SSA Announces 13 New Compassionate Allowances Conditions Involving the Immune System and Neurological Disorders
Michael J. Astrue, Commissioner of Social Security, today announced 13 new Compassionate Allowances conditions involving the immune system and neurological disorders. The Compassionate Allowances initiative identifies claims where the nature of the applicant’s disease or condition clearly meets the statutory standard for disability. Social Security states that with the help of sophisticated new information technology, the agency can quickly identify potential Compassionate Allowances and then quickly make decisions. This makes me wonder if this “sophisticated new information technology” is what was discussed in an Indianapolis Star article that I previously reported here. Added to the list are the following:
Malignant Multiple Sclerosis
Paraneoplastic Pemphigus
Multicentric Castleman Disease
Pulmonary Kaposi Sarcoma
Primary Central Nervous System Lymphoma
Primary Effusion Lymphoma
Angelman Syndrome
Lewy Body Dementia
Lowe Syndrome
Corticobasal Degeneration
Multiple System Atrophy
Progressive Supranuclear Palsy
The ALS/Parkinsonism Dementia Complex
The agency announced a small grant program for graduate students that will help Social Security improve its list and has recently awarded an approximately $1.8 million grant over a five-year period to Policy Research, Incorporated (PRI) through the Disability Determination Process Small Grant Program. This new program aims to improve the disability process through innovative research by graduate students who will receive small stipends for their work. In addition, the agency recently streamlined its online disability application for people who have a condition on the Compassionate Allowances list.
Information about prior announcements may be found in the archives of out blog. For a complete list of all of the compassionate allowance conditions, please clickhere.
Processing Time for Indianapolis Social Security Disability Hearings Falls Again!
The processing time for Indianapolis Social Security Disability Hearings at the Office of Adjudication and Review (ODAR) has fallen again. As reported elsewhere on this site, in November 2009, the number of days from the filing of a Request for Hearing until the case was completed at the hearing site averaged 579 days. In April of 2009, it was 738 days and in June of 2008 it was 896 days. As of March 26, 2010, the number of days from the Request for Hearing for average processing at the Indianapolis ODAR was 534 days. The Indianapolis office now ranks 130 out of 144 hearing offices. Processing time for Evansville Indiana (rank 86) is now at 460 days and Ft. Wayne Indiana (ranked 115) is at 509 days.
If you check in the archives of this site for the other postings for processing time, you will be able to see the other rankings for past times. Indianapolis has improved so that it no longer hovers in last or next to last place, and it has not for many months now. Be sure you check out the Archives for postings on many different issues connected to a Social Security Disability claim or you are not getting the full benefit from this site!
Another Reason You May Be Denied Your Social Security Disability Benefits
Most people who are turned down for Social Security Disability Benefits cannot believe that they were turned down when they applied for benefits. They do not realize that in Indiana approximately 65% will be turned down when they first apply. They just cannot believe the SSA would get such an important decision wrong.
When you apply for disability, your claim is sent to a state agency that SSA hires to made the medical determination of whether you are disabled. In many states this is called the Disability Determination Service, DDS, while in Indiana the current name is the Disability Determination Bureau, DDB. It is these State workers that decide your claim.
The National Association of Disability Examiners, NADE, describes itself as:
a professional association whose purpose is to promote the art and science of disability evaluation. The majority of our members work in the state Disability Determination Service (DDS) agencies where 15,000+ employees adjudicate claims for Social Security and/or Supplemental Security Income (SSI) disability benefits. As such, our members constitute the “front lines” of disability evaluation.
A recent issue of The NADE Advocate, Volume 26, Number 1, provides insight into why SSA may make the wrong decision in your case.
The growing complexity of the Social Security and SSI Disability Programs, coupled with the need to produce a huge volume of work, justifies even more the need for adequate resources in order to provide the service that the American public has come to expect and deserve from SSA. It takes an average of two years for a newly hired disability examiner to become fully trained and proficient to the point they can function independently and contribute to the process of making timely and accurate disability decisions. Thus, decisions not to replace productive personnel when they leave can take two or more years to correct even after new hires are made. NADE has long maintained that it is critical for SSA to be provided with the resources needed to hire and train new staff that can perform these duties. Low salaries, hiring restrictions and the stress of the job have contributed to high attrition (12.3%) in the DDSs. (Emphasis added)
Constantly having to replace 12.3% of the workforce and it taking two years before they can function independently, plus the stress of the job to get the work out fast, combined with low pay, may be a reason that DDB makes the wrong decision so many times.
The important point for you is that you should not be discouraged when your claim is turned down at the initial or reconsideration stages. With approximately 65% turned down on initial application and approximately 93% turned down at Reconsideration, you should take the steps necessary to increase your odds of winning. You will need an experienced attorney in Social Security claims to help you increase your odds in what NADE calls a “growing complexity of the Social Security and SSI Disability Programs.”
Unlike many attorneys, I will begin to help you with your case before your file your claim. Read When Should I Hire An Attorney For My Disability Case? for my reasons why. What are you doing to increase your odds of winning?
Indianapolis Social Security Disability Cases Appeal Processing Time Continues to Fall!
The processing time for appeals that go to hearing in Indianapolis continues to fall. At the end of November 2009, the average processing time from the Request for Hearing was 579 days. In June of 2008 it was 896 days and in April 2009 it was 738 days. As I noted in my June 12, 2009 post, a new hearing office is supposed to be up and running in Valparaiso, IN in September 2010. I would expect that once that office is open, SSA will reconfigure service areas of the different hearing offices so that all of the Indiana hearing offices will have shorter waiting times.
Social Security Compassionate Allowances Expanded For Disability
Michael J. Astrue, Commissioner of Social Security, announced that the agency is adding 38 more conditions to its list of Compassionate Allowances. This is the first expansion since the original list of 50 conditions – 25 rare diseases and 25 cancers – was announced in October 2008. The new conditions range from adult brain disorders to rare diseases that primarily affect children.
Compassionate Allowances are a way of quickly identifying diseases and other medical conditions that clearly qualify for Social Security and Supplemental Security Income disability benefits. It allows the agency to electronically target and make speedy decisions for the most obviously disabled individuals. In developing the expanded list of conditions, Social Security held public hearings and worked closely with the National Institutes of Health, the Alzheimer’s Association, the National Organization for Rare Disorders, and other groups.
“The diagnosis of Alzheimer’s indicates significant cognitive impairment that interferes with daily living activities, including the ability to work,” said Harry Johns, President and CEO of the Alzheimer’s Association. “Now, individuals who are dealing with the enormous challenges of Alzheimer’s won’t also have to endure the financial and emotional toll of a long disability decision process.”
“This truly innovative program will provide invaluable assistance and support to patients and families coping with severely disabling rare diseases,” said Peter L. Saltonstall, President and CEO of the National Organization for Rare Disorders (NORD). “On behalf of those patients and families, I want to thank Commissioner Astrue and his enthusiastic team for creating and now expanding a program that will have a direct impact on the quality of life of thousands of individuals.”
“The initiative not only assists those whose applications are quickly processed, but also assists those whose applications need more time and attention from SSA adjudicators,” said Marty Ford, Co-Chair, Social Security Task Force, Consortium for Citizens with Disabilities. “We are pleased to see today’s expansion and look forward to working with Commissioner Astrue on further expansion of this decision-making tool and other ways to expedite determinations and decisions for disability claims.”
“We will continue to hold hearings and look for other diseases and conditions that can be added to our list of Compassionate Allowances,” Commissioner Astrue said. “There can be no higher priority than getting disability benefits quickly to those Americans with these severe and life-threatening conditions.”
Social Security will begin electronically identifying these 38 new conditions March 1.
New Compassionate Allowance Conditions
- Alstrom Syndrome
- Amegakaryocytic Thrombocytopenia
- Ataxia Spinocerebellar
- Ataxia Telangiectasia
- Batten Disease
- Bilateral Retinoblastoma
- Cri du Chat Syndrome
- Degos Disease
- Early-Onset Alzheimer’s Disease
- Edwards Syndrome
- Fibrodysplasia Ossificans Progressiva
- Fukuyama Congenital Muscular Dystrophy
- Glutaric Acidemia Type II
- Hemophagocytic Lymphohistiocytosis (HLH), Familial Type
- Hurler Syndrome, Type IH
- Hunter Syndrome, Type II
- Idiopathic Pulmonary Fibrosis
- Junctional Epidermolysis Bullosa, Lethal Type
- Late Infantile Neuronal Ceroid Lipofuscinoses
- Leigh’s Disease
- Maple Syrup Urine Disease
- Merosin Deficient Congenital Muscular Dystrophy
- Mixed Dementia
- Mucosal Malignant Melanoma
- Neonatal Adrenoleukodystrophy
- Neuronal Ceroid Lipofuscinoses, Infantile Type
- Niemann-Pick Type C
- Patau Syndrome
- Primary Progressive Aphasia
- Progressive Multifocal Leukoencephalopathy
- Sanfilippo Syndrome
- Subacute Sclerosis Panencephalitis
- Tay Sachs Disease
- Thanatophoric Dysplasia, Type 1
- Ullrich Congenital Muscular Dystrophy
- Walker Warburg Syndrome
- Wolman Disease
- Zellweger Syndrome
Here is the list of the previously announced conditions.
Social Security Disability and Computer Usage
There are rumors that an administrative law judge stated in a seminar that he went on line and researched to see if the claimant had job applications pending during the claim. The speculation is that the ALJ is using on-line research skills to see if current resumes are being posted by the claimants. Why would this be important to the ALJ?
When you apply for Social Security Disability, you are stating that you cannot do an 8 hour a day job 5 days a week. If you have posted your resume seeking work, some might conclude that you really think you can work. The old adage “you cannot have your cake and eat it too” comes to mind. Some will conclude that you really are not disabled and you are only using the Social Security Disability system to provide you a means of support while you are looking for work. After all, if you cannot work, why would you be posting your resume seeking work?
Perhaps you posted a resume on line shortly before you became disabled. Have you forgotten about it? Did you remember to remove it from the site when you became unable to work? Even if you did, can it still be retrieved from the web?
Much has also been made in the news media about potential employers looking at social media sites such as Facebook and MySpace to see what they can learn. If someone might research you, what might they learn about you at these sites? If you participate in an online chat group, how might your comments be misconstrued? Also, if you are posting all the time, what might that say about your computer skills and your ability to concentrate? Do not assume that the postings are private because it is a disease support group web site. Who knows, your ALJ may actually belong to the support group and be reading about you.
There used to be an ALJ in Indianapolis that would state that he got on the SSA system the day before the hearing and personally ran the earnings records to see what it showed. He would then ask the claimant pointed questions about the latest findings. You need to be prepared to answer the ALJ’s questions about what the internet reveals about you. You may hear the ALJ begin a question with “I see on the web that…..”
ICLEF asks Tom S. Ebbinghouse to Teach Lawyers about Social Security Disability
The Indiana Continuing Legal Education Forum (ICLEF) has asked that I speak at the “Entitlements Planning” seminar on December 17th. I will be teaching other lawyers about Social Security Disability. The purpose of ICLEF is to advance and promote the administration of justice and understanding of the law through the institution, supervision, implementation, coordination and administration of a program of continuing legal education for the use and benefit of members of the legal profession. The directors of the Indiana Bar Foundation, which is associated with the Indiana State Bar Association, incorporated ICLEF as in independent non-profit corporation in 1964. The Co-sponsors are the Indiana Bar Foundation, the Indiana State Bar Association, the Indiana University School of Law, Notre Dame Law School and Valparaiso University School of Law. You can read the list of seminars that I have Chaired and/or made a presentation to teach lawyers about Social Security Disability here.
Substantial Gainful Activity Amount For 2010 SSA Disability
At Step One of the Five Step Sequential Analysis , Social Security determines if you are engaged in Substantial Gainful Activity (SGA). When you work for someone else and are not self-employed, SSA usually uses a “rule of thumb” to determine if someone is engaged in SGA. According to this “rule of thumb” if you earn a certain dollar amount or less, you are usually not considered to be engaged in Substantial Gainful Activity. In 2010, for non-blind individuals, the amount is $1,000 per month. Currently, the amount is $980 per month. For blind individuals, the 2010 amount is $1,600 per month, which is the same amount used in 2009. I previously posted the amounts back to the year 2000, which you can see by clicking here.
Why Your Nurse Pratitioner May Make Your Social Security Disability Case Sick
More and more of my clients have seen a Nurse Practitioner for their medical care. Some like the Nurse Practitioner so much that they no longer actually see the doctor or their return appointments just keep being made with the Nurse Practitioner. The Nurse Practitioner is giving them great care, so why should they care if they see a Nurse Practitioner instead of a doctor?
Social Security divides medical sources into two categories: “acceptable medical sources” and other health care providers who are not “acceptable medical sources”. Nurse Practitioners are in the category of other health care providers who are not “acceptable medical sources”.
In Social Security Ruling 06-03, SSA explains that it makes the distinction for three reasons: First, SSA needs evidence from “acceptable medical sources” to establish the existence of a medically determinable impairment. Second, only “acceptable medical sources” can give SSA medical opinions. Third, only “acceptable medical sources” can be considered treating sources whose medical opinions may be entitled to controlling weight.
This means that the medical evidence from a Nurse Practitioner can not establish your medical impairment at Step 2 of the Sequential Evaluation. You must establish your medical impairment in order to win your benefits.
This means that if all of your treatment is by a Nurse Practitioner, then you have no one who can give SSA a medical opinion about how your medical impairments restrict what you can do.
In a card game, a King beats a Jack. Social Security does not even treat a Nurse Practitioner as a Jack–more like a low card. This is not good for your case!
Medical Diagnosis Alone Is Not Enough in Social Security Disability Case
I recently saw an article on the Social Security Disability Lawyer by attorney Gordon Gates about it not being the diagnosis but the severity of the impairment that is important. He states:
“When talking with Social Security disability claimants, I often hear a statement like “I can’t work because I have been diagnosed with bipolar disorder” (or degenerative disc disease, or fibromyalgia). The claimant makes the statement like the matter is settled. The reasoning seems to be: since there is a doctor’s diagnosis of my impairment, my disability claim should be granted.
Unfortunately, that reasoning is not at all correct. It is not the diagnosis of the impairment but the severity of the impairment that matters in a Social Security disability claim. And I explain this to clients every day.
The diagnosis is just the beginning. A good beginning to be sure, since the diagnosis satisfies the medically determinable requirement in a Social Security disability claim. But the important thing is the severity of your impairment. How much does it affect your functionality? How does it affect your ability to work? These are the important questions in a Social Security disability case.
What is missing from almost every denied Social Security disability claim is evidence establishing a claimant’s functional limitations. A medical diagnosis alone does not establish any functional limitations. And unfortunately, a patient’s medical records usually have little information regarding functional limitations (medical records are created and maintained for medical providers to track a patient’s medical care, not to establish disability).
So remember, it’s not the diagnosis but the severity of the impairment that matters. And a Social Security disability lawyer spends a great deal of time trying to obtain evidence – often a medical source statement – that will establish a claimant’s functional limitations.”
I am in complete agreement with Mr. Gates observations. I have the same conversations with people all the time. I remind people that they need to tell the whole truth about their inability to work. You really do need to know the rules of Social Security disability.
