Hearing Strategies in an Age of Declining Allowance

8:00 a.m.-9:30 a.m.

Presented By

8th Circuit Social Security Disability

Friday, August 21, 2015

Timothy Cuddigan 1005 South 107th Avenue Suite 201 Omaha, NE 68114 Phone: (402) 933-5400

Gail Barnett Schott Mauss & Associates, PLLC 6611 University Ave , Ste 200 Des Moines, IA 50324 Phone: 515-277-4727

Mary Hoefer Hoefer Law Firm 332 S. Linn St. Suite 300 Iowa City, IA 52240 Phone: 319-338-5343

Blake Parker Parker Law Office 719 South 2nd Street Clinton, Iowa 52732

Updated 7/13/2015

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Interviewing Prospective Clients In the Age of Declining ALJ Approval Rates

Timothy J. Cuddigan 1005 South 107th Avenue, Suite 201

Omaha, NE 68114 Phone: (402) 933-5400

Facsimile: (402) 933-5440

Updated 7/13/2015

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MD Previous Client Attorney

Interview Sheet Date: Time: Schedule Decline

still working drugs/alcohol general decline needs medical

Name ( )

SS# Attorney Rep? Yes No

Phone Number Email

Address Referral Age Date of Birth Applying for: DISABILITY SSI BOTH INITIAL RECON ALJ DLI Prior Apps: Denial Date: Hearing Date: Judge: Current or past problems with drugs or alcohol? What is your disability that keeps you from working? Education Attending now? Online/On Campus Height Weight Driver’s license status If other than Valid please explain Date Last Worked Worked 5 out of last 10 years ?Yes No Reason for not working: What Kind of Work Have You Done?

What Doctors Are You Seeing? How long? How often?

Supportive doctor:

Medications: Have you been hospitalized in the past 12 months? Yes No How long can you sit? How long can you stand? Current Household Income: Any children under 18? If yes, how old are they? Spouse or Child(ren) receiving SSI/Medicaid? Yes No Work Comp Claim? Yes No W/C Attorney Settled? Yes No How much did you receive? Notes:

Updated 7/13/2015

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The Script Good morning/afternoon,  

Thank you for contacting Cuddigan Law. My name is Kendra, how may I help you?   

Pause. 

Great/Wonderful/Good news is.., it sounds like you have called the right place. 

May I have your name? (First, middle initial, last) 

Do you currently have an attorney assisting you? 

What is your date of birth? (If over the age of 66 or over 62 and receiving early retirement refer to exit script) 

How did you hear of our office today?    (Be sure to get a solid source – if a friend gave them our    

              info‐ are they a previous client or did they see our commercial?)  

How about a telephone number you can be reached at? 

What is your address? (If out of our area refer to exit script) 

Do you use email?   (If yes ask if we could have their email address) 

What is the date you last worked? (Still working? Close to stopping? If not refer to exit script) 

Now                  , what are your conditions that are keeping you from working? Pause – confirm conditions  

                by repeating them back to them in their words 

What medications are you currently taking?  Compare meds list to conditions – anything missing? (If they are not 

receiving treatment or haven’t for 6 months and do not have a condition that doesn’t require treatment (examples: 

vision/IQ) refer to exit script) 

Is this your first time applying for Social Security Benefits? 

(If they have not applied yet and it is an SSI only please refer to exit script, if they have worked even close to 5 out of the 

last 10 years get DLI) 

If yes  Do you have a recent denial?     If yes  Do you have your denial with you? 

If they have to look for it move on to the next section while they retrieve it 

If they don’t have it get as much information as they remember‐ we need date/reason/SSI? SSDI?  

What is the date on your denial? 

On the upper left corner it should tell you what benefits you applied for, what does it say? 

Now on the first page right below where they list the records they received it should explain the reason they 

denial you, can you read that to me?    

Have you ever had a problem with drugs or alcohol? If yes get what/date last used/if sober‐ meetings? (If current 

alcohol or drug problem refer to exit script) 

What is the highest level of education that you completed? Did you take any Special Education classes? Are you 

currently taking classes? (If yes ask ‐ on campus or online and how many hours/classes a week?) 

Do you have a valid Driver’s License? (If not why? Did doctor take it due to condition or legal like DUIs?) 

Now I see you stopped working about      , have you worked 5 out of the last 10 years? 

What was your reason for stopping at that time? Only list the reason they state 

What types of work have you done in the past 15 years? (If self‐employed – did they pay taxes?) 

What Dr.’s are you seeing?   Who/Where/For what/How long/How often 

Have you talked to your doctors about filing for disability?   (If yes are they supportive?) 

In the last 12 months have you been hospitalized for more than 24 hours?        (If yes Why/Where/When?) 

How long can you sit before you need to get up move around or lay down?  

How about standing, How long can you stand before you need to sit down or lay down? 

What is your current household income?  Are you married?  Does your wife/husband work? 

Do you have any children under the age of eighteen?    How old are your children? 

Does your spouse or children receive any SSI or Medicaid? 

Have you ever had a Workman’s Comp Claim where you were injured at work? 

Updated 7/13/2015

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Essential Information

Medical Treatment

Medical treatment is an essential factor in any case. It is difficult to take a case when there has been no treatment for six months. We tell the prospect to see the doctor and call us back after continuous care for at least three months. We send an assistance package with information about low and no cost clinics in our area when a response to this reason for not taking a claim is that the prospect does not have any insurance or money to get treatment.

Medical care by a family doctor in a case with only a psychiatric impairment is inadequate or a prospect who refuses to see psychiatrists is a problem.

Medications

Are they taking their medications?

Are the medications that they are taking consistent with their claimed diagnosis(s)?

Referral

A referral from a treating doctor or other health professional is a plus.

Helpful Information

Date Last Insured (DLI)

Have the prospect call their local SSA field office to obtain the DLI if:

They have not worked 5 out of the last 10 years or have not worked in the last 5 years

Sketchy job history

Part-time work or many jobs over past years

Self-employed and unsure if they have paid in /Owned their own business

If obvious they may qualify for SSI their DLI is not needed.

Why does a 50 year old man or woman not have a work history? Ask more questions.

Drugs/Alcohol

This is a serious credibility problem and often is a reason to decline a case. Current use or abuse can be a disqualifying factor.

What drug?

How long used?

How long sober?

AA, rehab, counseling, therapy? How did they quit?

Receipt of Unemployment Benefits

This is a real problem in the mind of some ALJs. Congress is likely to change this in the future

Updated 7/13/2015

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School Attendance

This may be inconsistent with a mental health claim because of problems of concentration or inability to be around others.

Borderline intellectual Functioning

This may limit the claimant to unskilled work but probably not exclude all work. This is especially true if the claimant has a work history.

Still Working

If they are earning more than current SGA ($1090 - 2015) the quick answer is no. But ask them to call us when they stop working. If they are earning less than $500 per month consider taking the case. Always find out if the work they are doing is inconsistent with their claimed impairments.

Reason Stopped Working

Be specific

Fired or quit? Why?

Long Periods of time with no work

What have you been doing all this time since you stopped working? (We want to know if they have been working under the table or just got out of prison)

Jail or Prison

When? How long? What for? Sex Offender?

Height and Weight A large person may need a special chair or grid

Children Younger than school aged children: Who takes care of children during the day?

Do you have the children full time?

Inpatient Stays during the last Two Years Multiple hospitalizations often correlate with severity

Over 24 hours?

For what?

How long there?

Multiple visits?

Which hospital(s)? Partial Care?

Surgical history?

Updated 7/13/2015

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Updated 7/13/2015

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MENTAL IMPAIRMENTS Experience:

Self-Harm? Suicidal? Homicidal? Isolation? Paranoia? Visual Hallucinations? Auditory Hallucinations? Problems getting along with others? Problems w/authority or supervisors? Problems w/motivation – bathing/hygiene?

Learning Impairment:

Special Education? What years? Tested for I.Q.? Trouble reading or writing? Trouble following simple instructions?

Treatment:

What doctors do you see? How often? Counselor or Therapist? First Appointment? Last Appointment? Medications? Only Family Doctor?

Hospitals:

How long was your stay? Why were you admitted? Suicide attempts? Self-harming? How many times in the last 12 months? Any Outpatient visits? Attend any programs – Partial Care?

PHYSICAL IMPAIRMENTS Cardiac:

Elevate legs? Lifting restrictions? Shortness of breath? Fatigue? Take naps? Problems w/hot or cold?

Diabetes:

Problems with blood sugars? Is your diabetes controlled? Neuropathy? Retinopathy? Type I or Type II? Insulin? Fatigue? Naps? Kidney Problems?

Gastro:

Vomiting? Diarrhea? Accidents? Stomach pain? Surgeries?

Neck/Back:

Problems rotating neck? Bending/Twisting? Lifting restrictions? Surgeries?

Stroke:

How many? Residuals: paralysis, speech or memory

problems? Therapy?

Pain:

Diagnosis? Cause? Restrictions? Limitations?

Updated 7/13/2015

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PHYSICAL IMPAIRMENTS Vision:

Blurred? Tunnel? Blind/Legally Blind - R or L? Surgery? Laser Surgery? Headaches? Problems driving: Day or Night? Cataracts?

Lower Extremity:

Swelling? Elevate legs? Use assistance device? Cane or Walker? Problems sitting/standing/walking? Need to change positions? Restrictions?

Upper Extremity:

Problems with hands/arms: Feeling, fingering, handling objects?

Numbness or Tingling? Raise arms above head? Lifting restrictions? Surgery?

Seizures:

How Often? What type? Residuals: fatigue, confusion, headaches,

paralysis? Duration of residuals? Take medication as prescribed?

Headaches:

How often? Duration? Vision Problems? ER visits or injections? Nausea or vomiting? Sensitivity to light?

Nerves:

Pain? Loss of sensation in arms, legs, hands or

feet? Skin:

Lesions? Open Sores? Visible?

Breathing Problems:

Do you smoke? Are you seeing a pulmonologist? Shortness of breath with walking? Shortness of breath with hot/cold weather,

perfumes, gases, humidity? Are you on oxygen, nebulizer, or emergency

inhalers? Misc.:

Lupus – flares? MS – flares and Symptoms? HIV – Blood Counts and medication side

effects? Fibromyalgia – Seen a Rheumatologist? Asperger’s syndrome – are you living in a

supported living environment?

Winning Cases in an Age of Declining Approval Rates

(Tips for a Hearing)

Gail Barnett, Schott Mauss & Associates

I. Is there really a problem?

Amid complaints about lengthy waits for Social Security disability benefits, congressional investigators say that nearly 200 administrative judges have been rubber-stamping claims, approving billions of dollars in lifetime payments from the cash-stripped program.

Associated Press, Report: Social Security judges rubber-stamp claims, (2014) available at http://www.foxnews.com/politics/2014/06/10/report-social-security-judges-rubber-stamp-claims/

Driven to reduce a huge backlog of disability claims, Social Security is pushing judges to award benefits to people who may not deserve them…

Stephen Ohlemacher, Judges tell lawmakers they are urged to approve Social Security disability claims, (2013) available at http://www.washingtonpost.com/politics/judges-tell-lawmakers-they-are-urged-to-approve-social-security-disability-claims/2013/06/27/ea990a7e-df66-11e2-b2d4-ea6d8f477a01_story.html

ALJ Dispositions

State

Offices

Judges

Avg. Hearin

g Wait Time

Average Processing Time

Avg. Dispositio

ns Per Day Per ALJ

Cases Dismisse

d

Cases Approve

d

Cases Denie

d

Arkansas 2 20 10.0

months 379 days 2.4 13% 42% 44%

Iowa 1 8 14.0

months 457 days 2.3 15% 39% 46%

Kansas 2 15 12.5

months 422 days 2.0 24% 33% 44%

Nebraska 1 7 14.0

months 433 days 2.1 18% 57% 24%

Minnesota

1 12 13.0

months 399 days 2.2 16% 45% 39%

Missouri 6 75 13.8

months 452 days 1.7 19% 41% 41%

North Dakota

1 6 12.0

months 358 days 2.6 13% 46% 41%

DisabilityJudges.com, Disability Judges.com: Administrative law judge case statistics, (2015), available at http://www.disabilityjudges.com/state

II. Legal Standard:

If denied by an Administrative Law Judge, a claimant can file a Request for Review of the Decision with the Appeals Council. Not only is this a long process, but the standard of review gives great deference to the findings of the Administrative Law Judge. It is important to make sure the entire record is developed, not only to prove a disability, but to preserve the record in case of any appeal.

Case Law

This court must affirm the findings of the ALJ if they are supported by substantial evidence in the record as a whole. 42 U.S.C. § 405(g). See Singh v. Apfel, 222 F.3d 448, 451 (8th Cir. 2000).

The Court must consider evidence that both supports and detracts from the Commissioner’s decision, but cannot reverse the decision, “simply because some evidence may support the opposite conclusion.” Perkins v. Astrue 648 F.3d 892, 897 (8th Cir. 2011) (quoting Goff v. Barnhart, 421 F.3d 785, 789 (8th Cir. 2005)).

A court should not disturb the ALJ’s decision only if it falls outside the available “zone of choice” and a decision is “not outside that ‘zone of choice’ simply because [the court] might have reached a different conclusion had [the court] been the finder of fact.” Bucker v. Astrue, 646 F.3 549, 556 (8th Cir. 2011) (quoting Bradley v. Astrue, 528 F.3d 1113, 1115 (8th Cir. 2008)).

If the Court finds that the evidence supports two inconsistent positions and one of those positions represents the Commissioner’s findings, the Court must affirm the Commissioner’s decision. See McNamara v. Astrue, 590 F.3d 607, 610 (8th Cir. 2010); also see England v. Astrue, 490 F.3d 1017, 1019 (8th Cir. 2007).

III. Hearing Procedure

The hearing is a representative’s chance to make a clear and strong record for appeal.

A. Pre-hearing preparation

• Video hearing or in-person

• Know your ALJ

• Discuss any last minute issues o Confidentiality o Changing position o Vocational testimony

• What to bring to a hearing o Updated, records o Summary of the evidence o Copy of the pre-hearing brief o Copy of the file

B. Hearing.

• Opening statement o Impairments o Treating source statements o Overview of DDS decisions o Theory of the case o Use exhibit numbers

• Client Testimony o Short and sweet answers o Provide client opportunity to comment o Making a record for non-verbal actions o Injury descriptions o Movements or gestures o Symptoms of pain o Identify any difficulties with testimony

• Witness Testimony o Know the ALJ’s preference o When to call a witness o Child cases o Mental incompetence o Supporting statements

• Vocational Testimony o Review work history!!!! o Objections to the Expert o Have hypotheticals ready o Don’t be afraid to challenge the expert

o One armed studies o Job Numbers

• Closing Statement o Post hearing brief o Short and sweet

C. Post-Hearing Issues

o Additional medical records o Delayed decisions and supplemental hearings

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Litigation Strategies Within the Disability Hearing Concept

Blake ParkerParker Law Office719 S Second StreetClinton, IA 52732Blakeparkerlaw@gmail.com800.387.8167

1. Theory of Case.

• Identify the disabling condition - focus hearing presentation towards the story thatis told by that condition.

• On set date.• Exhibits• Witnesses• Applicability of listing• Opening statement

2. Objections to the record.

• Identify exhibits (for appeal) that have errors or to which there can be anobjection

• Know your WHAT.• Identify jobs below SGA• Compare to Past Relevant Work prepared by VE• If PRW has jobs that do not meet SGA or simply don’t fit work experience

• Daubert objections.

• Opinion must meet standard of Federal Rule of Evidence 702• Evidence based on innovative or unusual scientific knowledge may be

admitted only after it has been established that the evidence is reliable andscientifically valid based on four tests of reliability.Four Daubert factors:• testing,• peer review,• error rates, and• acceptability in the relevant scientific community.Kumho Tire Co., Ltd. V. Carmichael, 526 US 137 (1999).

• Opinions from state examiners not within their area of expertise.• ALJ becomes “gatekeeper” - error for further review.

3. Time line.

10/19/2009 404 BJ Thomas, ARNP - Major Depression

10/19/2009 505 BJ Thomas, ARNP - Major Depression

10/29/2009 506 James D Wilson. Case Analysis DDS. Claimant hadnot complete an adult function or pain and Fatigue form. Insufficient evidence to make determination.

10/30/2009 507-519 Dee Wright. Mental RFC. Insufficient evidence.

10/31/2009 272 TRMC - ER Report, Nursing Chart - Back Spasm

10/31/2009 309 Anemia

11/05/2009 474 CHC - Back Pain

• Identify Date Last Insured• Identify onset date• Review GRID & Listings• Amend onset date. Dierickx v. Commissioner (S.D. Iowa 2015)• Negotiate, negotiate, negotiate.

4. Failure to develop functional limitations.

• CE’s with no mention of functional limitations• No CE’s• Description in medical record that claimant is disabled (or not disabled).• Obtain functional capacity opinions• Not making a liar out of the RFC opinion provider.

5. Preparation for cross examination of the Vocational Expert.

• SkillTran’s Job Browser. ® • Use of laptop at hearing sites.• Transferability of skills - GRID guidelines.• Know the DOT trailer Appendix C• Know the date from the DOT of the identified job(s). • Observations occurring during hearing related to job placement.

6. Create a record of non-verbal evidence.

• Sit and squirm• Sweating/hyperhydrosis• Shakiness or other distracting behaviors

. - .