Hospitals & Asylums
Nannette Rose v. Social Security Administration HA-9-6-06
Emily has been the most popular female name each year since 1996. Jacob has been the top male name since 1999. New to the top ten this year are Ava and Anthony. Emily and Jacob are the most popular baby names for the seventh year in a row,” said Commissioner Joanne Barnhart at the annual Mother’s Day report.
A. Studies show that a 20-year-old worker has a 3 in 10 chance of becoming disabled before reaching retirement age. Ms. Rose suffered a nearly fatal ruptured colon and has subsequently broken her arm. Ms. Rose, who had been working 60 hours a week as a waitress at a local diner, was informed by the hospital that she would die in half an hour if she did not get surgery after her colon ruptured. Whereas Ms. Rose hoped for a second a opinion and was overruled by the staff a tort claim arises because the treatment was adminstered without consent. Whereas the treatment was lifesaving and there have been no untoward complications there is no cause for grievance with the hospital and the United States is sought to bear the cost of prescription drugs and unpaid medical bills. Most recently Ms. Rose had her arm smashed by a brick that fell through her ceiling in her bathroom and landed on her arm causing such damage that her forearm is in a cast. As the result of this painful injury Ms. Rose has completely quit working at her job as a waitress and cannot drive her car. Whereas as her health is fragile, her savings are dwindling and she is not yet of retirement age, it is hoped that Ms. Rose will be awarded a Social Security Disability benefits so that she can work less and find the time to study for the recertification of her teacher’s license so that she could work in a less physically demanding job with a school until she retires. Wherefore Nannette Rose is encouraged to take a bus and go in person to the Social Security Office in Room 2000 at the Federal Office Building at 550 Main St. Cincinnati, Ohio 45202 between the hours of 9am and 4 pm take a number and be prepared to wait an hour or two and/or come back a second day. To make effective use of her day Ms. Rose should also apply for food stamps at the Hamilton County Department of Job and Family Services. When her arm heals she is encouraged to work part time and continue receiving benefits with the condition that she clean her apartment and pursue recertification as a teacher in hopes of finding employment that is not physically demanding and will get her off of public assistance.
B. Anybody who is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months is eligible for Disability insurance. An individual shall be determined to be under a disability only if his physical or mental impairment or impairments are of such severity that he is not only unable to do his previous work but cannot, considering his age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy under 42USC(7)II§423. On August 30, 2004 Jo Anne B. Barnhart Social Security Commissioner and Mark B. McClellan CMS Administrator wrote to
1. Secure Medicare costs up to $800 a year for all otherwise uninsured US citizens.
2. Establish the US poverty line for people with resources of less than $4,000.
3. Grant eligibility for Medicare Part A and Part B if they have an annual income of less $12,569 if single or $16,862 if married or monthly income of less than $1,068 as an individual or $1,426 married.
4. Ensure Americans for up to $600 a year for Drug Discount Card.
C. People can apply online for Social Security retirement, spouse’s and disability benefits. Applicants who do not wish to complete their Social Security application on the Internet, may call 1-800-772-1213 toll-free to arrange for the application to be taken over the phone or in person at a Social Security office. If you are deaf or hard of hearing, call our toll-free "TTY" number, 1-800-325-0778. Applications for Disability Insurance involve submitting two forms to SSA.
1. The Disability Report Form - Adult (SSA-3368), collects details about your illnesses, injuries or conditions, and your work history, and
2. The Authorization to Disclose Information to the Social Security Administration (SSA-827) is used to request information from medical sources to make disability determinations under Social Security law.
D. Representatives who wants to charge or collect a fee from a claimant or a third party, for services provided in any proceeding before the Social Security Administration (SSA) under the Social Security Act, must first obtain SSA's authorization. § 206(a)(1) of the Social Security Act 942 U.S.C. 406) gives to the Commissioner of Social Security the right to prescribe rules and regulations governing the recognition of agents or other persons, other than attorneys as hereinafter provided, representing claimants before the Commissioner of Social Security, and may require of such agents or other persons, before being recognized as representatives of claimants that they shall show that they are of good character and in good repute, possessed of the necessary qualifications to enable them to render such claimants valuable service, and otherwise competent to advise and assist such claimants in the presentation of their cases. § 206(a)(2)(A) specifies that an agreement between the claimant and another person regarding any fee to be recovered by such person to compensate such person for services with respect to the claim is presented in writing to the Commissioner of Social Security prior to the time of the Commissioner's determination regarding the claim,
(ii) the fee specified in the agreement does not exceed the lesser of—
(I) 25 percent of the total amount of such past-due benefits (as determined before any applicable reduction under section 1127(a)), or
(II) $4,000, and
(iii) the determination is favorable to the claimant,
E. Social Security Administration Office of Disability Adjudication and Review Hearings, Appeals and Litigation Law Manual (HALLEX) at Vol I-1-1-2. Qualifications of Representatives grants to the claimant the right to appoint an a representative in their dealings before the Commissioner.
1. An attorney in good standing is one who —1. has the right to practice law before a court of a State, Territory, District, or island possession of the United States, or before the Supreme Court or a lower Federal Court of the United States; 2. is not disqualified or suspended from acting as a representative in dealings before the Commissioner; and 3. is not prohibited by any law from acting as a representative.
2. A Non-attorney as Representative may also be appointed by the claimant to represent their dealings before the Commissioner if the person 1. is generally known to have a good character and reputation;
3. is capable of giving valuable help to the claimant in connection with the claim; 2. is not disqualified or suspended from acting as a representative in dealings before the Commissioner; and 3. is not prohibited by any law from acting as a representative 20 CFR §§ 404.1705 and 416.1505
F. At the time of the first draft of Chapter 3: Health and Welfare (HAW), the Social Security Protection Act of 2 March 2004 (Public Law No. 108-203) introduced a rigorous certification program for non-attorney representatives noted in the Federal Register notice published January 13, 2005 (70 Fed. Reg. 2447 that requires the Commissioner of Social Security (the Commissioner) to develop and implement a five-year nationwide demonstration project that will extend to certain non-attorney representatives of claimants under titles II and XVI of the Social Security Act (the Act) the option to have approved representatives' fees withheld and paid directly from a beneficiary's past-due benefits. Currently, this option is alleged to be available only to representatives who are attorneys, in good standing.
1. Beginning with direct payments SSA makes to representatives on or after September 1, 2004, the service charge is 6.3 percent of the amount of the fee payable from past-due benefits, but not more than $75 per case.
2. Before then, the service charge is 6.3 percent of the amount of the representative fee payable from past-due benefits, not limited to $75. The fee specified in the agreement does not exceed the lesser of 25 percent of the past-due benefits or $5,300. (For fee agreements approved before February 1, 2002, this maximum dollar limit was $4,000.)
G. Sec. 303. [42 U.S.C. 406 note] Nationwide Demonstration Project Providing for Extension of Fee Witholding Procedures to Non-Attorney Representative established prerequisites including a fee of $1000 (in U.S. dollars) per applicant for Non-attorney representative to be eligible for reimbursement:
1. The representative has been awarded a bachelor's degree from an accredited institution of higher education, or has been determined by the Commissioner to have equivalent qualifications derived from training and work experience.
2. The representative has passed an examination, written and administered by the Commissioner, which tests knowledge of the relevant provisions of the Social Security Act and the most recent developments in agency and court decisions affecting titles II and XVI of such Act.
3. The representative has secured professional liability insurance, or equivalent insurance, which the Commissioner has determined to be adequate to protect claimants in the event of malpractice by the representative. a minimum total annual amount of coverage of $1 million (for all incidents in that year) plus coverage of $250,000 per incident. The insurance policy must be underwritten by a firm that is licensed to provide insurance in the State in which the non-attorney representative conducts business.
4. The representative has undergone a criminal background check to ensure the representative's fitness to practice before the Commissioner.
5. The representative demonstrates ongoing completion of qualified courses of continuing education, including education regarding ethics and professional conduct, which are designed to enhance professional knowledge in matters related to entitlement to, or eligibility for, benefits based on disability under titles II and XVI of such Act. Such continuing education, and the instructors providing such education, shall meet such standards as the Commissioner may prescribe.
H. Scarborough v. Anthony J. Principi, Secretary of Veteran’s Affairs No. 02-1657 (2004) authorized the payment of attorney's fees to a prevailing party in an action against the United States where the Government was not substantially justified under the Equal Access to Justice Act Costs and Fees 28USCVI(161)§2412(d)(1)(A) overturning years of denial of the state’s right to pay exhibited in Califano, Secretary of Health, Education and Welfare v. Sanders 430 US 99 (1977) and all other social security claims brought before the US Supreme Court. In McElrath v. Califano, 615 F.2d 434, 441 (7th Cir. 1980) the contention that disclosure of one’s social security account number violates the right to privacy has been consistently rejected. The temporary leave of absence from work for health reasons of Ms. Rose is similar to that of Bloom v. Bexar County, Texas (5th Cir) No. 97-50027 who was denied her worker’s compensation and discrimination claims under the Americans with Disability Act (ADA). On the other hand disability insurance is so trustworthy that even convicted felons can get the remittances they are entitled to for their work for justice and arguments as to their innocence as in Bloom v. Social Security Adminstration No. 02-3362 (2003). I am happy to have a Rose for my collection of social security litigation begun in Anthony J. Sanders v. Social Security Administration HA-5-3-06.
I. This petition is for monthly social security disability benefits under 42USC(7)II§423, food stamps and back pay dated to the time of the colon surgery so that Mr. Rose can afford to pay medical and other bills under 42USC(7)II§206(a)(2)(A) and get recertified as a teacher.
Tony J. Sanders
Hospitals & Asylums