Wednesday, February 21, 2024

Processing Timeframes For SSDI/SSI claims

 If you have noticed that it seems to be taking longer to get disability decisions from the Social Security Administration ("SSA"), you are not alone. Depending on where you live, initial applications are still taking about 4 to 9 months to process. The national average waiting time for applications in January of 2024 was 231 day, or about 7.45 months. The fact that I represent claimants primarily in Southern California, one of the more populated areas of the country, means most of my clients are waiting for close to 9 months (if not longer) to get their initial determinations.  This isn't unusual. I have practiced Social Security Disability Insurance and Supplemental Security Income law for 20 years come June of 2024 and this is par for the course.

Where I am seeing significant delays, however, is at the reconsideration level, which is the second stage of the process. Most people receive an initial application denial and have to go through the reconsideration process. In fact, SSA granted 39 percent of initial applications for 2023, which means 61 percent of claimants had to request reconsideration if they wanted to continue to try to obtain disability benefits. This is the stage that I am noticing unusual delays....in Southern California at least. Historically, reconsideration decisions were also issued within 4 to 9 months of SSA receiving a request for reconsideration.  However, we have been seeing cases sit for 10 to 11 months pretty regularly at the reconsideration stage in Southern California over the last year or so. 

SSA actually contracts with Disability Determination Services ("DDS), a branch of the Department of Social Services to provide the medical development of SSDI/SSI cases at both the initial application and reconsideration levels. This is because SSA does not have the staff to provide the medical development at the lower levels of the disability process. 

Several California DDS offices have told me that they were ordered by SSA to pull reconsideration staff to work on initial applications due to complaints from government officials that it was taking too long  for people to get initial determinations from SSA. Pulling staff has created a bottleneck at the reconsideration level.  It hasn't "fixed" the process at all. It just pushed the delays to another stage. It isn't DDS's fault either. They haven't been given an adequate budget or enough staff to work up the volume of cases they are assigned to process from SSA. 

One DDS office told me last week that they just started assigning analysts for appeals filed on June 1, 2023. Another office told me it is taking them 6 to 8 months to even assign an analyst to a case. Once an analyst is assigned to assess a case, it is taking 3 to 4 months to get a decision. Thus, Southern California claimants are waiting 9 to 12 months to get decisions at the reconsideration stage in many cases. 

What is so frustrating is that reconsideration almost always results in a denial, as SSA only grants 15 percent (yes, 15 percent) of claims at the reconsideration stage, which is why I call reconsideration "the trash can." For years, practitioners have argued that SSA should eliminate the stage and allow us to go directly to a hearing if a claimant is initially denied. For a while, SSA looked into eliminating the reconsideration stage and allowed some prototype cases to go straight to the hearing level if an initial application was denied. However, the Commissioner ultimately decided that reconsideration was a necessary stage of the process and eliminated the prototype case test program.

Once denied at the reconsideration stage, a claimant must request a hearing at the Office of Hearings Operations ("OHO"). In California, there is data showing that claimants are getting hearings scheduled within 325 days (San Bernardino) up to 689 days (Santa Barbara). Santa Barbara is definitely taking close to 2 years to schedule  a hearing, but most of my clients seem to be getting their hearings scheduled at other hearing offices within 10 to 12 months. This is because I do not dispute the format of the hearing. Unless there is a reason that the Judge needs to physically see my client, I am happy to do phone or video hearings if it means my client's claim will be heard faster. If you demand an in-person hearing, clearly the waiting periods will be longer because more Judges are conducting hearings virtually, than in-person, post-Covid. I do not expect that fact to change. The Judges at OHO grant about 45 percent of the claimants based on statistics for 2023.

If you are denied at the hearing level, then you must file an appeal with the Appeals Council ("AC"). The AC only overturns 1 percent of the Judge's denials and it is currently taking the AC 15 to 18 months to make a decision. If denied by the AC, you have completed SSA's administrative processes and your only option is to file a complaint in a Federal District Court assigned to your jurisdiction.  

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 101.

 


Monday, January 22, 2024

The Media Continues to Investigate SSA's Systemic Struggles

 A news article was published by Ms. Sharon Jayson, at the AARP, on January 17, 2024. It is an excellent piece that realistically discusses the failure of the Social Security Administration ("SSA") and the Department of Social Services (“DSS”) to process disability cases in a timely manner. It is the most recent piece in a slew of articles and television stories that have been circulating about SSA's continued problems processing claims due to staffing and budgetary issues. Here is a link to the full article: https://www.aarp.org/retirement/social-security/info-2024/disability-claim-wait-times.html.

Media outlets have been particularly focused on the SSA’s processing when it comes to collecting delinquent overpayments, which in some instances, SSA has in fact caused by not processing the benefits properly. Anderson Cooper reported on the overpayment issue a couple of months ago and the news story is also an accurate portrayal of what is taking place at SSA. Here is a link to the video: https://www.youtube.com/watch?v=sIYsZw0PtlI .

While I find it depressing to find that SSA’s ability to process benefits effectively and efficiently continues to decline, I applaud the media for recognizing the newsworthiness of what is honestly beginning to look like the fall of the Social Security Disability system.

A Federal Agency cannot thrive without appropriate staffing and a healthy budget. While I do not see a way that SSA can be “fixed” without a complete overall of the system at this point, I do think the national news coverage is helping to wake up our nation.  

I do hope the national news outfits continue to write about the decline of the Social Security Disability system. I am really hoping that a journalist catches the scent of the whole consultative examination circus that is taking place at SSA and DSS currently. SSA has always used consultative examiners (“CEs”) to assess disability. CEs are vendors, hired by DSS, and paid for by SSA, to assess claimants’ disabilities. However, CEs are no longer performing thorough evaluations. They tend to last about 13 to 15 minutes and these CEs are almost never provided any medical records to truly evaluate a claimant’s disability. However, SSA is not really after an objective opinion backed by evidence. In the lion share of cases, SSA is purchasing these examinations, simply to justify a denial.  I consider the CE process to currently be the most corrupt aspect of the SSA/DDS system and it would be eye-opening for a national journalist to expose the whole CE process.

I thank all the journalists who are taking the time to report on the continued problems when it comes to the SSA. Keep it up and keep digging up the dirt because I promise you, there are many more stories that we as a country need to know about when it comes to the SSA system.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot me an email at megan@westcoastdisability.com or call us at (800) 459-3017 x 101. 


Friday, December 22, 2023

SSA Rings in the New Year with a New Commissioner

Martin J. O. Malley was sworn in as the Commissioner for the Social Security Administration ("SSA") on December 20, 2023. He will serve a term that will expire on January 19, 2025.  There is no denying that SSA struggling to deliver the critical benefits to the many Americans who are dependent on them for survival. I suspect Commission O' Malley, who previously served as a Governor and Mayor of Maryland, will be surprised to see how technologically rudimentary SSA is considering it is 2023. Commissioner O' Malley is noted to be a technological pioneer when it comes to customer service and performance management systems, so let's all hope that Commissioner O'Malley uses metrics and accountability as guiding  principles to turn SSA around. 

Now can someone give Commissioner O'Malley a workable budget to make a dent in the dumpster fire known as SSA? This is the other component that is absolutely crucial to making SSA a functioning agency again. Doubtful that SSA's budgetary problems will improve any time soon, but it's almost a New Year.....I can hope for a miracle, right? 

Happy (almost) New Year! 

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot me an email at megan@westcoastdisability.com or call us at (800) 459-3017 x 101.

Friday, November 24, 2023

Types Of Questions To Expect At Your Social Security Disability Hearing

 

Many individuals who attend a Social Security Disability Insurance and/or a Supplemental Security Income hearing are nervous about appearing before an Administrative Law Judge. Nowadays, the lion-share of our hearings are conducted by telephone or video, but we do occasionally have in-person hearings.  Regardless of whether your hearing is in-person or virtual, the types of questions are the same. For many people, this is the first legal proceeding that they have ever attended and it can be very intimidating. To help you prepare for your upcoming hearing, we have made a list of questions that are commonly asked at your hearing.

1.        What is your name and address?

 

2.        What is you date of birth?

 

3.        How old are you?

 

4.        How far did you go in school?

 

5.        When was the last date that you attended school?

 

6.        Are you in school now?

 

7.        Did you ever attend a trade school or have some other type of vocational training?

 

8.        When did you last work?

 

9.        What was your last job title?

 

10.    What were your tasks and duties at this job?

 

11.    How much weight did you lift at this job?

 

12.    Was it a sitting or standing job?

 

13.    What other work have you performed in the last 15 years?

 

14.    What is preventing you from being able to work?

 

15.    What made you stop working on a particular date?

 

16.    What are your symptoms?

 

17.    What do you do to relieve your pain?

 

18.    Are you right or left-handed?

 

19.    Do you use contacts or glasses?

 

20.    Can you drive a car?

 

21.    If you can drive a car, do you have any restrictions on driving?

 

22.    What is your level of pain on a pain scale? Zero being no pain and ten being pain severe enough to force you go to the emergency room.

 

23.    What types of treatment have you tried?

 

24.    Have you had any surgeries?

 

25.    Have you had any hospitalizations?

 

26.    What were your hospitalizations for?

 

27.    Do you have any side effects from your medications?

 

28.    Are you able to concentrate while watching a television program?

 

29.    Are you able to read and understand a page in a book?

 

30.    How long can you sit?

 

31.    How long can you stand at one time?

 

32.    How long can you walk at one time in terms of minutes or city blocks?

 

33.    How much weight can you lift at one time in terms of pounds?

 

34.    Do you require an assistive device to help you walk or stand? Which device?

 

35.    Where do you live?

 

36.    Who do you live with?

 

37.    What type of dwelling do you live in?

 

38.    Does your home have any stairs?

 

39.    Who does the chores in your household?

 

40.    Who does the cleaning?

 

41.    Who does the cooking?

 

42.    Who does the grocery shopping?

 

43.    Who does the laundry?

 

44.    Do you have any children? Who cares for them?

 

45.    Have you traveled at all since you applied for disability? Where?

 

46.    Why can’t you perform a sit-down job?

 

47.    Why can’t you perform a job that allows you to sit and stand at will?

 

48.    Have you ever abused alcohol or drugs?

 

49.    What is your date of sobriety (if the claimant is in a recovery program)?

 

50.    How have you been supporting yourself since you stopped working?

 

51.    Is there anything else that you would like to tell me that is important to your claim?

 

While the Administrative Law Judge or your attorney may ask you additional questions based on your specific disability, the above questions are representative of many of the general types of questions that you will hear at your hearing. Be open and honest when answering these questions. Listen carefully to what the Administrative Law Judge, or your attorney is asking you, so you stay on track when responding. Always answer questions succinctly.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot me an email at megan@westcoastdisability.com or call us at (800) 459-3017 x 101.

Saturday, October 21, 2023

SSA Announces a Cost-of-Living Adjustment (“COLA”) for 2024

The Social Security Administration has announced this month a 3.2 percent benefit increase for 2024. This cost-of-living adjustment (“COLA”) will begin on December 29, 2023 for Supplemental Security Income (“SSI”) beneficiaries. Social Security Disability Insurance (“SSDI”) and Social Security Retirement recipients will see the effects of the COLA in their January 2024 benefit payments. This COLA will affect the more than 71 million Americans who receive monthly Social Security and Supplemental Security Income benefits.

Additionally, the maximum amount of earnings subject to Social Security tax will be increased from $160,200 to $168,600.

For more information on the 2024 COLA adjustment, please visit Social Security’s website for more details.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot me an email at megan@westcoastdisability.com or call us at (800) 459-3017 x 101.

Saturday, September 23, 2023

The Social Security Administrations Announces 12 New Compassionate Allowances Conditions For 2023

 The Social Security Administration (“SSA”) added 12 new Compassionate Allowances conditions to the Compassionate Allowances program. This brings the total number of conditions on the list to 278. Disabilities that comprise the Compassionate Allowance list represent the most serious disabilities that affect individuals. The purpose of the program is to expedite disability decisions, so individuals suffering from these severe diseases receive their benefit decisions as quick as possible. Nearly 900,000 people with life-threatening disabilities have received their benefits through this expedited process.  The new additions include:


1.      1p36 Deletion Syndrome

2.      Anaplastic Ependymoma

3.      Calciphylaxis

4.      Cholangiocarcinoma

5.      FOXG1 Syndrome

6.      Leber Congenital Amaurosis

7.      Metastatic Endometrial Adenocarcinoma

8.      Paraneoplastic Cerebellar Degeneration

9.      Pineoblastoma – Childhood

10.  Primary Omental Cancer

11.  Sarcomatoid Carcinoma of the Lung – Stages II-IV

12.  Trisomy 9


To see a complete list of all the impairments which qualify for the Compassionate Allowances program, visit this website: https://www.ssa.gov/compassionateallowances/.

Got a question that you need answered? Please check out our website at www.westcoastdisability.com . We try to provide you with valuable information on our website that may help you navigate the Social Security Disability process. Also, feel free to shoot us an email at megan@westcoastdisability.com or call us at (800) 459-3017.

Thursday, August 24, 2023

President Biden Plans To Nominate Martin O’ Malley To Head The Social Security Administration

 President Biden announced last month that he plans to nominate former Maryland Governor, Martin O’ Malley, to head the struggling Social Security Administration (‘SSA”).  As both employee and consumer dissatisfaction plague the SSA, it is frankly amazing that anyone would want to be the Commissioner of the SSA. It someone came to me and said, “We have this impressive ocean liner named the Titanic that is about to set sail from Southampton, England. Would you be interested is piloting the ship?” I would take a hard pass. Luckily for SSA, there is someone who apparently thinks he can overt the iceberg that SSA has been steadily approaching the past several years. Here are some interesting facts about him:

1.      He was the Governor of Maryland from 2007 to 2015 and has an impressive record when it comes to creating jobs, tax reform, expanding healthcare, and reducing crime.

2.      He previously served as Maryland’s Mayor.

3.      He is a lawyer (but don’t hold that against him).

4.      He ran for President in 2016.

5.      He utilizes technology to manage employees and to improve customer service.

6.      His family originally hails from Galway, Ireland, and he is in a Celtic rock band. He even plays a penny whistle (I promise…it is a real instrument).

7.      The nation’s largest federal employee union has endorsed him.

 I know little about him, but I like what I have read about him so far. If appointed, O’Malley’s success will be dependent on whether he is provided an adequate budget to fix all the pervasive problems at SSA. If he turns SSA’s sinking ship around, I will be both surprised and impressed, but I never bet against an Irishman (or an Irishwoman for that matter)!

 Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 101.