The operating budget of the Social Security Administration (SSA) directly impacts Social Security Disability Insurance (SSDI) beneficiaries and claimants. On Friday, December 9, 2016, the government passed a continuing resolution (CR) to fund the government through April 28, 2017. The CR contained an across-the-board cut to funding for the Social Security Administration (SSA) in the amount of .1901%. Although on initial blush this cut seems small, it must be considered in conjunction with the fact that the last continuing resolution had a reduction of spending by .496% and there has not been an increase for funding for the SSA in quite some time. The SSA is tasked with handling many issues for both retirees and disabled individuals and it is being continually asked to do more with less.
The Social Security Administration (SSA) recently published final rules regarding the evaluation of medical evidence in Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims. These rules become effective March 27, 2017. A very important change under the new rules is that adjudicators of Social Security Disability Insurance (SSDI) or SSI claims no longer have to give special weight to the medical opinions of a claimant's treating source, i.e, a treating primary care physician, psychiatrist, or psychologist. The medical opinions now will be evaluated equally for "persuasiveness" based supposedly on consistency and supportability.
In determining whether a child qualifies for disability under the Childhood SSI regulations, the SSA decides if the child meets a listing or functionally meets a listing through deficits in any number of six domains of function. When dealing with a mental disorder, whether ADHD, autism, asperger's, intellectual disability (formerly known as mental retardation), the results of psychological testing are very important to the determination of disability. Some important factors from the regulations about testing are:
Often Social Security Disability claimants are confronted with a dilemma after receiving an unfavorable decision from an administrative law judge following a hearing. Does the claimant appeal to the appeal council, which can take a long time and is often unsuccessful, or file a completely new application? Years ago, a claimant could do both. However, the Social Security Administration passed SSR 11-1p in 2011 forcing claimants to choose between appealing or filing a completing new claim under most circumstances. I previously discussed these issues, but now there have been some clarifications by the SSA.
People applying for Social Security Disability or SSI are waiting longer to have their cases heard and fewer cases are being approved. The national average processing time for claims before the Office of Disability Adjudication and Review is up to 392, which is an increase of 10 from February of 2014, and up from 372 in December of 2013. Nationally, the average approval rate is 44% (down from 46% since December of 2013). In Tennessee, the average processing time is 419, which is up from the 407 days in February of 2014 and 388 days in December of 2013 with 49% of cases being approved. The approval rate has dropped from 50% in February of 2014 and 53% in December of 2013.
In claims for Social Security Disability or SSI, the ability or lack thereof to carry out certain activities of daily living (ADLs) has a great impact on the success of the claim. For instance, I received discussed the requirements for qualifying for SSD or SSI due to amputation(s). In some of the SSA's listings, the medical condition(s) must cause the person to have the inability to ambulate effectively. Though mentioned in the early blog entry, the SSD has a very strict definition of what it means by inability to ambulate effectively. The SSA defines ineffective ambulation as:
There is some good news for disabled veterans going through the Social Security Disability or SSI process! Effective March 17, 2014, the Social Security Administration (SSA) began expediting disability claims for veterans receiving VA service-connected disability and who have a rating of 100% "Permanent and Total" disability form the Department of Veterans Affairs. The SSA announced:
If a Social Security Disability or SSI claimant loses at a hearing before an administrative law judge (ALJ), the next step of the process often is an appeal before the Appeals Council (AC). At the AC, the SSA looks to determine if the ALJ's decision is not supported by substantial evidence or errors of law were committed requiring reversal or remand. The SSA recently released statistics about the AC for 2013.
A person can qualify for Social Security Disability or SSI benefits if she has suffered from an amputation or amputations. The Social Security Administration (SSA) follows a step-by-step evaluation to determine if someone is medically qualified for disability benefits. At the third step of the process, the SSA looks to see if the person has an impairment or several impairments that meet or equal a "listing." The listing is as follows:
Children suffering from systemic lupus erythematosus ("SLE" or "Lupus") may qualify for Childhood SSI. Lupus erythematosus is a name given to a collection of autoimmune diseases in which the human immune system becomes hyperactive and attacks normal, healthy tissues. Symptoms of these diseases can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs. Childhood SSI claims are evaluated differently than adult claims for Social Security Disability or SSI. The requirements are actually more stringent. The SSA determines whether the child has an impairment or combination of impairments that meets or medically equals the criteria of a listing, or that functionally equals the listings.