When we talk about Social Security disability benefits, we are generally talking about what is formally known as the Social Security Disability Insurance (SSDI) program. This is a program whereby people who work have money taken out of their paychecks, along with their state, federal, and, sometimes, local income tax, and that money is put in a disability fund. In the event that they become disabled and apply for benefits, if they have paid enough money into the system, they can collect benefits, assuming they are found disabled.
In a recent case from the U.S. Court of Appeals for the Tenth Circuit, a claimant was denied for what is known as Supplemental Security Income (SSI) benefits. The U.S. Social Security Administration (SSA) runs this program, as they do with the Social Security Disability Insurance benefits program, but this program is not for people who have worked and earned credits to qualify for SSDI benefits.
This program is designed to provide a financial benefit to disabled children, elderly, and blind individuals who have not worked enough to have paid into the SSDI benefits fund. If we think of SSDI like a private disability insurance policy, paying taxes each month is the equivalent of paying one’s premium. If you do not pay the premium, you do not have the coverage. It should be noted that, unlike the SSDI program, with Supplemental Security Income, the household income is taken into account, because this program is only available for people who fall below the federal poverty threshold.
In this case, the claimant applied for Supplemental Security Income benefits from SSA in 2010 after becoming disabled about five months earlier. Her initial application was rejected, and she applied for reconsideration. This is done either by filling out a rather complex application or by completing a series of questions on the SSA benefits online system. These days, it is much more common for people to apply online.
However, her request for reconsideration was also rejected. As our Boston SSI benefits lawyers can explain, this is very common, as the vast majority of applications are initially rejected and then denied for reconsideration without much to regard to whether the claimant is disabled or not. The reason for this is because the agency is constantly running short on money. While denying applications for no reason is not official policy, the claims agents are expected to deny the vast majority of all applications.
In this case, when she finally had a hearing before an administrative law judge (ALJ), the ALJ noted that there were not reports by any doctors submitted on behalf of the claimant. When ALJ asked about this seeming lack of evidence, claimant informed him that she had spoken with her treating physician, and he was preparing a report for the judge that would be available very soon. He said that he would not issue his final findings until after claimant had time submit the report from her doctor. Instead, he issued his finding and denied her claim for benefits without ever seeing this report. Claimant appealed.
On appeal, the court reversed the ALJ decision on grounds that the judge was required to hear evidence from the complainant and her medical records and thus did not have sufficient facts in the record to make such a finding.
If you or a loved one is seeking Social Security Disability Insurance in Boston, call for a free and confidential appointment at 1-888-367-2900.
Vallejo v. Berryhill, March 14, 2017, Untied State Court of Appeals
More Blog Entries:
SSDI Appeal Results in Affirmation of Denial, Feb. 15, 2017, Boston SSDI Attorney Blog