Sunday, November 19, 2017

WINNING AN SSI CLAIM BUT GETTING NO PAY

It is possible to be found "disabled" by Social Security and yet not qualify for a check.  How does this happen?

It can happen when a person files a claim for Supplemental Security Income or SSI.  This is a welfare based program that has two requirements:

1.  The claimant must be medically disabled or not able to work based on a medical condition.  This is called the "medical requirement."

2.  The second requirement is, the claimant must meet the financial resource, income and living arrangements required by SSI.  This is called the "financial requirements."

Generally, an individual with more than $2,000 in resources will not qualify for SSI benefits.  A couple with over $3,000 in resources will not qualify.  In addition, there are strict limitations on household income.  So, a person may meet the medical requirements (be disabled) but fail to meet the financial requirements.

These statements apply only to Supplemental Security Income or SSI, also called Title 16 benefits.  They do not apply to Social Security disability benefits (SSDI), also called Title 2 benefits.

SSDI is a program based on the claimant's work record.  He or she has worked and paid FICA tax into Social Security over the years, by payroll deduction, thus earning coverage under Title 2. There are no "financial requirements" for this person. However, persons filing for SSI have generally never worked, or have not worked enough to be covered by Title 2.   They must meet both the medical and financial requirements established by SSI in order to get paid a benefit.

These programs are confusing and individuals often don't know which program they have filed under.  The benefits are also very different.  For example, the maximum benefit for SSI is $733 per month, while the maximum benefit for SSDI is over $2,600 per month.  There is not waiting period for SSI, but SSDI does not pay for the first 5 months of disability.  As I have already explained, there are income limits for SSI but not for SSDI.

If you have worked at least 5 out of the most recent 10 year period, then you want to file for SSDI.  You only want to file for SSI if your work record won't support an SSDI claim--or in certain cases where the SSDI benefit will be very low (below $735 per month).

If you're confused by all this, seek out a representative or advocate who is qualified for Direct Payment of Fees by the Social Security Administration.  He or she will be able to advise you on the best type of claim to file.

SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM 

 

Saturday, November 18, 2017

WHERE IS YOUR DISABIITY REPRESENTATIVE LOCATED?

So, you have hired an attorney or advocate to represent you before Social Security?  Where is he or she located?

If you don't know, you are not alone.  Thousands of Social Security disability claimants have representatives, they just don't know where they are.

If you call one of those 800 numbers you see on late night TV commercials, you are probably calling Los Angeles, Las Vegas, New York or some city that is 2,000 miles from Huntsville.  And they may never actually tell you where they are.  One thing is for sure, you will never meet them.

I am not saying that all of those guys do a bad job.  I'm asking, "Do you want someone handling your Social Security disability claim who is 2,000 miles away, whom you cannot hope to meet?  Do you want to meet your representative for the first time a few minutes before your hearing begins? 

Or do you want a qualified local representative who will meet with you face to face and handle your local claim from his local office?  The Forsythe Firm is located at 7027 Old Madison Pike NW in Huntsville.  We're directly across from Bridge Street.  You will meet us on day one when you have your first appointment.  Your local Forsythe Firm advocate will prepare your case, file your claim, keep your case updated, and handle any appeals or hearings that are needed.  We will be available to speak to you, on the phone or in our office face to face.  The representative who shows up at your hearing will be the same familiar person you have been dealing with all along.

There are a large number of reputable, well qualified attorney and non-attorney representatives in North Alabama.  They maintain local offices, local phone numbers and they are familiar with local judges who decide Social Security claims.  Of course, no judge will pay you just because he or she knows your representative!  However, there is an advantage to knowing how the judge operates, what his or her preferences are and how they run their hearings.

I think there is a lot to be said for not going 2,000 miles away to do business.  We'd love to work with you...right here at home.

SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM 

Saturday, November 11, 2017

BENEFITS FOR CROHN'S OR INFLAMMATORY BOWEL DISEASES

There are problems for persons trying to work with an inflammatory bowel disease, such as Crohn's Disease or ulcerative colitis.

These conditions usually require very frequent breaks to use the restroom.  In fact, a worker may require a restroom be available at all times on very short notice.  This can be disruptive to the work process, cause excessive time off task and otherwise call for accommodations that the employer cannot meet.

Also, these bowel disorders may result in pain and medical treatment which will cause absences in excess of one or two days per month, the most generally allowed by employers.

When I argue for disability benefits based on inflammatory bowel disorders, I ask the court to consider issues of concentration, persistence and pace.  How often will flareups occur?  How much time will be required away from the work station?  How many days will the claimant be absent each month?  How would an employer deal with a worker's need to go to the restroom 6 or 8 times during an 8-hour shift?

In many cases, if the medical evidence shows a persistent and severe case of inflammatory bowel disease, the court will agree that it prevents full-time work on "a regular and consistent basis," which is the standard.  Therefore, disability benefits will be awarded.

It is important, to note, however, that judges are not willing to just accept subjective complaints.  They want medical evidence to support the claimant's statements and complaints.  Letters from former employers, co-workers or supervisors that validate the allegations can also be very useful.

THE FORSYTHE FIRM: SOCIAL SECURITY JUSTICE

Sunday, November 5, 2017

CERVICALGIA AND LUMBAGO: ARE THEY DISABLILNG?

Cervicalgia and Lumbago might qualify for disability benefits but it's not as simple as that.  First, let's define the terms.

Cervicalgia in the simplest terms is neck pain.  It is caused by three things.  One is gravity.  Your head weighs about 10 pounds and holding it erect all day puts enormous strain on the upper spine.  Another thing is muscle strain caused by overuse, such as gardening, yard work or sports.  A third cause of cervicalgia is degenerative disc disease or arthritis.

Lumbago is a word for lower back pain that doesn't radiate to the hips, buttocks or down the legs.  The reason for back pain may or may not be known.   While it is easy to diagnose, treatment is not so easy.

Now for the question, is lumbago or cervicalgia disabling according to Social Security rules?  The answer:  only if it causes you such severe symptoms that you cannot work.

Here are some general observations from my years as a Social Security disability claimant's representative:

1)  Social Security doesn't like to award benefits for subjective complaints of pain without objective medical findings which explain the cause of the pain.  In other words, they want to know the underlying cause of pain.  Is it degenerative disc disease, degenerative joint disease, a herniated disc, spinal canal or foraminal stenosis, etc.  They will prefer to have imaging (X-rays, MRI or CT scan) to show the cause of pain.  So, a claimant who says, "My back hurts a lot but I don't know why" has a very weak case.

2)   Social Security will need to be convinced that the symptoms of pain could reasonably be produced by the impairments shown in the objective medical evidence.  In other words, is it reasonable from a medical point of view that your medical condition would produce as much pain as you claim?

3) Social Security decision makers must evaluate how back or neck pain restricts certain work related functions:  sitting,standing, walking, bending, lifting, reaching, etc.  They must also determine the degree of restrictions.  For example, can you sit, stand, walk, bend or reach on a constant, frequent or occasional basis?  

4)  Finally, the decision maker must determine how your restrictions impact the occupational base -- or ability to perform jobs which exist in the national economy.  With your age, education, past work experience and residual functional capacity, are you restricted to sedentary, light, medium or heavy exertion levels?  What type of jobs and how many jobs exist in the national economy for persons with these restrictions?  There are generally two sets of guidelines:

A.  Persons age 50 or over who cannot perform their past relevant work and would be limited to sedentary work are generally disabled.  This may not be true for younger individuals.

B.  Persons under age 50 ("younger individuals") may not be disabled, even if they are no longer able to perform any of their past work.  They may be found able to perform "other jobs" which exist in the national economy.  For instance, a 45 year-old individual who was once a construction worker may not be able to perform construction work any longer.  However, if he can do the work of a garment folder, inspector or small parts assembler he will be found not disabled and not eligible for benefits.

It takes a great deal of knowledge and skill to piece together a scenario that finds a person qualified to receive benefits\ under the regulations.  It's not as simple as presenting a medical record that shows complaints of neck pain or back pain. You must show severe symptoms (explained by tests and objective findings) which severely erode the occupational base.  Then, if the judge is sympathetic, you may be awarded benefits.

THE FORSYTHE FIRM
7027 Old Madison Pike NW - Suite 108

Huntsville, AL 35806
(256) 799-0297

FORSYTHE FIRM - SOCIAL SECURITY JUSTICE WEBSITE
 

FILING A SUCCESSFUL VETERANS DISABILITY CLAIM

Disabled veterans get priority with Social Security, especially if they have a 100 percent VA disability rating in place.

In our experience, here are things that will help veterans get a faster decision and a faster disability approval:

1.  Make certain your application and the many attending forms and questionaaires are complete, accurate and "flawless."

2.  Provide all of your medical providers, including their names, addresses, phone numbers and estimated dates of service.

3.  Send Social Security a copy of your DD-214 with the application.

4.  Send a copy of your VA disability award letter.  If you have a 100 percent VA disability rating, attach a letter requesting expedited processing of your claim. It is the veteran's responsibility to request expedited processing and to document eligibility requirements.

5.  About 14 days after you submit your application, call Social Security to verify that they have expedited your claim.  Many times, Social Security will fail to expedite because of neglect or a careless error.  Never assume they have expedited; always check to verify.  An expedited veteran's claim can settle months earlier than a normal claim.

If you'd rather not take the responsibility for handling a claim upon yourself, contact us at the Forsythe Firm for help.  We can deal with the government for you.  (256) 799--0297.

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Friday, November 3, 2017

WHAT IS SSDI AND HOW CAN A DISABLED WORKER APPLY?

SSDI simply stands for "Social Security Disability Insurance." 

It's an insurance program mandated by the federal government and paid for by payroll deductions (called FICA withholding). The government withholds 7.5% of your wages and puts the money into a Social Security trust fund.  Your employer matches this money.  If you become disabled, you can apply for a monthly benefit out of the trust fund.  It's called simply "Social Security disability."

IS IT WELFARE?  No, it is not welfare.  It is an insurance plan that workers pay for--much the same way you would pay for auto insurance, life insurance or homeowners insurance.  It's just that the federal government forces you to buy it when you go to work.

MUST I BE POOR TO COLLECT A BENEFIT?  No.  SSDI is not means tested. You don't need to be poor to qualify for it. There is no limit on how much money you have, what type of home you live in, what property you own, etc.  You don't have to prove that you need the benefit financially--only that you are disabled and meet the terms of disability under the regulations.

IS THE SSDI BENEFIT HARD TO GET?  Yes.  You must prove that you are unable to work at any full-time job in the US economy because of your medical condition(s). The rules are very strict.  It can take 4 months to 24 months or longer to get approved.  Many people get attorneys or other specialists called non-attorney representatives to help them prove that they are disabled according to Social Security's rules.  A hearing before a federal administrative law judge is often required.

WHAT WILL AN ATTORNEY COST?   A representative cannot charge you a fee until (a) you are approved for a benefit and (b) you receive a back payment award.  Then, Social Security will withhold an agreed upon percentage of back pay for the representative.  If you are never awarded a benefit OR if you are awarded a benefit but without any back pay, your representative cannot charge a fee.

HOW DO I BEGIN?  You can apply for a disability benefit yourself or make an appointment with a representative to help you file an application.  Apply online at www.socialsecurity.gov.  

The Forsythe Firm will meet with you at no cost or obligation, review your claim, and decide if we can add value to your case.  If we represent you there will be no charge for our representation until you win + receive past due benefits. Social Security will withhold our fee from your past due benefits and pay us directly. Our initial consultation is absolutely free, without obligation and it is confidential. You will need an appointment.

Call (256) 799-0297 in Huntsville.

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APPLY FOR DISABILITY BENEFITS IN ATHENS, AL

Athens, AL workers who become disabled may qualify for up to $2,687 per month from the US Social Security Administration.  The actual monthly benefit will be determined using the worker's cumulative wage and FICA withholding record.  In 2017, the average SSDI benefit was around $1,150 per month.

What are the general requirements to get a SSDI benefit?  A worker must have a severe medically determinable impairment that has lasted for at least 12 consecutive months (or is expected to last for 12 consecutive months OR to end in death).  This impairment must significantly restrict the claimant's ability to perform full-time work.  There must be adequate medical records to show the onset and severity of the symptoms.

An application may be filed in one of 3 ways:

1.  On the internet at www.socialsecurity.gov (Go to "Disability" then "Apply for Disability" then "Start a New Application."  Allow at least 90 minutes to complete this application.

2.  Call the nearest Social Security field office.  For Athens, this is the Decatur Social Security office at (888) 289-9185.  Or visit Social Security in person at 717 McGlathery Lane, Decatur, AL 35601.

3.  Have an attorney or non-attorney representative file your claim for you and work toward having it approved.  You cannot be charged a fee simply for help with the application.  However, representatives may charge a fee if you are approved and receive an award of back pay. Your representative will also assist you in getting medical evidence, submitting evidence and completing all the Social Security forms that will come in the mail after you submit your application.

After you submit you application and all attending forms, it will take about 4 months to get a decision.  Unfortunately, about two-thirds of applications will be denied.  When this happens, you need to file an immediate appeal and ask for a hearing.  If you are represented, your representative will do this for you.

The Forsythe Firm handles Social Security disability applications, appeals and hearings in Athens and north Alabama.  Here is information about the Forsythe Firm:
  • Local north Alabama advocates helping local folks
  • Free consultation and case evaluation
  • No fees or money upfront - ever
  • Pay us a fee only if you are approved and receive back pay
  •  We pay all expenses associated with your claim up front; you pay us back only if you win and recover past due benefits.
  • Deal with local disability specialists - not long distance or mail.
  • We are accessible and will return your phone calls. 
  • We practice only in field of Social Security disability
If we can be of help to you, or answer a question or two, please call us:

THE FORSYTHE FIRM
Athens Phone        (256) 431-1599
Huntsville Phone   (256) 799-0297

Visit Us On The Web - Tell Us About Your Case 

THE INTERNET MISLEADS CLAIMANTS LOOKING FOR SOCIAL SECURITY DISABILITY


THE INTERNET MISLEADS CLAIMANTS LOOKING FOR SOCIAL SECURITY DISABILITY

Where is the first place people look when searching for information?  Why, the internet of course!

Individuals get on the internet looking for information about who may qualify for Social Security disability benefits.  And they often get misinformed.

Most likely, the search engine will direct you to the Social Security Listings.  These are lists of medical conditions, arranged by body systems, with a list of symptoms and laboratory findings that must be present to meet a listing.  Almost nobody meets a listing (and yet they may qualify for disability benefits).

Let's say for example, you google "Social Security disability for (my disease)."  You will be taken to a long complicated set of symptoms and laboratory tests that you must meet for that listing.  You will come away from it saying, "My condition is not that bad" or "I couldn't meet all of those standards."

Here is why the internet can be terribly misleading:

1.  Most people who qualify for Social Security disability do not meet a listing.  They qualify anyway but very few will meet a listing.  A listing award is made at Step 3 of the process.  Most awards, however, are made at Step 4 or 5 of the process and apply to persons who do not meet a listing.

Of all the cases I win, I would say that fewer than 1 in 10 meet a listing.

2.  Listings do not consider non-exertional impairments.  Exertional impairments restrict walking, lifting, pushing, pulling, etc.  They do not consider postural limitations like kneeling, crouching, crawling, reaching, handling, feeling, etc.  Listings also do not consider any mental limitations from depression, anxiety, PTSD, insomnia, etc.  Listings do not consider pain or fatigue.  All these factors (and many others) may cause you to be disabled, but you will never know it simply by reading the listings.

HERE'S THE BOTTOM LINE:  Don't access your own disability case online and miss out on benefits because you think you can't qualify.  A surgeon would tell you, "Don't diagnose your own medical condition to decide if you need surgery.  Let a doctor do that."

My advice is:  Don't try to evaluate your own disability claim online and fail to apply because you mistakenly believe you can't qualify.  Let an expert help you with that.

Even if you don't meet a listing (and most disabled people will not) - you may be disabled because of a combination of symptoms, including pain, fatigue, lack of concentration, postural limitations (can't sit or stand for prolonged periods); or you would be absent too many days because of your medical conditions.  There are a hundred factors that need to be considered, including age, education, past relevant work experience, and residual functional capacity--none of which are evident by reading the listings online.


"The internet is an OK place to look for general Social Security information.  However, it is dangerous to try to evaluate your case or odds of getting a disability benefit online.  You will be misled and may fail to claim what you are entitled to.  Get an expert opinion before you give up."

Call the Forsythe Firm at (256) 799-0297 and we will give your situation a free personal review, considering your age, education, past work, medical condition and limitations in your ability to perform work activity at the various exertion levels.

 forsythefirm.wixsite.com/website

THE INTERNET MISLEADS CLAIMANTS LOOKING FOR SOCIAL SECURITY DISABILITY

Where is the first place people look when searching for information?  Why, the internet of course!

Individuals get on the internet looking for information about who qualifies for Social Security disability.  And they often get misinformed.

Most likely, the search engine will direct you to the Social Security Listings.  These are lists of medical conditions, arranged by body systems, and a list of symptoms and laboratory findings that must be present to meet a listing.  Almost nobody meets a listing (and yet they may qualify for disability benefits).

Let's say for example, you google "Social Security disability for (my disease)."  You will be taken to a long complicated set of symptoms and laboratory tests that you must meet for that listing.  You will come away from it saying, "I'm not in that bad a shape," or "I couldn't meet all of those standards."

Here is why this is terribly misleading:

1.  Most people who qualify for Social Security disability do not meet a listing.  They qualify anyway but very few will meet a listing.  A listing award is made at Step 3 of the process.  Most awards, however, are made at Step 4 or 5 of the process and apply to persons who do not meet a listing.

Of all the cases I win, I would say that fewer than 1 in 10 meet a listing.

2.  Listings do not consider non-exertional impairments.  Exertional impairments restrict walking, lifting, pushing, pulling, etc.  They do not consider postural limitations like kneeling, crouching, crawling, reaching, handling, feeling, etc.  Listings also do not consider any mental limitations from depression, anxiety, PTSD, insomnia, etc.  Listings do not consider pain or fatigue.  All these factors (and many others) may cause you to be disabled, but you will never know it simply by reading the listings.

HERE'S THE BOTTOM LINE:  Don't access your own disability case online and miss out on benefits because you think you can't qualify.  A surgeon would tell you, "Don't diagnose your own medical condition to decide if you need surgery.  Let a doctor do that."

My advice is:  Don't try to evaluate your own disability claim online and fail to apply because you mistakenly believe you can't qualify.  Let an expert help you with that.

Even if you don't meet a listing (and most disabled people will not) - you may be disabled because of a combination of symptoms, including pain, fatigue, lack of concentration, postural limitations (can't sit or stand for prolonged periods); or you would be absent too many days because of your medical conditions.  There are a hundred factors that need to be considered, including age, education, past relevant work experience, and residual functional capacity--none of which are evident by reading the listings online.


"The internet is an OK place to look for general Social Security information.  However, it is dangerous to try to evaluate your case or odds of getting a disability benefit online.  You will be misled and may fail to claim what you are entitled to.  Get an expert opinion before you give up."

Call the Forsythe Firm at (256) 799-0297 and we will give your situation a free personal review, considering your age, education, past work, medical condition and limitations in your ability to perform work activity at the various exertion levels.

 forsythefirm.wixsite.com/website

5 CONSIDERATIONS (STEPS) IN A SOCIAL SECURITY DISABILITY DECISION

Are you disabled according to the Social Security Act?

That is a legal question.  You may be disabled in your opinion, in your doctor's opinion or in your attorney's opinion.  But you won't get paid unless you can prove that you are disabled according to the Social Security Act and its attending regulations.

Social Security will use a mandatory and sequential five-step process to decide. When you have a hearing, all 5 steps will be considered during that one 45-minute process.  Here are the 5 steps with very brief explanations.

STEP 1:  Are you now working at substantial gainful activity?  If so, you are not legally disabled, no matter how sick you are or how old you are.  You cannot work and be disabled at the same time. In 2018 the definition of "substantial gainful activity" is defined as earning at least $1,180 per month (from work related activity).

STEP 2:  Do you have a severe, medically determinable impairment that has lasted or is expected to last for at least 12 consecutive months OR to end in death?  If no, you are not disabled. Short term disabilities that last less than 1 year are not covered by Social Security.

STEP 3: Do you meet one of Social Security's published listings?  In other words, are your symptoms so severe that Social Security automatically recognizes them as disabling?  If yes, you are approved.  If no, you will move on to Step 4.  First, however, Social Security must determine your residual functional capacity--that is, what is the most you are able to do in terms of exertional activity?  (Note:  Very few claimants, even those who get approved, will meet a listing; you can be approved without meeting a listing).

STEP 4: Are you physically and mentally able to perform any of your past relevant work (any of the jobs you performed during the 15-year period before you applied for disability)?  If you are, you are not disabled.  If you are not, move on to Step 5.

STEP 5:  The final step.  Is there any work in the national economy that you are now able to perform, considering (only) your age, education, past work experience and residual functional capacity?  If the answer is yes, you are not disabled.  If the answer is no, you are disabled and will be approved for benefits. 

I think you can see from this sketch of the decision making process that Social Security disability is a very tough nut to crack.  It is for persons who have reached the end of their working careers and are not able to perform any type of full-time work.  It is not for persons who work in pain, who really don't feel like working or who believe it is time to slow down a bit.  Social Security works hard to keep people off disability benefits until it is their absolute last option.

I would add this, however.  The initial decision making process at Social Security is very imperfect.  Honestly, I would say it is flawed.  They deny individuals who really should be approved because they should meet the rules for disability benefits.  So, don't take their word for it when they tell you that you are not disabled.  About one-half of those denials will be overturned in the appeal process and benefits will be awarded.  The main point is:  appeal, appeal, appeal.  

1.  Apply
2.  Get Denied

3.  Appeal and go to hearing (Most cases that are won, are won here at this third step).
4.  Appeal again if denied at the hearing

Remember, your first decision from Social Security is probably not the correct decision.  Those errors are corrected only by appeal, not usually by filing a new claim.

THE FORSYTHE FIRM
PH (256) 799-0297


 

EXPLAIN MY SOCIAL SECURITY DENIAL

Understanding why you were denied disability benefits is a good way to know what do to next and how to get paid.

While Social Security can deny a claim at any of the 5 sequential steps, denials are more common at Step 4 and Step 5.  So, these are the steps I want to discuss here.

STEP 4 DENIAL.  Your letter will ready something like this:  "We find that you are not entitled to disability benefits.  This is because you are not disabled according to our rules.  You state that you cannot work because of (list of impairments); however, we have determined that you can perform some of your past relevant work."

A Step 4 denial simply means that the decision maker believes you are able to return to one of the types of jobs you have held during the past 15 years.  Even if you can't perform the exact job, they believe you can perform the job as it is customarily performed in the national economy.  For example, let's say you once worked as a cashier in a convenience store.  Once or twice a week you also had to help unload a delivery truck, which was much harder work.  You may not be able to perform that exact job any more because of unloading the truck; however, Social Security will argue that you could work as a cashier in a place that did not require unloading trucks.  So, Step 4 says you can return to some of your work you did in the past.

STEP 5 DENIALS acknowledge that you cannot perform any of your past jobs.  They look at all the full-time jobs you've held during the past 15 years and say, "No--all those jobs are beyond your capacity.  Can't do those any more."  However, Social Security will argue that there is other work in the national economy that you could do, even with your present impairments.  Your past jobs may have been in the medium exertion level, for instance, that required lifting up to 50 pounds.  You can no longer do medium level work.  However, they will here argue that you could do light or sedentary work.  Light work requires lifting no more than 20 pounds occasionally.  Sedentary work requires lifting no more than 10 pounds occasionally.  So, perhaps you can't be a construction worker any longer but you could be a laundry sorter, ticket taker or garment tagger.  So, you would be denied on the theory that there is some work in the US economy that you could perform.

THE SOLUTION?  Appeal and ask to appear at a hearing.  Have your attorney or representative prepare a medical case that shows you are not able to perform even light or sedentary jobs.  This will involve a careful and detailed analysis of your medical records, getting any new evidence available, obtaining a source statement from your treating doctor(s) and preparing to question Social Security's vocational expert that the hearing.  Unless you really know Social Security law and are skilled at making legal arguments, this is not something you want to attempt by yourself. 

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CALL US AT (256) 799-0297