Tuesday, June 28, 2011

If You’re Disabled, is Social Security an Option for You?

The general belief regarding disability benefits is: if you’re disabled, you can receive benefits. If only the system was that easy and uncomplicated, but it isn’t. And, if it was, we wouldn’t be here writing about it today! We’ve mentioned before how difficult and complex the system may be. That being said, even those who would qualify for disability based solely on their impairments, may not actually qualify for benefits in the long run.

Last month, we discussed the five-step process that one must be vetted through in order to be determined eligible for disability benefits. We’re not about to say that the five-step process is the only criteria for qualifying for disability, because it isn’t. A recent post on our Facebook page got us thinking. If you feel as if you meet the steps to qualify for disability, are there other issues standing in your way to receiving benefits? The simplest answer is: Yes.

As you may know, there are two different types of disability one can collect—Social Security Disability (SSD) and Supplement Security Income (SSI) benefits. SSD pays monthly cash benefits to people who have paid enough FICA taxes to qualify, and are now unable to work for a year or more because of a disability. Conversely, SSI is a governmental program that pays monthly cash benefits to people who are age 65 or older, those who are blind or those who have a disability and who do not own much or have a lot of income.

If you've worked most of your life and have paid your FICA tax, generally you're going to be eligible for SSD. Specifically, you must have worked ten years in your lifetime and five years out of the last ten at the time you became disabled for SSD eligibility. Unfortunately, if you do not fit the above-noted criteria, there is a chance that you may not qualify for SSD. SSI is available to certain people, like disabled adults and children who have limited income or resources. To qualify for SSI benefits, you must meet certain eligibility requirements, which can be confusing and may vary state by state.

There is, however, a slight chance that—due to individual, family or household circumstance—one may not be eligible for either SSD or SSI. Often times an individual will find out that their household income places them outside of the criteria for SSI. At the same time, they suffer from a disability that does not allow them to return to work, but they cannot qualify for SSD as they have not worked at least five years out of the last ten in order to be eligible. It’s an unfortunate and frustrating situation to be in, and the Social Security Administration’s regulations are not able to be adjusted.

Monday, June 27, 2011

In the News.

We’ve touched on this before; Social Security Disability cases can take along time. Some cases will take longer than others, but with the most recent reports coming in, it appears as if all cases may start taking just a little bit longer. We want to keep you informed of these changes, no matter how big or small. If there is a change in the system that could possibly affect you and how long it takes to receive benefits, you deserve to know.

As of May 27, 2011, Social Security Administration Commissioner Michael Astrue began questioning the recent increase in pending appeals. At present time, more than 740,000 individuals are awaiting an appeal of their case. The current number of individuals awaiting appeal has grown 5% in the last year alone, which could very possibly increase the wait time. According to the Transaction Records Access Clearinghouse, a data research organization at Syracuse University, “history shows that if this growth is unchecked, as hearing dockets become more and more clogged, wait times will grow” (USA Today, June 23, 2011).

If there is an increase in wait, the extra time can, and will be, used to your benefit. Sometimes when cases progress quickly, there isn’t enough time to gather as much support as we would like. With any extra time, we will use it to your advantage, spending the extra days following up with doctors and medical centers to make sure we have all past medical records and current support we can get; in the end, it will help us to establish the strongest case we can on your behalf.

While the continued increase may seem daunting, as extended wait time is the opposite of what anyone is hoping for, there is a light at the end of the tunnel. Commissioner Astrue has indicated that there are measures in currently in place to speed up the decision making process. And, for those applying for benefits, the bottom line is quicker decisions—and hopefully a quicker route to much needed benefits.

The bottom line for us is to keep you informed; it helps us as we continue to do things Better and Nicer. If you are a client and have any questions or concerns about your case, or its status, feel free to contact us. We would be more than happy to let you know how it’s progressing with the Social Security Administration, and give you an update on the status of your case in our office.

Wednesday, June 22, 2011

Social Security Disability Fraud Resulted in Prison for a Former Missouri Police Chief


Less than a year ago, a former police chief was sentenced to federal prison…for Social Security Disability fraud. Vernis Farmer, a 52 year old police chief from Hayti Heights, Missouri, was sentenced to 21 months in prison on just one felony count of making a false statement to obtain Social Security Disability benefits and two felony counts of concealing information from the Social Security Administration.

An article from the Southeast Missourian dated September 1, 2010, discusses Mr. Farmer’s case in detail. They reported the following: “On March 13, 2007, Farmer reported to the Kennett Social Security Office that he was working 20 hours per week and earning only $800 per month, as the police chief for Hayti Heights, between November 2006 and February 2007. The amount of money he reported was important, because the Social Security Disability work rules allowed beneficiaries to earn up to $860 per month in the year 2006 and $900 per month in the year 2007, without having their benefits suspended. Bank records showed that Farmer was receiving $1,920 per month for full-time work as the police chief.

Since Farmer reported his earnings were below the maximum amount, the Social Security Administration continued to pay his disability benefits. In addition, to the nearly two-year term of imprisonment that was ordered, Farmer was ordered to repay $43,374.50. That figure represents the disability benefits Farmer fraudulently received in conjunction with the current criminal case. The District Court found that since 2001, Farmer fraudulently caused the Social Security Administration to make more than $66,000 in disability benefits that should not have been awarded.”

As uncommon as we would like this type of story to be, it isn’t. In fact, it’s one of the main reasons the Social Security Administration is so strict when it comes to deciding cases, and why the process can often take such a long time. There are a high number of applicants applying for Social Security Disability and Supplemental Security Income benefits, and the Social Security Administration must take their time determining which applicants are being truthful and which ones are not.

We don’t want our clients to end up in Mr. Farmer’s shoes. Rather, we emphasize the importance of being honest and upfront when filing a claim for Social Security Disability benefits, and encourage the same honesty when they appear before an Administrative Law Judge.


Friday, June 17, 2011

There's no test for back pain.

I have been having severe back pain and it’s been effecting me working and even duties around the house. I’m trying to receive disability and keep getting turned down. I want to work but it’s hard when you have back problems”—Ms. R.

There’s so much we can say in response to Ms. R. After all, it is a story we hear much too often, and it doesn’t get easier to hear with time. Granted, everyone has experienced a bout with back pain once or twice in his or her life. But, to live with it on a constant, daily basis is a whole different story.

The biggest concern when it comes to back pain revolves around subjective pain. To clarify, back impairments are often objective; MRI scan and x-rays may easily indicate the culprit of pain. However, back pain is subjective. Regardless if tests and scans come back with or without evidence to indicate the cause of the pain, no one knows what you are going through, because there is no test for pain.

You might wonder what to do about your pain when it comes to applying for disability, especially knowing there is no specific test to measure your level of pain. Quite possibly, the most important thing you can do is to make sure you’re telling your doctor each time you visit. Most doctor’s offices record pain on a comparative pain scale, giving you a scale from one to ten (with ten being the worst pain ever) and asking you where you would place your own pain level along the scale. Additionally, it’s in your best interest to be as specific as you can with your pain. Is it sharp? Shooting? Burning? Whatever you’re feeling, it’s best to let your doctors know.

If you feel as though your pain has reached a level that has begun to interfere with not only your ability to maintain employment, but also your ability to maintain your activities of daily living, there are options for you. We won’t try to tell you we understand, because we know only you know the pain you are living with. But, we will try to help you in anyway we can; it’s just a part of the way we do things Better and Nicer at Binder & Binder®

Thursday, June 16, 2011

More on Medicals, Medicals, and Medicals...

At Binder and Binder®, we often recommend that our clients consider having an Independent Medical Examination (I.M.E.). An I.M.E. is given by a Board certified physician, doing an examination in his field of expertise. This physician is also skilled at writing the kind of thorough report we need to win your case. An Independent Medical Examiner report is not designed to replace your treating doctor’s report. A well written treating doctor’s report will always outweigh any other report. But an I.M.E. report is often an extremely valuable supplement to your own doctor’s report. Alternatively, if we are working with medical records only, we often recommend an I.M.E. to provide an opinion in the absence of one from a treating doctor. It is often vital to winning your case, because it can provide the documentation or explanations that we need to prove your disability.

When we recommend that you have an Independent Medical Examination, it is not because your doctor’s report is not good, or that your doctor isn’t a good physician. It is because we want to win your case. Therefore we want the evidence to be overwhelmingly strong.

We’ve found that powerful “medicals” can turn a close case into one which is an almost certain “win.” When you consider the cost of a medical report, remember that it is a key element in winning benefits that may continue coming to you for many years. We will be seeking to prove not only past disability, but continuing disability. And of course, in addition to the money involved, Medicare or Medicaid come with your successful Social Security Disability or S.S.I. award. It is almost impossible to put a price tag on the value of such great medical insurance plans.

Almost every client asks at one time or another, “Are we going to win my case?” No one can predict the outcome of any case with absolute certainty. But we are very proud of the fact that we are “America’s Most Successful Social Security Disability Advocates®.” When we urge you to make an appointment for an Independent Medical Examination, it is very much in your best interest to do so quickly.

We are very well aware that the expense of an Independent Medical Examination can be a financial problem. But our more than 25 years of experience process that it is a very wise investment. Because the three most important factors in winning your disability case are: medicals, medicals, and medicals.

Monday, June 13, 2011

Medical, Medicals, and Medicals...

You’ve probably heard that the three most important factors in Real Estate are “location, location, and location.” In proving your Disability Case, the three most important factors are “medicals, medicals, and medicals.” And by far, the most important of your “medicals” is a report from your own treating doctor.

In a perfect world, your doctor (M.D., PhD. or D.O.) would be a Board Certified expert who is treating you within his or her specialty. For example, if you have heart problems your “Perfect Doctor” would be a Board Certified Cardiologist. This “Perfect Doctor” would write a thoughtful report listing the complete history of your condition, including all clinical findings and whatever laboratory results that support those clinical observations. The report would conclude with the diagnosis, the prognosis, an explanation of your limitations, and a clear statement of your degree of disability. Unfortunately, we have found that “Perfect Doctors” are just as scarce as “Perfect Advocates.”

Many of our clients do not have a Board certified private physician who will dictate the kind of Medical Report that we need to win your case. Some very good doctors are not Board certified, and some very good Board certified doctors write very poor reports. Furthermore, many of our clients have no insurance and go to clinics. That makes it even more difficult to get complete reports.

We know that this may seem overwhelming, and perhaps a bit daunting. But, if it wasn’t important, we wouldn’t be bringing this up. For those of you who have gone through the process of becoming our clients, you know the importance we place on medical support from your treating doctor. We will be seeking to prove not only past disability, but continuing disability. We want the evidence to be overwhelmingly strong. Anyone can apply for disability, but those with medical proof and doctor’s support of their disability will fare much better in the end.

Thursday, June 9, 2011

High Jobless Rate Impacting the Social Security Disability Benefit Program

Perhaps it comes as no surprise that the state of the economy is, has been, and will continue to be, impacting the Social Security Disability benefit program (amongst other things). On the other hand, perhaps it does. Regardless, the numbers are quite staggering, and could undoubtedly have an affect on individuals applying for disability in the future.

A recent article in the Washington Post examined a 21 percent increase in disability application and discussed how the growth would not only add to administrative backlog, but may also impact the program’s fiscal stability. The 21 percent increase in application to the program occurred from 2008 to 2009, at the point in which the economy was facing serious trouble. That amount of growth was the sharpest in the 54-year history of the program, if that’s any indication as to how severe it was.

Many anticipated the number of individuals taking part in the program would be growing anyways, as we waited for the growing age of the baby-boom population to expand. However, policymakers suspect “the current surge has less to do with any worsening in the health of the workforce than with the poor health of the economy.”

The Social Security Administration (SSA) believes that their process for screening those with alleged disability allows them to screen out those who may be trying to obtain benefits without having a legitimate disability. However, when jobs begin to become few and far between, the SSA acknowledges that workers who might have otherwise struggled through their impairments will now try to secure disability benefits themselves.

But what affect will all of this have on you? The simplest answer is that the influx of all of the new applications is slowing the regular disability approval time. When the disability approval time can already extend beyond two years when factoring in appeals of unfavorable decisions, the increased wait time is something no one would look forward to. Despite having increased their staff, the SSA has continued to struggle to keep up with the workload.
Unfortunately, these issues are not predicted to end anytime in the near future. The overwhelming amount of new applicants is placing an unsustainable financial burden on the Disability Insurance Trust Fund. However, the SSA is taking measures in an attempt to make this less of a hardship on everyone. As we blogged yesterday, new work incentives and the Ticket to Work program have been created. The hope is that, with changed incentives to reward work, the drain on the fund will be lessened.

Wednesday, June 8, 2011

Working While Receiving Social Security Disability Benefits


Kind of sounds like an oxymoron, doesn’t it? Receiving Social Security Disability benefits and working? It doesn’t necessarily seem like the two would go hand-in-hand, but they can. The Social Security Administration (SSA) has special rules that make it possible for those receiving Social Security Disability (SSD) or Supplemental Security Income (SSI) to work and still receive monthly payments.

Many of our clients express their continued desire to work, while reporting that their disabilities simply do not allow them to do the work they used to do. Social Security has a work incentive and a Ticket to Work program, both designed to encourage and enable those receiving disability to return to the work force if they are interested in doing so.

There are some important things to keep in mind, however. If you decide you are going to return to the work force, you need to inform the SSA as soon as possible. They will be able to explain their work incentives to you, which include continued cash benefits for a time while you are working, continued Medicare or Medicaid while you work, and help with education, training, and rehabilitation to start a new line of work.

Obviously, if you are able to return to work full-time, and begin to earn wages that are what the SSA considers Substantial Gainful Employments, your cash benefits may come to a stop. The upside to this, though? If you return to work only to find out that you are unable to continue doing so because of your medical condition, your benefits can start again, and you would not need to re-start the disability process. This means you would not need to fill out another application, and you would certainly not need to attend another hearing.

Please keep in mind, however, that there is a time limit to how long you are allowed to work before you would actually need to restart the disability process. After your benefits stop because your earnings are substantial, you have five years during which you may ask the SSA to start your benefits immediately if you find yourself unable to continue working because of your condition.
Much like the above-noted work incentives, the Ticket to Work program may also help if you would like to return to work. The SSA provides individuals with vocational rehabilitations, job training and referrals, and support services free of charge. Additionally, you will not undergo medical reviews while you are using the ticket and making timely progress your return to work plan.
We want to make you aware of all of your opportunities; it’s the least we can do! If you have any questions about the work incentives or Ticket to Work program, feel free to leave us a message and let us know what’s on your mind. We’d be happy to provide extra information if you are interested, and point you in the right direction if you’d like to return to work!

Tuesday, June 7, 2011

Charles Binder…and The Hat.

We’ve heard it before. More times than we care to count. We’ve heard the good, and the bad—but we’re standing our ground. Or rather, the hat is here to stay.

We all have our own personal sense of style—a perfectly fitting shirt, a lucky pair of jeans, trusty shoes that never break down, or… a hat. Charles Binder is certainly no different than the rest of us when it comes to that concept.  Granted, you may not be the biggest fan of his hat; you might think it looks silly and unprofessional. We hear your thoughts and concerns, but we respectfully disagree.

Charles’ hat isn’t a gimmick. It most certainly isn’t a ploy to make you like or dislike our commercials. The bottom line is this: It’s Charles. It always has been and it always will be. The fact is, to be honest, Charles and Harry have both been collecting cowboy hats since college. And, regardless of the weather, Charles almost always has his hat on—especially outdoors. The season influences which hat Charles will wear, but it doesn’t change the fact that the hat is here to stay.

Charles was wearing his hat in the original commercial because it was a chilly day when then commercial was being filmed. And, on chilly days, Charles wears his hat. Plain and simple. The hat was not written into the commercial, it’s a mere factor of who the men behind Binder and Binder are. We couldn’t begin to ask them to change, nor would we want them to. Tell Charles he couldn’t wear his hat would be equivalent to telling him he could not be himself—and the last thing we, or you, would want is someone misrepresenting themselves for the sake of not looking silly to a select few non-hat adoring individuals.

Some people may say they don’t want to be represented by a guy who wears a hat.  We think it’s what’s under the hat that counts. It leaves people with a choice: Hire the guy whose hat you think is odd, but gives you the best chance of winning your case, or go with a guy who doesn’t have Charles’ track record, but doesn’t wear a hat in real life, or in commercials.

Monday, June 6, 2011

Compassionate Allowances

The Social Security Administration (SSA) has an obligation. What is that obligation we are hinting towards, you may wonder? Well, it’s quite simple. If an applicant’s condition is so serious that they obviously meet disability standards, the SSA has the obligation to provide benefits…quickly.

According to the SSA, “compassionate allowances are a way of quickly identifying diseases and other medical conditions and that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate allowances allow Social Security to quickly target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly.”

The Commissioner of Social Security, Michael J. Astrue, has held numerous Compassionate Allowance public outreach meetings over the past few years. Discussions have been held regarding disabilities such as rare diseases, cancer, traumatic brain injury (TBI), stroke, early-onset Alzheimer’s disease and related dementias, schizophrenia, and cardiovascular disease. The most recent public outreach meeting, held on March 16, 2011, opened the discussion of compassionate allowances with regard to autoimmune diseases.

Compassionate allowance cases are very similar in nature to terminal illness claims—however, not all compassionate allowance claims will involve a terminal illness. For example, an individual with a spinal cord injury may qualify as a compassionate allowance, even if they are expected to live a long life.

While their obligation may be quite simple, it doesn’t necessarily mean the process is also simple. In fact, the criterion to have a claim designated as compassionate allowance is strict. That’s where we come in. We’ll deal with the government; you have enough to worry about. Currently, the SSA’s list of compassionate allowance conditions holds just under 100 listings. We don’t expect you to know if you meet one of those listing, that’s our job. And, since we’re here to do things Better and Nicer, you can be assured we’ll help your case get on the right track to a compassionate allowance listing, if the criteria are met.

If you have any questions or concerns regard compassionate allowances, please feel free to leave a comment!

Thursday, June 2, 2011

Elimination of the Diabetes Listing.

Many Americans suffer from diabetes. Diabetes mellitus is a condition that results from the body's inability to use blood glucose for energy. One may be diagnosed with type I diabetes or type II diabetes. To manage the disease, an individual must carefully monitor blood sugar levels to minimize fluctuations, which requires continued vigilance and strict adherence to a perpetual, multi-faceted and demanding treatment regimen. They may need to inject insulin, follow a diabetic diet, exercise daily and test your blood sugar several times a day.

If a blood test shows a drop in glucose levels, one must stop all other activities and consume the kinds of foods that will bring their sugar levels back up to normal. Unless they act quickly, they may experience periods of dizziness, weakness, loss of ability to think or concentrate on work. It may even result in losing consciousness (or passing out). Conversely, spikes in blood glucose levels can cause equally adverse consequences.

Sometimes, this rigid schedule makes being both an insulin-dependent diabetic and a productive worker impossible. When your diabetes keeps you out of the workforce, you may be able to get Social Security Disability or Supplemental Security Income benefits to make ends meet.  Diabetes is the sixth leading cause of death in this country, and death rates for diabetes have increased by 45% since 1987.

In December of 2009, the Federal Register published a change to the Endocrine Listing (Medical Listing 9) proposed by the Social Security Administration (SSA); they proposed that the impairments set out in Medical Listing 9 be eliminated. Medical Listing 9 includes not only diabetes, but also thyroid and other endocrine disorders. The purpose behind the proposed elimination is based upon what SSA considers to be "advances in medical treatment in the detection" of endocrine disorders. As a consequence of these advances, SSA believes that these types of disorders no longer meet the 12-month durational requirement. If they no longer meet the 12-month durational requirement, these disorders cannot be considered disabilities.
Unfortunately, the proposed change to Medical Listing 9 has recently been approved. As of June 7, 2011, severe impairments such as diabetes and thyroid disorders will no longer serve as a basis to obtain Social Security Disability benefits on a stand alone basis. If endocrine disorders cause problems of medical listing-level severity in other organs or glands, SSA will "evaluate these effects under other body system listings."

Most importantly, however, is that current beneficiaries who have received or are receiving an award of Social Security Disability benefits based upon endocrine disorders will not be terminated. They will, however, continue to be reviewed for medical improvement under the original medical listing upon which their initial entitlement was based.
Despite the fact that the majority Medical Listing 9 will soon cease to exist, our job here at Binder and Binder® does not change. We'll deal with the government; you have enough to worry about. We’ll continue to fight for your disability in spite of the changes!