Can you get a second Social Security Disability Hearing if a judge denies you?

This is a complex multi faceted question. Many individuals attend more than one Social Security hearing in their lifetime. How does this happen? Well the controlling factor for multiple Social Security disability decisions including multiple hearing decisions is the date an individual is last insured for Social Security disability.

If an individual is still insured (an individual's work activity allows them to receive up to four quarters of coverage per year, which in turn leads to insured status for Social Security disability and retirement) for Social Security disability at the time of their hearing denial, they are free to file again and go through the process once more.

This can continue until the individual has a disability hearing that is past their date last insured, or DLI (to find out what your DLI is, you would need to contact a social security office). Once the individual receives a denial at this level, there can be no further disability claims unless the individual returns to work to extend their date last insured.

Now what are some exceptions to the above information? Some individuals appeal their claim to the Appeals Council if their hearing is denied, and on rare occasions the Appeals Council allows their disability claim, although it is more likely that the Appeals Council will return the case to the decisional administrative law judge to reconsider their ruling. Consequently, this may require a second hearing for the disabled individual.

Of course, if an individual is applying for Supplemental Security Income disability there is no limit to the amount of hearings an individual may receive, although the disabled individual must go through the entire Social Security disability process each time.

This is also true for individuals who were insured but are no longer insured for Social Security disability.








Return to:

Social Security Disability Secrets

When should you get a Representative for Social Security Disability or SSI?

Frankly, if your are able to attend an initial disability interview (at a social security office) or fill out and return your reconsideration appeal (the request for reconsideration is the first appeal in the process) paperwork, then you may not need representation yet. Often, individuals filing for disability just assume their case will go better if they have a representative or lawyer at the initial or reconsideration level.

Is this true? It can be for some individuals. As a disability examiner and in working in claimant representation, I have found that too many individuals fail to properly submit paperwork and miss important deadlines when they are not represented. And, far too often, claimants simply give up.

However, having said that, a person is not required to have representation at the disability application or reconsideration appeal level. At the disability hearing level, though, very few individuals would advise any claimant to go in unrepresented. Even administrative law judges will typically advise claimants who show up alone, without the benefit of an attorney or non-attorney representative, to have their hearing rescheduled and to come back at a later date.

Prior to the hearing level, however, things are different. The initial claim and the reconsideration level appeal are sent to a state disability agency for a decision (in most states, the agency that makes disability decisions for the social security administration is called Disability Determination Services). At this agency, a claimant's medical records are gathered and evaluated, and a disability examiner who has been assigned to the case will render a decision after consulting with a physician or psychiatrist (depending on the type of case) who is assigned to the examiner's processing unit.

At this level of decision-making, representatives (attorney or otherwise) are not permitted to make arguments to the adjudicator (who, at this level, is the disability examiner). With this in mind, some would argue that representation is unnecessary. But I would argue otherwise and here's why.

If a claimant gets denied on a disability application that has been filed with the social security administration (either for SSD benefits or SSI benefits), then they stand an 85 percent chance on averge of being denied on the reconsideration appeal, meaning they will have to request a hearing in front of an administrative law judge in order to win benefits.

In other words, if you get denied on a application, you might as well expect to go to a hearing---where you will do much better if you have representation.

So, when should you get a lawyer? You can get one at any time, but if you get denied you should certainly consider getting one immediately.








Return to:

Social Security Disability Secrets

I Did All The Work On My Disability Case - Why Should I Pay My Lawyer?

I have encountered situations over the years where a social security disability or SSI claimant would be of the opinion that their disability lawyer had done nothing to earn their fee after a case had been won. And a number of these individuals have openly stated, "Why should I pay my disability lawyer? He didn't do anything".

Well, how valid is this sentiment? In some cases, I suppose, it may be very valid. Here are some examples I can think of.

A) The attorney did not request medical record updates and for this reason did not properly present his case.

B) The attorney did not read the claimant's social security disability file and so failed to grasp what mistakes were made by the social security administration at earlier steps in the process (and, thus, why the case should now be approved).

C) The attorney failed to properly prepare the claimant for the social security hearing.

All of these occurrences are entirely valid for giving a claimant the feeling that they have received inferior service. However...even when inferior (perhaps "piss poor" would be a good description) representation has been provided, a claimant who has signed a fee agreement with a representative is still obligated to pay the fee, provided that the case was won. In other words, two wrongs don't make a right (though, I can certainly understand if any of the scenarios listed above had actually occurred).

Fortunately, the scenarios I mentioned don't happen too often. The vast majority of disability representatives take their job seriously and strive to win cases. After all, if they keep showing up at the same hearing office unprepared, they'll soon take on a poor reputation that may affect how they interact with the judges that hear cases---and also affect their ability to get referrals from previously represented claimants.








Return to:

Social Security Disability Secrets

Will Social Security disability cover sleep apnea as a disability?

Social Security will evaluate sleep apnea just as they would any other medical and/or mental condition. You may be wondering how Social Security evaluates disabling impairments. Social Security disability is awarded based upon functional limitations rather than specific medical conditions, consequently sleep apnea is considered a medical condition by Social Security.

However, Social Security disability examiners must consider how your sleep apnea limits your functional ability in order to determine the severity of your condition by Social Security disability rules and regulations.

It is most likely (in most cases) that sleep apnea will not be a severe enough condition to warrant an allowance for Social Security disability, although sleep apnea in conjunction with other cardiovascular or pulmonary conditions may result in a Social Security disability allowance.

Just how does Social Security evaluate any medical and/or mental condition? Social Security uses a five step sequential evaluation. This evaluation considers the severity of your conditions, your work history, education, the length of time you have been or expect to be out of work, and your ability to be retrained for a job that is compatible with your limitations.







Return to:

Social Security Disability Secrets

VA System Needs to be Updated

The Veteran’s Affairs Department (VA) has no problem admitting that they need to continually update their rating schedule, but it does argue against the need to update the entire retirement and disability systems. Fortunately, the subcommittee on memorial affairs and disability assistance is not backing down. They say that the system is ‘archaic’ and does not meet the needs of today’s veterans.

Members of the subcommittee state that the system needs improvements, from updating neurological criteria to showing progress in medical and science. They are worried that the system does not serve those with post traumatic stress disorder, or those who are disabled at a young age and suffer from a loss of quality of life.

The system has made progress, but 35 percent of the rating schedule codes have not been updated since 1945. One of the biggest issues they point out is that a veteran who is 100 percent disabled physically can still work and keep his compensation, whereas a veteran who is disabled 100 percent due to a mental disorder loses his compensation if he can find work.

Many are requesting and suggesting changes in this system to better serve Veterans, especially those with post traumatic stress disorder. While the VA is still showing no signs of changing the entire system, the debate is ongoing.







Return to:

Social Security Disability Secrets

Worker’s Compensation Rights

As a worker who has been hurt on the job and is receiving workers compensation, you have certain rights to protect the stability of your job. If you’ve been out of work on workers compensation and your employer tries to fire you or eliminate your position, it is best to know your rights.

Your employer is not allowed, under the workers compensation statute, to eliminate your job because you are receiving worker’s compensation. It is against the law. However, your company can eliminate your position if they deem your position null and void. If they are eliminating the position altogether, they may have a case.

When a position is being eliminated while a worker is exercising their rights to worker’s compensation, certain questions need to be asked. First and foremost, you’ll need to know if you are the only one being eliminated and whether or not someone else will be doing your position. Next, you’ll need to ask for documentation to determine why the position is being eliminated. Lastly, you might want to look into whether the company has treated others in their company similarly when they were exercising their rights to workers compensation.

If they are eliminating more than you, for example a whole department, then they are protected to do so, because it is more probable that you are not being targeted for worker’s compensation, but that the company is making changes that have nothing to do with your case.

There are many things to take into account when determining if your rights are being violated. Many states have different laws, so consult your local worker’s compensation laws to determine if you are being treated fairly.







Return to:

Social Security Disability Secrets












Additional Entries
Workers compensation workers comp - who decides if you get it?
Workers compensation workers comp - is there a statute of limitations
Workers compensation workers comp - how do you start the process?
Workers compensation workers comp - what jobs are not covered?
Workers compensation workers comp - who pays for benefits?
Workers compensation workers comp - mental psychological conditions
Workers compensation workers comp - independent contractor

Worker’s Compensation Dental Treatment Non-Existent

Have you ever had to use your workers compensation for dental reasons? Many would think that if you were dentally injured on the job that it would be easy to get treatment and worker’s compensation, but that is not always the case. In fact, there are few dentists who want to treat patients with workers compensation, due to not receiving fair fees for their work.

A survey was done on 50 Maryland dentists, asking them if they would take workers compensation cases. Most said ‘No’, though a few said they would with a written guarantee of payment. They stated that most insurance companies challenge their fees, pay them less and that dentistry needs to be included in the medical fee guide. Further research shows that this already exists, but no one is using it. The fee guide currently serves as a ‘cap’ and not a way to fairly reimburse dentists for their services. Dentists also stated that they are not paid in a timely manner for worker’s compensation cases.

Unfortunately the patients, not the dentists, are suffering the most due to this issue. Many are unable to get dental help and have to pay out of their own pockets, even when their dental disaster happened at work, such as a car accident that results in broken teeth.

The Maryland General Assembly is considering a bill that requires the Workers Compensation Commission to appoint dentists to its Medical Fee Guide Committee. Hopefully, with any luck, this bill will be heard loud and clear.









Return to:

Social Security Disability Secrets
















Additional Entries
Workers compensation workers comp - how much of your earnings do you get?
Workers compensation workers comp - when do benefits start?
Workers compensation workers comp - when can you file a claim?
Workers compensation workers comp - what do benefits provide for?
Workers compensation workers comp - what are the main benefits?

Workers Compensation Issued Improper Payments

A report from the Government Accountability Office (GAO) found that a program managed by the Labor Department to compensate on-the-job injuries (workers compensation) issued over $13 million in improper payments in 2006.

The report stated that the Labor programs relied on self-reported data from the claimants that did not include proper verification, a deficiency in performance goals that would help prevent over and under payments and a failure to assemble information on improper payments to federal employees injured on the job.

The Labor Department disagreed with their findings and issued a statement about their commitment to accurate workers compensation payments. They believe the report exaggerated the number of errors and overlooked a variety of improvements that were made in the program. They estimate they paid out $703,000 in improper payments, which is nowhere near the $13 million that the GAO estimates. They also disagree on the reasons for mistakes.

The GAO report found, most importantly, that none of their performance goals addressed compensation overpayments, underpayments or how to handle them at all. They found that performance goals concentrated on the quick processing of claims and customer service.

The Labor was reported as saying, “The GAO's interpretation of the accountability review error rate is inaccurate."









Return to:

Social Security Disability Secrets














Additional Entries
Workers compensation workers comp - can an employer dispute a claim?
Workers compensation workers comp - what if you lose at arbitration?
Workers compensation workers comp - why would an employer dispute?
Workers compensation workers comp - what injuries are covered?
Workers compensation workers comp - social security disability

Will Worker’s Compensation Take Care of You?

It is fair to say that most of us feel fairly protected while at work. We simply know, because of workers compensation, that if we are injured while on the job that we will be compensated fairly and that we will not have to take care of our medical bills. Unfortunately, that is not true for everyone, including a person we'll refer to as JS.

JS was hit by a drunk driver in 2003 while driving during a routine daily task to mail letters for her employer. The driver went to prison for two years, but JS feels like she’s still in prison.

At first her company’s third-party administrator paid for the bills, but after about five months the payments started being delayed and by the end of the first year, her treatments were being denied. She said she hasn’t received an acceptable reason and although she returned to work after about five months, the issues from the accident seem to keep mounting. At first she sustained a broken pelvis and fractured jaw from the accident, but now she has had to stop attending college and goes to two or three medical appointments a month for things such as chest pain, and gallstones (due to extreme amounts of weight loss from the fractured jaw).

Now, she is battling the California workers compensation system, along with many others that, for one reason or another, are not getting the workers compensation they deserve in California.

A Workers Compensation Story









Return to:

Social Security Disability Secrets













Additional Entries
What is workers compensation or workmans comp?
Workers compensation workers comp - when do you notify an emloyer of an injur?
Workers compensation workers comp - return to light duty
Worker compensation workmans comp - how much do you get?
Workers compensation workmans comp - how much do you receive weekly?