Team mentality dominates Balin Law's case strategy in recent victories

It’s often said winning cases is a team effort, but that “team” includes more than attorneys.

“One thing we tend to focus on very heavily is the treating physician rule,” said Matt Shupe, associate attorney at Balin Law. This treating physician is often relied on to provide expert medical opinions and a detailed patient history for the disability claimant.

In order to award disability benefits to the claimant, judges are required to give deference to that claimant’s doctors, provided the opinions given are supported by objective medical findings and not inconsistent with other “substantial evidence” in the record.

The Social Security Administration (SSA) also employs its own physicians to provide medical opinions on a claimant, though these physicians may not have treated that claimant for nearly as long or as extensively as a primary care provider.

“Administrative Law Judges (ALJs) will give more weight to the opinions of SSA’s physicians to deny an individual,” Shupe said. “In doing so, the ALJ’s decision often doesn’t include all the limitations a claimant faces as opined by SSA’s physician’s report.” This discrepancy in an ALJ’s ruling can be frustrating for clients, treating physicians, and attorneys alike.

“That’s why Balin Law brings suit against the government in federal court, when appropriate,” Shupe said.“ In these instances, we have a district court judge entirely separate from the SSA that rule on whether an ALJ adequately followed the law. If we prevail, the case goes back to the SSA instructing them to apply the law properly.”

Recently, Balin Law has succeeded in litigating this very issue in three recently published decisions: Moretti v. Colvin, Matejka v. Commissioner of Social Security, and Hovater v. Colvin.

The claimant is then entitled to a new hearing, this time with the law applied properly. “More often than not, the ruling is to the tune of a different result,” Shupe said.

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!