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Lawsuits Allege Fraud in Social Security Disability Decision-Making Process
It is not uncommon for a person who files a claim for benefits under the Social Security Disability Insurance (SSDI) program to be told that additional medical evidence is required. In many situations, applicants are required to undergo a consultative exam with a medical professional who is approved by the Social Security Administration (SSA).
Generally, there are at least a few approved contractors in a given geographic area who can provide such exams, but according to several lawsuits that were filed recently, some of them may not be providing the level of honest care that applicants should expect. Such was the case, allegedly, for a woman in Kansas City who sought a consultative exam as part of her 2018 SSDI application process.
Questions About the Consultative Exam
According to local news reports and court documents, a Kansas City woman applied for disability benefits in 2018, stating she could not work due to a number of health issues, including neck and back pain, carpal tunnel syndrome, hip surgery, arthritis, and constant migraines. As part of the application process, she visited a particular SSA-contracted medical provider in Kansas City.
Repetitive Stress Injuries Can Affect Your Ability to Work and Qualify You for SSDI Benefits
When most people think about health conditions for which Social Security Disability benefits might be available, they often envision life-changing conditions such as cancer, auto-immune diseases, and severe, obvious injuries. In reality, however, nearly any condition that prevents you from maintaining gainful employment could potentially make you eligible for benefits under the Social Security Disability Insurance (SSDI) program. This includes repetitive stress injuries such as carpal tunnel syndrome, tennis elbow, and more.
Understanding Repetitive Stress Injuries
Repetitive stress injuries (RSIs) are a type of condition that is caused by performing the same motions over and over again. This can happen at work if you have a job that requires you to perform the same task day in and day out. It can also occur during leisure activities, such as playing a musical instrument or participating in a sport.
Living with Lupus: What You Need to Know
If you suffer from lupus, you know how difficult it can be sometimes to do even the most basic things. Simply getting out of bed in the morning can be a struggle, let alone going to work and providing for your family. While there may not be a cure for this serious autoimmune disease, there are some things that may be able to help you. In addition, you might also qualify for Social Security disability benefits.
What Is Lupus?
In order to understand how lupus can affect your ability to work, it is important to first understand what the disease is. Lupus is a chronic autoimmune disease that can damage any part of the body. The immune system normally protects the body from infection and illness. However, in people with lupus, the immune system attacks healthy cells and tissues.
This can cause inflammation and damage in various parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain. Lupus can also cause mild to severe fatigue, as well as other symptoms such as fever, chest pain, hair loss, and headaches. There is no one test that can definitively diagnose lupus. Instead, doctors will often use a combination of tests and physical examinations to make a diagnosis. There is no cure for lupus, but there are treatments that can help manage the symptoms.
Can My SSDI Benefits Be Denied for Failing to Follow My Doctor's Orders?
If you are already receiving Social Security disability benefits or you have a condition that should qualify you for such benefits, it is important to follow your doctor's orders for treating your condition. Failing to do so can result in a denial of benefits. A qualified Social Security Disability Insurance (SSDI) attorney from The Law Offices of Coats & Todd can help you understand the potential consequences of failing to follow a doctor's orders and what you can do to avoid a denial of benefits.
What Happens if I Fail to Follow My Doctor's Orders?
When you apply for SSDI benefits, you are required to provide supporting medical documentation about your condition and how it is affecting your ability to work. Part of that information should be the specifics of your condition as well as what is being done to treat it. According to the Social Security Administration (SSA), you must follow your prescribed treatment if the treatment is expected to restore—even partially—your ability to work.
New Conditions Added to Accelerated Social Security Disability Approval Program
The application and approval process for Social Security Disability Insurance (SSDI) benefits can be time-consuming and stressful. Successfully navigating the process often requires the help of an experienced disability attorney. While we are happy to help our clients in obtaining the benefits they deserve, we are also excited when the Social Security Administration (SSA) takes steps to streamline the process.
Last month, the SSA announced additions to a specific program that has already accelerated the applications of about 800,000 Americans with disabling conditions. The additions come in the form of 12 new conditions that have been added to the Compassionate Allowance program, which expedites the processing of claims for applicants who are severely disabled.
Compassionate Allowances
When a “normal” applicant for SSDI submits an application for benefits, the application must include documentation and proof of the person’s disabling condition. In most cases, this triggers a medical review by the SSA.
Social Security Disability for Military Veterans
Social Security disability benefits are generally available to disabled veterans, regardless of the war in which they served and how long ago the conflict was. Many disabled or wounded veterans are also eligible to receive disability benefits through the Department of Veterans Affairs (VA). While the goals of these two programs are similar—that is, providing financial assistance to disabled individuals—there are some important differences.
If you are a disabled veteran who is looking to obtain Social Security Disability Insurance (SSDI) benefits, your first call should be to a qualified disability attorney at The Law Offices of Coats & Todd. We will help you work through your application and secure the benefits to which you are entitled under the appropriate program.
Definitions of Disability
Perhaps the biggest difference between SSDI and VA disability compensation is each program’s definition of “disabled.” To be considered disabled by the Social Security Administration (SSA), you must show that you cannot perform “substantial gainful activity” as the result of a “medically determinable physical or mental impairment” that has lasted or is expected to last for at least 12 months or can be expected to result in your eventual death.
What Information Is Needed in My Social Security Disability Application?
Life is often difficult for those who suffer from disabilities. One of the many forms of assistance offered by the federal government is financial help through Social Security. The Social Security Administration (SSA) oversees two such programs: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI).
The SSA gets tens of thousands of applications for each program every year, but not all applicants are approved. In many cases, the information provided in the application was either incorrect or insufficient to allow the claim to move forward. When you are applying for Social Security benefits, you need to have the required information prepared, organized, and included with your application.
Personal Data
The first set of required information is that which identifies you and provides details about your personal background. This includes your name, date of birth, place of birth, and Social Security number. You will also need to include your veteran status, if applicable. If you have a spouse and children, you must provide identifying information for them as well and include the date of your marriage or divorce if either of those applies to you.
Obtaining SSDI Benefits for Back Pain
Do you suffer from back pain? Chances are, you do, since nearly everyone will experience some type of back pain in their lives. For many people, back pain is a chronic problem. According to experts, back pain leads to more than 264 million hours lost at work each year in the United States, making it one of the leading causes of missed work. In fact, back pain is the number one cause of disability in the world.
If back pain makes it unbearable for you to work, you might qualify for Social Security disability benefits. A qualified SSDI attorney can help you understand your available options for seeking the benefits you deserve.
Understanding “Medical Determinability”
Social Security disability benefits are not typically available on the basis of mild, intermittent, or moderate back pain. In order to qualify, your back pain must be associated with an impairment that the Social Security Administration (SSA) finds to be “medically determinable.” Essentially, the SSA will not approve disability benefits based on your reporting that you have back pain. Instead, you must show that some type of detectable problem, condition, or injury is causing your pain.
Heart Disease: Find Out If You Qualify for Social Security Disability Insurance
Heart disease is no longer a “good ol’ boys club.” According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death for women, responsible for one in four female deaths. Despite increased awareness, only 54 percent of women recognize heart disease as their number one enemy.
More alarmingly, women often differ from their male counterparts in terms of heart-related symptoms. Men often present with the classic, clutching of the chest while almost 64 percent of women with heart disease are unaware that they even have a problem. Women often present without any type of heart-related symptoms at all. For many, feelings of dull chest discomfort, pain in the neck or lower jaw, or pain in the upper abdomen or back are often dismissed or self-diagnosed as stress or anxiety.
Benefits Might Be Available
Perhaps what else may not be evident, is that the Social Security Administration (SSA) recognizes heart disease under Section 4.00 Cardiovascular System - Adult, Disability Evaluation Blue Book as an approved medical disorder possibly eligible for Social Security Disability Insurance (SSDI) if all criteria have been met.
Crohn’s Disease and Social Security
According to the Crohn's and Colitis Foundation of America, Crohn's disease, named after Dr. Burrill B. Crohn in collaboration with colleagues Dr. Leon Ginzburg and Dr. Gordon D. Oppenheimer, was first classified as Inflammatory Bowel Disease (IBD) in 1932. Crohn's was later removed from the IBD classification and received its own designation as a chronic inflammatory condition of the gastrointestinal tract. Crohn's commonly affects those between the ages of 16 to 40 years of age. Even more interesting, Crohn's primarily affects those living in northern climates and is not gender-specific.
If you are living with Crohn’s disease, it can be difficult to maintain a “normal” lifestyle. With this in mind, you may be eligible for benefits under Social Security Disability Insurance (SSDI).
Common Indicators of Crohn’s disease
For the estimated 780,000 Americans who have been diagnosed with Crohn’s, the disease can be life-altering. Those living with this chronic condition usually find their lives disrupted by one or more of the following symptoms:
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