News, Disability Fund Is Running Out of Money—Fast (social security, federal, states)

[John1960]

If no changes are made, the Social Security Disability Insurance fund will run dry in four to seven years, according to government auditors. The Wall Street Journal takes a look at some of the reasons why, focusing at length on Puerto Rico, one of the easiest places in the US to go on disability.

Last year, 63% of applicants there were approved. The fact that US states and territories have such a large say in who is approved is one of the main problems with the SSDI system; unlike Medicare or Social Security retirement benefits, SSDI benefits are doled out largely based on doctor’s opinions, not age, making the selection process inconsistent.

Disability Fund Is Running Out of Money—Fast - Without changes, could be insolvent within 4 to 7 years

[livecontent]

Originally Posted by John1960

If no changes are made, the Social Security Disability Insurance fund will run dry in four to seven years, according to government auditors. The Wall Street Journal takes a look at some of the reasons why, focusing at length on Puerto Rico, one of the easiest places in the US to go on disability.

Last year, 63% of applicants there were approved. The fact that US states and territories have such a large say in who is approved is one of the main problems with the SSDI system; unlike Medicare or Social Security retirement benefits, SSDI benefits are doled out largely based on doctor’s opinions, not age, making the selection process inconsistent.

Disability Fund Is Running Out of Money—Fast - Without changes, could be insolvent within 4 to 7 years

Wrong, Disability evaluation is not "based largely" doctor's opinion. It is a violation of regulation that your doctor be asked for his opinion. His opinion, if given, cannot be taken, as the sole evidence, in ascerting the disabilty evalution of the applicant. All determination are done by the Disability Determination Service for their specific jurisdiction by their own medical authorities and their own evaluation of many factors, including age, education etc. Age is not the primary measure of work related disability. It only becomes a part of the evaluation of the applicants ability to work. The disability process is not inconsistent but must follow specific statutory regulations.

Livecontent

[texdav]

I am sure lie mnay things it wil be under goig a review as to its managemnt how thqat fundng will be under review.

[rational1]

Originally Posted by texdav

I am sure lie mnay things it wil be under goig a review as to its managemnt how thqat fundng will be under review.

Huh?

[jmking]

Originally Posted by livecontent

Wrong, Disability evaluation is not "based largely" doctor's opinion. It is a violation of regulation that your doctor be asked for his opinion. His opinion, if given, cannot be taken, as the sole evidence, in ascerting the disabilty evalution of the applicant. All determination are done by the Disability Determination Service for their specific jurisdiction by their own medical authorities and their own evaluation of many factors, including age, education etc. Age is not the primary measure of work related disability. It only becomes a part of the evaluation of the applicants ability to work. The disability process is not inconsistent but must follow specific statutory regulations.

Livecontent

You are correct liveconten. It's a very rigid system, for most it takes 2+years to receive if at all. Upwards to 90% of claims are rejected the first go round, most receive at least 2 two rejections. Each Appeal can easily take a year. Even if one receives SSDI it can still be overturned by review. And even if you do receive SSDI you stand to be re-evaluated every 3-7 years. I do not believe 63% of those who apply for SSDI are approved. If it was 63% last year what was the percent the year before or before that? Many Workman comp cases are asked to apply for SSDI (just in case and flooding the system) where majority do not follow through after the first rejection. My experiences has been you must prove beyond a shadow of a doubt that you can not work at all.

[kevxu]

Originally Posted by jmking

You are correct liveconten. It's a very rigid system, for most it takes 2+years to receive if at all. Upwards to 90% of claims are rejected the first go round, most receive at least 2 two rejections. Each Appeal can easily take a year. Even if one receives SSDI it can still be overturned by review. And even if you do receive SSDI you stand to be re-evaluated every 3-7 years. I do not believe 63% of those who apply for SSDI are approved. If it was 63% last year what was the percent the year before or before that? Many Workman comp cases are asked to apply for SSDI (just in case and flooding the system) where majority do not follow through after the first rejection. My experiences has been you must prove beyond a shadow of a doubt that you can not work at all.

Your comments reflect my experience with establishing qualification for SSD.

[jmking]

Originally Posted by kevxu

Your comments reflect my experience with establishing qualification for SSD.

One can be absolutely crippled and still must prove beyond a doubt over a span of time that "Hey, I'm in very bad shape here".

I wouldn't wish seeking SSDI on my enemy.

[lenora]

Originally Posted by livecontent

Wrong, Disability evaluation is not "based largely" doctor's opinion. It is a violation of regulation that your doctor be asked for his opinion. His opinion, if given, cannot be taken, as the sole evidence, in ascerting the disabilty evalution of the applicant. All determination are done by the Disability Determination Service for their specific jurisdiction by their own medical authorities and their own evaluation of many factors, including age, education etc. Age is not the primary measure of work related disability. It only becomes a part of the evaluation of the applicants ability to work. The disability process is not inconsistent but must follow specific statutory regulations.

Livecontent

Actually, I disagree. Although it is true that a physician's conclusory statement regarding disability is almost useless, the easiest way to win a disability claim is to submit a treating physician's opinion regarding the claimant's impairments and how those impairments affect the claimant's ability to function. SSA must give controlling weight to a treating physician's opinion if the opinion is not inconsistent with the medical evidence of record. I also disagree that the process is consistent. It may look consistent on paper, but many of the terms used in the regulations and policies are not adequately defined and are subject to different interpretations. In addition, SSA has issued rulings that are only applied to claims arising within specific federal circuits.

Finally, there is tremendous inconsistency among the DDS examiners, so-called vocational experts, and ODAR administrative law judges. Based on my professional experience, I think the entire disability process is crap.

[jmking]

Originally Posted by lenora

Actually, I disagree. Although it is true that a physician's conclusory statement regarding disability is almost useless, the easiest way to win a disability claim is to submit a treating physician's opinion regarding the claimant's impairments and how those impairments affect the claimant's ability to function. SSA must give controlling weight to a treating physician's opinion if the opinion is not inconsistent with the medical evidence of record. I also disagree that the process is consistent. It may look consistent on paper, but many of the terms used in the regulations and policies are not adequately defined and are subject to different interpretations. In addition, SSA has issued rulings that are only applied to claims arising within specific federal circuits.

Finally, there is tremendous inconsistency among the DDS examiners, so-called vocational experts, and ODAR administrative law judges. Based on my professional experience, I think the entire disability process is crap.

You may be correct. I'll tell you one thing I feel for those in bad shape going through this system. My wife went through shear hell with her health while I navigated through it all. Not pleasant, one of the worst experiences I've encountered.

[livecontent]

Originally Posted by lenora

Actually, I disagree. Although it is true that a physician's conclusory statement regarding disability is almost useless, the easiest way to win a disability claim is to submit a treating physician's opinion regarding the claimant's impairments and how those impairments affect the claimant's ability to function. SSA must give controlling weight to a treating physician's opinion if the opinion is not inconsistent with the medical evidence of record. I also disagree that the process is consistent. It may look consistent on paper, but many of the terms used in the regulations and policies are not adequately defined and are subject to different interpretations. In addition, SSA has issued rulings that are only applied to claims arising within specific federal circuits.

Finally, there is tremendous inconsistency among the DDS examiners, so-called vocational experts, and ODAR administrative law judges. Based on my professional experience, I think the entire disability process is crap.

With respect Counselor,

My point was to correct the OP statement that the decision is based "wholly" on the Doctor's opinion, which it is not. However, yes your personal physician can submit a statement but as you say it will have to agree with the medical evidence of record and not be considered the only and primary evidence.

You are correct the procedures are inconsistent in practice because each examiner will evaluate information differently, because they are people with differences and since the initial decision in based at the state level--it does make many cultural and regional difference come into play. Also, each disability applicant is different, as a person; and each case, in being a physical ailment, is different. With these differences, the measuring criteria is very difficult and sometimes impossible to define exactly in law.

So your opinion that the system is "crap". Perhaps you are correct or not correct in parts, but what can make the system foolproof and consistent over many difficult variables. It seems to me that the system constantly evolves with interpretations, discussions and eventually directions from Social Security--certainly it is not static. The system continually defines new problems, publishes the issues and invites comments to make a decision. I do not know what else one can do, to make it more open; but it will never be perfect and set in stone.

If law and the application of law did not involve interpretations, discussions and opinions, then we would not need lawyers. So, be happy that human affairs is not perfectly defined and you can have a career.

Livecontent