From KALB in Cottonport, LA:
Hundreds of thousands of people applying for Social Security Disability benefits are having to wait up to 10 months to hear back on the status of their application. That wait is wasting time and money for families dealing with health concerns that could ultimately be the difference between life and death.
Dr. Peter Lemoine, an attorney specializing in Social Security Disability law, said he fears that number will only double given the lack of manpower and efficiency in the Social Security Administration. One of his clients, Jalisa Johnson, is a 33-year-old single mother of four children battling stage four colon cancer. Lemoine said an application for disability benefits was sent out back in March, for a family in desperate need of financial and medical support. They have yet to receive an update and yet to receive thousands of dollars worth of assistance. ...
Johnson was placed on hospice over a month and a half ago in her fight against cancer. While still waiting for her approval from social security, many community members have helped raise money for her and her children. ...
I had posted about this earlier on Twitter. Immediately I received replies that tried to place the blame for the delay on the attorney. That's ridiculous. There's no reason to suspect that the attorney failed in any way.
I've recently had a case of a terminally ill client whose case was pending at the reconsideration level. We kept calling about it and were eventually told that the problem was that the claimant hadn't returned his work history report! In case you don't know, that's absurd. That form is unnecessary when the claimant is dying. By the way, we don't intentionally take on cases of terminally ill claimants. We tell them that they won't need us. In the case I've talked about the diagnosis of terminal cancer came after we took on the case.
32 comments:
But on the positive side, the Agency is spending lots of time and money on Diversity, Equity and Inclusion training, as well as worthless Improving Workplace Morale meetings.
Seriously though, since attorneys file their DIB claims online they do get shafted as those do not get the immediate attention they deserve. It is not uncommon for online DIB claims to sit for months before they get sent to DDS. Is just comes down to lack of manpower.
Actually those people need you the most! They are trying to navigate the healthcare system, looming death, possibly insurance or mediciad for the first time, partner and children futures, and a whole host of other problems. They need someone to take the SSA portion off of their hands, handle it and keep it moving so they can concentrate on more important things. But I guess there isnt a backpay and it has to go fee petition, so yeah, let them deal with it.
Expect it to get worse before it gets better unfortunately.
I can’t keep up with my work and see no help in sight for at least a few years.
New hires have been quitting before completion of their training.
This is true. 99% of the internet claims we get need a significant amount of development before sending to DDS.
That development is certainly affected by the lack in manpower.
There also seems to be a huge disconnect between the claimants and their attorneys when it comes to the internet claims.
In the past when I was responsible for working them, I can’t tell you how many times claimants would refuse to talk to me to finish their claim because they said that’s what the attorney was supposed to be doing. That’s even if I could get ahold of the claimant in the first place.
In theory filing online is great but with fewer and fewer trained employees and subpar information being submitted, any perceived advantage is gone.
If a case is properly identified as TERI--terminally ill--it should and almost always does receive expedited attention throughout the processing actions. However everything must still be done by the book, submissions, review, adjudication. No magic wands involved. DDS just as impacted as FOs, PSC, OHA by demand vs staffing.
Why vocational evidence may be needed even in a terminal case...this may be related to onset. Claimant has a do of cancer. There is no metas at this time.. She may or may not receive chemeotherapy and return to work full or part time. THe cancer later recurs and now meets. For onset we need to know re dates and nature of work from original dx to see if UWA or non SGA applies. Also at times claimant may have other conditions which could result in an earlier onset depending on the past work and we might also need med documentation for the other impairments
I recall a case where an SSI claimant was on their deathbed, couldn't attend the hearing. We had previously filed an on-the-record request, and if necessary, requested the hearing be expedited. We informed the ALJ, the case grided out, even using DDS' own statements, due to age change. The ALJ to their credit, got a fully favorable decision out the next day (shocking). The claimant died a few hours later, before the fully favorable decision was "effectuated," so no benefits payable. Disgusting.
Internet claims with representation always took longer to get to DDS just because there are forms to enter and scan in for the representatives and sometimes information was missing. Some national attorney firms didn't remember that California has state disability insurance which often precludes SSI and is frequently going to offset part of the SSA disability benefits.
But, there is no excuse for terminal cases to sit in the office for more than a few days. Terminally ill disability cases are the very highest priority for claims specialists.
I found that people hired in the last decade that were pretty good didn't frequently understand what a priority these cases are.
@10:20
I assume Charles did not historically take terminally ill clients, for the same reason we did not cases which are clearly going to be awarded due to the nature of the claim. It borders on unethical to just take a case where representation is unnecessary. Also, the past-due benefit amount and fee petition is not affected by someone being terminally ill, although we've also never considered either in taking a case. That's absurd.
@11:18 - They're dying. In my unasked for opinion, and something that SSA would probably NEVER do, I believe SSA should release to them part of the money pot they paid into for so long, the minute they see "Terminal", THEN do all the bureaucracy red-tape work that is backlogged. If they get better, great, they may have backpay coming! If not, at least they died with some sort of dignity. If only our world were perfect. There SHOULD be a "magic wand" in the case of the terminally ill. d:-/
We always filed TERI and CAL claims for people that came into us to make sure everything was as complete and proper as possible so there would be a complete clean claim with all the evidence to make a quick and proper decision. Getting the proper diagnosis paperwork and submitting it with the claim right from the start makes things go much swifter for all involved. Asking the sick or the family members caring for them to do this and know what they are doing is inhumane.
I have had terminal cases denied. Some in error but some because the "terminal cancer" wasn't terminal and is quite curable.
On internet cases I've seen terminal alleged for mental illness.
I have seen DDS approve a terminal case in one day although that was a few years ago.
Thank you to those reps who do not take claims that are sure to be awarded. Unfortunately, there are plenty who do. I come across them every month.
I have taken many Title II only Teri cases knowing that my work will likely be done pro bono. Assuming SSA does its job efficiently and approves the case within the five month waiting period, no fees are awarded. It is difficult to say “no” to a cancer patient on chemo who just needs help navigating the system and paperwork. I think it is unfair to generalize that any rep on a Teri case is being greedy or unethical.
My years of experience with reps in smaller offices was that they were just trying to help claimants. They were generally helpful if the FO needed more information. Nationwide offices generally were not cooperative or perhaps too overworked to be of much assistance.
11:18 - It is not "their money." They pay into retirement, which is irrelevant to a disability claim. They also pay insurance premiums, i.e. for "disability INSURANCE benefits." Do insurance companies pay back "a portion of the money" the insured sent in as premiums? Uh, no.
Not all TERI claims are TERI. I get TERI claims for prostate cancer, which is very curable. It is virtually impossible to meet the prostate cancer listing, but it is still flagged as QDD, CAL, TERI. I send work histories on these claims because I will need it. If it's a true TERI claim- pancreatic cancer, for example, I'll get it out as soon as possible. However, as others have said, I can't get to the claim until it's been assigned to me at DDS, and unfortunately, having a rep can often slow down the processing at FOs, for a number of reasons.
It's not fair to blame the rep, but it's also not fair to blame DDS or the FO. It's everything together, creating a perfect storm.
I’ve seen alleged terminal cases denied as well. It’s more common than you’d think. Also, seen quite a few stage 3 and stage 4 cancer cases denied.
Attorneys are doing a helpful service for the applicants. TERI/CAL/QDD cases rarely have past due benefits payable to the claimant which is where the attorney fee is derived. No one should go through red tape to get awarded benefits they are due.
The United States States Congress/ multiple Administrations under both political parties, specifically conservative administrations are responsible for feckless leadership and years of underfunding. SSA is a dumpster burning while congress and the administration look on from a distance. Politicians have no shame and the cronies installed by previous administrations are awful human beings.
Politicians have little concern for a person who received a terminal prognosis. If politicians had a sample of the policies they implement, they would be outraged.
If SSI is involved generally we can do a preemptive disability and they can get 6 months of SSI. For Title II if they have completed the five full month waiting period and it seems it will take a while to resolve the onset issues we can allow with what is called an interim established onset and ask that the case be returned after payment to further develop the onset issues. However unfortunately they rarely get returned and there is no tracking mechanism for these situations. Then there is the guy who told the DO his condition was terminal but the actual diagnosis was terminal insomnia
@8:43
...okay to be fair I suspect he meant that his condition is permanent.
I handle TERI cases pro-bono because I have no confidence these claims will be processed in compliance with the regulations. The local field offices I deal with on a regular basis are simply too overburdened/incompetent to handle these cases correctly. This was not the case 2-3 years ago. Sad state of affairs. I also had a TERI case where SSA imposed an incorrect over-payment due to my client earning too much after his official SSA retirement date. But ALL of his earnings for that year occurred before his election of early retirement. This client was an accountant and was able to draft a very detailed explanation himself--took me 6 months of follow-up with SSA to get his case resolved. This was before the FOs reopened.
At 3:52:
There is no such thing as a claim that is sure to be awarded. I used to tell people to file on their own because they didn't need an attorney. Then 5 months later I would get the call that they were denied. Reasons include, DDS classified a building maintenance man as sedentary work (even though the claimant reported repaving the parking lot, replacing toilets, etc in his job), DDS saying the condition would improve within 12 months (55 year old meat cutter that had a leg amputated due to diabetes), or consultative examiners finding nothing wrong with an individual that underwent a multi level spinal fusion two weeks after the examination.
If DDS and the SSA did their jobs correctly and honestly, people would rarely need representation.
That's too bad because it's a simple FO input to show months worked which would remove the overpayment.
I have practiced SSA Disability Law since 1979. I do not turn anyone away because of a terminal illness. I have seen such cases denied and I file for Reconsideration.
Most of the cases are decided within the five month waiting period and do not involve a fee. In other cases I waive the fee.
I look at these cases as follows: 1.) I am providing a service to someone in need. My service takes some of the burden off of the claimant and family. I can relate to the family stress. Ten years ago my wife spent four months and five operations in hospitals and nursing facilities. She received an infection from a pain injection. She never returned home and died too young. 2.) I believe in the concepts of good will and mercy to others. I do not advertise, never have and never will. I look at an attorney doing good works and handling work pro bono is good karma that will come back to me.
I believe claimants with terminal illnesses need a good attorney.
@1248 Bravo for you!
I would bet he filed online and didn’t show non-service months correctly. Happens all the time.
If you called the office for them to schedule an appointment, they would be called within three business days, have the claim sent to DDS that day and have a decision quickly, if it is a TERI case. File online and unfortunately it sits around in a backlog. With the ridiculous procedures that come out of Woodlawn, a claim filed online takes a lot of work. Having to call the claimant to verify a electronic signature is a joke. I would love to know how many claimants say they didn’t sign the forms. My guess is next to none, which is why I don’t bother anymore. Plus it’s a pain in the ass to fix all the edits in order to get it sent to DDS because the person who filled it out online did a terrible job.
12:48pm, You are an angel and others should emulate you!
They are really slow at DDS these days. They have a 2nd unit to review anything favorable. I'm representing a claimant with pretty serious CHF and they're nitpicking about the work report for which they now have different standards. I understand backlogs, but they are creating unnecessary work for themselves (and me).
I've taken on cases that I knew for sure would be awarded at initial. But - in every case - I have been honest with the client and recommended they file themselves, and gone over how to do it. What a lot of people are missing is this - a person who has been told they have a terminal disease is sometimes not mentally or emotionally at a place to do the paperwork. They would rather offload it to someone else. And, in the vast majority of these cases, they get picked up within the first 5 months and there's no fee due, which I am happy with. I do whatever the client thinks is most helpful to them. It's not out of greed.
You .ust be republican I take it.
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