Social Security Myth #3


“The vast majority of present recipients are on drugs but otherwise fine.”


Is there a link between Social Security Benefits and Drug addiction?  Some think so.  To determine the truth about drugs and Social Security, it’s important that we don’t confuse a correlation with causation.

Establishing Definitions

It might be true that those seeking Social Security or Disability benefits from the Social Security Administration (SSA) are circumstantially more likely to have abused drugs.  If there is a true cause and effect link between these benefits and drug use, then spotting it is pretty simple.

Take two sample groups and measure the amount of drug use.  In one sample put a number of SSA benefits recipients, and in the other put their peers.  If there is some sort of free reign of drug users in these programs, the sample will reflect this.  There will be a higher use of drugs or alcohol among Social Security recipients.  If not, the assumption is false.

Has anyone ever done this?  

We’ll get back to that in a minute.  First, this post needs to cover how this myth might have started.  And how the simple method just explained above was once used to great effect about 20 years ago.

Social Security’s Historical Problem with Drugs

In the early 1990s, the SSA really did have a drug problem.  At least according to lawmakers.  In 1994, the Government Accountability Office (GAO) estimated that “the number of addicts receiving disability benefits has substantially increased at an annual cost of about $1.4 billion per year.”  That would be about $2.8 billion per year in 2016 dollars.

This didn’t go unnoticed.  Less than two years later after the GAO report, Congress passed the Contract with America Advancement Act.  This stopped benefits for those whose primary diagnosis was drug addiction or alcoholism.

The results of this act were markedly clear.  Of the 140,000 or so recipients that were receiving Social Security benefits due in part or whole to substance abuse, about 60,000 still did so after Jan 1, 1997.  The rest were found to have other disabilities of a strong enough nature that they would still be deemed disabled without the substance abuse.  <- This remains the basis of determination to this date in dual diagnosis cases.

Social Security & Substance Abuse Recipients Before & After the “Purge” in 1997

Modern Rules on Drugs and Social Security

The rules now state that a person may be approved for these benefits only if it can be determined that they would still be disabled without using drugs or alcohol.  Drugs and alcohol cannot be a contributing factor in an applicant’s disability.

So, how well do the rules work?  Everyone has an opinion on this, but let’s go back to the assumption and conclusions that worked in the past.

If Social Security has a drug problem, one would reason that drug use amongst recipients is higher than a control group of their peers.

The Hard Facts

The United States Library of Medicine asked this question in 2006.  The study was titled: Effect of Social Security Payments on Substance Abuse in a Homeless Mentally Ill Cohort.

The conclusion of this study, “(recipients) did not have any different drug use changes than those without benefits.”

In fact, digging into the study yields surprising insights.  Long term recipients of Social Security benefits have less average years of drug use in almost every category when compared to their peers.

 

The Truth

Neither the vast majority nor a majority at all, of Social Security and/or Disability recipients are ‘drug addicts.’  Since 1997, it has become much harder for those abusing drugs or alcohol to get Social Security benefits in the first place.  And for those who are receiving them, by and large, they are not retaining them while actively abusing.

The rule of thumb used in 1996 still works today.   The proof: the rate of use among the population receiving benefits is less than among their peers.  Their peers who don’t receive benefits abuse drugs MORE often.  Myth Busted.

Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI

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Social Security Myth #1

“You have to apply three times and then you win”

Did you know that you have to apply three times before you win a Social Security Disability claim?  Well, that’s the rumor.  This particular rumor is a common theme, or curse, in many discussions about claim denials. Though the idea is mostly false, it has enough truth to it to make it believable to those recently denied disability.

We’ve already talked about the odds of achieving success at each level of your Social Security Disability claim in some of our other articles.  Keeping it simple, if you were to look at all the claims put in for Social Security Disability, you would see about 30% are awarded at the initial application level.  From this perspective, it seems to follow that you have a one in three chance each time you apply… By the third time, you’ll have a great chance of achieving a successful outcome.  And a myth is born…

The Truth…

There are a lot of great reasons why this is not an accurate perspective.  But let’s assume it is in fact true, and the myth is therefore true.  Furthermore, let’s assume, this is the direction you want to go.  On your third application, you achieve success and are awarded your disability claim.  Is this the best possible method you could have used?  Applying multiple times.  Is this the method with the highest likelihood of success?  Is it the best outcome financially and support wise?

The short answer is no & no & no & no.  This “3rd Time’s a Charm” method would not have provided you with the best overall chance of success.  And it certainly wouldn’t have provided you with the greatest level of benefits, financial or otherwise.  At best you’re getting the award a couple of months faster IF you get the award at all.  Why gamble when there is really a very little benefit to doing so?


Continuing to Break it Down

 You may be awarded on the third time you apply for benefits.  You might be awarded Disability Benefits on the second, first, or even fourth time as well.  But it is not the best approach.  This approach doesn’t provide the greatest likelihood of success.  And it does not provide you with the greatest level of support or benefits to keep re-filing a claim.  Look below to see your chances at the initial claim when compared to pursuing an appeal.


 

Your best bet is to speak with an advocate that understands this, and will talk about the approval rates where you live.

Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI

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3 Mistakes to Avoid when Denied Disability

The application process for disability and Social Security is tough enough, being denied disability only adds to the mess.  You first have to more-or-less discover that you are not able to keep working.  Then you have to state that you can’t work in a very deliberate way.  You do this by applying for benefits directly to the Social Security Administration.  If your family is involved in your support, you often have to teach them at the same time you are seeking help yourself.

Add to this, you have to do a lot of things to keep your claim alive. 

Answering questions relating to your disability and challenges.

Timely returning mail.

Attending uncomfortable and sometimes hostile medical appointments.

If you’re lucky enough to have all your documentation lined up and a great support system, you may be one of the 30% that finds success on their initial claim for disability benefits.  But if you’re like the majority of those that apply (and the majority of those that eventually get their claims approved) you’re likely to be denied disability and see a denial letter for your efforts.

We’ve covered several times in this blog, why a denial is not to be unexpected.  And also why a denial for disability is something that you can beat. 


The First Step in Beating a Denied Disability is Avoiding these Three VERY Common Mistakes.


Common Mistake #1: Waiting Too Long to File an Appeal for a Denied Disability

60 Days, not two months, or 6 weeks… 60 Days.  That’s how long you have to file your appeal or to have someone file the appeal on your behalf.  This can be challenging from the perspective of someone who just received their denial letter.  You may wish to set the letter down and come back to it when you’ve collected yourself.  Whatever you do, don’t wait 61 days.  Remember that for better or worse, most people who eventually get social security were denied at one point.


Common Mistake #2: Filing a New Claim Instead of an Appeal

The idea and process of an appeal may sound challenging and complicated.  You might be thinking that maybe the people at the Social Security Administration didn’t understand.  Or perhaps, you feel you didn’t answer everything the “right way” at your medical appointments.  If you’re unsure which is better, filing a new claim or filing an appeal.  File an appeal, do not file a new claim.  You’re throwing away months of support and you do not have a better chance the second time around than you had the first time.


Common Mistake #3: Going it Alone

The appeals system in Social Security is set up in such a way that it is very difficult for someone not familiar with advocating Social Security Law in front of a judge to be able to do so, effectively.  It takes years of experience for Social Security attorneys to become proficient advocates for their clients.   The best way to use your 60 days to file your appeal is to have a discussion with one or several attorneys within the first 15 days.  The best attorneys will listen to you to understand your claim and explain to you, in simple terms, if and why it may be in your best interest to continue pursuing your claim.

Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI

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What Does a Disability Look Like?

Each year the Social Security Administration (SSA) awards claims to over 750,000 newly disabled workers.  This means that over 750,000 people are successful in claiming an SSDI award because they are or were physically or mentally unable to work anymore due to an injury or illness.  

To have found success, these claimants must have demonstrated to the Social Security Administration what disability looks like for them.  You can do this too!

If you are fighting for your claim and note sure if SSDI is the right path, how do you get to the point where you will reach out for help? 

It might be that simply knowing you’re not alone in struggling to identify and express what your disability looks like is all the help you need.  

What barriers do you have that are keeping you from getting a job or keeping that job? How can you speak the language of Social Security?  How can you say what disability looks like for you, in terms they (SSA) use?

Source

What Disability Looks Like in 2016


Muscles, Skeleton, and Tissues:  280,000

(36% of all awards)

The aches and pains that keep you from bending over, squatting, walking, standing or sitting for long periods of time.  Bone deterioration in your back, knees, and other joints.  Muscle injuries, burns, fractures, and amputations.  These are the most common claims and the most awarded.    More here.


Mental Health: 124,500

(16% of all awards)

This is a broad range of challenges that together are the second most common in SSDI claims.  Mental disorders include mood disorders, lapses of time or place, confusion, memory challenges, schizophrenia, psychotic disorders, autism spectrum disorders, developmental disorders, and intellectual disability.

 More here.


Circulatory / Cardiovascular: 85,500

(11% of all awards)

 These concern the arteries, veins, capillaries, and lymphatic systems.  Think heart failure, heart disease, stroke, aneurysm, arterial disease…   More on these here.


Neo-Plasms: 85,500

(11% of all awards)

Cancers are classified by Social Security under this term.  A breakdown of how Social Security looks at cancer – including treatment and impairment can be found here.


Nervous System & Sense Organs: 62,500

(8% of all awards)

Sense organs include the eyes and ears.  Total or partial blindness or deafness are typical claims within this category.  Nervous system disorders include epilepsy, paralysis, multiple sclerosis, meningitis, Alzheimer’s, and Parkinson’s Disease.


Other: 140,000

(18% of all awards)

At least 140,000 claimants each year don’t meet any of the criteria above.


If any physical or mental health barriers reflect where you are today, you should contact someone who knows how Social Security works to work with them on the best way to seek an SSDI claim or appeal.

Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI

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The Three Tenets of All Successful VA Claims and Appeals

Like Social Security, many VA claims for service-connected disability compensation are denied in the initial claims process.  The reasons for denial can be varied.  For those seeking service connected claims while employed, or after recently being employed, the arguments of the VA often appear hard to overcome.  In every case, there are three fundamental tenets of all successful VA claims. 

Failing to answer one of these will usually result in claim denial and confusion for the Veteran claiming service connection.


1) Something currently exists that is disabling.

You must present a disabling condition.  This can be either mental or physical or both.  For example bad back, bad knees, poor hearing, lost eyesight, bad sleep, emotional outbursts, anti-social behavior, and other challenges or disabling conditions.  Of course, you’re not a doctor, so you do not have to self-diagnose, you can claim to experience these and get an official diagnosis during the process.

Regardless, for successful VA claims you must have a disabling condition by the time your claim is being decided.


2) Something must have occurred during service to act as a nexus event to your current claim.

An event or series of events can be shown to have had at least a 50% chance of causing or making worse your condition.   This last statement is one that most claimants don’t realize. Neither do many health care providers, doctors, or advocates.

A doctor does not need to be 100% certain that a certain event caused a Veteran’s current condition.  The doctor only needs to be willing to state that in their medical opinion:

“the claimed nexus event is/was as likely as not (50/50) the cause of the Veteran’s current condition.”

Or, that the nexus event made the injury worse.  This last point is often not made clear to doctors.


3) A clear connection between the Nexus service event and today’s current condition must be shown.

For the working disabled, or the recently working disabled, this is often the key piece to detail for successful VA claims.  It is also, the piece most missed when filing a claim or appeal.

Most people will say something to the effect of:

“I have a bad back, it’s caused by a fall while in service.” 

While this meets the criteria of #1 and #2 above, it does not explain how you have been able to work for 20 more years on your bad back.  The argument for #3 is not answered and the result is usually denial.

Denied claims for Veterans who are working are often a result of failing to answer #3 clearly.


 

Successful VA Claims

For item #1, there is not much you as the Veteran can do except to seek the diagnosis of your condition from a doctor or therapist.

#2, is a challenge due to the state of many Veterans’ service records.  The challenge can be overcome by a good advocate or attorney that knows the requirements of VA law.  And one that knows to adapt your claim into an effective appeal strategy.

The best thing an advocate or attorney can do for a Veteran is to get a timeline created of what happened.  Then to start gathering evidence from the time of the injury to today.  Build a timeline.  This is also the best way to approach answering #3 as well.

For #3, an advocate or attorney should detail where you, the Veteran, went after discharge.  Also

Why you discharged.

Whether you were successful in school or work after discharge.

If there were any accommodations made for you to be successful at work or school.

Did you took additional sick time, rest days, or required working from home at any point.

If you have a healthy family life and history of one, e.g. divorce?

All of the pieces of your life since your injury reflect in some manner on your current condition.  You and your attorney have to tell a story that makes sense how you got from your military service to today.  Whether that journey has been 3 months or 30 years.

Lilac City Law advocates on behalf Veterans in appeals for Service Connected Disability Benefits

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The ‘First’ Worst Letter You Will Get From Social Security

“Dear Applicant…Based on a review of your health problems you do not qualify for benefits on this claim.  This is because you are not disabled under our rules… We have determined that your condition is not severe enough to keep you from working…~Social Security”


This is the denial letter you don’t want to get from Social Security.  There’s more information specific to your claim in the letter.  However, this language is common to all disability denials.   It says that for whatever reason Social Security chose to list in the letter, and possibly for other reasons, they (SSA) doesn’t believe that you rate Disability Benefits.

 

But you are disabled, right?

You can’t work because of your injuries, you haven’t worked in months.   It’s very possible you have a hard time taking care of basic tasks, including the hoops the SSA required in filing the initial claim.  And now you have to deal with this?!?

As much as it hurts to be turned away for an impairment that stops you from working, you’re in good company.  We already know that Social Security denies about 70% of claims at the initial stage.   Statistically, you’re on track to get your claim approved if you stick with it.  This denial letter is par for the course, it seems.

Sticking with your claim can be a gut check though.  You have a short period of time to file your appeal.  You want to make sure you start to line up the support you’re going to need for your hearing, and whatever else may follow.  If you’re not careful your claim can spin away from your control and you can easily miss deadlines.

What to Consider in Response of your Denial Letter

Another thing to consider is the risks of being too careful and meticulous.  Questions could arise about the real impediment your disabilities present.  If you’re able to successfully navigate and pursue a disability claim appeal on your own, maybe you aren’t “that” disabled.  It’s a perverse coincidence that a system designed to provide support for a disability is so full of barriers to achieving that benefit for those with disabilities themselves.  Unless those with disabilities get help from someone else, SSA seems to want to play a cat and mouse game.

You can still achieve a positive outcome in this.

If you have received one of these “It’s not us, it’s you” letters, the first thing you should do is take a breath.  There are hundreds of thousands of disability recipients who received the same letter and were eventually granted benefits.  The second thing to do, seek help, even if it’s in the form of a free consultation.   The clock is ticking on your claim.  It’s not dead, but it will be if you take too much time to start your appeal.

Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI

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How Much Will I Make on Disability?

You’ll see this question online in other blogs.  Most of the time it will be phrased differently though.  Instead of saying, “how much will I make on disability,” attorneys or agencies will phrase it in the form of “what will my compensation be if…”  But whether you’re deciding to file a claim, or deciding to file an appeal to denial, the financial consideration is very much a piece of information you need to know.  For that reason, let’s dispense with couched language and talk frankly about Social Security Compensation for a bit.

Social Security Compensation (SSI)

Social Security Compensation for SSI is fixed at a standard rate that is established every year.  Most years there is a cost of living (COLA) increase.  In recent history, the payout for an individual who is receiving this benefit is roughly 20% of the average wage.  Average Wage Index.  For couples, the compensation hovers around 30% of the average individual wage.


Note, a married couple, both receiving SSI will receive about 75% of what two unmarried people would be receiving.

Monthly Social Security Compensation compared to average monthly compensation


Social Security Compensation (Disability)

Social Security Compensation for SSDI is a little harder to peg because it is based on your wage earning history.  There are online calculators to help you figure out what your award might be.  Here’s one from the Social Security Administration.  For the sake of discussion, we did the research and found that the Social Security Administration paid out a monthly average of $1165 in 2016 to recipients of SSDI.  That is about $13,980 per year or 30% of the Average Monthly Income.  Of course, higher or lower earnings history will skew this number up or down in your claim, this is an average.

So here’s the flat truth on this.  You are not going to be making a lot of cash on these benefits.  But, the cash benefits you will receive may be the difference between zero income and some income and that cannot be understated.

Another factor to consider is that succeeding in pursuing these benefits has more benefit than the face value of the monthly cash in the bank.  The financial benefit at the end of the road is only part of the overall picture.


Compensation in Forms Other than Cash

Here’s an example..student loans

Student loan debt will not go away.  It will chase you the rest of your life.  You can’t typically discharge or get forgiven of these loans.  Even though bankruptcy.   In addition to this, student loan debt is also growing.  Depending on how you read the data, between 17-25% of those that owe student loan payments are either past due or in default.

Among those that are TBD and receiving a social security award, the default rate is 46%.  There seems to be a link between total disability and ability to pay down student loan debt.  This may be related to the monthly compensation rates?

If you are found to be totally and permanently disabled (TPD) you can apply to have your federal student loan debt discharged.  In a real-life scenario, this would free up a couple of hundred dollars per month.

This benefit, and others like it, need to be factored into the discussion of how much you will make on disability (SSI/SSDI).

Here’s a couple more benefits 

Reduced or free state and national parks passes; and

Reductions or waivers of property taxes

What Next?

A consultation with someone who knows the disability system and processes is a great place to start exploring the not so clear answers to this discussion.

Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI

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Your To-Do List for Social Security Disability

There was a great article published recently by Tim Moore, a former Social Security Claims Examiner. In the article, he provided advice for those seeking a Disability claim with the Social Security Administration.  We loved everything he said so much, we wanted to pass it on and add a couple of thoughts of our own about picking the right disability attorney!


 

1) Don’t Wait to File for Disability.

We already covered the fact that wait times are increasing in the article, ”I’m Too Tough for Social Security: They Denied me Because I Worked Through my Injury.”  As the US population continues to grow and age, the number of claims for Social Security Disability rises as well.

From a pragmatic perspective, the earlier you file the earlier you’re going to get through the system.  Whether you are one of those whose claims are approved up front, or you go through a several year’s long processes, getting in the process today should be the number one item on your list if you are unable to work because of an injury or disability.

 

2) Hire an Attorney to Appeal a Disability Denial

Hang on, did a hearing examiner ^ just suggest hiring a disability attorney to appeal a denial?

If you’ve been through this process, you can probably attest to why.  Claimants already have an uphill fight to get a claim approved in the first place.  This is a challenging process. A good disability attorney will understand court processes and have the experience of having done these appeals many times.

 


A Couple of Our Additions


 

3) Hire an Experienced Disability Attorney to Appeal a Denial

You wouldn’t want to take your car into a librarian to fix it.  While the librarian would have access to all the “how-to” books in the world, you just cannot replace experience.  Perhaps if this were a crafty librarian they would have read Outliers by Malcolm Gladwell.  In Outliers, Gladwell systematically demonstrates that it takes 10,000 hours of practice to develop world-class expertise in any given subject.

A bit of back of the envelope math says this is the equivalent to about 1250 social security appeal cases.  This is generous – it might even be a bit low.  Work with someone who has spent the time (10,000 hours or more) & effort to master disability claims.  After all, your social security claim is worth so much more than a car.

 

4) Don’t Wait for a Denial to Consult with a Disability Attorney

Assume that most claims for Social Security Disability are going to be denied up front.  Do you want to be pursuing representation when you’re up against a 60-day deadline to file your appeal?  At that point, you’re not a savvy consumer, you are a desperate one.

Getting a head start gives you time to figure out which attorneys will work best for you.  Would you want to hire someone that was unwilling to talk to you before you were denied your claim?   Even before there was an up-front financial consideration?  Of course not!

There are many Social Security Disability Attorney.  Not all are willing to become invested in your outcome prior to a denial.  Use the time while your claim is processing to consult with an attorney about the process and any questions you have.

 


Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI


 

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Gulf War Illness and Unfair VA Claims Denial Practices

Gulf War Illness and Unfair VA Practices

In our article, How the VA is Failing Gulf War Vets, we described how systematic problems at the VA seem to be resulting in neglect of legitimate service connected claims for Gulf War Illness.  Since we published that article, Anthony Hardie, a Gulf War Veteran and Director for the Veterans for Common Sense published written testimony of his before a Congressional Hearing on Gulf War Veterans & Gulf War Illness service connected detail rates.

It is especially noteworthy to recognize the historical denial rates for service connection are between 30% & 40%.  Some estimate that 60% of those denials are later found to be erroneous. We are going to look into how that compares to other injuries and eras of Veterans.

 

Recent History of Gulf War Illness Claims

Since 2011, denial rates for service-connected claims related to Gulf War Illness climbed from 76% to near 82%.  Remember, historical denial rates for all applications hovers between 30% ~ 40%!  Denials of claims for exposure to the Middle East is 2x the average of all other claims.  And depending on the year, denials for these claims can be almost three times the average rejection rate.

We can take this one step further if you’re saying…

“But I saw Gulf War Illness on the X-Files once, so maybe it’s not so cut and dry as the VA is goofing this up at the expense of Veterans who don’t have data and a clear understanding of the process on their side.”

First of all, we just happen to have a control population of 2 million Veterans that had exposure to the same region and hazards.  That control population we can contrast is the Global War on Terror generation of Veterans (GWOT).  Over 1 million unique service-connected compensation claims were filed by this generation of Veterans, so far.  The denial rate is for these claims is 2%!

 

 

 

 

Gulf War Veterans vs. GWOT Veterans

2% is such an extreme that it deserves another closer look.  We should probably look further into this number at some point in the future.   So, let’s look at this average, taking away the 98% approval rate.  And for the sake of argument, let’s also take away the 81% denial rate on the Gulf War Illness issue. If we normalize this data, it shows us that Gulf War Veterans’ claims are denied 25% more often than the average VA claim!

In conclusion, what’s the recourse?  Education and discussion.  Keep this discussion alive and relevant.  Share this information with friends and Veterans. And educate them on their options.

And please remember, get your claim take care of if you have experienced any of the issues associated with service in the Middle East and Afghanistan.

 

Lilac City Law advocates on behalf Veterans in appeals for Service Connected Disability Benefits

 

 

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