Social Security Proposes to Tighten Rules on Disability Appeals

Posted Date: March 11th, 2014 | Categories: Social Security Disability

The Social Security Administration, under pressure from Congress, is moving to tighten rules that would require people applying for disability benefits to present the government with all relevant medical information – even if it says they can work.

The proposal, recently published in the Federal Register, was made in response to a 2011 Wall Street Journal article that revealed officials at a large national disability firm would often withhold certain information that might prove detrimental to their client’s case.

“There have been allegations that when some representatives submit evidence to us, they deliberately withhold evidence they deem unfavorable to the claimant,” the SSA wrote in its proposal. “We also know, based on our program experience, that we do not always receive complete evidence.”

The agency’s new proposal would require people to submit “all evidence known to you that relates to whether or not you are blind or disabled. This would include evidence that may be either favorable or unfavorable to your claim.”

The agency put the legal burden on the person applying for benefits, not the person’s legal representative. This could be one way of avoiding challenges based on attorney-client privileges, for example.

Applying for Social Security disability benefits is complex. If a person applies, their initial request is decided by a state agency, which can approve or deny the case. If the person is denied, they can reapply with the state agency, and then eventually request a hearing with a Social Security judge.

The process with the Social Security judge is equally complex. The judge is responsible to “develop the record,” which means he or she must collect the medical evidence needed to decide the case.

Often, these judges are under pressure to decide multiple cases a day and so they peruse whatever records are submitted by the person applying for benefits before making a decision. Judges can seek more information, but they often do not because they would have a hard time knowing which doctors or hospitals to subpoena if they wanted more files.

There has been major disagreement in the legal community in recent years as to whether lawyers representing people seeking benefits were required to submit “all” the medical information to these judges, or just information that would help their client win benefits.

Federal law suggests that all information must be required but the agency backtracked on this requirement several years ago under pressure from the trade group that represents the disability law community. Some lawyers have said their ethical obligation is to help their client win the case.

The SSA has asked for feedback on their proposal, and it could make changes in the coming months. The SSA gets bombarded with applications for disability benefits, fielding 3.2 million applications in 2012 and 820,000 requests for hearings.

Contact the Jones Law Group, LLC at (614) 545-9998 if your SSD claim was denied for free consultation.

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