I do not think the system though should be judging claimants as potential frauds that have diagnosed conditions and have no SGA work history, ones that apparently were getting benefits as a child if I understand correctly, for severe possibly related to Autism childhood medical issues, and especially when that agency is widely known for lack of objectivity and denying claims that fully met their guidelines.
Of course there are those who defraud the system, just as there are professionals who commit such violations all the time, or that turn a blind eye to things in their system that is unethical, corrupt or discriminatory, but that is not an excuse to assume guilt before innocence. Look at each case separately, to be judged on its own merits. Service and professional persons are human too, but their demeanor and resulting decisions can make the difference between life and death, homelessness, divorce or condition worsening. They must be held to higher standards.
Video problems are not an excuse to treat claimants bad, as, from what I know elsewhere, it was that office that requested the video conference, and likely to benefit them, not with intent to help the claimant even if the claimant wanted that. Can video of the claimant at home in more relaxed surroundings pick up how the claimant could have acted differently in a more stressful medical setting? Can video at home pick up other things that could show up more in medical settings, like when walking, sitting down, seeing a new environment or live doctor in person for the first time, exiting, etc? So, that could be favoring the examiner, if that examiner already had an idea beforehand where they were heading, based on not enough or not more recent medical evidence, that justified the CE, or if they receive pressure–indirect or direct– from SSA/DDS to not approve or support the disability.
The bottom line is, if the SSA/DDS want to assume guilt, until proven otherwise, fine okay play that game. Then the claimant/beneficiary can assume fraud coming from that bureaucracy, and hurtful intentions behind many things they say or do, as research will show those agencies are far from saints, as there is far more dishonesty and unfairness, and lack of objectivity coming from those agencies, than from the typical disability claimant who most do not want to apply for such meager benefits, or get such a label, but must for their health and well being, and because of an inability to work to SGA levels by no fault of their own...
That unfairness happens at all levels in that system, as seen through research and findings, but especially lower stages, and it is widely known the Consultative Examiners are not objective, fully trained in evaluating all conditions, nor are they independent thinkers there, in addition to DDS internal doctors who too often go against claimant doctors. These people, and the claims examiners, receive pressure from the SSA/DDS to not approve certain number of claims, to meet internal desired quotas. And look at the stats. The vast majority of the 70% denied claims at the initial stage, are overturned later, from my research with 13% reversed decisions at appeal stage number one and then 47% of cases won at the 2nd appeal Administrative Law Judge stage.
So, what does this mean? Either the SSA/DDS were unfair earlier on with the majority of cases, for 60% of decisions to be reversed later, to an approval, or the claimant did not provide enough medical evidence earlier on, with or without a lawyer. I suspect the truth is somewhere in the middle, for most cases, but clearly the 2 bureaucracies involved have shown to play a big part there in not being fair and timely in giving accurate rulings for many cases that had much merit. The lower stages do not fairly weigh the evidence, and are in no hurry to do so, either because of pressure to push the cases forward to appeal stages, or as they do not have the time, or training to analyze medical findings and compare it to their 5 step process, or as they figure serious cases will be appealed to the end, and a judge will determine the merits of the claim there.
Well, again, the assumption is that many of these claimants can wait two years or so to get through that ALJ third stage. Many of these disabled applicants have severe mental or physical conditions whereby such delays or stress handling the cold and often seen as not-objective system, even if a lawyer is handling that, will exasperate their health and conditions regardless. So yes, fraud cases are weeded out, through these stages, and that is good, BUT at the expense of suffering of so many of the other cases that should have been approved more timely, with those person's, with cases with much merit, giving up, because they could not deal with that bureaucracy, or naively thinking the system must have been fair for what they were initially saying and for the denials , and when they acted as if they knew the situation well, but often what they were saying was the partial truth or just fiction, OR assumptions.. Many with Autism and other conditions assume professionals and agency people are neutral parties, following the rules. Well not in all cases, as the disability reversals later show, and if one does research. Or was it just that their rules are slanted again the claimants?
What is ironic is that our entire family(4 members) were approved during the initial stage. No appeals were needed. It is not because we are more disabled necessarily than most all the others who applied, and who were denied. It is because I knew how to present the evidence, in a logical and factual way, and to show in detail how each of us satisfied each step of their 5 step process. I did so in a polite, very convincing, yet professional way. You think many disabled will do this? And not instead resort to generalities or intense emotion which gives them reason to deny?
And, many disabled persons do not either know the rules there, or have the patience or abilities to do that. It should be the examiner who should realize that many disabilities can make doing that hard too, and if they cannot articulate things well to a lawyer/doctors because of the nature of their conditions. The examiner thus should have more leeway to factor this in and make educated guesses or reasonable inferences based on medical and other evidence, and as not all doctors will be specific in stating detailed limitations too. The SSA knows that, but they want disabled persons to act like lawyers or something and be able to express everything.
So, if one has no SGA work history, one or more well documented diagnosed conditions listed in the SSA BlueBook, that are acceptable conditions as a disability if meeting severity, and if a doctor just generally states they feel the claimant has difficulties with day to day activities and/or functioning, for instance, it should be up to the SSA to then ask the right additional questions needed to the patients doctor, or to get an independent doctor, not CE that is paid for by the SSA, to probe further. Asking all disabled persons to prove they are disabled seems unreasonable, in light of certain conditions make that impossible and as many doctors are not thorough and are prohibited by SSA to state they feel that claimant is disabled. .
So, yes, look at educational and work history, but also take into consideration what is on the application, ask further relevant questions and looking for consistency, and assume not that disability is not present, if things were leaning in that direction but just needed further inquiry. Make the process more caring, fair and timely, and not as unfeeling, lengthy, and with adversarial stance. Go straight to the law Judge stage, soon after any denial. If this requires more judges hired, so be it, as it is clear the 1st two stages are a joke. Mostly the very savvy with disabilities who get their points clearly across get approved, or those with very rare obvious severe physical conditions. The majority of the rest suffer, just to weed out a few bad, fraud apples.
The reason I am slightly venting a bit here is I tried to help dozens of claimants, and most cases with extreme merit were not approved until stage three, but I cannot write their applications for them or cover letters, or find rare competent, probing or detailed lawyers and doctors. I can point them in the right direction, but without a good lawyer and thorough doctor, unless things are perfectly presented, as as most lawyers are average at best or do hardly nothing really helpful, the odds are against one being approved stage one and two, if not presented in an overwhelming and convincing way. The SSA would rather assume either ability, or want you to prove yourself to a judge. For those with substantial work histories, chances of prevailing are poor, even if well documented disability, unless you can prove the disability began after that, or condition worsened much after that..
