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Social Security Disability
Update on the SSA Using Electronic Medical Records
Here's an article from an Indiana newspaper that gives an update on Social Security's advancement into using electronic medical records. This National Health Information Network is gradually rolling out across the country and this article tells of the ways it will speed up the process.Apply for SSD On Your Computer
Last winter I wrote about how the Social Security offices are trying to speed up processing and also use less paper by going digital. Using technology for medical record codes is starting to work. The National Health Information Network is a first for a federal government agency, according to a published article, and it's great that it has started with Social Security. The SSA recommends that you apply for disability benefits on-line. You can click here to get to the website, and you can submit your application electronically.Disability Claims Processing Data
As an update to my recent post, the national average for processing a SSD claim is 494 days. That's nearly a year and five months. The Greensboro office operates at 541 days (almost 50 days longer), while Charlotte beats the national average slightly at 490 days.
It is important to note that North Carolina has had a slight drop (just under 4%) in the number of claims processed this year compared to 2008, which makes us one of only two states where this happened. Compare NC to Ilinois where the number of cases has unbelievably doubled, due possibly to more baby boomers in the market and people who had not planned for the economic dilemma we are in.
According to the latest reports, the Social Security Administration has the goal to end the backlog in hearing level claims in all states by 2013. Additional Administrative Law Judges, funding and efficient staff and productivity could make this happen. As always, we will keep you updated.
Fixing a Broken Mental Health System
Every day we talk to people with mental health issues who can't get the treatment they need because of cuts in the North Carolina system. The slashing of state's budget ($155 million in cuts for 2010) and the downsizing or closing of mental health facilities have left some people in a crisis situation, especially those who live in rural areas. It's frustrating to us and to our clients and their families. People with mental health disabilities deserve care and treatment and our tax dollars should fund adequate if not excellent programs to meet these needs.
GAO Follows SSA's Efforts to End Hearings Delays
In a report released this month by the US Government Accountability Office, the Social Security Administration is still plugging along in its efforts to speed up the approval process of SSD claims. Following a plan that started in 2007, the GAO reviewed the May update and noted that the SSA must continue to move forward to reduce the backlog by 2013. Much of the effort centers on Administrative Law Judges, focusing on the hiring of judges, their availability to hear cases and their productivity. According to the GAO, claims are now at 446,000 and the SSA needs to set up performance goals and measures in order to be productive.
Hospitals in NC
Before you schedule a surgical procedure or even a consultation at one of our state's hospitals, it's a good idea to compare facilities and also visit the hospital's website. Here's a handy chart, compiled by US News & World Report, which lists hospitals in North Carolina. (click here)
- How many procedures have you done like mine?
- How many have been performed here at the hospital?
- How many people have died after this surgery?
- What complications can occur?
As a patient, you have a right to know these answers before you make a decision about your medical care.
America's Best Hospitals
US News & World Report recently rated our nation's hospitals based on the quality of care, the reputation among colleagues in the medical field, the death rate, patient safety and other patient care factors (such as the technology at the hospital and the level of nursing care). Nearly 5,000 hospitals and medical centers were reviewed with a special focus on those that have specialty areas. For 2009, Duke Medical Center in Durham ranked in the top 10 of hospitals nationwide.
To see the article and a list of the rankings, click here.
No Cost of Living Increase for Social Security Benefits
With the Congressional Budget Office projecting no cost of living increase for social security benefits in 2010 and 2011, many people who receive this income will be in a tough spot. For some folks, the SSD benefits cover the absolute necessities of living. They depend on their check and make it only from month to month. Without a cost-of-living increase to cover outside expenses, many people will be forced to cut back on an already small fixed budget.Preparing for a Hearing
Early-Onset Alzheimer's Disease Added to Compassionate Allowance List
Last month Commissioner Astrue announced that early-onset Alzheimer's disease will now be part of the 50+ medical conditions that automatically qualify the SSD applicant for quicker claim processing. The SSA Commissioner noted: "Early-onset Alzheimer’s disease is a rapidly progressive and debilitating disease of the brain that affects individuals between the ages of 50 and 65 and clearly deserves our consideration." Individuals applying for benefits will get a quicker response from the SSA --perhaps in weeks rather than the typical months or even years -- and that is certainly a bright spot.
SSD, SSI Benefits and Same Sex Marriages
While gay marriages may be recognized in some states, the Social Security Administration, as a Federal office, does not give them validity. The Defense of Marriage Act prohibits any acknowledgement. As such, benefits are not distributed to a spouse if there is a same-sex marriage. As a result, couples will need to consider if a union is in their best financial interest.
Claims for Disability Continue to Take More Time
The backlog of applications for SSD at the initial application stage certainly is increasing with some of it caused by the slump of the economy. The SSA projects that by 2011 another 500,000 claims will be initiated due in part to the ongoing recession. Across the country, there has been an increase in new claims through May 2009 of almost 13%, compared to this same time in 2008. A much higher pending workload of these claims (more than a 26% increase) is leading to much longer processing times. Now, more than ever, it's important to have the assistance of an attorney to stay on top of a claim and to be sure it's filed correctly.
State DDS Jobs Should Be Secure
Biden asked Governor Ed Rendell, Chairman of the National Governor's Association, to urge all US governors not to furlough or downsize their DDS departments. If all DDS personnel are able to continue with their jobs, then social security benefits for the disabled will not be disrupted or delayed. Commission Astrue noted that state-wide reductions would save no money from state budgets because salaries and overhead are self-funded from within the department. With this plea from Vice President Biden, the heavy workload that our country's DDS program manages for more than 12 million citizens, and the predicted increase in the number of claims, should continue to be handled without concern of DDS employees losing their jobs. And that should keep the system moving along.
Inclusive Health: A New Healthcare Plan
If you do not have a health plan with an employer and if you are looking at higher premiums because of a pre-existing medical condition, you may qualify for the North Carolina Health Insurance Risk Pool (NCHIRP), commonly called Inclusive Health. This individual health plan also helps people whose jobs have been lost due to overseas competition and people who have used all of their COBRA benefits.
Established by the State Legislature which underwrites the plan that began offering coverage in January, Inclusive Health participants may pay premiums that average $300 to $500 a month. This plan is only available to residents of NC who have no access to group coverage and who do not qualify for Medicare or Medicaid. This is not a family plan. Each family member who qualfies will receive his/her own separate rate which applies to his/her own circumstances.
Learn more about the program and to access enrollment details and forms by clicking on their website here. You will also see a list of medical conditions that automatically qualify a person for Inclusive Health Coverage.
Obtaining some type of medical treatment is crucial for those individuals applying for Social Security Disability. The Judges who hear your case want to know what the doctors are saying about your condition. No treatment often leads to a denial. Claimants applying for Social Security Disability need to be resourceful and determined to get treatment. Programs like this offer people who cannot otherwise afford private health insurance another option.
Winston-Salem Company Offers Hope for Chronic Back Pain Sufferers
Back injury is a frequent cause of concern among many of our clients. There are just so many ligaments, discs, nerves, muscles and tendons. Let's face it -- if your back hurts, you pretty much hurt all over. We recently heard about a new invention called VerteLoc. It's hailed as a "minimally invasive spine stabilization system" and the inventors are in North Carolina. The implant is unique in that it uses human bone rather than metal screws and bolts to limit the motion of the affected spine segment. With early intervention in back problems, there's a shorter recovery time and you get back in your daily routine quicker. If you have lower back pain caused by osteoarthritis and spinal stenosis, VerteLoc may help you. News sources state that it was first implanted in May 2008. There are more than 330 US patients within this first year. Here's a link to their website. We haven't had a client yet who has used this device, but we're all for people feeling better quicker. We'll keep you up to date as we hear more about this invention.
Understanding SSA Denial Paperwork
It has finally been recognized that the Social Security Administration needs to provide more detail in denial notices. The US Government Accountabilitiy Office (GAO) determined that denied claimants sometimes received communications with inconsistent or hard-to-understand information. Medical sources and reports were not clearly linked to how a determination was made. The SSA generally agreed with the GAO but said that it would require computer system changes with funding for information technology. The story can be read here.
I have read hundreds of application and reconsideration denials. The Social Security sends out these form letters and except for a few lines in a few paragraphs, the denials are always very similar. It is almost impossible to understand exactly what information was used to make the denial. It is nice to see that the GAO has called out the Social Security Administration and that there is a chance something will be done.
SSD and Workers Comp in Utah
Some state legislators will do just about anything to keep their state looking business friendly. A Utah law that reduces workers’ compensation benefits for workers over 65 that receive social security benefits has been ruled unlawful. In most states, only Social Security disability benefits are reduced when the injured worker receives periodic workers’ compensation payments. The law Utah tried to hold up essentially kicks injured workers’ off of periodic compensation payments simply because they turn 65. You can read the article here.Insurance companies and business lobbyists will often push government to pass laws that keep older workers from receiving full workers’ compensation benefits. Having a workers’ compensation age cut-off reduces exposure for insurance companies and hurts the leverage of injured workers negotiating with insurance companies. This is something that businesses in North Carolina are actively pursuing. Unfortunately, state legislatures are often willing participants in passing these laws because it makes them look more business-friendly. I imagine this will continue to be the case as long as big business have more money to lobby with than injured and disabled people.
Workers Comp and SSD - Why not in NC?
New way to diagnosis Chronic Fatigue Syndrome?
Researchers may have found a new way to diagnosis Chronic Fatigue Syndrome. Chronic Fatigue Syndrome, or CFS, is a condition that causes seemingly endless and severe fatigue to those who have it. It is an impairment that is not well understood by the medical community. The study can be read here.A new diagnostic tool for CFS has huge Social Security Disabiliy implications. For years I have seen claimants alleging CFS have great difficulty getting approved for Social Security Disability benefits. The Administrative Judges who hear CFS disability cases have a difficult time believing claimants with CFS because CFS is easy to allege and almost impossible to prove. If CFS claimants now have an opportunity to present an objective and scientific test proving they have CFS, then I believe their chances of getting approved would increase dramatically. It will be interesting to see if this new test finds acceptance in the medical community. At the very least, this study gives CFS claimants a reason to be optimistic.
Social Security Disability backlogs exist nationally
A newspaper in Oregon recently had a great article about Social Security Disability backlogs. The Oregonian submitted a Freedom of Information Act request to the Social Security Administration and interviewed several Administrative Law Judges to try to understand why it takes a claimant 650 days to get a Judge's decision in Portland while the national average is 480 days. It should be noted that the frustration with backlogs is not particular to Portland, Oregon. Many of the same problems exist in Charlotte, Raleigh, and Greensboro. The article can be read here.Administrative Law Judges are supposed to decide 500 cases every year. According to statistics, only about 11% of the Judges hit this mark. The biggest problem, according to most of the Judges, is that there is insufficient staff to work up the cases. Each claimant has a file with the Social Security Administration that holds medical records, employment earnings records, and other documents that are necessary to determine whether the claimant qualifies for Social Security Disability benefits. It is extremely difficult for a Judge to make a decision when medical records are lacking or the file is a mess (an unorganized stack of several hundred documents is hard to make heads or tails of especially if you are asked to do it 500 times a year). Let's hope the new Administration properly staffs the Hearing Offices.
Social Security to Start Gathering Medical Records Electronically
The Social Security Administration recently announced that it would be the first government agency to use the Nationwide Health Information Network (NHIN). See the announcement here. The hope is that Social Security will have almost instantaneous access to an applicant's medical records. The medical records Social Security reviews helps them determine whether an applicant is entitled to Social Security disability.The plan is for the Social Security Administration to start using NHIN in early 2009. I spoke about this possibility in an earlier blog post. I think NHIN is a positive step in making claim decisions quickly and with less expense.
Medicare to Pay For Telemedicine
A story recently published by Minnesota Public Radio outlines the benefits of Medicare's recent decision to pay for telemedicine. Telemedicine is simply patients videoconferencing with their physicians instead of being seen at the doctor's office. This technology has existed for years, but the cost to implement this technology has been too high. Also, Medicare has refused to pay for this type of medical treatment and counseling.With the cost of videoconferencing lowering, medical providers are now reconsidering the value of seeing patients with cameras and televisions rather than in person. This idea is especially attractive to medical providers who treat their patients in rural areas. Patients cannot always travel hours round trip to see their doctors because of sickness or frailty. In the future, nursing homes will be able to wheel patients one at a time into rooms with video equipment that will allow each patient to see the physician in another distant facility. With the help of nursing facility staff, physicians can examine their patients, diagnose problems, and recommend treatment. The cost of travel will be negated by the patient and the physician.
It is great to hear that Medicare will now begin covering this medical treatment beginning in 2009. This should allow medical facilities to aggressively invest in technology to drive down costs for their patients. The full story can be read here.
Spinal Fusion in Pictures
One of the most common types of disability I see is spinal disc injury (it is also a common workers' compensation injury). Many clients have had different types of spinal procedures designed to lessen back pain or nerve pain that radiates into arms or legs because the discs between the vertebrae impinge on the spinal cord. The below animation shows what a herniated disc looks like and what a fusion procedure might look like:
One of the interesting things about this video is the ending where it is revealed patients should not lift over ten pounds soon after undergoing this type of procedure. Administrative Law Judges often do not understand why claimants with this disability do not return to work performing work that requires significant lifting or bending, stooping, and squatting. Claimants needs to be able to explain how their range of motion or flexibility is affected by a procedure like this.
A New Insurance Product For Tough Times
The New York Times has recently reported that UnitedHealth may soon be offering a new insurance product for those people concerned about losing their health insurance. The new policy will allow current customers who have UnitedHealth coverage to pay an extra twenty percent of their monthly premium in order to guarantee their right to buy health insurance in the future.Most people in the United States receive health insurance as a benefit of their employment. Once these people lose their jobs (not hard to imagine considering the current economic times), they often lose their health insurance. Options exist, such as Cobra coverage or individual coverage. These options are usually expensive - especially if they are unemployed. Individuals on Social Security disability are eligible for Medicare after two years, but there are few good options during this time period. Most companies have rules that allow them to avoid paying for costly pre-existing conditions.
There are still not too many details about these programs. However, it is an interesting concept for people who are approaching the end of their working days and know they will not be able to cover themselves as individuals once they start working. If the new Presidential Administration really tackles healthcare reform, then new products like the one being considered by UnitedHealth may be unnecessary.
Is Social Security Going Digital?
According to Government Health IT, the Social Security Administration is considering new programs that would allow its Disability Determination Services to gather medical records electronically. Right now, the disability determinations are made from paper records provided by doctors and hospitals. The story indicates that this is a huge expense to the government - costing over $500 million a year. The Social Security Administration is proposing several programs that would incorporate available technology to make gathering records quicker and less expensive.This is something that has been in the works for years. Social Security has initiated several programs over the last several years that make the process quicker. Claimants can submit new evidence online and have video hearings (where the claimant is in one office and the Administrative Law Judge is hundreds of miles away). Most law firms that practice this type of law have been investing heavily in the technology and equipment necessary to gather and submit records quickly and efficiently. OTP, with offices all over the state of North Carolina, is doing amazing things with technology. Our Social Security practice, for instance, is almost completely digital and paperless.
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Greensboro, NC 27405
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OTP - Winston-Salem
110 Oakwood Drive, Suite 420
Winston-Salem, NC 27103
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OTP - Burlington
409 Alamance Road, Suite C
Burlington, NC 27215
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OTP - Asheboro
854 South Cox Street
Asheboro, NC 27203
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OTP - Raleigh
3700 Glenwood Avenue, Suite 350
Raleigh, NC 27612
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OTP - Fayetteville
4200 Morganton Road, Suite 200-11
Fayetteville, NC 28314
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OTP - Charlotte
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Charlotte, NC 28202
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OTP - Hickory
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Hickory, NC 28601
Phone: 828-322-1271
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Wilmington, NC 28405
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OTP - Greenville, NC
3800 East 10th Street
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Greenville, NC 27858
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Rock Hill, South Carolina 29730
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FAQs
Social Security Disability
Is alcoholism a disability? What about drug addiction?
Will receiving Social Security disability benefits affect my current COBRA health insurance plan?