Disability Secrets: July 2010 Archives

Can a Congressman get you your Disability?

By Tim Moore on July 28, 2010 4:03 PM | Permalink "My Congressman got me my Disability". I've seen this sentiment expressed a number of times in various places. And I understand why people believe this, especially if they have contacted a congressman or senator's office and then someone from that office had contacted the social security administration to conduct an inquiry on their behalf. The notion becomes even stronger if, sometime after the congressional inquiry has been made, a claimant receives a favorable notice of decision and, later, a notice of award. (Bear in mind also that when we say "the social security administration, this could mean either A. a social security field office, B. disability determination services where claims are worked on at the disability application and reconsideration appeal levels by disability examiners, or C. a social security hearings office). However, the simple truth is this: a congressman or senator never ever gets you your disability benefits. The system simply does not work that way. It never has and never will. And if it ever did, the system could no longer be counted on to make even as many accurate decisions as it currently does. If your disability claim is being worked on at the lower levels (a disability application or a first social security appeal, known as a reconsideration), and you have a politician contact disability determination services, the inquiry will, most likely, not result in much. This is because when cases are being evaluated and no decision has yet been made, there's really nothing to inquire about. From my own experience as a disability examiner, I found that congressional inquiries were simply filed away with no discernable impact whatsoever. Why is that? Because as I said, until a claim has been decided there's nothing to take issue with aside from how long a claim is taking. And the truth is, at the disability determination services level, unit supervisiors are like egyptian slave drivers cracking down on examiners who have aged cases. Now, at the disability hearing level, a congressional inquiry has been known to speed things along and actually get the scheduling of a hearing expedited. However, even then, that has nothing to do with the decisional outcome of a case, though it certainly can make an inquiry worth having. So, can a congressman get your disability benefits approved for you? Absolutely not. Why do some people believe this? Simple. Those that do are people who contacted a senator or congressman's office and then, later, happened to be approved. Sheer coincidence. Fortunate coincidence to be sure, but coincidence nonetheless. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

Can Someone Get Social Security Disability Even After They Start Drawing Social Security Retirement?

By Tim Moore on July 24, 2010 8:38 AM | Permalink Many individuals file for both retirement and disability at the same time. These individuals can receive their retirement benefits while waiting for a disability decision. The same is true for those individuals who are already receiving Social Security retirement who find themselves disabled due to a medical or mental impairment. An individual can file for disability while receiving Social Security retirement up to six months prior to their full retirement age. The reason being, all disability benefits convert to retirement benefits at full retirement age because disability beneficiaries are already receiving the full amount payable on their records. Why is there an advantage to filing for disability even if you are already receiving Social Security retirement? Well there are a couple of potential advantages to filing for disability either concurrently, or after receiving Social Security retirement benefits. First, if an individual files for disability at age sixty-two and they are approved for disability benefits, they may receive Medicare insurance benefits up to a year prior to age sixty-five (Medicare entitlement based upon age is sixty-five). Additionally, if an individual is approved for Social Security disability benefits, they will receive a higher benefit amount with the month of entitlement to disability benefits. Individuals who receive early retirement benefits are receiving benefits that are significantly reduced when compared to their full retirement amount. However, if an individual is approved for disability benefits (remember disability benefit amounts are based upon the maximum amount payable) their disability benefit is only be reduced by the months they received retirement benefits. For most individuals, this is far less a reduction than they took when they filed for reduced retirement benefits at the age of sixty-two. To reiterate, many individuals who are already receiving Social Security retirement benefits file for disability with Social Security. And If an individual is considering filing for retirement benefits they should consider filing for disability benefits at the same time if they have a medical or mental impairment that would prevent work activity. Basically, it cannot hurt to file for disability and, if approved, it could substantially increase the amount of Social Security an individual receives monthly. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

What is the Process for Deciding a Social Security Disability Claim?

By Tim Moore on July 21, 2010 7:26 PM | Permalink Step 1: Is the individual working at or above the SGA earnings limit? If the individual is working above the SGA, or substantial gainful activity, limit, they are not disabled (and this is true no matter what their disabling condition is). Step 2: Is their impairment severe? For Social Security purposes, any medically determinable impairment is considered to be severe it if interferes with necessary and essential job related activities. Step 3: Does the individual meet an impairment listing contained within the âSocial Security blue bookâ. The blue book (some refer to this as the social security list of impairments) lists impairments for the major body systems as well the criteria needed to meet or equal each listing. If an individualâs condition is so severe that it meets or equals an impairment listing, they are found disabled at this point. Note: many very common impairments are not listed in the blue book, and most claims that are approved are typically not approved on the basis of satisfying a blue book listing. Most individuals who apply for disability actually find that their disability cases are determined in the next two steps of the sequential evaluation process. Step 4: Can an individual do any of their past work? Social Security looks at the demands of a person's relevant past work (work they've performed for a significant duration sometime within the past fifteen years) and they compare the demands of this work to the individualâs âresidual functional capacityâ. Residual functional capacity is really what the phrase implies. It is what an individual is able to do despite their condition. When deciding out of all the jobs performed in the last fifteen years which ones are relevant, social security takes into consideration how long the individual performed the past work and whether or not the individual could actually have "learned the job" in that amount of time. Often this means that any job performed at the SGA level (translation: working and earning at least the SGA amount) for longer than three months could potentially be considered to be "past relevant work". If Social Security determines that an individual can perform any of their past jobs as they describe them, or as they are described in the national economy, they will be found to be not disabled. If the individual is not able to perform any of their past work, the process moves to the final step of the sequential evaluation system. Step 5: Can an individual do other work? Social Security considers an individualâs age, education, work experience, and an individualâs residual functional capacity, to determine if they might be able to perform other work or be trained to perform other types of work. If an individual is unable to perform any of their relevant past work and their residual functional capacity prevents the performance of any other work, they will be awarded disability benefits. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

What Does it mean When You get a Court Date for Social Security Disability?

By Tim Moore on July 17, 2010 11:00 AM | Permalink You don't really get a "court date" for a social security disability or SSI claim. If you've been denied on a disability application, then been denied on a request for reconsideration appeal, and have, after all that, filed a request for a hearing before an administrative law judge, then you will be given a date for an administrative hearing. The hearing is conducted by a federal administrative law judge who is an employee of the social security administration. This particular type of judge--the ALJ, or administrative law judge--is not connected with any type of court system in the sense that most people think of court systems. He or she deals specifically with social security disability and SSI disability claims. And though the ALJ is a federal employee, the ALJ rules independently of others. This makes the ALJ disability hearing quite unlike the disability application and reconsideration appeal. Because at those levels, decisions are made by disability examiners who must have their work reviewed by a unit assistant supervisor and/or a processing unit manager. The decisions of most disability examiners must also made in conjunction with either a unit medical consultant who is an M.D., and/or a unit psychological consultant who is usually a Ph.D.-level pyschologist (but is sometimes an M.D. who is a psychiatrist). Disability judges, by great contrast, make their decisions without having to gain the approval of anyone above them, or anyone working alongside them (though their decisions are potentially subject to later review by an appeals council). And that fact alone seems to make a world of difference for disability claims since judges approve more than sixty percent of claims in which applicants have representation, while disability examiners only approve thirty percent of claims at the initial claim level, and only about fifteen percent of claims at the reconsideration appeal level. When does it mean when you get a court date for social security disability? It means several things. It means that you, and your disability attorney if you have one, will have received a notice of hearing advising you that your hearing is to be held on a certain date and at a certain time, whether that hearing is to be conducted in person at a hearing office, at a satellite location that basically functions as a hearing office, or via video. It also means, for you or your representative, that there is a definite time limit left for getting prepared for the disability hearing itself. This usually implies making sure that the hearing office receives copies of whatever medical records you have obtained, and also doing followups on whatever medical records have been requested (from doctors, hospitals, clinics, etc) but have not yet been received. What it mostly means, however, is that you will have the opportunity to have your case presented to the individual (an administrative law judge) who will actually make the decision on the claim. Presentation of the case at a hearing is very different from the manner in which cases are handled at the lower levels of the system by disability examiners. At those levels, examiners do not interact with claimants except for an occasional phone call to question them regarding their daily activities, work history, and medical treatment sources. Unlike judges, decisions made by disability examiners do not allow an opportunity for a claimant to appear and provide information, with or without their chosen disability representative. The disability hearing, on the other hand, does present this and makes the process far more two-sided, especially since the claimant can appear with a representative who understands key concepts such as date last insured, residual functional capacity, ranges of work, sequential evaluation, trial work months, unsuccessful work attempts, and how work activity is treated and regarded by the social security administration. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

When do you Pay a Disability Lawyer Their Fee?

By Tim Moore on July 15, 2010 1:51 PM | Permalink Here's a comment I came across recently, paraphrased. "We were going to wait on getting a disability lawyer but now we will get one and will pay the fee...which is fine as long as we get approved". To be clear, a person who is represented by a disability lawyer or a non-attorney representative will never pay a fee for social security representation unless their case is won. That fact is dictated by the social security administration. Can you be charged fees other than the fee for representation? Yes, you can be charged for all sorts of incidental expenses that may include the cost of obtaining medical records and any other incidentals that are indicated in the fee agreement that you sign when you obtain representation. All fee agreements must be approved by the social security administration. But each individual who obtains representation should certainly read their fee agreement before signing it, just as any contract of any kind should be read before a signature is put to it. To address the title of this post, however, "When do you pay a disability lawyer their fee?"--this is done after a case is concluded and won. However, the payment of the fee will be handled by the social security administration. SSA will determine the amount of the claimant's back pay, what the disability representative is to be paid, and will send the payments to the claimant and the representative accordingly. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

The Opinion of Your Doctor and Your Social Security Disability or SSI Case

By Tim Moore on July 8, 2010 6:54 PM | Permalink How do you know if your doctor records are good enough for a disability case? You may not be able to tell yourself if your doctor's medical records provide the information that the social security administration is looking for. I say that for several reasons. 1. Claimants who choose to represent themselves at disability hearings and at prior levels of the disability system typically have no idea what to focus on as regards the information in their medical records. 2. Your own doctor is likely to be as clueless when it comes to knowing what type of information the social security administration is looking for. I make this statement based upon my own observation of hundreds of instances in which claimant's doctors have submitted very brief and fairly useless supporting statements. Usually, such statements make little mention of the patient's functionality and how their condition or conditions affects their ability to engage in work activity. If you choose to represent yourself on your social security disability or SSI claim, know this: the disability examiner or the disability judge, depending on the level of the claim, will be looking for indications of functional limitation in your medical records. Functional limitations can be mental and physical. And functional limitations are measured against the physical requirements of jobs that you have done in the past and jobs that you might be considered potentially capable of switching to. If you get representation, your disability lawyer or disability representative should know to look for information in the medical records that points to physical and mental limitations, certainly to the extent that a reliable rating of your residual functional capacity can be made and measured against the demands of your past jobs. Representatives also know, however, that most medical records (medical records include office notes, nurse's notes, admission and discharge summaries, imaging studies, lab panels, and synopses of treatments) often do a poor job of evoking specific limitations and functional capacity profiles. For this very reason, good disability representatives will always--unless the medical records are extremely strong and it is clear that the prior decision-makers were extraordinarily offbase in issuing denials on the claim--attempt to obtain a medical source statement (also known as an RFC form) from a claimant's treating physician, or treating physicians if there is more than one doctor who is thought suitable for providing such information. What does a medical source statement a.k.a. RFC form do? It provides a clear, unambiguous statement of opinion from the claimant's treating physician, the individual who is qualified to comment, by virtue of a history of treatment, on the claimant's functional abilities and limitations. Such statements can "unmuddy" the ambiguity and fuzziness of medical records by allowing the claimant's doctor to state what he or she believes to be the effects of the claimant's condition, or conditions. A medical source statement may ask the doctor to comment on the following: 1. Whether or not the claimant has pain, and whether or not it is serious enough to interfere with attention and concentration. 2. The side effects of medications that may have implications for working such as dizziness or nausea. 3. The claimant's ability to sit in a working position for periods of time. 4. The claimant's ability to engage in certain postures or balance or stoop. 5. Whether or not the claimant has poor memory, decreased energy, time or place disorientation, etc, etc, etc. These, of course, are just a few examples of the information that may be provided by a doctor on a supporting statement. It should go without saying that the opinion of your doctor (treating physician) is ultimately what your case may hinge on. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

Will Social Security Decide That I Can Do My Old Job and deny my claim?

By Tim Moore on July 6, 2010 8:58 AM | Permalink If you file for disability and get denied on your claim as an adult, it could be for one of several different reasons. It could be that your condition was considered to be an NSI, or non-severe impairment. Or it could be a SGA issue (sga stands for substantial gainful activity, which basically means working and earning too much to be eligible for disability). In a certain percentage of cases, it comes to light that the claimant is working and earning too much (i.e. more than the SGA limit) to be considered eligible for disability benefits. However, when SSA decides to deny a claim it is usually because an evaluation of the claimant's medical history and work history has lead to the determination that the claimant can either return to one of their former jobs or perform some type of other work. If the social security administration comes to the conclusion a person can return to their past work (which could be any one of a number of jobs performed in the last 15 years), it will be because the adjudicator (the decision maker, either a disability examiner or a disability judge, depending on the level of the claim) will have determined that the demands of the past work were within the limits of the individual's rated functional capacity. For those who are unaware, the decision-maker on a claim will examine the applicant's medical records to look for indications of functional ability and functional restriction. This can be problematic as most doctors do not go out of their way to indicate how limited a person may be as a result of their condition, or conditions. However, nonetheless, after reviewing the records, the disability decision-maker will rate the applicant on a residual functional capacity form. Ratings can be made for either mental and physical residual functional capacity, depending on the types of conditions an applicant has. If the claim is being decided at the level of a disability application (an initial claim), or a request for reconsideration, the decision-maker will be a disability examiner, a claims specialist who does not actually possess a medical background but who has been trained to evaluate medical and job history information. When it comes to the actual process of evaluating a claim, a disability examiner's function is not too dissimilar from that of an administrative law judge at a disability hearing. However, unlike a judge, a disability examiner will be required to consult with a medical doctor who is attached to his or her processing unit and/or a psychologist who is attached to his or her processing unit to ensure that the residual functional capacity rating is accurate (keep in mind, this is said with a grain of salt since the accuracy of a large percentage of claim decisions seems to be in doubt given the fact that so many decisions are effectively reversed by the time a claim gets to the hearing level). In answer to the question, "Will Social Security Decide That I Can Do My Old Job and deny my claim?", it may happen. And if it does, it will be a result of: A) whatever social security determines your remaining (residual) functional capacity to be and B) how your past work history has been identified. "B" is very important, of course, and more important than most claimants might realize since different jobs involve different phsyical and/or mental requirements. Though some might assume that mental requirements equate with IQ and the limitations that result from affective disorders and anxiety-related disorders (bipolar disorder, depression, panic attacks, etc), mental requirements can also involve the ability to interact socially and the ability to learn and recall information. By the same token, physical requirements can entail more than just one's ability to lift "x amount" of weight or one's ability to sit or stand for a certain amount of time. Physical requirements might involve one's senses such as hearing and sight, or one's ability to deal with certain environmental factors that are part of a job (and which might also involve the senses, such as the ability to smell). The proper, or improper, identification of a claimant's past work is important because it can affect the decision that is made on a disability claim. And the issue is one that claimant's should be mindful of since the classification of their past work will be based on the information that that they provide to the social security administration. I.E, when work history information is submitted, a claimant should take the time to provide accurate job titles and descriptions of the actual work performed on the job. Return to the homepage for:Social Security Disability Secrets Social Security Disability Resource Sections

Social Security Disability Posts and Pages

If They Stop My Social Security Disability Benefits, What Will They Base That On?

By Tim Moore on July 1, 2010 10:29 AM | Permalink Social Security does not arbitrarily stop paying a disability beneficiary their benefits. Social Security disability has guidelines that must be followed in order to stop an individualâ s benefits for any reason. One of the most common reasons for an individualâs monthly benefit to be stopped is work activity and this is true for either SSI (Supplemental Security Income disability), or SSD (Social Security disability). For instance, a report of work activity for a disability recipient triggers an automatic work continuing disability review. Work reports can come from the beneficiary themselves, Internal Revenue Service wage reports, or sometimes from disgruntled friends, coworkers, neighbors, or even family members. It does not matter where the report of work came from; Social Security has to investigate work activity. One of the primary factors of disability entitlement is that an individual is not able to work at a level that is considered substantial gainful activity (SGA). Basically, SGA is a monthly earnings amount that Social Security considers self-supporting. So it is only logical that Social Security would take a close look at all earnings. Disability beneficiaries who work should make sure that they thoroughly understand how work activity can affect their eligibility to disability benefits. All Social Security disability beneficiaries are entitled to a nine month trial work period in which there is no limit to the amount of money that they can earn in those months (i.e. you can earn as much as you want without it affecting your disability benefits). However, the nine trial work months do not have to be consecutive and can occur anytime during a five year rolling period. If an individual is performing work activity that is over the SGA monthly earnings amount i

Disability Secrets: July 2010 Archives

Social Security Disability

Workers Compensation

Can a Congressman get you your Disability?

Can Someone Get Social Security Disability Even After They Start Drawing Social Security Retirement?

What is the Process for Deciding a Social Security Disability Claim?

What Does it mean When You get a Court Date for Social Security Disability?

When do you Pay a Disability Lawyer Their Fee?

The Opinion of Your Doctor and Your Social Security Disability or SSI Case

Will Social Security Decide That I Can Do My Old Job and deny my claim?

If They Stop My Social Security Disability Benefits, What Will They Base That On?

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