An unprecedented and comprehensive article on the problems with Dedicated Accounts, written by Professor Mary E. O’Connell, of Northeastern University School of Law

This is an introduction to a problem that we (The Children’s Disability Project) have struggled with for years. The problem is called the “ dedicated account,” and we are not alone in our frustration with it.  In fact, three Commissioners of Social Security have tried to have it repealed!

The Children’ s Disability Project (CDP) has been representing children for ten years.  Early on, we discovered, to our dismay, that the families whose cases we had won could not access the money now owed to them by Social Security. When we tried to fix the problem, most often we ran up against a brick wall of confusion and misinformation.

As the dedicated account problem consumed more of our attention, we turned to Mary O’Connell, the mentor of CDP, longtime friend, and our former professor at Northeastern University School of Law.  Mary agreed to research and write an article about the history of the children’s SSI disability benefits program and explain the confused and confusing dedicated account.  Mary has written a splendid article, first of its kind, in which she lays out the history and the rigidity of the dedicated account as well as the undeserved bad reputation that parents have had who try to access their money.

Here is a shortened version of Mary’s article.

If you would like to read the original article you may do so by clicking HERE.

 

 

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Interested In Volunteering or Interning with CDP? Hear from CDP’s 2017 Interns!

How to Apply:

CDP is currently accepting applications for Spring and Summer interns and volunteers. If you are interested in joining the CDP team, please send a resume and cover letter to Maria Casas, via email at jobs@gbls.org

Shermila Kher, Harvard Law School

Shermi When Taramattie Doucette offered me a summer intern position at the Children’s Disability Project (CDP), I immediately accepted. I wanted a job that involved advocating for children, I enjoyed my interview for the position, and I’d heard only good things about GBLS. But as excited as I was, I tried not to let my expectations get too high.

After all, I was an awkward 23-year-old nobody stumbling out of 1L, going to work among seasoned attorneys at the largest provider of legal services in New England. I figured I should be prepared for the chance I might spend 98% of my time quietly fetching coffee and papers for the real lawyers, and 2% giving redundant input on a project that would be shamelessly exaggerated on my résumé later. I never imagined that within ten weeks I would have written three briefs, independently interviewed multiple clients, presented the opening statement at a hearing, and learned the names of most hospital records department heads in Eastern Massachusetts.

The CDP is a small group with an enormous caseload, and all employees – including interns – are used to their full potential to keep things running smoothly. In June Tara was set to interview the mother of “Liam,” a potential CDP client. Unfortunately, on the day Liam’s mother was free, Tara had to appear at a hearing. Since Jessica Podesva (a Fellow), had trained CDP interns on how to do an interview, and I was already planning to observe this one, Tara asked me to fill in. The interview went swimmingly, and I wrote a detailed memo for Tara explaining everything I knew about Liam.

Another great thing about CDP is that once you start working on a case, you generally get to keep it. This allows interns to more deeply invest themselves in their clients, and to have variety in their daily work. Plus, having one person take on most of the duties of managing a case is usually the most practical choice. At the end of the interview with Liam’s mother, I had her sign release forms so we could access Liam’s records. Once I had the release forms on hand, sending requests for records was a quick and easy task. Since I sent the requests, naturally it fell to me to follow up with the records departments. When the records finally arrived, I had to go through them to check the dates – page by page, since hospital records are not always in perfect chronological order – and if I was flipping through a file anyway, I might as well read it. And if I was taking the time to read a record, and look up all of the medical abbreviations contained therein, I might as well take notes…

But, to me, the most amazing thing about interning at CDP was the respect and trust everyone gave us. During one of Tara’s regular check-ins, she asked me to write a memo explaining the evidence in Liam’s case, and give my opinion on whether his claim had merit. I believed we could prove Liam’s impairments met Social Security’s definition of childhood disability. When Tara and Jane Smith (co-founder of CDP) read my merit assessment, they immediately agreed, and Tara told me to notify both Social Security and Liam’s mother that we had accepted the case. At this point, I was still the only one who had interacted with Liam’s mother, or directly reviewed the evidence. I was thrilled that Tara was willing to take on a case based on my disability law analysis; that a child was going to get legal representation because I believed in him.

I could say much, much more, but this is already shaping up to be one of the longer posts on CDP’s Blog.  Working for the Children’s Disability Project was one of the most meaningful, educational, and affirming experiences of my life. If you want to use your skills to help children and their families, and to make friends and mentors who will surely last for years to come; apply to be an intern at the Children’s Disability Project.

Charlotte Anrig, Harvard University

image1 My work at the Children’s Disability Project this summer far exceeded my expectations. As an undergraduate, I never imagined that I would be entrusted with important work, and yet Attorney Taramattie Doucette and fellow Jessica Podesva encouraged me to write briefs, conduct interviews, and gather school and medical records for over ten cases. (My work paid off: we won one of my cases, and we had a favorable hearing for another.) I gained hands-on experience with legal practice, and I became a better writer, researcher, and problem-solver. I also received extraordinary mentorship throughout the summer. Tara and Jessica pushed me, taught me, and inspired me, and they continually demonstrated the power of compassionate and thorough counsel.

Beyond the CDP office, my summer internship brought me into contact with an intricate social system. I learned about some of the life-saving possibilities and unacceptable limitations of government benefits programs, and I realized what an important role advocates play in the entire ecosystem. Through my work gathering school and medical records, I also learned more about how school and healthcare systems within Boston serve low-income families. My work with these records helped me understand the kinds of support that these families do (and do not) have access to, and it brought my attention to the ethical nuances of handling client records. In reading through records, I often gained an incredibly intimate view into someone else’s life, and I thought a lot about the balance between reading for useful evidence and reading with respect and empathy.

Undoubtedly, though, the best parts of my summer experience involved getting to know clients. I met some wonderful children and some truly amazing parents—mothers and fathers who worked tirelessly and with enormous love to help their families, even when faced with the harshest circumstances. Working for them was an honor and a privilege.

Edward Kim, New York University

Working at Greater Boston Legal Services for my first college internship was an incredible experience. I spent my time divided between the Children’s Disability Project (CDP) and the Family Law unit at GBLS. My summer work  for CDP included pursuing records from treating sources and schools in order to gather as much information as possible about the child’s disability.  I got to know how to advocate and navigate large hospitals and treating facilities in my pursuit of  medical information.  I drafted many letters and file memos concerning seeking evidence or about the case itself.  On the cases assigned to me, CDP depended on my development of the evidentiary record because it was used for representation of individual clients at administrative hearings.  I enjoyed being a part of the CDP team where staff willingly taught me and valued my input.

My tasks for Attorney Patricia Tellis-Warren in Family Law consisted of organizing, and preparing the evidentiary record for court.  The community at GBLS is incredibly supportive; everybody offers their time and assistance to help the interns achieve the most accomplishments that they can during their time in the office. This internship has greatly deepened my understanding of the legal field, and has prepared me for any future legal pursuits, such as attending law school. The knowledge that the work done at Greater Boston Legal Services provides life-changing help for people who truly deserve it is an inspiration.

 

Emergency hospitalization leads to “On the Record” win for CDP client

“Ivan” is a 5-year-old boy who has what his psychiatrist says is one of the worst cases of Attention Deficit Hyperactivity Disorder (ADHD) she has ever seen. He also suffers from Oppositional Defiant Disorder (ODD) and Post Traumatic Stress Disorder (PTSD). He witnessed serious domestic violence from his father against his mother when he was very young. Now, he is a loving boy who is quite attached to his mother, but simply cannot control his impulses.

When Ivan’s mother came to CDP for help, Social Security had already denied Ivan’s application for SSI twice. Ivan’s case seemed like a strong one from the start. He had already been kicked out of several school and camp programs due to his out-of-control behavior, at only five years of age. We had the support of his psychiatrist. He was receiving wraparound services at home from a team of therapists and social workers. All of this meant that we felt confident the judge would approve his claim when we went in for a hearing.

But then we got a call from Ivan’s mom that something horrible had happened. Ivan’s behavior had been escalating for a few weeks, resulting in problems at school and at home, and finally his mother decided that she needed to call for emergency assistance. Ivan was checked into an emergency room for three days, guarded by security officers, while they waited for space in a psychiatric facility for a thorough assessment.

While Ivan’s mother dealt with this incredibly difficult health scare for herself and Ivan, CDP knew that Social Security would have to approve the claim for SSI without a hearing, due to this serious new development. We quickly drafted a compelling letter to the judge, arguing that this latest hospitalization showed what we already knew and would have convinced the judge at a hearing: that Ivan qualified for SSI. Because of the gravity of the new evidence, the judge agreed, and granted the claim without holding a hearing.

Luckily for Ivan and his mother, they are set up with a fantastic team of psychiatrists, therapists, and social workers. His psychiatrist helped him successfully make the transition out of this latest hospitalization back to home. The therapists and social workers helped his mother find a specialized camp for him over the summer. And they are finally receiving the financial support they need and deserve through the SSI program, removing just one significant concern each month and allowing them to focus on keeping Ivan healthy and stable at home, school, and in the community.

Hear from CDP’s 2016 interns…

Headshot croppedXue Gao, L.L.M. candidate at Northeastern University School of Law

As an international student coming from Shanghai, China, I came to United States to study law for my second graduate degree because I would like to see how the U.S. legal system helps promote equality and well-being in community. It is always my firm belief that we study law not only to make more profits out of it, but more to see how law changes people’s lives for the better.  Advocating for children’s health is completely new to me because few non-profit organizations support children with disabilities in China. I was excited to start my internship at CDP to further confirm my desire to work for vulnerable groups.

My internship at CDP far exceeded my expectations. I used to draw a line for myself, and I assumed that line was my limit. Working at CDP creates magic for me to go beyond that limitation. My supervisors, attorneys Doucette and Leidel gave me enough space to self-learn a new area and offered me great help whenever I needed it.

As a non-native speaker, I highly appreciated the opportunity given by my supervisor to observe multiple client intakes. I did not expect that as a non-native speaker, I would have a valuable experience of interviewing a client on my own. My supervisor provided me with excellent instructions on next steps for clients’ cases and I now have a clear picture of how a typical CDP case works. This is especially a rewarding learning experience I could bring back to China in the future. Also, my supervisor gave me timely constructive feedback on all the client intake memos, assessments, briefs, and record follow-ups I have worked on.

The most challenging yet rewarding work during my internship was to read through almost two thousand pages of medical and school records for a child with ADHD, and write the brief for his upcoming hearing. The legal skills and respect I have received in working with CDP far exceeded my expectation. My supervisor shared with me all her thoughts on the case and enlightened me in the way she dealt with those unexpected situations. Also, I appreciated how much my supervisor did to review my brief and help present it in a more convincing and organized way.

I was much honored to work with CDP to contribute my share to help children with disabilities. For me, the internship with CPD definitely made a step forward to advocate for more vulnerable children across the world. I hope to bring this experience back to my home in China in the future, and work with children with disabilities there, because so few organizations do it now.

Photo by GBLS Staff

 

Brittany Peck , first-year law student at Suffolk University Law School

As a first year law student, I was able to get hands-on legal work that had a tremendous impact on the clients that the Children’s Disability Project serves. I was able to visualize a timeline of how clients are brought to the Project through intake or referral, to the individualized legal process that each client brings, and the projected outcome. I was able to see the inner workings of how the Office of Disability Adjudication and Review works, and the process of appeals.

The ability to work with such great mentors, Attorney Taramattie Doucette and Attorney Sarah Leidel, have truly made an impact on my career path of being an attorney. Before clerking for the Project, I knew that I wanted to be in the field of Public Interest, but I did not know exactly what type. After 7 months of experience clerking and engaging with clients, I now know that I want to strive to be a disability/mental health advocate and attorney.

CDP wins “On the Record” decision five years after initial application filed

“Brian” is a 14-year-old who suffers from severe and poorly controlled Attention Deficit Hyperactivity Disorder (ADHD). Brian’s ADHD is so poorly managed (even when he complies with medication) that it causes such severe behaviors that many therapists think he should be diagnosed with Oppositional Defiant Disorder (ODD). However, Brian’s psychiatrist has a nuanced understanding of him and his ADHD, and has made it clear that he should not be labeled as a “defiant” child – she explained to Social Security that his defiant, irritable, angry behavior is really only an effect of the fact that his medication does not completely control his ADHD.

Brian is a sweet young man who is excited to start a new high school next year, after being kicked out of one middle school for discipline issues, and starting a new one halfway through eighth grade. His mother, a hardworking per diem nurse at a Boston-area hospital, first applied for SSI for Brian in 2011, when he was nine years old. CDP represented them at the first hearing before an Administrative Law Judge in 2013. The ALJ denied the case and CDP appealed all the way up to the federal District Court in Boston. The federal court judge sent the case back to the ALJ with several instructions on how to reconsider the case.

Before the new hearing in April 2016, CDP collected thousands of pages of evidence to support the case. We contacted the treating psychiatrist and other therapists working with Brian, and worked with them to write convincing letters of support. We submitted all this evidence to the court. We prepared Brian and his mother for the emotional and stressful experience of yet another ALJ hearing. Brian missed a day of school and his mother missed a day of work. We arrived at the court and sat down in front of the ALJ to proceed. And then… the ALJ informed us that the new evidence had not been sent to the medical expert set to testify, and the hearing would be postponed. When counsel asked when we could expect to have a new hearing scheduled, the ALJ said Brian’s name would go back on a list to wait for the next hearing date, something which can take five to six months.

CDP, Brian, and his mother were all frustrated and let down. Brian and his mother were facing yet another six months without money that they were entitled to. So CDP called the court and did everything we could to convince them that to make Brian and his mother come to a new hearing was unnecessary and unjust. We worked with a senior supervisor at the court to facilitate an “on the record” decision, meaning they should make a decision based on CDP’s brief and all the evidence, without a hearing. On the record decisions are difficult to have approved. The support from Brian’s treating sources, the clear instructions from the federal court, and the persistent work of CDP finally paid off when the court informed us that they would grant the on the record decision, and Brian and his mother would not have to attend yet another hearing. When CDP called to tell her the good news, Brian’s mother said simply “I can’t breathe… finally after all these years.”

CDP is thrilled to have helped Brian and his mother. Five years after the initial application, they will receive the money that they deserve.

CDP Wants to Hear From You!

When children receive large retroactive Supplemental Security Income (SSI) benefit payments, the person receiving the benefits on their behalf – the “representative payee” – is required to open a separate bank account called a “Dedicated Account.” There are many specific rules about how the representative payee can spend the money from the Dedicated Account. It is restricted to academic or medical expenses which relate to the child’s disability. See CDP’s workbook with more information on the Dedicated Account rules here.

CDP is requesting information or experiences that advocates and/or representative payees themselves have had with the Dedicated Accounts. If you have tried to get Social Security to approve an expense, and they have denied it, we would love to hear your story. Please contact Tara Doucette at tdoucette@gbls.org or 617-603-1575.

Poverty & Children with Disabilities

Blog post by: Northeastern University School of Law Professor Mary O’Connell

Why are poor people poor? There’s a question lawyers, law students – indeed, many in the U.S. and around the world — could chew on for many hours. The answers, one would assume, are highly complex, and vary substantially by country and over time. In fact, however, American law has shown a remarkable tendency to oscillate between two highly simplistic explanations of poverty, what we might call the “luck hypothesis” and the “work ethic” hypothesis. Under the luck hypothesis, anyone could wind up poor. Those of us who aren’t poor were/are lucky. We had gifts like competent, loving parents, good health, decent schools. Those who are poor, under this hypothesis, have been unlucky. Under the “work ethic” hypothesis, by contrast, the poor are, at least disproportionately if not entirely, individuals who lack self-discipline and good habits. Yes, people are dealt different hands in life, but those who wind up poor didn’t try very hard. They don’t plan, they don’t work hard, they don’t capitalize on what is available to them. Given these competing – and seemingly mutually exclusive – hypotheses about poverty, what makes for sensible social policy?

For many years, I’ve had the privilege of working with two NUSL grads – Attorney Taramattie Doucette and Attorney Jane Smith of Greater Boston Legal Services (GBLS) — the founders of the Children’s Disability Project at GBLS. Tara and Jane work with poor families who have a child with a disability. Under the Social Security Act (SSA), a child with a disability whose family has an extremely low income qualifies for Social Security benefits. (The family must also have assets of less than $2000, in toto, though a car and a house — if they own one – are excluded). Added to the Social Security Act in the 1970’s, the children’s disability provisions seem to reflect the luck hypothesis. A child with a disability probably faces challenges that a non-disabled child does not, and those challenges are shared by her family. When that family is very poor (and 9.7% of U.S. children live in what the U.S. Census Bureau denominates “extreme poverty”), wise social policy might provide a modest income stream to help the family help the child.   It turns out, however, that today’s poor children with disabilities find themselves in the path of exactly the luck/work ethic collision described above. While the diagnoses of some disabilities are steady or falling (e.g., cerebral palsy), others are expanding – some rapidly. Rates of childhood diabetes, for example, have exploded, as have diagnoses of Attention Deficit Hyperactivity Disorder (ADHD) and what are referred to generically as “speech delays”, a possible early indicator of dyslexia or other learning disabilities. But what are these new diagnoses? Are they made up disorders, fastened on by parents eager for the income that SSD (Social Security Disability)-Children’s might bring? Are they the child or parent’s “own fault”, for neglecting exercise, eating a poor diet, etc.? While it might seem that a medical diagnosis of a disability – signed off on by an M.D. – would be sufficient to meet applicable legal requirements, disability law is an ever-changing mix, with lots of discretion on both the administrative and judicial levels. Is ADHD a “disability”? Should very poor parents whose child is diagnosed with ADHD get financial help? Or does the existence of benefits push parents to burden their child with a label that may compromise her chances for a bright future?

It’s easy to assume that the most complex legal arguments arise in clashes between corporate titans – and to be sure, many do. But much of American law’s complexity – from the text of arcane regulations, to procedural mazes, to Congressional inertia and deep philosophical rifts – plays out in the daily lives of poor children – a stunning 22% of whom currently live below the federal poverty line. Painful as it is to say, this seems to be a growth industry – with lots of room for the work of good lawyers.