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.
Indiana To Have Additional Hearing Office for Social Security Disability Claim Appeals
According to David V. Foster, Deputy Commissioner of Social Security, in his June 5, 2009 Deputy Commissioner Broadcast to Social Security employees, Indiana will have an additional hearing office to hear appeals of denials of Social Security Disability claims. The new office is to be in Valparaiso, IN and is supposed to be up and running by September, 2010. Help is coming to Indiana to work down the backlog of claims so that you do not have to wait so long for a hearing.
Star Trek and Social Security Disability In Indianapolis
The new Star Trek movie is out. As I have not seen it yet, I can not tell you what you can learn about Social Security Disability hearings in Indianapolis from the new movie. I did learn a great deal about Social Security Disability hearings from the original TV show. Click here to find out what you can learn about Social Security Disability hearings from the original Star Trek.
More of the Priorities of Social Security and the Proposed Budget
As noted yesterday, with the recently released statement of Michael J. Astrue, Commissioner of Social Security, commending the President’s Fiscal Year 2010 Budget Request, SSA posted a link to a document that spoke about the priorities of SSA and the proposed budget. Here are some more statements of interest:
“SSA is responsible for the Nation’s two primary Federal disability programs: Disability Insurance and Supplemental Security Income. Over the last 5 years, our disability workloads have grown significantly, and this trend will accelerate as baby boomers reach their most disability-prone years. We cannot lose sight of the fact that this longer-term increase in disability claims is coming, regardless of when the American economy begins to recover.
The time is now, despite the challenges of the economic downturn and the hearings backlog, to modernize the disability process to avoid future backlogs and provide applicants with speedy decisions. Technological improvements alone cannot remedy the issues in the disability process. We must revise the policy and medical guidance at the core of the program to align with medical technology and knowledge. A modernized disability process will help us to better serve the public and fulfill our obligation to provide a fair process to the American people. The following initiatives form the core of our disability modernization program in FY 2010:
Improve Occupational Information for Making Disability Determinations and Decisions
SSA is working on the development of a new occupational information system that will replace the out-of-date Dictionary of Occupational Titles (DOT) used in SSA’s disability determination process. The DOT was originally created by the Department of Labor (DOL) and has become a cornerstone of our disability policy. We rely on the descriptions of work in the DOT to determine whether individuals can do their usual work or any other work in the U.S. economy. However, DOL has not updated the DOT since 1991 and has no plans to do so. DOL’s replacement for the DOT, O*NET, does not serve SSA’s purposes. It is critical that we base disability determinations on current job information.
SSA awarded contracts in 2008 for the use and evaluation of updated occupational information. In December 2008, Commissioner Astrue established the Occupational Information Development Advisory Panel to provide advice and recommendations on plans to replace the DOT. The panel advises SSA on the creation of an occupational information system for disability programs and adjudicative needs. Specifically, the panel will advise on medical and vocational analysis, occupational analysis, data collection, use of occupational information, and other areas. The panel had its first meeting in February 2009 and has three more meetings scheduled this year.
SSA will continue its efforts to replace the DOT in FY 2010, when the agency will begin identifying the physical and mental abilities and skill levels that occupations require, developing the means of gathering occupational information, and researching assessment of residual functional capacity.
Update Medical Listings
SSA uses the Listings of Impairments to describe impairments considered severe enough to prevent an individual from working and earning above a defined level. The listings are a critical factor in our disability determination process; however, we have not updated some listings in decades. We are working to expand the listings to include rare disease and permanently disabling conditions. We are also working to update all of our existing listings by the end of FY 2010. We have also developed a long-term schedule to ensure that in the future we update all listings, as needed, but at least every 5-7 years. Updated listings allow disability examiners and SSA adjudicators to identify eligible applicants early in the disability determination process and result in improved disability decisions.”
All of this sounds good in the abstract. However, ONET was going to replace the DOT for disability hearings until it was determined it would not actually work in a disability hearing. Listings have been updated and some old listings have been completely removed because the listing was supposed to be covered by the new listing; however, the ALJ’s and Medical Experts do not always understand this. SAA has rolled out other plans that were supposed to help but only made things worse. Time will tell if these “improvements” actually improve things in the real world.
Social Security Commissioner Releases Statement Commending the President’s Fiscal Year 2010 Budget Request
Michael J. Astrue, Commissioner of Social Security, recently released the following statement:
“By requesting $11.6 billion for Social Security’s administrative expenses, a ten percent increase over the previous year, the President has demonstrated his commitment to help us reduce longstanding backlogs as well as handle the recession-related work that is flooding the agency. With this support, we can continue to drive down the hearings backlog, process increasing numbers of retirement and disability claims, modernize our information technology, and improve service in our field offices and teleservice centers.
It is critically important that Congress enact President Obama’s budget proposal in a timely manner so that we can make the changes that will provide the American public with better and more timely service.”
A link was provided to another document that provides more information about the thoughts of Social Security regarding its priorities and the proposed budget. Here are a few statements that are of interest:
“Eliminating the hearings backlog remains a top priority. Despite the setbacks caused by the economic downturn, SSA is on track to eliminate the backlog by 2013. SSA will also continue to make critical changes to the disability process to improve timeliness, quality, and efficiency. These changes will align SSA’s disability policy with modern medical technology and knowledge….
Hearings and Appeals: In FY 2010, we will maintain the staffing levels that we reached at the end of FY 2009 and add roughly 700 new employees. These hires will help us to process nearly 80,000 additional hearings in FY 2010 and will ensure that the hard earned progress we have made towards eliminating the hearings backlog is not lost because of the economic downturn.
We are devoting more resources to the Hearings Backlog Reduction Plan in both FY 2009 and FY 2010 to ensure that we continue to make progress. This includes:
→ Hiring 157 ALJs in FY 2009 and 208 ALJs in FY 2010 to reach a target total ALJ corps between
1,400 and 1,450 by the end of FY 2010. We also plan to add support staff in FY 2010 to maintain
our ALJ to support staff rat o;
→ Continuing to increase productivity in the hearing process;
→ Opening 13 new hearing offices;
→ Opening more National Hearing Centers;
→ Implementing standardized business processes that will ensure consistency and improve
processing times;
→ Expand Quick Disability Determinations by increasing the percentage and types of claims
processed;
→ Piloting the new Compassionate Allowance initiative, allowing us to quickly identify individuals
who we believe are clearly disabled under SSA’s rules; and
→ Continuing to explore potential electronic initiatives that can reduce case preparation time.”
More will be posted from this document tomorrow.
Indianapolis ODAR Processing Time Update
A recent report on average processing time of a Social Security disability claim from the time of the Request for Hearing shows that the processing time is becoming shorter at the Indianapolis Office of Disability Adjudication and Review. In a prior post, I noted that the processing time was 896 days. A recent report shows that the processing time has been reduced by 177 days to an average processing time of 719 days. The average processing time at Evansville was reported to be 588 days and Ft. Wayne is listed at 600 days. This is tangible proof that while the wait is still very long, things are improving.
Congressional Subcommittee to Hold Hearings on SSA Backlog
Congressman Michael R. McNulty (D-NY), Chairman, Subcommittee on Social Security of the Committee on Ways and Means, announced that the Subcommittee will hold a hearing on the performance of the Social Security Administration’s (SSA’s) appeals hearing offices on Tuesday, September 16, 2008 Read more
Indianapolis ODAR Average Processing Time
According to a recently released report from SSA, as of June 27, 2008, the Average Processing Time at the Indianapolis Office of Disability Adjudication and Review (“ODAR”) is 896 days. By this ranking, Indianapolis was in 147th place out of 147th ODARs. The Evansville ODAR was at 136th place with 762 days. Fort Wayne was at 130th place with 711 days.
In a previous report, as of May 30, 2008, Indianapolis was in 144th place with average processing time of 815 days, Evansville was 135th place with average processing time of 704 days, and Fort Wayne was 122nd place with average processing time of 638 days.
Why is there such a delay at the hearing offices? Click Here!
