Create an Account and View Your Benefits Online

SSA continues its foray into the digital age by making it easier for Americans to view their personal SSA information online. When you visit http://www.ssa.gov/mystatement/, you can create an online account that will allow you view the following:

1.       Estimates of the retirement and disability benefits you may receive;

2.       Estimates of the benefits your family may collect if you become disabled or die;

3.       The earnings you have accumulated over your lifetime according to SSA’s records; and

4.       The taxes you have paid into Social Security and Medicare

This information is very important to review to assure its accuracy. It is advisable to check your personal SSA information periodically to make sure your earnings are posted correctly, and report any errors to SSA promptly. Failure to do so can result in issues in the future when you attempt to collect disability or retirement benefits. You may also print this information for your paper records.

Since 1999, Americans have relied on receiving the familiar green and white SSA statements that would be mailed to their homes once per year. These forms would often be misplaced or sometimes not received at all. Now that the information can be viewed online, anytime, it is easier, more convenient, and surprisingly more secure.

Americans will also have easy access to important information that may answer some of their common questions related to collecting disability or retirement benefits. Along with the personal information, your account also includes:

1.       Information about qualifying and signing up for Medicare;

2.       Things to consider for Americans age 55 and older who are considering retiring;

3.       General information about Social Security for everyone; and

4.       The opportunity to apply online for retirement and disability benefits*

Creating an account is as easy as creating any other online account. SSA will ask for personal information including your name and Social Security number to match you up with their records. You will then create a user name and password and also be asked to set up security questions to protect your account further. SSA has also contracted the credit reporting bureau, Experian, to provide additional verification. You may sign in to view this information as often as you wish.

There are some exceptions to the online rule, however. Beginning in February of this year, SSA resumed mailing paper statements to people aged 60 and older until they begin to draw retirement benefits. Younger workers will receive one paper statement when they turn age 25. If your identifying information does not match SSA’s records when you try to create an account, you may request having a paper statement mailed to you. You may also take a physical piece of identifying information to your local field office to have them set up an online account for you, should you run into difficulties online.

This is another exciting step SSA has taken in regard to its strategic plan for the 2013-2016 fiscal year. With more and more services going online and becoming available to the public, it will be interesting to see what SSA has planned to do next.

*= SSD applications only. SSI applications must be made in-person at a local field office.

Written by Anna Westfall & Attorney Andrew November

We are located in Mentor, Cleveland, Ashtabula, Akron, Canton, Youngstown, Lorain and Toledo for your convenience. Learn more about our firm by clicking here!

What is Considered a Critical Case?

When a person has to file a claim for disability benefits, that alone can constitute a difficult situation in that person’s life. However, due to several other factors that may come in to play in an individual’s claim, that difficult situation can become a critical one.

For SSA, a Critical Case is considered such if one or more of the following is true:

1.       The claimant’s illness is terminal (“TERI case”);

2.       The case involves a disability claim for any military service personnel injured October 1^st, 2001 or later, regardless of how the disability occurred and where;

3.       The claimant’s file is flagged as a Compassionate Allowance case;

4.       The claimant is without, and is unable to obtain, food, medicine or shelter (“dire need”); and

5.       There is an indication that the claimant is suicidal or homicidal.

Critical Cases are identified either by the Regional Chief Administrative Law Judge or Regional Management Officer in the regional office, or by the Chief Administrative Law Judge at a local hearing office. It is the responsibility of all regional and hearing office employees to bring possible critical cases to the attention of these officials so they are expedited.

TERI Cases

TERI (short for “Terminally ill”) cases are flagged when the impairments the claimant suffers from will inevitably result in death. This does not necessarily mean the claimant is deemed disabled, however. The claim will still be subject to the sequential evaluation process, but because time is of the essence in TERI cases, it is given priority to be evaluated as soon as possible. Disability adjudicators refer to POMS DI1105.601 in order to properly flag TERI cases.

Military Service Casualty Case (MSCC)

This applies to an active-duty military service member who is injured on or after October 1^st, 2001, regardless of how the disability occurred. It also does not matter where the disability occurred, whether it was in the United States or on foreign soil. These cases are processed in the same way as TERI cases, but are not classified as TERI unless there is the presence of a terminal illness.

Compassionate Allowance

A case in which a claimant suffers from a disease or condition previously determined as a Compassionate Allowance case (CAL). This must be identified with the help of objective medical evidence. A CAL case can be identified at any stage of the disability process when the claimant is found to have an enumerated disease or medical condition.

Dire Need

SSA defines a dire need situation as one that exists when a person has insufficient income or resources to meet an immediate threat to health or safety, such as the lack of food, clothing, shelter or medical care. The claimant must provide proof of a specific dire need situation, such as shut off notices from utility companies or an eviction/foreclosure notice.  It is also important to remember that SSA will investigate the claim of a dire need situation to determine whether expediting is warranted. Because many disability claims can be considered “dire,” designating all cases as critical under the dire need criteria would “defeat the effectiveness of any priority plan for the processing of the most serious claims” (Hallex I-2-1-40). Although SSA is instructed to err on the side of expediting vs. not expediting, it is important to remember that a claim in a dire need situation may not always be expedited.

Suicidal/Homicidal

If a claimant threatens suicide or homicide, the Office of the Regional Commissioner within the claimant’s jurisdiction must be notified immediately. According to HALLEX I-2-1-37, even though a threat of suicide or homicide is typically an extreme cry for help, each instance of a threat must be handled quickly and carefully, as not to cause harm to the claimant or any other individual. It must be determined whether the threat is imminent, and SSA has procedures in place to handle these situations, whether they are in-person or over the phone.

What Happens Next?

Once a Critical Case is identified, SSA employees refer to work up instructions outlined in HALLEX I-2-1-5. The case will then be evaluated to determine whether an On-The-Record (OTR) decision is possible. If an OTR decision is not deemed appropriate, the case is then expedited for pre-hearing development and scheduling.

Critical Cases are given the first available open hearing slots when they are ready to be heard by an ALJ. If there is a cancellation of another hearing, Critical Cases are given priority to take the opening. However, if the opening is in 20 days or less, the claimant and/or his representative must agree to waive the right to the 20-day advance notice in order to be given the open slot. After the hearing, the hearing office will also expedite the issuing and writing of the decision.

While waiting for a decision on a disability claim can be difficult for a claimant, it is heartening to know that SSA understands that some situations simply cannot wait for the long process. By being cognizant of the most critical cases and expediting the claims with care, SSA is helping our citizenry by identifying the most drastic situations and allowing those claimants to have their day in court as early as possible. 

Written by Anna Westfall & Attorney Andrew November


Please visit Paulette F Balin & Associates online by clicking here! We are located in Mentor, Cleveland, Ashtabula, Akron, Canton, Lorain and Toledo for your convenience.

Malingering: Why SSA Must Proceed With Caution

Malingering is defined as pretending or exaggerating incapacity or illness as to avoid duty or work (http://www.merriam-webster.com/dictionary/malingering). People may malinger for a variety of secondary gain motives, which may include financial compensation, avoiding work, school or military service, obtaining prescription drugs, or simply to attract attention or sympathy.  Malingering presents a problem for SSA when it comes to determining disability, however, SSA must be careful about how possible malingering is investigated.

In the past, ALJs had the option to order tests from Disability Determination Services (DDS) to determine whether a claimant is malingering. The most widely-used tests were the Test of Memory Malingering (TOMM) and the Rey Memory Test.

The TOMM is a 50 item visual recognition test. It is specifically tailored to be sensitive to malingering while at the same time, insensitive to a wide range of neurological impairments, such as traumatic brain injury and dementia. The test consists of two learning trials and an optional retention trial. The results are based on two cut-off scores: below chance and criteria based on head-injured and cognitively impaired individuals. The examiner uses the TOMM manual to evaluate the results.

The Rey Memory test was devised by Andre Rey. It consists of the examiner showing the claimant a page of items for 10 seconds and instructing them to memorize 15 items. After the page is taken away, the claimant would then be asked to re-produce as many of the items as possible either immediately or after a short delay.

Beginning January of 2012, SSA ordered DDS to deny ALJ requests for malingering tests. This is an important step for claimants and their representatives, due to the fact that these tests were entirely too subjective. A claim would be completely denied by the ALJ if the state examiner conducting the TOMM or Rey Memory Test felt the claimant was malingering based on the test results. There is no set “gold standard” for malingering that can be used across the board, making the use of these tests unfair. In the audit report Consultative Exams at the Indiana Disability Determination Bureau, the Inspector General stated: “[y]ou cannot prove malingering with tests; there is no test that, when passed or failed, conclusively determines the presence of inaccurate patient self-report. Even a high likelihood of malingering does not preclude severe limitations resulting from a genuine MDI (Medically Determined Impairment).” (please see http://oig.ssa.gov/sites/default/files/audit/full/pdf/A-05-10-21061.pdf for the complete audit report)

While it is important for SSA to discover a malingering claimant as quickly as possible, this cannot be done with one Consultative Exam alone. The combination of medical records, observations of the claimant, as well as any consultative exams, is what SSA should be looking to in order to evaluate malingering.

Written by Anna Westfall & Attorney Andrew November


We are located in Mentor, Ashtabula, Cleveland, Akron, Canton, Youngstown, Lorain and Toledo to serve you! Please click here to visit our website for more information!

SSA's Role in the Wounded Warrior Project

In order to help expedite claims for our military service members who have become disabled while serving our country, SSA became part of the Wounded Warrior Project. The mission statement of the Wounded Warrior Project is “To Honor and Empower Wounded Warriors.” The Project will achieve this by:

-          Raising awareness and enlisting the public’s aid for the needs of injured service members

-          Help injured service members aid and assist each other

-          Providing unique, direct programs and services to meet the need of injured service members

One such program is the Wounded Warrior Initiative provided by SSA. This is an expedited process used for military service members who became disabled while on active military duty on or after October 1^st, 2001, regardless of where the disability occured.

It is a wide misconception that if a service member receives military pay and is on active duty that this would disqualify him or her from receiving SSA benefits. SSA encourages service members to apply for benefits as soon as they become disabled to see if they qualify. While working and earning over SGA (Substantial Gainful Activity, currently $1,010 for 2012) may disqualify a non-service applicant, for a Wounded Warrior applicant the actual work activity is the controlling factor in deciding disability and not the amount of pay received or military duty status.

Disabled service members are encouraged to apply for benefits as soon as possible. This can be done either in person, by phone, mail or online by visiting www.socialsecurity.gov/woundedwarriors. The service member will be asked to provide his or her original birth certificate, Form DD 214 if discharged from service, W-2 form or income tax return from last year, proof of military pay or worker’s compensation, Social Security numbers of minor children and spouse (if applicable), contact information for a third party if you are unavailable, and any medical records you have or that you can easily obtain from all military and civilian sources.

Once the application is made and the claim is identified as being a military service member claim, the process will be expedited through all phases of processing, both at Social Security and Disability Determination Services.

Service members who are awarded retroactive Social Security benefits may also become entitled to Medicare Part A for months before they receive the disability award notice. Effective October 2009, TRICARE beneficiaries who are awarded retroactive benefits do not have to enroll in Part B for those months in the past and can keep their TRICARE coverage as long as they enroll in Part B currently. Service members need to contact the Department of Defense to find out whether they need to enroll in Medicare Part B in order to keep TRICARE coverage. For more information about TRICARE and recent changes to the law, please visit www.socialsecurity.gov/legislation/tricareinfo.html.

A service member may remain on active duty while receiving disability benefits, however, it is important that the service member contacts Social Security right away if there is a change in:

-          Military Occupational Specialty Code (MOS)

-          Air Force Specialty Codes (AFSC)

-          Navy Enlisted Classification (NEC) or

-          Permanent Change of Station (PCS)

To SSA, these are potential indicators that a service member may be returning to work. If a service member does wish to return to full-time employment, he or she is encouraged to use the Benefits Planning Query, which allows the service member to check the status of benefits, work history, health insurance and more. A copy of the Benefits Planning Query can be downloaded from SSA’s website,  http://www.socialsecurity.gov/.

The Wounded Warriors Initiative is an exciting advancement in regards to how SSA is making the disability determination process more efficient and effective. Not only that, but our military service members will get the respect and treatment they deserve after giving so much for us and our country.

Written by Anna Westfall & Attorney Andrew November

We are conveniently located in Mentor, Cleveland, Ashtabula, Akron, Canton, Youngstown, Lorain and Toledo to serve the disabled of north east Ohio. Please visit us online for more information by clicking here!