Local attorney, paralegal pen book to help health providers help patients get SSDI, SSI benefits
Nov. 21—PLATTSBURGH — Attorney Mark Schneider and paralegal Kayla Herbert, MSW, Social Security Hearing representative, wrote a booklet, "Social Security Disability Guide for Medical and Mental Health Providers," to fill a void.
"We try to concisely review the law for doctors and nurse practitioners and PAs, who treat our clients who are applying for disability and SSI," Schneider said.
"To win Social Security or SSI disability a person needs to prove that they have a medical condition that prevents them from working. To meet that standard, you need to have a treating Medicare source describe your symptoms and limitations. Just coming in and saying my back hurts or I feel bad, I'm depressed, I'm anxious is not sufficient. The critical piece of evidence to win disability either on the initial application or on an appeal, you need to have a written medical opinion and that is what this book is about."
For more than 40 years, Schneider has dedicated his legal career to helping people. He has worked as a Legal Aid lawyer, appealing Social Security decisions and other legal work for low-income clients. Since opening his office in Plattsburgh 25 years ago, Mark has won thousands of disability cases with Social Security judges. He is one of the only lawyers in the area that takes disability cases to the Northern District of New York and the Second Circuit of Appeals federal courts.
Hebert has worked for the Law Office of Mark Schneider for three years. In 2020, Kayla passed the Social Security non-attorney disability representative exam, making her one of the only non-attorney disability representatives eligible for direct payment in the North Country. Herbert has written numerous legal briefs for Social Security judges and won many appeals. Her master's degree in social work equipped her with the skill set to deliver empathetic and personalized support to clients.
"Kayla Hebert and I wrote this book so that doctors and other medical professionals in the North Country can better understand the disability process," Schneider said.
"Many providers are worried about a time consuming burden or liability if they give records, letters, opinions, or forms to Social Security. We explain how medical providers can scrupulously do the required paperwork quickly and effectively. We explain how the system works so that people who are unable to do any work can get the benefits they deserve."
Some of the issues explained in this booklet are:
1) The difference between Social Security disability benefits (SSDI) and Supplemental Security Income (SSI) benefits
2) The benefits from Social Security disability and SSI
3) The financial eligibility requirement for each of these benefit programs
4) The medical eligibility requirements for each of these benefit programs
5) The requirements regarding treatment by a medical or mental health provider
6) The importance of medical records to the application and appeal process
7) The importance of medical opinions regarding the claimant's impairments and limitations
8) The importance of legal representation during the application and appeal process
The booklet contains forms for medical professionals to use when assisting their patients and clients. The Social Security judges do not require medical providers to give testimony or attend disability hearings.
Rather, they ask providers to provide copies of records and to give their opinions of limitations. The booklet will assist providers in giving consistent and supportable opinions that are correctly evaluated by the Social Security judges.
Currently in New York, only 40% of people who apply for Social Security disability are approved at the application level. Claimants who are not approved on application need to file and win an appeal to get benefits. It is very difficult to win an appeal without legal representation.
Lawyers and other representatives are not allowed to charge people up front for representation at a Social Security hearing. They can only be paid their fee if the client win benefits. And, representative fees are limited to the amount approved by the Social Security judge and agreed upon by the claimant.
While, specifically tailored toward the medical community, including doctors, nurse practitioners, physician's assistants, licensed mental health therapists, etc., "Social Security Disability Guide for Medical and Mental Health Providers" is also helpful to the general public.
MISCONCEPTIONS
Schneider said there are several misconceptions by medical providers.
"One is medical providers kind of mix up being an expert in an injury case or some kind of a malpractice case with social security," he said.
"We're asking them to just give their honest opinion based upon their treatment and based upon the objective evidence like X-rays, MRIs, etc. For physical limitations, often there are specific tests — your blood pressure, your breathing pressure, MRIs and X-rays that can document if you really have pain."
If somebody says they have great pain when they sit and walk, that's not enough.
"A person can have a lot of pain, but if it's not backed by the objective evidence. ... They look at whether a person is getting the treatment you would expect under that condition," he said.
"For a physical condition, it might be getting injections. It might be physical therapy. It might be surgery. For medical limitations, it might be getting psychotropic medications. If a person says they can't work, they have too many limitations, you need to be getting treated for it and that's what Social Security looks at."
Doctors and providers worry about getting sued.
"They are very busy," Schneider said.
"The people who treat low-income patients are very, very busy around here. They don't have the time to sit down maybe and write a letter for five or 10 minutes. So, there are many reasons why providers are hesitant to give medical opinions."
The booklet's goal is to help providers understand why a lawyer sends applicants for disability to them and why they are asked to fill out paperwork.
"And for them to understand how important and critical it is to somebody's case," Schneider said.
"We are not asking anybody to exaggerate or lie or mislead. If a medial professional thinks their client could work or should work, if it's therapeutic, we're not expecting somebody to say something that is not supported by treatment and by the records."
The booklet contains examples for medical and mental forms for source statements.
"It has check boxes and really summarizes some of the issues," he said.
"For instance, to do sedentary work, which is the lightest work, you would need to be able to walk for two hours a day and sit for six hours a day.
"So in our questionnaire, we ask how long can your patient sit and stand without great pain? We can check that off. We also have other questions how much weight can somebody lift? If they'll be off-task if a person can't concentrate. We have that in our mental questionnaire. We are doing this to help clients who are disabled get social security or SSI and we're trying to educate the medical community of how they can help their patient."
A copy of this valuable resource is available for free to all medical providers in the North Country. The Law Office of Mark Schneider is sending copies to medical and mental health offices. Also, individuals can get a free copy by contacting the Law Office of Mark Schneider at 518-566-6666.
Email: rcaudell@pressrepublican.com
Twitter@RobinCaudell
