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Post by trekker on Oct 8, 2013 22:12:06 GMT -5
And for anyone that thinks that it is easy getting an IFP approved at the state court level, I would advise you to talk to your local legal aid attorneys. It is fairly easy to get them approved in federal court but not so in state court. And who do you expect to approve them at ODAR? And what happens if it is denied.
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true
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Post by true on Oct 8, 2013 22:38:55 GMT -5
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Post by BagLady on Oct 9, 2013 7:49:53 GMT -5
I think if you charge a filing fee you will eliminate legal services and other charitable organizations from representing claimants. And if you allow someone to file for a waiver of the fee based on income/net worth, then about 95% of my clients wouldn't have to pay it. Furthermore, some ALJs have a pay rate of 10% so you couldn't even have the rep repaid from the claimants past due benefits. Plus, I can't say how many cases I have done essentially for free or at a loss because there was no back pay. If I had to pay a filing fee it would discourage me from taking some of the more difficult cases. And what about those claimants who disappear during the waiting game? I'd be out that filing fee for that missing claimant. What you describe sounds like personal injury practice in my tort-reformed state. But those very risks are the ones that make attorneys think twice about taking every case that walks in the door.
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Post by lurker/dibs on Oct 9, 2013 8:48:56 GMT -5
I agree, but in a personal injury case you can add attorney fees in a settlement agreement, whereas you can not do that in SS cases. At least we do in my state. Also, any attorney who does SS cases and takes every case that walks in the door and properly prepares those cases would be bankrupt. I so not get reimbursed for my expenses in very many cases. I consider that a price of doing business. And because of that, I do end up losing money on a very small percentage of cases. It is not until I have worked up a case that I can always know if a case has merit. But I have to file the appeal to stay the time to file the appeal (60 days from denial) before I can work up a file. Once it's worked up I can convince a merit less claim to withdraw, usually. But if I had to front that filing fee, I would have to reconsider this practice style. Perhaps more unrepresented claims would result. I couldn't pay a filing fee, discover a claimant has lied or exaggerate their conditions, and then be able to collect that filing fee back from the claimant. It wouldn't happen. I understand that is a risk that is assumed in civil court. But the fees are much greater in civil court. Remember, we are limited to $6k fee in SS cases. And the $6k fee is rare these days. My average fee in 2011 was less than $2200 per fully favorable.
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true
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Post by true on Oct 9, 2013 9:32:22 GMT -5
I agree, but in a personal injury case you can add attorney fees in a settlement agreement, whereas you can not do that in SS cases. At least we do in my state. Also, any attorney who does SS cases and takes every case that walks in the door and properly prepares those cases would be bankrupt. I so not get reimbursed for my expenses in very many cases. I consider that a price of doing business. And because of that, I do end up losing money on a very small percentage of cases. It is not until I have worked up a case that I can always know if a case has merit. But I have to file the appeal to stay the time to file the appeal (60 days from denial) before I can work up a file. Once it's worked up I can convince a merit less claim to withdraw, usually. But if I had to front that filing fee, I would have to reconsider this practice style. Perhaps more unrepresented claims would result. I couldn't pay a filing fee, discover a claimant has lied or exaggerate their conditions, and then be able to collect that filing fee back from the claimant. It wouldn't happen. I understand that is a risk that is assumed in civil court. But the fees are much greater in civil court. Remember, we are limited to $6k fee in SS cases. And the $6k fee is rare these days. My average fee in 2011 was less than $2200 per fully favorable. But, SSA claimants must pay a filing fee to appeal their case in federal court already. They can file a motion to have the fee waived. Why would a filing fee be so detrimental to access to justice at the ODAR hearing level?
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Post by 71stretch on Oct 9, 2013 9:37:53 GMT -5
I agree, but in a personal injury case you can add attorney fees in a settlement agreement, whereas you can not do that in SS cases. At least we do in my state. Also, any attorney who does SS cases and takes every case that walks in the door and properly prepares those cases would be bankrupt. I so not get reimbursed for my expenses in very many cases. I consider that a price of doing business. And because of that, I do end up losing money on a very small percentage of cases. It is not until I have worked up a case that I can always know if a case has merit. But I have to file the appeal to stay the time to file the appeal (60 days from denial) before I can work up a file. Once it's worked up I can convince a merit less claim to withdraw, usually. But if I had to front that filing fee, I would have to reconsider this practice style. Perhaps more unrepresented claims would result. I couldn't pay a filing fee, discover a claimant has lied or exaggerate their conditions, and then be able to collect that filing fee back from the claimant. It wouldn't happen. I understand that is a risk that is assumed in civil court. But the fees are much greater in civil court. Remember, we are limited to $6k fee in SS cases. And the $6k fee is rare these days. My average fee in 2011 was less than $2200 per fully favorable. But, SSA claimants must pay a filing fee to appeal their case in federal court already. They can file a motion to have the fee waived. Why would a filing fee be so detrimental to access to justice at the ODAR hearing level? Administrative hearings at the initial level for things like SS, worker's comp, unemployment, other assistance programs, have never required a filing fee. There's enough paperwork flying around now. Having to have them make an indigency filing at the initial level is really unnecessary-- and, won't stop baseless claims, if they can get the filing fee waived just by saying they can't afford it.
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true
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Post by true on Oct 9, 2013 9:43:06 GMT -5
But, SSA claimants must pay a filing fee to appeal their case in federal court already. They can file a motion to have the fee waived. Why would a filing fee be so detrimental to access to justice at the ODAR hearing level? Administrative hearings at the initial level for things like SS, worker's comp, unemployment, other assistance programs, have never required a filing fee. There's enough paperwork flying around now. Having to have them make an indigency filing at the initial level is really unnecessary-- and, won't stop baseless claims, if they can get the filing fee waived just by saying they can't afford it. I agree to an extent. But, you assume that all SSA claimants are indigent. If that were true, Congress would not be considering implementing means testing!
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Post by 71stretch on Oct 9, 2013 9:56:02 GMT -5
I'm not quoting your post as it's not going to show up correctly.
They aren't all indigent. But, back to your premise that a filing fee (which could be waived) will significantly reduce baseless claims. I simply don't think that's the case.
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Post by BagLady on Oct 9, 2013 10:00:04 GMT -5
I agree, but in a personal injury case you can add attorney fees in a settlement agreement... Oh, lurker, I wish we could do that here! Tort reform has destroyed small/solo firm personal injury practices here. We can deduct our fees from the distribution, of course, but when insurance companies aren't paying enough to cover the medical liens, or paying liens plus $1,000, it's difficult to make any money at all. I have my own practice representing insurance companies as well as injured parties, and it's ugly out there. Ug-ly.
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Post by mcb on Oct 9, 2013 11:13:29 GMT -5
I am glad you used the term "supposed to give" because as a representative for close to 30 years I can tell you a lot of those IME are written by physicians who want to remain on the list of physicians used by SSA, so a lot of them tailor their reports in order to get future IMEs. Some are fair, but a lot are not. I have received eight page reports from an IME physician who literally spent ten minutes with the client and the report lists someone of the wrong sex and age and is a duplicate of a report with minor changes from an IME report from the same physician done on a previous client six months earlier. Sounds like those reports Eric Conn had generated. Yes when I ws a claimant's rep I had two claims denied by ALJs in which the claimants, both 49, were limited to sedentary work with their PRW being light SVP 2. Both filed new apps and were now 50. Both were denied at the initial level, then recon level, with light RFCs, even though the only evidence submitted in both cases were sedentary PCEs from treating sources. One case received an OTR at ODAR gridding out, the other was pending when I became an ALJ. RE: IMEs, it's amazing how many folks are limited to light work when they are 50 to 54, and when they turn 55 they can immediately do medium work. These people don't have lumbar DDD, they have lumbar RDI (regenerative disc improvement).
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Post by bartleby on Oct 9, 2013 11:25:11 GMT -5
MCB, you have touched upon an area of much mystery in SSA. I do not know very many healthy 55 year olds that can engage in medium work. Perhaps if we rewrite the GRIDS, we will find that they can do heavy work at 60? Very Heavy at 65? I think we are on to something. This is better than back surgery which has a very large failed percentage over a period of time.. Let's hear it for miracle healers at SSA..
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Post by sealaw90 on Oct 9, 2013 12:10:00 GMT -5
mcb, you crack me up - I call dibs on converting my own DDD into RDI when I turn 55! Now I don't feel so bad about getting DDD in my 40's. This reminds me of an old thread that went toxic - the one over smoking. If I have DDD and can work in my job, why can't other 'sedentary' workers do the same? As we know, you've got to keep your personal bias out of the decision-making process obviously, but it's great fodder for this discussion board.
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Post by moopigsdad on Oct 9, 2013 12:37:57 GMT -5
Sounds like those reports Eric Conn had generated. Yes when I ws a claimant's rep I had two claims denied by ALJs in which the claimants, both 49, were limited to sedentary work with their PRW being light SVP 2. Both filed new apps and were now 50. Both were denied at the initial level, then recon level, with light RFCs, even though the only evidence submitted in both cases were sedentary PCEs from treating sources. One case received an OTR at ODAR gridding out, the other was pending when I became an ALJ. RE: IMEs, it's amazing how many folks are limited to light work when they are 50 to 54, and when they turn 55 they can immediately do medium work. These people don't have lumbar DDD, they have lumbar RDI (regenerative disc improvement). So true mcb, so true! Unless you have practiced for years (SSA law and other law) like I have (30 years) and have seen so many things happen in your practice, it is hard for many attorneys to understand. Ask the older ALJs or practitioners around from the 70's and 80's about all the things that have happened or changed at SSA. Many practitioners have no idea. How many people remember SSA use to advertise on television, in newspapers and in magazines informing people they can file for Title XVI (SSI) benefits even without a work history?
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Post by lurker/dibs on Oct 9, 2013 19:23:01 GMT -5
Bag lady, I guess I should say I'm proud not to live in a tort reform state. Still insurance companies are paying less and less. That is why we converted to primarily SS and bankruptcy. Better living with volume practices. Well, at least I can say steady living with volume practices.
As far as the means testings go, I think congress was referring to those making too much money. If you have millions and can afford and do purchase private insurance, why do you need the extra $2500 +\- from SS and Medicare? I don't think they are advocating for those making too little. Prior to receiving SSI, peoples assets are calculated to see if they qualify. A household size of two--husband and wife--can not receive more than $1300 per month per couple (I think that is the correct figure for 2013) and they can not have more than $5000 combined assets (again, I believe that is right) excluding one vehicle and the home. If that's not indigent, I don't know what is. Approximately half of my cases are SSI only or concurrent cases. Adding the requirement of filing for a waiver of a fee would add another form for me to file and would force SS to add workers to assist unreped claimants to file them. Of course this is just my two cents.
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Post by mcb on Oct 9, 2013 22:53:55 GMT -5
Bag lady, I guess I should say I'm proud not to live in a tort reform state. Still insurance companies are paying less and less. That is why we converted to primarily SS and bankruptcy. Better living with volume practices. Well, at least I can say steady living with volume practices. As far as the means testings go, I think congress was referring to those making too much money. If you have millions and can afford and do purchase private insurance, why do you need the extra $2500 +\- from SS and Medicare? I don't think they are advocating for those making too little. Prior to receiving SSI, peoples assets are calculated to see if they qualify. A household size of two--husband and wife--can not receive more than $1300 per month per couple (I think that is the correct figure for 2013) and they can not have more than $5000 combined assets (again, I believe that is right) excluding one vehicle and the home. If that's not indigent, I don't know what is. Approximately half of my cases are SSI only or concurrent cases. Adding the requirement of filing for a waiver of a fee would add another form for me to file and would force SS to add workers to assist unreped claimants to file them. Of course this is just my two cents. I thought the most a couple could receive was 1K a month and could have no more than 3K in assets, minus the vehicle and home, but I haven't had to deal with that since September 2010.
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Post by moopigsdad on Oct 10, 2013 5:42:27 GMT -5
Bag lady, I guess I should say I'm proud not to live in a tort reform state. Still insurance companies are paying less and less. That is why we converted to primarily SS and bankruptcy. Better living with volume practices. Well, at least I can say steady living with volume practices. As far as the means testings go, I think congress was referring to those making too much money. If you have millions and can afford and do purchase private insurance, why do you need the extra $2500 +\- from SS and Medicare? I don't think they are advocating for those making too little. Prior to receiving SSI, peoples assets are calculated to see if they qualify. A household size of two--husband and wife--can not receive more than $1300 per month per couple (I think that is the correct figure for 2013) and they can not have more than $5000 combined assets (again, I believe that is right) excluding one vehicle and the home. If that's not indigent, I don't know what is. Approximately half of my cases are SSI only or concurrent cases. Adding the requirement of filing for a waiver of a fee would add another form for me to file and would force SS to add workers to assist unreped claimants to file them. Of course this is just my two cents. I believe the asset limit for a couple is $3,000, but I could be wrong and $1,300 in income sounds correct. The asset limit for an individual is $2,000. Yes, this is close to being indigent as you an get without living under a freeway underpass in a box. Don't laugh because it still happens to many homeless people.
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Post by lurker/dibs on Oct 10, 2013 6:20:25 GMT -5
Moopig , you may be right about the asset amount. I thought it went up in. 2013, but I didn't commit it to memory when I looked it up last time. I was thinking $3k was for an individual and $5K for couple.
I represent homeless people occasionally. It's sad. And, oddly, many of them are vets. I do VA cases, too.
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Post by maquereau on Oct 10, 2013 7:44:34 GMT -5
Regarding fraud, waste, abuse: I think there should be a lifetime cap on the number of times a person can apply. Some people have complained that endless filing by an individual is just playing the lottery for free. Of course it's not free. Each application that proceeds to hearing costs many thousands of dollars. Recently I have had some cases where the applicant had applied six or seven times already. A colleague of mine had one where the applicant had applied thirteen times! NO - SAVE YOUR APPLICATIONS FOR WHEN YOU ARE TRULY DISABLED; DON'T START APPLYING AT AGE 23. I think that a cap (let's say 3 times total) would cause the reps to screen the cases and advise the ones with relatively weak cases to drop their appeals. The other thing is, what do you think a judge thinks when he sees someone who has been filing serial applications? You can only cry "Wolf" so many times before you lose all credibility.
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Post by trekker on Oct 10, 2013 8:46:04 GMT -5
SSI asset limits haven't been changed since the late 1970's. $2000/individual; $3000/couple. There are exempt assets like a house where you live, one car, a burial fund (max of $1500) or irrevocable burial plan (sold by funeral homes), burial plot, medicaid qualifying trust, etc.
Multiple applications: hmmm -- not that many people have temporary disability insurance (and you don't even want to know how aggressive the temp disability insurance companies are at making sure that someone who has a disability policy gets on SSDI or SSI after 18 months of disability payments); not everyone has a reliable mailing address (the homeless) or access to a computer (about half of my clients have missed a deadline or two); and then there is the progressive nature of some illnesses (cancer, diabetes, AIDS) so that someone will have an acute medical problem and gets laid off by an employer (files and is denied), starts to feel better after getting treatment because of the emergency, is hired by employer #2 (but loses medical coverage and employer does not provide health insurance), gets worse, starts missing days, gets fired (refiles, etc). Missed appeal deadlines. This is not a perfect system. FMLA and EMTALA don't work as well as we are led to believe.
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Post by bartleby on Oct 10, 2013 10:23:44 GMT -5
Trekker, you bring up a good point and not to derail this conversation, I too notice a great deal of my claimant's state they do not have a computer or are not computer literate. Usually these are the poor and the bottom of the rung claimant's, ie, the ones that usually really need the help. How are they supposed to access and sign up for ACA?
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