Spencer Bishins has a master’s degree from the London School of Economics, and a law degree from Florida State University. Working for SSA for more than 10 years, he drafted or reviewed thousands of disability decisions. After leaving SSA, he wanted to help demystify the complicated disability system. His first book, Social Security Disability Revealed: Why it’s so hard to access benefits and what you can do about it, explores the obstacles that disability claimants face as they try to access benefits.
INCLUDED IN THIS EPISODE (But not limited to):
· SSA System Demystified
· Veteran’s Concerns
· The Impact On The LGBTQIA+ Community
· Are Drugs & Alcohol A Factor?
· SSI Vs. SSDI
· Medicaid & State Level Implications
· Acceptable Income Levels
· The Way Claims Are Handled
· Treatment Record Hassles
· HIV Rules
· How Approvals & Denials Are Decided
· The Impact Of Politics
· Interesting Info On The Kinds Of Judges That Decide Cases
CONNECT WITH SPENCER:
CONNECT WITH DE’VANNON:
· Pray Away Documentary (NETFLIX)
o TRAILER: https://www.youtube.com/watch?v=tk_CqGVfxEs
· OverviewBible (Jeffrey Kranz)
· Hillsong: A Megachurch Exposed (Documentary)
· Leaving Hillsong Podcast With Tanya Levin
· Upwork: https://www.upwork.com
· FreeUp: https://freeup.net
VETERAN’S SERVICE ORGANIZATIONS
· Disabled American Veterans (DAV): https://www.dav.org
· American Legion: https://www.legion.org
· What The World Needs Now (Dionne Warwick): https://www.youtube.com/watch?v=FfHAs9cdTqg
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You’re listening to the sex drugs and Jesus podcast, where we discuss whatever the fuck we want to! And yes, we can put sex and drugs and Jesus all in the same bed and still be all right at the end of the day. My name is De’Vannon and I’ll be interviewing guests from every corner of this world as we dig into topics that are too risqué for the morning show, as we strive to help you understand what’s really going on in your life.
There is nothing off the table and we’ve got a lot to talk about. So let’s dive right into this episode.
De’Vannon: Spencer Bishins is the author of the Eyeopening book Social Security Disability Revealed why it’s so hard to access benefits and what you can do about it baby. Now in this episode, we’re peeling back the pages to give you an inside look at what really goes on inside the Social Security Administration.
And as you can guess, it’s lots of Tom Foolery lies honey scandals in every [00:01:00] imaginary type of deception. Listen close, learn some new shit. Share this with a bitch, you know, and reach out to me and let me know what bothered you the most about what you found out about the Social Security Administration.
Hello, are you beautiful and special people out there? And welcome back to the Sex Drugs in Jesus podcast. My name is Hubert and I’m your house. And I have with me the mentally stimulating, mind opening, feeling spilling. Spencer Bishops and he is an author and he has come to help us out a lot today.
Spencer, how are.
Spencer: I’m good. How are you? I am
De’Vannon: fan fucking,
Spencer: and I, I, I have to say that is the most unique intro I’ve had so far. No one has given me that exact same intro yet, , [00:02:00]
De’Vannon: god damn it. And they never fucking will unless they steal my shit. So, I mean, that’s bowing to happen. So so Spencer, he, he wrote a book, it’s called Social Security Disability Revealed.
Oh, there it is. Beautiful. Why it’s so hard to access then to fits and what you can do about it. So, Spencer Bishop, he has a master’s degree from the London School of Economics and a law degree from Florida State University. Go FSU now. He worked for the Social Security Administration for more than 10 years.
Then he pieced out from them motherfuckers because he wanted to demystify the complicated disability system. This book here, Gonna help you overcome the obstacles that stand in the way of you getting your damn money. Especially after we work, they take all goddamn damn money outta our check and then when we want it, they don’t wanna give it back.
Ain’t that some shit? [00:03:00] Fucking
Spencer: bitches. You don’t even need me. That’s just summarize the whole book right there, . Yeah. So.
De’Vannon: I’m gonna pull up the table of contents and read just a few of the chapters and then, I mean, read, read a few of the chapter titles just cause I found them to be interesting. And then, and then right after that, I’m gonna let you tell people why you wrote it and who you are, in your own words.
But I thought, I just thought the, the table of contents would like, kind of spill some of the t. So some of the chapter titles from this book are called like after the hearing the Appeals Process, permanent Mental Health Conditions, drug Abuse and Alcoholism, child claimants, deceased Claimants and Widow Claimants Firing Your Representative, and fraud, waste and Abuse.
You know, this, this book has 34 chapters in it. So during this podcast show here, and I don’t know, we might have to have you back on for a second [00:04:00] time, but be it once or twice, we won’t be able to cover all this. So, Y’all wanna get your money, gonna have to get this booked here. So we’re thankful that you, after having worked there, gave us this testimony.
Now tell us why you did this in your own words and who you are.
Spencer: Before I do that, I just wanna say, I promise what’s in those chapters is far more interesting than the titles themselves. I wanted to do some more like catchy chapter titles and my editor suggested, no, just tell people what’s in the chapters.
Don’t get too fancy with the chapter titles themselves, but the actual content is far more interesting. So I worked for Social Security for 11 years. During the first four years, I reviewed thousands of cases on appeal decisions that had already been written. And then I went before, as you say, before I pieced out.
I spent another seven years at the hearing level actually writing decisions for [00:05:00] administrative law judges. So, and I wrote almost 2000 decisions. So with a sample size that large, as you can imagine, I learned a lot about who gets paid, who doesn’t, how judges make the decisions that they make, what techniques they use to deny cases, even when there’s really good evidence suggesting someone is disabled.
And as you said in the intro, everyone who has paid into the system, that’s your. If you work, if you’ve paid the social security tax, whether you’re an employee or have been an employee, or are, or have been self-employed, either way you’ve paid the social security tax. Mm-hmm. , and that’s why it’s called an entitlement because you are entitled to get money if you qualify.
But I learned a lot of the ways that Social Security and its judges look at people and medical records that should qualify for benefits and figure out ways to deny those [00:06:00] claims. And so I wanted to present the information that I had learned about what the Social Security disability process is. Cause it, it, you know, it’s the government and it’s, it’s social security.
It’s like two things that if you are not sleeping well, you know, just think about those right. And it’ll be your cure for insomnia. And so most Americans don’t want to think about boring things like the government or social security or government benefits until you actually need them. If you get hurt, injured, have some sort of chronic condition or something, all of a sudden it ain’t so boring anymore, right?
Then you realize, wow, this is something that I actually need. I really need to know how to work this system. I need to know how to play the government game, and so that I can give myself a decent chance of actually getting these benefits that I’ve paid for. Mm-hmm. ,
De’Vannon: show us the [00:07:00] money. We need our money. So how many people do you think are on disability right about now, and about how many applications do you think come in a year?
Spencer: So it wasn’t long ago that it was like 2 million applications a year. I think now it’s somewhere between around 1 million applications a year. I don’t know if we’re still above that number or not. And somewhere around nine or 10 million Americans are on are receiving disability benefits. And for social security overall, I think it’s like 40 million.
It’s a lot because that baby boomer generation is in the retirement zone and in like another 10 years as they’ve died out. I mean it sounds heartless, but that’s just statistics and math and reality. Right. At the point where they’ve died out, the number of overall recipients will probably come down, but the number of disability recipients probably hold pretty steady over time.
De’Vannon: [00:08:00] so, so somebody, it’s a, it is a state benefit as I understand it, or is it federal?
Spencer: No, it’s a federal benefit. When you apply, the first place your application goes is to your state agency and someone at the State Department of Health is responsible for making that initial decision. But if you’re approved, it comes out of the federal pot of money, either the Social Security Trust fund for Social Security Disability Insurance, or for supplemental security income, which is a different program.
It just comes right out of that plot of general revenues in federal income tax that we all pay. But, but it’s federal both ways. So at the initial level and at the reconsideration level, which is the second, second step of the process, it’s a state employee making the decision, but still as to whether or not you can get federal money.
Okay. So, but, but as I [00:09:00] talk about in the book, Their decisions can impact the state budget too, which is why they’re not neutral decision makers. They’re not disinterested parties. There’s a conflict of interest because if they approve you at the, if that state employee approves you for ssi, you can then get the Medicaid.
And Medicaid is a federal state partnership, right? So it’s a state employee deciding whether or not you should be approved for ssi, but knowing if they approve you, it’s gonna cost the state money from their Medicaid program. So what would you do if you were that state employee and you could potentially cost the state lots of money and your boss has told you, stop costing our state.
It’s a conflict of interest, isn’t
De’Vannon: it? Yeah. They do shit like that. That’s why I don’t work for anyone anymore because bosses are bitches. So you mentioned ssdi. I, so what is the difference between SS I versus [00:10:00]S S D
Spencer: I? Yeah, so, and I, and I cover this more in depth in part one of the book. But SSDI is, so I think it, you used to work for someone then, right?
Were you ever an employee, W2 employee and you got a pay stub? Yeah. Most of us have done that at some point. Right? On that pay stub, you see three federal taxes coming outta your paycheck every two weeks. Federal income tax. But then there’s also the social security and Medicare tax, that social security.
Goes to pay for the Social Security Trust fund. And normally we think of that as retirement. I got something I get when I’m an old bart. Right? Don’t have to worry about that now. But that also pays for the disability program, which think of that like as your retirement benefits, but sooner if you become disabled and unable to work.
So that tax pays for both of those programs, which are kind of really the same [00:11:00] program. That’s ssdi Social Security Disability Insurance, that tax you pay. Think of that like an insurance premium that you’re paying. And then you have this insurance coverage and you have to have that insurance coverage in order to file an insurance claim.
So it operates like an insurance company in that regard. Separate from that is supplemental security income. And that program is really for people who either, who don’t have that. Insurance that I just talked about, because they haven’t paid enough into the social security system to earn enough credits.
So that could be stay at home parents, it could be young workers who haven’t paid in long enough. It could be recent immigrants, it could be older people who are retired and haven’t worked in the last five years, and so their insurance ran out. So for whatever reason, maybe you just can’t get that S S D I insurance.
Well, you can go file a claim for [00:12:00] ssi and as I said, that comes out of just regular income taxes. But because that’s not an earned benefit, you didn’t pay that insurance premium. It’s a lot more unstable of a program. First, there’s asset and income limitations, so if you have even a little bit of money or you’re earning even a little bit of money, you’re not gonna qualify.
And even if you get approved, it’s like 800 bucks a month. And if you work part-time, they’ll offset that 800 bucks a month. And as I talk in the book, they’ll even offset it for other things. Like let’s say you’re homeless, so you’re crashing on someone’s couch. Social Security will say, well, you’re getting air quotes pre-read, and they’ll deduct whatever they think the value of that is from your ssi.
So that SSI program, it’s there. And for some people it’s all they can get, but it’s really not a very good or very useful program. [00:13:00] So the SS D I program is much better. It’s an earned benefit. And with that you can get Medicare coverage if you’re disabled, which helps with healthcare. If you’re not working, you don’t have private health insurance.
Right. And the other great thing about the S S D I program, the insurance program is that you can actually work. And still get paid benefits at the same time. And that’s totally allowed. And the reason Social Security allows that is they want people to try and go back to work. So they let you collect your benefits while you’re getting back into the workforce and making sure you can do it.
De’Vannon: that’s so sweet of them. I
Spencer: know, right? Yeah. But people get confused cuz they’re like, my neighbor’s disabled and I saw him out pushing a lawnmower and they think like people are gaming the system by working while collecting disability. But that’s just a misunderstanding of the system. System actually wants you to go out and try and work [00:14:00] to see if you can do it.
And then if you do that long enough, then you graduate from the S S D I program. And they stop your benefits and you return to the workforce. So it’s actually a good thing that we let people collect benefits and work because otherwise nobody would go back to work. Right. And that’s what we want. We want people who can go back to work.
To go back to work if possible.
De’Vannon: So if somebody’s working in collecting those benefits, is there like a maximum amount of income they can work? I mean can bring in in order for that to
Spencer: happen? You read the book didn’t you? ? I can tell. Cause that’s an excellent question. And you know the answer is yes, there is
So there’s a maximum amount of money that you can be earning per month when you’re an applicant and a separate number. That’s a maximum that you can earn after you’re already receiving S S D I benefits. And that amount is lower. And the thing is, if you work and [00:15:00] earn under that amount, You can just keep working indefinitely as long as Social Security keeps paying you your benefits.
If you exceed that amount, that’s fine, but you only get to exceed that amount for nine months. At the point where you’ve exceeded that amount for nine months, social Security decides that’s what, how they decide that you can go back to work. And so that amount changes every year. But I believe it’s $970 this year in 2022.
So if you are getting benefits, you’re allowed to work. But if you exceed $970 per month, it actually isn’t a lot to think about it, right? Like if you’re making 50 bucks an hour, it’s 20 hours a month or five hours a week. So it doesn’t take a lot to show that you can go back to work, but that’s what social Security wants to see.
They don’t need to see that you’re working 60 hours a week. They just need to see enough to know that they can cut you loose. [00:16:00] And that you’ll be okay on your own. Mm-hmm. and, and that number is a little higher when you’re an applicant. It’s $1,350 per month that you can work and earn and still claim, Ben still file an application for benefits because that amount indicates that even though you can work, you’re probably not doing full-time work.
If you exceed that amount, social Security decides that’s, that means you can probably show that you can do full-time work and you’re not disabled. Mm-hmm. .
De’Vannon: So why thank you for that breakdown. Why, why or so many people not at the beginning of the process? Well, we talked about
Spencer: one reason already, right?
Which is that when you go to the state agency, you, when you first file your application, someone at your state government, usually it’s the State Department of Health. Some like $40,000 a year bureaucrat is gonna look at your disability claim and basically like, Make a decision on your life. They’ll look [00:17:00] at your medical records and your work history and they’ll make a decision as to whether you’re disabled.
But as I talked about a few minutes ago, they’re a state employee and they work for people who wanna keep the state Medicare costs down. So one reason is there’s a conflict of interest and they just wanna save the state money. But another reason is, I mean, just think about your own medical records, like they’re probably, you probably, if you went to try and get all your medical records for the last couple of years today, you’d have a hard time doing it.
And if you have physical impairments, that mean you can’t leave your home. So when your doctor says, just come pick ’em up at our office, maybe that’s hard to do. Or if you have mental health impairments, Agoraphobia or anxiety, depression, you can’t deal with other people. It might be hard to talk to people in, in your doctor’s offices.
I, not too long ago, a doctor literally told me, we’ll [00:18:00] fax you the records. What’s your fax number? Like it was 1987. So it’s often just really hard for people to get their medical records, to get them organized, to make sure they’re complete, to get records from all the different places they’ve been getting treatment.
So I guess they even back up from that. The first thing is sometimes it’s hard for people to just get medical treatment. In the United States, 80% of people get their health insurance from work. So if you can’t work, cause that’s why you’re filing a disability claim, right? You can’t work, you lose your health insurance, well then you can’t go get medical treatment.
So the first obstacle is, I can’t even get treatment. So how am I supposed to get records? Even if you can get treatment, it’s sometimes hard to literally get the actual pieces of paper from your doctor. And then you’ve gotta get it all organized and give us a social security. You’ve also gotta fill out their application, their other endless paperwork, like functional reports rely on them probably losing [00:19:00] something along the way and making you fill it out again.
Or like, oh, sorry, we lost some of your medical records. Can you like go get those a second time for us? Thank you. It’s just barrier after barrier after barrier. The social security puts in your way, a lot of it with very specific intent to keep you from getting through the process and getting a favorable decision on your claim.
They know it’s hard for Americans without a job and insurance to get treatment. They know it’s hard for Americans to gather medical records. Our medical record keeping system in the United States is. In France, everyone has a card. It’s kinda like your driver’s license and it’s like it’s got a barcode on it and that card you can take to any medical facility in the entire country and they scan it and they can immediately pull up your entire medical history.
In the UK they have something similar with their National health Service and [00:20:00] during the pandemic, within one week, they knew every single British citizen who was a high risk for Covid and they were able to deliver food boxes to those people’s homes because they knew where they lived and they did it within one week because they had that information.
It was well organized. They knew exactly where to find it, and they knew how to keep people safe. And in the United States, we still have doctors saying, we’ll fax you your records. It’s ridiculous. But Social Security knows that this is happening. So they know that the records that they’re gonna get when you first file your application are gonna be kind of a mess.
So is it any surprise that they’re denying over 70% of people at that initial application? Somewhere along the line, someone gets tripped up. They don’t fill out a form, right? They don’t get certain medical records in they can complete, they miss a meeting with someone with the Social Security Office.
They can’t [00:21:00] go see. Social Security will send you to see this doctor that they basically pay to give you an opinion that you’re not disabled. They literally tell you you have to go see a doctor. And we’re paying that doctor, and those doctors know to send Social Security and opinion saying that you can work.
Otherwise they’re not gonna keep getting referrals. And so if you cooperate, you’ll probably get an opinion saying you can work. And if you don’t cooperate, social says, security says you’re not cooperating. So like at some point, one of everything that I’ve just said will trip up most people and that’s why most claims get denied at the initial level.
I do know someone who got approved at the initial level, but he was like, he was in the hospital for several months and like, you know, you can imagine how many thousands of pages of medical records that was and they all came from one source. That’s the kind of case that social security probably [00:22:00] approves at the initial level, but that’s a very rare situ.
De’Vannon: Mm. Well y’all of, y’all wanna find out how to circumnavigate that sort of issue. You better grab a copy of this book now. Talk to me about any kind of implications related to, hum. Human immuno efficiency virus, hiv.
Spencer: Yeah, so Social Security has a listing for, I it’s in the immune disorders section and let’s see if I can get it right.
I think it’s listing 14.08. I haven’t been with Social Security in a year, so we’ll see if how close I came to that. But the thing is, the social Security listing requirements, they’re really strict. And so while every. I was wrong. It’s 1407, so I was close though. And [00:23:00] the requirements are super strict for every impairment listing and HIV is no exception.
So if you meet the requirements, you can be found disabled without social security considering your work history or whether you could work. That’s to talk about in section two of the book, how that’s just a medical determination. But you have to have not only the infection diagnosed, but you have to have something else that is either resistant to treatment or requires hospitalization.
And that has to happen three or more times in a 12 month period. And there’s a list of what these other diagnoses have to be, or you have to have something else for a full 12 month period. Or you have to have repeated manifest manifestations of your disorder. At least two. So there’s so many requirements is my point.
And that’s the case with all the social security [00:24:00] listings. It’s not just like an HIV diagnosis. It’ll say, you know, an HIV diagnosis with this, this, this, this, and this. And the last thing will have like three elements under that. And that’s only like the most severe case is end up meeting these listings.
And so for most people, the way that they’re found disabled is based on their functioning. So if you don’t meet this very specific list of requirements, what social security does is they say, okay, you didn’t, you’re not disabled medically, but how does your impairment now impact your functioning? What are your functional limitations?
And is there a job you can do in the national economy? And so I think with I probably a lot of it is fatigue. And, and there and there may also be difficulty standing and walking or lifting because of fatigue. Do I have that right? As far as like, those are kind of typical functional [00:25:00] limitations someone might have.
De’Vannon: I don’t really feel like there’s like a limit to limitations with someone with HIV man because hiv. Lowers, you know, the immune system and it depends on that person’s body.
Spencer: That’s a great point. Yeah. So you could have gastrointestinal issues, you could have breathing issues, and then of course, it’s really common when people have any kind of physical impairments.
It’s really, really, really common to then have mental health impairments as well. Actually, I, I would say most cases that I saw that had anxiety, depression, PTSD, listed as impairments, they were secondary to some sort of physical condition, be it musculoskeletal or respiratory or an immune system disorder, like hiv.
And so, yeah, when you take into account all of this person’s impairments and all the ways that it impacts the mind and body, what happens is social security [00:26:00] comes up with a list of functional limitations and then they go to a, a vocational expert, a jobs expert, and they say, Here’s a hypothetical person with a bunch of limitations.
Are there any jobs in the national economy that person can do? And as I talk about in the book, the thing is when they ask that question, when the judge asks that question, they already know the answer. And here’s, I’ll give you an example. If I say, I have a hypothetical person who can only work six hours of an eight hour workday, are there any full time eight hour jobs that person can do?
We already know the answer is no. Right? Cause the person can only work six hours out of an eight hour workday. So there are certain limitations that SSA judges and attorneys, there are certain limitations that they know will result in a finding of disability. And certain limitations that they know will not result in a finding of disability because there are jobs out there that someone can do with [00:27:00] those limitations.
So that’s where it becomes a really. Personalized review of your situation where the judge and the attorney looking at the case, have to look at your very specific medical records. Look at what you’re telling doctors, look at your overall functioning, look at your attempts at work and see if you couldn’t work, why you couldn’t work, and try and figure out for this one specific person what that specific person’s individualized limitations are based on their personal medical situation.
Because as you said, something like HIV and other impairments as well impact people on such an individualized basis at that point. It really, it is about getting into the fine details of that person’s medical record to understand what it is that person can or could not do on a 40 hour per week basis.[00:28:00]
De’Vannon: gonna get a little bit ahead of myself here since you’re, since we’re talking about the individualization of it all. Before we had, before, before this recording here, we had talked about a remand rate, a remanding, and you were telling me how not necessarily each and every last review is individualized.
Yeah. So can you talk to us about that? Cause I don’t want people thinking that they’re necessarily going to get special attention, .
Spencer: Well, it’s, the thing is, it’s kind of a mix because the judge who’s deciding the case and the attorney who’s their staff attorney, who’s actually writing the decision, and that was my job, to write the actual decisions for the judges.
They do look at every individual’s medical records and they do conduct an individualized review of every case at the same time. You are both an individual person but also a statistic because while you’re being looked at as an individual case, [00:29:00] that judge has 50 cases that they’re doing every month, which means they’re doing about 600 case, five to 600 cases a year.
And then that hearing office is doing a few thousand cases a year. And then your region is doing 10,000 cases a year or 20,000 cases a year. And then that means nationally it’s, you know, over a hundred thousand cases a year. And at each level of the process, you have people looking at the big picture.
What is our pay rate? How many cases are we paying? How many are we denying? Is that pay rate too high? Are we getting too much pressure for members of Congress? Cause we’re paying too many cases. Maybe we need to bring down the number of cases we’re paying. And then if that happens, that filters all the way down to your individual judge who starts thinking.
Maybe I’m paying too many cases, maybe out of my 600 cases this year, instead of paying 200, maybe I should pay 1 75 or one 50. And so now they’re thinking about which cases [00:30:00] that they may have paid. Now they’re gonna deny instead. And that’s where you become both the statistic at an individualized person.
Because yeah, they’re looking at your individualized situation, but they’re sitting there thinking, headquarters is telling us to pay fewer cases this year. Maybe this is one that I should be denying. Maybe a week ago I would’ve paid it. And maybe today, after getting that email from headquarters, maybe today, I think about denying this case.
And so it’s both and every case is both. You’re constantly being evaluated as an individual and a statistic. And that can be really hard on the person writing the decision because. My job was to write the decision the judge wanted. So I don’t actually get to decide whether the person’s disabled or not.
I just have to justify whatever their decision is. And so I would often see cases that I thought there was [00:31:00] really good evidence to approve the person, solid evidence, showing their diagnoses. Say it’s something like hiv. I saw a lot of HIV cases. I see their diagnosis. I see their, their test results with cdr CD four, sorry, CD four levels over 200.
And I see white count levels that were, were low. And I see other limitations. Difficulty walking long distances. Or someone would say, you know, I tried to go back to work and I just got too tired and I had to quit that job after a week. And the judge would be telling me, we’re denying this case. I’d be like, why this?
This is really good evidence for I making an individualized analysis saying, I think this is good evidence. I think we should approve this. But then that judge has these external factors that they’re thinking about that [00:32:00] in addition to looking at you as an individual, they’re also thinking about this case as a statistic.
And sometimes when those things, you know, come into conflict, sometimes I then have to write a decision that I don’t wanna write or that I don’t think the evidence.
De’Vannon: Well, I’m so happy you have a soul. You know, I, I know not everybody in the Social Security Administration does, but and you have filled that soul out onto these pages, so I appreciate the, the love that I feel reverberating from you, man.
Now there is this book, cuz this little book called The dsm and y’all, that stands with the Diagnostic and Statistical Manual of Mental Disorders. And I think now we’re on like the DSM five, it’s gone through a few changes over the years. Yeah. So there’s a word in there called gender dysphoria. Spencer, and I don’t care for that word, dysphoria.
However, [00:33:00] that is what is in that book. And so talk to me about what that means and then what it means for dis for the, for these disability claims.
Spencer: Yeah. It doesn’t mean much. Well, we’ll just boil it down to that. So, after the revisions to the DSM happened in 2013 We did start to see diagnoses of gender dysphoria.
here’s the thing, I’m not a doctor, I’m not a medical professional. The medical training that the lawyers at Social Security who make the legal decisions, the medical training they’re given isn’t how to look at a person and make a decision. It’s really more how to read medical records. Cause that’s what we need to do.
We need to read medical records and know how to find, know how that evidence translates into the legal aspects of disability. Right? And so if I’m reading a psychologist or psychiatrist’s [00:34:00]report and I see a diagnosis of gender dysphoria, I’m not making a decision on whether or not that’s accurate. Cause I don’t have medical training.
All I know is, okay, this one individual medical. Offered that diagnosis. And so what happens then is if the judge, the, the, the definition of a medical impairment for social security is any medical condition that causes even the most minimal impact on any kind of functioning. And so if you were diagnosed with gender, if a person is diagnosed with gender dysphoria and there’s even like the slightest amount of a lack of functioning in some kind of area, so like a lack of concentration or I have difficulty getting along with other people because they don’t understand my, my choices or my body or what’s happening with me, [00:35:00] that’s enough.
And so the good thing is judges are, they’re not rejecting that completely. The judges will di will take that diagnosis of gender dysphoria. And they’ll put it in the decision and they’ll call that a medically determinable impairment. The problem is having a medical impairment isn’t enough because what we talked about is you ha then have to have work related limitations in order to find someone disabled.
And there, I, I just, I had my experience from working with the agency and through mid 2021 judges, in my experience, were just not able to find much in the way of specific work related limitations due to that diagnosis. And maybe that’s actually a good thing. Maybe that’s kind of progressive in saying like, we don’t, we, we understand that this diagnosis is there, but like whatever gender you identify with doesn’t impact your ability to [00:36:00] do a job.
So on the one hand, if it’s, if someone’s really struggling with that and they’re having anxiety or depression, Or PTSD or personality disorder or suicidal ideations, that could be a separate diagnosis alongside gender dysphoria and that could have work related limitations. But my experience is the gender dysphoria itself doesn’t really result in, in and of itself work related limitations.
And so that’s really not gonna be a basis for finding someone disabled and unable to work.
De’Vannon: I hope. I hope not. And because people should be able to identify sexually as they want, be non-binary, whatever the case may be, without any sort of negative implications.
Spencer: Yeah. And can I say, can I say one other thing?
I also saw a lot of medical reports where the person [00:37:00] identified as a member of the LGBTQ community and there was no diagnosis of gender dysphoria. And that was probably a more. Maybe a younger doctor or more progressive doctor who is like, I I the pa, there’s nothing wrong with the patient. They’re telling me they’re lesbian, gay, transgender, bisexual.
It’s not a diagnosis. And so I’m just gonna focus on their anxiety or depression or these other things they’re telling me about. I don’t need to focus on how they identify. That’s not a diagnosis. In the same way that if someone is a cis I’m not gonna diagnose them with something either. So I saw a lot of medical reports where the medical professional, it just, it didn’t matter.
It wasn’t a thing. It wasn’t important. It wasn’t, they were what they were focusing on in their medical evaluation. And then other doctors who I could tell just by the [00:38:00] language that they were using were probably baby boomer generation, and maybe they just didn’t understand that 25 year old who was coming in and, and talking to them.
De’Vannon: Right. And then, and then you, you mentioned that you wrote the decision. The judge, judge did not write the decision, so I wanna be sure that, that, that we’re super clear on on that. So the judges don’t actually write the decisions. What, what was your exact job title again? Tell us so that we can know. Sure.
Spencer: So my job title is Attorney Advisor, and here’s the way it works. Social Security is a massive system with over a million applications a year. Several hundred thousand cases are going to the hearing level. There’s about a thousand judges Nation. Several thousand other support staff and they’re seeing several hundred thousand cases.
The numbers are absolutely massive and that means you really need an assembly line in order to keep things moving efficiently. [00:39:00] Cause as it is, people have to wait like a year to get a hearing with a judge. So if you’re waiting that long and you’re thinking like, why is it taking so long? That’s ridiculous.
It’s just because of the enormous scope of the system. So the judges are doing about 50 hearings per month, so that’s about 12 hearings per week. So in a 40 hour week, they’re doing about 12 cases. So that’s like three to four hours per case. And during that three to four hours, they’re doing a, a pre-hearing review of all your records so that when you come into your hearing, they know what’s going on with you.
They have some idea of your medical history and your work history before they even see you. Then they’re doing about a one hour hearing, and then they may have to look at some evidence again after your hearing. And then they write this list of instructions and agency shorthand and I talk about this process in the book, they write this list of instructions and they give it to an attorney, [00:40:00] staff, attorney like me, and then the attorney takes 4, 8, 10, 12 hours to actually write the decision.
That’s where we’re looking at every single one of your medical reports, looking at all the doctors you saw, any medical opinions that are in there from your medical sources, thoroughly, completely evaluating all of that in complete sentences so that, you know, we looked at everything and then that decision gets handed back to the judge, and most of them honestly just sign it.
They don’t even read it, they don’t edit it. They just. They’ve already spent three and a half hours on the case. They don’t have time to do anything else, so they just sign it. Other judges will read through it, make some changes here and there, and tinker with it, and then sign it. But they’re really spending very little time in the actual decision.
Their job is to just big picture, like approve it or deny it. That’s my decision. [00:41:00] My, my staff goes and, and breaks that decision down and, and does the full analysis, and then the judge signs it. So when you get it, it looks like Judge John Smith wrote the decision, you know, wrote this comprehensive 15 page decision.
But in reality, they’re just taking credit for someone else’s work.
De’Vannon: Okay, now let’s talk about drugs, man. Drugs. Let’s talk
Spencer: about drugs. .
De’Vannon: This is the sex drugs and Jesus podcast. So, you know, the marriage Iana is like super useful and shit. And so like, and, and then we have all these hallucinogenics starting to come up, you know, lsd, celly, masculine and all of that.
What are the implications of that? Can since somebody having like medical treatment like that hurt their chances to get approved?
Spencer: Yes and no. I was a government attorney, so I’m gonna give you the government answer. So there is a chapter in the book that com [00:42:00] thoroughly discusses how drugs and alcohol work.
It. Chapter 26, it’s called Drug Abuse and Alcoholism. I don’t like those terms, by the way. Those terms come directly from a law passed by Congress in 1996, and that’s the law that social security still uses. To decide if drugs or alcohol should be a factor in your case. And there’s guidance from 2013 as to about how they apply that.
But here’s the basics. If you’re using any kind of drugs or alcohol, and that’s the what causes you to be disabled and unable to work. Social Security can deny you benefits, but if it’s secondary, in other words, if they remove the drugs and alcohol from consideration and consider everything else, if you would still be found disabled, then they still find you disabled.
So it really has to be the drugs or alcohol use that tips you over the line, right? That that puts you [00:43:00] from, maybe you had limitations, but you could still work full-time and you were not disabled. And then if you’re using drugs or alcohol and now you’re disabled, that’s the point where Social Security says We’re applying that law.
We’re finding that Congress says, if that’s the reason that you can’t work and you’re disabled, then we’re gonna find you not disabled. But it has some interesting implications because a lot of people do use drugs for, or alcohol, I guess not alcohol, but a lot of people use different substances for treatment.
Right. And there’s a lot of states where it’s legal. I worked in the state of Washington where cannabis has been legal and you could walk into a store and buy it for eight years now, and the stores are everywhere. Anyone who’s been to Washington or Colorado, I think they’ve got a lot now in California, knows that you just go into cannabis or you show your id, they scan your id and you can buy things to [00:44:00] smoke, chew.
They have drinks, they have gummies they have like bath salts. Not bad baths, just like fizzies that you put in a bath to soak in for mu to like help your muscles relax. And so a lot of people use these to help reduce their symptoms so that they can try and go back to work. Luckily the judges do understand this and you have different judges, right?
You have some judges that are on one end of the political spectrum and other judges that are more conservative and more hard, harder to deal with when it comes to drugs or alcohol. But even those judges understand that in certain states, cannabis is illegal and people can just go to sore and buy it, and that a lot of people are using it in order to try and improve their medical situation, not to make it worse.
So my experience, the judges are actually really good at doing that analysis and [00:45:00] not just looking at what you’re using, but why you’re using it and how it impacts you. And some of it is self. People ask me like, well, how do they know you’re using substances? Some of it is self-declared because they’re gonna make you fill out function reports and that’s all under penalty of perjury and they’re gonna ask you if you are using any drugs or alcohol.
And so if you lie, that’s really, that’s a bad thing. So most people will just declare it, and as I talk about in the book, it really is best to just be honest with Social security and just tell them if you’ve been using something and why? Because it’s not that difficult for a qualified, knowledgeable social security representative to explain to the judge why you were using that substance and why that’s not the reason you’re disabled, that there’s some other reason that you’re disabled.
That use of that substance was in some way a brand of [00:46:00] self-treatment. And in a lot of cases it is. . And then there are some cases where it’s not, and you can tell that the person has a substance addiction and maybe that’s their only impairment or their other impairments only surface when they’re using substances.
And and, and so that’s, that’s what that analysis is. It’s trying to figure out what the core reason is for you being unable to work full time.
De’Vannon: Okay. Thank you for that. And I wanna lean more into exactly what type of people these judges are. When we were, before getting ready for this interview, you were telling me, you know, these bitches make like 180 k a year.
I don’t remember if there’s bonuses and stuff like that, but what, what was
Spencer: the Probably, I don’t know. I’m not a judge, but they probably have some kind of bonus.
De’Vannon: But what was important to you? You told me that you said a lot of them were JAG officers and [00:47:00] and that stands for Judge Advocate General.
These are people who were in the military, military officers. And so talk to me about the incompatibility, the incongruence the incongruency that you found in between how the health level and the age level of these judges versus the people who they’re
Spencer: judging. Yeah, so it’s not everybody, but a lot of new newly hired judges, a lot of them are from the military because the whole federal government gives a, a preference, a hiring preference to veterans.
I think it’s the only group where when you’re filling out an application for a federal job, your federal employment from the USA Jobs website, it’s the only identified group that gets a hiring preference. And that’s across the whole federal government. And so, of course, a job with social security, it’s a federal agency, is no different.
So there tend to be a lot of people who [00:48:00] were lawyers in the military or their lawyers and then maybe they were separately in the military and maybe they had another job in the military. But there are a lot of lawyers who have military service, either past service where they’re veterans or maybe past plus current service where they’re still in the reserves.
And those people will apply to be ALJs, administrative law judges and social security. They’ll hire people in their fifties, but they’d rather hire people in their forties so that they can train those people and then have those people working for them for 20 years instead of 10. So I noticed when I was working for Social Security, a lot of judges in their early to mid forties, a lot of judges with military service and if whatever branch of the military they’re in, that means they’re probably.
Going to be fairly physically fit, probably they’re not gonna have substantial health conditions because substantial health conditions usually keep you [00:49:00] out of the military. And so you get these young fit judges who like to get up at 5:00 AM who have multiple jobs because they might be judges, but they’re also in the reserves and maybe they like, you know, go volunteer somewhere and they go to the gym for two hours a day.
So they’re physically fit, they’re mentally fit, they’re really active people. And then they have people coming in front of them who don’t have a college degree, who have been working a really hard job where, you know, like construction work, working in a warehouse or nurses’ assistants. Or like delivery people.
I mean, sometimes we’re at a gas station and we see like the pre, the people unloading drinks into the cooler and we don’t think about how much they have to lift on a daily basis. Cause they’re constantly lifting these [00:50:00] cases of beverages onto these carts. Mm-hmm. and people who have jobs like this, you know, where you’re doing that 50 hours a week after 5, 10, 15 years, at some point you’re either gonna have some kind of acute injury or your body’s just gonna totally break down over time.
And people come in and they’re, they’re in pain. Maybe that means they’re on narcotic medications so they’re not able to fully concentrate. They maybe have mental health impairments as well cause they can’t work. So they’re anxious and depressed. And these like, you know, super, the fittest people on the planet are standing up there.
Sitting up there cuz they also have a sedentary sit down air conditioned job. Right. And they’re literally passing judgment. Over people who have had a life that is totally different from theirs as far as education, upbringing, where they live, what kind of childhood they had, what kind of job training they’ve had, what kind of job opportunities they’ve [00:51:00] had, what kind of medical situations they’re in, their lack of ability to get treatment.
They have no health insurance. The judges have federal employee health plans. And so you get people, these judges who they’re just, they’re looking at people who they, a lot of times they can’t identify with at all. And they’re saying things like, well, I can work. Why can’t that guy, I can’t tell you how many times I heard that.
When I would go and let’s say the judge says it’s the denial. And I look through the medical records and I go to the judge and I try and convince them that they should change that to an approval. Cause I can do that. The person writing the decision talks to the judge all the time. Talk through the evidence, talk about what they’re seeing.
Hey, maybe we should change this decision until it’s signed. It’s changeable. And I would go to talk to the judges all the time about like, look, there’s this medical evidence and I, I think this guy has these opinions and I think that maybe we should consider paying this case. [00:52:00] And I would hear things like, well, I can work.
Why can’t he? Or, you know, I, I, I come to work, I, I I commute an hour a day each way that guy could do it. He’s fine. And these aine statements that are detached from reality. And that’s where I think the, the personalities and the upbringing and the medical situation of the judges comes into play. And I have observed that as judges get older, as they themselves experience certain medical conditions that come with age, like.
Oh my, I threw out my back. I need to have back surgery. Or, you know, maybe now I, I, I hit 50, now I need glasses and I didn’t use to before. Or something happens medically in their lives as they age. And you do, I, I would see that the judges start to get more sympathetic over time. They start to understand [00:53:00] pain, frustration, lack of mental acuity and they start to be able to sympathize more with the stories that they’re being told and to say, yeah, you know, actually now I do believe this person, this person is 55 and, and they worked in a warehouse for 25 years and they threw their back out.
And I can see on an MRI that their back is totally destroyed, and they’re telling me they’re in too much pain to work. I now have back pain myself. So now I get what they’re saying. And so that does cause this disconnect between these like young fit judges who kind of come in swinging with denials and older, more seasoned judges who I think tend to be more sympathetic to people and have higher pay rates raise.
Their pay rate tends to go up over time.
De’Vannon: Okay. Okay. I’m gonna [00:54:00] ask you
Spencer: So can I, can I just say one thing? Who your judge is, is something that you can’t choose. You as I talk about in the book, there’s certain things you can control and certain things you can’t control and you can’t control who your judge is.
And the reason that’s important is I wrote the book because I want people to understand. How to get through this process, regardless of who your judge is, regardless of how much of you know, how, how mu, how much difficulty the agency is gonna put you through everything that I’ve talked about so far.
Let’s assume you get every single one of these barriers put in your way. I want you to know what all of these barriers are so that you can navigate them. Even a low paying judge, that young fit military judge, maybe they’re a 20% payer, but if they’re paying 20% of their cases and they have five hearings today, that means statistically they’re still gonna approve one of those five people today, right?
And so I want you to [00:55:00] know how you can gather the right medical records and present the right case and h and have the right representative sitting with you and work together so that you can present to that judge a situation, a story. Where even the most hardcore, low paying fit military judge says, yeah, that’s a pretty good presentation.
I think we’ll approve that one. I’ll use my discretion to deny the next floor, but I don’t feel like I have any discretion here. And that’s what you wanna do, is you wanna take away that discretion. You wanna make those judges feel like There’s nothing I can do about this. This is a solid case. I’m gonna approve this one, and I wanna give you the tools to be able to do that.
And that’s why I wrote the book.
De’Vannon: So, so you mentioned it um, a 20% or so. Talk to us then about the like the approval rates and kind of like how these [00:56:00] judges are rated. And then I want you to tell that story about that one judge who they you know, I think they took like her telework away and they gave her like extra training or whatever.
Spencer: Yeah, so the, there is, as we talked about earlier, you’re not only a person, you’re also a statistic, right? And so headquarters, cuz they’re getting pressure for members of Congress and to testify, testify in front of congressional committees. And then that pressure just makes its way down the system to the individual judges.
And so if the agency wants to pay fewer cases, if they’re getting pressure, Hey, we’re paying too many cases, let’s pay fewer cases. And that pressure makes its way down to the judges. They’re also pressured to pay fewer cases and they’re, the judge will tell you, I’m an independent decision maker and I can make whatever decision I want and I’m not bound by any prior denials.
And all of that is true and every judge has the authority to [00:57:00] approve any specific case. But they also are looking at the 50 cases for that month and thinking about how many. Do I wanna approve this month? Because I know if I approve too many, I might get hassled. And I knew a judge and I worked for a judge that had a fairly high pay rate and he kept getting hassled by, by his superiors, by the, the higher ups within the agency who basic, they didn’t tell him you’re paying too many cases because like they don’t want that on the front page in the New York Times, right?
But they would say things like, we think maybe you need extra training. Maybe you don’t fully understand how our agency works. Maybe you don’t fully understand the definition of disability, so we’re gonna give you extra training. And they would like make him sit through hours and hours and hours of extra training that he didn’t wanna do.
That’s annoying. And that’s a pressure point, right? That’s a way of [00:58:00] saying like, you know, we’re gonna make you an offer. You can’t refuse. You, you start denying more cases or there’s gonna be consequences, but they don’t use the word consequences. And yeah, as you said, I wrote for another judge and they took away her telework.
People like working at home, we found that during the pandemic, right, and the judges can work from home, especially during the pandemic, when all the hearings, with telephone hearings, there’s no reason why they can’t work from home. And that my job, just writing and reviewing your medical records, which are all on the computer, we can all work from home.
And so the pressure point for that judge, they knew she liked working from home. So that pressure point was, you do what we need you to do, where we’re gonna take away your telework. And so while the judge tells you they’re an independent decision maker, you have to understand that they’re looking at your specific records, but they’re also thinking about themselves.
The judges are human. They’re thinking about their, [00:59:00] their salary, their health insurance benefits. They don’t wanna get fired. They also don’t wanna get transferred. They don’t wanna be hassled. And so, you know, they’re public servants, but of course, even public servants are thinking about their own wellbeing and their own job and their own families.
And so when that pressure comes down on them from above, they’re gonna, they’re gonna react to it and and a fairly reasonable way and in the way that the management wants them to. So that does also happen. I wrote a lot of favorable decisions when I worked for Social Security. I, I just wanna make sure as we get near the end here, and as we conclude, I want people to understand I did write a lot of favorable decisions.
But I noticed certain things about those cases. I noticed how well those medical records were put together, how those medical opinions were worded, how those representatives that represented those people presented that case. And so I know with this large [01:00:00] sample size of cases, I have some idea of the things that work, even with low paying judges, the things that can work to get an approval and the things that don’t work or the things that people don’t do that they should do when they’re presenting their case.
And so, and that’s, that’s what really made me say, I need to write a book. I need to get all this knowledge that I have on paper and out to the general public. Because some of this isn’t necessarily publicly known information, but it’s not necessarily trade secrets either. Right? The law is a certain way and the law defines disability a certain way.
And a lot of this is just education that social security doesn’t provide you. They’re not telling you how to present your disability case, but over time, I’ve seen the things that work. And so I wanted to present this educational guide to let people know, here are the things that you can do to [01:01:00] present your case in a way to give yourself the best possible chance of success.
De’Vannon: And I think you’ve done quite well, you know, a very good job at doing that.
Talk a little bit about like, especially for veterans, you know, since I’m a veteran, just to kind of like talk about that a little bit, you know.
Spencer: So just we can cover that real quick. The, the way the VA decides if someone’s disabled is different from Social Security because the VA is not only looking at whether your medical conditions are connected to your service, whereas social security doesn’t care why your impairments occurred. They are.
But the VA also then asks about whether what your fitness is to return to some kind of military duty. And so there are a lot of veterans that will get a hundred percent service connected rating because their impairments are connected to their service and they’re found to not be able to return to whatever their military duty was.
Asks, can you [01:02:00] do any job in the national economy? And so there are a lot of judges who will see a hundred percent service connected disability for a veteran and just say, okay, that’s enough for me. I’m gonna find them disabled. But I wrote a lot of denials for people who at 80, 90, a hundred percent service connected ratings.
And it’s because even though they couldn’t do military duty, they could do other work in the national economy like being a cashier and. There is somewhat of a disconnect between the definitions and the two systems, and that’s why it’s really important for veterans or military families to also understand how social securities rules operate.
Because you can’t assume that just because you’re a veteran and that maybe your judge is a veteran, you can’t assume that’s gonna help you out. Actually, again, I wrote decisions for judges who are veterans who looked at a veteran claimant with a hundred percent rating and said, well, I’m a veteran and I can work, so why can’t he [01:03:00] and denied those claims.
So you have to know the system, you have to know the rules, and you have to know how things work within the Social Security disability system. You can’t just assume because you’re a veteran or because you have a hundred percent rating that things are gonna work out well for you when you get in front of the social security.
De’Vannon: Okay, well there you have it. Y’all’s website is visions publishing.com. The social medias of Facebook, Twitter, , Instagram. Of course, all of this is going to go in the show notes, as it always does. So as always with my guests, I’d like to let you have the last word. I thank you so much for your time today, Spencer.
Are there any final closing remarks you’d like to say?
Spencer: I just wanna say we, we’ve gone over like the first part of the subtitle today, right? A lot of why it’s so hard to access benefits. But I just wanna conclude on a more positive note with the second half of the subtitle, which is what you can do about it.
There are specific strategies, there are ways you can get around things. At the [01:04:00] beginning I talked about how Social security will send you to see this doctor who’s being paid to say you’re not disabled. Well, there are strategies that you can use to counter. That you have to go to that exam. But there are ways that you can get evidence to counteract that medical opinion that do work.
There are things that you can present in your medical record or ways that you can testify at the hearing. There are strategies that you can use to try and convince even the lower paying judges that you’re not disabled, that you can’t work full-time, but they’re not things that you would necessarily think.
For example, people think like, oh, if I try and work part-time, that might hurt my disability claim. It actually helps your disability claim. So if someone’s a disability claimant and you see them working, they might be working because they’re representative has told them, this will help your disability claim.
And I explain why that is in the book. So don’t make assumptions and don’t take anything. Social [01:05:00] Security tells you at face value. They’re not there to help you. They’re not on your side, they’re not on your team. They’re. They’re really there. The Social Security disability system is trying to keep people out and trying to deny as many people as they can so that they can have those benefits for people who are collecting retirement later on.
So be your own advocate. Get your own information, educate yourself, hire a good representative, and use the strategies that I’m teaching you about and they will. I can’t guarantee you’ll be approved, but I can say that these strategies are what you need to give yourself the best possible chance of being approved, even if you get a lower paying judge.
De’Vannon: All right, there y’all have it. The name of the book is Social Security Disability Revealed, why it’s so Hard to Access Benefits and What You Can Do about It. Thank you [01:06:00] so much, Spencer.
Spencer: Thank you for having me.
De’Vannon: Thank you all so much for taking time to listen to the Sex Drugs and Jesus podcast. It really means everything to me. Look, if you love the show, you can find more information and resources at SexDrugsAndJesus.com or wherever you listen to your podcast. Feel free to reach out to me directly at DeVannon@SexDrugsAndJesus.com and on Twitter and Facebook as well.
My name is De’Vannon, and it’s been wonderful being your host today. And just remember that everything is gonna be all right.