STL News reports that there are efforts underway to reduces backlogs in the St. Louis and Creve Couer Offices. “The agency has begun making offers to 144 of the 175 new welcome any efforts to help those who are suffering due to delays.The hiring of these new ALJs is a critical step in our plan to reduce the backlog of disability cases,” Commissioner Astrue said.  “They represent one of the largest investments in ALJs this agency has ever made.  When these ALJs are fully-trained, and combined with the other steps we are taking, we will be able for the first time in this decade to reduce the number of cases waiting for a disability hearing.  I can hardly wait for them to start.” As a social security disability attorney, I can’t be sure how soon the effects will be felt, but atleast I can tell my clients that something is being done.

STL News reports, “The new ALJs will be brought on board in phases with the first hires reporting for duty in April, when they will begin an intensive orientation and training program.  While initially handling a reduced docket, newly hired ALJs should be scheduling a full docket of cases by the end of the year.” We can only hope so.

This is an interesting case which states that Social Security Judges cannot act as doctors in denying a social security claim.
FREE CONSULTATION 314-481-7778

Social Security: Denial Of Benefits – Mental Disability – Medical Noncompliance

Pate-Fires v. Astrue (MLW No. 59069/Case No. 07-3561 – 22 pages) (U.S. Court of Appeals, Eighth Circuit, Bye, J.)

Where an administrative law judge denied the application for disability benefits and supplemental security income of a claimant with mental impairments based on his determination that she could perform her past relevant work as a retail store stocker, the medical evidence proved that the claimant suffered from a severe mental impairment and could not engage in gainful employment, and the ALJ’s contrary conclusion was not supported by substantial evidence because the claimant’s treating doctor found her to be disabled and the ALJ improperly disregarded the doctor’s opinion based on his own conclusion that the claimant’s drug use and refusal to take her medicine precluded a finding of disability.
Judgment is reversed and remanded.

‘Playing doctor’

“The ALJ’s conclusion Pate-Fires’s medical noncompliance was not justifiable and precludes a finding of disability is not supported by substantial evidence. Further, the ALJ’s determination Pate-Fires’s medical noncompliance is attributable solely to free will is tantamount to the ALJ ‘playing doctor,’ a practice forbidden by law.”

Improper basis

Dissenting opinion by Shepherd, J.: “I respectfully dissent from the majority’s conclusion that remand for an immediate award of benefits is the appropriate remedy in this case. At step four of the sequential evaluation process, the ALJ decided that Pate-Fires retained the residual functional capacity to perform her past relevant work ‘The majority finds that the ALJ reached this step-four conclusion in error. Specifically, the ALJ relied on an improper basis to reject Dr. Erby’s opinion, and substantial evidence did not support the ALJ’s conclusion that Pate-Fires’s medical noncompliance precluded a finding of disability’ To the extent the majority’s decision to reverse the judgment of the district court is based on these errors in the ALJ’s step-four analysis, I concur.”

Judgment is reversed and remanded.
y claim.

Font SizeA A A Spinal fusion (arthrodesis)
Spinal fusion (arthrodesis) is a surgical procedure that joins, or fuses, two or more vertebrae. Spinal fusion is major surgery, usually lasting several hours. There are different methods of spinal fusion.

Bone is taken from the pelvic bone or obtained from a bone bank. The bone is used to make a bridge between adjacent vertebrae. This bone graft stimulates the growth of new bone.
Metal implants are secured to the vertebrae to hold them together until new bone grows between them.
What To Expect After Surgery
You will need to be watched in the hospital for a few days after spinal fusion surgery.

Bed rest is not usually necessary during your recovery period at home.

Your doctor may recommend that you wear a back brace during recovery.

Rehabilitation can be a prolonged process and includes walking, riding a stationary bike, swimming, and similar activities.

Why It Is Done
Spinal fusion may be done by itself or in combination with decompression to treat painful symptoms caused by misalignment or instability of the vertebrae, such as spondylolisthesis.

Spinal fusion may also be done as a follow-up to decompression and debridement procedures done to treat spinal stenosis, herniated discs, spinal injuries, infection, tumors, and deformities.

How Well It Works
This surgery was originally developed as a way to stabilize the spine and treat deformity or fractures of the spine. Its use has now spread to treatment of degenerative bone or disc changes and spinal stenosis. 1

Spinal fusion is often necessary to stabilize the spine after a traumatic injury, infection, or tumor. There is no solid body of research supporting the effectiveness of spinal fusion for various other spinal conditions. One study showed no clear difference between spinal fusion surgery and intensive rehabilitation for treating chronic low back pain. 2 In addition, the surgery is expensive and has significant risks. Therefore, although this type of surgery is common, it is controversial, and there is no guarantee of treatment success.

Risks
The risks associated with this procedure vary depending upon your age and overall health, diagnosis, and the type of procedure that is done.

Spinal fusion procedures frequently cause other problems. Risks include:

Pain at the bone graft site.
Failure of the fusion process and/or breakage of metal implants.
Deep venous blood clots that may also lead to pulmonary embolism.
Nerve injury.
Graft rejection.
Superficial infection.
Deep infection.
What To Think About
Because there are so many things to consider when spinal fusion is recommended, seek a second opinion before making a decision.

Complete the surgery information form (PDF) (What is a PDF document?) to help you prepare for this surgery.

Citations
Deyo RA, et al. (2004). Spinal-fusion surgery-The case for restraint. New England Journal of Medicine, 350(7): 722–726.

Fairbank J, et al. (2005). Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: The MRC spine stabilisation trial. BMJ, 330(7502): 1233–1239.

Author Shannon Erstad, MBA/MPH
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer William M. Green, MD – Emergency Medicine
Specialist Medical Reviewer Robert B. Keller, MD – Orthopedics
Last Updated February 6, 2008
WebMD Medical Reference from Healthwise
Last Updated: February 06, 2008
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

Back Pain Health Center

Font Size  Below is a great article about making the decision whether or not to have surgery.  JEFF SWANEY FREE CONSULTATION 314-481-7778

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Interactive Tool: Should I Consider Surgery for My Low Back Problem? – What does this tool measure?

Click here to find out whether surgery may help reduce the symptoms of a back problem.

This interactive tool will not diagnose a back problem, but it will tell you whether surgery might help reduce or get rid of symptoms related to your low back problem. There are always risks with any surgery, so most people don’t want to have surgery unless there is a very good chance it will help them. Although research shows that surgery is very likely to be effective for some problems, it rarely helps with others.

This tool will help you find out whether your own low back problem might be helped by surgery. After you use this tool, you can show the results to your doctor when you talk to him or her about surgery and your other options.

This tool is not meant for people in emergency situations. Talk to your doctor immediately if you have any of the following problems:

• Bladder and/or bowel problems, including not being able to go to the bathroom as you normally do or not being able to control bowel movements or urination
• Loss of feeling or rapidly decreasing feeling over your feet and heels or in your “saddle area,” which includes any part of your body that might touch a saddle if you were on a horse, including your buttocks, your inner thighs, and the backs of your legs
• Increasing pain, weakness, numbness, or problems with coordination in one or both legs
• A fever for 2 or more days
• A serious injury, an accident, or a big fall in the last 2 weeks
• A history of spinal stenosis
• A history of cancer

Obama: Entitlement Changes Key To Budget Health
Obama Says Social Security Disability Part Of Broad Review Of Entitlement Programs

RIO RANCHO, N.M., May. 14, 2009
E-Mail Story
Print Story
Below is a recent article regarding the possibility that disability benifits may soon increase.

(AP) President Barack Obama says he likes the idea of increasing income limits for those receiving Social Security disability payments, but also says it costs money.

Obama on Thursday told a town hall-style meeting in New Mexico that he is open to giving federal disability payments to more people. But he said it has to be part of a broader review of government entitlements, such as Medicare and Medicaid.

He says changing entitlement programs is a major piece in his plan to rein in federal spending. He says his team is going through the budget line by line to eliminate waste.

Obama says that disability claims have gone up during the economic downturn.
submitted by Jeff Swaney FREE CONSULTATION 314-481-7778

(CBS) This is the first part of a CBS News investigation into Social Security disability benefits.

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Below is an article from CBS News investigating the Social Security System. St. Louis Lawyers and their clients know the problems all to well.I hope you find the following to be informative.
Each year, millions of people who are disabled from an accident or disease turn to the federal government for Social Security disability payments – a benefit that every worker who is declared disabled is eligible to receive. It’s a 51-year-old government insurance program – a lifeline of sorts – that every worker pays for through that line-item on their pay stub, known as FICA.

But a two-month CBS News investigation reveals that safety net may not be there when you need it most.

“I always figured that I’d die in a fiery car wreck or something, never that I’d be disabled,” 33-year-old Scott Watson told CBS News chief investigative correspondent Armen Keteyian.

Two years ago, a failed surgery left Watson with a fracture in his spinal cord. It turned his life upside down, leaving him unable to work in his job as a broadcast engineer.

“Everybody says, ‘You gotta have a positive attitude,’” Watson said. “You know, and I say, ‘Well, I am positive. I’m positive this is the end,’ you know. I mean it’s not going to get better.”

Declared disabled by the state of Maryland, Watson was told he was “shoo-in” when he applied for federal disability last year, only to be turned down three months later on the grounds, according to federal guidelines, he wasn’t disabled enough. Watson appealed, and was denied again.

He’s one of 27,000 Maryland residents – 68 percent of all those who applied – to suffer such a fate.

Overall, two out of every three people who apply for federal disability benefits are rejected by a government agency that critics say is out of date, underfunded, and incapable of serving the exploding number of disabled Americans. Waiting times for a hearing in some cities are more than three years.

Linda Fullerton, an advocate for the disabled, told Keteyian: “I have people all the time writing to me, saying they are suicidal.”

Fullerton’s online support site is home to one horror story after another.

Reading from emails, she said: “Had to file bankruptcy to keep home. Losing home with four children.”

A two-month CBS News investigation has found that over the last two years, at least 16,000 people fighting for disability benefits died while awaiting a decision.

Overall, the backlog of cases now stands at 750,000 – up 150 percent since 2000.

People wait an average of 520 days for a hearing on their claims.

People like Jerry Rice, who calls an abandoned tool shed home. When we found Rice, who suffers from mental illness, he’d been waiting for three years for his day in court.

“So. Jerry, this is how it ends up for you?” Keteyian asked.

“This is how it is,” Rice replied. “I hope it’s not how it ends up.”

But he believes he deserves the disability?

“I’m not asking them to give me welfare,” Rice said. “I’m just asking them to give me what they promised. Yeah, I deserve it.”

“It’s a mess from the time you apply – till the time you get a hearing,” said attorney John Hogan, who has represented thousands of folks in Atlanta, the backlog capital of the nation.

“We’re the furthest behind of any area of the country, it could take 2.5 years to get your hearing,” Hogan said.

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When someone becomes disabled, starting the process of filing for Social Security Disability benefits can be overwhelming.  You should expect to fill out numerous forms and questionnaires.  You can start the process in one of two basic ways.  You can look up the site for the Social Security Administration and begin your application online.  For some, this may be preferable because it gives you time to think and carefully consider your answers to the questions that are being put forth. 

On the other hand, you may decide that you would prefer to go to the local Social Security office and have someone assist you with your application.  This may result in some inconvenience and you may end up waiting for quite some time before you are helped.  You may also feel rushed, but if you have a good assistant working with you, then you may ultimately be glad that you took the extra time.  At some offices, you can call ahead in order to schedule an appointment.  This may be preferable to just walking in and catching an assistant who isn’t having a good day. 

Once you have filed the application, one of the problems is that no one seems to be directly responsible for your claim.  You can contact the Social Security Administration and you will likely talk to a number of different people.  While many of these individuals will do the best that they can in order to be helpful, they are basically looking up information on a computer and they are usually not personally familiar with your case.  One thing to keep in mind, the individuals who are helping in the application process are not the decision-makers when it comes to your case.  Frustrated individuals often want to blame the assistant who is helping them .  The decision-makers at the initial stage of review are insulated from contact and the people who are on the front lines are simply trying to give you status information which they may be finding on their computer. 

If your case is denied initially, it is important that you understand that you have 60 days in order to file an appeal.  At this stage, you can obtain a face-to-face hearing with an Administrative Law Judge who will give your case a fresh look.  You may decide to go it alone, or you can obtain the services of an experienced attorney.  If you win, you may be drawing disability benefits for the rest of your life.  It seems that going it alone perhaps means that you can save yourself a little money if you are successful, but if you lose, you may be forfeiting years of benefits which you would have obtained if you had a better understanding as to how to present your case.

When you enter the Social Security office, you should be prepared to provide them with a list of all of your doctors and hospitals, including their addresses and the reason that they are treating you.  The disability examiner will ultimately want to request all of these records.  If you have a good relationship with your treating doctors, you should tell them to expect requests for information and perhaps a disability questionnaire from the Social Security Administration.  Your doctor should understand that the Social Security Administration will be interested in the work restrictions which he provides.  You can also offer lay evidence which might consist of letters from friends, or a letter from your former employer. 

I know that the intitial paperwork can be overwhelming, but do not put off filing your claim because you may have to wait a considerable amount of time before a decision is made.

Submitted by:     Jeff Swaney

Free Consultation:  (314) 481-7778

At our office, we typically meet with individuals after their disability has been denied by the government.  We will usually set up an initial appointment in order to go over all of the pertinent information regarding the individual’s claim.  As an attorney, my starting point is looking at the denial.  This gives me information as to the basis of the government’s denial of the claim and it tells me whether the only issue is disability, or whether there are other issues such as eligibility for benefits.  In the initial interview, I  like to find out the names of all of the treating doctors and hospitals and I can then compare the decision that was made by the government in order to see whether they have obtained all of the records, or whether there may be important missing records. 

By the end of the initial interview, I have made a determination as to whether the case is winnable and what the appropriate strategy is going to be.  We will then file our Request for Hearing, along with some other forms which are required by the Social Security Administration.  We additionally take a look at whether other records need to be requested and we attempt to obtain a copy of the Social Security Disability file which is now on a computer disk. 

Eventually, the case will be set for a hearing.  There is usually between 30-90 days notice and we like to set up another appointment in the office in order to go over all of the questions that are likely to be asked and to further plan strategy. 

In some cases, we will find individuals who, because of their financial circumstances, have not been seeing any doctors regularly.  We may recommend medical services through a facility that treats low-income individuals.  This may help to provide us with further evidence of the individual’s disability.  As a lawyer, when I prepare an individual for their hearing, I need to make sure that their testimony is consistent with every form that  they have ever signed, questionnaire they have filled out, and every statement that they have made to a doctor.  Sometimes there will be statements that appear on the surface to be contradictory, but really aren’t.  For example, I recall one client who said that he would walk 45 minutes at the mall for exercise.  However, upon further questioning, he did so by breaking up his walk into 10 minute segments and was normally out of breath and in pain by the time he finished.  He was determined to try to do his best to get some exercise, but he suffered greatly.  It is important to get your arms around these apparently contradictory statements which simply need to be further explained. 

Finally the big day comes when the case is set for hearing.  There are two main offices in the St. Louis area.  One is located in Creve Coeur and the other office is in downtown St. Louis.  You will be assigned a judge and each judge has their own record and reputation in terms  their approval rates.  Each judge also has a different style in terms of the approach that they may take under differing circumstances.  A lawyer who is familiar with the reputations of the various judges will have a better chance of knowing how to present your case.

Some judges will take control of the hearing by starting out with questions that they want to have answered first.  Other judges will allow the attorney to approach the case based on the format that he or she has set up with his client.  Still other judges will let the attorney lead off with the questions, but will frequently interrupt with questions of their own.  As an attorney, I prepare differently based upon which type of judge I am going to encounter.

The determination as to which judge is assigned to your case will not be determined until you receive your hearing notice. Sometimes a judge may be ill or other circumstances may occur which cause a last minute reassignment. As an attorney, it is important to be able to quickly readapt.

During the course of the hearing, a Hearing Assistant will be recording everything that is said on a tape recorder.  Just like anywhere else, judges vary in friendliness, temperment, attention to detail, and their desire to take in testimony.  As an attorney, I find that it is important to recognize that the judge’s time is important.  Being prepared helps the judge because it results in efficiently presenting sharp, crisp, clean testimony.  Unprepared testimony often sounds rambling and unfocused and it is difficult for a judge to get his or her arms around testimony which is undefined and sloppy.  Expect that the judge will most likely want to hear all of the testimony within a 30 to 40 minute period.   If time allows, there may be room for some additional elaboration and some hearing may last for about an hour and a half.  Your attorney should be able to explain to you what the basic strategy is with respect to trying to win your claim.  A judge does not want to hear everything about you, but only what is important.  Minor “problems” such as broken toes and fingers, or, for example, frequent nasal congestion, should be left out in order to make time for things that matter. 

Most judges will not say how they are going to rule at the end of the hearing.  There are occasions when a judge may seem negative, but will ultimately rule in your favor.  There may be other cases where the judge seemed friendly, but didn’t think that your claim warranted approval.  There are also some instances in which a judge will take time at the end of the hearing to tell the claimant that he is going to approve the claimant’s case.  This is done in order to alleviate anxiety on the part of the claimant.  There are also cases where the judge may be on the fence and wants to thoroughly review all of the evidence and exhibits before making a final determination. 

Whenever a judge finally rules on your case, there will be a decision in writing that will be mailed to you and your attorney.  The decision can either be fully favorable, partially favorable, or it could be a denial.  A partially favorable decision often occurs in cases where the judge finds that there may be a long period of disability, but ultimately believes that the claimant recovered and is capable of working.  Whenever you get your decision, you should contact your attorney in order to make sure that you understand the judge’s ruling. 

Submitted by:    Jeff Swaney

Free Consultation:    (314) 481-7778   �CBS NEWS STORY ABOUT SOCIAL SECURITY DISABILITY
 http://www.cbsnews.com/video/watch/?id=3713125n

Many individuals who contact my office are severely disabled, but are working when they contact me.  They often have questions as to whether or not they can work and collect Social Security Disability benefits.  The purpose of this article is to address that question. 

First of all, you cannot be working full-time, regardless of how disabled you are, and receive Social Security Disability benefits.  By virtue of working full-time and earning a significant income, you are proving that you are not disabled.  In order to have a chance to recover Social Security Disability benefits, you must either stop working, or have your hours reduced.  We do not recommend reducing your hours just to apply for benefits, but this should only be done by those who truly are disabled.  However,there are many individuals who may damage their health if they continue working and there are others who are so disabled that they risk further injury. 

Under the present law, a person can work as long as their income is not defined as “substantial gainful activity”.  If you earnless than $980.00 a month before taxes in 2009, you can apply and potentially receive Social Security Disability benefits.  If you are earning more than the amount which Social Security defines as substantial gainful activity, regardless of how severely disabled you are, then you  will not be eligible for benifits.  The amounts that Social Security defines as constituting substantial gainful activity can change from time to time.  Consequently, it is important to check with the Social Security Administration in order to make sure that you are under the appropriate amount.  In fact, you can continue working, even while you are on disability, provided that you do not exceed the amount that you are allowed to earn. 

It should be understood, however, that the Social Security Administration can look at the type of work that you are doing in order to determine whether they believe you are disabled.  If you are working ten hours a month, but you are a jackhammer operator, they may contend that your work is rigorous and is inconsistent with your claim.If you work full-time, but for a short period, a judge may classify this as an “unsuccessfu work attempt.” 

If you decide that you are going to reduce your hours, or leave your employment, you must keep in mind that it may be quite some time before a decision is ultimately rendered in your case.  If the decision is favorable, then you may have gone through a lot of financial hardship, even though you will eventually begin receiving benefits.  On the other hand, Social Security operates by stringent standards and, if you are not approved, you may never be in a position to make up the lost income which you received. 

Submitted by:    Jeff Swaney

Free Consultation -  (314) 48l-7778

�

As an attorney handling Car Accident Injury cases, “Work Comp” cases and Social Security Disability claims, I find it challenging to balance the demands which are made on my time.  First, it is important to accomplish results.  As an attorney, you may be a nice guy, but you were hired to accomplish the best possible result for your clients.  This requires meticulous attention to detail.  Every day pages and pages of medical records run across my desk for review.  In addition, time needs to be made to think through a game plan for determining how each case needs to be approached.  You must be more prepared than your opponent, and not paying attention to detail can cause heartache to an attorney, or perhaps, even worse, a heart attack!  Also, a lot of time must be spent when legal research needs to be done.  Secondly, time has to be spent reading and keeping up with developments in your field because the law is constantly changing and being reinterpreted by the courts.  When you meet with someone, they aren’t interested in what the state of the law was six months ago, they want to know how good their case is now.   Thirdly, it takes time to manage your own personnel,  to make sure that you are complying with all of the requirements of running a law office, and to evaluate the directions and trends in your field.  After all, you must manage people, pay their salaries and benefits, pay your taxes and make sure that you are in compliance with numerous requirements of running a law office.  Fourthly, you must allow time for evaluating new cases and meeting with new people.  Unfortunately, what is often missing is giving personal attention to clients.  There is no easy way to put the “personal“ back in personal injury claims.  It requires a consistent effort to take time out of every busy day in order to report back to the people who are placing their trust in you.  Any true personal injury attorney will only get this done working long days, including weekends.  In short, the only way to put the personal in personal injury  is through dedication and hard work.  Come to think of it, this is no great secret and it is the common ingredient in all successful businesses.  So the question is “Is your attorney too busy to call you back?” Submitted by Jeff Swaney FREE CONSULTATION 314-481-7778