This blog post is meant to address the concerns that SSD is not strict enough and to defend a system that helps millions of disabled people get by when they can no longer work. If you are disabled or have an illness that keeps you out of work, you may qualify for SSD, even under the current standards. Having a Social Security Disability lawyer on your side can help you meet SSD's definition of disability by presenting evidence of your disability and its impact on your daily life.
]]> Changes to SSDThere have certainly been changes to the SSD standards over the last few decades; however, as Jon Dubin and Robert Rains mention in their article for the American Constitution Society for Law and Policy, Scapegoating Social Security Disability Claimants, "Virtually every amendment to the Social Security Act in the past forty-five years and virtually every recent regulatory change, have rendered the substantive disability standards more strict." The only exceptions are parts - and only parts - of the 1984 Disability Benefits Reform Act.
For example, over the last four decades:
The great majority of people who receive SSD are seriously disabled. Many people who receive SSD die two years after they begin receiving benefits and some do not even see their first check. Furthermore, the majority of people who do not receive benefits are unable to return to work because of their disabilities and must simply go without those benefits, even if they have paid into the system.
Now is not the time to make SSD any tougher for individuals with legitimate claims.
Source: American Constitution Society for Law and Policy, v. 34, No. 3, "Scapegoating Social Security Disability Claimants," Jon C. Dubin & Robert E. Rains, Mar. 2012.
]]>The federal government has two primary reasons for making the switch from mailed Social Security disability benefit checks to electronic payments. First, there is more safety and efficiency in electronic payments. Benefits checks get lost or stolen quite frequently. Over 540,000 lost or stolen checks were reported in 2010. Electronic payments significantly reduce the potential for fraud or theft of personal information.
]]> The second reason is that sending benefits payments electronically will save the federal government roughly $120 million every year. According to the United States Treasury Department, the switch will result in a savings of $1 billion for Social Security over the next 10 years.In general, the switch from mailing paper checks to sending payments electronically should not make too many waves throughout the system. The federal government started the process of switching from checks to electronic payments last year when it began requiring new benefits enrollees to get their benefits payments electronically. Approximately 90 percent of all recipients of federal benefits get their payments delivered electronically already.
The people who would likely be most affected by the changeover are elderly benefits recipients who are unfamiliar with electronic payments or debit cards, or who do not have bank accounts. Therefore, people aged 90 or older are exempt from the change and can continue to receive paper checks. Others have the option of applying for a hardship waiver to keep receiving checks, but according to the Treasury Department, those will only be granted in "extreme, rare circumstances."
Source: Bloomberg Businessweek, "Don't wait for Social Security check in the mail," Stephen Ohlemacher, Apr. 15, 2012.
]]>While not everyone who applies for Social Security Disability benefits is eligible, the statement fails to recognize the serious disabilities and illnesses that millions of Americans face. In the Journal of Health Policy and Law, Professor Jerry Mashaw (quoted in "Scapegoating Social Disability Claimants" by Jon C. Dubin and Robert E. Rains) made the point clearly:
It is difficult to imagine that a person who can continue to work will instead leave
work to seek disability benefits that pay (on average) one-third of the mean wage,
require a six-month waiting period for application, a two-year waiting period for
medical benefits, and provide any benefit to fewer than one-half of those who
apply.
Most people who apply for SSDI would prefer to work. They face crippling disabilities and illnesses. They must go through an arduous approval process to receive the money they need to live outside of poverty (if they are able). They are only eligible for SSDI if they have worked a certain number of years in jobs that pay into Social Security. Very few people choose to go through this process to "rip off taxpayers," and those that do are rarely rewarded for their choice.
]]> Societal costs to denying legitimate SSD claimsAs Dubin and Rains explain, there are actually "significant societal costs" when legitimate applicants are denied Social Security Disability benefits. For example, the following increase when legitimate SSD claimants are denied:
"In addition," they say, "these costs also include the social malaise and frustration generated from a perception that the social contract has failed and that a government insurance system which most claimants have been required to pay into for decades on the promise of protection in the event of disability, has proven illusory."
The Social Security Disability program is a vital program for millions of Americans who cannot work due to disability or illness. There are very stringent disability guidelines and many eligible people must appeal their cases multiple times before they are approved. This means they must wait for months, oftentimes years, to receive the money they need to just get by.
Let's defend the SSD program, find effective - not damaging - ways to reduce the costs, and support those individuals who are forced to apply for SSD by events outside of their control.
Source: American Constitution Society for Law and Policy, v. 34, No. 3, "Scapegoating Social Security Disability Claimants," Jon C. Dubin & Robert E. Rains, Mar. 2012.
]]>Whether or not a Social Security Disability application is approved on appeal can depend, in part, on the administrative law judge hearing the case. Yet, the same can be said about the reconsideration process. According to an article by John C. Dubin and Robert E. Rains, New Hampshire's Disability Determination Services (DDS) granted 49.5 percent of all initial claims on reconsideration in 2010, while Mississippi's DDS only granted 24.9 percent of claims. Even when the Social Security Administration (SSA) decides reconsiderations, the number of approvals varies upon location (18.4 percent in Atlanta and 58.4 percent in New York).
]]> These numbers not only show the disparity but also reflect one important fact: state disability agencies feel pressured to deny claims and deny them frequently. Administrative Law Judges (ALJs) do not experience the same level of pressure.However, that lack of pressure does not mean that ALJs feel comfortable approving all SSD claims. In 2011, ALJ approval rates were at 58 percent, one of the lowest rates in a quarter century. Compare that to 72.3 percent in 1994.
Instead, ALJs are able to look more objectively at the facts of each case. They also usually have more facts (including medical evidence) to help them make their decisions than the agencies that handle reconsiderations. For example, administrative law judges can ask vocational experts and medical experts to testify at the hearings, giving them more information on which to make a decision. The state agencies, on the other hand, must usually rely on state medical advisors.
The administrative law judges also get the opportunity to speak with the claimants, which means that claimants are able to explain any ambiguities or clarify confusing parts of their application.
In sum, administrative law judges are an important part of the SSD process and are needlessly under attack. Their higher approval rates may merely reflect the greater level of information they have about an applicant's disability.
Source: American Constitution Society for Law and Policy, v. 34, No. 3, "Scapegoating Social Security Disability Claimants," Jon C. Dubin & Robert E. Rains, Mar. 2012.
]]>Yet, as we all know, the media does not always have all of the facts. Or, as an article by Jon C. Dubin and Robert E. Rains in the American Constitution Society for Law and Policy states, "the problem is misinterpreted."
Let's first consider the role of the administrative law judge.
]]> One Professor, Richard Pierce, has written an article for the Cato Institute where he states that SSA administrative law judges are approving more SSD cases because the standards are more subjective. He makes this assertion based on the new mental impairments and pain-related impairments. According to Pierce, not only are undeserving claimants receiving benefits, but the SSD system has become unconstitutional because the ALJs now have the authority to create policies.Yet, most SSD decisions in favor of applicants are made during the initial application and following reconsideration stages. These decisions are made by the SSA and, more often, state agencies - not by administrative law judges. In other words, ALJs represent fewer than 25 percent of the favorable decisions granted to SSD applicants.
Furthermore, the average SSD approval rating at the administrative hearing level is only 58 percent, a far cry from the 99 percent approval rating of the one judge who made news. In fact, many ALJs have approval ratings below 25 percent.
More on this next week, when we will speak about the difference between the impact of state agencies and the impact of ALJs on the SSD program.
Source: American Constitution Society for Law and Policy, v. 34, No. 3, "Scapegoating Social Security Disability Claimants," Jon C. Dubin & Robert E. Rains, Mar. 2012.
]]>Through the Disabled Military Child Protection Act of 2012, military retirees would be able to transfer benefits from a Survivor Benefit Plan to a special needs trust for their children. As the law currently stands, military service members are not able to establish a special needs trust for their disabled children, even though civilian retirees have that option.
]]> Instead, a retiree can put up to 55 percent of his or her monthly pay into a Survivor Benefit Plan. Unfortunately, the funds in these plans are considered income and can disqualify a special needs child from both SSD and Medicaid.Jim Moran is the father of a child with special needs. He stated, "I know how important it is for parents to be able to provide [special needs children] the best possible care."
Children on Social Security Disability
A child with a disability can receive Supplemental Security Income (SSI) payments if he or she meets income eligibility limits (he or she must not be earning more than $1,010 a month in 2012). He or she must also have a physical or mental condition that "results in marked and severe functional limitations" and the disability must last, or be expected to last, at least a year or be terminal.
An adult who has been disabled since childhood (before turning 22 years old) can receive Social Security Disability benefits if his or her parent receives Social Security retirement or disability benefits, or if his or her parent passed away after working a certain amount of time in a job that qualifies for Social Security. The adult applying for SSDI disabled adult "child benefits" must meet the SSA's definition of disability.
Source: Insurance News Net, "Moran Introduces Bill to Protect Disabled Military Children," Apr. 3, 2012.
]]>The Listing of Impairments includes the disorders and illnesses eligible for SSD as well as the standards that the SSA uses in determining whether an SSD applicant is disabled. If an applicant meets the criteria on the list, the SSA presumes he or she is disabled for SSD purposes. Generally, a person is eligible for SSD if he or she cannot work due to an impairment that is expected to last for at least a year or result in death.
]]> Musculoskeletal disorders are common conditions that involve pain in bones, muscles, joints or structures surrounding bones, muscles and joints. In fact, these conditions are so common that approximately one third of adults have some sort of musculoskeletal condition in the U.S.Simply having a musculoskeletal condition is not enough to qualify someone for Social Security Disability Insurance. Instead, the applicant must fall under the SSD's strict and somewhat complex definition of qualifying musculoskeletal disorders. The category of impairments listed in the SSA Listing of Impairments includes:
The SSA's public comment period may lead to changes in the Listing of Impairments, including additional impairments that could fall under into the musculoskeletal category.
Source: Social Security Online, Listing of Impairments, 1.00 Musculoskeletal System - Adult.
]]>A large portion of the testimony submitted for the hearing discussed what the Social Security Administration (SSA) has done to revise the Social Security Disability process, as well as the challenges it faces.
]]> Some of the principal points made on the SSA's challenges include:Unlike with previous hearings, the written testimony for this hearing did not go in depth about the disability applicants. Rather, the testimony reiterated that the Social Security definition of disability is strict and the SSDI program is both necessary and effective.
According to Lisa Ekman, "One in five male SSDI beneficiaries and one in seven female SSDI beneficiaries die within the first five years of receiving benefits." Furthermore, beneficiaries often remain poor while receiving SSDI - one in three people receiving SSDI live in households whose total income is below the federal poverty level.
There is a wide range of propaganda that points fingers at SSDI beneficiaries as the cause of the current "Social Security Disability crisis." Instead, as shown in the testimony for this hearing, the potential problems lie within the process itself, not with the SSDI applicants. And the SSA needs more funding, not less, to make improvements.
Source: Committee on Ways and Means, "Chairman Johnson Announces the Third in a Hearing Series on Securing the Future of the Social Security Disability Insurance Program," Mar. 20, 2012.
]]>What are some of the mistakes people make when they apply for Social Security Disability benefits? How can you avoid making those mistakes?
]]> Not defining your limitations: Many people do not spend enough time describing the limitations caused by their disabilities. They may say that they cannot walk, but that isn't enough to win an SSDI case. Instead, applicants should discuss their limitations in detail. How long can you stand up or sit down? How often do you have to readjust your position?Not enough medical evidence: This is perhaps the number one mistake that individuals make when applying for SSDI. The SSA's Bluebook lists a number of disabilities and illnesses that SSDI can cover. Unfortunately, simply showing that a doctor believes you have the disability or illness is not enough. Instead, you must be able to show the extent of your disability through medical records.
Changing addresses without notifying the SSA: Some people will move without letting the SSA know where they can be reached. If the SSA cannot find you, they will deny your application.
Not meeting the qualifications: Will your disability last more than one year or is it terminal? Have you stopped working? Are you unable to continue working? Did you work enough to pay into the Social Security system? Did you seek medical treatment consistently? If the answer is "no" to any of these questions, you will not qualify for SSDI.
Quitting: It can take up to two years to receive Social Security Disability Insurance benefits. That's a very long time for people who are suffering, especially when applicants may need to go through multiple stages of appeal. Don't give up. If you have a good case, it is worth fighting for financial relief.
Not hiring an attorney: While hiring an SSDI lawyer is not necessary, having an attorney on your side can help improve your chances of receiving SSDI. An SSDI lawyer can help you provide the right documentation of your illness / disability as well as meet the specific requirements required in this difficult process.
]]>In most situations, if you are eligible for SSI, you will be eligible for Medicaid. If you are eligible for Social Security Disability and receive SSD payments for two years, you will receive Medicare. In unique circumstances, you may be eligible for both SSI and SSDI. In those cases, it is less clear whether you will receive Medicaid and/or Medicare.
]]> There are also exceptions. For example, under the Employment for Disabled Americans Act of 1986, adult children who were disabled before they reached 22 years old may continue to receive Medicaid when they switch from SSI to SSDI. Of course, if those children receive income from other sources than their SSDI, they may lose their eligibility for Medicaid.As you can see, the interplay of Medicaid, Medicare, SSDI and SSI is complicated. We recommend speaking with an experienced benefits lawyer to better understand your options.
Medicaid and SSI: Medicaid is a federal-and-state health insurance program available for low income individuals. In most states, if you are eligible for Supplemental Security Income (SSI) benefits, you are eligible for Medicaid. However, in Minnesota, there are separate eligibility rules for Medicaid (called medical assistance or "MA") and you must file a separate application.
Generally, individuals are eligible for Medical Assistance and SSI if they are state residents with little income and assets who are 65 years of age or older, blind or disabled.
Medicare and Social Security Disability: Social Security Disability is available to individuals who have worked Social Security-eligible jobs and who fall under the Social Security Administration's definition of disability. Individuals are eligible if they are not able to do the work they did before and will be unable to adjust to another job due to their condition. The disability must also last for at least one year or be terminal.
The Social Security Administration automatically enrolls individuals in Medicare coverage after they have received disability benefits for at least two years. Medicare covers hospital insurance as well as medical insurance.
Source: Social Security Administration, "Medicare Coverage if You're Disabled."
]]>How do you report SSDI on your income tax return, especially if you received a lump sum payment from the Social Security Administration (SSA)?
]]> Do You Owe Taxes on Your SSDI Benefits?First, it is important to note that many people who receive SSDI do not owe taxes because the average annual income for SSDI recipients is less than $13,000.
According to the SSA, approximately one third of SSDI beneficiaries pay taxes on their benefits. This includes individuals making more than $25,000 (SSDI plus other income sources) and spouses whose combined income is greater than $32,000.
The SSA may send you Form SSA-1099. If you do not receive this form and would like to know if your SSDI benefits are taxable, you should request it from the SSA.
Reporting Lump Sum Payments
Many people mistakenly report their entire lump sum SSDI payments as income on their tax returns, which can cause them to pay much more in taxes. Instead, recipients of lump-sum payments can spread those payments over prior tax years, and they can do this through this year's tax return.
Even if your SSDI benefits are not considered taxable income, you should still file your tax return. Depending on your other sources of income, you may be able to receive a tax refund and take advantage of other credits available, such as the Earned Income Tax Credit.
Source: Social Security Administration, "About Your Benefits: Paying Taxes on Your Benefits," 2011.
]]>One editorial in USA Today states that there has been a 20 percent jump in the number of Social Security Disability recipients in the last five years, increasing from 8.9 million in 2007 to 10.7 million today. According to the article, Social Security "was never meant to be a continuation of unemployment benefits."
What these articles don't address is the fact that many applicants for SSDI have real disabilities and have spent years working despite the constant struggle with their disabilities. When those individuals were laid off from their jobs during the Great Recession, many were unable to obtain new jobs that supported their disabilities. They finally applied for the benefits to which they have been entitled for months, even years.
]]> Furthermore, the news stories do not capture the full reasoning for the rise in SSD applicants. Applications have increased in large part due to changes in social trends. For example, there are more female workers and older workers than ever before.As the opposing view to the USA Today editorial states, Social Security Disability "is a time-honored expression of our nation's commitment to help care for those who must stop working due to illness or injury. . . . We should work on fixing the problems and not join the current rush to condemn an entire system because of rare instances of abuse or mounting political pressures to cut federal spending."
Social Security Disability is more difficult to obtain today than it has ever been before. The standards are tougher, applicants must provide more medical evidence of their disabilities, and there are multiple appeals that many applicants must go through before they receive disability.
Do we want to make an already difficult process more difficult for the millions of people suffering from serious illness and disabilities? Perhaps now is the time to show compassion, not disdain, for this group of people - most of whom would rather be working than collecting SSDI checks.
Source: USA Today, "Opposing view: Disability benefits remains a vital lifeline," Charles Martin, Feb. 2, 2012.
]]>The Administrative Conference of the United States will conduct the review, focusing on approximately 1,500 administrative law judges (ALJs). The Conference will likely offer recommendations to the SSA in November of this year.
Administrative law judges are part of the Social Security Disability appeals process. Once SSD applicants reach this stage of the process, they have already been denied Social Security Disability benefits twice. Applicants appear before ALJs for hearings that usually take about an hour. Some hearings will take less time, depending on the evidence provided to the ALJ.
]]> The average approval rating for Social Security Disability cases before ALJs is only 60 percent. However, that average can vary depending on the ALJ. According to the Wall Street Journal, one ALJ approved nearly 99 percent of SSDI applicants while another only approved 13 percent. Approximately 100 judges award benefits more than 85 percent of the time.Some ALJs have claimed that the large backlog of SSD applicants waiting appeal (more than 770,000) and the SSA's focus on decreasing this backlog has led to the disparity. Some ALJs take less time to review SSD cases before them, which also means they do not thoroughly analyze each case.
Another reason cited for this vast difference in approval rates is the wide discretion that Social Security ALJs have in deciding cases. The ALJs are appointed for life. They are required to look at each case on its own merits and based on the SSDI requirements. However, determining whether someone is "disabled enough" to receive SSDI is often subjective.
Many people are wary of the high approval rates of some ALJs. However, the discrepancy in approval rates is at issue in the study, not simply the fact that some ALJs have higher approval rates than others. In fact, federal courts overturn more than half of all ALJ denials that come before them on appeal.
We will await the results of the study and the recommendations to find out what impact they will have on the SSA disability process.
Source: The Wall Street Journal, "Disability - Benefits System Faces Review," Damian Paletta, Dec. 15, 2011.
]]>The woman's Social Security Disability case was typical, especially among sufferers of Fibromyalgia who seek SSD. It included:
There are multiple stages in an SSD case. While some people are granted SSD based on their initial application (35 percent), many more are denied. After an initial denial, applicants can ask for reconsideration, then a hearing in front of an administrative law judge, then an appeal with the SSA. If none of these steps lead to approval, applicants can choose to take the case to federal court.
As seen in the Pioneer Press article, the support of an advocate can go a long way. Having an experienced Midwest disability lawyer on your side may also increase your chances of receiving an approval earlier on in the process.
Source: Pioneer Press, "Watchdog: When Social Security Says 'No,'" Debra O'Connor, Dec. 21, 2011.
]]>Compassionate Allowances Program
The Compassionate Allowances program is a system of fast-tracking applications for disability benefits by those who are obviously disabled. The SSA has identified a list of conditions that meet the SSA's definition of disability. If a person applying for disability benefits is affected by a condition on the list of Compassionate Allowances, advanced information technology equipment will flag the application and put it into an expedited review process.
]]> In the expedited review, the Disability Determination team requires much less supporting medical evidence to make a determination on an application. The team can make a decision in a matter of weeks, rather than the months that it normally takes.With the addition of the newest 13 conditions, the list of Compassionate Allowance conditions has reached 113.
New Compassionate Allowance Conditions
The new conditions that the SSA added to the Compassionate Allowances list are:
Applying for Social Security disability benefits can be a complicated process. If you are disabled and unable to work, talk to an experienced Social Security attorney who can help you navigate the disability benefit application maze.
Source: Social Security Administration, "Social Security Expands Compassionate Allowances Conditions," Oct. 13, 2011.
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