Disability claimants sometimes report that a Social Security representative refuses to let them look through their personal claim folder. These claimants ask, does SSA have the right to keep me from seeing this information? Generally not. Generally, you have the right to examine your own folder.
Section GN 03360.030 of the SSA Program Operations Manual System (POMS) says,
“An individual's request for his/her record, or authorization by that person to release the record to a third party must be honored regardless of the workload imposed on the component that receives the request.”
Section GN 03301.005 says:
“Generally, SSA must honor an individual's request to see the information contained about himself/herself in SSA's records.”
Section GN 03340.035 says this right of access applies to medical records, as well as other records, except where allowing the individual un-counseled access to medical records is thought likely to have an adverse effect on him or her.
If SSA refuses a person direct access to his or her medical records, GN 03340.035C(3) authorizes release of the records to a responsible person appointed by the claimant who is capable of explaining the records to the claimant.
So, if an SSA representative refuses to show you your records, you can bring these POMS sections to his or her attention. Or to the attention of the office manager.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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Sunday, March 13, 2005
Friday, February 18, 2005
Be sure to furnish SSA details on physical and mental demands of past jobs
Disability examiners have the option of not asking claimants for details of their past work under a Social Security Administration (SSA) policy dated June 2004 [1] SSA is permitting this practice even though the agency’s regulations explain the potential need for job history going back fifteen years.
When examiners exercise their option to dispense with details of work history, it can have serious consequences for claimants who need and deserve benefits.
When examiners forgo asking claimants to complete the SSA work history questionnaire, it deprives the claimants of an opportunity to demonstrate that their past work is now too hard for them.
Is it wise for claimants to leave it up to disability examiners to decide whether this important evidence is in their claim folders?
Incapacity for past relevant work (PRW) is something claimants must prove to win benefits, except in cases where medical findings are unusually severe. [2] SSA reaffirmed the necessity for this proof in Social Security Ruling (SSR) 05–1c published February 15, 2005.
Unless claimants have the foresight to furnish work history without being asked, they often may fail to win the cash and healthcare benefits they paid for with their FICA withholding.
To avoid this potentially fatal gap in proof, claimants can do one of two things. They can either fill out and submit to SSA a Work History Report on Form SSA-3369, or can furnish SSA a completed set of Disability Workbook worksheets. Following either procedure assures that SSA has the evidence with which to compare their current limitations with the physical and mental demands of their past jobs, and to make a sound decision on their capacity to do past work.
The Form SSA-3369 is available free on the Internet at: http://www.ssa.gov/online/ssa-3369.pdf
The Worksheets are available as part of the Pds Disability Workbook for Social Security Applicants and separately as a downloadable e-book on: www.disabilityfacts.com.
[1] For example, SSA Program Operations Manual System (POMS), Section DI 20501.035.
[2] Code of Federal Regulations (CFR), Title 20, Section 1565.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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When examiners exercise their option to dispense with details of work history, it can have serious consequences for claimants who need and deserve benefits.
When examiners forgo asking claimants to complete the SSA work history questionnaire, it deprives the claimants of an opportunity to demonstrate that their past work is now too hard for them.
Is it wise for claimants to leave it up to disability examiners to decide whether this important evidence is in their claim folders?
Incapacity for past relevant work (PRW) is something claimants must prove to win benefits, except in cases where medical findings are unusually severe. [2] SSA reaffirmed the necessity for this proof in Social Security Ruling (SSR) 05–1c published February 15, 2005.
Unless claimants have the foresight to furnish work history without being asked, they often may fail to win the cash and healthcare benefits they paid for with their FICA withholding.
To avoid this potentially fatal gap in proof, claimants can do one of two things. They can either fill out and submit to SSA a Work History Report on Form SSA-3369, or can furnish SSA a completed set of Disability Workbook worksheets. Following either procedure assures that SSA has the evidence with which to compare their current limitations with the physical and mental demands of their past jobs, and to make a sound decision on their capacity to do past work.
The Form SSA-3369 is available free on the Internet at: http://www.ssa.gov/online/ssa-3369.pdf
The Worksheets are available as part of the Pds Disability Workbook for Social Security Applicants and separately as a downloadable e-book on: www.disabilityfacts.com.
[1] For example, SSA Program Operations Manual System (POMS), Section DI 20501.035.
[2] Code of Federal Regulations (CFR), Title 20, Section 1565.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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Monday, February 14, 2005
Social Security will send its exam reports to your doctor
Many who apply for Social Security disability benefits are examined by Social Security doctors. Often these applicants would like copies of the government medical examination reports to be sent to their personal doctors. Social Security Administration (SSA) policies permit this.
The disability determination services (DDS) appointment notice that you receive when the government schedules exams will normally explain that a copy of the report will be sent to the treating doctor if you (the applicant) request it.
If the claim was decided a long time ago, the request may be made to the Social Security office where the claim was filed.
We have listed below some SSA Program Operations Manual System (POMS) sections that describe the policy, and short extracts from pertinent text.
DI 22510.016 . . . After the examination or test is completed, we will be glad to send a copy of the report to your treating source if you give your permission.
DI 22510.020 . . . With the claimant's permission, or where the examination discloses new diagnostic information or test results which reveal potentially life-threatening situations, refer the CE report to the claimant's treating source. Notify the claimant if the CE report is referred to the treating source without the claimant's permission.
DI 22510.065 . . . With or without the claimant's permission, when the CE discloses new diagnostic information or test results that reveal potentially life-threatening situations, send a copy of the CE report to the claimant's treating source.
DI 30510.055 . . . The DDS should institute procedures which provide for prompt identification and referral of consultative examination reports to attending physicians where the examination turns up diagnostic information or test results which would be of significance in the claimant's or beneficiary's treatment. Referral to the claimant's treating source is particularly important where the information reveals a previously undiagnosed condition that may require immediate treatment.
The full text of the first three references may be found at:
http://policy.ssa.gov/poms.nsf/subchapterlist!openview&restricttocategory=04225
The full text of the fourth reference may be found at:
http://policy.ssa.gov/poms.nsf/subchapterlist!openview&restricttocategory=04305
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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The disability determination services (DDS) appointment notice that you receive when the government schedules exams will normally explain that a copy of the report will be sent to the treating doctor if you (the applicant) request it.
If the claim was decided a long time ago, the request may be made to the Social Security office where the claim was filed.
We have listed below some SSA Program Operations Manual System (POMS) sections that describe the policy, and short extracts from pertinent text.
DI 22510.016 . . . After the examination or test is completed, we will be glad to send a copy of the report to your treating source if you give your permission.
DI 22510.020 . . . With the claimant's permission, or where the examination discloses new diagnostic information or test results which reveal potentially life-threatening situations, refer the CE report to the claimant's treating source. Notify the claimant if the CE report is referred to the treating source without the claimant's permission.
DI 22510.065 . . . With or without the claimant's permission, when the CE discloses new diagnostic information or test results that reveal potentially life-threatening situations, send a copy of the CE report to the claimant's treating source.
DI 30510.055 . . . The DDS should institute procedures which provide for prompt identification and referral of consultative examination reports to attending physicians where the examination turns up diagnostic information or test results which would be of significance in the claimant's or beneficiary's treatment. Referral to the claimant's treating source is particularly important where the information reveals a previously undiagnosed condition that may require immediate treatment.
The full text of the first three references may be found at:
http://policy.ssa.gov/poms.nsf/subchapterlist!openview&restricttocategory=04225
The full text of the fourth reference may be found at:
http://policy.ssa.gov/poms.nsf/subchapterlist!openview&restricttocategory=04305
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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Monday, January 10, 2005
You also can find the Work History Report Form SSA 3369 BK
Social Security Disability Forms: A downloadable version of Form SSA 3369 BK Work History Report is available at: www.ssa.gov/online/ssa-3369.pdf
This form helps SSA understand the most demanding physical and mental tasks of your past jobs, and helps them make an informed judgment on whether you could do any of the jobs now.
Sometimes SSA may not ask for this form right away, but it is handy to have a draft roughed out.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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This form helps SSA understand the most demanding physical and mental tasks of your past jobs, and helps them make an informed judgment on whether you could do any of the jobs now.
Sometimes SSA may not ask for this form right away, but it is handy to have a draft roughed out.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
CLICK BELOW TO ADD COMMENTS TO THIS BLOG
Tuesday, December 28, 2004
Social Security hides Disability Report Form 3368 but you can find it
Social Security Disability Forms: Social Security has removed the downloadable standard Form SSA 3368 BK Disability Report from the "forms" and "starter kit" pages on the Social Security website. But you can still get an electronic copy of the Form SSA 3368 BK at: www.ssa.gov/online/ssa-3368.pdf
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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To follow developments in Social Security disability, visit: www.disabilityfacts.com
CLICK BELOW TO ADD COMMENTS TO THIS BLOG
Thursday, December 16, 2004
People with disabilities may face "conversion handicap"
Many people underestimate the economic challenges of disability, a Nobel prize-winning economist told a group at the World Bank in early December.
Economist Amartya Sen told the group that "conceptual confusion" has contributed to insufficient attention being paid to disability and its correlation with poverty, according to Financial Times reporter Andrew Balls. So although disabled people might find it harder to find well-paying jobs, in what Mr Sen called an "earning handicap", they may also require higher levels of income.
This is because of a "conversion handicap" - or the assistance that disabled people may need to achieve everyday tasks, such as mobility or allowing children to attend school.
"Poverty statistics tend to look at poverty as if able-bodied and disabled people can do the same things with the same amount of money," said Mr Sen. "The earnings handicap is far exceeded by the conversion handicap, not just for the individual involved but for families where there is a disabled person."
The full story appeared in the Financial Times of December 2, 2004, under the headline: Donors urged to focus more on disability in allocating aid budgets.
Comment: People in Congress who set the Social Security disability benefit, and delay the effective date of Medicare coverage for Disability Insurance beneficiaries until twenty four months after start of cash benefits, should give more consideration to this reality.
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Economist Amartya Sen told the group that "conceptual confusion" has contributed to insufficient attention being paid to disability and its correlation with poverty, according to Financial Times reporter Andrew Balls. So although disabled people might find it harder to find well-paying jobs, in what Mr Sen called an "earning handicap", they may also require higher levels of income.
This is because of a "conversion handicap" - or the assistance that disabled people may need to achieve everyday tasks, such as mobility or allowing children to attend school.
"Poverty statistics tend to look at poverty as if able-bodied and disabled people can do the same things with the same amount of money," said Mr Sen. "The earnings handicap is far exceeded by the conversion handicap, not just for the individual involved but for families where there is a disabled person."
The full story appeared in the Financial Times of December 2, 2004, under the headline: Donors urged to focus more on disability in allocating aid budgets.
Comment: People in Congress who set the Social Security disability benefit, and delay the effective date of Medicare coverage for Disability Insurance beneficiaries until twenty four months after start of cash benefits, should give more consideration to this reality.
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Friday, October 29, 2004
Social Security Disability Insurance replaces part of earnings
What percent of earnings are replaced by SSDI?
Social Security Disability Insurance (SSDI) benefits replace part of a disabled worker's prior income. The fraction varies according to the earnings history; the lower the earnings the higher the replacement rate. It also varies according to whether you have family members who who qualify as auxiliary beneficiaries.
To get an idea of the wide variations in earnings replacement rates, consider a hypothetical example. Assume that three disabled workers, all age 45, were earning at three different salary levels when they became disabled in 2003. According to the Social Security Administration (SSA) the following earnings would be replaced in the following percentages by SSDI benefits.
Earnings $14,600 annually, replacement rate 60.4% (with qualifying family member, 83.7%)
Earnings $32,444 annually, replacement rate 44.6% (with qualifying family member, 66.9%)
Earnings $80,978 annually, replacement rate 29.2% (with qualifying family member, 43.8%)
The above is a simplified illustration; actual replacement rates will vary because of differences in workers and work histories. Also, as noted above, auxiliary benefits paid to dependent family members can significantly increase the replacement rate. (Source: SSA’s FY 2003 Performance and Accountability Report, Overview, page 10.)
Your situation probably does not match any of these hypothetical ones. For an estimate of what your personal SSDI benefit would be if you were disabled now, call SSA at 1-800-772-1213 and ask them to send you Form SSA-7004, Request for Social Security Statement. Or, on the Internet, go to: https://s044a90.ssa.gov/apps6a/isss/main.html
What are auxiliary benefits?
When you receive SSDI benefits, other members of your family may qualify for what SSA calls “auxiliary benefits” Here is what the agency says about auxiliary beneficiaries in its booklet, Disability Benefits, SSA Publication No. 05-10029:
Certain members of your family may qualify for benefits based on your work. They include:
● Your spouse, if he or she is 62 or older;
● Your spouse, at any age if he or she is caring for a child of yours who is younger than age 16 or disabled;
● Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be under age 18 or under age 19 if in elementary or secondary school full-time; and
● Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The child’s disability also must meet the definition of disability for adults.)
NOTE: In some situations, a divorced spouse may qualify for benefits based on your earnings if he or she was married to you for at least 10 years, is not currently married and is at least age 62. The money paid to a divorced spouse does not reduce your benefit or any benefits due to your current spouse or children.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
CLICK BELOW TO ADD COMMENTS TO THIS BLOG
Social Security Disability Insurance (SSDI) benefits replace part of a disabled worker's prior income. The fraction varies according to the earnings history; the lower the earnings the higher the replacement rate. It also varies according to whether you have family members who who qualify as auxiliary beneficiaries.
To get an idea of the wide variations in earnings replacement rates, consider a hypothetical example. Assume that three disabled workers, all age 45, were earning at three different salary levels when they became disabled in 2003. According to the Social Security Administration (SSA) the following earnings would be replaced in the following percentages by SSDI benefits.
Earnings $14,600 annually, replacement rate 60.4% (with qualifying family member, 83.7%)
Earnings $32,444 annually, replacement rate 44.6% (with qualifying family member, 66.9%)
Earnings $80,978 annually, replacement rate 29.2% (with qualifying family member, 43.8%)
The above is a simplified illustration; actual replacement rates will vary because of differences in workers and work histories. Also, as noted above, auxiliary benefits paid to dependent family members can significantly increase the replacement rate. (Source: SSA’s FY 2003 Performance and Accountability Report, Overview, page 10.)
Your situation probably does not match any of these hypothetical ones. For an estimate of what your personal SSDI benefit would be if you were disabled now, call SSA at 1-800-772-1213 and ask them to send you Form SSA-7004, Request for Social Security Statement. Or, on the Internet, go to: https://s044a90.ssa.gov/apps6a/isss/main.html
What are auxiliary benefits?
When you receive SSDI benefits, other members of your family may qualify for what SSA calls “auxiliary benefits” Here is what the agency says about auxiliary beneficiaries in its booklet, Disability Benefits, SSA Publication No. 05-10029:
Certain members of your family may qualify for benefits based on your work. They include:
● Your spouse, if he or she is 62 or older;
● Your spouse, at any age if he or she is caring for a child of yours who is younger than age 16 or disabled;
● Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be under age 18 or under age 19 if in elementary or secondary school full-time; and
● Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The child’s disability also must meet the definition of disability for adults.)
NOTE: In some situations, a divorced spouse may qualify for benefits based on your earnings if he or she was married to you for at least 10 years, is not currently married and is at least age 62. The money paid to a divorced spouse does not reduce your benefit or any benefits due to your current spouse or children.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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Saturday, October 23, 2004
New electronic folders for Social Security disability claims excite SSA, concern others
Social Security leaders are excited that they soon will have electronic folders for all disability claims, as part of a new system the agency calls the electronic disability system or “eDIB.” This means there will be no troublesome paper folders to clutter employee desks or get lost in the mail. It means that many different people in Social Security can work with a folder at the same time, speeding up decisions.
However, eDIB also means that individuals claiming disability benefits may be blindfolded when in a few months there is no longer a conventional paper folder for them to look through. Already, offices in fourteen states are using the electronic folders, the SSA Commissioner said in testimony to Congress on September 30, 2004.
The states using electronic disability folders are: Alabama, California, Florida, Georgia, Illinois, Minnesota, Mississippi, North Carolina, Ohio, South Carolina, Tennessee, Texas, Utah, and West Virginia, according to the Social Security press office.
Lawyers and other advocates have voiced concern about folder access and have gotten some response from SSA. A representative of the National Organization of Social Security Claimants’ Representatives (NOSSCR) testified in the same hearing that SSA had assured some NOSSCR members that:
“SSA will ‘burn’ a CD and send that to the appointed representative and to unrepresented claimants as well. Representatives can then print out the file or view it on their own computers. In addition, at some point in the future, SSA plans to set up a special, secure website for appointed representatives. With their assigned identification numbers, they can go online to see the contents of their clients’ folders.” 1
Not content with only an SSA commitment to provide computer disks, a witness for the Consortium for Citizens with Disabilities testified in favor of offering people the ability to review their folders “online”:
“To know what is in the record at any given point during the process, we believe that optimum meaningful access requires secure online access with a ‘read-only’ capacity.” 2
Though meaningful, these electronic access measures will not people who lack computers. Between 44 and 76 percent of people with disabilities lack computers, according to recent surveys. 3 We have discovered no SSA plan to give folder access to computer-less people. We have not even found mention of a simple solution like printing folder contents for people who lack computers and ask for access to their Social Security records.
The changeover from paper to electronic folders is going fast. The SSA Commissioner said:
“In the DDSs, we rolled out eDIB in January 2004 starting in Jackson, Mississippi, and implementation has begun in 14 states. We expect this process to be complete by June 2005.”
If Social Security is to extend equal treatment to all claimants, it cannot accommodate computer-owning claimants by furnishing them disks containing copies of their folders, while providing computer-less claimants no opportunity to have the same information.
Can computer-less people do something to assure that they can examine and copy their Social Security disability claim folders after the agency goes electronic? Yes. Fortunately, roll-out of the new disability process still is at an early stage. This is a good time to ask SSA and Members of Congress to remove the blindfold and give computer-less and computer-owning claimants equal access to disability information.■
__________
1 Statement to House Ways and Means Social Security Subcommittee, September 30, 2004.
2 Same.
3 About 44 percent of Americans who describe themselves as having a disability lack computers, according to a report of The Pew Internet and American Life Project released April 16, 2003. Three quarters (76.1 percent) of people with work disabilities lack computers, according to a March 2000 study by the National Institute on Disability and Rehabilitation Research.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
CLICK BELOW TO ADD COMMENTS TO THIS BLOG
However, eDIB also means that individuals claiming disability benefits may be blindfolded when in a few months there is no longer a conventional paper folder for them to look through. Already, offices in fourteen states are using the electronic folders, the SSA Commissioner said in testimony to Congress on September 30, 2004.
The states using electronic disability folders are: Alabama, California, Florida, Georgia, Illinois, Minnesota, Mississippi, North Carolina, Ohio, South Carolina, Tennessee, Texas, Utah, and West Virginia, according to the Social Security press office.
Lawyers and other advocates have voiced concern about folder access and have gotten some response from SSA. A representative of the National Organization of Social Security Claimants’ Representatives (NOSSCR) testified in the same hearing that SSA had assured some NOSSCR members that:
“SSA will ‘burn’ a CD and send that to the appointed representative and to unrepresented claimants as well. Representatives can then print out the file or view it on their own computers. In addition, at some point in the future, SSA plans to set up a special, secure website for appointed representatives. With their assigned identification numbers, they can go online to see the contents of their clients’ folders.” 1
Not content with only an SSA commitment to provide computer disks, a witness for the Consortium for Citizens with Disabilities testified in favor of offering people the ability to review their folders “online”:
“To know what is in the record at any given point during the process, we believe that optimum meaningful access requires secure online access with a ‘read-only’ capacity.” 2
Though meaningful, these electronic access measures will not people who lack computers. Between 44 and 76 percent of people with disabilities lack computers, according to recent surveys. 3 We have discovered no SSA plan to give folder access to computer-less people. We have not even found mention of a simple solution like printing folder contents for people who lack computers and ask for access to their Social Security records.
The changeover from paper to electronic folders is going fast. The SSA Commissioner said:
“In the DDSs, we rolled out eDIB in January 2004 starting in Jackson, Mississippi, and implementation has begun in 14 states. We expect this process to be complete by June 2005.”
If Social Security is to extend equal treatment to all claimants, it cannot accommodate computer-owning claimants by furnishing them disks containing copies of their folders, while providing computer-less claimants no opportunity to have the same information.
Can computer-less people do something to assure that they can examine and copy their Social Security disability claim folders after the agency goes electronic? Yes. Fortunately, roll-out of the new disability process still is at an early stage. This is a good time to ask SSA and Members of Congress to remove the blindfold and give computer-less and computer-owning claimants equal access to disability information.■
__________
1 Statement to House Ways and Means Social Security Subcommittee, September 30, 2004.
2 Same.
3 About 44 percent of Americans who describe themselves as having a disability lack computers, according to a report of The Pew Internet and American Life Project released April 16, 2003. Three quarters (76.1 percent) of people with work disabilities lack computers, according to a March 2000 study by the National Institute on Disability and Rehabilitation Research.
To follow developments in Social Security disability, visit: www.disabilityfacts.com
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