Claimant Advocacy and Supportive Services
Dr. Zabian Crosby, D.H.Ed.
Emory Long, J.D.
What is COOFIA?
The California Office Of Federal Insurance Advocacy (COOFIA) is a regional collaborative of attorneys, educators, government employees, business executives and private citizens who have witnessed the corruption in the federal insurance benefits system and provides assistance to citizens facing tumultuous challenges at a time when they are most vulnerable and in need of help. Professional disability advocates have extensive knowledge of the complexities of the Social Security Administration and the overwhelming difficulties presented by the federal judiciary in meting out real justice against a monolithic system that is in dire need of change.
Who are Disabled Veterans?
From the State of Vermont Office of Veterans Affairs:
“Some disabled veterans run Fortune 500 companies; some disabled veterans will never be able to work again. Some disabled veterans run in marathons; some disabled veterans need help performing daily life functions, like eating or bathing. In other words, disabled veterans come in all ranges of abilities. Many disabled veterans do not consider themselves disabled, nor do they meet our society’s definition of disabled. The stereotype of someone in a wheelchair or missing a limb isn’t an accurate description of the vast majority of our nation’s disabled veterans....Specifically, a disabled veteran is someone who has applied for disability benefits from the VA and had their application approved.”
http://veterans.vermont.gov/benefits-and-services/veteran-benefits/va-disability
Dr. Crosby’s comments about disability claims and preventable death:
“These deaths may not be directly caused by the disabling condition(s), but rather through lack of financial resources to sustain life. This, combined with the illnesses that prompted the claim in the first place, may be overwhelming to the claimant, resulting in preventable death.”
Disabled Americans are Conservatives’ New “Welfare Queens”
Center for American Progress:
FACT: “Nearly 80 percent of applicants are denied at the initial level, and fewer than 4 in 10 are approved after all levels of appeal. Underscoring the strictness of the disability standard, thousands of applicants die each year while waiting for benefits. And one in five male and nearly one in six female beneficiaries die within five years of being approved for benefits. Disability Insurance beneficiaries have death rates three to six times higher than other people their age.”
What do you think?
Dr. Crosby’s comments regarding Social Security Disability Insurance and Fraud:
“The Government Accountability Office (GAO) reported as of 2013 that less than 1 percent of all SSDI payments can be attributed to fraud. Social Security has rigorous fraud detection systems in place to minimize and prevent fraudulent payments. While no program is perfect, the notion of a disability ‘free-for-all’ remains a myth.”
COOFIA Claimant Advocacy: Social Security Self-Defense Guide
COOFIA Disability Fact:
Did you know that you might be eligible for disability benefits even if you worked during a period of claimed disability? If you worked for a period of six months or less and had to stop working due to a medical condition, you are eligible for benefits during the same time frame. This is called an Unsuccessful Work Attempt and is allowed under SSA rules and guidelines in determining the onset date of disability. However, claimants should be wary of administrative law judges and SSA attorneys in federal court who may obscure this fact and use the same period of work to cast doubt on the integrity of claimants. Before you complete an application for disability you should carefully consider the onset date and any unsuccessful work attempt, as you will have to defend this decision in an ALJ Hearing and/or in federal court. Contact COOFIA for more information and assistance in filing a claim.
COOFIA Disability Tip:
Beware of seemingly neutral statements such as this one:
“ODAR directs a nationwide field organization of administrative law judges (ALJ) who conduct impartial “de novo” hearings and make decisions on appealed determinations involving retirement, survivors, disability, and supplemental security income benefits.” (SSA, n.d., p. 1)
We see two problems with this statement that are inherently misleading:
1- ALJ hearings are not “impartial”. All ALJs are employees of the Social Security Administration, with a vested interest in limiting the number of claims approved.
2- ALJ hearings are not conducted “de novo”. By the time the claimant appeals for an ALJ hearing, the SSA has compiled years of information to be used against the claimant by the agency. This means that the ALJ is not looking at the claim with a fresh perspective, but based upon the statements and recommendations of other SSA staff who have observed the claimant and made notations as to why the claimant should not receive benefits.
COOFIA strongly encourages claimants to seek professional assistance before attending an ALJ hearing.
COOFIA Disability Fact:
Bacterial infections of any kind are serious medical conditions that can prevent gainful employment. The prevalence of infection has led to antibiotic resistance in many cases, which can quickly become a life-threatening illness.
FACT: Bacterial and fungal infections are included on Social Security’s list of impairments, which automatically qualify a claimant for benefits. All that is required is medical diagnosis of the infection, and symptoms that do not dissipate after three months of treatment.
If you suffer from a persistent bacterial or fungal infection, we encourage you to seek immediate treatment, and then to contact COOFIA for assistance with your claim for benefits.
COOFIA Disability Fact:
Nine years in court fighting for disability? TRUE. But only if you live long enough to collect- and can afford the cost of litigation.
FACT: “Efforts to collect disability payments often turn into legal battles that critics say are stacked against the claimant. The agency denies an average of two-thirds of applications from low-income individuals who are disabled and more than half of claims submitted by disabled workers. And some administrative law judges are far less likely than others to approve claims.” (Wenger, 2012, p. 1)
COOFIA Legal Factoid:
Federal Judge Carolyn K. Delaney States VA and SSA Programs Serve Same Purpose, ALJs Should Not Automatically Dismiss VA Determinations.
http://ca.findacase.com/research/wfrmDocViewer.aspx/xq/fac.20121030_0014845.ECA.htm/qx
COOFIA Review Rating:
Beware of seemingly helpful statements such as this one:
“Arguably the most important part of the agency review process is the step after the initial application that was denied, when a claimant is entitled to a hearing before an administrative law judge (ALJ). An ALJ is a Social Security Administration employee who takes a fresh look at the application after considering live testimony and any newly submitted evidence.” (Babut Law Offices, 2013, p. 1)
We find at least two problems with this statement:
1- The first sentence is inaccurate: The step after the initial application has been denied is Reconsideration, not the ALJ Hearing. A claimant may not request a hearing until he or she has first requested reconsideration of the initial determination.
2- The second sentence is also inaccurate: Contrary to popular belief, the ALJ does not take a “fresh look” at the testimony and newly submitted evidence. The ALJ relies heavily upon the documentation assembled by SSA staff prior to the hearing, and in some cases, even makes medical determinations without physician review of the medical records.
Before you select a disability attorney, make sure that he or she is well versed in SSA procedures to give you the best chance of winning your claim.
*COOFIA Rating: 1 of 4 stars
COOFIA Legal Factoid:
FindACase™ is designed to be used by non-lawyers, small businesses, pro-se litigants, part-time lawyers, schools, colleges, libraries, publications, and activists for legal research across a wide range of topics and jurisdictions. FindACase™ is a product of VersusLaw, Inc. and uses the same powerful search engine and extensive libraries.
COOFIA Disability Tip:
ALJ abuse of power is more prevalent than commonly disclosed. A sweeping class action settlement was implemented in the New York area after five administrative law judges were found to have wrongfully denied thousands of claimants of disability benefits.
COOFIA representatives are familiar with the signs of ALJ abuse of power- contact our office before you attend an ALJ Hearing.
Dr. Crosby Comments on Fraud, Waste, and Abuse:
“According to the Government Accountability Office (GAO), less than 1 percent of all disability payments can be attributed to fraud. The idea of SSDI as a welfare system for those who are lazy and unwilling to work is a perception issue as well as a misconception that in recent years have been promulgated by the media. When the facts do not match the statements presented, the statements amount to nothing more than propaganda in order to mask the true situation. The Social Security system is a necessary and useful tool in preventing destitution for millions of Americans who are retired or too sick to maintain employment.
“Eligibility for SSDI first requires that these persons have worked and earned enough work credits to meet initial eligibility. Therefore, by definition, these applicants cannot be discounted as “lazy”. The real fraud and abuse occurs more often than not within the agency by allocating massive amounts of funding for employee social functions and staff bonuses to deny claims. Eliminate the internal abuse of Social Security funds and the problem becomes less pervasive.”
Note: Facts regarding SSA waste and abuse of funds, and the stigmatization of claimants filing for disability, are discussed in Chapter 1 of the Social Security Self-Defense Guide by COOFIA Publications. Be sure to obtain your copy so you can know the facts and be better prepared should you find yourself filing a claim for benefits.
COOFIA Disability Tip:
Sometimes in the course of medical treatment, a patient may develop a second illness or injury that was caused by treatments provided to alleviate the initial ailment. Secondary illnesses may also be disabling conditions, which is why it is important to have a comprehensive review of all of your signs and symptoms, in order to establish a history of disease, and not merely isolated incidences of sickness and improvement of symptoms.
Contact COOFIA to find out how secondary illnesses could increase your chance of winning your SSI/SSDI claim. Also be sure to ask about the Social Security Self-Defense Guide for Claimants.
COOFIA Asks: “Why is it so difficult to qualify for disability?”
Response from Logan Wimer, Disability Program Navigator:
“Unfortunately, the system is adversarial and designed that way intentionally so that only those who persist and are consistent are those who receive any assistance. The belief is that only those who are of the deserving will stay…. SSA does not train their staff well or sometimes at all. The laws for it (Red Book) change each year and the staff are frequently not current with the changes in the law each year.”
For qualified assistance with your claim, contact COOFIA for a no-cost consultation.
Dr. Crosby Advises: Social Security Consultative Examinations
SSA regulations require ALJs to consider all of the medical evidence as a continuum of care, and not as isolated events. Further, where a claimant has a history of care by a treating physician, the opinions of the treating physician are assigned greater value than that of a non-treating physician who has only observed the claimant and not treated the claimant. A Consultative Examination is a one-time evaluation by a hired contract physician of the SSA that lasts for a duration of approximately 15 minutes. It is not possible to establish complete medical history, diagnosis, and prognosis when compared with years of treatment notes by claimant’s physicians. CE doctors may be qualified to tell you what is “not” wrong with you (as in the ability to stand up, sit down, move your arms, and turn your head), but they are deficient in testing and treating for conditions that go beyond dexterity and include internal illness, along with reporting how the illness began, how to treat the illness, the side effects of medications used to treat the illness, how long the illness will last, and any occupational adjustments that need to be made during and after treatment.
http://www.disabilitysecrets.com/resources/should-you-trust-social-security-disability-doctor.htm
Fraud, Waste, and Abuse
From the Social Security News Blogspot:
“It’s also worth noting that San Francisco Regional Commissioner Pete Spencer apparently did not receive any award money in Fiscal Year 2010. Spencer sponsored “Management Tango” in 2009, an event that cost more than $675,000 and generated a great deal of bad publicity for Social Security....Spencer recently announced his retirement from the agency.”
https://socsecnews.blogspot.com/2011_10_01_archive.html#.TzIviDykjBc.email
About COOFIA Membership
COOFIA assists disability claimants nationwide. As such, we welcome new professionals who want to join our team. If you are interested in becoming a disability advocate, please contact our office. There are many opportunities within our organization to assist regionally, giving you the ability to make a difference in your local community. When contacting our office, please provide your resume or curriculum vitae along with a brief introduction letter stating why you want to serve as a disability advocate. The California Office Of Federal Insurance Advocacy believes in equal opportunity for all citizens, and does not discriminate on the basis of age, gender, race, ethnicity, orientation, religion, or disability.
