Major Rule Change Enacted By Social Security Administration

A major change in the game rules for social security disability claimants has been quietly enacted effective July 22, 2011 by the Commissioner of the SSA. This rule change will immediately and drastically effect large numbers of disability claimants and their families very likely resulting in a loss of disability benefits. Meanwhile the rule change will very likely benefit the SSA allowing the SSA to keep disability monies that otherwise would likely have gone to disabled Americans and their families.

This new rule changing the entirety of the social security disability process for disabled claimants and their families is available here.

Here is a brief explanation of what the SSA has done and how they have changed the rules for SSA disability claims in the middle of the game to greatly favor the SSA.

In a typical social security disability claim, a person will file a claim for disability, for example in 2010, claiming he has been unable to work since 2009 due to severe physical or mental impairments. Due to to severe bureaucratic delays and inefficiencies within the SSA itself, that claimant will not likely have his claim reviewed and approved for disability for another 2 years or more, or until 2012. if his claim is approved, the SSA will pay the claimant his disability back to 2009; his onset date of disability if he had filed within one year of his application date. Thus the claimant and his family would receive almost 3 years of disability benefits backpay. If his average monthly disability benefits were $1200 per month, that would be a payment to him of over $43,000.00.

If however the claimant loses his claim, he must then appeal to the SSA Appeals Council. The Appeals Council will easily take another 2 years to review the claim. (For all these years waiting on the government the claimant and his family are without any income). If the Appeals Council then awards him benefits, once again, he would be entitled to back pay of benefits to 2009.

However the SSA Appeals Council is notorious for simply rubber stamping denials on the vast majority of appeals filed with the Council. Thus our typical claimant and family will wait 4 to 5 years after first filing his claim to only to be denied by the Appeals Council. He waited 4 to 5 years on the SSA without income to gain nothing.

So, in order to simply survive all those years of waiting for the SSA bureaucracy to process their claims, many claimants smartly filed a new claim for disability while waiting for the first claim. In our case, the same claimant files a new claim in 2012 while he is still waiting for his old claim of 2010 to be reviewed and processed by the SSA. That way if the 2010 claim is denied by the SSA and Appeals Council, the claimant would not lose 4 to 5 years of benefits. He would already have his new claim of 2012 in processing with the SSA. Thus, at most, if the new 2012 claim is awarded, he would lose only 1 or 2 years of back pay.

This is only fair to claimants and their families as otherwise they would simply be at the mercy of the SSA to bureaucratically “starve them out” as the SSA took forever to process their claims for disability. Now, under the new rule change announced the SSA, claimants and their families will no longer be allowed to file a new claim for disability while they are waiting — years — for their first claim to be processed by the SSA.

Under the new rules, claimants who have their disability claims denied by the SSA and are waiting years for the SSA Appeals Council to review their appeal, will no longer be allowed to file a second, new claim to “tide them over” in case the Appeals Council denies their first claim. Claimants who have a pending claim with the Appeals Council are now required to choose to (1) either wait years for the Appeals Council to rule on their first pending appeal with a high chance of denial, or (2) drop their pending appeal and accumulated benefits and proceed only with the new claim.

This means that social security disability claimants and their families now have a “lose/lose” situation. If they stay with their first claim at the Appeals Council, the Council will more than likely deny their appeal and the claimant loses several years of accumulated disability benefits. If they instead chose to waive their first claim that is on appeal to the Appeals Council and go with a new claim, the claimant immediately loses all their accumulated benefits with no guarantee of being awarded any benefits on their new claim. Even if awarded on their new claim, they will lose all their prior years of back pay that had accumulated on the first claim before they filed their new claim.

And this means that the SSA has now changed the rules to make theirs a “win/win” scenario. It is now to the advantage of the SSA to delay even further any claimant’s appeal to the SSA Appeals Council. The SSA can now literally “starve out” claimants and their families with years of delays. If the claimant chooses to stay with his first claim that is on appeal to the Appeals Council, the SSA can simply delay that appeal for years and years to the point that the claimant has no choice but to stay on with the appeal in the hope of winning his claim or starve. When the Appeals Council eventually denies the claim, the SSA of course keeps all the money. If on the other hand the claimant decides he cannot afford to starve his family while waiting for the Appeals Council to review and likely deny his first claim and he files a new disability claim, the claimant immediately gives up years of accumulated disability benefits back to the SSA which keeps all.

If you believe that this rule change by the SSA is not right and needs to be immediately dropped, please feel free to contact your US Senator here and your US Representative here.