From the Cleveland Plain Dealer:
Today is the day Isaac Everhart has long been waiting for, the day he appears before an administrative law judge with the Social Security Administration in a bid for disability benefits.
Isaac is counting on the benefits to lift his wife, Violet, and daughter, Tiffany, out of their subsistence existence – the result of his inability to work since 2015 because of a back injury. ...
Isaac assumes the hearing is just a formality, that the judge will make an immediate ruling to grant him monthly disability checks and retroactive pay to the date of his fall. But he is mistaken.
At the end of the hearing, the judge informs Isaac that a review of the material in the nearly six-inch binder could take as long as 75 days. If the decision is in Isaac’s favor, it would likely be three to six months before Isaac sees the first check.
The news reduces Isaac to tears.
“I don’t understand how they can make us wait any longer,” Isaac tells his lawyer. ...
No, it's not likely to take three to six months to get first payment of benefits. In most cases, it's a month. It can certainly take longer to get everything paid, particularly if there's a windfall offset or a workers compensation offset but it doesn't sound like that would be the case here. The 75 days to get an ALJ decision would be on the optimistic side where I practice. There's a big backlog in getting out ALJ decisions nationally. It's good that this article talks about the delays AFTER an ALJ hearing is held. They're significant. Claimants also need relief on that side.
The difficulty with trying to interpret articles like these that are written by individuals with little to no knowledge of the process is that anything could be happening.
ReplyDeleteThe 75 days comment is odd to me as it indicates that it'll be that long to review the records. That makes it seem like this could be the odd judge that reviews files after hearings (which always made zero sense to me) or that this could be a rep that didn't provide 6" worth of records until a couple of days or less before the hearing. If it were simply the delay between hearing and signing the decision, I would expect the judge or article to be more careful with their language.
Regardless of the interpretation of that timeframe, it'll still take 3-6 months from the date of the hearing to receive their first check (2.5 months plus at least one month).
I agree about the post-hearing delays being a problem, but let's not pretend reps don't contribute to the problem by having things put in POST for 15-30 days following the hearing. And it's not as though you're only adding 15-30 days to the timeline by doing so. Sure, the records may come in within that time, but once it's moved to the judge's status, a decision can't be instantly made in most cases because the judge still has other cases to review, other hearings to hold, and other instructions to write. She/he will need time to become reacquainted with the individual's case, review the new evidence, and then make a decision and issue instructions. That's done in their "free time."
Not fair to blame reps. Here is a standard timeline:
ReplyDeleteHearing notice received 75+ days before hearing.
New medical release immediately sent to claimant.
Claimant sits on the release and fails to return it for two weeks, despite repeated follows-up. Now 50 days remain until the hearing.
Requests for updates are immediately send to providers.
A week later, two providers respond saying the release is insufficient, even though it is completely legally executed. A new one is sent. Now 43 days remain until the hearing.
Two weeks later, one provider sends a bill for $322 for the records, even though we live in a no-fee state. I call and dispute. After threatening a subpoena request, the secretary sighs and says she will get the records to us "ASAP". Now 29 days remain until the hearing.
They drag their feet and the records do not come in until 5 days after the hearing. I have submitted a 5DL to the ALJ. After all this..."reps contribute to the problem".
There's a LOT that goes into prepping a case for hearing. And don't tell me that I can always request records prior to receiving the NOH. Sure, that's TECHNICALLY possible, but to make any kind of a living in this practice you have to take as many claims as possible. This necessitates waiting until the NOH is received before requesting updates. Plus, requesting beforehand would mean the record is not UTD, and the occasional ALJ will complain that the latest two treatment notes are not in the file.
There are a handful of lazy reps, but I resent being painted with a broad brush.
Once a person has to ask for a hearing, they have to understand that it's not smooth sailing. While back problems can be the most disabling, back cases can be the most difficult to prove.
ReplyDeleteI concur with 6:36am. Most ALJs I know review the file BEFORE the hearing so that a meaningful hearing can be conducted in the first place. Even if the rep was negligent in keeping the record updated, it should not take another 75 days to review even voluminous records. Regardless of the article, those I know in SSA are doing are best to get timely decisions to disability claimants and things are getting better with additional hiring of staff and decision writers.
ReplyDeleteWhile the time to get a hearing scheduled is dropping, I've noticed that the time to get the written decision has grown. It typically takes 3-4 months to receive the decision from the ALJ. Add the time to send the file to the payment center and the SSI update from the district office if there is SSI involved, and it's easily 6 months to get the first check after a hearing.
ReplyDelete@6:36
ReplyDeleteHmm...on my first read, I assumed the 6" binder was just a paper copy of the evidence of record. If the rep (assuming he claimant had a rep) just brought that much new evidence with them...that's a problem.
As to the 75 days statement, that's optimistic from our perspective, but only slightly. We usually get decisions around 90 days.
Based on the claimant's expectations in the article and the mention of a 6 inch binder of evidence, presumably presented to the ALJ for the first time at hearing, it sounds like the claimant was going without representation. It's hard to believe that any rep would lead their claimant to believe that a decision and payment would be forthcoming without delay especially if all that evidence is really new.
ReplyDeleteThe legal community, legislators--attorneys--judges, created the process and corrupted the process by over complicating just about everything. Simplification is needed but the vested interests must see a plus side to the status quo that defies common sense.
ReplyDeleteI have waited nearly 7 years since my rheumatologist called my case a "slam dunk." Denied by ALJ, Federal Court... AFTER my pain and other symptoms got progressively worse. It has been 5 years since I last "worked," with several major accomodations. Sorry , pal. This system doesn't give a damn!! !!!!!!
ReplyDelete"Not fair to blame reps."
ReplyDeleteYes, it is, but you're right that it's not always fair to blame the rep. I'll go ahead and amend my earlier statement to many reps contribute to the delays after the hearing but not all. And those reps are only part of the problem. So is SSA/OHO. So are claimants. So are medical providers, medical records companies, and anyone else involved in the development of the record.
I suppose like you, 9:57, I bristled at the implication that I am largely responsible for post-hearing delays. I try to move cases as quickly as I can. My office is currently getting decisions back to me within a month it seems, but back when I'd see 2-3 months lag time on decisions, I often, if not always, wrote favorable decisions the day of the hearing and had them signed the following day to expedite the process for the claimant instead of waiting 3-4 months after the hearing to receive their benefits.