Fighting the Social Security Administration

If you were awarded benefits, why would you need to fight SSA?

If you were awarded benefits, why would you need to fight SSA?

After completing a two year journey through SSA’s disability determination process you have been awarded Social Security Disability benefits. You made contact with the SSA payment center which set you up to receive your back benefits in installments and your monthly benefits going forward. At some point in time you were told by SSA to continue to provide updates about work, medical updates, and any time at all you have any other income. You were also told that at some time SSA may want to review your case to ensure that you are still disabled. At the time, you were excited about finally generating a source of income which you did not have in the prior two plus years.

Three years go by. You received a number of letters from the Administration which describe staying on disability, reminders of what the requirements are, and what you need to report. These letters are only occasional. One letter you received mentioned something about overpayment, but you remembered having an interview with an SSA worker who determined the dollar amount of your benefits. You have received payments in that amount every month for years now and you never did go back to work or won the lottery, so clearly, you were not overpaid.

Your benefits are monthly and you have adjusted to live within your means. You also try to save the benefit checks where you can so once in a while you can go out to eat, see a movie, or buy gifts at the holidays. It is not easy, especially since you need to keep up with your treatment, but since you are single and without child-related costs  you have managed to save and maintain about $1,800 in your bank account for emergencies.

Two Christmases ago, right after you were awarded benefits, your grandmother Millie sent you a $250 check to help get you back on your feet. That was especially nice of her since she usually only sends a sappy card with a $20 bill in it. You deposited that $250 check at the time and forgot about it.

On the three year and one month anniversary of the award of your benefits, you receive a thick packet from SSA. Inside is a letter asking you to report any income you may have received, a function report for you to complete, a release so that SSA can collect medical records, and a statement showing the payment schedule for your benefits with the cost of living adjustments for the next two years, among other documents. You complete these documents and return them to SSA.

Thirty days go by. Your benefits are not deposited into your account as usual. You try calling SSA and the first time you wait on hold until the Administration’s phone system hangs up on you. You call again and get a front desk person who tells you that they are not sure why your benefits have stopped, but that you can talk to a case worker. You call the case worker several times and leave several messages. At the sixty day mark, you receive a letter stating that you have been overpaid, that you owe SSA $26,000, and that you have no defenses because you knew or should have known that you needed to report earnings and did not do so.

You frantically call and call SSA, the case worker, and anyone that would answer the phone. Eventually, the case worker calls you back. They inform you that SSA performed a continuing disability review on your file, and determined that three years ago in December, your bank account showed an amount of $2,050 for two weeks because of unearned income of $250. The case worker further tells you that to remain eligible for your benefits, you can never have a back account balance above $2,000, that you did, and because of that SSA retroactively determined that you were ineligible for benefits. You were also determined to be ineligible because you had unearned income you failed to report. Because of that retroactive determination, you owe SSA all of the money they paid you from that December to present. The case worker further tells you not to waste everyone’s time trying to appeal SSA’s decision because you will lose any appeal you file automatically.

Is there anything to be done? Can SSA really tell someone they owe $26,000 because of some Christmas money that you received three years ago? Don’t SSA’s case workers have the final word on how your disability benefits get paid? Aren’t they right when they tell you that you will lose any appeal?

Look for the answers in our next post!

If you were awarded benefits and you are currently going through a similar experience to the one above please contact us today!

If you are interested in learning more about Social Security Disability please contact us for a free consultation!

The SSI/SSDI Appeals Process

Unknown

One thing that any new applicants for disability benefits will hear about shortly after submitting their application is the disability appeals process. It can sound like a daunting and difficult process filled with claimant participation, occasionally making the claimant feel responsible for keeping the process moving. However, most times, while the claimant will be asked to fill out some paperwork, go to an interview, or a doctor’s visit, the process for claimants can be relatively seamless. This post (and the parts that come after it) will take readers through some brief descriptions of the steps in the appeals process and what the roles of the claimant and representative are at each stop.

The Application

The application is actually the first step in the appeals process. Most people think of the application as only beginning their claims for benefits. However, even the best compiled application can fall into the 60-65% of applications that are denied. Well thought out applications and supporting documents will lay the foundation for any subsequent appeals that may be necessary.

At this stage of the process a claimant should gather everything that they can to provide to SSA either directly or through their representative. This information is going to include doctors’ names, addresses, and dates of treatment; former employers and dates employed, education history, bank account information, and more. It is a lot of information to provide, but the more of it you have on hand, the more complete your application will be; the more complete your application is, likely means the quicker the response from SSA will be and with a greater chance of success.

For the application, the representative will have the responsibility of compiling the information from the claimant in a way that makes sense to SSA. This is going to mean several things. First is literally organizing the information. When completing an application for a claimant a representative will be required to enter this information in a certain order for an online application and then mailing, faxing, or both the packet of information collecting from the claimant to the Administration. The representative will have to find out which office it goes to, to whom the case has been assigned, and whether to request that SSA take certain actions such as requesting a consultative exam.

They will also be responsible for pointing SSA to the locations of the claimant’s medical records so the agency can procure everything relevant to the claim. Many representatives will do more to develop the record such as collecting medical source statements, collecting letters from collateral witnesses, and drafting briefs. The representative may also work closely with an SSA case worker on more detailed cases or SSI cases which are dependent upon the confirmation of detailed information and subjective valuations (i.e. blue book value vs. true car vs. eBay auction value) of assets such as homes and cars.

In a nut shell, it benefits the claimant to present as much information as possible when submitting a disability application. So, the representative’s role is generally to assist them in collecting it and communicating it to SSA in a manner that is easily digested by the agency.

Stay tuned for the next part of our discussion of the roles of the representative and the claimant during the appeals process! If you have questions about this before our series is done please do not hesitate to contact us!