Monday, September 12, 2016

Tell Congress to Fully Fund Social Security's Budget

On an average, disabled Americans are waiting 575 days to present their Social Security Disability claims at a hearing before a judge.  A record one million SSDI and SSI cases are currently pending. This is an alarming crisis.  
While disabled individuals wait for a hearing, utility bills go unpaid, families struggle to put food on the table and many face the risk loosing their homes.  
This problem is not happening by mere chance.  This situation has been caused by dramatic cuts in the Social Security Administration's operating budget.  Since 2010, the SSA's budget has been cut by 10%.  In the meantime, the agency's workload has increased due to the rise in the demand for services caused by the ageing of the baby boomer generation.  Services have been cut across the board.   Since 2010, the SSA has closed approximately 60 field offices and 500 mobile offices.
Unfortunately, the Republican controlled Congress is considering even deeper budget cuts.  A proposed bill envisions cutting the agency's budget by over $250 million in 2017.  These additional cuts will aggravate the current crisis even more.
Under the proposed house bill, the Social Security Administration would need to close all its offices for two weeks as a result of employee furloughs. And a looming hiring freeze can lead to even longer wait times and delays in all parts of the Social Security system, including retirement, survivors’, and disability programs. A Senate version containing a similar proposal for cuts provides slightly more funding, but still fails to address many critical agency resource needs.
Social Security advocates across the country are asking everyone affected to contact their representatives in Congress.  President Obama has requested funding for 2017 that would allow Social Security to begin reducing the disability claims backlog and to reduce other agency service delays.
Call your Members of Congress TODAY. You can find their contact information at and (upper right corner of each page).

Monday, September 5, 2016

NFL Player is Denied Long Term Disability Benefits

When it comes to disability insurance claims, it seems like all claimants are subject to the same hassles regardless of their financial status or social class.  Long term disability insurance companies are billion dollar giants that really don't care much about what individual policy holders think about them or about the negative effects that bad publicity can have against their businesses. Take the example of Haruki Nakamura, an Ex-NFL player who was recently denied long term disability benefits.  
Nakamura, a former safety for the Baltimore Ravens and the Carolina Panthers, purchased a 1 million dollar long term disability policy from Lloyd's of London that provided benefits in the event that, due to illness or injury, he became unable to "participate ever again in his occupation of football player". In August 2013, during a Carolina Panthers pre-season game against the Pittsburgh Steelers, Nakamura suffered a hit to the head and was diagnosed with a concussion a few days later. Nakamura was placed on the injured list in September 2013 and two days later was released from his Carolina Panthers contract due to his “concussion.”
In October 2014, Kakamura's treating doctor wrote a report stating that his patient would not be able to play professional football again due to the disabling effects of his concussion.  Despite the well documented evidence of the effects of concussions in football and the medical evidence on record, the insurance company chose not follow the recommendation of Mr, Nakamura's doctor.  Instead, the insurance company invoked its right to conduct its own medical examination by a doctor hired by them.   
After unnecessarily prolonging the application for benfits for more than 18 months, the insurance company denied the claim.  In many ways the actions by the insurance company in Nakamura's claim, resemble many other denials that I see on a regular basis.  The company's decision to deny benefits is typical of the insurance industry's arrogance.   For example, the insurance company claimed that Nakamura could return to play, however their own doctor cautioned Nakamura to consider the “probable long-term effects of repetitive concussions” before making the decision to go back to football.  This leads me to believe that the insurance company knows that it doesn't have a strong case but it denied the claim merely to force Mr. Nakamura to compromise his claim. 
Another aspect of Nakamura's claim that resembles some of the issues faced by my clients is that the insurance company seems to be preying on the highly subjective aspects of disabilities claims caused by concussions.  Nakamura has alleged that due to the concussion he suffers from headaches, vision problems, fatigue, depression and suicidal thoughts.  Unlike usual orthopedic injuries suffered by football players, the subjective effects of head trauma are a lot harder to assess with objective tests.  
Nakamura has filed his complaint in the North Carolina Superior Court.  To read a copy of the complain click here.  Since Nakamura purchased his policy individually, his lawsuit is not covered by ERISA.  As you can see from the complaint, he is entitled to a jury trial and damages for unfair and deceptive practices.  If his claim had been governed by ERISA, such legal remedies would not have been available to him

Monday, August 29, 2016

State Grant Will Help Disabled New Yorkers Fight for Benefits

Denial rates of Social Security Disability claims is at one of its highest points in history.  It is common for some administrative law judges (ALJ's) to approve only 25% to 30% of the cases that they hear.  Due to the high odds of loosing a Social Security Disability case, many disabled claimants are going through the system unrepresented.  This lack of legal representation has lead to many abuses within the system particularly against individuals who are indigent and suffer from intellectual limitations and mental illness. 
Fortunately, the State of New York has announced a $8.2 million grant to assist claimants in the pursuit of benefits such as Supplemental Security Income, Social Security Disability Insurance and other similar Federal programs.  Commissioner Samuel Roberts of the Office of Temporary and Disability Assistance of the State of New York is pleased with the results that the "Disability Advocacy Program" has brought to New Yorkers.  From July 2014 to July 2015 approximately $17 million in benefits were generated for disabled recipients.
Several great non-profit legal legal advocacy organizations are currently participating in this grant. Here is a partial list of the organizations:
  • Legal Services NYC has received $2.29 million -  the largest amount.
  • The Empire Justice Center will provide services in 13 western New York counties.  They will also administer the statewide advocacy program.  The total grant of this organization is $1 million.
  • The Urban Justice Center will receive $819,189
  • New York Legal Assistance Group $794,528
  • Nassau/Suffolk Law Services Committee  $676,858
  • Legal Aid Society if Mid-New York $628,522
  • Legal Aid Society of Northeastern New York $619,023
  • Legal Services of the Hudson Valley $558,493
  • Meighbohood Legal Services $526,371
  • Erie County Department of Social Services $162,242
  • Legal Aid Society of Rockland County $105,323


Monday, August 8, 2016

Social Security Disability Insurance Marks its 60th Birthday!

On August 1956 President Dwight D. Eisenhower signed Social Security Disability Insurance (SSDI) into law.  President Eisenhower stated at the time of signing: "I am hopeful that the new law... will advance the economic security of the American people".  Sixty years later, SSDI has provided injured and disabled workers with a safety net for their economic stability.  
We must all do more to educate the public about the importance of Social Security Disability Insurance.  Please share my blogs and social media posts.  With a backlog of more than a million cases, the Social Security Disability programs need your support more than ever.  
Public opinion polls show a strong support for SSDI.  Nearly nine in ten American's have expressed their support for the program.  (See poll results here.)  Nonetheless, over the past two years a strong minority of ultra conservatives such as Sen. Tom Coburn and Sen. Tom Cotton have done everything possible to undermine the program.

Tuesday, August 2, 2016

Bill Establishing Time Limits for SSDI Payments Likely to Fail

Republican Senator Tom Cotton (R-AR) and Representative J. French Hill (R-AR - 2) are pushing a piece of legislation that would set time limits for Social Security Disability payments.  This bill hasn't received much support.  The proposed bill called "Social Security Disability Return to Work Act of 2016" establishes four categories in which beneficiaries can be placed.  Each category sets a different durational period for the payment of benefits.  

The four categories are:

  1. "Medical Improvement Expected" (MIE)- Under this category benefits would end at the 23rd month of benefits.
  2. "Medical Improvement Likely" (MIL) - Under this category benefits would end at the 59th month of benefits.
  3. "Medical Improvement Possible" (MIP) - Under this category the claimant would have to undergo a Continuing Disability Review ("CDR") after five years.
  4. "Medical Improvement Not Expected" (MINE) - Under this category the claimant would have to undergo a Continuing Disability Review ("CDR") after ten years.
The proposed legislation does not allow claimants to appeal the category that they are placed in.   The bill also provides a benefit offset for individuals who are placed on the MIE and the MIL categories. Earnings above the Substantial Gainful Activity level would result in $1 reduction in benefits for every $2 earned.

Fortunately, no action has been taken on these bills and this Congress will probably never act on this initiative.  

Monday, July 25, 2016

Social Security Amends the Respiratory Disability Listing

The Social Security Administration has enacted comprehensive changes to disability listings 3.00 and 103.00 for Respiratory Disorders.  See  81 CFR 37138  This listing will be effective for cases filed or pending after October 7, 2016.  This is the first major overhaul of the respiratory listing since 1993. The amendment also changes the name of the of the listing from Respiratory System to Respiratory Disorders.
The new listing places a great deal of emphasis on the tests used to measure lung capacity.  The agency will continue to require spirometry testing to determine a person's forced expiratory volume and forced capacity.  Under the proposed changes proof of equipment calibration will no longer be needed.  One particular aspect to keep in mind is that under the new listing the agency seems to require that tracing results of the spirometry be submitted with the medical records.  If tracing results are not submitted, the SSA may then request the claimant to undergo a consultative examination.  
On positive aspect of the changes includes a reduction in the number of hospitalizations needed in a year in order to meet the listing.  The old listing required six hospitalizations but the new listing has reduced them to three.  In enacting this change, the agency acknowledged that claimants are not always able to visit a hospital or able to pay for care when they suffer exacerbations of their conditions.  
Under the old listing lung transplant recipients were automatically considered disabled for a period of one year,  The new changes increases this time period to three years. 

Monday, July 4, 2016

Social Security Disability Recipients Can Have Their Student Loans Discharged

As a Social Security Disability Lawyer, clients and other claimants constantly ask me questions on how to make ends meet with the humble income that they receive from their monthly check.  Since I am not a financial adviser, my advise in this are is somewhat limited.  However, as I learn of different programs that can help relieve their financial hardships, I like to pass the information to them through this blog.
One program available to Social Security Disability beneficiaries to help them deal with their financial stress is the "Total and Permanent Disability Discharge of Student Loans".  To learn the specific details about this program click into
Under this program, if you are receiving SSD you might be able to have your entire student loan forgiven.  If approved, you will not have to pay your loan money back.  However, there are numerous exceptions to the program and must seek help from a financial planner before taking the bold step of requesting that your debt be forgiven.
The rules for student debt forgiveness are somewhat like the rules for Social Security Disability.   In fact, they are almost identical except that the "durational" requirement for debt forgiveness is much longer.  Therefore, you must be disabled for a longer period of time or expect to be disabled for a longer time than for SSD in order to be eligible for debt forgiveness.  To be eligible to receive Social Security Disability you must be disabled or be expected to be disabled for twelve months or more. On the other hand, in order to be eligible for student loan forgiveness you must be disabled or be expected to be disabled for 60 months or more.  Please note that individuals who are told by Social Security that their disability awards will not be reviewed in the next five to seven years (those SSD beneficiaries who are considered as "Medical Improvement Not Expected") are automatically qualified for the student debt forgiveness program.  If your case is supposed to be reviewed within the next five years and you want to be eligible, then you must complete an application an provide a certification from a doctor stating that your disability is expected to last 60 months or more.