January 2011 Archives

January 20, 2011

Video Conferencing Does Not Do Much to Improve Social Security Disability Hearings

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I read with interest a report that conducting video hearings is a new measure to help reduce the backlog of claims pending a Social Security disability hearing.

I have been participating in video hearings for a number of years, and have found that the effort to farm out hearing to other offices and do them by video has had mixed success vis a vis the hearings backlog. The problem is that very often, cases get shipped from one hearing office to another where each time they are put in the end of the queue for a hearing. This means that a case that sat in office #1 for 8 months and was then shifted to office #2 to help ease backlogs in office #1 will be find itself behind newer cases that were referred to case #2 for a 'live' hearing.

Furthermore, nothing is necessarily gained using a video hearing for claimants who have difficulty traveling, since these hearing can still only be conducted at a Social Security office set up to conduct these hearings.

Finally, the technology for video hearings has still not evolved to a point where the Administrative Law Judge (ALJ) can, in fact, effectively get the sense of a claimant by using the pan and tilt features of the video appliance. In my experience, the ALJ's camera is set and there are never any adjustments made to close in on the claimant during the hearing.

In my humble opinion, the benefits of video hearings continue to be outweighed by the deficits. I know of many ALJs who prefer a live hearing because they feel that something is very much missing from the video hearing.

I tend to agree with them.

Gabe Hermann

For more on video conferencing at disability hearings, see these other blog entries Lew and I have written in previous months: "Video Hearings Don't Help the Claimant" and "Social Security Continues to Lead the Federal Government in Providing Internet and Technology Assisted Services."

January 17, 2011

Avoiding the Pitfalls of a Tricky MS Disability Claim

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Within the disability spectrum, our clients who suffer from Multiple Sclerosis tug at my heartstrings just a little bit more than most. Perhaps because they are invariably vibrant, successful people who are totally blindsided by the disease, they are very sympathetic clients and we usually expect their claims to be decided favorably.

However, there are two reasons why winning an MS disability case is not always as easy as it might appear at first glance.

The first is that in many cases, people suffering from MS are not actually diagnosed or treated until many years after their symptoms arise. They might see many doctors before they are correctly diagnosed, or they might not see a doctor at all. Just this week I reviewed a set of records where the claimant was diagnosed with MS and spent the next year treating for Lyme Disease before accepting that MS was the cause of his problems and starting to take Copaxone.

The result of a delayed diagnosis in some cases is a loss of retroactive benefits. In the worst case scenario, a correct diagnosis is not reached until after the claimant's disability coverage has expired, and no claim at all can be brought. Other than asking a doctor for a retrospective opinion, which the judges often do not credit, we can't do much about this problem.

The other reason that MS claims can be tricky to win is that very often the medical records don't contain all of the claimant's relevant medical complaints or they state that the claimant is "doing well." There are two reasons that happens, and both can be dealt with by an experienced attorney.

Often, patients don't tell their doctors the full extent of their problems, and sometimes the doctors either are not paying attention or do not see the need to record the patient's medical complaints in detail. Both of these situations can be remedied by having the client make a special appointment with their physician to go over their complaints, and to make sure that their chart is accurate and that the doctor notes the length of time the complaints have been present.

When the records say "doing well," it usually means "no change," or is in relation to a baseline that relates to the patient's medical condition, not that he or she has no problems or limitations. When we see a notation like that in the records, we have the doctors complete a Functional Capacity Assessment in which they have to note the patient's specific limitations and the findings that support them. Most neurologists who deal frequently with MS patients are quite willing to complete these forms for us.

My best advice to anyone with MS fighting a disability claim is to seek treatment immediately, and make sure to tell your doctor about all of your medical complaints. And that goes back to what I always tell ALL of my clients when they ask me "what do I have to do?" I tell them: "your job is to try to get better, and we'll take care of your claim."

Lew Insler, Esq.

January 6, 2011

New York State Health Insurance Program for People with Pre-Existing Conditions

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Several months ago I wrote about the New Jersey health insurance program available for individuals with pre-existing conditions (click here for that blog entry).

A similar program exists in New York State as well.

As with the New Jersey plan, pre-requisites include:
• having a pre-existing condition - although, in New York, the conditions are specifically identified and if an application's condition is not on the list, eligibility is subject to medical review.
• Not having had health insurance coverage for 6 months
• Being a legal US resident and a resident of New York State

Rates are as follows:
$421 for residents of the 5 counties that make up New York, Nassau and Suffolk, and counties North of the city including Ulster, Dutchess, Westchester, Rockland, Putnam and Sullivan.
$362 for all other counties of New York State.

Please note that this program is first come, first served and thus will likely fill up quickly. If that happens, the state and GHI (the plan administrator) will create a waiting list.

Click here for an application and further details.

Happy New Year!

Gabe Hermann