9:00am - 5:00pm

Our Opening Hours Mon. - Fri.

866.438.8773

Call Us For Free Consultation

Facebook

LinkedIn

Search

Timely Issues

Covid-19

Covid-19 (coronavirus) is changing life as we know it; at least temporarily. The virus has the potential to be deadly and overburden the nation’s healthcare system. Large gatherings are being canceled, universities are canceling in-person classes, sports leagues are suspending seasons; all with the goal of slowing the spread of the contagion.

So far, the Social Security Administration has not announced any closings or special protocols related to the outbreak. SSA field offices and hearing offices are open and continuing as they normally do.  

Many of our clients have compromised immune systems and all of us rely on our healthcare facilities. We encourage everyone to follow the CDC’s guidance for slowing the spread of the virus:

  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Clean and disinfect frequently touched objects and surfaces.

We will post updates as we learn more about the virus in relation to SSA procedures.

 

The Problem with the SSI Program

Supplemental Security Income (SSI) benefits are paid to disabled persons who do not qualify for Social Security disability insurance (SSDI) program because they have not paid sufficient Social Security taxes or do not have enough work credits.  The definition of disability and claims process is the same for both SSI and SSDI and in fact, many people are able to apply for both at the same time. The SSI program was designed to provide cash for food, clothing, and shelter it has kept many Americans from becoming homeless. SSI benefits total approximately $771 per month in 2019 (can be more with state supplements) and recipients usually continue to receive Food Stamps and retain their state Medical Assistance card.

When filing an SSI claim, the applicant must show that he or she meets a “needs test” by virtue of low income and resources. This test is similar to the one used to determine whether a person is entitled to Public Assistance.  There are two components to the needs test; income and resources.

 

The problem with SSI is that most of the SSI eligibility rules have not been updated since the program was signed into law by President Nixon over 40 years ago.  The economy has changed since then. The cost of living today is more than 5.5 times what it was in 1972. In addition, the asset (resource) limit for the program–$2,000/$3,000–has not been updated since 1989. Many Americans are finding themselves unable to qualify for SSDI because they lack work credits, and unable to qualify for SSI because they are over the income and resource limits.

The Supplemental Security Income Restoration Act of 2019 has recently been introduced and would update these income and asset limits to better reflect reasonable assistance in today’s dollars. The National Association of Disability Representatives has made it easy for you to support this legislation. Simply text “ssirestoration” to 52286 or click here to send a message of support to your representatives.

Osterhout Berger Disability Law handles both SSDI and SSI claims. If you or someone you love is unable to work due to a physical or mental impairment, call us for a free consultation: 1-866-438-8773

 

The Case for NOT Reporting Your Neighbor for Possible Disability Fraud

Q: When I moved to my new home a few years ago, my neighbor told me that she’d had multiple back surgeries. She is in her mid-50s and does not work. She does, however, shovel three feet of snow from her roof, uses a rototiller in her yard, lugs mounds of leaves, etc.

From conversations and from what I’ve witnessed, it is my understanding that she is on disability. It is disturbing to be contributing financially for her welfare via my tax dollars, when it is obvious that she’s very able-bodied. Additionally, she is an ever-present annoyance who is unable to respect boundaries, even after we’ve repeatedly asked her to respect our space. One of her dogs bit my husband in our yard. She can be spiteful and has temper tantrums.

The bottom line is that it’s highly likely that I contribute to her well-being (through disability), just so she can make our lives uncomfortable.
 
I’d like your take on this. I’ve taken a few photos showing her physical abilities — just in case. Should I bring it to the attention of the Department of Social Security? I suspect this is a common issue facing many people.

Upset Neighbor

 


 

This question appeared in a recently published national advice column and is a common complaint we hear, not only from the general public but from some of our own disability clients. It can be frustrating to have to endure a complicated process such as filing for disability benefits, only to see someone who you believe is faking it receive monthly benefits. Though columnist Amy Dickinson did a fine job at answering the question, we wanted to take our own stab at it, particularly with respect to some key phrases we noticed immediately.

“Multiple Back Surgeries” – With any back surgery, there is a long recovery period and a good chance that either the surgery doesn’t resolve the issue or that the patient is left with new pain-causing problems. The fact that this woman had to have multiple back surgeries leads us to believe that she either had a failed surgery or that she had issues at multiple levels in her back; neither leading to a good prognosis for a pain-free life. Nevertheless, just based on this detail alone we would have a hard time disagreeing with the author’s complaint. But, as we will see as we move through some of the other comments, even this fact is not necessarily inconsistent with a legitimate award of disability benefits.

“Mid-50s” – If the woman is receiving Social Security disability benefits, her age could have been a factor. “Disability” as SSA defines it does not necessarily mean that the recipient must be unable to perform all types of jobs; this is most obvious when one considers the age of the person applying for benefits. SSA considers that at “advanced age” (age 55 or older) the claimant’s age is a significant additional factor which affects the ability to adjust to other work. Basically, the older someone is, the harder it is to adjust to work that -requires different skills. It is kind of a “you can’t teach an old dog new tricks” rule; SSA does not, for instance, expect someone who is older and who has been doing heavy construction all their life to go out and get a job as a secretary when they are 55 years old. So, to put it yet another way, a combination of impairments that could not be disabling for a 40-year-old person can be disabling for a 55-year-old.

“Obvious That She’s Very Able-Bodied”– Again, based on the surface facts of the ability to do yard work, etc., this does not strike us as necessarily way off base. But, even then, this activity is not necessarily inconsistent with receiving disability benefits, because the question in a disability case is not what a person can do intermittently; rather, the question is whether the individual can work “8 hours a day, 5 days a week…on a regular and continuous basis.” In other words, as anyone would agree, making oneself a meal, driving a car, or cleaning one’s apartment is not the same type of activity as being a cook, a taxi driver or a janitor for a living. Does the author observe her after she works in the yard? It’s not uncommon for individuals that live with chronic pain to have the ability to do manual labor for short periods of time. Often, the pain does not set in until hours later and they often pay the price for the physical work with increased pain, and a need for bed rest, potent pain medications and lots of heat and ice, etc.

“My Tax Dollars” – Social Security disability benefits (SSD) are not welfare or an entitlement program and with all due respect to the author is not “her money.” Working Americans pay, from their own paychecks, into the disability trust fund with FICA withholdings from their paychecks. If they have paid enough in (typically this means they have worked 5 of the last 10 years) they are insured for disability benefits and may be eligible to draw monthly benefits from the trust fund, if they meet the medical criteria. Supplement Security Income (SSI) is the other disability program administered by SSA and eligibility is based on need; not based on work history. From the information given, we do not know if the woman is drawing SSD or SSI, or any disability for that matter since this is all an assumption on the author’s part. If we assume she is drawing SSD, then it is important to understand that she contributed to her trust fund with her own FICA contributions.

“Unable to Respect Boundaries” – The columnist answered correctly that the disability payments could be unrelated to the back surgeries. Frankly, given the author’s description, this is quite likely; it is quite common for disability to be based upon a combination of multiple impairments that includes mental impairments, and it seems likely that this woman could have also had a mental diagnosis that leads to problems with boundaries. This limitation could certainly affect her ability to sustain full-time employment, especially when considered together with the physical limitations caused by back issues. Another factor is that it is also possible that this woman has impairments that the author has no idea about, since not all disabilities are visible. For instance, while this woman apparently has difficulty hiding her obvious social impairments, she may also have episodic impairments, such as migraine headaches or seizures, which occur intermittently and, often, out of view of other people. Some people have chronic gastrointestinal issues with embarrassing symptoms like needing to use the bathroom frequently during the day, soiling oneself, etc., that people do not usually go around talking about. When we hear people say things like, “My neighbor is getting disability and there’s absolutely nothing wrong with him” one of the things we always say is that you really can’t always know if someone meets the criteria just by looking at them.

The other thing we always point out is that these rules regarding the effect of age in a disability claim, that SSA does not use the ability to perform intermittent activities as a basis to deny disability claims, that the combined effect of all impairments must always be considered, etc., apply in their case as well and that, where appropriate, we will rely on all of these rules, and any others that apply, to ensure that their legitimate claim of disability is awarded.

Nobody really knows what is really going on with someone. Another way that a potential reporter of fraud who is also a disability claimant can look at it is this: “What if someone made a movie of my daily life?” Would that movie demonstrate intermittent activities which, if taken out of context, could make it look as though you were a lot more able than you are? While SSA encourages citizens to report fraud, we’d like to remind you that unless you have read someone’s medical records and have evidence that they are able to work on a regular and continuing basis, maybe you should reconsider. The original column can be read HERE. Read it and decide for yourself whether the author has enough to prove her neighbor is fraudulently collecting benefits.

Medicare Annual Enrollment: What Disability Recipients Should Know

Disability beneficiaries receiving Medicare should be asking the following questions right now:

  • Do I have proper prescription drug coverage?
  • Should I enroll in a Part C Medicare Advantage plan?
  • Am I on the best plan for me?
  • Can I save money?

This time of year, it’s hard to turn on the tv without being bombarded by insurance company commercials advertising their Medicare products. Each year, the Medicare annual enrollment period is between October 15th – December 7th. During this time, Medicare beneficiaries have the option to add, change or remove coverage. Many assume that the commercials are targeted to senior citizens but the insurance carriers also want to get the attention of individuals receiving Social Security disability insurance (SSDI).

SSA automatically enrolls SSDI recipients in Medicare after receiving benefits for two years, but typically, it is only Original Medicare, Part A (hospital coverage) and Part B (medical). The SSDI recipient has the option to enroll in a Part C (Medicare Advantage) plan or a Part D (stand-alone prescription drug) plan. Part C plans, which replace traditional Medicare, are offered by private insurance companies such as Humana, Aetna, AARP, and other carriers. These plans cover everything that traditional Medicare does and they usually have a very low and sometimes no monthly premium. Not only do they protect costs by limiting out of pocket expenses, but most of them include prescription drug coverage as well as dental, vision, and hearing coverage. A lot of times, Part C may be the best option for Medicare recipients under age 65, but not always. Sometimes the best option is to stay on Original Medicare (A&B) and add a Part D prescription drug plan. Once Medicare starts for SSDI recipients, they only have a limited initial enrollment period to elect Part C or Part D. If the deadline is missed, the recipient must wait until the annual enrollment period to enroll for the next year.

If you would like to see if there is a better plan for you that can reduce your cost, this is the time! After December 7th, beneficiaries may not be able to make these changes until the next annual enrollment period begins in October of 2020.

We can help you with this confusing process. We have a licensed insurance agent on staff who is prepared to help you understand your options at no cost. Complete the form below to have someone from our team call you for a no-charge consultation.

When we represent SSDI claimants before the Social Security Administration, part of our goal is to secure Medicare benefits in order to give them affordable medical coverage. There is no obligation for OBL clients to use our in-house agent; we simply want to help our clients and others get the best care possible.

    Trump Eliminates Student Loan Debt For Disabled Veterans

    https://www.forbes.com/sites/zackfriedman/2019/08/21/trump-eliminate-student-loan-debt-for-disabled-veterans/

    (PHOTO BY MANDEL NGAN / AFP) / ALTERNATIVE CROP (PHOTO CREDIT: MANDEL NGAN/AFP/GETTY IMAGES)

    President Trump signed an executive order today that will make it easier for disabled veterans to receive student loan forgiveness.

    Here’s what you need to know.

    Student Loan Debt Forgiveness

    Trump, who signed the memorandum following his speech at the American Veterans National Convention in Louisville, Kentucky, directed the federal government to have an “expedited” process for military veterans who are permanently and totally disabled to have their federal student loans discharged. The current student loan discharge program for disabled veterans is known as Total and Permanent Disability (TPD) Discharge.

    While student loan discharge for disabled veterans is not a new program, less than half of the nation’s 50,000 disabled veterans have received a student loan discharge due to a complicated application process. Today’s executive order hopes to simplify and expedite the process so that more disabled veterans can have their federal student loans discharged. The U.S. Department of Education says it plans to notify more than 25,000 eligible veterans about student loan discharge.

    “Supporting and caring for those who have sacrificed much in service to our country is a priority for President Trump and the entire Administration,” U.S. Secretary of Education Betsy DeVos said. “I appreciate the President’s strong leadership on this issue and his willingness to provide much-needed student loan relief. We will continue to prioritize the needs of our nation’s veterans and provide them the help and support they have earned and deserve.”

    Veterans Have A Right To Opt-Out

    Within 60 days of notification of their eligibility, veterans can decline the discharge of their federal student loans. Why would a veteran decline student loan relief? There may be several reasons, but the Education Department notes that a veteran may decline student loan debt relief due to potential tax liability or if it makes it more difficult to borrow future student loans.

    How Student Loan Discharge Works and How To Apply

    Under the current process (which may change with today’s announcement), borrowers who are identified will be sent a letter that explains eligibility for student loan discharge as well as a Total and Permanent Disability Discharge application. The borrower then signs and returns the application to apply for the discharge.

    Borrowers can also apply by email or phone.

    Phone: 888.303.7818

    Office Hours:

    Monday – Friday: 8:00 AM – 8:00 PM (ET)

    Email: [email protected]

    Completed applications should be mailed to: U.S. Department of Education, P.O. Box 87130, Lincoln, NE 68501-7130.

    A Total and Permanent Disability application can be completed online.

    Your Rights If You Have Student Loan Debt And Are Permanently Disabled

    The Consumer Financial Protection Bureau estimates that tens of thousands of disabled veterans may not know that they are eligible for student loan forgiveness. Since the formation of the federal student loan program, borrowers who are considered totally and permanently disabled have been eligible to have their federal student loans forgiven.

    Student loan forgiveness in this context includes:

    Importantly, cancellation of your student loans here are only for federal student loans. If you have private student loans, check with your lender regarding options for permanent discharge. Many private student lenders offer similar permanent discharge benefits. In 2016, the Education Department collaborated with the U.S. Social Security Administration to identify borrowers with disabilities who were eligible for permanent discharge. The joint effort found 387,000 borrowers with disabilities, who collectively owed over $7.7 billion in federal student loans. About half of those those borrowers were in default on their student loans (and evidently not aware of the student loan forgiveness program).

    Good News: No Tax Bill

    The good news is that, per the memorandum Trump signed today, disabled veterans will not owe any federal income taxes on discharged student loan debt. Trump is urging states also to absolve those veterans who receive student loan discharge of state income taxes.

    Overall

    A positive step to help America’s heroes and families for their selfless service.

    Beware: SSA Phone Scam

    There is a phone scam that has been going around for a few years but seems to be happening more and more. In fact, it just happened to OBL Partner Lindsay Osterhout the other day! Lindsay said the call says it’s from “United States” and tells you to “press one” and then has an automated message that says “This call is from the Department of Social Security Administration.  The reason you have received this phone call from our department is to inform you that we just suspended your SSN because we found some suspicious activity.  If you want to know about this case, press one”. Once you press one, they will likely ask for your social security number. Other calls may say they are calling from the “Inspector General” or they are calling from the Social Security Office and may threaten to suspend benefits if payment is not received. Most, if not all, of the scam calls are automated.

    The Social Security Administration has released several warnings to the public about these calls and instructs citizens to stay vigilant. How do you know whether the call is really from SSA or not? SSA will never do any of the following:

    • Call you to demand an immediate payment;
    • Demand that you pay a debt without the ability to appeal the amount you owe;
    • Require a specific means of payment, such as requiring you to pay with a prepaid debit card;
    • Ask you for your personal information or credit or debit card numbers over the phone; or
    • Threaten you with arrest or deportation.

    SSA instructs citizens who receive a suspicious call to hang up immediately and to report Social Security impersonations to the Office of Inspector General at https://oig.ssa.gov/report.

     

     

     

     

     

     

    Cash Assistance Has Been Reinstated in Pennsylvania!

    Not being able to work can be financially devastating and some applicants even become homeless while waiting on a disability hearing. The General Assistance program has been reinstated and we think it may be able to help some of our clients while they are waiting for disability benefits to be approved. The program offers $205 per month for one person and $316 per month for two people to help provide for basic needs. Pennsylvanians can qualify for General Assistance if they are in one of the following situations:

    • have a temporary or permanent disability;
    • are a child who is not living with a relative;
    • are caring for an unrelated child under the age of 13 or are caring for someone who is ill or disabled;
    • are victims of domestic violence (benefits are limited to 9 months in a lifetime); OR
    • are in a drug or alcohol treatment program that prevents them from working (benefits are limited to 9 months in a lifetime)

    In addition, individuals must have less than $205 in income ($316 for two people) and less than $250 in countable assets, or $1,000 if there is more than one person applying. A house and one car do not count as assets.

    Residents who believe they are eligible are encouraged to either apply online through the department of human services (DHS) website http://www.dhs.pa.gov/ or in-person at their local county assistance office. DHS helpline can be reached by calling toll-free 1-800-692-7462. For individuals with hearing impairments please call 1-800-451-5886.

    House Bill 335 Would Eliminate Services and Negatively Impact the Health of 2.9 Million Pennsylvanians and Their Families

    Recently, Lindsay Osterhout, OBL Managing Partner Administrative Division, met with case management staff at Southwestern Pennsylvania Human Services, Inc (SPHS) in Charleroi, PA. Among other local news, they discussed new proposed state legislation, HB 335, and the devastating effects it would have on our community.

    HB 335, sponsored by Representative Seth M. Grove, would eliminate the current Behavioral HealthChoices (BHC) program thereby making it difficult for counties to provide coordinated and integrated human services and negatively impact the health of 2.9 million Pennsylvanians and their families. BHC is the statewide program through which every county delivers mental health and drug and alcohol services to vulnerable Pennsylvanians enrolled in the Medical Assistance program, and their families. The program, created 21 years ago, has allowed Pennsylvanians to receive needed mental health services.

    We at Osterhout Berger Disability Law, frequently work with disability claimants who rely on these services to manage their care. If these programs are eliminated, it will be very difficult for our claimants to find affordable care to manage their symptoms. We are concerned that HB 335 passes, we will see tragic consequences. Several health and human services agencies have signed onto a letter opposing this legislation. Read the letter that was sent to Members of the House of Representatives HERE. Please consider contacting your state representatives and urge them to oppose this bill. Locate your legislator using this LINK.

    We value our community partnership with SPHS and thank them for bringing this proposed legislation to our attention.

    New Rule Makes it Easier for Military Spouses to Find and Keep Jobs in the Law

    On January 29, 2019, the Pennsylvania Supreme Court’s Board of Law Examiners adopted the Military Spouse Licensing Rule, which allows military spouse attorneys who accompany active duty service members to Pennsylvania to apply for a temporary license to practice law in the state. Historically, because service members are subject to frequent military-ordered relocations, attorney spouses were presented with the difficult choice of remaining in a jurisdiction where they were licensed to practice without their spouse or incurring the significant costs of obtaining a bar license in the relocation state. Osterhout Berger Disability Law is very excited to hear that Pennsylvania has joined the trend of issuing licensing accommodations for these attorneys. The new rule goes into effect in July 2019.

    OBL is very fortunate to have several military spouses who are attorneys on our team. Hannalore Merritt, Managing Associate of our Appellate Department, who was a military spouse herself and knew the struggle of trying to maintain a career being married to an active service member, was familiar with a group called Military Spouse JD Network comprised of individuals in similar situations. Due to growth of the firm, when it came time to hire additional attorneys, she suggested that the firm look to this population. “I knew there was lots of talent out there but that it was hard to maintain a job when you were facing having to take a bar exam every few years with changes in orders and duty stations.” Merritt explained. “To be honest, until Hannalore brought it to my attention, I really hadn’t thought about this issue at all,” explained managing partner Karl Osterhout. “Since we have always had at least some attorneys in our Appellate Department who worked remotely, that part was a natural fit, and I like very much feeling like I am, and some small part, being helpful to these families who sacrifice so much for the defense of our Country,” said Osterhout.

    The first active military spouse hire was Christine Huber, Senior Associate Attorney; she and Hannalore attended law school together in Seattle. Christine’s family is currently based at Kings Bay Naval Submarine Base in Georgia, and they typically move every 2 years. She describes numerous difficulties to maintaining a career as a military spouse; “As an attorney, one of the biggest hurdles is obtaining a license to practice in every state. While many states have or will soon have the military spouse exemption, it still involves a lengthy process and high fees.” Another difficulty faced by many career spouses who also have children, is being the primary caregiver. “It is difficult to find an employer, especially in the legal field, who is willing to accommodate you being the sole person responsible when school calls for an unexpected pick up or when your child is home sick,” explained Huber. Finally, another difficulty is maintaining a resume that is attractive to employers. “Often with moving every few years, your resume begins to look quite choppy and most employers will pass right over it as it appears you would not have loyalty to their firm. While this is far from the truth, it often gets in the way of securing an interview,” said Huber.

    Christine Huber, OBL Sr. Associate Attorney, and husband Mike

    Christine describes the profound impact her employment at OBL has provided; “All of the difficulties mentioned previously disappeared with working at OBL. I can maintain my bar license and ability to practice, without having to retake a bar examination in every state we move to. I am able to have a resume which shows my loyalty and retention at a law firm. I have now worked at OBL over the course of 3 separate moves, something I had never thought was possible.  Further, being able to work remotely allows me to maintain my workload while also handling any issues that may arise for my family.  It has afforded us the ability to be present for the special moments in military life (i.e., homecomings, meetings, send offs, etc.) without having to put my professional career on hold or take time off or work. Perhaps most importantly, working at OBL and being exposed to various areas of law has allowed me to realize that my true passion is advocating for the rights of those who feel like they are being lost in the system, for those who can no longer work due to physical or mental impairments, and for those who were wrongly denied benefits.”

    Since hiring Christine in 2015, OBL has hired two more associate attorneys who are military spouses, Amanda Whitt-Downs, found through MSJDN, and Meghan Lambert, found through a military spouse page. They are all attorneys in our Appellate Department, and work on researching and drafting briefs to Federal District Courts across the country for our clients who have been denied SS disability benefits by the Agency. Explains Osterhout, “It’s just been a privilege to get to know these women. I am particularly indebted to Christine, who really stepped up when I had an illness last year; she was an incredible help to Hannalore in making sure that we continued to meet our deadlines in the Appellate Department. She really, as they say, ‘went over that wall’ for me and I’ll never forget it.” Merritt states, “They are all highly versatile women who are driven and compassionate, not to mention able to balance a lot in addition to their careers. They also have excellent resumes – we are fortunate to have been able to set them up remotely because they are really talented and do great work.”

    OBL applauds the Pennsylvania Supreme Court in adopting the Military Spouse Licensing Rule and the effort the Military Spouse JD Network put forth in advocating for these talented group of attorneys.

    Read more about the Supreme Court adoption HERE

    The “Social Security 2100 Act,” championed by Rep. John Larson (D-CT), is getting a hearing in Congress!

    The “Social Security 2100 Act,” championed by Rep. John Larson (D-CT), which was the subject of another recent OBL News post, is getting a hearing in Congress!

    Social Security 2100 proposes to shore up this benefit program for 62 million beneficiaries while ensuring the program’s financial stability. Among its proposals are that any increase in benefits under its provisions wouldn’t affect eligibility for other key federal programs, including Supplemental Security Income, Medicaid, and the Children’s Health Insurance Program.

     

    https://thehill.com/opinion/finance/427835-a-bill-to-boost-social-security-will-finally-get-a-full-and-fair-hearing