SSD Medical Consult Exam

Average SSD Payment

The average SSD payment in 2008 was $1,063 a month. Once you have received disability payments for two years, you automatically qualify for Medicare coverage.

Ohio, Michigan, Minnesota, Wisconsin, Indiana, Nebraska, Illinois, Missouri, the District of Columbia and Alabama face the 10 worst Social Security Disability Insurance (SSDI) hearing-level processing backlogs.

Hearings are held when an SSDI decision is appealed, many people have already waited 12 or more months following their application, denial and, for many, reconsideration. By the time they reach the hearing, it's not unusual for applicants to have waited two to four years for an SSDI decision.

The 10 states with the lowest wait times are Delaware, Maine, Texas, Louisiana, West Virginia, Utah, Massachusetts, Oklahoma, Connecticut and Hawaii.

The SSA reports the national average processing time for a hearing decision is now 442 days, down from 514 days in September 2008. The total hearings backlog has decreased by more than 71,000 cases since December 2008.

Last year, more than 2.8 million people filed SSDI applications, and the SSA projects 3.3 million will file disability claims in 2010. The SSA recently reported that the level of initial claims pending now exceeds 1 million people - nearly a 40 percent increase over the level from FY 2008.

High Rate Claim Denial in Texas

In Texas at the initial claim level (the application), SSD and SSI claimants have been denied at the rate of 61.5%.

For those who were denied and chose to file appeals, Texas claimants were again denied at an even higher rate: 84.2%.

More initial claims are denied than are approved and an astoundingly high percentage of first appeals are likewise denied.

Steps to protect your Social Security Disability, Veteran's or Pension Benefits:

Do NOT commingle Social Security and exempt benefits with nonexempt funds.

Do NOT obtain a loan or credit card from the bank where your Social Security or pension is deposited. If sued, go to court and demand proof of the debt.

If your bank account is frozen, file an exemption claim within 10 days.

IRS and SSD

The IRS can take money each month from a Social Security disability check.

The practice is part of the agency's Federal Payment Levy Program, which allows up to 15 percent of any federal payments a delinquent taxpayer receives to go directly to the IRS until their overdue taxes are paid in full.

The IRS employs an automated levy system that withholds Social Security payments to taxpayers with incomes below the poverty line. If this is happening to you ... call.

Ask for a person -- not a computer -- to provide a review. You may be classified by the agency as unable to pay.

IRS Taxpayer Advocate: 1-877-777-4778

If your reasonable expenses are more than your income you may be eligible to have an IRS levy from your bank account refunded. The IRS will have a telephone interview with you to determine your ability to pay. This includes and discussion of your assets and resources. They will then ask for your monthly expenses. Typically you will have to fax the IRS your last three months of bank statements.

While the IRS has ten days to decide on a refund they actually can and usually do act more quickly. You bank may require 72 hours to restore your funds. In reality the IRS may act more quickly than your bank.

There is a possibility that you will have a partial restoration of funds rather than a full restoration.

A restoration of funds for hardship and a classification of 'unable to pay' does not mean your debt is forgiven. You will continue to owe your debt. However, your funds for living expenses may be partially or fully restored.

Social Security Medical Consultive Examinations

A claimant has a high probability or being sent to a physician by the Social Security Disability Examiner for a Consultative Medical Examinations for either a social security disability or an SSI claim.

The Consultive Medical Examination will be conducted by an independent physician with a contract to perform exams with the Social Security Administration.

Once a Claimant files for SSI based on disability (Title 16), or Social Security Disability (title II), the case is assigned to an Examiner with the States Disability Determination Service.

The Examiner may determine the medical records are inadequate, for example a Claimant may not have a long duration of treatment with a physician.

Consultive Medical Examinations provide the Examiner a report on the Physician's opinion and medical basis of the claimant's conditions and various limitations. These examinations are NOT for treatment.

If you are sent on a Consultive Medical Examination be certain to take YOUR OWN medical records. WHile the physician is supposed to have these at least half the time they do NOT -- or at least claim they do not.

Social Security Medical Examinations are very brief. Take a list of your history of treatment, and diagnosis with you. Make certain the physician understands what you diagnosis has been and how that has limited your ability to perform your work.

Consultative Examination Report Content

Remember the visit may be brief but the REPORT prepared by the Medical Consultive Examiner is Extensive. Help your examiner understand your condition. Your medical records, well organized, with diagnosis highlighted in yellow and a narrative will help the Examiner prepare YOUR report.

A complete CE report will involve all the elements of a standard examination in the applicable medical specialty and should include the following elements:

the claimant's major or chief complaint(s) - BE PREPARED, write these down.
a detailed description, within the area of specialty of the examination, of the history of the major complaint(s) - KNOW YOUR DATES, write these down.
a description, and disposition, of pertinent "positive" and "negative" detailed findings based on the history, examination, and laboratory tests related to the major complaint(s), and any other abnormalities or lack thereof reported or found during examination or laboratory testing - KNOW WHAT TESTS YOU HAVE HAD AND WHEN, what were the results. write these down.
results of laboratory and other tests (for example, X-rays) performed according to the requirements stated in the Listing of Impairments (see Part III of this guide);
the diagnosis and prognosis for the claimant's impairment(s); Know your diagnosis. Show where it is in your medical records. Highlight it in yellow.
a statement about what the claimant can still do despite his or her impairment(s), unless the claim is based on statutory blindness. Be able to specifically respond to RFC questions. BE PREPARED.
- if the claimant is an adult age 18 or over, this statement should describe the opinion of the consultant about the claimant's ability, despite his or her impairment(s), to do work-related activities, such as sitting, standing, walking, lifting, carrying, handling objects, hearing, speaking, and traveling;
- in adult cases involving mental impairment(s) or mental functional limitations, this statement should also describe the opinion of the consultant about the claimant’s capacity to understand, to carry out and remember instructions, and to respond appropriately to supervision, coworkers, and work pressures in a work setting.
- if the claimant is a child under age 18, this statement should describe the opinion of the consultant about the child's functional limitations compared to children his or her age who do not have impairments in acquiring and using information, attending and completing tasks, interacting and relating with others, moving about and manipulating objects, caring for yourself, and heath and physical well-being.

the consultant 's consideration, and some explanation or comment on, the claimant's major complaint(s) and any other abnormalities found during the history and examination or reported from the laboratory tests. The history, examination, evaluation of laboratory test results, and the conclusions will represent the information provided by the consultant who signs the report.

BE PREPARED

Be able to quickly and concisely explain the following to YOUR Medical Examiner:

These include information provided by treating and other sources regarding:

Impariment of claimant's daily activities;
Location, duration, frequency, and intensity of the pain or other symptom;
Precipitating and aggravating factors of pain --- what causes it --- what brings it on;
Type, dosage, effectiveness, and side effects of any medication;
Treatments, other than medications, for the relief of pain or other symptoms;
All measures the claimant uses or has used to relieve pain or other symptoms; and
Other factors concerning the claimant's functional limitations due to pain or other symptoms.

In assessing the claimant's pain or other symptoms, the decision makers must give full consideration to all of the above-mentioned factors. It is important that medical sources address these factors in the reports they provide.

In some instances an Examiner my simply need additional evidence which would mean blood work or an xray.

Keep Your Appointment - Crucial

Claimants should always keep the examination appointment. Examiners may close disability claims for "failure to cooperate" if you do not keep your examination appointment.

DDS Physician is NOT a CME Physician

A physician who conducts a physical examination is NOT a Disability Determination Service Physician. These physicians who consult with the Disability Determination Service Physician Examiners in their reaching their decisions regarding disablity claims.

Lee Ann Torrans
Attorney at Law
6532 LBJ Freeway
Dallas, Texas 75240

http://socialsecuritystrategy.com

ltorrans@gmail.com

214-500-5410 (cell)
214-231-2886 (E-fax)

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