Look to SSA Publication No. 05-10071, www.SSA.gov:
What you should do if you think you were treated unfairly:
If you think any ALJ treated you unfairly, you should tell SSA about it and ask SSA to look into it. You can ask even while the Judge is deciding your claim for benefits.
Your complaint should be in writing. But you also can call SSA about your complaint, and SSA will write it down for you.
The details should include: Your name, address and telephone number;
Your Social Security number; Who treated you unfairly;
How you think you were unfairly treated;
When you think you were unfairly treated;
The actions or words you thought were unfair;
Who else saw or heard the unfair treatment; and
If you are making the complaint for someone else, also give us your relationship to that person, and your name, address and telephone number.
What else you need to know:
Filing an unfair treatment complaint is not the same as appealing a decision. If you received a decision on your claim and you do not agree with it, you have 60 days from the date you receive the decision to ask for an appeal. The ALJ’s decision letter will explain how to file an appeal. You can describe the unfair treatment in your appeal. For more information, ask for The Appeals Process (Publication No. 05-10041), which also is available online at www.socialsecurity.gov/pubs/10041.html.
Where to send your complaint, send it U.S. Certified Mail/Return Receipt Requested to the following:
The Chief Administrative Law Judge
Office of Disability Adjudication and Review
5107 Leesburg Pike, Suite 1608
Falls Church, VA 22041-3255
[ add comment ] | permalink | related link |
( 3 / 10 )Free Lecture Outline for August 3, 2010 at Center Place in Brandon: The Basics of Social Security Disability
THE BASICS OF SOCIAL SECURITY DISABILITYI. Introduction: History
II. The Application Basics
III. The Claims Process
IV. Tips On Pursuing The Claim
The Speaker: David W. Magann, Esquire
Training / Education/Background:
United States Marine Corps Veteran
Criminology Degree from The University of South Florida
Law Degree from The University of Miami
Law Intern with The United States Custom Service Associate Chief Counsel's Office
Associate with B. Lee Elam, P.A., the oldest law firm in Brandon
Law Offices of David W. Magann, P.A. (Tampa & Brandon Offices) established March 2000.
Social Security Representative in over 1000 Social Security Hearings
Speaker: State Seminar; “Handling a Social Security Case in Florida”
BLOG: See, www.DavidWMagann.com, www.BrandonSSA.com, www.TampaSSA.com
www.FloridaSocialSecurity.com
Memberships:
Sustaining Member of the National Organization of Social Security Claimants' Representatives (NOSSCR)
Member of the Brandon Chamber of Commerce
Member of the Brandon Bar Association
President of the Brandon Bar Association 2001-2002
Brandon Bar Association Board of Attorneys
Past Member of the Hillsborough County Bar Association
Past Co-Chair of the Hillsborough County Bar Association, Social Security Section
Life Member of Pi Kappa Alpha and Order of Omega
Past Member of the American Bar Association
Past Member of the Association of Trial Lawyers of America
Past President of Seffner Chamber of Commerce 2003
Member of the Brandon Lion's Club
Past Board member of the Bread of Life Mission
*This seminar is for informational purposes only. The statements made by the speaker are not legal advice. All questions answered are given for informational purposes only. For legal advice you must seek an in person office consultation with a lawyer. This seminar is brought to you on behalf of the Brandon Bar Association.
I. Introduction:
"We can never insure one-hundred percent of the population against one hundred percent of the hazards and vicissitudes of life, but we have tried to frame a law which will give some measure of protection to the average citizen and to his family against the loss of a job and against poverty-ridden old age."
– Franklin D. Roosevelt’s Statement on
Signing the Social Security Act (Aug. 14, 1935).
The federal government provides benefits under two separate programs administered by SSA. The older program, known as the Old-Age, Survivors, and Disability Insurance program (OASDI), was originally proposed by Franklin D. Roosevelt and passed by Congress in 1935. At
first, benefits were available only for retired workers. Through amendments made in 1956 and 1960, Congress expanded the program to provide benefits to workers who become disabled before retirement and to their dependents, called Social Security Disability Insurance (SSD). OASDI is for individuals who have worked or for their family members. The benefit amount depends on how much a wage earner paid into the Social Security system.
Congress created the Supplemental Security Income (SSI) program in 1972 (The program came into effect in October, 1974)to provide benefits to a separate and more vulnerable group—needy individuals unable to work as a result of disability or advanced age. SSI is for individuals who are disabled or elderly, have little or no work experience, and who are very poor. Their benefit amount is fixed. To qualify for SSI, it is income sensitive.
II. The Application:
1. Online Application www.SSA.gov
2. In person at your local SSA office.
3. Over the phone.
A. Phone numbers for SSA (Social Security Administration).
1. 1-800-772-1213 (call center)
2. 1-866-331-2317 (Tampa - local)
3. 1-866-593-8721 (Valrico/Brandon - local)
The easiest method of applying is the phone interview. You must call and specifically request the “phone interview” and then an SSA intake person will give you a date and time for your at home, over the phone SSA application interview generally within 2 weeks of your initial call to SSA.
B. Protective Filing Date: Protective filing is a Social Security term for the first time you contact the Social Security Administration to file a claim for disability. Protective filing dates may allow an individual to have an earlier application date than the actual signed application date. This is important because protective filing often affects the entitlement date for disability along with their dependents.
C. Key Terms:
1. SSI (Supplemental Security Income) also known as Title XVI benefits and “welfare benefits”.
2. SSD, DIB, OASDI, SSDIB (Social Security Disability Insurance Benefits) also known as Title II benefits and “insurance benefits”.
3. Auxiliary Benefits also known as “child dependent benefits” which is calculated via a “Family Maximum” amount.
4. PIA (Primary Insurance Amount) the amount of “insurance” benefits you receive IF you have a SSD Title II claim.
5. DLI (Date of Last Insured) this refers to SSD Title II benefits and is an actual date of “last” being insured such as any other insurance policy.
D. Application Checklist - Adult Disability Interview: The following is a check-list of items you should gather together for the phone interview:
You should have as much of the following information as possible ready for your interview. Keep your appointment, even if you do not have all of the information.
Check off the items below as you get them together for your interview.
1. Medical Information:
Names, addresses and phone numbers of all doctors, hospitals and clinics.
Patient ID number(s):
Dates seen:
2. Names(s) of medicine(s) you are taking:
3. Medical records in your possession.
4. An original or certified copy of your birth certificate. If you were born in another country, SSA needs proof of U.S. citizenship or legal residency.
5. If you were in the military service, the original or a certified copy of your military discharge papers (Form DD 214) for all periods of active duty.
6. If you worked, your W-2 Form from last year, or if you were self-employed, your federal tax return (IRS 1040 and Schedules C and SE).
7. Workers' compensation information, including date of injury, claim number and proof of payment amounts.
8. Social Security Number(s) of your spouse and minor children.
9. Your checking or savings account number if you have one.
10. Name, address and phone number of a person who we can contact if we are unable to get in touch with you.
11. Kinds of jobs and dates you worked in the 15 years before you became unable to work.
The check-list will help you collect the information you need for your interview. You should always default on making the application rather waiting to see if you might get better.
III. The Claims Process:
1. Initial Application - estimated process time: 120 days
2. Reconsideration - estimated process time: 120 days
3. Hearing - estimated process time: 18 to 22 months
The average claim takes 24-36 months before having a hearing in front of a Judge.
A. Whether or not you are aware you, the claimant, are alleging the following statement when you make an application for Social Security Disability:
“I am disabled and unable to engage in any substantial or gainful employment activity.”
B. Key Terms:
1. Disabled - can not competitively engage in work activity on a full time basis at Substantial Gainful Activity (SGA).
2. Substantial Gainful Activity (SGA) - Currently SGA is $1000.00 gross pay for claimant’s and $1640.00 for Blind (20/200 both eyes best correction) claimants.
C. Part-Time Work: you can engage in part-time work while pursuing your application but you must consider three important claim fundamentals:
1. Have I already been out of work for 12 consecutive months without work activity? (If YES, other rules under a “Trial Work Period” (TWP) may apply).
2. How much am I making, per month, for the part-time work, more than SGA?
3. Under what rules am I trying to be found disabled? See, Listing of Impairments under the Social Security Act.
Applicants and recipients are required to report events and changes of circumstances that may affect their SSD & SSI eligibility and benefit amounts. Such reports are required, for example, when an individual has a change in the amount of his/her income or resources, changes living arrangements, or leaves the United States. Failure or delay in submitting a required report can result in monetary penalties or ineligibility for SSD & SSI benefits and cause “overpayment” issues.
IV. Tips On Pursuing The Claim: Top Ten (10)
1. Have a theme, theory, or basis for the claim and focus on those medical problems which have or will last 12 consecutive months or more.
2. To identify the theme, theory, or basis of the claim inform yourself on what are the medical impairments you can obtain disability for under the Social Security Act. (“Listing of Impairments” and the “Grids”)
3. Limit your verbal communications with the SSA Adjudicators, SSA employees and Judges. All information should be sent in writing U.S. Certified Mail.
4. Allow your medical records to speak for themselves.
5. Tell your doctors that your are pursuing a Social Security claim.
6. Cooperate in completing all SSA forms on time.
7. If you have a private disability insurance policy do not allow any “third party” recommended by your insurance company to “monitor” or “assist” you with your Social Security claim and obtain a private Florida Bar licensed attorney immediately.
8. Generally, keep the status quo, for example, if you decide to go to school full-time during the application process then SSA Adjudicators may conclude you can do at least “sedentary” or “light” work activities.
9. Do not go to a hearing without an attorney. At the very least the cross-examination of the Vocational and Medical Expert should be done by an experienced attorney. Do not hire a non-attorney. Look at your fee agreement and go to www.FloridaBar.org to look up the person. Do not allow a non-attorney to sign the fee agreement or appointment of representative form (SSA-1696). If you find out at the hearing before the Judge that a non-attorney is your representative tell the Judge immediately that, “I want an actual attorney”. SSA can provide a list of actual attorneys. Interview the attorney to find out his/her experience, if he or she will be the one actually representing at the hearing and get it in writing, e.g., he or she solely, should sign the fee agreement with you!
10. Call an experienced attorney and speak with him or her about the claim. The consultations are FREE! Even if you do not hire an attorney you at least can get some insight on your claim.
[ add comment ] | permalink | related link |
( 2.9 / 16 )Continually we meet with claimants who have been previously represented and find that important medical evidence was not obtained in order to win the previous claim. Time and time again with especially untrained and incompetent non-attorney representatives this theme of not obtaining medical evidence, when it could of and should of been sent into to SSA,is the primary reason for a claim denial.
As we have repeated in past blogs do not hire a non-attorney, consultant or supposed experts, whatever they might be calling themselves. Sadly when these non-attorneys neglect your claim there is no agency, except OIG (Office of Inspector General) who can help you. Generally, suing the non-attorney representative is your only option and an expensive option.
For a current list of people and companies to avoid at all costs here are the following "posers":
1.Montefu Consulting, Inc. (a for profit non-attorney company who shockling is also attempting to sell "discount health" cards which are a waste of your money)
2. Morgan & Morgan - in most cases a clerk attends hearing not a lawyer. Beware of your contract if a non-attorney also signed the document. This is the classic bait and switch and is immoral.
3. Allsup, Inc. - this company falsely states the percentages of "wins", is simply a collection agent for insurance companies, has non-attorney representatives and in many cases will take your hard earned money for the benefit of their "real" client, the insurance company. Beware, never use or enter into any agreement with Allsup.
4. Disability Group, Inc. - falsely states winning percentage, not Florida Bar licensed, California based company and good luck getting an actual attorney at your hearing or for you to meet in person for the initial meeting.
5. Disability Experts of Florida - non-attorney representatives, no legal education, "expert" is used loosely to describe themselves.
6. Binder & Binder - a New York based company, an "en mass" company meaning their business model is to obtain as many claimants as possible in volume and some will win but the marginal claims, good luck on prevailing.You will not see your attorney, if any, until you get to the hearing and by then if you have a marginal claim it is too late.
At least once a weeke we hear from a claimant formerly represented by one of the above and hope you will be wiser to avoid these problematic and often unethical representatives. To see who is an actual attorney go to www.Floridabar.org.
[ add comment ] | permalink | related link |
( 2.9 / 17 )At the many hearing offices that we visit it is both sad and astonishing to see how unprepared, blissfully ignorant and lax many representatives are before going in front of the Judge. For example, if a representative has never seen you, the claimant, before the hearing, this is a red flag that indicates you should immediately tell the Judge you want to seek other counsel, not to mention if your representative is not even a lawyer and merely a poser. The following is a list of "posers" which are either non-attorney representatives, generally have little to no education and in some cases you think your hiring a law firm when in fact you have an uneducated clerk as your representative, the old bait and switch. Topping the list of posers is shockingly a Florida law firm:
1. Morgan & Morgan - in most cases a clerk attends hearing not a lawyer. Beware of your contract if a non-attorney also signed the document. This is the classic bait and switch and is immoral.
2. Allsup, Inc. - this company falsely states the percentages of "wins", is simply a collection agent for insurance companies, has non-attorney representatives and in many cases will take your hard earned money for the benefit of their "real" client, the insurance company. Beware, never use or enter into any agreement with Allsup.
3. Disability Group, Inc. - falsely states winning percentage, not Florida Bar licensed, California based company and good luck getting an actual attorney at your hearing or for you to meet in person for the initial meeting.
4. Disability Experts of Florida - non-attorney representatives, no legal education, "expert" is used loosely to describe themselves.
5. Binder & Binder - a New York based company, an "en mass" company meaning their business model is to obtain as many claimants as possible in volume and some will win but the marginal claims, good luck on prevailing.You will not see your attorney, if any, until you get to the hearing and by then if you have a marginal claim it is too late.
In general avoid the above and any representative who is not an attorney. In the bait and switch tactic like Morgan & Morgan has going on,just simply never ever deal with a "poser" non-attorney for processing your claim. Also avoid any referral services. Just take a minute and find an actual attorney who does Social Security claims as their primary practice.
[ add comment ] | permalink | related link |
( 3 / 84 )There are non-attorney representatives who can represent you at the hearing which first came into being because the SSA Disability process was established to allow access to all in an informal manner.
However, informal or not your Social Security Hearing is often the "final chapter" of a three year or more long battle. In other words, your final chance to win in consideration of all of the evidence.
It is shocking to think that many claimants leave the task of proving up their claim to non-attorney, often unskilled, without even the requirement of a high school diploma, representatives. In other words, claimants that would typically not hand over the future of tens of thousands of dollars are doing just that with a non-attorney representative.
Even more shocking, law firms such as Morgan & Morgan who even advertise about representatives "hurting you" are in fact the same where they send non-attorney clerks to your hearing. Very true and very sad fact of the confusing process where you think a regulated law firm has your best interest in mind but then send an uneducated clerk to do a lawyers job.
Words of advice: don't enter into any agreement with a non-attorney representative even if an attorney also signs the document.Do not let some Tom, Dick or Harry non-attorney poser represent you at your most important hour of need.
Make sure you have an attorney at your hearing, if you don't, then immediately tell the Judge you want a real lawyer and not a non-attorney poser.
[ add comment ] | permalink | related link |
( 3 / 99 )The decline of pensions and Social Security Retirement now being "pushed back" is creating a liability or a likely outlook that Social Security Disability applications will be on the rise.
For example, individuals born after 1959 will now have to wait until age 67 to receive full benefits from Social Security. Many people believe Social Security will get them through their retirement years. But a growing body of evidence indicates that Social Security Retirement may not be enough and may be delayed even further in the next decade. Even then, Social Security may not be able to meet your needs. In aggregate, the Social Security Retirment benefits paid to current retirees replaces only 37% of their pre-retirement income.1 And the higher your compensation, the smaller the percentage of pre-retirement income that will be replaced by Social Security Retirement.
What one can do now is take a look at your Social Security Statement, which you should have received in the mail or can be requested from Social Security. Look at the Statement and find out what your payment amounts will be if disabled, retired, etc. In other words, plan for your financial future or at least take notice of the amounts Social Security will pay. Often, claimants are shocked to find out how small the payout will be for disability and/or retirement.
1 Data Source: www.ssa.gov. “Fast Facts and Figures About
Social Security, 2008
[ add comment ] | permalink | related link |
( 3 / 102 )Since 1996, the Social Security Act has precluded a finding of "disabled" if there is a finding that DAA is a contributing factor material to the determination of disability. The 1996 changes further narrowed a 1994 statutory amendment that imposed a time-limit on receipt of benefits if there was a DAA "material" finding. It is interesting to note that SSA issued final regulations after the 1994 amendment, but never the revised its regulations after the 1996 statutory change precluding eligibility. 20 C.F.R. §§ 404.1535 and 416.935. As a result, the primary guidance for determining eligibility where DAA is an issue is Emergency Message (EM) EM-96200, "Questions and Answers Concerning DAA from the 07/02/96 Teleconference--Medical Adjudicators- ACTION."
SSA has published a notice in the Federal Register "requesting your comments about our operating procedures for determining disability for persons whose drug addiction or alcoholism (DAA) may be a contributing factor material to our determination of disability.'' 75 Fed. Reg. 4900 (Jan. 29, 2010). Comments are due no later than March 30, 2010.
The issues are:
1.What evidence should SSA consider to be medical evidence of DAA?
2. How should SSA evaluate claims where there is a combination of DAA and at least one other mental or physical impairment?
3. Should SSA include use of cigarettes and other tobacco products in its instructions?
4.How long a period of abstinence or nonuse should be considered to determine whether DAA is material to the disability determination?
5.Is there any special guidance SSA can provide for individuals with DAA who are homeless?
[ add comment ] | permalink | related link |
( 3 / 122 )SUPPLEMENTAL SECURITY INCOME GENERAL INFORMATION
SSI MONTHLY FEDERAL BENEFIT RATES (FBRs) AND LIVING ARRANGEMENTS
See the amounts below to determine the maximum monthly SSI benefit you can get in the following living arrangements if:
• your State does not add to the SSI monthly FBR, and
• you have no countable income. See SSI Income on page 19 for more information.
However, depending on what State you live in, you may receive a supplemental payment. Some States contribute to the total amount payable to SSI beneficiaries. This amount varies from State to State. See SSI Benefits on www.SSA.gov for more information on the State supplement. The amounts below refers to the amount you get from the federal government only, provided you or your spouse does not receive any other countable income as of January 2009.
Live alone or pay your share of food and housing costs:
• Individual/Child $ 674
• Couple $ 1,011
Live in the household of another:
• Individual/Child $ 449.34
• Couple $ 674
Live in a Medicaid Institution:
• For each Individual/Child $ 30
NOTE: Amounts given are general guidelines only.
SSI RESOURCE LIMITS – You can get SSI in all States if we count the things that you own and they are worth less than the following:
• Individual/Child $2,000
• Couple $3,000
NOTE: SSA does not count all of the things you own as a resource. For more information about Resources, see www.SSA.gov.
SSI ELIGIBILITY REQUIREMENTS
WHO IS ELIGIBLE FOR SSI?
Anyone who is:
• aged (age 65 or older);
• blind; or
• disabled.
And who:
• has limited income; and
• has limited resources; and
• is a U.S. citizen or national, or a certain category of alien (Note: In general, an alien who is subject to an active warrant for deportation/removal does not meet the citizenship/alien requirement); and
• is a resident of one of the 50 States, the District of Columbia, or the Northern Mariana Islands; and
• is not absent from the country for a full calendar month or more than 30 consecutive days; and
• applies for any other cash benefits or payments for which he or she may be eligible, e.g., pensions, Social Security; and
• gives SSA permission to contact any financial institution and request any financial records that the financial institution may have about you; and
• files an application; and
• meets certain other requirements.
WHAT DOES “AGED” MEAN?
“Aged” means age 65 or older.
WHAT IS “BLINDNESS” FOR AN ADULT OR CHILD?
“Blindness” in Social Security disability programs is “statutory blindness,” which means:
• you have a central visual acuity of 20/200 or less in your better eye with best correction; or
• you have a limitation in the field of vision of your better eye, so that the widest diameter of your visual field subtends an angle no greater than 20 degrees.
If you have a visual impairment that is not “blindness” as defined above, you may still be eligible for SSI benefits on the basis of disability. See the definitions of disability for children and adults below.
WHAT DOES “DISABLED” MEAN FOR A CHILD?
An individual under age 18 is “disabled” if he or she has a medically determinable physical or mental impairment, which:
• results in marked and severe functional limitations; and
• can be expected to result in death; or
• has lasted or can be expected to last for a continuous period of not less than 12 months.
If the individual is age 18 or older, the adult definition of disability explained below applies.
WHAT DOES “DISABLED” MEAN FOR AN ADULT?
An individual age 18 and older is “disabled” if he or she has a medically determinable physical or mental impairment which:
• results in the inability to do any substantial gainful activity (see definition of substantial gainful activity on page 35); and
• can be expected to result in death; or
• has lasted or can be expected to last for a continuous period of not less than 12 months.
WHAT DOES “LIMITED INCOME” INCLUDE?
Income includes:
• money you earn from work;
• money you receive from other sources, such as Social Security, workers compensation, unemployment benefits, Department of Veterans Affairs, friends or relatives; and
• free food or shelter.
WHAT ARE “LIMITED RESOURCES”?
Resources are things you own such as:
• cash;
• bank accounts, stocks, U.S. savings bonds;
• land;
• vehicles;
• personal property;
• life insurance; and
• anything else you own that could be converted to cash and used for food or shelter.
The SSI limits for resources that SSA does count are:
Individual/Child $2,000
Couple $3,000
CITIZEN/NON-CITIZEN STATUS
To get SSI, you must be:
• a citizen or national of the U.S.; or
• a non-citizen who meets the alien eligibility criteria under the 1996 legislation and its amendments.
[ add comment ] | permalink | related link |
( 3 / 231 )After the initial application a "bar code" is identified with your claim which usually appears on most DDS or adjudicator correspondence and requests. The "bar code" should be sent via facsimile to the phone number identified on the correspondence.
The actual forms and bar code is being sent to a sub-contractor hired by SSA to process the documents electronically. In other words, to put the documents in an electronic format so the adjudicator can view the documents on his/her computer rather than having an actual paper file.
The problem that often arises is the fact that many claimant's do not have access to a fax machine or must pay a $1.00 plus for each page to be faxed and many adjudicators/SSA employees do not include a return pre-paid envelope via the paper method when specifically requested to do so in a claim.
It is important to note that the "bar code" at the initial and reconsideration claim levels is different than the "bar code" used at the Hearing level. Many times claimant's, SSA employees and representatives can confuse the two different bar codes which can cause chaos at the Hearing level. Although no human being can be expected to be a bar code reader, there is a noticeable page format difference between the two, which only an experienced practicioner or SSA employee can identify.
At the Hearing level a CD or disc is available for review and yes, you must have a computer to view the documents or Exhibits in your claims file. In Part III we will review what should be and what often is not on the CD that you may need to request.
[ add comment ] | permalink | related link |
( 2.9 / 198 )First SSA "Security Policy" regarding your electronic filings should be acknowledged. Details of SSA's Security Policy are the follpwing:
"The Internet is an open system and there is no absolute guarantee that the personal information you enter to request verification will not be intercepted by others and decrypted. Although this possibility is remote, it does exist. We have included the safeguards described below to reduce the risks:
•SSA is taking all reasonable and appropriate measures, including encryption, to ensure that personal information is disclosed only to you.
•So your Internet communications can remain confidential, you must use a Web browser which supports the Secure Sockets Layer (SSL) security protocol. Your Web browser probably already supports SSL.
•Social Security will not give, sell or transfer any personal information to a third party.
If you are not comfortable with these risks, please call 1-888-772-2970 to speak to a specially trained technician about your concerns. For TDD/TTY call 1-800-325-0778."
Generally, for the initial application I advise to either do an in person interview at the SSA offices or the phone interview. The internet application is both overly lengthy and labor intensive for the typical disabled person.
[ add comment ] | permalink | related link |
( 3 / 202 )Next
Calendar
