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Hydroxychloroquine is a drug that’s a lifesaver for many lupus patients across Georgia. Unfortunately, these patients are now facing an uncertain landscape in which there are severe shortages of the drug in the future.

Hydroxychloroquine is familiar to most Americans who suffer from Lupus. Lupus is an autoimmune disease in which the body cells literally attack each other. There is no complete cure for lupus, and patients may suffer a variety of debilitating symptoms, including severe pain, organ damage and chronic fatigue. All of these symptoms mean that many patients are no longer able to earn a sustainable income, and have to apply for Social Security disability benefits.

Hydroxychloroquine is a life-saver for these patients, who may use the drug to alleviate some of the mind-numbing pain they can be subjected to on days when the flare ups are severe. When President Donald Trump touted the merits of hydroxychloroquine as a miracle drug to treat Covid-19, many states witnessed mass buying of the drug, by persons who believed that the drug could also work as a preventative measure. This hoarding has left lupus patients very nervous about the looming shortage of a drug that, for many of them, is the only way to get through the day.

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Trauma is one of this country’s most urgent public health issues.  In a Center for Disease Control Report of 2019, Americans who had experienced adverse childhood experiences (“ACEs”) were at a higher risk of dying from five of the top ten leading causes of death.  The reported noted that one in six children across the United States had experienced four of more kinds of adverse childhood experiences.  An “adverse childhood experience” is defined in a landmark 1998 study by Kaiser Permanente as physical, sexual and emotional abuse; living with household members who abuse substances, had mental illness or were suicidal, violent treatment of mother/stepmother; and criminal behavior in the household or imprisonment of a household member.

The National Institute of Health reports that trauma affects a person’s mental and physical health, employment, education, and social functioning. Childhood trauma, particularly those that are interpersonal, intentional and chronic are associated with greater rates of PTSD, depression, anxiety and antisocial behaviors, including alcohol and substance abuse disorders  Secondarily, exposure to a traumatic event or a series of traumatic events (e.g. child maltreatment) activates the body’s biological stress response system.  Stress activation has biological, behavioral and emotional effects.

The majority of abused or neglected children have difficulty developing strong, healthy attachments.  Children who do not have strong healthy attachments have trouble controlling and expressing emotions and may react violently or inappropriately to situations.  A child with a complex trauma history may have problems in romantic relationships, in friendships, and with authority figures such as teachers or police officers.

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If you suffer from a disability, are above the age of 45, and do not speak English, you may qualify for disability benefits based on the lack of employment opportunities available to you. However, a new rule drafted by the Trump administration would specifically target persons who do not speak English, placing their eligibility for disability benefits at risk.

The federal administration is now in the process of finalizing a rule that would bar Social Security examiners from taking into consideration a person’s inability to speak English while evaluating a claim. The Social Security Administration currently does take a number of factors into consideration while evaluating an applicant’s claim. These factors include not just the primary criteria that the agency will consider (the person’s history of having paid into the Social Security system in taxes, as well as the duration of his disability), but also the applicant’s ability to find employment in another field. That determination will consider the person’s age, his education levels and the likelihood of finding a suitable job in another field. The determination of the applicant’s education does take into consideration the person’s ability to speak English. Failure to speak English can be a major deterrent for many types of jobs.

The new rule would, however, bar examiners from considering the applicant’s inability to speak English as a factor while determining the validity of a claim.  According to the administration, the agency currently pays out disability benefits to far too many non-English speakers from Puerto Rico. The administration is also asserting that non-English speakers now have better education levels than their English-speaking counterparts and, therefore, are less likely to be genuinely eligible for benefits.

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Having a child diagnosed with a birth defect can be a traumatic experience for any parent.  Besides the emotional toll that such a diagnosis can take on parents, there are also the financial implications to consider. Many such conditions require occupational therapy, speech and language therapy and other treatments to help the child manage or overcome the limitations placed on him or her by the defect.

There are several types of birth defects that could qualify your child for Social Security disability benefits.  These benefits can prove to be a substantial source of income for your child that could help meet some of his uninsured therapy needs.

It’s hard to predict whether your child will be eligible for disability benefits for his condition. Two children with the same disability may not be equally eligible for benefits. Mild defects that allow the chill to lead a normal life will not be considered for disability benefits.

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President Trump released his proposed FY 2021 Budget on February 10, 2020. The President’s proposed budget includes reductions in many social safety net programs and foreign aid, but increases spending for defense and veterans.

The president’s proposed budget is not very useful for estimating how much money SSA will have for administrative expenditures next fiscal year. Instead, it reflects the administration’s priorities for the next fiscal year. In an election year, the budget also provides insight to the president’s fiscal policy objectives, should he win reelection.  Congress has to pass a spending bill or a continuing resolution before September 30, 2020, and is unlikely to agree on the proposed budget as written.

The proposed budget requests $13.555 billion for SSA. This would be a $475 million increase over the amount Congress provided in Fiscal Year 2020. Since SSA estimates its fixed costs increase by over $300 million per year, an increase of this size could allow SSA to make additional investments. However, the budget proposal provides somewhat limited details of how this money would be spent. The Office of the Inspector General would get an additional $10 million. There would be $15 million less for research and demonstrations. The money required to be used for program integrity would decrease by $7 million, but SSA could still use additional funds for program integrity. The proposal estimates SSA would lose over 700 full-time equivalent staff and DDSs would gain more than 310 staff. This indicates that SSA plans to use increased funding towards the mandated raises for federal employees and for other expenditures, not to increase SSA’s workforce.

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Cervical cancer is the one of the most common cancers affecting women.  Fortunately, this is also one of the most easily detectable cancers. Globally, cervical cancer is the second most common cancer.

In most developed societies like ours, regular PAP smear tests can detect the presence of the cancerous cells faster. This can mean quicker commencement of treatment and a faster path to recovery.

The number one cause of cervical cancer is chronic infection of the human papillomavirus or HPV virus that is transmitted through sexual activity. These viral infections may be passed between sexual partners, and the infection can remain for several years in the system without the person even being aware of it.  Other risk factors for cervical cancer include obesity and smoking.

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First, some good news.  The Social Security Administration received its annual appropriation from Congress in September and that funds the agency through this February.  Second, even if that were not the case, funding for programs such as Title II (SSDI), Title XVI (SSI) and XVIII (Medicare) are funded through a combination of taxes and long-term investments.  The shutdown only affects funds annually appropriated by Congress.   So the checks still get delivered.

Core programs like disability claims or appeals over benefits continue to function.  But you would see a slow-down in non-essential programs.  Employees for non-essential services would be out on a furlough, meaning they do not work and do not get paid.  For Social Security, some non-essential tasks are issuing Social Security cards, applying for Medicare, getting benefit verification or correcting earnings records.  Some 10,400 SSA employees will be furloughed out of the 63,200 total employees.

That being said, if you have an appeal pending in the federal districts courts, your action has been stayed.  Yesterday, the Northern District of Georgia issued an order staying all cases involving federal government agencies.  The Department of Justice requested that all federal courts pause proceedings in its cases, including meeting court-ordered deadlines.  For those with appeals pending at the district court level, your case is on hold.

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Yesterday the Regional Counsel’s office for the Social Security Administration Office of Hearing Operations invited disability attorneys and disability representatives downtown to its conference room at the federal building to roll out a new program.  As one of colleagues remarked, “this is a one way conversation.”  Nevertheless, anytime, SSA lets me peek behind the screen to see how things work, I am going to be there.  With a grand entrance and rousing cheer for its new program, Centralized Scheduling, SSA tried to get the claimant’s reps and attorneys on board with this initiative.  Cut to the chase, we all know this will not be in our interest.  The hearing offices will be scheduling cases without calling us first.  The burden is now on me to apprise the agency of my conflicts and hope they take that into account so I don’t miss my son’s graduation.  While I won’t miss a graduation, I am not complaining about this program – if that gets more cases scheduled then I will get on board.  I also will not complain that their Power Point presentation took an hour to upload because someone’s laptop was running an update.  While an unnecessary expenditure of time, the crowd was fairly patient.  But here is why I am writing this blog today.  Because underneath the purported rally for serving the public, was the percolating contempt for those of us working to help claimants get their benefits.

If a government program is going to work, it cannot be run by people who have contempt for it.  That’s true of Social Security, the justice system and the White House.   Those of us who showed up yesterday, taking time out of our schedules for the free invite, probably do not need a lecture on our ethical obligations as attorneys.  We do not need another layer of regulations placed on us that serve no purpose; and whose purpose cannot be articulated.  And if yesterday’s crowd started to balk at the presentation, it was probably because the three picture power point seemed to suggest that agency problems will be cured by placing more burdens on the claimant’s attorneys; and a not so veiled suggestion that they are routing out our fraud.

Don’t get me wrong, I don’t like fraud.  We should stamp it out; it ruins the program for good people with legitimate claims.  Although I can count on one hand in the last six years the times I met someone who has trying to scam the system.  But they exist.  Yahoos from Wall Street to Wal-mart will try to scam the system.  Good riddance to all of them.  But you know what else I hate?  I hate when hard-working people fall on hard times due to poor health; lose their jobs; lose their savings; apply for benefits from a disability program they paid into for years and then get kicked to the curb.  I hate the forty-five minute delay times on the SSA 1-800 number.  I hate the local offices that are being closed around the country.  I hate that the offices that remain open are closed at noon on Wednesday and Friday.  I hate that important paperwork that has a 10 day deadline for a return gets mailed out nine days after the printed date on the letter.  I hate that claimants show for consultative exams with SSA contract doctors and no medical records accompany the appointment.  I hate that claimants whose cases meet medical listings get denied on the initial application.  I hate that claimants who meet compassionate allowance listings get denied on initial applications.   I hate that legitimate cases get denied on reconsideration even when the treating doctors and the consultant SSA doctor agree on the severity of the claimant’s condition.  I hate that the wait times for hearings in Georgia have run between 12 and 15 months.  I hate that after a hearing, some judges take over 90 days to issue a decision (and that is even for cases that met a Dire Need request).   I hate that the Payment Office can take over three months to issue payment to the claimant after they finally get a Favorable Decision.  Here is one I really hate, I hate that the Payment Office routinely forgets to pay my fee.  I hate that it will take 9 months of my letter-writing appeals to the Payment Office to finally release it.

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On July 10, 2018, the White House signed an Executive Order that gives agency heads greater discretion over the selection of administrative law judges. The United States federal government employs 2,000 judges, with the largest number serving in the Social Security Administration as the judiciary for benefit claims. This, in effect, overturns the Administrative Procedure Act (1946), which set up a system for choosing judges based on scores in detailed examinations. This places the future selection of administrative law judges more directly in the hands of political appointees, who may not have adequate experience or knowledge on important issues to make effective decisions. In this order, it states that the only requirement for an appointee is to “possess a professional license to practice law and be authorized to practice law”—making any lawyer qualified to serve as an administrative law judge. Before this order, requirements to serve included a vetting process through the Office of Personnel Management (OPM), as well as 7 years of experience as an attorney. The order does, however, add that “each agency shall follow the principle of veteran preference as far as administratively feasible,” which is vague and open to interpretation.

John Palguta, a civil service expert, cautioned of the importance of oversight from the OPM to “assure that departments or agencies do not abuse this authority by violating the merit system principles…” Many people are concerned that this order could lead to what Palguta fears: the appointment of judges based on political ideology, rather than their merit. Marilyn Zahm, president of the Association of Administrative Law Judges, warned that this system “could lead to abuse and biased decisions.”

For those applying for Social Security disability benefits, this decision could impact you or a loved one. If judges selected lack education about the importance of benefits for those with disabilities and the long and trying process until a decision is made by the court, many people’s cases in the courts could be at risk. Those applying for Social Security benefits deserve to have lawyers who are unbiased and well versed in the issues that affect these people’s lives. This Executive Order may negatively impact many people applying for benefits if the administrative law judges are biased against them.  It will be important to watch the appointment of Administrative Law Judges to the agency over the next months to see its impact on the court’s rulings for those with disabilities.

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In Georgia, there are various programs that help people living in poverty.  These programs include Supplemental Nutrition Assistance (SNAP), Head Start, and Temporary Assistance for Needy Families (TANF). SNAP is a program that provides low-income households with food stamps to help pay for the cost of food. In order to be eligible for SNAP in Georgia, you must be a resident of the state and have a current bank balance (savings and checking combined) of under $3,001 if you share your household with a person with a disability or person over age 60. If you do not fit into these categories, your bank balance must be under $2,001. You must also have an annual household income (before taxes) below a certain amount (for example, no more than $32,630 for a family of 4).

Another program supporting low-income families is TANF, which provides temporary assistance to families. This program has four goals, which includes giving families support and job preparation.  In order to be eligible for TANF, you must be a US citizen, national, legal alien, or permanent resident, and also have a low income. For example, a family of three must have an income of less than $784/month to qualify for TANF. The amount of cash benefit this program provides depends on the county you live in and your family’s income.  However, there is a five year lifetime limit on TANF benefits.

Head Start, a federal program, educates and supports infants and children up to five years old in families with incomes under the national poverty level. Head Start programs enhance young children’s cognitive, social, and emotional development and work to prepare them for success in school. There are also some Early Head Start programs which support pregnant women and babies living in poverty. The maximum income eligibility for Head Start depends on your household size. However, there are groups eligible for Head Start programs regardless of income including:

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