Lawsuit Seeks Equal Assistance for Guam Residents with Disabilities

A Guam resident with a permanent disability has sued the Social Security Administration in the U.S. District Court of Guam, challenging the inability of Guam residents to receive support payments under the federal Supplemental Security Income (SSI) program. The failure to provide benefits to people on Guam with disabilities violates the Organic Act and also the equal protection clauses of the Constitution, the lawsuit states.

Residents of the Commonwealth of the Northern Mariana Islands are eligible for SSI payments because the benefit is included in the CNMI covenant with the United States; however, residents of the other U.S. territories, Puerto Rico, Guam, and the U.S. Virgin Islands, were intentionally excluded from the SSI program, which started in 1972.

The lawsuit, filed on behalf of Guam resident Katrina Schaller, notes that her twin sister, Leslie, suffers from the same debilitating genetic disorder – myotonic dystrophy – but receives about $800 a month in SSI because she lives in Pennsylvania, not Guam.

“Katrina is denied eligibility for federal SSI benefits solely because she lives on Guam, rather than in any of the 50 states, the District of Columbia or the nearby territory of the CNMI,” her lawsuit states.

The lawsuit further notes that Katrina Schaller received the benefits when she lived with her mother in Pennsylvania, “But when she moved to Guam to be with family upon her mother’s death, Katrina’s SSI benefits were cut off.” The lawsuit also states that Leslie Schaller also wants to travel to Guam to see her sisters, “but she cannot do so for more than 30 days for fear of losing access to the SSI benefits necessary for her support.”

The lawsuit asks the court to find that provisions of the SSI law discriminate based on status as a Guam resident and are unconstitutional, and to prevent the Social Security Administration from enforcing those provisions.

Source: https://www.guampdn.com/story/news/2018/12/07/lawsuit-seek-equal-assistance-guam-residents-disabilities/2236363002/

By: Joyce Trudeau of Premier Disability Services, LLC^®

The Beginning of the End for Prototype States

Before a case for Social Security disability benefits may be filed in federal court, claimants must give the Social Security Administration (SSA) an opportunity to review the claim and render a final agency decision. Administratively, there are typically four stages of review: initial determination, reconsideration, a hearing before an administrative law judge (ALJ), and review by the Appeals Council.

The initial determination in each state is made by Disability Determination Services (DDS), which applies strict guidelines set forth in the Programs and Operations Manual (POMS). If a claim is denied initially, most states have a reconsideration process which allows a different examiner at DDS to review the case again before the claimant may file a request for a hearing.

In 1997, the SSA introduced a redesign program to bypass the reconsideration process, allowing claimants to file a request for a hearing immediately after the initial determination in ten (prototype) states, including New York, Pennsylvania, Alabama, Michigan, Louisiana, Missouri, Colorado, Alaska, and parts of California. The intent was to achieve earlier decisions and shorter wait times. Yet, in a 2010 statement before the House Ways and Means Commission, the SSA found the opposite was true of its implementation in prototype states.

This past summer, the SSA announced plans to reinstate the reconsideration process in those prototype states, citing to data from a 2001 detailed study of the prototype procedure as well as the need for a uniform process. The announcement spurred opposition from legislators in both parties, who criticized the 2001 data as obsolete and cited to shorter wait times in the prototype states since the inception of the redesign program. Without more recent data and analysis from the SSA, it may be difficult to predict the likely effects. Still, others have suggested that such broad changes to our Social Security program ought to be handled by a duly appointed Commissioner confirmed by the Senate, though there has not been one since the Bush Administration.

Several prototype states will now be instituting reconsideration on January 1, 2019: California (Los Angeles North and Los Angeles West), Colorado, Louisiana, New Hampshire and New York. This means that for any case in which an initial denial is issued on or after January 1, 2019, in those states, the next level of appeal is to file a request for reconsideration, not a request for an ALJ hearing.

Reconsideration is scheduled to be reinstituted in Pennsylvania on April 1, 2019. Alabama and Michigan are scheduled to start reconsideration on October 1, 2019; Missouri on January 1, 2020; and Alaska on March 1, 2020.

https://www.ssa.gov/legislation/testimony_042710.html

https://waysandmeans.house.gov/social-security-subcommittee-questions-changes-to-social-securitys-disability-appeals-process/

https://nosscr.org/senators-to-berryhill-do-not-reintroduce-reconsideration/

By: Joyce Trudeau of Premier Disability Services, LLC^®

Working and Receiving Disability Benefits

Federal law defines disability as the inability to engage in any substantial gainful activity (SGA) by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. According to the Social Security Administration (SSA), SGA is generally defined as work that generates a certain amount of income per month. In 2018, that amount is $1,180 for non-blind disabled applicants and $1,970 for blind applicants. An individual who generates more income than the SGA limits will likely be ineligible for Social Security Disability benefits. However, there are exceptions to this rule:

Trial Work Period

To be eligible for disability benefits, your injury must be expected to keep you from working for at least one year. After becoming disabled, it is often difficult to know whether you will be able to return to work. To help disability applicants determine whether they will be able to return to work, the SSA will allow disability applicants to engage in a work trial period for nine months. During this time, you can receive disability benefits in full, regardless of how much income you make.

According to 2018 standards, any month that you earn at least $850 counts as a trial month. Similarly, if you are self-employed, any month where you work more than 80 hours (or earn more than $850) is considered a trial work month. Your trial period will continue until you’ve worked nine months within a rolling 60-month timeframe. The trial months do not need to be consecutive. If you earn more than $850 for more than 9 months within a 5-year period, your disability will be deemed to have ended and your benefits will stop.

Extended Period of Eligibility

Once you have completed your trial work period, the SSA does provide resources in the event that you are still unable to consistently work. You can receive Social Security Disability benefits for any month where your earnings fall below the SGA amount, within a 36-month window following the completion of your trial period. This is referred to as an extended period of eligibility.

Following your trial work period, if your Social Security Disability payments stop because your income exceeds the SGA amount, you still have a five-year period in which you can receive benefits without filing a new disability application. This is known as expedited reinstatement and can save you significant time should your condition worsen—or if you become re-injured—in the future.

Offset your Earnings with Expenses

If you are consistently earning more than the SGA limit, it is very possible that you are ineligible for disability benefits. However, the SSA will deduct certain disability-related expenses, potentially allowing your overall income to fall below the SGA threshold. Depending on your unique situation, certain activities or expenses could be deducted to help your income remain below the SGA threshold.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

By: Joyce Trudeau of Premier Disability Services, LLC^®