June 27, 2009

News from the San Francisco Social Secuirty field offices

Posted by Geri Kahn under Disability application procedures, Health, SSDI, SSI | Tags: |
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Yesterday, at our monthly meeting of Social Security disability attorneys and claimants’ representatives, we had two district managers from the Social Security Administration’s San Francisco field offices come and speak to us. Both of them offered a dim picture of what is happening locally. Essentially, they are seeing more claimants at the field offices and they are overwhelmed. Each office sees about 300-400 people a day. They do not have the staffing to serve all the people they see. While they are hiring additional staff, they informed us that it really takes about three years for a new hire to learn the job. Many of the people they serve are not native English speakers and the language barrier makes it more difficult to communicate with the claimants.

The district managers encouraged us to file online as much as possible because it makes their jobs easier. Initial claims for SSDI can be filed online. Requests for reconsideration and Requests for a hearing in front of an Administrative Law Judge (”ALJ”) may be filed online for both SSI and SSDI. (Ironically I just had a look at their website and their online filing system is down.)

They warned us against faxing documents in and mailing a duplicate set in. They told us to choose one or the other. One attorney mentioned that he mails and faxes because he does not receive a confirmation by Social Security that they have received the material. Both managers agreed that if we were to prepare a form receipt for a Social Security employee to fax back, they would start using it. Their advice was to begin including a receipt with anything we send in. The receipt should have a space on it for the Social Security employee to sign and date. Of course, the receipt should contain a fax number on it so that the employee knows where to send it. I will be curious to see if this works. I send everything certified mail so I already feel confident that my materials have been received. Nevertheless, the receipt is a good idea and I will try it out.

All in all it was a productive meeting and I gained some insight into the inner workings at the Social Security field offices. Hopefully the field office managers also benefited by hearing some of our concerns.

 

June 17, 2009

Lessons in compassion and respect

Posted by Geri Kahn under Health, ODAR, Social Security Disability Law, Social Security disability hearings
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In a one week period of time, I have have more lessons in compassion and respect than I have had over the past couple of years. It started last week after my hearing at the Office of Disability Adjudication and Review in San Rafael. After my hearing was over, the Administrative Law Judge (”ALJ”) told me a story of an unrepresented claimant whose case had been assigned to this ALJ. The ALJ decided to make an “on the record decision” in favor of the claimant. He related the procedural history and the outcome of the case with such compassion; I could see it in his eyes. I thought to myself that I wish there were more of him and that I should make it my goal to emulate him.

The opposite experience occurred two days later when I went to a citizenship interview at U.S. Citizenship and Immigration Services with my elderly and disabled client. We were not treated with compassion and respect. We were treated with almost some kind of presumption that my client was lying – as if she wanted to be disabled. It was an awful experience. This will definitely be a case to appeal.

This week I have been accompanying my elderly relative to legal and health care appointments. My relative has noticeable cognitive impairments; nevertheless, the people we have met have treated him with respect and have taken the time to listen to him. He feels like he has been heard and that is very important to him.

Finally, today, I had my last physical therapy appointment with my physical therapist at Sport and Spine Therapy of Marin. (I would mention my therapist’s name but she would be embarrassed if I did.) It turned out that I did not have carpal tunnel but rather tendonitis. Through her care and treatment, my hands feel normal again. While sitting at therapy for an hour twice a week, I have been able to observe how she relates to others and of course to me. She took the time to listen to each person she saw and plan a course of treatment specific to that patient. Although she was very busy, I believe everyone felt that she knew their medical condition. I saw her treat everyone with respect and compassion. As with the Judge, I felt I could learn something from the physical therapist. It is possible to be busy but still treat people with respect and compassion.

We are living in difficult financial times, as we all know. We all could use a little compassion and respect in our lives. It goes a long way.

 

June 15, 2009

It only takes a gene

Posted by Geri Kahn under Consultative exam, Health, ODAR, SSDI, Social Security Disability Law, Social security
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DNALast week I had a Social Security disability hearing at the Office of Disability Adjudication and Review (”ODAR”) in San Rafael, California. My client suffers from a rare auto-immune disease called ankylosing spondylitis (”AS”). “AS” is a type of arthritis of the spine. It causes swelling between vertebrae and over time it can fuse vertebrae together. (You can obtain a brief description of this disease on MedlinePlus’ web page about ankylosing spondylitis.)

While preparing for my case, I learned that diagnosis of ankylosing spondylitis is done through a blood test. There is a gene, HLA-B27 which is present in the blood of approximately 95% of people who have ankylosing spondylitis. My client had the blood test taken by her treating physician and the test showed it was positive for the gene.

I wondered why then the Disability Determination Services wrote a note in the file, “Inconsistencies between reports and allegations.” I know they write that for everyone, or so it seems, but in this case, the medical diagnosiss was confirmed. Upon further review, I realized that the Social Security Administration had failed to give the consultative medical examiner all of the evidence.

Social Security will send a claimant to a consultative medical exam if they feel the claimant’s evidence provided by the claimant’s own medical sources is inadequate to determine disability. At the reconsideration stage of my client’s case, she was sent to a consultative medical exam. The Disability Determination Services provided the medical examiner with a partially completed Disability Report and back x-rays taken by her treating physician. They did not provide the doctor with the results of the blood test, dated the same date as the x-rays and included in the claimant’s file. The consultative examiner wrote in her report that she could find no evidence of ankylosing spondylitis. Well, it is not surprising. If Social Security did not provide the blood test results to the doctor, how could the doctor find it?

I do not know if my client would have succeeded at the reconsideration stage if the doctor would have been able to confirm the existence of the disease but it seems that my client never had a fighting chance to succeed without the submission of the medical evidence to the consultative examiner.

It does not make sense to me. It is expensive to pay for a consultative examination. It is even more expensive to pay for judges, clerks, and experts at ODAR. Perhaps if Social Security spent a little more time and money at the initial stages, it would not be necessary for claimants to pursue their cases to hearings in front of Administrative Law Judges.

My client’s case does have a happy ending. We succeeded at our hearing in front of the administrative law judge. While I am happy (and of course she is very happy), it is a shame it took a judge’s review of all the evidence to make the decision that could have been made a year ago.

 

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