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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Getting a diagnosis of cancer when you are uninsured is a harrowing event.  Many times the options depend on your sex, your type of cancer, and where you live.  Federal legislation provides that female patients diagnosed with breast or cervical cancer qualify for Medicaid for cancer treatment if low income.   For female patients with other types of cancer or for male cancer patients, the federal coverage laws do not apply.  For states, like Georgia, that did not expand Medicaid under the Affordable Care Act, patients have fewer options.

Uninsured adults often delay preventive care which can worsen survival outcomes.  Also more advanced stages of cancer require more expensive care.   Whether an uninsured cancer patient can get care often depends on where the person lives and the type of cancer he or she has.

Researchers at the American Cancer Society estimate that 30,000 uninsured people are diagnosed with cancer every year.  Uninsured cancer patients incur credit card debt or launch GoFunMe campaigns.  People mortgage their homes for cancer treatment.  While cancer patients can purchase insurance through the Affordable Care Act marketplace, they must wait until the regular enrollment period in November of each year.  Then the plans do not activate until the start of the next calendar year.

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WHY YOU MIGHT HAVE BEEN DENIED SOCIAL SECURITY DISABILITY

There are two kinds of disability benefits the Social Security Administration provides.  One is Social Security Disability Insurance (SSDI).  It covers citizens between ages 18 to 65 and who paid into the Social Security program through payroll taxes.  For SSDI the maximum federal monthly amount in 2023 is $3627, but the average benefit is $1483 per month.  Disability beneficiaries are not allowed to work above substantial gainful activity and collect benefits.  SGA in 2023 is $1470 a month in gross income. SSDI comes with Medicare.

The other program is Supplemental Security Income.  SSI is for people who are low income, and have  been unable to enter the workforce to sufficiently pay into the SSDI program.  Typically, you need to have worked five out of the last ten years to be eligible for SSDI.  The monthly maximum benefit for SSI in 2023 is $914.  SSI comes with Medicaid.

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Staffers at the Social Security Administration gathered in Washington, D.C. this summer to protest a staffing and funding crisis at the agency.  Employees contend more Americans will be denied benefits due to decades of low funding by Congress.  Field office employees from across the country have sounded the alarm to Congress.

Over the last decade Social Security beneficiaries have increased by 25% while SSA’s operating budgets have decreased by 17% and hiring is down by 50 %.  By the end of Fiscal Year 2022, staffing levels reached a 25 year low.  Employee surveys indicate that SSA is the “worst agency” to work for in the federal government.  Workers claim “toxic levels of stress” and “impossible workloads.”

Low staffing results in backlogs of claims, frustrated claimants, overworked employees, long lines at field offices, and unreasonable delays in phone service.  Under-funding has led to poor training of new employees.  SSA uses a self-taught training manual rather than one-on-one training with personal staff.  SSA spends less than a penny of every dollar on administrative costs.  Applicants for disability benefits face processing times of more than six months.  The agency’s toll free number has wait times in excess of thirty minutes.  Wait times at field offices for unscheduled appointments have been as long as three hours.

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This July and August offered record-breaking heat waves with temperatures reaching at 99 degrees over week-long periods.  Middle and South Georgia experienced temperatures reaching up to 100 degrees.  The National Weather Service defines any heat index of 105 degrees Farhenheit or higher as dangerous.

A person experiences overheating when the body temperature goes up to 104 degrees.  Sustained temperatures cause decreased blood flow to the organs and eventually multisystem organ failure.  Without prompt intervention to lower the body temperature, heat stroke can be fatal.   Prior to heat stroke, a person can experience heat exhaustion.  The symptoms are headaches, dizziness, lethargy and malaise.  Symptoms of heat stroke are confusion, altered mental state, slurred speech, loss of consciousness, profuse sweating, seizures, and a very high body temperature.  Heat stroke is a life threatening emergency.

According to the United States Environmental Protection Agency, Georgia is predicted to have more frequent days of temperatures in the 95 degree range.   As climate change drives higher temperatures, Georgia residents become vulnerable to flooding of homes, over-heating in densely packed urban heat islands, and increasing energy bills.  Health risks are not distributed equally.  Some Georgia residents do not have air conditioning.  Some Georgians are homeless.  Some neighborhoods lack sufficient green space and tree canopies which provide cooling shade.  Some citizens work in occupations, such as construction, agriculture or maintenance, that require being outdoors during extreme heat.   Across the country, poor and minority neighborhoods disproportionately suffer the consequences of rising temperatures.

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The Social Security Administration Compassionate Allowance program quickly identifies claims where the applicant’s medical condition or disease clearly meets Social Security’s statutory standard for disability.  Due to the severe nature of these conditions, these claims are often allowed on medical confirmation of the diagnosis alone.  To date, nearly 900,000 people with severe disabilities have been approved through this accelerated disability process.  The entire list comprises 278 conditions.

SSA added 12 conditions to the Compassionate Allowance list:   1p36 Deletion Syndrome, Anaplastic Ependymoma, Calciphylaxis, Cholangiocarcinoma, FOXG1 Syndrome, Leber Congenital Amaurosis, Metastatic Endometrial Adenocarcinoma, Paraneoplastic Cerebellar Degeneration, Pineoblastoma – Childhood, Primary Omental Cancer, Sarcomatoid Carcinoma of the Lung – Stages II-IV, and Trisomy 9.

For more information about the program, including a list of all Compassionate Allowances conditions, please visit www.ssa.gov/compassionateallowances

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During the period of the public health emergency of COVID-19, states were required to keep individuals on Medicaid rolls without annual reviews.  In May of this year, the Biden administration removed the public health emergency.  Now states have from April 2023 to June 2024 to requalify for Medicaid. This period is referred to as Medicaid Unwinding.   Nationally, 93 million Americans were on Medicaid during the pandemic.   In Georgia 2.7 million adults and children receive Medicaid.

On August 30th, The Centers for Medicare and Medicaid alerted state that they may be incorrectly disenrolling participants – mostly children – from Medicaid and the Children’s Health Insurance Program (CHIP). Two programming errors occurred during this period of unwinding.  First, states evaluated Medicaid eligiblity per household as a whole rather than separately by children and adults.  Second, states that were awaiting replies to questions from one household member would disqualify the whole household.  These procedures violate Medicaid and CHIP regulations.

Georgia is one of ten states that have not fully expanded Medicaid. Georgia began a limited Medicaid expansion in July 2023.  Adults who earn less than $14,600 a year will now clear the income threshold to apply for a Medicaid insurance card.  However, applicants must complete 80 hours of work, job training or qualifying activity each month to keep their coverage.  For those awaiting a decision on Social Security disabilty, they will not be eligible because the work requirements would eliminate disability eligibility.  Georgia is the only state with a work requirement for Medicaid eligiblity.

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U.S. residents under 40 are dying of accidental overdoses.  Death rates in this age group rose 21% from last year.  Overdose deaths took 177,000 lives nationwide.  In 37 states, overdose deaths are the number one cause of death in this age category, higher than deaths from vehicle accidents, suicide and gun violence.  The primary reason for overdose deaths is the presence of fentanyl in recreational drugs.  Drug dependency rose during a prescription opioid crisis, particulary involving the opioid, OxyContin, during the early 2000s.  As legislation curtailed the mass marketing of OxyContin, users turned to heroin, synthetic opioids and finally fentanyl which is 50 times more potent than heroin.

In Georgia from 2019 to 2021, drug overdose deaths increased by 61% and fentanyl involved overdose deaths increased by 230% representing 2,404 and 1,294 lives lost in 2021.  In Georgia drug overdose rate  (23.5 per 1000) is higher than the death rate from firearms and homicide.  Only COVID took more lives according to 2023 statistics from the National Center for Health Statistics. 

Lack of education about the dangers of fentanyl combined with its increasing presence in illicit drugs fuels this health crisis.  Fentanyl is often cut into other drugs, such as oxycodone, hydrocodone and benzodiazepines, because it is cheaper and provides same or greater effects with less product.  Counterfeit drugs are also hard to detect.  Yet, just two milligrams of fentanyl can be fatal. 

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In 2020, Congress passed the National Suicide Hotline Designation Act which sought to address a crisis nationally in mental health.  The bill created a national crisis hotline:  9-8-8, an easy number to remember in a time of crisis.   The hotline is a direct line to trained National Suicide Prevention Lifeline counselors.   Georgia residents can also call the Georgia Crisis and Access Line available 24/7 at 1 800 715 4225

Initially, the hotline is funded by the federal government through the American Rescue Plan.  Later, states will have to pursue statewide funding.  The bill allows states to enact telecommunications fees to help support 9-8-8 operations.  The hotline is administered by the Substance Abuse Mental Health Services Administration (“SAMHSA”), a federal agency.  SAMHSA provided all states and territories nearly $105 million in grant funding thru the American Rescue Plan.  Future funding will depend on volume and needs of community.

In July 2022 Georgia rolled out the 9-8-8 crisis hotline.  The hotline provides counseling for emergencies regarding threats of suicide, substance abuse and mental health crises.  This year, Governor Kemp red-lined $2.2 million earmarked for 9-8-8 funding in the FY 2024 budget.  State officials say 9-8-8 has led to a 12% increase in call volume since last year and the Georgia crisis line has had 40% increase in call volume since 2020.  Demand is growing in rural communities.  Kemp also nixed salary bumps for mental health professionals.  While state tax collections were slightly down (0.4%) from last year, the state still maintains a budget surplus of $4.8 billion.

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September is the last month before the end of the federal government’s fiscal year.  The Senate came back into session on September 5th and the House returns on September 12th.   Government funding for the next fiscal year must occur by October 1, 2023.

While the Senate Majority Leader and House Speaker have agreed on a short term continuing resolution to meet funding obligations during the debt ceiling negotiations in May, the House Freedom Caucus has threatened to pursue the shutdown unless their demands are met.

Currently, the Senate Appropriations Committee has approved $772.5 billion for non-defense discretionary spending and $858 billion for defense funding with broad bipartisan support.  The House has approved bills only along partisan lines.  The House bills make deep cuts in non-defense appropriations, particularly with programs related to climate change, the IRS, the Justice Department and the Pentagon.   The bills also contain “poison pill” legislative riders pushing policies against LGBTQ programs, racial equity and access to reproductive health care.

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The retirement age is a crucial factor for Social Security and Medicare because it determines when individuals become eligible to receive benefits from these programs.

Social Security is a federal program that provides retirement, disability, and survivor benefits to eligible workers and their families. Initially, at the outset of these programs, the full retirement age was set at 65.  However, a 1983 overhaul of this program began raising the age for full retirement.   The retirement age for Social Security benefits is currently 66 for those born between 1943 and 1954, and it gradually increases to 67 for those born in 1960 or later. If a person starts collecting Social Security benefits before their full retirement age, their benefits are reduced. Conversely, if they delay their benefits past their full retirement age, they receive a higher monthly benefit.  Those whose retirement age is 67 will only receive 70% of their benefit if they retire at 62.  If full retirement age is increased, it could mean a further reduction in early retirement benefits.

When Congress made changes to Social Security in 1983 it envisioned that newly implemented 401K plans would provide retirement assistance and decreased dependency on the program.  Economists point out that that scenario has not occurred.  Employer provided pension plans used to provide retirement income.  Those gave way to 401K plans which put the responsibility of saving on the worker.  Labor economists show that many retired workers have little or no savings plan at all.  Thus, many Americans are wholly dependent on Social Security for retirement income.

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