There have been recent changes to the Social Security rules which now expand the list of “acceptable medical sources” to include advanced practice registered nurses (APRNs), licensed audiologists, licensed optometrists and physician’s assistant. Additionally, the rules have changed so that no longer are treating physician’s opinions given controlling weight as compared to non-treating medical sources. This new rule affords the Administrative Law Judges more deference to weigh evidence as they see fit. Consequently, the opinions of a treating physician are no longer given controlling weight but rather are considered with all other medical information for purposes of the Judge’s decision. These rules take effect on all claims filed after March 27, 2017.
Two things can cause Social Security to decide that you are no longer disabled and to stop your benefits.
Your disability benefit will stop if you work at a level they consider “substantial”. In 2017, average gross earnings (per month) of $1170 for a non-blind individual and $1950 for blind individuals are considered substantial.
Your disability benefits also will stop if they decide your medical condition has improved to the point that you are no longer disabled. Ongoing Continuing Disability reviews are mandated by the law. If your doctor indicates that there has been no change or improvement in your condition, that is usually enough to stop the review. Be certain to promptly appeal all negative decisions.
You are responsible for promptly reporting any improvement in your condition or return to work. Be sure to send certified letters when reporting income.
Here’s a list of the most common mistakes made in applying for disability benefits:
1. Not applying soon enough
2. Taking “no” for an answer…not appealing a denial
3. Taking “yes” for an answer-accepting a late onset (beginning) date and thus reducing the back benefit award
4. Not reapplying if the condition becomes worse after an appeal time ends
5. Not verifying that all the medical records are in the file
6. Believing a note from a doctors saying you are “disabled” is enough to win
7. Filling out a claim form before talking to a legal advisor
SSI FOR YOUR CHILD? Children with marked & severe functional limitations (that have or are expected to last 12 or more months) may qualify for SSI payments provided their family meets strict resource and income limits.
COST OF LIVING ADJUSTMENTS (COLA) for Disability & Retirement checks will rise between 0.2% to 0.5% in 2017. That works out to between $2.61 and $6.53 a month more for retirees. This is the smallest percentage increase of any year benefits did rise but it’s better than 2016 when Social Security checks didn’t rise at all.
VETERANS’ MEDICAL RECORDS go electronic to Social Security on Nov. 11th Veteran’s Day. eHealth Exchange will go live to all Social Security Disability processing sites to receive medical records electronically from all VA facilities. This should result in faster processing times for Veterans.
The Social Security Administration is proposing to change the rules regarding an Unsuccessful Work Attempt
The Unsuccessful Work Attempt (UWA) allows a beneficiary of social security disability insurance benefits (SSDI) to work after the Trial Work Period (TWP) and not have the work count as Substantial Gainful Activity (SGI) if certain requirements are satisfied. The Social Security Administration’s proposed rule changes would simplify the UWA rules by eliminating the existing requirements of work performed between 3-6 months.
The Social Security Administration proposes a rule on reporting beneficiaries to gun control data base.
The Social Security Administration proposes to report certain disability beneficiaries to the National Instant Criminal Background Check System (NICS). The NICS requires federal agencies to submit to the Attorney General “any record of any person demonstrating that the person falls within one of certain categories of individuals excluded from owning or purchasing a firearm or ammunition by the Gun Control Act of 1968. To learn more about the SSA’s proposed rule see: 81 Fed. Reg. 27059 or https://www.gpo.gov/fdsys/pkg/FR-1016-05/pdf/2016-10424.pdf/
The Senate addresses the need to reduce the backlog of hearings.
On May 12, 2016, a committee held a hearing to address the Social Security Administrations plan to reduce the backlog of hearing. The plan would involve utilizing Administrative Appeal Judges at the Appeals Council to hold hearings.
A number of states have adopted laws and regulations addressing what medical facilities can charge for reproducing medical records for a patient. In Michigan, Section 333.26269 of the Medical Records Access Act of 2004 is controlling.
Under the Act, in 2016 the initial fee is $23.34; $1:17 per page for the first 20 pages; .58 cents per page for pages 21-50; pages over 50 cost .23 cents per page. For “medically indigent” individuals, the first copy is free. (See section 9(4) of the Act). Section 9(4) does not apply to mental health providers.
Representatives, Senators and their staff members like talking to constituents. If you have comments about your experience with the Social Security Administration contact your Congress representative.
Interstitial Cystitis (IC) is a complex genitourinary disorder involving recurring pain or discomfort in the bladder and pelvic region. Treatments for IC are mostly directed at symptom control. They include, but are not limited to: changes in diet; physical therapy and pelvic floor strengthening exercises; stress management; bladder distention; bladder instillation; oral drugs, such as prescription drugs indicated for IC (for example, Elmiron and dimethyl sulfoxide), antidepressants, antihistamines, antacids, anticoagulants, and narcotic analgesics; transcutaneous electrical nerve stimulation; and surgery, such as substitution cystoplasty or urinary diversion with or without cystectomy. Treatment is not effective for everyone because response varies among patients.
SSA recognizes that IC can be a Medically Determinable Impairment (MDI) when accompanied by appropriate symptoms and medical signs or laboratory and can be the basis for a finding of “disability.” SSA has a specific ruling to follow when evaluating IC as a basis for disability. To learn more about IC and applying for disability benefits contact us for a fee consultation.