Tools of the Trade for Disability Representatives

With so much technology now on-hand for so many different aspects of our daily lives, it should come as no surprise that it plays a heavy roll in the work of Social Security disability representatives. SSA has made several tools available online that help them closely monitor and develop your disability claim.

Electronic Records Express (“ERE”)

This program can be used by anyone who is going through, or helping someone go through, a disability claim. If you have a computer and a scanner, you can submit medical records and other correspondence directly to SSA through this designated website.

The ERE website accepts medical records, representative correspondence, claimant correspondence, school records, representative briefs, requests for hearing postponement or change in location, address changes, and forms SSA sends to claimants for completion, which often include their own barcode that must be used.

During all stages of claim adjudication, a disability claimant is issued a paper barcode. This is placed on top of whatever document you are scanning to submit. On the barcode itself are codes you would type where prompted on the website. Once you submit the information, it is received by SSA immediately and exhibited in your exhibit file. You also get a confirmation you can print out and keep with your submission.

Electronic Folders

In the past, attorneys relied on paper exhibit files that must be copied from a claimant’s master file kept by Social Security. Your exhibit file contains your entire procedural history, notes made by SSA employees regarding your claim, your correspondence with SSA, and your medical records. Paper files were time-consuming (and paper-consuming!) to obtain, and if there was a problem with SSA’s copy machine, you were out of luck until it was repaired.

Later, SSA began sending representatives exhibit files on CD’s that could be opened on a computer. These were troublesome, however. If the SSA employee who made the disc did not do it correctly, it will not open and a new disc would have to be requested. Sometimes SSA would mail the discs and the representative would never receive it – very troublesome when you are dealing with an impending hearing.

Today, your exhibit file can be obtained by your representative through another dedicated website, Appointed Representative Services. Once requested, the file is ready for viewing within 48 hours. It can be downloaded for easy viewing into PDF form, so your representative can view your entire file on a computer or tablet. If your representative has Adobe Pro, he or she can also make electronic notes on the exhibit file. Now instead of lugging a big paper file to court (which can sometimes be over 1,000 pages), your representative can bring up particular exhibits with ease in the courtroom.

Hearing Office and Appeals Council Status Reports

Instead of calling the hearing offices or the Appeals Council of Social Security to check the status of your claim, your representative can now download a report that tells him or her exactly what is going on with your claim.

Hearing office reports can tell the representative what Administrative Law Judge (ALJ) is assigned to your case, if a hearing has been scheduled yet, where it will take place, and how close the ALJ is to issuing a decision after a hearing is held.

Since the Appeals Council can take anywhere from 15 to 18 months to review an ALJ’s decision, the Appeals Council Status Reports are particularly helpful. These can tell a representative is an analyst has been assigned, if the case is being worked up, or if a decision has been made. 

The great thing about these tools is, by making the more mundane tasks of developing a disability claim easier, your representative can dedicate greater time to the real meat of your case. Our office staff in particular is well-versed in these tools that SSA offers, and we look forward to continuing to serve our clients in the most efficient capacity possible!

Written by Anna Westfall

Help is just right around the corner! We are conveniently located in Mentor, Cleveland, Akron, Canton, Lorain Youngstown, Toledo and Ashtabula. Click HERE for more information!

No Insurance? No Problem!

In order to prove disability, SSA must have access to your medical records. However, many claimants find themselves in a position where, due to the loss of employment, they do not have sufficient insurance coverage and/or funds to see their doctors and generate those much-needed medical records. 

There are other options, however. It may take some persistence, but when it comes to proving disability, finding some type of medical treatment is critical if a claimant wants to prevail and obtain the benefits they need to survive.

Hospital Rating Systems

In the Cleveland area, hospitals like MetroHealth Medical Center have a rating system for patients who cannot afford care. MetroHealth’s website states that they will provide certain basic medically necessary hospital services, as long as the patient is a resident of the state of Ohio, is not currently receiving Medicaid, and meets Federal Poverty Guidelines in regards to income. The hospital also covers other services for Ohioans who are at or below 400 percent of the Federal Poverty Level.

Many major hospitals have similar programs for low income families and adults. Contact your local hospital and ask to speak with the financial assistance department to find out if they offer this type of help.

Free Clinics

Most major cities also have area free clinics that offer many basic services for free or very low cost. Free clinics are typically funded by local donations and are often staffed by student doctors. Most free clinics offer acute, non-emergent care. Some offer on-going preventative care and even dental care. Free clinics are open to anyone who lacks insurance, and/or do not qualify for Medicare or Medicaid.

If you are unsure if there is a free clinic in your area, visit http://www.needymeds.org/free_clinics.taf , which lists free clinics by state.

The Health Department

Similar to free clinics, your local health department may offer either basic low-cost or free medical care. Here in Cleveland, the health department boasts three wellness clinics that offer access to free vaccinations for children, free lead screenings, pregnancy tests, TB tests, family planning and HIV testing. 

The phone number to your local health department can usually be found in the phone book, and most government agencies have websites online explaining the services they provide as well as their contact information.

The Drug Store

It has become a recent trend for drug stores, such as Walgreens and CVS, to start offering some basic services right within their store. Most of these mini-clinics can diagnose, treat, and write prescriptions for common family illnesses, provide routine vaccinations and lab tests, as well as treat minor wounds, abrasions and sprains (minuteclinic.com). 

Most services for people without insurance cost under $100.00, and the clinics are staffed by certified nurse practitioners. Check out the costs and services CVS offers here. See what Walgreens has to offer by clicking here.

No matter where you decide to treat, it is a great favor you do for yourself to have the conditions that disable you not only properly treated, but well-documented by a healthcare professional. This is how SSA sees what’s really going on in your disability claim. If you require further assistance seeking treatment in relation to your disability claim, contact us today to find out how we can help.

 Written by Anna Westfall

We do whatever it takes to win your case!! If you live near Akron, Canton, Youngstown, Lorain, Toledo, Cleveland, Ashtabula or Mentor (or even if you don't!), contact us today to find out how we can help you!

So, How is SSA Doing?

There has been a lot of press lately regarding the financial health of the Social Security Administration. On May 31st, 2013, SSA issued a press release stating that the combined assets of the Old-Age and Survivors Insurance, and Disability Insurance Trust Funds are projected to become depleted in 2033, with 77 percent of benefits still payable at that time. The Disability Insurance Trust Fund will become depleted in 2016, with 80 percent of benefits still payable.

Obviously this is worrisome to just about all of us – those of us currently collecting benefits and dependent on that income, as well as those of us who may need to rely on receiving some type of benefit in the future.

Polls have been conducted throughout the general populous to get an idea of what Americans think of the SSA’s current financial state and what should be done about it. Selzer & Company conducted the Bloomberg National Poll between February 15th and 18th of 2013 and asked 1,003 adults several questions pertaining to what they thought about the current health of SSA. One question asks, “How certain are you that Social Security will be there if you need it in retirement?” The Americans polled were almost 50/50 on this one: 39% of people polled said SSA will probably be there, while 30% responded it probably won’t be there. A smaller percentage of Americans responded that it will definitely be there – 15% - while a similar number of Americans said SSA will definitely not be there – 13%. A small percentage – 3% - remained unsure.

Interestingly, even though most Americans polled believed SSA would either probably or definitely be there when they needed it; most Americans polled also believed a major overhaul would be necessary to reduce the deficit the agency faces. While 39% of Americans polled stated that it was not necessary, 51% felt it was needed while 10% remained unsure.

Another question asks, “Do you favor or oppose reducing the cost-of-living adjustment that automatically increases the amount of benefits Social Security pays out to help the program remain financially secure?” Americans polled responded with an overwhelming 64% that they would favor this reduction.

With the new data that was released in May, it would be interesting to know whether the opinions of those polled have changed. One factor that is not disclosed in this poll, and would be interesting to note, is whether any of these Americans polled are already receiving benefits? A dependence on the income Social Security provides would surely color the opinion of a person giving these answers. A major overhaul may be warranted, and the cost-of-living increase may require some adjusting, but at what cost? In 2012, an estimated 57 million people received over $775 billion dollars of benefits. That’s a lot of people and a lot of money. It may be enough for some to live comfortably, but not nearly enough for others to scrape by. According to ssa.gov, the average monthly benefit is $1,269.00.

It begs the question of who would be affected by what choice? If a major overhaul is executed, will anyone suffer? On the other hand, if it is not done, will the suffering come down on us all? This problem could potentially be avoided by moving funds from the Old-Age and Survivors Insurance fund to the Disability Insurance Trust fund. SSA has done this many times in the past as the amount of disabled workers vs. retired workers has waxed and waned. If Congress has known that this problem was approaching, why wouldn’t they take this proactive step? Without this transfer, only 80% of benefits will be payable to disability recipients. With many disabled people already on tight budgets, how will this decrease affect them?

This is an important question the decision-makers at SSA must strongly consider for the well-being of this country and its people. Thousands of people – our friends, family member and coworkers - have been saved from destitute poverty and even death by the receipt of much-needed Social Security benefits. Let us, as the American people, who either now depend or may come to depend on programs such as these, continue to let our voices be heard so the choice that is made is in the best interest of us all.

Written by Anna Westfall & edited by Attorney Andrew November


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H.R. 1502 and Your Disability Benefits

Bob, 55 years old, has severe arthritis. He has been working the same job as a machinist for the last 20 years. Due to the economy, Bob is laid off from his job. Since he is still in need of income to care for himself and his wife, Judy, he applies for unemployment benefits while he looks for other work. 

As the months go by, and Bob finds his arthritis seems to be getting worse. He has a harder time getting around and doing simple things like opening jars. After a visit with his doctor, the doctor tells Bob that perhaps he should consider filing for disability. Bob’s doctor is concerned that he would have a hard time going back to work as a machinist.

This puts Bob in an unusual situation. Bob wants to go back to work, but no one is calling him in response to his job applications, and his doctor warns if he goes back to strenuous work such as a machinist he may not be able to perform like he used to.

So, what is Bob supposed to do?

Fortunately, Bob can apply for disability while he is receiving his unemployment benefits and still seeking work. However, Congress might be putting and end to this option soon.

The purpose of H.R. 1502 is “to amend title II of the Social Security Act to prevent the concurrent receipt of unemployment benefits and Social Security disability insurance, and for other purposes.” Also known as the “Double Dip Elimination Act,” should this bill become law, it will prevent people like Bob from collecting disability benefits for any month in which he was receiving unemployment.  

Those months in which a person is collecting unemployment would be considered the same as engaging in substantial gainful activity (SGA), a term used by SSA to describe a certain monthly amount earned by working. The current SGA amount for non-blind individuals is $1,040.00. 

This basically means that people like Bob may have to choose either one route (collecting unemployment and seeking work) or the other (seeking disability). If someone in Bob’s position does collect unemployment while seeking disability, any months in which unemployment was received will disqualify him from any disability benefits he may be entitled to for those months. 

This is particularly disheartening when you take into consideration the amount of past-due medical bills most disability claimants are faced with. Many awarded-claimants rely on their back-benefits to catch up on these bills, as well as the mortgage, credit card bills and auto loans.

A memorandum released by the Social Security Administration to Regional Chief Judges on November 15^th, 2006, references Supreme Court case Cleveland v. Policy Management Systems Corp and states:

 “The Court noted that, under the presumptions embodied in our five-step sequential evaluation process, a person can qualify for Social Security disability benefits even though he or she remains capable of performing some work. Similar logic applies to applications for unemployment benefits.

“In addition, it is often uncertain whether we will find a person who applies for unemployment benefits ultimately to be disabled under our rules, and our decision-making process can be quite lengthy. Therefore, it is SSA’s position that individuals need not choose between applying for unemployment insurance and Social Security disability benefits.”

While it can be argued that collecting unemployment benefits while telling the government you can’t work is contradictory, there are exceptions to the rule, such as in Bob’s case.

The ultimate purpose of H.R. 1502, according to Representative Johnson, Chairman of the Ways and Means Committee, is to save our country $1 billion over the course of ten years. This may be the case, but at what cost to the individual benefit claimant? We still have a chance to tell Congress what we think of this bill. Write to your Congressman today and voice your opinion on H.R. 1502 before it is voted into law.

Written by Anna Westfall

Are you feeling overwhelmed by information such as this while your disability claim is pending? Our knowledgeable staff will put your mind at ease. Chances are we are located in your hometown: Cleveland, Akron, Canton, Youngstown, Toledo, Lorain, Mentor and Ashtabula. Learn more by clicking here, and send us an email so we can start helping you TODAY!

“You WILL Get Through This!” 10 Inspirational Quotes For People Struggling with Disability

“When you focus on someone's disability you'll overlook their abilities, beauty and uniqueness. Once you learn to accept and love them for who they are, you subconsciously learn to love yourself unconditionally.”
-- Yvonne Pierre

“I am conscious of a soul-sense that lifts me above the narrow, cramping circumstances of my life. My physical limitations are forgotten- my world lies upward, the length and the breadth and the sweep of the heavens are mine!”
-- Helen Keller

“The worst disability in life is a bad attitude.”
-- SupaNova Slom

"It is a waste of time to be angry about my disability. One has to get on with life and I haven't done badly. People won't have time for you if you are always angry or complaining." –
-- Stephen Hawking

“The world has a fast-growing problematic disability, which forges bonds in families, causes people to communicate in direct and clear ways, cuts down meaningless social interaction, pushes people to the limit with learning about themselves, whilst making them work together to make a better world. It’s called Autism – and I can’t see anything wrong with it, can you? Boy I’m glad I also have this disability!”
-- Patrick Jasper Lee

“One's dignity may be assaulted, vandalized and cruelly mocked, but cannot be taken away unless it is surrendered.”
-- Michael J. Fox

“Just because a man lacks the use of his eyes doesn't mean he lacks vision.”
-- Stevie Wonder

"We know that equality of individual ability has never existed and never will, but we do insist that equality of opportunity still must be sought."
-- Franklin D. Roosevelt

“We, the one's who are challenged, need to be heard. To be seen not as a disability, but as a person who has, and will continue to bloom. To be seen not only as a handicap, but as a well intact human being.”
-- Robert M. Hensel

“Hold my hand and walk with me.

We must break the back of social inequity;

We must empower every individual with a disability

To live with dignity in an inclusive society.”

-- William E. Lightbourne

Compiled by Anna Westfall

You don't have to struggle alone! If you are disabled and fighting for your benefits, we can help. We are located in your hometown: Cleveland, Akron, Canton, Youngstown, Toledo, Mentor, Lorain and Ashtabula. Call or email us today by clicking here!

The Consequences of Failure to Follow Prescribed Treatment

If you are currently in the process of a Social Security disability claim, you probably understand how important it is to receive medical treatment and generate medical records for disability adjudicators to review. However, the truth is what is contained within those records is what’s really important.

According to SSR-82-59, the failure to follow treatment prescribed to you by your doctor could result in the prevention of benefits being payable to you, or cessation of benefits should you already be receiving them. The ruling states:

“Individuals with a disabling impairment which is amenable to treatment that could be expected to restore their ability to work must follow the prescribed treatment to be found under a disability, unless there is justifiable cause for the failure to follow such treatment.”

In order to identify a failure to follow treatment, all of the following conditions must exist:

1.       The evidence establishes  that the individual’s impairment precludes engaging in any substantial gainful activity (SGA) or, in the case of a disabled widow(er) that the impairment meets or equals the Listing of Impairments in Appendix 1 of Regulations No. 4 Subpart P; and

2.       The impairment has lasted or is expected to last for 12 continuous months from onset of disability or is expected to result in death; and

3.       Treatment which is clearly expected to restore capacity to engage in any SGA (or gainful activity, as appropriate) has been prescribed by a treating source, and

4.       The evidence of record discloses that there has been a refusal to follow prescribed treatment.

Once the “failure” is identified, SSA must then determine whether or not the failure is justifiable.

First, SSA must determine if the prescribed treatment was recommended by a physician who is actually attending to the claimant’s medical needs. In other words, this person cannot be a consultative examiner seen on one occasion. Hospitals, clinics or other medical facilities where the claimant goes for medical care are also considered treating sources.

Next, SSA must consider whether or not the prescribed treatment is expected to restore the claimant’s ability to go back to work. If it is not, then the issue of failure to follow prescribed treatment is dropped. However, if a treatment exists that SSA believes may restore the claimant’s ability to go back to work, but said treatment has not been prescribed by a treating source, SSA may refer that individual to Vocational Rehabilitation Services.

Once the issue of failure to follow prescribed treatment is identified, the claimant is then allowed an opportunity to explain the failure. The claimant should be asked if he or she understands the implications of the treatment prescribed, as well as the implications of failure to do so. The claimant should also be made aware by SSA the reason for this questioning and the possible consequences. 

Of course, a claimant could have very good reasons for not following prescribed treatment. Some justifiable reasons identified by SSA are as follows:

-          Acceptance of prescribed treatment would be contrary to the teachings and tenets of the claimant’s religion.

-          Cataract extraction for one eye is prescribed but the loss of visual efficiency in the other eye is severe and cannot be corrected through treatment.

-          Intense and unrelenting fear of surgery. However, SSA may require this be documented by the treating source who recommended the surgery.

-          The individual is unable to afford prescribed treatment which he or she is willing to accept, but for which free community resources are unavailable.

-          Any duly licensed treating medical source who has treated the claimant advises against the treatment prescribed for the currently disabling condition.

-          The claimant is presently unable to work because of a condition for which major surgery was performed with unsuccessful results, and additional major surgery is prescribed for the same impairment.

-          The treatment carries a high degree of risk because of the enormity or unusual nature of the procedure.

-          The treatment recommended involves amputation of an extremity.

The issue of failure to follow prescribed treatment is a complicated yet important one. Our blog covered only a few very important points. If you are in a position where you feel you might be under this type of scrutiny, it is advisable to seek the counsel of a disability attorney.

Written by Anna Westfall

Source: http://www.socialsecurity.gov/OP_Home/rulings/di/02/SSR82-59-di-02.html


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Utilize Your Resources! What You Can Do While Waiting for Disability

When a person becomes too disabled to work, he still needs a place to live and food to eat. While waiting for the disability adjudication process, saved funds can run out fast. So, if you can’t work, how else can a person survive? When tough times get tougher, there are a many resources in your community you can utilize.

What Can I Do About Food?

The most obvious answer is to apply for food stamps through your county’s Department of Job & Family Services, now known as SNAP (Supplemental Nutrition Assistance Program). However, there are also other programs that ODJFS touts on their website that are just as helpful and less well-known, such as the EBT Farmer’s Market Demonstration Project. This allows SNAP recipients access to fresh, locally-grown foods.

Food banks are also in abundance in most metropolitan areas.  They are typically run by local non-profit organizations or churches that operate off of donations and volunteering. In our area is the well-known Cleveland Food Bank. Since 1979, this organization had fed millions of families, and recently won an award from the organization Feeding America for outstanding SNAP outreach efforts.

How Can I Keep My Home?

Most metropolitan areas are also home to organizations that can help you keep your home. If you can no longer make your mortgage payment, there are organizations that will work as liaisons between you and your mortgage company to make your payments affordable. ESOP is an organization in the Cleveland area that specializes in helping people that are victims of predatory lending and cannot afford their mortgages.

If you rent, don’t be afraid to approach your landlord about your situation. He or she may be able to work something out with you, but if not, you can also turn to the U.S. Department of Housing and Urban Development (HUD) for assistance. A HUD counselor can help you find an apartment you can afford in subsidized or Section 8 Housing.

If your home has already been foreclosed or if you have been evicted from the residence you rented, there are organizations that will help you secure a new place to live. In Cleveland, Maximum Accessible Housing of Ohio (MAHO) specializes in helping disabled people find safe, affordable and clean housing.

What About Other Needs?

There are a countless number of charitable organizations who do various things. Perhaps you are unable to take your children on trips or participate in other fun activities with them. Non-profit organizations such as Open Doors Academy can provide fun, educational opportunities for your child as well as mentorship. 

Perhaps you need an outlet for your frustrations, but cannot afford to enjoy the hobbies that you love. Organizations such as Art Therapy Studio in Cleveland can give you that outlet as well as help you learn more about yourself.

Churches are wonderful places not only for food pantries, but other charitable drives as well. Don’t be shy about contacting your local church to see what programs they provide. They may run clothing drives, or toy drives at Christmastime so your children can still enjoy receiving gifts from Santa Claus.

Never Give Up!

While waiting for your disability claim to be processed, it is easy to become overwhelmed, frustrated, or depressed about your situation. Never give up! With a little bit of conviction and plenty of resources at your fingertips, you WILL get through this tough time.

At Paulette F. Balin & Associates, we will help put your mind at ease by dealing directing with SSA regarding your disability claim. We will make sure all of the pertinent medical evidence is received and that your claim flows as smoothly as possible for you. Call us today to see how we can help!

Written by Anna Westfall

Please note that Paulette F. Balin & Associates does not specifically endorse any of the organizations named in this blog. They are intended to be examples of the different types of help you may be able to receive.