The Social Security Disability system in the United States is very complicated. Whether you are a recently disabled father trying to provide for your family, a single mother who can no longer work because of an illness, or the parent of a child who needs extra help because of a challenging condition, obtaining benefits is not easy. The “system” involves a complex set of rules and requirements that make it very hard for the average person to successfully receive payments.

There is hope, however, and we appreciate you looking for help here. Our law firm provides unique benefits to clients just like you, which include:

  • A singular focus on representing the injured and disabled.
  • Having all important work performed by an experienced disability attorney.
  • A guarantee that you pay no fees unless you obtain social security disability benefits.
  • A proven track record of success in both routine and difficult cases.

Regardless of whether you are considering filing for benefits for the first time, or have been denied numerous times in the past, please call our office at (404) 255-9838. We will discuss your options free of charge, and help you make an informed decision about what to do next. We look forward to talking with you.

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Last week I blogged on national trends with the opioid epidemic.  Georgia data tracks national trends, and unfortunately, seems to be leading the nation in opioid overdoses.  A 2017 research paper from the Georgia Prevention Project tracked the following data.  Of the 1,307 drug overdose deaths in 2015 in Georgia, 900 or 68 percent were due to opioid overdoses including heroin.  Georgia ranks among the top 11 states with the most prescription opioid overdose deaths.  Recent data indicate that 55 of Georgia’s 159 counties had higher drug overdose rates than the U.S. average.  Sixty percent of the 55 counties with drug overdose rates higher than the national average are located in rural areas with limited access to substance use disorder treatment and/or medication-assisted treatment.

Over just two days in June 2017, 33 people overdosed on opiates in central Georgia. Five of them died.  Law enforcement tied the outbreak to a street version of counterfeit Percocet laced with fentanyl. The Centers for Disease Control says fentanyl is 50 times more potent than heroin and 100 times more potent than morphine

What is Georgia doing about the opioid epidemic?  You can read more about the steps Georgia is taking to prevent opioid addiction and overdose at the Governor’s website.  Georgia funds specific programs that focus on education and training on opioid use as well treatment and recovery programs for those addicted to heroin or opioids.

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Many people ask how to win a Social Security Disability case.  However, it also might be helpful to analyze why people lose their claims.  Here are my top 6 reasons why a case is not successful.

  1. You are working while applying for disability.  Nothing hurts a case more than claiming you cannot work while simultaneously working.  When I realize my clients have been working and it constitutes “substantial gainful activity” we usually have two options.  If the work has stopped, then they need to amend the onset date to a time after the work ended.  If the work has not stopped, we may be able to claim a closed case to cover that period of time when they were not working – provided it lasted at least twelve months.    If you never stopped working, then dismiss your application.
  2. You are not treating with a doctor. I know how hard it is to access medical care when you have lost your healthcare insurance and you have no income due to a job loss.  However, you must find alternative ways to treat for your severe medical impairments.  Go to your local emergency room or to a nearby community healthcare center and ask for help.  It is very difficult to win a disability case if you do not have current treatment records.  And no, Social Security will not send you to one its doctors.  Consultative exams are not treatment.   Occasionally, the CE reports are supportive of disability, but that alone will rarely result in a favorable decision.
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Last Thursday, the Trump Administration invited states to add a work requirement to Medicaid eligibility.  States and the federal government jointly fund Medicaid, but states are responsible for running it. The federal government cannot impose work requirements without Congressional approval.  However, states can impose a work requirement by requesting a waiver from the regulations for new programs that carry out the underlying mission of Medicaid.  States do this by applying for a waiver and having it approved by the President.  Hence, it is news when the President of the United States invites states to do this.

Presumably, the work requirement will exempt children, pregnant women, the elderly, and people with disabilities.  There is hope that it will also exempt full-time students and family care-givers.  Assuming all of these groups that currently receive Medicaid would be exempt under the new work requirement proposal that only leaves a small group that would be affected by it.

According to research by the Kaiser Family Foundation, only 1 in 10 people who receive Medicaid would be subjected to the work requirement.  Kaiser research further shows that in the non-exempt populations, more than 50% of the adult Medicaid recipients who would not be covered by the exemption are already working. Thus, a relatively small portion of the individuals who receive Medicaid would be affected.

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This week the A&E channel  highlights Atlanta in a series of Intervention episodes focused on the “Heroin Triangle.”  Intervention documents individuals addicted to drugs and alcohol.  “The Heroin Triangle” consists of areas just outside of Atlanta, mainly in Cobb County.  Cobb County officials report a growing opioid and heroin epidemic.  Examples of opioids are morphine, hydromorphone, methadone, fentanyl, hydrocodone, codeine, tramadol and burprenorphine.  Heroin is an opioid drug made from morphine.  Research indicates that 80% of Americans using heroin first misused prescription opioids. 

The National Institute of Drug Abuse reports over 30,000 deaths last year from opioid overdose.  There were 20,000 overdose deaths from heroin and illicit opioids.  Drug overdose deaths in 2016 totaled approximately 64,000 people, making it the leading cause of death of individuals under 60 – exceeding car accidents.  Opioid death rates are highest for white males.

What is the cause of this opioid epidemic?  The New England Journal of Medicine (“TNEJM”) reports that the “widespread use of opioid analgesics has resulted in a national epidemic of opioid overdose deaths and addictions.”  Opioid analgesics are the most commonly prescribed class of medications.  Thirty percent of adults and forty percent of older adults suffer from chronic pain.  However, research suggests that opioids soon become the problem.  As TNEJM explains:  For a patient in chronic pain,  even mild levels of pain can trigger the learned associations between pain and drug relief, which are manifested as an urge for relief.  Such a conditioned urge for relief from even mild pain can lead to the early inappropriate use of an opioid outside of prescribed scheduling.  Given the current overdose and addiction epidemic, doctors and medical associations are starting to question the practice of prescribing opioids for chronic pain.    The Center for Disease Control reports that over 2 million Americans are estimated to be dependent on opioids and an additional 95 million are dependent on prescription painkillers.

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We had a successful hearing last week for a young client who was diagnosed with Amplified Pain Syndrome, also known as Amplified Muscoskeletal Pain Syndrome (AAMPS).   AAMPS is a medical condition in which a young person develops an abnormal pain reflex.  The overactive reflex causes constriction of blood vessels which deprives oxygen to the muscles, bones and skin causing lactic acid build up.  Hence, a mild pain is amplified.  This claimant also had arthritis and other auto-immune diseases.

Some of the symptoms of AAMPS are pain in limbs, whole body pain, abdomen pain, headaches, and swelling of extremities.  For a diagnosis at least three major body parts must be affected longer than 3 months.  Also, other symptoms such as sleep disturbance, weather sensitivity and abdominal pain must manifest as part of a diagnosis.  The treatment protocol appears to be exercise and desensitizing through the pain with aquatic and other occupational therapies.

At the hearing Social Security’s physician expert fully supported disability for our client and was able to synthesize a vast amount of treatment records to explain this condition.  Since many times patients with this condition are suspected of “making it up” it was validating to have a board certified pediatrician, hired by Social Security, support this child’s real and genuine pain.   Many times a hearing is required so that experts can testify as to whether such conditions are actually disabling.

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First, right before the holidays, Congress approved another short-term funding bill, funding the government through January 19, 2018.  Congress did fund the Children’s Health Insurance Program through March 31, 2018.  I have previously blogged on the importance of funding that program.  More on that as we head to March.

The final version of the tax bill repealed the penalty for not having health insurance (“the individual mandate”) that was an important part of the Affordable Care Act.  The structure of providing low-cost, affordable and portable healthcare available to all Americans depended on everyone — young and healthy alike — purchasing healthcare.  Not only does this control costs for the consumer and risks to the insurance provider, but it reduces the number of uninsured Americans.  Sure, many healthy young adults balked at the mandate.  But since even these individuals cannot rule out getting hit by a bus or injured in an accident, it was hardly an onerous federal regulation.

But Congress eliminated it so there you have it.  According to the National Budget Office, the repeal of the individual mandate will cause 13 million fewer people to be insured by 2027.  Some people will elect not to purchase coverage and some will not be able to afford coverage.

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Many potential clients I speak with daily are shocked to learn that the average wait time for a disability decision with the Social Security Administration is two years.  Yes, you heard me correctly – two years.  Why is that?  First, most applications are denied.  Second, the time period for a decision on the initial application is five months.  An appeal to the next level of review (reconsideration) is three to five months.  The next level of review – and where your best chance of a favorable decision exists — is the hearing level.  The current approval rate in Georgia at the hearing level is 48%.

But wait times for a hearing are currently over a year.  Here are the official wait times for a hearing in Georgia:  Atlanta Downtown Hearing Office – 20 months; Atlanta North Hearing Office –         18 months; Covington  –  18 months; Macon  –  16 months; Savannah – 17 months.

From a  2017 CBS News report, there were 1.1 million applicants waiting on a hearing before an administrative law judge.  That is a 31 percent increase from 2012.  However, the agency’s annual budget is the same as it was in 2011.  Five years ago the hearing wait times were less than a year.   “No search for efficiencies, reprioritization of tasks or technological improvements can substitute for adequate resources,” said Lisa Ekman of the National Organization of Social Security Claimants’ Representatives.

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One of the most frustrating problems people with disabilities experience is that a loss of a job usually leads to loss of healthcare coverage.  Filing for Social Security disability takes several months if not two years on average for a decision on an application.  When people with chronic or traumatic health problems lose their health insurance, they usually go without needed care.   Sadly, many health-impaired individuals who are unable to return to work for health reasons, also lose much-needed access to health care.

Researchers at the Boston University School of Public Health found that poverty has “emerged as an increasingly important risk factor for mortality in American adults.”  “Income is more associated with length of life now than it was 15 years ago .. we may be seeing the emergence of a health poverty trap, where essentially people who are poor don’t have the same access to the important determinants that allow them to stay healthy,” explains Jacob Bor, Assistant Professor of Global Health at Boston University and the author of the study.

We see this every day in this practice area.  One of the most frequent questions I hear is: what should I do about healthcare?  First, stay on a spouse or relative’s healthcare policy even if it means an extra expense.  Second, use any other income to purchase coverage on the healthcare exchange.  A problematic loophole to this advice is that without income, many individuals are not eligible for subsidized plans provided through the healthcare exchange.   Third, COBRA coverage allows you to stay on employer-provided healthcare coverage for 18 months after leaving a job.  However, the employee is responsible for paying the entire monthly premium amount.  Most people who are losing income due to a medical-related job loss often find this is cost-prohibitive.  Fourth, after exhausting assets and income, apply for financial assistance at Grady Healthcare, Emory University or Wellstar Kennestone.  I will not profess to be an expert in their financial departments, but many of my clients have found assistance at these three hospitals.

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The Food and Drug Administration (FDA) has just approved a personalized cancer treatment that has the potential to have dramatic benefits for some types of cancer patients.

The therapy called Yescarta is a gene therapy, and involves the removal and genetic engineering of the immune cells of patients, so that they are better equipped to fight off the cancer cells.  This is the second gene therapy treatment for cancer approved by the Agency, and the first such therapy to be approved for the use of certain types of cancers like non-Hodgkin’s lymphoma. Experts believe that over the next few years, thousands of lives will be saved because of the treatment. There are, however, risks involved with the treatment and severe side effects attached. The therapy is also expensive, and it is likely to be used only in those cases where other treatment options have failed.

Persons who suffer from cancer may be eligible for disability benefits under the Social Security Disability Insurance program. To qualify for benefits, you must have paid into the Social Security system. Persons who suffer from certain types of cancer may qualify for expedited processing of their application. Several types of cancers are included in the SSA’s Compassionate Allowances program which allows claims to be approved quicker. If your cancer is inoperable, is recurrent in spite of treatment, or is spreading across the body, you may qualify for expedited processing of your claim.

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Young athletes who suffer frequent concussions have a higher risk of suffering multiple sclerosis later in life.

These findings were part of a study recently published in the journal Annals of Neurology.  Researchers in Sweden analyzed medical histories of Swedes who had been diagnosed with multiple sclerosis since 1964. When the same data was compared with another control group, the researchers found that the risk of development of multiple sclerosis later in life was higher in people who had suffered multiple head injuries during their youth.  Persons who had suffered at least one concussion were 22% more likely to suffer symptoms of multiple sclerosis later in life, compared to those who had not suffered such injuries. In the case of multiple concussions, the likelihood increased by a staggering 150%.

The study also revealed that concussions do not seem to be so damaging when they occur during childhood. Adolescent brains seem to be much less resilient, making them more vulnerable to the long-term effects of consistent concussions.