Post on 15-Apr-2017
transcript
An Introduction to Social Security
Disability
Attorney Precious L. Vines, MSHS Friday, March 20, 2015
IntroductionMy history
O 2000-present
O Former Disability Examiner
O Worked with Private Attorneys, Law Firms, and in Private Practice
O Pro Bono Service-Legal Aid of NC
Starting a Social Security Disability Practice….
O Goals?
O Time Commitment?
O Knowledge and Understanding?
O Assistance?
O Additional Sources of Income?
O Client Relations?
Starting a Social Security Disability Practice….
O Representative Learning Opportunity:Pro Bono Service-Legal Aid
Representative Learning and Resources: Disability Rights of NC
Client Resources:www.disability.gov
Client Resources:www.lawhelpnc.org
StatisticsO Does having a representative
increase chances of an allowance?
O Will a representative speed up the process of processing a disability claim?
ToolkitO Bluebook-SSA Disability Listings
O SSA website: Videos, Tutorials and Handouts
O Forms Review
O Shadow a Disability Attorney
Case DevelopmentO Adequate medical records
documentedO Complete list of all medical providersO Complete list of all alleged
impairments and datesO Documentation of current activities
of daily livingO Documentation of past work and
current work, if applicable
Interviewing and Information Gathering
O Allow extra time for interviews/calls.O Ask about client’s time to do
interview.O Quiet Environment.O Break up complex questions.O Ask clarifying questions.O Use summarizing.O Be aware of “Open Questions” and
“Closed Questions”.
Forms to RememberO SSA
561-U2-Request for ReconsiderationO SSA 821-Work Activity ReportO SSA
827-Authorization to Disclose Info.O SSA
1696-Appointment of RepresentativeO SSA 3368-Disability Report (Adult)O SSA 3369-Work History ReportO SSA 3441-Disability Report-AppealO SSA 3820-Disability Report-Child
Medical RecordsO Ensure time period covered
O Clear documentation of allegations
O Beware of inconsistenciesO A. medical diagnosisO B. Claimant’s ADLs or continued workO C. Substance abuse
OUnderstanding of abbreviations and terminology
Resource LinksO Disability Planner
O Disability Starter Kit (Adult)
O Disability Start Kit (Child)
O Online Application for Disability Benefits
O Representing Social Security Claimants
O Medical Abbreviations Dictionary
Client FileO Disability Determination and TransmittalO Disability Determination ExplanationO Notice of any Disapproved ClaimsO Representative Fee AgreementsO Appointment of Representative FormsO Hearing NoticesO Earnings QueriesO Work HistoryO Disability ReportO Recent Medical TreatmentO Medications ListO Medical Records
Medical Summary/BriefO Submission before hearing to ALJ
O Ensure no outstanding records
O Time period adequately covered
O Have client’s prior file
O File has been thoroughly reviewed
Organization of Medical Summary/Brief
O Claimant’s identifying informationO Age at onset and current age O Alleged onset date (AOD) O Date Last Insured (DLI)O Application DateO Claim Type(s)O Prior Claims and any ALJ denialsO Work History
Organization of Medical Summary/Brief
O Education and Special Education
O Return to Work Attempts
O Physical and Mental Impairments
O If claimant meet or equals a listing
O Medical evidence of record
Organization of Medical Summary/Brief
Medical Evidence of Record RemindersO List all medical record synopsis in chronological order
O All exhibits listed in the file, as provided by SSA should be addressed unless duplicate or not substantial
O Pull relevant information from records that support claimant’s alleged impairments
O Address any discrepancies in file with client before submission of medical brief, and before hearing
Meeting or Equaling a Listing
O 607. Medical Evidence as Basis for Decision of “Disabled” -- Listing of Impairments
O Meeting a listing?
O Equaling a listing?
“Red Flags”O Substance abuse
O Cane usage
O Current work not addressed
O Malingering
O “Doctor shopping”
Defining Non-compliance
O What is non-compliance?
O Common types
O Relevancy to case
Mental Impairments: Areas to Remember
O Special Education classes O IQ=59 or less (12.05 B)O IQ=60-70 and dual diagnosis (12.05
C)O IQ=60-70 and marked deficiencies
(12.05D)O Marked restrictions noted a. (ADLs)b. Social Functioningc. Concentration, Persistence, and Pace
Global Assessment of Functioning (GAF)
O Defining GAF
O Relevancy to mental impairments
O Relevancy to functioning and case analysis
Mental Impairments: Areas to Remember
O 12.04-Affective Disorders (Mood Disorders)
a. Ex.-Major Depression, Bipolar Disorderb. Extensive documentation and marked decompensationc. Inpatient hospitalizationd. Medical records supporting physical symptoms resulting from affective disordere. Inability to function in basic areas
Substance AbuseO 12.09-Subsance Addiction Disorders
O Not a “stand-alone” listing
O History and cessation is important
O Materiality of substance abuse-Code of Federal Regulations Section 416.935
Application of Ethical Code20 Code of Federal Regulations Section
404.1740:Rules of Conduct and Standards of Responsibility for Representatives
Disclosure-NC State Bar
O Rules of Professional Responsibility-Rule 4, Rule 7.2
O 98 Formal Ethics Opinion 1-Disclosure of Adverse Evidence in a Social Security Disability Hearing
O RPC 230-Disclosure of Adverse Medical Reports in a Social Security Disability Case
Client Fraud
O Cooperative Disability Investigations
O New York Social Security Disability Fraud Scheme; Press Release
O Attorney Eric C. Conn-West Virginia
MarketingO 2012 Formal Ethics Opinion 1Use of Client Testimonials in Advertising
O Binder v. Disability Group Inc.1. Trademark Infringement2. False Representation3. Unfair Competition)
Client Representation
O 2005 Formal Ethics Opinion 2Representation of Nonlawyer for Social Security Disability ClaimsO 2003 Formal Ethics Opinion 10Fee Sharing with Nonlawyer/Claimant’s Representative in Social Security CaseO 2005 Formal Ethics Opinion 6Compensation of Nonlawyer Employee Who Represents Social Security Claimants
Client Competence
O RPC 157Representing a Client of Questionable Competence
UpdatesO Administrative UpdatesO Court and Administration Decisio
ns
ResourcesO National Organization of Social Security
Claimant’s Representatives (www.nosscr.org)
O North Carolina State Bar: Rules of Professional Responsibility (www.ncbar.gov)
O Office of the Inspector General (www.oig.ssa.gov)
O Social Security Administration (www.ssa.gov)