New York Social Security Disability Lawyer Blog

"This is not close."

As experienced Social Security disability attorneys who have represented thousands of disability benefits claimants in New York, New Jersey and Connecticut, we know all too well that sometimes the Social Security Administration (SSA), its experts and even its judges just plain get it wrong. According to Connecticut federal Magistrate Judge Thomas P. Smith, however, the SSA Administrative Law Judge (ALJ) reviewing Mathew Lavallee's benefits claim got it very, very wrong.

In Lavallee v. Astrue, Judge Smith runs through the litany of mistakes that the ALJ apparently made in denying Lavallee's claim. He also provides important insight into how a judge should consider a person's alcohol abuse in deciding on the person's Social Security benefits claim.

Mathew T. Lavallee filed a claim for Social Security disability benefits, alleging that he is unable to work due to : severe arthritis; alcoholism; torn meniscus in his right knee; an ankle injury that required repair with a metal plate and screws; degenerative disk disease; seizure disorder; and a left shoulder deformity which causes one shoulder to be four inches lower than the other.

The SSA denied the claim. Following an appellate hearing before an SSA ALJ, the ALJ found that although Plaintiff suffers from a number of severe impairments, he nevertheless could control these limitations through medication and abstinence from alcohol. Plaintiff then appealed to the federal District Court for the District of Connecticut.

"Plaintiff has so many serious impairments and maladies that it seems strange for one not to think of him as 'disabled' if the word 'disability' is given its common, everyday usage," Magistrate Judge Smith ruled in reversing the ALJ's decision and remanding the case. According to Smith, the ALJ unduly discounted Lavallee's credibility based on his previous history of alcohol abuse. The ALJ's suggestion that this abuse has caused Lavallee's various impairments was also unsupported by the record. This abuse, according to Judge Smith, "is arguably a result, rather than the cause" of Lavallee's sundry impairments.

Continue reading "Connecticut Judge Eviscerates Social Security ALJ, Explains How to Consider Alcoholism in Benefits Claims - Lavallee v. Astrue" »

Earlier this month, the Social Security Administration (SSA) announced that it's expanding the list of conditions for which Social Security disability benefits claimants may seek a "Compassionate Allowance," a program that fast tracks certain claims based on the nature of the claimant's disability.

"Social Security handles more than three million disability applications each year and we need to keep innovating and making our work more efficient," SSA Commissioner Michael J. Astrue said in announcing the expansion on October 13. "With our Compassionate Allowances program, we quickly approved disability benefits for more than 60,000 people with severe disabilities in the past fiscal year. We have made significant improvements, but we can always do more."

Under the program, the SSA has identified certain serious medical conditions requiring only minimal objective medical evidence to show that a person suffering from the condition is disabled and entitled to Social Security disability benefits. A claimant whose condition falls under one of these categories may apply for a "Compassionate Allowance," speeding the claim process to a matter of weeks rather than months.

According to the SSA, the agency approved more than 100,000 cases, usually in less than two weeks, under both the Compassionate Allowance and Quick Disability Determination (QDD) - which uses a computer predictive model to screen initial applications to identify cases where a favorable disability determination is highly likely and medical evidence is quickly and easily obtainable - processes in 2010. This year, the agency expects to fast-track nearly 150,000 cases.

The conditions added to the program earlier this month include immune system and neurological disorders such as Malignant Multiple Sclerosis, Pulmonary Kaposi Sarcoma and Progressive Supranuclear Palsy. The announcement comes three months after the SSA added 12 conditions, including Aortic Atresia, Eisenmenger Syndrome and Endomyocardial Fibrosis to the list.

While persons with these conditions should be approved with little difficulty and we would often tell someone to apply on their own so they don't have to pay an attorney's fee; we find that for a lot of people the stress and paperwork associated with even a compassionate allowance claim is more than they can handle alone. We certainly will handle those cases when representation is necessary.

The SSA launched the Compassionate Allowance program in 2008, beginning with a list of 50 eligible conditions. Since that time the list has grown to 113 based on information received at seven public outreach hearings, comments received from the Social Security and Disability Determination Service communities, input from medical and scientific experts and National Institutes of Health (NIH) research.

The addition of the new conditions to the Compassionate Allowance program is effective December 1.

Social Security disability benefits are available for persons who are unable to work for a year or more due to a physical or mental impairment, or a combination thereof. A person seeking benefits through either the standard or fast-track processes must submit an application or claim, which can be done by telephone, mail or online. In addition to other background information, the applicant is asked to describe the impairment and any treatment of it. This is the most difficult and confusing part of the process and the point at which a good attorney's help can be invaluable. An experienced disability lawyer knows what information must be included in the initial application, and an excellent Social Security attorney will not only guide his or her client through the process but file the application for the client as well.