Winter, Chewning & Geary, LLP Opening Milwaukee Office

Winter, Chewning & Geary, LLP is pleased to announce the expansion of its offices to Milwaukee.  Previously we had focused our practice on serving Northeast Wisconsin through our offices in Green Bay and Oshkosh.  On October 1, 2013 we are opening our Milwaukee office, which will serve as our main office and mailing address.  The office is located at 740 N. Plankinton Ave, Suite 430, Milwaukee, WI 53203.  The local phone number (414) 455-0944.  We can also be reached at our toll free number 1-888-836-3456.

The new office is conveniently located in downtown Milwaukee, in the River Bank Plaza building and can be accessed easily through several freeway exits.   Appointments to meet with Attorney Don Chewning or Attorney Stacy Vogeltanz can be made by calling the Milwaukee office.  Complimentary valet parking is available in the lot neighboring the building.   We are also easily accessible through numerous bus routes.

Obamacare enrollment starts October 1

            For so many of our clients, the lack of access to medical care is a significant problem.  With the passage of the Affordable Care Act, the federal government is seeking to get as many Americans insured as possible through the individual mandate.  If you are not already covered by health insurance, you will need to apply for health insurance through the state exchanges.  You will also apply for subsidies in the form of tax credits if you need help paying for the insurance.  Open enrollment through the exchanges begins October1.  Coverage will then begin January 1.  Open enrollment ends by March 31, 2014, at which time open enrollment closes.  For information please go to HealthCare.gov which links to the Health Insurance Market Place:  https://www.healthcare.gov/quick-answers/#step-1

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Manitowoc to be home to two new community clinics

According to the Lakeshore Chronicle, two clinics for low- and no-income individuals are opening on October 1, 2013. These clinics are the Red Shield Health Clinic, 402 N. 9th St, Manitowoc.  Services are available on Tuesdays from 5 – 10p.m.  The clinic’s phone number is (920) 684-7117.  Also, Community Clinics of Manitowoc County is opening at 600 York St, Manitowoc. That clinic will be open Tuesdays, Wednesdays and Thursdays from 8 a.m. – 5 p.m.  Community Clinics of Manitowoc County can be reached at (920) 320-6775.

Winter, Chewning & Geary, LLP believes it is important to keep our clients informed of free and low cost health care.  Too many of our clients lack access to the treatment they need.  Hopefully with the implementation of the Affordable Care Act, all of our clients will have access to necessary health care, but if not clinics for low- and no-income individuals are a valuable community resource.

Should I pursue medical treatment if I am applying for Disability?

                In order to be found disabled under the Social Security regulations, it must be determined that you have a condition or combination of conditions that severely impairs your ability to perform work related activities for at least a year.  This finding by Social Security cannot be based solely upon your complaints of pain or limitations.  In other words, you must be diagnosed with a severe impairment by the medical community in order for Social Security to consider your impairment.  So the simple answer to the question is Yes.

                As a result, many Social Security Disability claimants find themselves in the following Catch-22 situation:

(1)    The claimant lacks medical insurance because they are not working due to their disability

(2)    The claimant cannot treat with a doctor because they do not have medical insurance or money to pay for a doctor because they are not working

(3)    The claimant cannot prove that they are disabled because they have no medical evidence to prove that they are disabled

On the other hand, I am often asked by my clients whether or not they should treat for a certain condition.  Although is it important to have medical evidence of your claim, it is more important to be forthright in your presentation to Social Security.  Social Security considers medical evidence provided by claimants in large part because the medical evidence represents a true sense of what the claimant is experiencing when they go to their doctor’s office.  If the claimant is going to the doctor for a secondary purpose, such as bolstering their claim for Social Security, this system breaks down with potential negative consequences for the claimant for both his/her efforts to obtain both future medical treatment and Social Security Disability Benefits.

The medical community is interested in treating people with an actual desire to improve their condition.  They are generally not interested in treating people who primary goal in seeking treatment is to support some secondary claim such as a Social Security Disability or SSI claim.  If Social Security reads in your medical evidence or suspects that you are seeking out medical care solely to support your Social Security claim (doctors will make these observations and put them in your medical records!), they will likely find you not credible and this may result in the denial your claim.

A rule of thumb to use when deciding whether to treat for a certain condition:  Ask yourself, if you had unlimited free access to healthcare and were not applying for Social Security Disability benefits, would you treat for your condition?   If the answer is yes, then by all means treat for the condition if you can.

In my next blog post I am going to discuss the implications of not treating for conditions and the circumstances surrounding when Social Security can use this decision against you in your claim and when Social Security is not permitted to use this decision against you.

What the Budget Cuts Could Mean to you

On March 1, 2013, automatic budget cuts will be made across the board in our federal government. You may have heard the word “sequester” in the news lately, which is the term for these automatic budget cuts. The cuts only apply to discretionary spending, and not to mandatory spending. Mandatory spending includes the monthly amount you are paid for disability, retirement, unemployment, food share or Medicaid. The delivery of checks should not be interrupted. However, the cuts will have an impact on the Social Security Administration’s day-to-day functioning and will mean different things for different people who are currently receiving benefits or are in the process of applying for SSDI/SSI benefits.

The Social Security Administration is facing an 8% budget cut totaling $11.5 billion. Former Commissioner, Michael J. Astrue estimated 5000 positions would be cut, 1500 temporary employees would be terminated and all overtime would be eliminated. These cuts will create more backlog, longer waits and reduced hours.

Although SSA has already started opening their doors later and closing them sooner, sequestration would likely leave us with even more limited hours. Currently, most offices are open from 9 AM to 3 PM Monday, Tuesday, Thursday and Friday, and from 9AM until noon on Wednesdays. With the budget cuts, these hours would be further reduced. It is also likely that entire office locations would be forced to close, making it more difficult for people to get to an office in person.  Wait times on the phone or in the office will increase with more limited hours and limited staff expected to handle the same amount of claimant traffic.

Furloughs, or days where the admiration is not open, are also a possibility, as they would save SSA $25 million a day. Not only would phone lines and offices not be open, hearing offices would be forced to close, meaning Administrative Law Judges would not be able to hear claims. Approximately 3000 ALJ hearings are held each day across the country. The potential for backlog if furloughs are needed is certain. The budget cuts will lead to more backlog within Social Security. For you, that means longer waiting times. It is estimated an initial application will take two weeks longer to process and waiting for a hearing could take up to a month longer than current estimates. If you are already receiving SSDI or SSI benefits, the changes will likely have little impact on you. However, if you are just beginning the application process, or appealing a denial, you can expect to spend more time waiting and more frustration in dealing with SSA.

 

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What does “Insured Status” mean?

When you are denied Social Security disability benefits, you are sent a form letter from Social Security. Most times, this letter tells you absolutely nothing about why Social Security denied your claim. For most people, the only meaningful piece of information is the date the decision was issued. That date is important because it lets you, or your attorney, know when your appeal needs to be filed.

Sometimes, however, the notice you receive will indicate that your insured status is at question in the case. In order to collect Title II Social Security Disability benefits, a person must have insured status. If your insured status is at question, the bottom of the first page of the notice will have similar language to the following:

“We also considered that your condition was not disabling on any date through 03/31/2011, when you were last insured for disability benefits. In deciding this, we studied your records, including the medical evidence and your age, education, training and work experience in determining how your condition affected your ability to work.”

If you receive a denial notice that has the above language, there is a question about whether you are currently insured for Social Security Disability benefits. Title II Social Security Disability benefits (SSDI) is a publicly funded disability program that is paid for through payment of FICA taxes on wages by workers and their employers. (or through the payment of self-employment tax by the self-employed) When a person pays FICA or self-employment tax, they are in essence paying premiums into a government run disability insurance plan. Some people have private disability plans. In a privately funded disability insurance plan, premiums are paid directly from the insured to the insurance company. In such a plan, a person remains privately insured for so long as (1) The person pays their insurance premiums and (2) The insurance company continues to offer insurance. For Title II Social Security Disability, the “premiums” paid by the individual, just like in a private insurance plan, only provide for coverage for so long. For Social Security purposes, all American citizens and other authorized individuals are eligible for the program provided they have worked enough to achieve insured status.

With limited exceptions, insured status is obtained by having worked a sufficient amount in both the workers lifetime and during the last ten years. In the example above, the individual has insured status through March 31, 2011. For this worker, March 31, 2011 is that claimant’s date last insured. If you have a date last insured listed on your denial notice, this can be a serious issue for your claim. Although a date last insured may make it difficult to obtain your benefits, it is not the end of your case. Even if you cannot prove that you are disabled prior to your date last insured, you may still qualify for Disability under Title XVI Supplemental Security Income.

The Ins and Outs of the Social Security Disability Program – February 21 at the Appleton Public Library

I will be giving an informational talk at Appleton Public Library on February 21, 2013 at 6:30 p.m.  I will be giving background information on the Social Security Disability and Supplemental Security Income (SSI) programs, including the basics legal requirements and procedure.  We will be in Meeting Room C.  The Appleton Public Library is located at 225 N. Oneida St.  Appleton, WI 54911.   For more information, you can visit the library’s event posting.

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