Judge Mary Hubert has joined the Portland hearing office as Chief Judge. Judge Hubert replaces Judge Paul Martin, who had been serving as interim Chief Judge. Judge Martin has returned to his previous post at the Manchester hearing office.
Judge Hubert was serving previously at the SSA hearing office in Valparaiso, Indiana.
I have a client with a claim for disability benefits that has been pending at the initial level of review for over 365 days. That is just too long.
This client applied online with me in my office, on April 10, 2024. The claim was sent to DDS on June 7th. After 3 months in “staging,” DDS assigned a disability adjudicator on September 3, 2024. It has been awaiting a determination since.
All forms were promptly completed. Medical records were promptly ordered and received by DDS, and we supplied some older medical records. A physical consultative exam was scheduled; that delayed the claim by 10 weeks, due to scheduling lead time and then waiting for the CE report. Since then, the claim has been in the queue waiting or medical review for over two months and counting.
4/25/2025 Update: At the national NOSSCR conference, it was noted that there is a Social Security regulation that sets targets for DDS review times for initial disability claims. The processing target level for state agency review of initial Title II disability claims is 37 days. See 20 C.F.R. 404.1642(b)(1).
4/30/2025 Update: An initial determination has been made.
My hearings this week with an administrative law judge (ALJ) to determine medical eligibility for Social Security disability benefits followed the usual pattern: opening remarks by the judge and then the claimant’s lawyer (me), the claimant’s testimony, and then testimony of a vocational witness regarding the claimant’s past relevant work, and whether various functional limitations would preclude that past relevant work and/or other work. This, broadly speaking, is pretty much the course of most hearings. At the end of the hearing, the judge often will say something like “Thank you for coming today. I will review the record again and issue a written decision soon.”
At the end of one of my hearings this week, however, the judge said this, instead: “Based upon my review of the file, your testimony, and the testimony of the vocational witness, I will be issuing a Fully Favorable decision.”
What a difference that makes! While we still have to wait for the written decision to be issued, it gives tremendous relief for the claimant to hear from the judge that their claim for Social Security disability benefits will be granted. There is no uncertainty or worrying while waiting for the decision. It is a generous act by the judge.
I wish judges would follow this example more often when they know they will grant a disability claim.
Multiple Sclerosis (MS) is a chronic illness that affects the central nervous system, which includes the brain and spinal cord. MS occurs when the body’s immune system mistakenly attacks the protective covering of nerve fibers, known as myelin.
Myelin acts like insulation around electrical wires, allowing nerve signals to travel quickly and efficiently. When myelin is damaged, the nerve signals are disrupted, leading to a wide range of symptoms. The symptoms associated with MS vary depending on the areas of the brain and spinal cord that are affected, and can vary widely from person to person.
In many cases, MS symptoms lead to disability over time. As MS progresses, the damage to nerve fibers accumulates, which can result in significant limitations. Some common effects include:
In my view, MS presents two principal challenges for those applying for Social Security disability.
First, as a progressive disease, it can be hard to determine at which point along the progression the MS symptoms become disabling. That point is almost impossible to discern from the treatment notes alone. The objective evidence in the medical file never tells the complete story, because MS patients with similar lesions shown on their MRIs can have symptoms that vary dramatically in their severity.
Second, it is often the constant fatigue that prevents MS patients from being able to work and even maintain their daily activities. Unfortunately, there is no way to objectively measure fatigue. And while the treatment notes will often cite fatigue, they usually do not detail the severity of the fatigue.
The treating neurologist can usually help, by providing an opinion regarding the severity of the patient’s symptoms.
I get calls (and emails). People find the blog and get in touch with a question, which is terrific. The purpose of the blog is to help.
Every now and then someone gets in touch with this question: “I am already receiving disability benefits. I have developed an additional medical condition, and as a result I am more disabled now that I was before. How do I increase my monthly disability benefits to reflect my increased level of disability?” Short answer: you don’t.
For those disabled under Social Security’s rules, the monthly benefit (which Social Security calls the Primary Insurance Amount, or PIA), is determined by a formula based upon how much you have paid into the FICA system over the years. The monthly benefit is a little different for everybody, depending upon their contribution. The benefit amount has nothing to do with the level of your disability, so there are not additional disability benefits available if your condition worsens.
I recently helped a client over the age of 55 with their initial application for Social Security disability benefits. I get involved early in these cases because the claimant’s past relevant work is often the most important aspect of the claim, and I want to ensure that both the application and the Work History Report are completed accurately.
When I first spoke to the client, they said they had been out of work for about 5 months, since September of 2024. Upon further inquiry, it turned out that the client’s last long-term job ended the year before, in September of 2023. Since then, they tried to work for three different employers, with 30+ day gaps in between each job. Those jobs only lasted 2-3 months due to the client’s physical impairments. Looking at the dates of employment and the reason for departing each job, it became clear that these three jobs were unsuccessful work attempts. Unsuccessful work attempts are by definition not SGA (substantial gainful activity), and therefore do not interrupt the disability period. See 20 CFR 404. 1574(c).
As a result of this analysis, when we filed the application for disability benefits, we correctly alleged an onset date of September 2023, when the long-term work ended, disregarding the subsequent unsuccessful work attempts. This resulted in an award of 12 months of additional disability benefits for the client.
Charles Hall has the details.
Social Security has just published Tips and Best Practices for Appointed Representatives (link opens a PDF). It is a wide-ranging guide for Representatives navigating Social Security’s rapidly evolving rules regarding representation, registration, and payment.
The PDF includes information about:
Please also review Social Security’s Best Practices for Claimants’ Representatives.
When I have a client over the age of 55 with physical impairments, this is typically the final paragraph of my brief for the disability adjudicator or the administrative law judge:
At Step 5 of the sequential evaluation, Mr. Jones is 58 years old. He does not have acquired job skills that transfer to a significant range of skilled or semi-skilled work within his RFC (please see Section 202.00 (e) of the Medical-Vocational Guidelines). Also, his mental health symptoms would prevent the transfer of any acquired job skills. Mr. Jones does not have recent education allowing direct entry to skilled work. Under these circumstances, Medical-Vocational Rule 202.06 directs a finding of “disabled” at the Light exertional level. As the regulations explain, “the limitations in vocational adaptability represented by functional restriction to light work warrant a finding of disabled.” See Section 202.00(c) of the Medical-Vocational Guidelines.
If the client’s limitations are adequately established, this is a winning argument every time.
Social Security has a process for expediting certain disability claims for people with some rare diseases and diagnoses that often have poor outcomes. It is called the Compassionate Allowance program (they abbreviate it as CAL). A list of the conditions which qualify for the program is here.
Although Social Security uses the same criteria to determine disability in compassionate allowance cases as other cases, the CAL cases move quickly through the system. I did not realize how quickly the claims moved until this past week, when I helped a new client with a compassionate allowance condition with their disability application. Look at the speed with which the claim was handled:
To recap, the claim went from a disability application to payment of benefits in 10 days. Remarkable! And the money has already landed in the client’s account via direct deposit.
Every Social Security employee involved in the claim, particularly the specialist at the field office and the DDS adjudicator, acted expeditiously to make this result possible. They deserve great credit for it.