When I started in this industry I told people that they should expect about 18 months from application date until their hearing. Now, we're telling people to expect at least 2 years. The wait time from start to finish is horrendous. Our clients are suffering there's literally nothing we can do for them. The most common question we get is how to survive during their disability hearing's pendency. We have no good answers. Section 8 housing, food stamps, and Medicaid typically fail to make ends meet when the breadwinner is disabled.
Even if you have a 1 year emergency fund saved up, you're still likely to run out of money before you finally get to the hearing. Then, you're only looking at a 47% chance of winning (unless you use an attorney).
Overall, the life of a disabled individual is pretty bleak.
I just had the "what am I supposed to do while I'm waiting for my hearing" discussion with a new client with Multiple Sclerosis who just received her initial denial. She's going to elect to receive unemployment benefits in order to keep her home while she waits another 14+ months. I'm just hoping that her future ALJ does not hold this fact against her for she is clearly disabled. She has no other choice.
12:05: I'm just filing the appeal and letting it sit on the shelves and doing nothing as my eventual fee grows....
I know that's what you're insinuating with your question. It's next to impossible to receive an OTR favorable decision unless I can show a terminal diagnosis. The authority of senior advisors to look at files and request favorable decisions has been mostly eliminated. Most of my dire needs requests which I file with foreclosure/shut off notices are ignored. So I will order updated medical records, obtain residual functional capacity evaluations from the treating physicians and tell her to hold on until her hearing is eventually scheduled. There really are no other options.
10:39 is an asshole and/or ignorant. Only a diagnosis of malignant MS will get compassionate allowance. There aren't any other real alternatives. I'm going to guess that 10:39 works in the SSA and assumes all claimants are full of it.
Yeah, the quotes around "clearly disabled" by 12:05 seems to indicate that he/she thinks that the MS-diagnosed claimant with lesions on the brain who has difficulty walking/chronic pain is faking it in a ruse to cheat SSA out of $1000/month.
MS is a great example of the disability conudrum. Reps see the diagnosis and think, bam! payday. But the reality is, MS is a very, very slowly progressive disease. Most people work for years, if not decades after being diagnosed. At the point most claimants file for disability, they were probably not able to do their PRW...but since it's a young person's diease, it's very likely that there are other, sedentary jobs they COULD do. But the reality is, no one is going to hire you with MS. so you're not disabled, but also unemployable.
So you wait for a hearing until a sympathetic ALJ, will pay you because he realizes you're never going to be employed, and have a condition that at some point will degenerate such that you are actually incapable of working. good ole 96-9p
Between W.Va. and some peculiarities of agency metrics, ALJs are (unintentionally) incentivized to not do as many OTRs. Throw in the recent severely limited senior attorney adjudicatory authority and you've got yourself a perfect storm of nobody paying OTRs for the past few years.
Hopefully the agency will be able to better use its senior and other attorneys and have more reviewing and OTR'ing within the near future.
Our law firm used to get 35-40% of our cases approved otr after the submission of a brief with updated meds. Now this number is about 15%. I think I saw national stats on this blog where otrs used to comprise 25% of all hearing decisions but now it is less than 10%. I have been told by more than one judge (after apologizing for dragging the clearly disabled client into a hearing) that if they grant an otr it will be scrutinized but if they hold a hearing, even a 5 minute hearing, then their decision won't be reviewed. Really shameful.
Regarding the comments about MS claimants, MS is an episodic illness. During a flare-up, MS patients are often literally dependent upon others for daily care. Then, between flare-ups, they COULD possibly work, but what employer will hire someone with that problem, when there are many able-bodied persons available? I am an employer who, 3 times in the past, has hired part-time employees who were receiving disability benefits, but I will not do it any more--the episodic nature of many impairments causes a tremendous burden on the employer. Workers who've never run a business don't understand this.
When I started in this industry I told people that they should expect about 18 months from application date until their hearing. Now, we're telling people to expect at least 2 years. The wait time from start to finish is horrendous. Our clients are suffering there's literally nothing we can do for them. The most common question we get is how to survive during their disability hearing's pendency. We have no good answers. Section 8 housing, food stamps, and Medicaid typically fail to make ends meet when the breadwinner is disabled.
ReplyDeleteEven if you have a 1 year emergency fund saved up, you're still likely to run out of money before you finally get to the hearing. Then, you're only looking at a 47% chance of winning (unless you use an attorney).
Overall, the life of a disabled individual is pretty bleak.
I just had the "what am I supposed to do while I'm waiting for my hearing" discussion with a new client with Multiple Sclerosis who just received her initial denial. She's going to elect to receive unemployment benefits in order to keep her home while she waits another 14+ months. I'm just hoping that her future ALJ does not hold this fact against her for she is clearly disabled. She has no other choice.
ReplyDelete10:39: what are you doing to get this "clealry disabled" individual approved on the record instead of waiting 14+ months for a hearing?
ReplyDelete12:05: I'm just filing the appeal and letting it sit on the shelves and doing nothing as my eventual fee grows....
ReplyDeleteI know that's what you're insinuating with your question. It's next to impossible to receive an OTR favorable decision unless I can show a terminal diagnosis. The authority of senior advisors to look at files and request favorable decisions has been mostly eliminated. Most of my dire needs requests which I file with foreclosure/shut off notices are ignored. So I will order updated medical records, obtain residual functional capacity evaluations from the treating physicians and tell her to hold on until her hearing is eventually scheduled. There really are no other options.
10:39 is an asshole and/or ignorant. Only a diagnosis of malignant MS will get compassionate allowance. There aren't any other real alternatives. I'm going to guess that 10:39 works in the SSA and assumes all claimants are full of it.
ReplyDeleteYeah, the quotes around "clearly disabled" by 12:05 seems to indicate that he/she thinks that the MS-diagnosed claimant with lesions on the brain who has difficulty walking/chronic pain is faking it in a ruse to cheat SSA out of $1000/month.
ReplyDeleteMS is a great example of the disability conudrum. Reps see the diagnosis and think, bam! payday. But the reality is, MS is a very, very slowly progressive disease. Most people work for years, if not decades after being diagnosed. At the point most claimants file for disability, they were probably not able to do their PRW...but since it's a young person's diease, it's very likely that there are other, sedentary jobs they COULD do. But the reality is, no one is going to hire you with MS. so you're not disabled, but also unemployable.
ReplyDeleteSo you wait for a hearing until a sympathetic ALJ, will pay you because he realizes you're never going to be employed, and have a condition that at some point will degenerate such that you are actually incapable of working. good ole 96-9p
That was a cheap shot at the MS claimant rep.
ReplyDeleteBetween W.Va. and some peculiarities of agency metrics, ALJs are (unintentionally) incentivized to not do as many OTRs. Throw in the recent severely limited senior attorney adjudicatory authority and you've got yourself a perfect storm of nobody paying OTRs for the past few years.
Hopefully the agency will be able to better use its senior and other attorneys and have more reviewing and OTR'ing within the near future.
Our law firm used to get 35-40% of our cases approved otr after the submission of a brief with updated meds. Now this number is about 15%. I think I saw national stats on this blog where otrs used to comprise 25% of all hearing decisions but now it is less than 10%. I have been told by more than one judge (after apologizing for dragging the clearly disabled client into a hearing) that if they grant an otr it will be scrutinized but if they hold a hearing, even a 5 minute hearing, then their decision won't be reviewed. Really shameful.
ReplyDeleteRegarding the comments about MS claimants, MS is an episodic illness. During a flare-up, MS patients are often literally dependent upon others for daily care. Then, between flare-ups, they COULD possibly work, but what employer will hire someone with that problem, when there are many able-bodied persons available? I am an employer who, 3 times in the past, has hired part-time employees who were receiving disability benefits, but I will not do it any more--the episodic nature of many impairments causes a tremendous burden on the employer. Workers who've never run a business don't understand this.
ReplyDelete@ 10:39 AM, November 20, 2014
ReplyDeleteYou sound like a good rep. God bless!
Justin