In The News

On Thursday, 11 people were charged in a fraud scheme—a scheme that involved hundreds of Long Island Rail Road (LIRR) Workers. The LIRR Workers involved in the scheme are being accused of falsely having claimed a multitude of disabling injuries that have allowed them to collect tens of thousands of dollars from their pension funds, in addition to disability payments. Included in the group of individuals charged were two doctors. A sampling of hundreds of claims that were approved by the two doctors revealed that over $100 million dollars, if not much more, had been paid out to LIRR workers whose disabilities were either fabricated or exaggerated.

While there is a separate federal disability and retirement fund for railroad workers, the fund mirrors that of the Social Security Administration’s in many ways. It’s unfortunate that instances of fraud, even as enormous as the LIRR Workers scheme, are not uncommon. But what is also unfortunate is the impact that fraudulent claims, whether they occur through a single individual or as part of a larger scheme, have on disability funds.

When an individual fabricates or exaggerates a disability and has their claim awarded benefits, they are drawing monies from the disability fund. The benefits awarded to fraudulent claims are subsequently no longer available to help individuals with legitimate disabilities. In an attempt to control fraudulent claims, the Social Security Administration participates in Continuing Disability Reviews to weed out those who are not or are no longer disabled. In 2008, Continuing Disability Reviews were expected to eventually cut benefits to 33,000 people who were not disabled or were no longer in need, but continuing to collect benefits fraudulently. The reviews in that year alone were estimated to yield a savings of $3.3 billion dollars that would have been spent in future benefits.

But fraudulent claims have more than just a monetary effect on the system. They can make the process of obtaining Social Security Benefits more difficult, as they lead way to increased skepticism. Individuals with legitimate claims may run into amplified pressure to provide more information in support of their disability—a task that can often be difficult on its own.

At Binder &BinderÒ, we fight for our clients because we understand what they are going through — how it can be difficult to make ends meet when you cannot work and how many people worry about keeping food on the table and roofs over their heads. But, we also know how of negative an impact a fraudulent claim can of have on the Social Security Disability fund. We want our current clients and future clients to know that we diligently screen our potential cases to help cut down on fraudulent claims. 

Did I Say the Wrong Thing?

By Stacey Laskin, an Advocate from the Chicago Binder & Binder® office

If you say something in your hearing that is not supportive of disability, I’ll probably let you know. But I’ll also tell you what options we have now that the record reflects that you spend your afternoons deep sea diving or dirt bike racing.

Most likely, whatever you said was not “wrong.” You testified about your story, and whatever your story is, it’s not wrong as long as it’s true.

But, if you lie to the judge, the judge will know. The judge has access to a great number of official and unofficial records about your life. If you tell one lie, whether it be about your weight, your medical conditions, your embarrassing past, or your entangled love affairs, the judge can use that slip to unravel your claim by finding that you are not a believable witness. It’s not worth it.

COLA Increased for the First Time since 2009

 The Social Security Administration announced a 3.6 percent Cost-of-Living Adjustment (COLA) today. This adjustment, the first cost-of-living increase since 2009, is set to begin in January 2012. Since 1975, Social Security's general benefit increases have been based on increases in the cost of living, as measured by the Consumer Price Index.

The latest COLA will have an affect on Social Security retirement benefits. The COLA will also have an affect on those receiving Supplement Security Income (SSI)  benefits, as payment levels will also increase by 3.6 percent effective for payments made for January 2012. Because the normal SSI payment date is the first of the month and January 1 is a holiday, the SSI payments for January are always made at the end of the previous December.

The monthly maximum Federal amounts for 2012 are $698 for an eligible individual, $1,048 for an eligible individual with an eligible spouse, and $350 for an essential person. The chart below (via the SSA) provided a detailed looked at the increase in SSI amounts.

Don't Ever Give Up.

If you're disabled and you can't work anymore, call Binder & Binder® at 1-800-66-BINDER or contact us online for a free initial consultation. Don't ever give up.

When Will I Find Out If I’ve Won?

By Stacey Laskin, an Advocate from the Chicago Binder & Binder® office

If your hearing is one of the many that ends with some uncertainty, your next question will be some variation of, “How long?”

The answer is that I don’t know how long. I really don’t. For the most part, it’s completely outside my control. However, some judges are known for quick turn-around in just a few weeks and others have a reputation for dragging their feet for months. I can let you know about my experience with your judge and what you might expect.

Your judge will probably take your file after the hearing and stick it in a pile. Some time in the future, he or she may look at your file again and propose a decision. Then a staff attorney might review the file. The attorney and the judge may discuss the proposed decision. That decision could change several times throughout the course of their research. Eventually, the staff attorney will write up your decision and then give it to the judge for review and editing. Once the decision is completed, the Social Security Administration will mail a copy to both you and me.

Top Five Questions Clients Ask After a Hearing

By Stacey Laskin, an Advocate from the Chicago Binder & Binder® office

Stacey Laskin is an Advocate from Binder & Binder®, and is a graduate of The Ohio State University Moritz School of Law. Although she is stationed out of the Binder & Binder® Chicago office, she travels frequently to meet clients for hearings in Michigan, Ohio, North Dakota, Nebraska, and Wisconsin.

You’ve spent restless nights playing out the exchange. The judge is a kindly woman in a black robe, she smiles, and she asks you, “What’s wrong?” You both cry together, and then she hands you a check, which you use to pay off your mortgage and buy a celebratory chocolate cake.

Then you wake up to spend another day worrying about why Dr. So Busy won’t answer the phone and whether you should wear new shoes to your hearing. The entire process is exhausting. And this is why, after your hearing, you’ll inevitably still have questions.

These are the ones I’m most commonly asked:

Did I Win? Social Security judges, experts and representatives speak in jargon. We use abbreviations, numbers, regulations and rule citations to talk about the experiences you live. As a result, it can be difficult to determine exactly what happened at a hearing.

Occasionally, a judge will issue an official decision at a hearing. Other times, a judge will only give an indication as to what his or her decision may be. More often than not, the hearing ends with some ambiguity.

Even when the judge explicitly states that he or she has issued a decision on-the-record, many clients don’t realize they’ve won benefits until afterward, when I’ve shaken their hands and expressed my congratulations.

This proves there really is no such thing as a stupid question. I should be able to help decipher the “harrumphs” and the code words.

How to Get the Respect You Deserve From the Legal System

By Charles Binder

Times are changing. The federal courts are beginning to believe that CFIDS can be disabling. But for those of us who care about people who suffer from chronic fatigue and immune dysfunction syndrome (CFIDS), we still have a long way to go.

            I gave a talk a few years ago at a gathering of lawyers who practice Social Security Disability law. In my address, I proposed several re-tape-cutting systems that would greatly speed up the process for dismissing obviously wild claims.

            An Administrative Law Judge came up to me after my talk and told me he liked my proposals. With one exception: “Don’t send me any of those chronic fatigue or fibromyalgia cases,” he said.

            If you have CFIDS, getting the respect you deserve from the government’s legal system means you have to first convince your doctor you’re disabled. Then your doctor has to help you and your attorney convince the government.

            Here are five ways you can help your own case:
1. Find a doctor who is specifically familiar with your disorder and is well-respected in the medical profession.

            The degree of respect your doctor’s testimony gets at a hearing is often directly related to his or her expertise with your particular problem, and his or her standing in the medical community.

            The Social Security Administration (SSA) routinely calls doctors to testify as “impartial” witnesses to explain unusual disorders to the Administrative Law Judges. Most of these doctors seem to feel their role is really to justify denying claims.

            In order to properly refute their testimony, it helps your attorney if your doctor’s qualifications concerning your specific disorder are as good as, or better than, the government’s doctor.

2. Be a model patient.

            Keep records of doctor visits. Keep a daily log of symptoms. When you describe fluctuations accurately, your testimony becomes more believable. Keep written notes on low-grade fevers, variable muscle aches and pains in the joints. It makes you a better patient for your doctor and a better witness for your attorney.

3. Ask your physician to make their reports in a simple and straightforward form.

            Reports that look “slick” or “faddish” create credibility problems. Chiropractors frequently use fancy, color stationery that pictures the spinal cord. Often judges think the author of a report presened like that is somehow not serious enough.

            Judges are lawyers. And lawyers tend to be stuffy. Their perception is that a really distinguished doctor, like a professor of medicine at a major teaching hospital, is not likely to use such stationery. Perception counts in winning your case.

4. Avoid self-serving doctors.

            One of my favorite CFIDS clients was seeing a physician who was attentive and a good listener. That’s good. My client felt she was doing better under his care. That’s also good. Unforuntately, his reports always seem to mention how much better she is doing that when under another doctor’s care. That’s not good. It severely weakens the impact of his reports. To an experienced Administrative Law Judge, his reports lack credibility.

5. Always maintain your own self respect.

            I think I understand how difficult that must been when you are suffering from CFIDS. But you can never expect to get respect from other people, let alone from the government and the legal system, if you don’t respect yourself.

Administrative Law Judges in the Social Security system are trained to follow acceptable medical proof of disability. As the medical profession more readily accepts CFIDS as a disabling disorder, the Social Security system and the courts in general will follow.

Times are changing. For the better. You can helpp the times change a little faster for yourself and for everyone who must deal with CFIDS by following these five simple rules.

            

What Qualifies as a Disability?

Many people want to know if their illness or impairment qualifies as a disability. In almost every case, no matter what the disease or impairment is, the answer is the same - "Maybe.” A more in-depth answer would indicate that it really depends upon how badly an individual is affected by the disease or impairment. Let’s take cancer, for example. There are many cancers that can be treated and cured very quickly, often resulting in little or no lasting effect. In the same aspect, however, there are many forms of cancers that result in great suffering and possibly even death. The question in each individual case is "How sick is this particular individual with cancer and how long is this person going to remain sick?" Headaches are another example. The vast majority of headaches, while troublesome and annoying, would not be considered to be disabling. On the other hand, there are some individuals that suffer from daily headaches and migraines, which can be disabling. So, while a common headache, which is not rare, may not be disabling, an extreme case of constant headaches and migraine can be considered disabling. The fact that an individual has a disease with a certain name does not guarantee that the individual either will or will not be found disabled. It all depends upon how sick the individual is.

Keep in mind that Social Security is supposed to consider the combination of impairments that an individual suffers when determining disability. Many of our clients have more than one health problem and it is the combination of their health problems that lead to their disability. It is important to also keep in mind that an individual has to have been disabled for at least a year or be expected to be disabled for at least a year or have a condition that can be expected to result in death within a year for their condition to be considered a disability, and their disability to be awarded. Essentially, an individual may apply for Social Security Disability or Supplemental Security Income benefits the day their disability begins—they needn’t wait an entire year before doing so, so long as the disability can be expected to last at least a year.  If you have any questions or concerns, feel free to leave us a comment and let us know!