CBS reports on Social Security cutting off disability benefits to one young woman suffering from cystic fibrosis. Note that people involved in helping those with cystic fibrosis report that this is not an isolated case, that they’ve seen many similar cases lately.
I’ve seen this sort of thing many times over the years. Suddenly, I start seeing a run of clients with a particular disorder. I can remember seeing cystic fibrosis cases quite a few years ago but not recently. Mostly, what I see now is multiple sclerosis cases. It’s not that there are suddenly more people with cystic fibrosis or multiple sclerosis. It’s that Social Security has suddenly started turning down or cutting off disability benefits to people suffering from these disorders. There’s been no announcement, no public discussion of the change. The decision is made in private and almost certainly doesn’t involve really high level people. Congress isn’t consulted. It’s never written down. It’s all done through QA, Quality Assurance. Suddenly, whenever Disability Determination tries to put a claimant on benefits for a particular medical problem, the case gets sent back. Perhaps, since this case is a termination, Social Security has decided, ultra quietly, to target people with cystic fibrosis who are already on benefits for full medical reviews. Once the personnel involved in making disability determinations receive a few such cases back and notice the targeting of those already on benefits they get the picture and start denying the claims and cutting off benefits. Social Security doesn’t have to take responsibility for what it’s doing because it’s all hidden away in individual claimant files which are not available to the public.
13 comments:
Interesting you mention MS. At our practice we've noticed MS cases facing intense scrutiny the last few years. We blame it on the fact that MS patients often work for a long time after diagnosis. Plus, ALJs are poorly trained or fearful (not sure) about addressing conditions that really impair stamina. These "96-8p" cases that have faced greater resistance include MS, breast cancer/chemo treatments, and stroke cases.
I think ALJs are uncomfortable finding someone can do sed/light work only a few hours a day, but are not able to sustain it. Presumably, they are afraid of remand/re-training.
With MS, we've also seen that ALJs refuse to acknowledge any diminished mental capacity unless they see psychiatric treatment or specialist neurology treatment for mental abilities. Of course, some MS patients have reduced mental functioning, especially concentration, without having bad depression/anxiety.
the burden of proof on these cases is way higher than it used to be. If anyone can explain how SSA identifies impairments like this, I'd be interested to know.
Not exactly on topic but seems germane - my son has filed for DAC benefits on his mom's account. He gets SSI and is IDD - IQ less than 50. (There are other issues with activities of daily living but this was the primary decision point for SSI.) CR advised me that a recent change meant that the dib decision couldn't be adopted but a new one was needed. She sad that certain dib categories are now required to reprove the disability when filing for another benefit. Hey, I get that perhaps with ADD or disabilities with a wide range of impacts that prudence says check if it still applies, but damn, for an IQ less than 50? I wish he'd test higher but unlikely. So yes, "tweaks" to the process seem to be ongoing. Wonder what caused CF to get attention?
I do not think cystic fibrosis is particularly being targeted. The problem is that the criteria for cystic fibrosis has always been too harsh even after they. were changed in 2005 and then again in 2016. In this case she was eligible for benefit continuation up through the ALJ level. In addition as a student she could be eligible for continued benefits under the 301 program even if her conition had improved. Probably her recent hospitalization allowed her to be continued at the preheating level. This family's real complaint is the lack of medical insurance. Shame on Florida for not having expanded Medicaid.
2:44 they did recently change the mental listings which means prior SSI determinations cannot be automatically adopted under collateral estoppel. Hopefully they or you have the original documentation and an allowance should still be fairly rapid and straightforward. ...unless you mean his ADLs are quite normal.
Same thing with Fibromyalgia, even with other things. Such as Ankylosing Spondylitis.
4:39 - Of course :) It just seems odd that the documentation that satisfied an IQ below 50, ADL deficits that hit every theater of life, required 24/7 supervision needs that remain unchanged needs to go through the process a 2nd time to arrive at the same result. I realize they changed the rules and am not sure how to interpret 12.05 A but inability to read or write certainly messes up standardized testing. And all was well documented before. I was just being wistful that what was documented before was thought to even have some chance at improvement.
Cases are supposed to be reviewed periodically. Now that SSA has caught up with their---not the DDS --- backlog more cases that were allowed more recently are likely being reviewed. Each year, once DDS completes the mandated amount of cases to be reviewed, the CDRs stop.. The more severe the case when allowed , the more likely it is to be ceased. In the cases of those with the more minimal impairments when allowed it is usually impossible to find improvement
Shameful the SSA would go after those with cystic fibrosis (CF).
My best friend would not have tolerated this. He was a disability attorney while working with CF. We both work at a large disability law firm. He was my best friend and died about 2 years ago at around age 38 (after a complete lung transplant). He never drew SSD but he easily met a CF listing. Towards the end of his life, he literally rolled an oxygen machine with him to hearings. CF is a horrible disorder.
This is atrocious.
So, when SSA published the proposed pulmonary criteria in the federal register did any of you write to say that the criteria for cystic fibrosis were way too severe or suggest that this condition be considered a MINE category??
Or did you do so when they changed other Listings to make them way more difficult to meet?
It's not the impairment that makes your client disabled, it's their functional abilities and limitations.
I am always amazed at the way some folks overcome a condition and other succumb. The human animal is mystery indeed.
Would a policy like this be discoverable in a FOIA request?
"It's not the impairment that makes your client disabled, it's their functional abilities and limitations."
Wrong Anon 9:16. Meeting or equaling a listing is step 3 before you have to prove a person cannot perform PRW (step 4) and other work (step 5).
So when I was talking about my friend who had CF who died while working as a SSD attorney. He was extraordinary (or not the norm). He literally defied almost all odds to even live to be 38. Most people with CF are gone at most in their 20s.
There are many listings people overcome. For example, being totally blind (listing 2.03 or 2.04) is a disability. But I had blind people finish law school and become lawyers. Good for them. But they could have drawn SSD or SSI if they want. They wanted more money. They defied the odds. Google Helen Keller on defying the odds. Some people just have extraordinary will and determination. But they are still disabled.
I would call them a disabled worker who can summon the strength to work.
The SSA better not be targeting those with CF. I already attack the SSA as an attorney and sometimes in public. But in honor of my friend, I will make it my personal mission to legally and publicly pummel the SSA.
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