stating that benefits have been denied. If the claimant misses the 60 day appeal period it can only file a late appeal for good cause.

According the Emergency Message, the SSA failed to send notices in all or some of the following situations:

• Cessation of benefits letters telling the beneficiary that he or she was no longer disabled. 
• Denial of initial applications filed by disability claimants. 
• Letters informing a beneficiary that there has been an over payment of benefits. 
• Letters informing a claimant that there has been a change on the onset date of disability. 

Due to the failure to send these notices many beneficiaries have no idea that their benefits have been stopped or denied. Moreover, they have no idea that they have a right to appeal these adverse decisions.

In addition, the Emergency Message tells the SSA staff: "If the beneficiary alleges he or she did not receive a notice during the relevant period, technicians should take the allegations seriously, carefully review the case and provide due process as required by existing regulations and agency policy." Given the wording on the message, if any claimant did not receive notice of a denial or cessation of benefits, he or she would clearly have a strong argument of "good cause" to file a late appeal. 

Unfortunately, the Emergency Message does not state whether or not the claimant and beneficiaries who didn't receive notices will receive a belated letter informing them of their right to appeal. At RamosLaw we believe that sending new notices would be the right thing for Commissioner Berryhill to do. We will keep our readers informed if we receive any new information regarding this issue.

At RamosLaw, we have seen a lot of problems regarding the SSA's failure to provide claimants with notice letters. We weren't sure if this was a Connecticut and Massachusetts problem or whether this was an agency-wide error. We are glad that at least the agency is acknowledging that it has widespread problems with regards to the issuance of notices.

New Bureaucratic Realignment at Social Security

Not even the most experienced Social Security Lawyers are able to comprehend what is going on with the latest plans to reorganize the Social Security Administration.  A few weeks ago, in the midst of an astronomical backlog of cases and rock bottom morale among her employees, Social Security Commissioner Nancy Berryhill announced a series of pointless bureaucratic changes aimed at creating a false illusion of progress.  

The changes create a series of new acronyms: The Office of Disability Adjudication and Review (ODAR) will now be the Office of Hearings Operations (OHO).  There will be a newly created office called the Office of Analytics, Review, and Oversight (OARO).  In addition to this new organizational changes, the Office of Budget, Finance, Quality, and Management will now be the Office of Budget, Finance, and Management (OBFM).  Thanks Commissioner for making the Social Security alphabet soup even thicker!  Just what more than one million disabled Americans, who are waiting for a hearing, needed.

From what it seems so far, it looks like the hearing offices (ODAR which now will be OHO) will no longer be under the same umbrella as the Appeals Council (AC).  Exactly what effect this change will have in the appeals process is not yet clear.  We will keep you posted on what effect this changes will have as more details are revealed in the next few months.

How to Find Out if You Have Enough Work Credits to Apply for SSDI

Many potential disability applicants call a Social Security Law Firm to find out if they have enough work credits to be eligible for SSDI benefits. However, since Social Security Lawyers do not have access to your Social Security work history prior to assuming legal representation on your case, a lawyer in not the right person to call to find out this information.  Instead, the best way to find out this information is by contacting the Social Security Administration.

The amount of work credits a person needs to be eligible for Social Security Disability is proportionate to the person’s age. For example, a person who is 50 would need 28 work credits, and a person who is 62 or older would need 40 work credits. In general, younger applicants are expected to have less work experience.  Therefore, more credits are required as person gets older.

A person earns work credits from earning an income subject to the FICA tax. FICA is a payroll tax that all workers must pay. Under-the-table income does not count towards earning work credits. For each $1,300 a person makes, they receive one work credit, and a person can earn up to four work credits per year.

Before applying for SSDI, you need to know how many work credits you have earned. If you know how many work credits you have, you can potentially save the time and effort of completing an application and then finding out that you arebeing denied benefits due to lack of credits. To find out how many work credits you have, you can get your Social Security statement online at:

http://ssa.gov/mystatement/

Social Security information is confidential, and lawyers do not have access to information about a person’s work credits. For this reason, it is important to get your Social Security statement on your own before contacting a lawyer. 

If you do not have enough Social Security work credits to be eligible for SSDI, you can still apply for Supplemental Security Income, or “SSI”. SSI, unlike SSDI, is based off of demonstrated financial need. If you are unsure about whether or not you can receive SSI or SSDI, please call our office to discuss your best options.

Good Cause to File a Late Social Security Appeal

After being notified of a Social Security decision, a claimant has 60 days to file an appeal. If this deadline is missed, the claimant usually has to make an entirely new Social Security claim, but in some cases claimants are allowed to file late appeals.

The SSA will decide if a claimant has a “good cause” for filing a late appeal. “Good” causes include circumstances that prevent a claimant from filing an appeal on time, whether or not the claimant understood what needed to be done, whether or not SSA or CMS misled the claimant, and whether there was a physical, mental, educational, or language limitation that kept the claimant from filing a timely appeal.

Examples of “good causes” for the SSA to accept a late appeal include:

• If you were very sick when the appeal was due and you could not have contacted Social Security yourself or through anyone else. You will need to show that you were seriously ill; otherwise Social Security will find that you could have submitted the appeal paperwork on time or asked someone to do it for you.
• If there was a death or serious illness in your immediate family.
• If records that you needed for the appeal were destroyed by a fire or other accident. You will need to show that the records were destroyed close in time to the appeal deadline and that they were important to your meeting the deadline. For example, if your house burned down the week before your deadline and your denial notice was inside the house, you would have a strong argument that you had good cause for missing the deadline.
• If you were actively looking for evidence to support your claim but failed to ask for an extension of time before the deadline passed.
• If you or your lawyer asked Social Security for more information about its denial before the appeal deadline passed. You would have 60 days after Social Security gave you the additional information to file for reconsideration or for a hearing.
• If Social Security or CMS gave you incorrect or confusing information about appealing your claim.
• If you did not understand that you were required to file an appeal by the deadline or you were not able to appeal because of a physical or mental problem.
• If you did not receive a denial notice. You will need proof that you never got the notice. For example, if Social Security mailed the notice to the wrong address, and you had notified them of the right address, then they might find good cause for your late appeal.
• If you sent your appeal to another government agency within the time limit because you misunderstood that the appeal needed to be sent to Social Security, and the other agency did not forward your request until after the deadline.
• If there were any other unusual or unavoidable circumstances, and you could not reasonably be expected to have met the deadline.

Social Security has published these examples of “good causes” to file late appeals, but this list is not exhaustive. If you believe you have a good cause for filing a late appeal to your SSI or SSDI decision but it isn’t on the list, Social Security may still accept it. The later an appeal is filed, the less likely it is that Social Security will accept it.

To make a late appeal, you must attach a written document with the reason for the late submission to the appeal form. Social Security is obligated to consider your late appeal request, but has the right to deny the request if they find there is no good cause. Even if the request is denied, Social Security may consider the date you made a late appeal request as a protective filing date for the next time you apply for benefits.