SSI candidates turn to Balin Law, MetroHealth for help

We understand people sometimes find themselves in difficult situations – financially, physically, emotionally or otherwise. It’s our privilege to advocate for them. People who are disabled and have limited resources but not enough of a work history to qualify for Social Security Disability Insurance (SSDI) may qualify for Supplemental Security Income (SSI). The Social Security Administration site is a great resource for SSI information, like this SSI overview page and this page on resources the administration considers when applying for SSI.

 “If you have too much in assets, you don’t qualify for this program which is an additional hurdle,” said Andrew November, associate attorney at Balin Law. “With SSDI, you just have to be disabled.” Some assets, like the home you live in or the land it’s on, grants, and personal effects aren’t counted as a resource, but items like cash, stocks, or “deemed resources” are taken into account during the approval process. “There’s a ‘deeming chart’ that’s used,” said November. “The SSA uses mathematical formulas based on the size of the house and the source of the income for children and from spouse-to-spouse.”

Separate from the assets portion of a case is a client’s access to medical care. “It’s always a large concern,” associate attorney Matthew Shupe said of Balin’s clients. “That involves a lot of education from our staff and attorneys regarding what our clients’ options are for subsidized or free physical and mental healthcare in their area, be that through Medicaid or a financial means-based charity program through various hospital systems in the area.”

With the expansion of Medicaid in Ohio only occurring in January 2013, many of Balin’s clients have turned to the MetroHealth System for health care. “This is the only treatment option for a lot of people,” November said. MetroHealth’s financial assistance program helps patients pay for health care costs, while their shuttle service allows patients to be transported to and from various MetroHealth locations.“ Having limited resources means limited access to medical care,” November said. It doesn’t mean you have limited access to us. Balin Law is here to help – click here for our contact information and call today.

MetroHealth Phone Numbers

Transportation Service - 216-778-5258
Financial Assistance - 216-957-2325
Switchboard - 216-778-7800

For a complete list of MetroHealth contact information, click here.

Partnerships with VA, healthcare providers and veteran facilities critical to Balin's success

Over the past several years, Balin Law owner Paulette Balin presented at various healthcare providers and veteran facilities, ensuring the firm works closely with nurse practitioners, case workers and veterans themselves to build critical relationships that better serve clients and their cases.

“It’s so satisfying to see these health care providers that treat our clients so engaged and interested in what we do in the same way we’re so indebted to veterans and their services,” said Matt Shupe, associate attorney at Balin. “It’s crystal clear how committed they are to their patients.”

Shupe and his team share the same commitment to clients, using every tool at their disposal and exhausting every resource to hopefully earn a win on their clients’ behalf.

“Over-prepare for everything,” Shupe said of Balin’s winning strategy. “Spend more time than it takes. You need to know the case better than the client, the judge and, any experts combined. If you can convey that that is your level of knowledge, it builds confidence in yourself and in the client, too.”

With veteran disability cases, Balin’s attorneys also seek out narrative statements from an individuals’ treating physician citing any physical limitations that support the clients’ claim and the physicians’ own treatment notes.”

Even with all those tools, representation for disabled veterans is newer territory.

When Andrew November, a litigation attorney at Balin, started at the firm in 2009 he found very few attorneys in the state of Ohio even represented veterans.

“The backlog and volume for these veterans to get representation was incredibly frustrating,” November said. “Using our experience as disability attorneys, we thought it would be a natural transition to start representing veterans.”

The VA hasn’t had the high level of development that programs like Social Security have, making partnerships between firms and the VA challenging. This is largely attributed to most employees’ inexperience working with attorneys and the sheer amount of cases they're asked to address daily.

“The VA regional office in Cleveland Ohio handles all claims for the state of Ohio,” November said.“Compare that to the abundance of Social Security offices that are used to breaking up the case load, working with attorneys and supplying documents to us.”

Still, Balin hasn’t let the challenges in working with the VA dissuade them from working to build a meaningful and collaborative partnership.

“What our firm decided to do was learn as much as we can about the law now,” November said. “If we continue to make ourselves known to the VA, we can be better known for representing our country’s veterans on a larger scale."

Balin meets challenges facing disabled veterans head-on

Following the May resignation of Erik Shinseki, former head of the Department of Veterans Affairs, some wondered how such a broken health care system that left thousands of veterans in the dust could even be repaired.

Answers may take time to find, but the flaws in the VA are more apparent than ever.

“We see delays at every point of the appeals process right now for veterans applying for service-connected disability,” said Matt Shupe, associate attorney at Balin Law. This compensation program provides a tax free monetary benefit paid to veterans with disabilities that are the result of a disease or injury incurred or aggravated during active military service.

Compensation may also be paid for post-service disabilities that are considered related or secondary to disabilities occurring in service and for disabilities presumed to be related to circumstances of military service, even though they may arise after service.

The primary difficulty representing veterans for Balin is the backlog of cases before the Department of Veterans Affairs. With already longstanding delays faced by veterans claiming service-connected disabilities, the culmination of two major and recent conflicts is only adding to the wait time every veteran and their representative must face.

“There’s an enormous backlog,” Shupe said. “It’s very overwhelming to them as it is to all our clients.”

When a veteran approaches Balin Law for assistance, they have already waited for a determination on their claim and have been denied. This is because attorneys are prohibited from receiving a fee for representing veterans in service-disconnected disability compensation cases until the veteran has been denied at least once. As a result, veterans must often navigate an extremely complex field of law without the assistance of a licensed attorney for months or years.

Balin Law uses every tool at its disposal and exhausts every resource to ensure the veteran is in the best position possible when the time comes to have their case adjudicated.

“The key is to over-prepare for everything,” Shupe said of Balin’s winning strategy. “Spend more time than it takes. You need to know the case better than the client, the judge and, any expert combined. If you can convey that that is your level of knowledge, it builds confidence in yourself and in the client, too.”

Balin’s winning strategy pays off

Disability in America
The increased prevalence of disability in the U.S. today cannot be overstated. According to the Social Security Administration, disability claims in 2013 totaled 2,640,100 – nearly twice as many as in 2000.

“We’re faced with a time when the baby boomer generation has been aging out,” said Matt Shupe, associate attorney at Balin Law. “Those who have performed manual labor in particular, their bodies tend to start wearing out from 54 onwards. They have a great deal of pride in their work, but also a great deal of fear with what they can do in their fifties until they meet the qualifications for SSDI.”

Complicating that fear is the constant attack on federal disability programs, which are often – mistakenly – listed as entitlements.

“The SSDI program is just an insurance policy,” he said. “These individuals are paying a premium on this policy, which comes in the form of FICA taxes taken out of paychecks.”

With SSDI claims, Balin provides clients with a questionnaire to fill out then files the application online. This saves valuable time and gives relief to clients knowing the application process is seamless.

Even after an application is filed, there can be a lengthy approval process due to the increase in baby boomers, the recent fiscal crisis and the diminished number of hours federal employees have to process these claims.

“We’re talking a year or two – or more – in particular cases, especially when issues are more mental than physical,” Shupe said. “It's easy to look at an injury and say, ‘This femur has been rebuilt.’ It’s a very different evaluation process for mental disabilities.”

Thankfully, Balin’s standard of excellence and history of winning cases sets the bar for ensuring this process goes as smoothly and painlessly as possible.

Balin’s winning strategy

“We take the hard cases,” Shupe said. “A lot of firms would look at a client and say, ‘This person’s in their thirties, sporadic work history, criminal record, or issues with alcohol or substance abuse – no way we can take this on.’ We would be an advocate for that client if we thought we could develop the facts and if the claimant was compliant with medical treatment.”

Balin’s focus on a cohesive, team-oriented approach helps clients not only win cases, but educates them about subsidized medical care programs like Medicaid for the disabled, disability cash assistance, and hospital financial aid programs.

This approach extends to clients with mental disabilities, too.

“There needs to be great communication between our staff, our attorneys and the mental health care providers,” Shupe said. “A lot of times this involves getting opinions from the treating psychologists and psychiatrists and nurses who see this person to rebut the opinion of one-time  SSA consultants who see the client and evaluate them for maybe twenty minutes, at most an hour.”

Balin also takes time to sit down with case managers and case workers to make sure a client understands an appeal is due and that new case notes and progress notes from physicians are in their file.

Additionally, clients are assigned a member of Balin’s staff to help put their mind at ease throughout the entire process, and the firm’s tireless attitude certainly accomplishes that.

“It's about managing expectations,” Shupe said. “You hire an attorney not necessarily to speed the process up but to make sure everything gets done right. Most places, five o'clock comes around and you're clocked out,” Shupe said. “Then there are people like us, where work is always on our mind. We do whatever it takes to properly win the case for our clients as early as we can.”

 

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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