By Tim Moore on April 24, 2010 8:41 AM | Permalink When evaluating social security disability and SSI disability claims, disability examiners must investigate mental limitations to the same extent that they would physical limitations. Even though mental limitations are very often not given their proper weight by social security, it is still in the best interests of applicants with mental impairments to provide a complete treatment history. Mental limitations become especially important for individuals with physical impairments who have always worked at a light to sedentary job. A good example of this type of situation would be an individual who has a documented back problem with severe pain, but who works a desk job that requires no lifting, and not much standing or walking or carrying. The physical limitations of a back problem are not going to easily get an individual out of their past work if that involved being a skilled worker who sat at a desk doing computer work, data entry, etc. But say this same person has depression
in addition to their
back problems, and their depression is causing problems with concentration, memory, and job performance. If so, they may be precluded from performing their skilled job...not because of the physical limitations caused by their back problem but, instead, because of their mental limitations. Once a disability examiner rules out a disability applicantâs skilled past work, they can turn their attention to the applicantâs ability to do other types of work that may be performed in the general economy. If an individual has mental limitations, it makes it less likely that their job skills will transfer to another job. And this makes it less likely for Social Security to deny the individualâs disability claim
because they can perform other work. In fact, with mental limitations and significant physical limitations, an individual will most likely be given a
residual functional capacity rating that is so restrictive that they will be considered to be unable to perform their past work, or any other type of work. Social Securityâs five-step sequential evaluation process includes an evaluation of
past work activity and the potential for other types of work activity. If a disability applicant is precluded from performing any of their past work, the Social Security disability examiner will have to consider if the applicant's job skills are transferable to another job. The simple fact is, the more transferable an individualâs job skills are, the more likely it is that Social Security will determine that there is "other work" they can perform. Mental limitations are often key to preventing the transfer of job skills to another type of work, which will potentially allow the individual to be
approved for disability benefits based on a medical vocational allowance. Return to the homepage for
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By Tim Moore on April 19, 2010 2:55 PM | Permalink I've heard many disability applicants make this complaint: "I'm being sent to a mental examination. Why is social security doing that? My disability is physical". Social Security disability examiners are required to determine the severity of all impairments whether alleged or found through some part of the medical determination development process. For example, many individuals allege that they have a back problem that has prevented them from working. However, the disability examiner receives medical records that indicate that the individual is also receiving medication from their primary physician or their orthopedic specialist for
depression or
anxiety. If a claimant has no mental health treatment for their depression, the disability examiner may have to send the individual to a consultative examination to determine how the individualâs depression or anxiety affects their ability to perform daily activities that might include work activity. The only way an examiner can avoid scheduling a consultative examination (to evaluate an individualâs mental condition) is
if the mental condition can be determined to be non-severe or situational in nature. Situational depression does not normally trigger a consultative examination if the individual states that they would be fine if they did not have to deal with the chronic pain of their back condition, and they allege no other significant functional problems related specifically to their depression. Disability examiners gather information from the disability applicant and their third-party contact person through questionnaires that address the disability applicantâs ability to perform routine and normal daily activities. These questionnaires explore an applicantâs disability from their own perspective and through the perspective of a third party contact person (often a neighbor, friend, or relative) who knows the disability applicant. The development of
mental impairments is another important part of the disability process. Mental conditions can affect an individual in many ways. Mental conditions sometimes are more likely to affect an individualâs residual functional capacity than their physical conditions, even though many individuals do not even consider the effect their depression, anxiety,
PTSD, etc. has upon their overall residual functional capacity. For Social Security disability applicants, mental health limitations may be the key to their receiving disability benefits, particularly if they have a physical impairment but their job is not physically demanding. It is important to remember that
Social Security disability determinations are based upon an individualâs inability to perform any of their past work as well as an inability to perform other types of work, given their limitations. For example, if an individual has a back problem, but they have a desk job, it may be difficult to prove that their residual functional capacity is so restrictive that it prevents them from working their desk job. However, if that same individual has a mental impairment that limits their ability to, say, concentrate, remember, or remain on task due to their mental condition
in addition to their physical limitations, the disability examiner may determine A) that they are unable to perform their more skilled past work and B) their skills may be less transferable to a more physical job. Return to the homepage for
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By Tim Moore on April 15, 2010 12:31 PM | Permalink What medical information does SSA need to determine your claim? Basically, information that shows the degree to which an impairment (or impairments) affects an individual's ability to function in a work setting. The ability to function, or lack thereof, in a work setting is key to all adult disability determinations. Therefore, your chiropractorâs records may be used in conjunction with an acceptable medical source (however, let me specify that it will be unlikely for a disability examiner to utilize anything obtained from a chiropractor aside from xrays) to show how your disabling condition affects your everyday life including your ability to work. However, although a chiropractor may provide you with relief from your symptoms (generally
back pain or neck pain, they are not an approved medical source for
Social Security disability determinations. Acceptable medical sources might include: 1) licensed physicians (both medical and osteopathic doctors); 2) licensed or certified psychologists including school psychologists (and other certified or licensed individuals who perform the same functions as school psychologist in a school setting) only for establishing mental retardation, borderline intellectual functioning, and learning disabilities; 3) licensed optometrists - can be used only to establish visual disorders (except in the U.S. Virgin Islands where they can only be used to give visual acuity and visual field measurements); 4) licensed podiatrists (can only be used when the impairment involves the foot or foot and ankle depending up the state they practice in; and lastly, 5) qualified speech and language pathologists (only to establish the fact that an individual has a speech or language impairment) and they are only qualified if they are licensed by a state education agency in the state they practice in, or they have a Certificate of Clinical Competence from the American Speech-Language-Hearing Association. Chiropractors are considered âOther Evidenceâ providers. Other Sources include social workers, public and private agencies, parents and caregivers, employers, and other practitioners such as chiropractors, neuropaths, and audiologists. This means that Social Security can use objective medical evidence such as x-rays or MRIs contained in their records and even consider their opinion as to an individualâs ability to function, but they cannot be a source of medical information. Return to the homepage for
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By Tim Moore on April 12, 2010 12:48 PM | Permalink The simple answer to this question is that Social Security disability examiners do not call individual disability applicantâs treating physicians.
Social Security disability decisions are processed
on the basis of medical records obtained from treating physicians. And also, to a far lesser extent, on the basis of the results of consultative examinations scheduled by the social security administration (if needed). Once an individual has provided Social Security with contact information for their treating physician or treating physicians, a disability examiner sends formal requests for the MER (medical evidence of record) or, simply, medical records. Once they receive the requested medical records (which can take quite a long time--in fact, the wait for records is one of the largest holdups for claim processing), they--the disability processing agency--pay the provider (treating physician) for the records. The disability examiner then reviews all of the medical records received from the disability applicantâs medical sources to determine if there is enough medical information to make a
Social Security disability determination. If the examiner determines that there is enough information to make their determination, there will be no need for a consultative examination (s). However, if an individual has no medical treatment information or their medical treatment is too far in the past, it is likely the disability applicant will be scheduled for a consultative examination with an independent physician (or psychologist if the exam is psychological in nature) to provide
current medical information. Once the disability applicant attends their consultative examination, a report will be completed by the consultative examination physician and forwarded to Social Security. The above mentioned methods are commonly used by Social Security to obtain medical information for disability cases. However, neither of the above methods involves phone calls to obtain information. Generally, any phone calls that are made to treating doctors are made in an effort to obtain
medical records that have not been received (i.e. followup calls). Social Security must have objective medical information substantiated by clinical notes, testing, etc. Consequently, phone calls would not be that helpful. However, it is always helpful if an individualâs treating doctor provides a written statement that has objective medical information such as: a prognosis, diagnosis, and a statement as to what the your doctor thinks you are able to do in spite of your disabling impairment (the opinion is most helpful if it actually details specific limitations in certain functional areas such as sitting, standing, stooping, crouching, lifting, reaching, hearing, seeing, understanding instructions, getting along with co-workers and supervisors, etc). Return to the homepage for
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By Tim Moore on April 8, 2010 2:10 AM | Permalink Unlike VA disability benefits that are based upon a percentage of disability, Social Security disability benefits do not increase with additional conditions. When an individual applies for Social Security disability, they are
filing for total disability benefits, and, as such, Social Security pays the maximum disability benefit. Social Security disability benefits are based upon an individualâs earnings prior to their becoming disabled. Once an individual has been
approved for disability benefits, a benefit computation is done and that establishes the individualâs disability benefit amount. From that point forward, their disability benefit amount is established and only cost of living increases (small yearly benefit increases that are tied to the inflation rate) and work activity can increase their disability benefit amount. Yes, individuals who receive disability benefits can work...but they have to be careful. Individuals who decide to return to work should speak with a Social Security claim representative. The Social Security representative can explain how work activity can potentially affect an individualâs
eligibility to receive disability benefits. If an individual decides to return to work, they are entitled to nine trial work months in any sixty-month period. The nine months do not have to be consecutive and they can occur anytime throughout a five year period. If an individualâs earnings are equal to the trial work month earnings amount (each year the earning amount for a trial work month increases, however the trial work month amount is lower than the
substantial gainful activity amount) or more, they have used a trial work month. Trial work month earnings can be at the trial work month minimum amount, or over SGA. Disability beneficiaries are allowed nine of these months. If an individual is earning SGA in the tenth month, their benefit is suspended and they begin their thirty-six month extended period of eligibility. During the extended period of eligibility (EPE), an individual can restart their disability benefit any time they are unable to work. Once the extended period of eligibility is completed, any month that an individual earns over the SGA limit, it will terminate their disability benefits unless the month is included in an
unsuccessful work attempt. Generally, work that does not last three months and ended up that way because of an individualâs disabling condition is considered an unsuccessful work attempt. There are even times when work that lasts up to six months can potentially be considered an unsuccessful work attempt with proper documentation from the employer. In a nutshell, Social Security disability benefit amounts are pretty much set at the time an individual is
approved for disability and additional disabling conditions have no bearing on the amount of their disability benefit. There are only a couple of ways an individualâs disability benefit can increase: work activity and cost of living increases. Return to the homepage for
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By Tim Moore on April 3, 2010 12:41 PM | Permalink Social security disability and SSI disability are two separate disability benefit programs administered by the social security administration. Both programs--when it comes to deciding whether or not a claim will be approved or denied--are handled exactly the same way. For each program, medical records are gathered and evaluated in the same manner, and an individual's level of severity is gauged in the same manner. However, there are important distinctions between the two programs. Individuals who apply for social security disability are able to do so because their record of work activity has allowed them to be come insured for title 2 SSD (a.k.a. social security disability) benefits. SSD is simply a benefit that one is entitled to based on having worked enough to have
become insured for disability. Because SSD is this type of benefit, a person's assets have nothing to do with their potential eligibility to draw and collect SSD. In other words, whether you have fifty dollars or fifty thousand dollars in the bank makes no difference to the social security administration.
SSI disability is different in this regard. SSI is a need-based program. What does that mean? It means that SSI disability provides disability benefits for those who are not covered for SSD, or were covered but have lost their coverage for SSD, or are covered for SSD but are only eligible to receive a very low monthly SSD benefit check. Since SSI is a need-based program, a person's resources, or assets, are taken into consideration. Currently, to
receive SSI (after being determined to be disabled according to social security rules), an individual cannot have more than two thousand dollars in countable assets? What are countable assets for social security? Well, it's easier to define what these are by pointing out what they are not. Countable assets do not include the house you live in, and do not include your primary automobile. However, additional real estate would be counted and so could additional automobiles. Both could make you ineligible to receive SSI disability, even if you are found to be disabled following a medical review of your claim. Other items that could be counted include cash surrender value in insurance policies, revocable trusts, and burial plots other than your own. Return to the homepage for
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