2024 NADR Q1

FIRST QUARTER 2024

CONTENTS

IN THIS ISSUE

3 A NOTE FROM THE PRESIDENT

4 JANUARY 2024 THANK YOU PAC

5 HOW TO AVOID STEP 4 DENIALS

7 NADR SAVE THE DATES

8 FEBRUARY 2024 THANK YOU PAC

A NOTE FROM THE PRESIDENT

As NADR greets the new year, we’re excited to welcome a new confirmed Commissioner, Martin O’Malley.

Commissioner O’Malley’s initial contact with NADR has already led to a productive collaboration, notably the introduction of a status report detailing representatives’ initial and reconsideration claims. This development, a joint effort between NADR and SSA, enhances transparency and reduces inquiries to SSA.

NADR has outlined key policy priorities for 2024, focusing on addressing challenges in SSA’s disability adjudication process. These include reducing the claims backlog, revising overpayment collection policies, adjusting representation fees, reforming SSA policies to support disability claimants, and modernizing SSA’s systems.

We are also on the cusp of a transformative era with the integration of Artificial Intelligence (AI) in the field of disability representation and its use within the Social Security Administration (SSA). AI technology is poised to revolutionize how we process claims, analyze data, and interact with clients. This advancement will enable more efficient and accurate handling of disability claims, ensuring quicker resolutions and potentially higher success rates. NADR recognizes the importance of staying ahead in this technological shift. We are committed to equipping our members with the necessary tools and knowledge to understand and leverage AI effectively. Our focus will be on training and resources that help our members make AI work to their advantage, ultimately benefiting the

individuals we represent by securing the benefits they rightfully deserve. Embracing AI will not only streamline our operations but also enhance the level of service we provide, marking a significant step forward in all of our personal missions to advocate for those in need.

We’re also offering various events and resources for our members in 2024, including our annual conference in Atlanta, Georgia, many educational Webinars, continued informative episodes of the NADR podcast and much more.

Remember, as you plan for 2024, to check out the NADR website on the events tab for what is happening this year.

We appreciate your support of NADR and are eager to collaborate for a successful 2024.

Christopher Mazzulli, ADR NADR President

HOW TO AVOID STEP FOUR DENIALS

BY LEANNE HERNANDEZ, EDPNA, ADR

The fourth step of sequential evaluation is determining whether the claimant can perform any of their past relevant work (PRW) either as they actually performed it or as it’s generally performed in the national economy. Step four denials can be avoided much of the time by looking closely at the claimant’s PRW and correcting it as needed. Here are some considerations and things you can do to get past this step.

1. Did the claimant describe their work history accurately? If the claimant filed the application or completed the 3369 without assistance, there is a good chance that the work history as reported is either incomplete or incorrect.

2. Did the work meet the requirements to be classified as PRW? Those requirements include that the work must have been:

• Performed within the last 15 years (or 15 years prior to the date last insured if that is expired);

• Performed at the substantial gainful activity (SGA) level or higher;

• Performed long enough to learn how to do it; and (Remember, the higher the SVP, the longer it takes to learn how to do that work.)

• Done without special accommodations and was not sheltered.

Use the Detailed Earnings Query (DEQY) to help you identify what might be PRW.

• Look for companies where the claimant made a significant amount of money during the relevant time period.

• Don’t worry about places where the claimant made below SGA. For example, SGA in 2023 was $1470 for non-blind individuals. If the claimant had total earnings of $900 at an employer in 2023, it is not going to be PRW.

• If you’re not sure if the earnings were SGA, verify with the claimant how many months they worked at the employer, then divide the earnings by that number of months and compare to SGA for that year. If was done at the SGA level, then look the occupation up to see what the SVP is to determine if it was done long enough to learn how to do it.

3. Was any of their past work composite in nature? Remember, a composite job does not have a single counterpart in the Directory of Occupational Titles (DOT). The claimant can only be found capable of performing a composite job if they can perform all parts of the job. A recent client of mine worked at a travel center/gas station. She accepted payments from customers, but also cleaned the bathrooms, made pizzas and Cinnabons, shoveled snow in the winter, put down salt when the parking lot was icy and unloaded trucks when deliveries were made. On her application, I listed her job as Cashier/Stocker/Janitor/Cook to highlight that her job was composite. As she performed that job, it was medium as actually performed. If we had only listed “Cashier,” it would have been easier for DDS to deny her at step four because that occupation is generally performed at the light exertional level.

4. Ask “Did you ever” questions. In the example above, my client had just listed her job as a cashier. The way I found out that she did a lot more was by asking her “Did you ever do anything other than take payments from customers and get things from behind the counter for them?”

Many times, if a person works at a small company, they will have to do things beyond the scope of how that particular occupation is generally performed in the national economy. For example, an administrative assistant for a family-owned small plumbing business may have to clean the office or go pick up plumbing supplies for the owner.

HOW TO AVOID STEP FOUR DENIALS

BY LEANNE HERNANDEZ, EDPNA, ADR

(CONTINUED)

5. If it doesn’t make sense, it’s probably wrong. If someone worked in a factory as an assembler, they would be reaching most of the day. If they put that they only reached an hour each day, you need to ask them questions about how they performed their work. If someone worked as a janitor and put that they never lifted over 10 pounds, you should be asking questions such as if they had to use a 5-gallon bucket to mop floors. If so, ask if they had to lift the bucket into a utility sink, fill it up and then put it down on the floor. 5 gallons of water weighs over 40 pounds.

6. Be careful about putting “0” for postural activities. For example, many claimants will put that they never did any climbing as part of their job. You should ask “Did you ever have to climb any stairs to get in the building or within the workplace?” If so, you should not be putting “0” hours for climbing. Truck drivers nearly always put that they did no climbing, but they have to climb in and out of truck and that counts.

7. Be careful about job titles. Just because someone says that they were a manager doesn’t mean that they were. For example, if someone worked at a fast food restaurant as a “manager” and showed new employees how things are done, but didn’t hire/fire, make schedules, do performance evaluations, etc., you wouldn’t want to plant the seed that they were a manager by listing that as the job title. You want the job title to be an accurate reflection of what they did. In this example, I’d indicate that the claimant was a fast food worker, but I would include in the description that they helped to train/orient new employees.

I will look occupations up that I think are a better fit for what the claimant did, but the title is different. I will read through the occupational description to the claimant and ask if they did those things. If they did more than the description includes, that is indicative of a composite job so I’ll look for another occupation that includes the additional tasks they had to do.

8. So how do you correct work information? There are a couple of ways you can do it. The first is by completing a new 3369 form and submitting it. I will put a note that the first one submitted was incomplete/incorrect and the new one includes additional detail and information provided by the claimant. You can also address this during the hearing by having your client testify about how they performed their past work. Ask the questions that will demonstrate the work was misclassified by DDS. Perhaps you can get a copy of the claimant’s actual job description from the employer as well, but be sure you look at it carefully to be certain that all tasks they had to do are reflected on it.

9. You can get past step four with either physical or mental limitations. If a person’s past relevant work was skilled or semi-skilled and the claimant is limited to unskilled work, that gets you to step five. If the claimant’s past relevant work was performed at the medium exertional level and that’s the way it’s generally performed in the national economy, a limit to light work gets you to step five.

-Leanne Hernandez, EDPNA,ADR

than unnecessarily paying large medical bills.

FEE ISSUES

For Important Evidence ‐Based Work Decisions

1. FACT CHECK the Voca�onal Expert

2. COMPARE VE DOT Occupa�ons to hypothe�cals

3. ONE BUTTON CLICK to see the latest ORS Data

4. EXPLORE / CONFIRM ESTIMATED DOT JOB NUMBERS

5. SEARCH the DOT with various hypothe �cals

6. WIN MORE CLAIMS !

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