IIRRC, a news article listed a few states in which, it was reported, that Social Security benefits were the easiest to obtain. I remember not which states were listed, only that a few were. I’ve searched the 'Net but cannot find confirmation. Can someone assist?
Social Security is a federal program. As far as I know, no state agencies are involved, either in the assigning of or paying of benefits.
I suppose that as a practical matter there might be some local offices that are more lax than others in terms if granting social security benefits, but they’re sure not supposed to be.
Actually they are. The SSA takes the case and assigns it to the state where you reside for eligiblility determination. When the state says yea or nay then the SSA takes over.
The SSA takes your case and assigns it to the local Social Security office, which will most likely be in the state in which you reside.
The Social Security website includes a “Find your nearest Social Security office” link that takes you here.
Took awhile but I found it. Using “GAO” helped narrow the search. The newspaper article was recent but the report is three years old.
In a nutshell, you initially take the case to the local District Office, which is manned by the State. It makes the original determination, based upon the medical evidence, medical advisors, and vocational experts, along with the guidelines in the Act, Regulations, and Rulings. (Actually, the District Office, having non-attorney employees, rely upon a massive treatise called the POMS (Program Operating Manual System), which is basically a rehash of the Act, Regs, and Rulings in easy to understand terms – as if the Regs were not, due to re-writing which President Carter mandated.
If you disagree in whole or in part, you then ask for a reconsideration, from the same office. If you still disagree, you then take it to the Office of Hearings and Appeals (OHA), which is manned by federal employees. You have a hearing before an Administrative Law Judge (ALJ), who, of course, is a federal administrative law judge. He decides the case de novo, based upon the same considerations the State did. However, at this point, you usually get a lawyer familiar with SSA, and he can argue the case. He or she can also adduce additional evidence. There is about a 70% reversal (in your favor) at OHA. If you still disagree, you can appeal to the Appeals Council, another federal institution. That is the end of the administrative process.
If you are still unhappy, you can file a suit in the District Court. You cannot file a civil action until you exhaust your administrative remedies, as above summarized.
At the state level, you are likely to get denied unless you have such a serious impairment or impairments that meet the severity of an Impairment described in the Listing of Impairments in the Regs. If the state has to consider vocational factors (age, past work experience, and education), you are likely to get denied.
For what it’s worth, I agree that as a practical matter, some jurisdictions are better than others for getting SSD benefits.
Where I work – NYC – there are several OHA’s. A buddy of mine who practices social security law says that he hates cases in Queens because the ALJ’s there are very conservative.
Come to West Virginia, I personally know of three men in their late 30’s - early 40’s who receive SSI disability because they are drunks. One has never had a job. One other was involved in an auto crash, but can still work. The third was working a full time job when he found out he could get disability because he is illiterate. So he quit. All three are perfectly healthy people who just found a way to beat the system.
The law was amended several years ago to preclude alcoholics from receiving benefits, if alcoholism is the reason they are disabled. If they would be disabled anyway, they are still eligible for benefits. Being illiterate is a vocational factor in a very limited number of cases: those between the ages of 45-49 and have the “residual functional capacity” (RFC) for only sedentary work. Never having had a job is another vocational factor, but your RFC would have to be quite limited. If one doesn’t meet a Listing in the Listing of Impairments, there is a 5-step sequential evaluation to be used to determine disability combining one’s RFC with one’s vocational factors, which include the questions of whether one can perform his or her past relevant work. If the person can, no matter the RFC, he or she will be found not disabled. If one has no past relevant work, you automatically address the last sub-issue: whether he or she can perform any other work which exists in significant numbers in the national economy.
The burden of proof is on the claimant to show that he or she is “disabled;” however, once the fifth step is reached, the burden shifts to the government. The government uses a grid which has met approval by SCOTUS if a claimant has only exertional limitations. However, if there are also non-exertional limitations, vocational experts must be used.
As I said before, this issue is first resolved by a state agency (which I said was the District Office, but actually is the Department of Disability Services (DDS)), but what state is involved does not really matter, as a prior post pointed out, it is the ALJ that matters. It really is not fair but much depends upon the ALJ. There are some who won’t pay anyone, and others who will pay everyone.
A few years back, DDS would not pay anyone who did not meet a Listing, and 70% of those cases who reversed by an ALJ. The Appeals Council (AC) was then merely a sign-off office (it is located in Baltimore). But a class action suit was brought pointing out the tremendous reversal rate. I don’t know all the particulars of that suit, but I do know it got the government in a big sweat. The government prevailed on the basis that at the ALJ level, new and additional evidence is often produced, that an attorney can present the case more favorably, and some other arguments. After that, the government took action to get the state agency and OHA in more agreement, and DDS now pays more cases. The AC, also, is no longer a sign-off agency.
Thanks for the information barbitu8. I could get into this further, but it (the subject, not you) would end up in the pit. Suffice to say, the three men I referenced are all capable and able to work. Two were working. They just found a way to make the system work in their favor. No wonder SSI is going broke.
Many receiving these benefits are able to work. But, as you say, they’ve found a way to make the system work for them without working. OTOH, there are some who receive benefits and do work. This is OK, within limits and provided they inform SSA. I’m not going to go into all the ramifications of that, unless you insist, but they include a trial work period, extended period of eligibility, etc. But there are some who work and don’t inform SSA. I remember a case where an individual was receiving benefits due to macular degeneration which caused either legal blindness or such low visibility that the ALJ found he could not work at any significant numbers of jobs. (I did not read the decision.) Due to SSA’s nexus with IRS, SSA found he was working, and overpayments were charged against him. He came before the SSA and was represented not by a lawyer, but by a friend (who obviously knew nothing about the law). His friend said to the ALJ (and I know this because I listened to the tape), “Come on, I know you can waive the overpayments if you wish.” Or words to that effect. In actuality, an ALJ cannot arbitrarily waive overpayments, but is bound by the law as to when such payments can be waived. But the thing is that his friend said something about the claimant’s using a motorbike. The ALJ said, “You use a motorbike?” The guy said that he had to in order to get to work.
I should have added that that meant that he continued to work and not report his work to SSA. I think the guy and his friend should both get benefits for meeting the low IQ standard (IQ under 50).
And these people screw it up for those of us who actually a) are disabled b) need the money, at least for a while and c) are honest enough to TELL Social Security if we get a job. AAAAAGH.
This is very true! BUT there is MORE!!! I have just filed my appeal and live in Utah. I just turned 50, have fibromyalia, degenerative arthritis, bi-polar, ptsd, and and an anxiety disorder. In addition, i have almost no work history over the past 20 years. :eek: However…what i have done for these years is be the sole caregiver for a son who is considered severely disabled. This includes (but is not complete…) cerebral palsy, moderate to severe retardation, a behavioral disorder, possible bi-polar, chronic constipation, a ganglion cell anomaly of the colon and a colostomy tube. I was denied because i did not have enough medical proof (these 20 yrs i had $O personal income and $O benefits, http://boards.straightdope.com/sdmb/images/smilies/eek.gifmy son supported us on his SSI.) and because i made it to the appointment all by myself. the fact is: each and every state has it’s own criteria for SSI or SSDI. even once you have it you will co through reviews, i know because i have had to work on the paperwork for my son. And even though one state approved him at the age of 18, the next state in transferring it tried to take his social security away because the owners of the house where we paid to rent 1 room didn’t want to have to list their financial information. It is Often directly related to the particular individual/s handling your claim! Always try to have as much of your own medical records as possible! While you may have a diagnosis of Bi-polar, it may be listed as “mood disorder” in the new “efficient” electronically records system. In fact while i have been told what i have one medical records system says i mood problem, muscle pain, current tobacco use and elevated CPK. well i did have an elevated CPK, and i smoke. but as they say these are my medical “Issues”. I have many “Issues” but what any one us us would much rather have is a solid diagnosis. Having vague broad reaching “Issues” can cause many Huge Issues like incorrect treatment in an ER, another medical professionals office, and can not only allow for you to be denied benefits you are entitled to but also can kill you! I am currently dealing with this because my son needs his colostomy tube replaced! luckily the hospital he originally was seen in that last time in 2009, well they are awesome and and the pediatric surgery unit is so appalled at the idea that even after the University Hospital clinics here said they had tried several time to get his records, only to find no one requested them. Social Security is supposed to make sure of this. But they do not always! This is another place i had made a huge Mistake! because since I could call and find out on my own claim that out of the 5 places over the past 15 yrs i had received medical care… 1 place was shown as responding. but as i was not careful enough, in constant pain, and manic, i only thought to call and check after i fought with my son’s issues today. I never thought to even make sure of anything! And the Lawyers i have spoken with will not take cases until you have been denied at least 2 time and/or if you can get a doctor to give you written conformation that you can not work for a minimum of 12 consecutive months! smiles and the fight is on and today i will be making calls and kicking but til i have what i need! Because for the first time in a very long time… i remembered that if i don’t at least try to ensure that i take care of myself, even if that is fighting to get SSI… even the least possible amount so that i can continue to have the ability to get the medical attention i need then i cant take care of the person most important to me in the world, my son! and i will sort of shush up now and wish everyone the very best luck and thank you for having a place like this so i can try to see whats going on out there. laughing and to blow off some steam!
Chuck Shepherd on News of the Weird reported on judges that had very, very high approval rates for disability requests. It seems like the judge you wanted resided over a West Virginia/Ohio venue. So statisticially, some judges are more likely to give out the benefits. The same as some of the disability lawyers make claims that they win 80% of their cases, as opposed to the guy down the block that only wins half. Some try harder, some know the tricks better, or are better connected. Some judges are sympathetic, some may think everyone can work, or some may simpy be tired of caring. It might not matter what state you are in, but which judge you get.
The benefit for someone who has never worked is $600 a month, ever try to live on that without supplementation? Anyone who scams the system and structures their entire life around receiving a cool $600 off Uncle Sam has by process of elimination some serious problems. What able bodied adult would scorn work and a normal life for $600 a month and not have a mental problem? How does dating go when you’re eating cat food?
I’ve known people living on this that considered themselves scammers, most people would call them scammers too. They exaggerated their mental problems, and many considered themselves just fine and sly playing the system. All had serious problems from depression to substance abuse and anxiety, none had ever held a job more than a few days.
Zombies should automatically be judged to be disabled. Since this is a zombie, I haven’t read any of the old posts, but it is a fact (which I might have already stated) that some administrative law judges (ALJs) are very lenient and some would not pay anybody. Having had worked for ALJs for over 20 years, I can vouch for that. In addition, some lawyers get a reputation for taking only cases that should be paid. The ALJs know who these are and are inclined to pay those cases. As far as lawyers not taking a case until after two denials, this is as it should be. The first denial is the initial determination and the second is the reconsidered determination, both made by the Disability Determinations Service, a state agency. It is at that point, the claimant should get a lawyer to argue the case before the Office of Hearings and Appeals, where the case will be heard and decided by a federal ALJ. BTW, when I worked for OHA, the reversal rate nationwide was around 80%.
But some people I know have worked, such as a few who worked at a casino as their last job before going on disability, and they get paid ~$2000 a month. Even for those who never worked and got it, they might be with a partner and that $600 may be enough for them. Plus there is a whole host of other programs for them to collect on. Most of the people I know on it, that I feel shouldn’t be on it, had sense enough to work hard right before so they could get the big payout instead of that $600 a month.
Another person I helped that deserved it was denied immediately. I took him to several of their doctors, and surprise, surprise, they all said nothing was wrong with him. I got him a lawyer the morning he decided he was going to apply, and applied officially that afternoon. We held out, and he was up for appeal. In the meantime, he was hospitalized again, and the lawyer took that to a judge that agreed to give him his monthly payment. I picked a good lawyer for him, it only took 9 months from applying to get a check. Other people I know have gone for 2 and 3 years fighting the system. They hope to starve you out, hoping you’ll have to take employment while you wait, and then use that to say you’re not disabled.
THIS! Unfortunately I am receiving Social Security Disability. My monthly benefit is $1650 per month with $100 of that taken for Medicare premium. This leaves me with $1550 per month to live on. While not quite poverty level, it certainly isn’t easy living on this amount. I once had a co-worker of a friend of mine say to me “I guess you won the lottery”. I looked at him like he was a moron. Prior to breaking my back on the job I earned on average $75k a year and some years more depending on overtime. Why in the hell would I give up working at 38 years old so I could stay at home on SS? Newsflash for anyone out there that thinks this is a great deal, those of us on SS have no money. We don’t get to eat our at nice places, buy new cars or take vacations. We have to live a very Spartan life, watching every single penny. And I apparently am one of the more fortunate ones. Your benefit is based on your income while working and the amount of SS taxes you have paid into the system. Since I had a fairly high income, my benefit is much larger than most.
Now keep in mind that when I said unfortunately, I wasn’t trying to knock Social Security. I am very grateful for the safety net that has helped me. However, I do get very tired of reading on the internet those that think people on disability are free loaders living off the system. We are able to collect our benefit because we worked and paid into the system. No different than an insurance policy, we paid into SS with the agreement that if we ever became unable to work, or contributions ensured us an ongoing benefit. I am not happy being in disability and would do anything to return to work, but until modern medical science comes up with something, it isn’t in the cards.
As far as being able to work, I would suggest not judging anyone on disability because you see them doing something you think a disabled person shouldn’t be able to do. I am 6’ tall, 225lbs and appear to be in good shape. However, I am constantly on morphine to control the pain and while there are times when I am able to do some physical work, there is always a price to be paid for that work. Usually it’s terrible suffering for the remainder of the day. I can do just about anything I could do prior to my injury, the problem is I can’t do it for very long or on a consistent basis. I can’t think of any employer who will hire someone who can work for 45 minutes, but must stop for the next three hours because of the pain. Or one who will allow someone to call in sick two days a week because the pain will not allow movement on those days. Even when my pain is in check thanks to the medication, how many employers are willing to hire an employee who is always on morphine, percocet and amphetamines? If I am an employer that sounds like a huge liability to me. Let someone on those types of medications drive a company vehicle or operate company machinery? Probably not. The point is, you can’t judge a person’s ability to work from a short look at their current activity level, for an hour from then it is quite possible that even simple movements are beyond their ability.
As far as being easy to qualify for disability, I can’t answer for all States (my application was in Georgia), but it took me 5 years from first application until approval. I finally had to appear in front of a Federal Judge who reviewed my medical records and gave approval. The whole prices took less than ten minutes and almost no questions from the Judge. His decision was based solely on reviewing my medical records. Why it took five long years is beyond me. During that time I exhausted all of my savings and would not have made it if I didn’t have family to help me. Long story short, I and almost everyone I have meet on disability would give anything to not be. We have suffered devastating or injuries and most of us have had our promising financial futures destroyed.