Below is a note in my firm's database concerning a telephone conversation with a client whose claim for Supplemental Security Income (SSI) was recently approved. We had told him to contact the District Office (DO) since it had been a couple of weeks since he had been approved and the DO had not yet contacted him to begin processing him onto benefits, as would be normal:
DO told him it would be 60 days from when he received his decision before he hears from them - So not to expect to hear from them until ~ Nov 20th.
I doubt they would wait 60 days to contact the claimant. They have to have it paid within 60 days. The information claimant relay on isn't always the most accurate. (not a knock on the claimants, just a comment on the unreliability of second hand information)
ReplyDelete@3:03
ReplyDeleteI am not aware of any 60 day rule, and the existence of the interim benefits program which allows benefits to be paid if preeffectuation review contact is delayed at least 110 days, suggests there is not a 60 day rule.
Do you have a citation for the 60 day rule? It would be very useful.
I don't see any implication that there is a rule, simply that the DO has a workload that is pushing out the required contact up to 60 days.
ReplyDeleteThe point is that in an ideal world, the client would be reviewed by the FO in 2 weeks or less so benefits could start. Telling a client it oculd be 60 days simply implies a crushing workload. Not a rule.
re: 3:34pm
ReplyDeleteThe requirement to pay cases within 60 days of an ALJ decision is one of those "public service indicators" contained within the Agency's FY 2019 DCO strategic plan, a meaningless document published every year by under-worked upper level managers who couldn't process a claim even literally to save their lives. You know, one of those "let them eat cake" type documents.
The document presupposes, of course, that there are people available in the field offices to do all the claims within the suggested timeframes and ignores the deleterious effects "system modernization" is having on agency workload processes.
Now, that being said, as a practical matter it really ought to be done well within 60 days of the decision date. I'd suggest that Charles encourage the claimant to contact their federal congressional representatives and ask them to intercede if they don't hear from the FO soon (like in the next week or so).
If a client really needs the money, I've encouraged them to go to the field office with their bank account info, documentation of living arrangement, and award notice to see if it can be processed sooner. Some clients are happy to wait in the field office (for many clients it's a more comfortable place than where they spend their days otherwise, with a restroom, decent HVAC, and chairs to sit in) if it means they'll get paid faster. If applicable, sending them with a letter from you explaining the need for an emergency advance payment or immediate payment and a copy of the relevant POMS can be a nice touch.
ReplyDeleteIf that doesn't work, Congressional staff or a "7 on your side" reporter can often make it into the "potential public relations problem" that justifies an IP.
I do not agree with telling the client to contact the DO. That is what they hire an attorney to do. My office contacts the DO in these situations. Also, I attend the SSI update appointment with the client. I am probably the only attorney to do that in my area. I feel it is part of my job to make sure the claimant gets the maximum amount allowed. In a number of cases I have been able to point out that the claimant is homeless and is therefore entitled to a full amount for past due benefits. In other cases, I have been able to use the records in my file to assist the claimant in answering questions about dates of residences etc. In some of these cases I even have to pick up my client and give them a ride to the SSA office. Most of them appreciate what I do but few of them pay for the medical records.
ReplyDeleteUp to the 60th day is common with a PERC interview. They have been pushed out longer and longer, and most are being done by phone in my area. They will NOT deal with the attorney unless they can't find the claimant. Post decision, you are not the rep anymore!
ReplyDelete@2:53pm...They are wrong then.
ReplyDeletePOMS GN03910.060 A.2, 1st bullet.
Until the SSI award letter is sent, the claim is not completed. The appeal period does begin until 60 days after the date of the claim award or disallowance/denial letter. An ALJ medical decision does not conclude the claim.
Also, the attorney does have the authority and should be the first person contact to request any evidence or information from except for cases in which a claimant signature is required (POMS GN03910.050 A).
You may want to brush up on policy instead of aggravating claimants and their representatives with unnecessary drivel.
@6:48
ReplyDeleteI am pretty sure 2:53 is a representative. They weren't saying that this was correct as a matter of policy, just this was the response from the local DO when 2:53 tried to assist their client post-decision.
That has also been the response from our local DO once or twice. We just send them a strongly worded letter, threatening to go to regional (as we have once or twice) and they usually comply.
Anyone approved for SSI is probably desperately poor but if they are only awarded SSI they have been poor for some time usually.
ReplyDeleteIt's worse for T2 claimants who have to wait because they have bills that they previously paid and are waiting for something they paid into for many years.
@2:47
ReplyDeleteBeing poor does not immunize you to the hardships experienced by continuing poverty. If anything, it makes you more desperate as your already limited resources are fully depleted.
Being unable to pay bills is a hardship experienced by claimants under both programs, as is administrative delay in connection with a program you paid into as; under T2 you paid social security tax into the trust funds which support T2 payments, whereas under SSI you paid sales taxes and any other taxes into the general fund which supports SSI payments.
You are missing the point. SSI claimants, once found disabled, experience exceptional delay subsequent to this finding because of administrative delay, while T2 claimants do not. Once found disabled, T2 benefits are activated immediately, whereas SSI benefits are only activated once the Administration gets around to confirming their financial eligibility.
We already pay SSI recipients far less, require they have assets well below what is reasonable (they are not adjusted for inflation, and the bar was set nearly half a century ago), and the medical standards are the same. What sense does it make to not immediately pay? Go seek an overpayment if they are subsequently found not disabled. I get that would be a matter for Congress, but further delay is unreasonable.
As a representative, I would contact the local office immediately. I am sure that a supervisor or the right worker would get them in and taken care of much sooner. I am not sure what the rule is, but there is a standard of promptness for getting SSI paid; there isn't one for social security benefits. If our claimants in Mississippi have to wait over a month for SSI, it's because some information wasn't submitted. There was a lawsuit filed on this issue back in the 70's. I don't remember the style of it, but I never heard of an SSI claimant having to wait 60 days to get set up for payment.
ReplyDeleteThat set of circumstances just doesn't sound right.
While you are telling them to contact their Congressmen, please ask that they ask for more staff also. As an SSA DO employee, I don't spend by days by the water cooler. I would love to have the time to process all workloads timely. However my days are spent being pulled to answer phones, work on putting out fires, processing mandated workloads like CDRs and RZs, etc. A Congressional Inquiry only pushes someone else aside. There are only so many hours in a day. The majority of us try our best to balance all of our clients needs. And believe it or not, we do care about our public. Like you, I love my job and truly enjoy serving the pubic, but there is only so much we can do with the limited resources we have.
ReplyDelete@ 1219--SSI is welfare and other than State Supplements has nothing to do with sales tax. Taxpayers who pay federal and state tax are the ones bearing the burden for SSI claimants.
ReplyDeleteYou do realize that SSI hearings decisions are effectuated in the local field office while Title II hearings are effectuated at payment centers. Sometimes payment centers can be quick but in my experience they aren't all that quick most of the time. If a T16 CR does the review for the hearing and can get all the documentation for living arrangement, resources and income, the person could be paid in a couple of days. Title II is a completely different matter.
SSI resource limit has changed since 1974. It was originally $1500 for individuals and $2250 for couples. While that change was quite a while ago, it hasn't been nearly 50 years.
As far as confirming a claimant's financial eligibility, one may find it reasonable to make sure welfare is paid to those that are eligible, no? Once money is paid to a desperately poor person it is not so easy to get the money back if they weren't eligible for some of the benefits.
Preach it 7:37! They are quick to cast stones but damn few of them have been at the keyboard processing these claims and the hot tickle list of the month. Bravo!!!!
ReplyDelete@9:37
ReplyDeleteNo, it absolutely does not make sense to confirm eligibility prior to release of benefits. That is my point. If the process takes 3 months, that's $2250 in SSI benefits. If the benefits were released first, and clawed back in the event of ineligibility, I find this risk tolerable, and appropriate given the claimant has been found medically-disabled. The fact that the Administration already allows for pre-payment of benefits through the interim benefits program, in the event of a delay of 110 days or more, acknowledges this is a possible policy. I find it the appropriate policy.
As to SSI being the burden of "taxpayers," as I said, SSI claimants do pay taxes.
In regard to SSI hearings decisions being effectuated in local field offices, whereas T2 hearings are effectuated at payment centers. Yes, I acknowledge that. I am sure a T16 CR could handle a PERC in a matter of a few days. They don't. That's the problem.
Finally, while SSI resource limits were increased in 1984, it has still been 34 years since an increase. My point stands.
Lets see you claw back your fee from an SSI person if they get the funds first and SSA doesn't cut you a check!
ReplyDelete@12:53
ReplyDelete"Also, I attend the SSI update appointment with the client. I am probably the only attorney to do that in my area. I feel it is part of my job to make sure the claimant gets the maximum amount allowed."
I absolutely commend you to attending every SSI interview. That is pretty impressive. My law firm and time would probably not make this doable. But I would be open to it if had the time.
But giving them a ride? I always wondered about the liability if there was an accident. I did this once for a claimant. The attorney in me knew it was probably not a good idea.