How Will the Affordable Care Act Affect Social Security Disability Claims?

October 20,2009
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The Affordable Care Act is in the news again, with certain significant provisions set to take effect, state health exchanges coming online and politicians in Washington squabbling over the sweeping reform law as part of the recent government shutdown/debt ceiling soap opera. It’s no surprise that people have questions and concerns about the ACA: it is a comprehensive and complicated law that is likely to have an impact on millions of individuals and families across the country.

That includes many people who currently receive or may eventually seek Social Security Disability benefits.

The ACA, the divisive legislation which was passed in 2010 and generally upheld by the Supreme Court last year, includes a number of provisions aimed at making health care more accessible for Americans. It extends insurance coverage for families and individuals by barring insurers from denying coverage based on “pre-existing conditions,” eliminating lifetime caps on coverage and expanding the availability of Medicaid coverage. In one of its more heatedly-contested provisions, the law also requires individuals to obtain health insurance or face fines and penalties. Earlier this month, the federal government and individual states launched health care exchanges authorized under the Act, marketplaces in which users can shop for insurance plans.

The promise of making a wide range of health care prevention and treatment opportunities more readily available to Americans has led some to speculate that the ACA will eventually mean a tougher road to temporary Social Security Disability benefits for persons who are unable to work on a non-permanent basis because of a physical or mental impairment or combination of impairments. Because a person must be unable to work for a year or more in order to be eligible for benefits, the thinking goes that increased treatment under the ACA – doctors visits, access to medication, etc. – may mean that some impaired persons are able to recuperate sooner, leaving them ineligible for benefits.

In our view, however, the ACA also has the potential to be an important tool in helping a person seeking Disability benefits to prove his or her claim. As experienced Social Security Disability lawyers, we know that claims are often won or lost based on medical records and other evidence of impairment. To the extent that the ACA creates a system in which people are insured and thus seeing their doctors regularly, this may mean that they also have the documentation – x-rays, lab test results, diagnoses, treatment plans, etc,. – necessary to prove a Disability benefits claim. It may also help speed up the claims process for many benefits seekers by ensuring that the required documentation is before the Social Security Administration from the start.

At Hermann Law Group, PLLC, our New York Social Security disability lawyers understand just how difficult and stressful navigating the claim process can be for persons seeking Disability benefits. We guide clients through this trying time with care, compassion, professionalism and experience. Our firm proudly maintains a success rate of just under 90 percent for all decisions received over the past twelve months. That’s almost three times the national average at the initial application level and more than twice the national average overall. Please call or contact us to set up an appointment.