Affordable Care Act & Disability in Texas

Ongoing, regular medical care is crucial to establishing the presence of a severe “medically determinable impairment” needed to secure social security disability benefits in Texas and throughout the nation.  Failure to secure and sustain medical treatment for the disabling condition is one of the big mistakes I routinely see being made in my social security practice in Dallas Texas.

I realize that calling the absence of medical care for the unemployed and disabled as the individual’s “mistake” can seem a little harsh.The vast majority of disabled Texans without medical treatment that I encounter are uninsured because they have lost employer-provided medical insurance, and could not afford to exercise their COBRA rights to continued coverage.

Yet the reality is that non-treatment will torpedo most social security disability claims. Even the “Hammer” and “Strong Arm” personal injury attorneys who have decided in the last few years to also be social security disability lawyers know to ask in preliminary screening about medical coverage and care.

Texas remains one of the least generous states for medical care assistance, but all Texas counties are required to provide indigent health care services. In general, household income cannot exceed 21% of the Federal Poverity Guideline (FPG), but counties are allowed to provide benefits to households with income of up to 50% above the FPG.

Then there are large metropolitan areas like Dallas, Fort Worth, Houston and San Antonio that maintain county hospitals with their own indigent care programs that are much more available to Texans without medical insurance. Dallas county residences, for example, can enroll in Parkland Plus at Parkland Memorial Hospital. As you can see, Texas indigent medical healthcare is very county sensitive  Consult the directory at    http://www.dshs.state.tx.us/cihcp/county_locator.shtm for information about your Texas county of residence.

The Afforable Care Act (so-called ObamaCare) opens up a new path to medical coverage for social security disability applicants without medical coverage. Unfortunately the flawed roll out of the healthcare.gov website, and the fact that Texas is the reddest of the red state have made many Texans reluctant to pursue medical coverage under ObamaCare. One need only spend the evening on Fox News to be convinced that by applying for ObamaCare on healthcare.gov you contribute to a vast government conspiracy to destroy freedom. We are hearing from some of our social worker contacts that many in North Texas are securing very afforable medical insurance under ObamaCare. Up until now the best path to coverage is to use the phone contact/application number on healthcare.gov rather than applying online.The online application must have improved greatly, however, because even Fox News has slowed its criticism of the site.

Texas social security Administrative Law Judges (ALJs) routinely ask Dallas social security disability applicants that have no medical insurance about their efforts to secure medical care through Parkland Hospital. Is it just a matter of time before ALJs ask uninsured claimants whether they have tried to secure coverage under ObamaCare? I think so.

Common & Dangerous Myths (5th of 5 Parts): “I will Get Disability if I Just Convince the Judge I am an Honest & Good Person Who Really Needs Help”

This is a subtle point that I have come to over the past 20 years of representing social security disability applicants.  Of course no one specifically tells me that they believe that they will get disability if they just show the Administrative Law Judge what a good, honest, hard-working, and needy person they are, but it comes through loud and clear in other ways.  Some of the statements I hear often include:

  • “I have worked since I was 14 years old”
  • “I have never asked for any help from the government”
  • “Don’t they really I would rather be working?”
  • “Don’t they realize I would be making a lot more from working than from disability?”

I would suggest that such statements in part reflect a belief that securing disability benefits is primarily about a social security disability claimant’s credibility, honesty and need.  Claimants often offer the Administrative Law Judge unsolicited statements about how bad their financial situation is, thinking that their dire need will be persuasive.

Its is true that a claimant’s credibility is important.  The fact that a claimant has a good work record is positive, but is it only a very minor part of the picture. A person’s dire financial situation is of very limited use in a social security disability case, although it can tip the balance in your favor.

What is critical to winning a social security disability case is medical proof, medical support for your impairments, and a wise and experienced social security disability attorney who knows how to present these medical facts along with your testimony to provide a legal basis for the Administrative Law Judge to say “Yes” to the disability claim.

Binder and Binder Draws Unwanted Attention from Congress

Binder and Binder is the largest social security disability advocate firm in the country.  I doubt there is a single TV viewer who has not seen attorney Charles Binder in his cowboy hat urging social security disability applicants to “let them take care of the government”.

The Wall Street Journal has written a recent article about attorneys Harry and Charles Binder titled “Two Lawyers Strike Gold in the U.S. Disability System”. The article indicates that the Binders as attorneys earn more in social security disability attorney fees than anyone else in the nation, and that ex-employees have said that Binder and Binder routinely withholds medical records it deems unfavorable to their client’s case.  The article can be found at http://online.wsj.com/article/SB10001424052970203518404577096632862007046.html?mod=WSJ_hp_LEFTTopStories

I have commented before about the Wall Street Journals series of articles on the social security disability system, and the general poor journalistic standards these articles seem to be upholding.  This article is about the same as the prior ones.

The article suggests that there is something wrong with the Binder brothers making a lot of money in their disability practice.  Apparently the Wall Street Journal finds that Wall Street investment bankers making millions by churning money and selling worthless investments is an example of the free market system at its finest, but it is reprehensible for the Binder brothers to make a good living by helping disabled people!  Keep in mind those fees are not just lining the pockets of the Binder brothers, but pay for the substantial overhead, salaries, and advertizing of the Binder and Binder business.

Congressman Tom Coburn, the top Republican on a subcommittee on Social Security, is now calling for an investigation of Binder and Binder on the issue of withholding medical records.http://www.upi.com/Top_News/US/2011/12/23/Coburn-calls-for-Binder-Binder-review/UPI-98491324620881/#ixzz1hOT1v46m.  Coburn has been a long time critic of the social security disability system, and has opening called for social security to approve fewer disability claims.  It is naive to think he is just interested in reigning in the Binder and Binder firm.

Though some attorneys believe their ethical duty to “zealously represent” their clients may leave some wiggle room on what they choose to submit into evidence, one thing is clear:  ALL Administrative Law Judges believe it is wrong  for the social security disability attorney to withhold medical evidence.  In my 20 years of social security disability practice in Dallas Fort Worth I have never withheld evidence, and I have worked hard to make sure there is not even a suggestion that I have done so. Every medical file has some evidence that may not be supportive of a disability claim.  The social security disability attorney’s job is to explain why that evidence is less credible than the favorable evidence – not try to bury it.

An experienced social security disability attorney must maintain high integrity before the ALJs that decide disability.  While I know of no ALJ that would deny a meritorious claim because she does not trust the lawyer, the tone of respect and trust your disability attorney sets in the court room is critical to your success in securing social security disability benefits.

I make no judgment as to what has gone on at Binder and Binder.  It is clear, however, that they now have a huge credibility problem with the ALJs.  It may be much easier for a national like Binder and Binder to make these kinds of errors giving their heavy reliance on non-attorney staff.  In my office, I personally handle the submission of medical evidence. You should expect no less from any social security disability attorney you hire.

As a national lawfirm with a bigfoot print, Binder and Binder makes a big target.  But I would submit the real target is their, and my, clients: disabled Americans.

Binder and Binder, and I pursue a very different social security disability practice: they are nation wide, and I focus only on the Dallas Fort Worth, North and East Texas area. I believe, that social security disability claimants should hire a local, experienced attorney with whom they can have a more personal relationship. But that does not mean Binder and Binder handles disability cases in the “”wrong way”, or that they are unethical.

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214-219-7288
stanley@disabilityapproved.com

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