SSA Issues New Regulations for Evaluating Obesity

social security obesity disabilityRecently, the Social Security Administration (SSA) issued ruling SSR 19-2p on Evaluating Cases Involving Obesity. Social Security will apply the ruling to all new applications, and any claims pending, on or after May 20, 2019.

SSR 19-2p explains and establishes obesity as a stand-alone, medically determinable impairment that can cause disability. The regulation outlines that impairment must be based on “measured height and weight, measured waist size, and BMI measurements over time.” Specifically, a BMI of 30 or higher, or “a waist size greater than 35 inches for women and greater than 40 inches for men” will generally establish an impairment of obesity. However, the ruling emphasizes that an impairment of obesity requires the person’s weight, measured waist size, or BMI to show “a consistent pattern of obesity,” meaning there must a be a longstanding history of obesity documented in the claimant’s medical records.

This important ruling now allows a claimant’s obesity to be a stand-alone impairment, whereas in the past, obesity would factor in only as an enhancement to another impairment, for example arthritis or cardiac injuries. It is important to note that the impairment of obesity must limit a claimant’s ability to do basic work functions. For a finding of disability based on obesity, a claimant’s obesity must prevent them from sustaining gainful activity.

With the ever-changing legal landscape, it is crucial that you have an experienced, qualified, and hard-working attorney on your side when applying for disability benefits. If you are hurt, injured, or unable to work, contact Bailey & Galyen for a free social security disability evaluation.

The Ugly Truth Behind the Sunny Financial Outlook in a New Social Security Report

social security

New Social Security Report Findings You Should Know

The 2019 Annual Report of the Board of Trustees of the federal Old Age and Survivors Insurance (OASI) and Disability Insurance (DI) Trust Funds was released on April 22, 2019. The 2019 Trustees Report notes that social security is funded through at least 2035, one year longer than last year’s estimate. One concern, though, is the fact that next year, the social security system’s total cost is projected to exceed its total income (including interest) for the first time since 1982.

The Report found that the financial health of the Disability Insurance Trust Fund improved dramatically and can now pay full benefits until the year 2052. This represents a 20-year improvement over last year’s report. This major change is the result of new projections that the percentage of people receiving disability benefits will not increase as quickly as previously expected. While on the surface this seems like good news, a deeper look at the numbers reveals some concerning trends. The slowing rate of citizens receiving disability benefits is due at least in small part to the increased processing time for claims, including the reinstatement of the reconsideration level in all jurisdictions.

Additionally, the sunnier outlook is due in part to overestimated award rates from last year. Disability applications have been steadily declining since 2010, and tellingly, the number of people receiving disability insurance benefits has been falling since 2014. The decline in the number of people awarded disability benefits can be traced in part to the increased difficulty claimants have getting their claims approved. The award rate for those applying for social security disability benefits has been steadily declining since 2007, which has resulted in the savings that have extended the solvency of the program.

In plain language, this means that disabled persons are facing increased hurdles in their attempts to receive awards on their social security claims, and this has resulted in fewer people receiving the benefits they are entitled to, thus improving the financial outlook of the program.

Contact Our Social Security Attorneys Today

These numbers reveal that a finding of disability at social security is becoming increasingly more difficult. Now more than ever, it is imperative that you have an experienced, qualified, and hardworking attorney on your side when applying for disability benefits. If you are hurt, injured, and unable to work, please contact us at Bailey & Galyen for a free case evaluation.

Expediting Your Social Security Claim

socialsecurity

Expedite Your Social Security Claim with an Attorney Advisor

The Attorney Advisor Program allows certain staff attorneys at the Social Security Administration (SSA) to conduct prehearing proceedings and issue fully favorable decisions on the record (OTR) when appropriate, without the need for an administrative hearing. This program can be useful for claimants age 50 or older, or those facing life-threatening illness. Attorney advisors can expedite a social security case review and potentially allow the claimant to receive their social security benefits months sooner than a case handled in the traditional manner.

Social Security Claims and the Attorney Advisor Program

The Attorney Advisor Program was originally enacted as a two-year temporary program in 2007 and has been extended ever since. An attorney advisor may issue a fully favorable OTR decision when the severity of a claimant’s impairment meets a prescribed listing level, or when the impairment precludes a claimant 50 years of age or older from doing their regular work and leaves them unable to adjust to work that is less physically demanding. If an attorney advisor issues a fully favorable decision, then the case will be awarded and closed. If a fully favorable decision cannot be reached, the attorney advisor will document the reasons, and the case will proceed to a hearing in front of an administrative law judge.

Does your Social Security Claim Meet Criteria?

On the record decisions issued by attorney advisors are one component of SSA’s Compassionate and Responsive Service (CARES) backlog-reduction plan. Unfortunately, even though the program has been extended, backlogs prevent most staff attorneys from reviewing potential expedited decisions on their own. However, if your claim meets the criteria, your Bailey & Galyen attorney can prepare and draft the request for your claim to be reviewed by an administrative law judge or an attorney advisor ahead of a scheduled hearing. By calling attention to your claim early, and submitting written legal arguments, your Bailey & Galyen attorney can overcome the staffing shortfalls at Social Security and potentially reduce your wait for a favorable outcome by several months.

The Attorney Advisor Program is only one of the tools an experienced Bailey & Galyen attorney can utilize to shorten the wait for a favorable outcome at Social Security. Of course, not every claim will qualify. A careful analysis of each case must be undertaken to determine if an expedited evaluation is appropriate or possible. If you’re over the age of 50, we encourage you to contact our office to determine whether your social security claim is eligible for expedited processing.

Now more than ever, it is crucial that you have an experienced, knowledgeable attorney working for you when applying for disability benefits. If you are hurt, injured, or incapacitated, and find yourself unable to work, contact Bailey & Galyen for a free case evaluation

Study Reveals Positive Effect of Legal Representation at Social Security Hearings

Close Up Of Social Security Card Rolled Up With Money RollA Government Accountability Office (GAO) study of hearings-level award rates for disability claims revealed that “claimants who had representation at their hearings, were awarded benefits at a rate nearly 3 times higher than those who proceeded without representatives.”

The report also quotes Social Security Administration officials as stating, “[A] representative can help the claimant by ensuring that the medical evidence and other records are fully developed and help the claimant present their case at a hearing.”

At Bailey & Galyen we have always believed in the value of personal, quality, experienced representation at Social Security hearings, but it is gratifying to have validation from an official source. The report, entitled “Additional Measures and Evaluation Needed to Enhance Accuracy and Consistency of Social Security Hearings Decisions,” was released in January 2019. It studied decisions made by administrative law judges (ALJ) on Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) claims between fiscal years 2007 and 2015, a period when requests for hearings increased, peaked, and then declined. During this time period, 77% of claimants at ALJ hearings had attorney representatives and 12% had non-attorney representatives.

During the studied time period, the overall award rates and findings of disability decreased significantly. Interestingly, judges who joined the Social Security Administration between the years 1995 and 1999, and who were still hearing cases between 2007 and 2015, had higher award rates than newer ALJs. Several other factors also impacted the likelihood a claimant would receive a favorable outcome. For example, older claimants, and those with a college education, were more likely to be awarded benefits. Additionally, favorable awards were more likely in cases involving dire need, and SSDI claims had a greater chance of success than SSI claims. Hearings that included testimony from a medical expert were more likely to result in an award of benefits, while vocational expert testimony decreased the chance of a favorable award.

The study reveals that a finding of disability at a social security hearing is becoming increasingly difficult. More than ever, it is imperative that you have an experienced, qualified, and hardworking representative on your side when applying for disability benefits. If you are hurt, injured, or unable to work, contact Bailey & Galyen for a free case evaluation.

Affect of the Government Shut Down on Social Security and Disability Benefits

Government Shutdown sign

As congress and the President continue to debate the federal budget and as the government shutdown enters it second month, many clients have questions on how this will impact their social security payments or pending applications. The good news is unlike prior shutdowns Social Security will remain unaffected by the budget impasse. This means that unlike in previous shutdowns, no social security workers have been furloughed and applications are continuing to be processed and payments are continuing to be made in the normal course of business. Similarly, VA disability payments, Medicare payments, survivor benefits, and retirement benefits will continue to be paid as well.

Bailey & Galyen will continue to monitor the effects of the government shutdown and will keep our clients aware of any changes.

If you are hurt and unable to work it is crucial that you have hardworking experienced attorneys helping you navigate the complicated social security application process. Please contact us at Bailey & Galyen for a free disability evaluation.

SSA Proposes Implementing More Video Conference Hearings

Social Security Administration SignIncreasingly the Social Security administration is utilizing video conferencing technology to conduct hearings in less urban locations and to ease the current back log. However, the claimant’s have always been given the opportunity to “opt out” of video conferencing if the claimant so desired. SSA is now proposing to eliminate the opt out provision, thereby expanding the use of the program.

Under the proposed rule, claimants would no longer be allowed to opt out of or object to hearings being scheduled, via video conferencing, or (in limited circumstances) by telephone. The rule would apply to all administrative law judge hearings. At Bailey & Galyen we do not automatically oppose video conference hearings, especially in circumstances where it will expedite the client’s hearings. However there are circumstances where a video conference hearings are not beneficial or practical for an individual client.

Witnesses to a hearing, such as medical and vocational experts are also increasingly appearing via video conference or phone. Expert Witnesses, would have similar restrictions: The proposed rule says that “in general, we would schedule witnesses to appear at hearings by VTC or telephone,” though certain exceptions apply. Witness appearing over video or on the telephone can prove problematic as technological challenges can end up delaying previously scheduled hearings. Additionally an increase in video conference hearings can hinder your attorney’s ability to cross examine these potentially vital witnesses.

Bailey & Galyen will continue to monitor the situation and will keep our clients apprised of the their rights as the proposed rule change evolves. Social Security’s rules and regulations are always changing. Now more than ever, if you are hurt, injured, or otherwise unable to work please contact us at Bailey & Galyen for a free social security evaluation and let us help you get the benefits you deserve.

Payment of Retroactive Benefits

Payment of Retroactive BenefitsSSI claimants are often disappointed when they learn that their past due benefits will be paid in installments after a finding of disability. Often times it can take a full year for social security to pay all the money owed. However there are circumstances that can effectuate an acceleration of the payment of past due benefits.

Since many SSI claimants accrue debt while awaiting their disability determination social security’s rules allow for the accelerated payment of past due benefits, if the claimant can show that the debt is related to medically necessary services or expenses. The definition of “medically necessary” is construed broadly and varies from office to office, however it can include, a car to travel to appointment, a cell phone to contact providers, and a computer to access records or my SSA account.

Similarly, if a claimant can show accrued debt or upcoming expenses related to the acquisition of food, clothing, or shelter (including rent and mortgage) social security can expedite the payment of the lump sum settlement. Lastly the payment of past due benefits can also be accelerated in circumstances where the claimant has expenses related to the purchase of a home.

The acceleration of benefits is only allowed in circumstances where the expenses will not be reimbursed by another public program, insurance policy, or other method.

Contact Us

To set up a free initial consultation, contact us online or call us at 844-402-2992. For your convenience, we answer our phones 24 hours a day, 7 days a week. We will meet with you evenings or weekends upon request.

Social Security Moves Forward With Plan to Re-instate Reconsideration Level Appeal Nationwide

social securityThe SSA experimented with removing the reconsideration appeal level in 10 “proto-type states” for the last few years. Claimant’s living in these states were able to file a request for hearing immediately after receiving their initial denial. The elimination of the additional layer of appeal allowed claimant’s to have their cases heard in front of judges more quickly. However, the SSA is now repealing the program despite concerns from claimants and their representatives. The National Organization of Social Security Claimant Representatives has long supported the elimination of the reconsideration step of the disability process and devoting the resources to improve decisions made at the initial level. However, despite the opposition, the SSA is moving forward with reinstituting the reconsideration level by 2019.

This decision while not directly affecting Texas claimant’s, shatters hopes that the program would have been expanded thereby reducing the average claimant’s wait time for a disability determination.

As it stands now, processing times for the major hearing offices in Texas are as follows:

Ft. Worth – 505 days
Dallas Downtown – 522 days
Dallas North 407 Days
Houston North – 359 days
Houston – Bissonnet – 617 days
San Antonio – 478 days

These figures represent how long it takes for a claimant requesting a hearing before an administrative law judge to receive a decision on their disability. Now more than ever, it is imperative that you have an experienced, qualified and hardworking representative on your side when applying for disability. An experienced Bailey & Galyen attorney can make sure your paperwork and medical records are submitted timely, thereby eliminating wasteful delays and helping expedite your claim. If you are hurt, injured or otherwise impaired and unable to work, please contact us at Bailey & Galyen for a free case evaluation.

Changes to Social Security Coming in 2019

Changes to Social Security Coming in 2019

More Money in Recipients’ Checks

Social security recipients will see more money in their checks every month starting in January of 2019. The government approved a 2.8 percent increase to cover cost of living adjustments. This is the largest such increase since 2012; it is a $39 monthly increase for the average retiree. Social security payments, by law, have to keep pace with inflation, and recipients saw a 2 percent raise last year.

Increases in High Earner Social Security Contributions

In addition, high earning workers will contribute more tax dollars to social security in 2019. The maximum amount of earnings subject to the social security tax will increase by $4500 in 2019, capping it at $132,900 per year. This will represent a $279increase per year for high wage earners meeting or exceeding the cap. In 2019, every worker will pay 6.2 percent of his/her earnings into the social security trust, but annual contributions are capped at $8,239.80 for people that make over $132,900 per year.

An Older Full Retirement Age

People who will turn 62 in 2019 will have to wait longer to collect their full retirement benefit. The full retirement benefit age for people born in 1957 (and turning 62 in 2019) is will increase to 66 years and 6 months, which is an increase of 2 months from last year. The full retirement age will continue to increase in two month increments each year until it reaches the age of 67 for everyone by 2021.

Higher Earnings Limits for Recipients Still Able Work

There is good news for beneficiaries who continue to work in 2019. Recipients age 65 and younger can earn up to $1470 per month before having any benefits withheld. This represents a $600 annual increase. In the year a beneficiary reaches full retirement age the income limit climbs to $3910 per month. Once an individual is over the full retirement age, there is no limit to how much one can earn and also collect social security benefits.

There are a number of changes to social security payments and benefits taking effect in 2019. If you are hurt, injured or otherwise unable to work, please contact Bailey & Galyen for a free social security evaluation, and let us help you get the benefits you deserve.

Importance of Medical Care, Treatment Compliance, and Medical Records, at Social Security

Social Security Medical RecordsThe first step in any claim for social security disability is proving that you have an impairment that prevents you from sustaining gainful activity. To prove the existence of an impairment, the social security administration looks to your medical records, your doctor’s opinions of your capabilities, and then, if necessary, incorporates your testimony at a hearing to determine your eligibility for benefits. No matter the diagnosis, how you feel, or what you know your limitations to be, it is crucial that you have sought and received medical treatment. Medical treatment can not only provide a diagnosis, but can outline the specific limitations caused by your impairments.

It is also important for claimants to continue treatment during the application and appeal process and follow the recommendations of their treating physicians and/or medical professionals. Compliance with treatment over a long period of time bolsters the credibility of your application and proves that your condition is long lasting, severe and disabling.

The path to a favorable outcome can be a long and difficult journey that takes a toll financially, emotionally and physically on even the strongest of individuals. As such, it is important that you take advantage of any and all resources available to continue treatment during your application process. At Bailey & Galyen, our experienced staff can help you find affordable treatment solutions available in your community that can provide medical care at reduced costs during this difficult time.

Bailey & Galyen can also provide your doctors with forms and questionnaires specifically designed to outline your limitations. These forms can be customized to your unique physical and mental diagnosis and the specific limitations they cause. A strong opinion statement from your treating physician can considerably bolster your chances of a favorable outcome.

If you are hurt and unable to work, it is crucial that you have hardworking experienced attorneys helping you navigate the complicated social security application process. Please contact us at Bailey & Galyen for a free disability evaluation.

Social Security is Extending the Attorney Advisor Program

Social Security is Extending the Attorney Advisor ProgramThe Attorney Advisor Program allows certain staff attorneys to conduct certain prehearing proceedings and issue certain fully favorable decisions on the record (OTR), when appropriate. The Attorney Advisor Program was originally enacted as a two-year temporary program in 2007 and has been continually extended ever since. An attorney advisor may issue a fully favorable OTR decision when a claimant’s severe impairment meets a prescribed listing or when the claimant is at least 50 years of age and is unable to make an adjustment to other work. If an attorney advisor issues a fully favorable decision, then the case will be awarded and closed. If a fully favorable decision cannot be reached, the attorney advisor will document the reasons why a decision cannot be issued, and the case will proceed to a hearing.

On the record decisions issued by attorney advisors are one component of the Social Security Administration’s (SSA) backlog-reduction plan, Compassionate and Responsive Service (CARES). Unfortunately, although the program has been extended, the drafting efforts have been put on hold because the SSA has assigned all qualified staff to write decisions on cases that have already had administrative law judge (ALJ) hearings. In fact, as of the end of May 2018, attorney advisors had not written a single decision this fiscal year. However, if a claim is deemed appropriate, your Bailey and Galyen attorney can prepare and draft an OTR request to be reviewed by an ALJ or an attorney advisor.

While this can be a useful tool to expedite a favorable decision, a careful analysis of each claim must be undertaken to determine if such a request is appropriate. If you are over the age of 50, please contact our office to determine your eligibility for the expedited processing of your social security claim.

Now, more than ever, it is crucial that you have an experienced knowledgeable attorney on your side when applying for disability. If you are hurt, injured or otherwise impaired and find yourself unable to work, please contact us at Bailey and Galyen for a free case evaluation.

Payment of Retroactive Benefits

Social Security DisabilitySSI claimants are often disappointed when they learn that their past due benefits will be paid in installments after a finding of disability. Often times it can take a full year for social security to pay all the money owed. However there are circumstances that can effectuate an acceleration of the payment of past due benefits.

Since many SSI claimants accrue debt while awaiting their disability determination social security’s rules allow for the accelerated payment of past due benefits, if the claimant can show that the debt is related to medically necessary services or expenses. The definition of “medically necessary” is construed broadly and varies from office to office, however it can include, a car to travel to appointment, a cell phone to contact providers, and a computer to access records or my SSA account.

Similarly, if a claimant can show accrued debt or upcoming expenses related to the acquisition of food, clothing, or shelter (including rent and mortgage) social security can expedite the payment of the lump sum settlement. Lastly the payment of past due benefits can also be accelerated in circumstances where the claimant has expenses related to the purchase of a home.

The acceleration of benefits is only allowed in circumstances where the expenses will not be reimbursed by another public program, insurance policy, or other method.
 

Contact Us

To set up a free initial consultation, contact us online or call us at 844-402-2992. For your convenience, we answer our phones 24 hours a day, 7 days a week. We will meet with you evenings or weekends upon request.

Social Security Disability Award Rate Continues to Drop

Social Security DisabilityRecent studies indicate a continuous drop in favorable decisions coming from Social Security administrative law judges. For the fiscal year 2018, of the 423,224 decisions made by administrative law judges, only 43% of the claims were awarded. More than a third— 36% of the claims— were denials, and 21% were dismissed without adjudication. These numbers represent a significant drop from previous years—, in 2013, the award rate was 48%; and just ten years ago, in 2008, 63% of all claims were approved.

Now more than ever, it is crucial that you have an experienced attorney on your side when applying for Social Security disability. A government accounting office report from January of 2018 revealed that claimants with an experienced lawyer were three times more likely to obtain a favorable outcome than those without representation.

A hardworking and experienced Bailey and Galyen attorney can help you avoid costly delays, ensure all paperwork is submitted in a timely manner, gather and file all required medical records, and can even expedite your application process, if you meet certain criteria. We can also provide your doctors with forms and questionnaires specifically designed to summarize the physical and mental limitations your impairments cause and bolster your chances of a favorable outcome.

If you are hurt, injured, or otherwise impaired, and find yourself unable to work please contact us at Bailey and Galyen for a free case evaluation.

Importance of Medical Records, Continuing Treatment, and Treatment Compliance at Social Security

Social Security Medical RecordsThe first step in any claim for Social Security disability is proving that you have an impairment that prevents you from sustaining gainful activity. To prove the existence of such an impairment, Social Security looks to your medical records, your doctor’s opinions of your capabilities, and then incorporates your testimony regarding the severity of the impairments when determining your eligibility for benefits. No matter how you feel or what you know your limitations to be, it is imperative that you have sought and received medical treatment that outlines an impairment that is causing your limitations.

It is also important for you to continue treatment during the application and appeal process and follow the recommendations of your treating physician or medical professional. Compliance with treatment over a long period of time bolsters the credibility of your application and proves to Social Security that your condition is long-lasting, severe, and disabling.

The path to a favorable outcome at Social Security can be long, as well as financially and physically challenging as the time wears on. For those reasons, it is important that you take advantage of any and all resources available to continue treatment during your application process. At Bailey and Galyen, our experienced staff can help you find resources available in your community that can provide medical care at reduced costs during this difficult time.

Bailey and Galyen can also provide your doctors with forms and questionnaires specifically designed to summarize the physical and mental limitations your impairments cause and bolster your chances of a favorable outcome.

If you are hurt and unable to work, it is crucial that you have hardworking experienced attorneys helping you navigate the complicated Social Security application process. Please contact us at Bailey and Galyen for a free disability evaluation.

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