We frequently represent individuals with Epilepsy or seizures in the attempt to get Social Security disability benefits.
While
a seizure disorder may certainly be disabling under Social Security's
rules, this isn't always the case. Social Security will evaluate the
disorder based on it's nature (type of seizures), frequency and medical
treatment.
Here is what you will need to be approved and paid:
- a diagnosis of epilepsy or other seizure disorder
- a detailed description of your typical seizure, including all pre- and post-seizure symptoms
- a statement from your doctor corroborating your account of the nature and frequency of your seizures
- a description of your seizures from a third-party witness
- a record indicating the frequency of your past seizures
- results of an EEG, and
- a detailed treatment history, including medications and other treatments that you’ve tried and your response to them.
Social
Security will want to see where the claimant has been taking
anti-convulsant medications for at least 3 months. A doctor should have
reviewed the medication and adjusted the dosage in an attempt to
control the seizures. If the seizures continue to be frequent enough to
interfere with sustaining regular, full-time work, benefits may be
approved.
Besides
medical care, the one thing that will help your case the most is a
diary or written record of your seizure activity, kept by a third party
who can document the type of seizures, what activity accompanies a
seizure and how often they occur. You can't just depend on doctors or
emergency room records because by the time you get to the ER or doctor's
office, the seizure has already long passed. Also, many people don't go
to the doctor or ER every time they have a seizure.
The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
Free evaluations and consultations
Social Security disability hearings only happen if you were denied and then filed an appeal. The hearing is the government's response to your appeal. They will appoint a federal administrative law judge (ALJ) to listen to your evidence and render a new decision.
The hearing will last less than one hour on average but it may be the most important hour of your life, financially speaking. How do you get ready for it?
1. Be certain that all of your medical records have been ordered and placed in your Social Security file. Most cases these days have electronic files. If you are unrepresented, Social Security is supposed to order your medical records, but they will only order the records you tell them about. It is imperative that you review your file about 3 months prior to your hearing and see if the records from each treating medical provider are included in your file. If not, you will need to obtain these records and submit them. If you have an attorney, he or she is responsible for obtaining all these records. Incomplete records will either result in a postponement of your hearing or possibly a denial.
2. Figure out the exact date you last worked, even if it was for just one day. Step 1 of the hearing will be to determine when you last worked. You will be asked this question and you should know the answer. Judges determine this first because the law doesn't allow a disability benefit to be paid for months in which you worked at "substantial gainful activity," no matter how sick they were.
3. Medical records are essential but they alone often aren't enough to get an award. Try for opinion evidence from your doctor. Specifically, try to get a form called a "Medical Source Statement" completed by your doctor that details the limitations in your work-related functions: sitting, standing, walking, bending, lifting, etc.
4. Be able to explain why you can't hold a full-time job--from a health or disability point of view. Be able to articulate your functional limitations that prevent you from working. Speak in specific terms: "I can't sit longer than ___ minutes. I can only stand for about ____ minutes, etc."
5. Research the technical issues involved in your case. These include:
- Do you meet one of the published Listings?
- Will a grid rule direct a finding of disability at your age?
- Does your application date allow Social Security to pay back to your alleged onset date?
- Did you have substantial earnings after your alleged onset date?
- Do you need to amend your alleged onset date?
- When is (was) your Date Last Insured? Can you prove disability onset prior to that date?
- Classify each job you have held during the 15 year period prior to filing for disability. Be familiar with the the classifications of sedentary, light and medium work.
6. Research questions that you should ask Social Security's vocational expert. Nearly all adult hearings will include testimony by a vocational expert who has been called by the government to testify.
7. Read your medical records. Make a note of where to find each of your major illnesses or impairments in the record. For example, "My bulging lumbar disc is medically documented by an MRI report in Exhibit 4F, page 16." Or, "My severe depression is noted by Doctor Feelgood in Ex. 9F, pgs. 3, 9 and 15; and in 11F, 6, 11 and 17).
8. If Social Security sent you to one of their doctors for a consultative examination (CE), read and study that report, which will be in your file. Note what that doctor said concerning your physical and/or mental limitations and how those limitations restrict your ability to do work-like functions. Sometimes, these reports actually help you win.
9. Prepare yourself to speak Social Security lingo. If the judge uses terms you don't understand, ask him or her to explain what they mean.
10. Here are common sense tips I give to all my clients before they set foot in a hearing room:
- Always tell the truth.
- Tell the truth, then stop. Don't say too much.
- Never answer a question that you do not understand.
- Avoid generalities such as: sometimes, once in a while, a little bit, not very often, pretty bad, not much.
- Answer questions with defined words, using terms like: days, hours, minutes, feet, yards, etc. Example: "I can sit for about 15 minutes before my legs no numb." Better than, "I can only sit a little while before my legs go numb." ("A little while" is not defined).
Do You Need Help?
Many people will benefit from hiring an attorney or experienced disability advocate to prepare the hearing and attend with them. In the first place, it will save you enormous time and hard work. In the second place, it increases the odds that you will be awarded benefits. Finally, it may save you untold frustration and anxiety--just having someone who knows what it's all about sitting beside you, and having prepared for all the angles.
___________________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across From Bridge Street"
CALL (256) 799-0297
SOCIAL SECURITY JUSTICE - WEBSITE
Free Consultations - Never a Fee Unless You Win
I assume that you have a legitimate long-term disability that basically meets the rules and regulations for a Social Security check. You are not working now at a job which plays at least $1,180 per month. Your impairment is expected to last at least 12 straight months. Those are the starting points.
What do you have to do?
First, file an application with the Social Security Administration: go online to www.socialsecurity.gov and file, call or visit a Social Security office and file, or find an attorney or disability advocate who is willing to help you file an application. You will wait 4 to 6 months to get a decision, which is often a denial.
Why Most Benefits Are Initially Denied
The denial letter will disguise the reason they denied your claim. However, it usually boils down to one of two reasons:
1. They find that you can perform at least one of your past jobs (called a Step 4 denial) OR
2. They find that if you can't perform any past jobs, there is other work in the national economy that you could perform (called a Step 5 denial).
Neither of these assumptions by Social Security may be true. The truth is, they probably rated your ability to work much higher than it really is. (The technical term for the ability to work is residual functional capacity). So, the denial isn't fact-based, it's error-based.
What Do You Have to Do If Denied?
File an appeal within 60 days of the date on the denial letter. This is the second step and the most important step.
Gather additional medical evidence from your doctors and medical providers that prove how severe your symptoms are and how your impairment makes it impossible for you to work a full-time job. Be prepared to make an impregnable argument before the administrative law judge who will preside at your hearing.
Will You Need an Attorney or Legal Representative?
Well, you are headed to a judge who will decide your case based on complicated rules and regulations of the federal government, specifically based on 20 Code of Federal Regulations, Part 404. If you aren't familiar with the Code or the burden of proof required to be awarded federal benefits in an appeal case, you may want help.
Also, keep in mind that preparing an appeal is a time consuming affair. Not only must you order and then read all your medical records, you must annotate them with notes that you use at your hearing to tell the judge where the medical records indicate that you are unable to work. Some cases that I work on have 4,000 pages of medical records (or more), which can takes weeks just to read.
Then, there is the problem of the hearing itself. You will be confronted by a vocational expert, or jobs expert, who is likely to testify that there are indeed thousands of jobs available which you could still perform. You will need to refute this idea with pointed questions to the VE if you want to win. And the regulations will let you ask some questions, not others. Some questions are helpful, while others can hurt your case. So, you must prepare to ask the right questions.
Finally, there are the technical issues of the case: alleged onset date, date last insured, listings, medical-vocational rules, acceptable medical sources, etc. Should you amend your alleged onset date if the judge suggests it, or should you hold firm?
All things considered, I think legal representation is a good idea and worth what it costs (which is nothing unless you win).
Many Medicare recipients enroll in a prescription drug plan (called Part D) and just assume that the plan continues to remain the same year after year. But, that isn't at all true. Medicare Part D plans change almost every year. What was the best plan for you in 2018 may be a terrible plan for 2019.
You have until December 7th this year to change your plan. After that, you're stuck with it for another year.
Some changes that drug plans make each year incude:
- Increasing the monthly premium
- Eliminating some of the drugs that they cover (formulary changes)
- Increasing co-pays
- Increasing annual deductibles
- Raising your out-of-pocket annual costs
If you simply stay with the same drug plan you had last year, without comparing other plans, it may cost you hundreds of dollars in increased drug costs for 2019.
Here's What You Should Do
Go to Medicare's official website at
https://www.medicare.gov/find-a-plan/results/planresults/plan-compare.aspx
This link takes you to the official government website for Medicare. [CAUTION: www.medicare.com, once operated by Medicare, is no longer a government website].
Once on this site, look for the blue tab in the upper left corner of the screen that says "Sign Up/Change Plans." Click this tab, then on the left side of the screen, click "Find Health and Drug Plans." Then, follow the cues.
You will be able to enter your information and type in each of the prescription drugs that you take regularly. Be sure to enter the correct dosage and number of pills or capsules that you buy each 30-day or 90-day period. (*Mail order drugs will save you up to 50 percent compared to buying at a local pharmacy, and your prescriptions will come from a Medicare-approved mail order pharmacy).
Another caution: There are dozens of websites run by insurance companies that look like Medicare websites. They are not. I had to search for 20 minutes just to find the official government website (in the link above). The insurance companies have agents that want to sell you insurance. So, avoid the sales pitches and go straight to the official Medicare website. Compare premiums, co-pays and deductibles for 2019. This website will actually let you customize your prescription use and tell you which Part D plan has the lowest out-of-pocket cost for you.
By way of disclaimer, I'd like to say that neither I or anyone at the Forsythe Firm are licensed insurance agents and we do not sell or recommend insurance plans to anyone. We do think you need to compare Part D drug plans every year to be sure you're getting the best deal. It takes about 30 minutes on your computer to be sure. And the deadline to change plans this year is December 7th.
________________
The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
(256) 799-0297
*Please do not call us about insurance related questions. However, if you have a Social Security disability question, we welcome your call. We offer free consultations.
SOCIAL SECURITY JUSTICE - WEBSITE
A couple of years ago Laura Kwerel wrote an article in the Atlantic Monthly titled "The Hell of Applying for Government Benefits." The link to the article is given below:
https://www.theatlantic.com/politics/archive/2016/06/social-security-administration/486410/
Ms.
Kwerel had attempted to get Social Security benefits for her daughter.
She describes how the government bureaucracy battled her every step of
the way.
Anyone considering applying for Social Security disability or SSI benefits should read this article first.
It
explains why there is a huge national industry of lawyers who do
nothing but help claimants applying for Social Security and other
government benefits.
You
may be told that you can do it yourself, you don't need a lawyer. And
while that is technically true, you must be prepared to spend countless
hours entangled in frustrating bureaucratic red tape, complications,
delays and confusing regulations. If the system worked the way it ought
to, lawyers or advocates would not be required. But the system doesn't
work that way.
The
article by Laura Kwerel is sad but fascinating--worth reading by anyone
who wants the real story of how difficult it is to deal with Social
Security yourself.
_____________
THE FORSYTHE FIRM
Social Security Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
(256) 799-0297
When you go in for a Social Security disability hearing the Government will have an expert or two on hand to testify.
There is always a vocational expert (VE). This professional is called by the judge to provide expert opinion about the claimant's past work and also about other work that exists in the national economy. This expert will testify in terms of technical matters, such as DOT codes, SVP factors, etc. If you are unrepresented, you will be at a real disadvantage. There are questions that must be asked of this witness. Failure to adequately challenge the VE's testimony may cause the case to be lost with all the benefits.
The second witness that may appear at your hearing is a medical expert, usually an MD or a psychologist. Not all hearings will use a medical expert, but some will. This individual has been called to address the judge's questions about your medical conditions, their severity and whether or not they meet one of the Listings. The judge may also ask the doctor what limitations you have on the ability to work an 8-hour day. Again, unfavorable testimony needs to be challenged by someone who knows how to do so.
I hope you see that walking into a hearing unrepresented and trying to handle these experts by yourself is a really bad idea. I have attended hundreds of successful hearings where I am convinced that if no claimant representative had been present the decision would have been unfavorable.
Here are common questions the judge will pose to the vocational expert:
- Please classify the claimant's past relative work.
- Are there any transferable skills?
- If the claimant were limited to light exertion level, would any jobs be available?
- If the claimant cannot perform his past relevant work, what other jobs may be available, based on my hypothetical questions?
The medical doctor may be asked such questions as.....
- Does the claimant meet or equal any listed impairment?
- Would you summarize the claimant's medical record?
- In your opinion, does the medical record support the claimant's complaints of pain or other symptoms?
If you are about to face one of these hearings, it is imperative that you get legal help in dealing with these experts.
____________
The Forsythe Firm
Huntsville, AL
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE WEBSITE
If you applied for Social Security disability benefits and were told you are not eligible, we strongly urge you to contact us for help.
Denials are very common but can usually be overturned on appeal. When you file an appeal your case goes before a federal administrative law judge for a hearing. Most of the cases that are won today are won at this level.
Here is what one of our experienced Social Security advocates will do for you:
- Analyze your case and set a strategy
- Gather evidence from doctors
- Prepare you to testify at the hearing
- Question the expert witnesses
- Answer the judge's technical questions
- Explain your case in terms of Social Security's regulations
WHAT ARE OUR FEES?
We do all the work on your case with no money upfront. We never ask you for a fee. If your case is successful, Social Security will withhold our fee out of your back pay and pay us directly. If your case does not result in back pay, we will not charge you a fee--ever.
And you always keep 100 percent of your monthly benefits--forever.
A Social Security denial is not the end. It marks an opportunity to take your case in a new direction. Contact us and get the help you need to turn a denial into victory and a claim paid!
_________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike
Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
PHONE: (256) 799-0297
SOCIAL SECURITY JUSTICE WEBSITE
Let's face it. 7 out of 10 applications for disability will be denied for one reason or another. Very few people get approved with an application.
You must appeal the denial within 60 days. What does the appeal do for you?
First, the appeal keeps your claim alive. It protects your back pay, your disability onset date and other benefits under the original claim. If the appeal is eventually decided in your favor, benefits can go back to the original onset date of your disability. This can pay you tens of thousands of dollars in past due benefits or back pay.
Second, a timely appeal puts you on track to appear at a hearing before a US Administrative Law Judge (ALJ). It will take a long time to get there, however, the appeal is the same thing as a Request for a Hearing.
Third, the appeal gives you time to gather new or additional evidence. You should keep seeing your doctor(s) and submitting the new records to your file.
Finally, the appeal allows you to appear in person before a judge who will give you a new decision without being bound by the negative decision already made on your claim. The judge will review all the facts in your case, including new evidence, including your testimony, including your attoney's arguments. You are entitled to be represented at these hearings and you should be. It won't guarantee a victory but it will increase your chances of winning.
I come in contact with claimants who have been denied three, four or even five times. They keep filing new claims and getting denied over and over again. This is the worst way to approach an SSDI claim. A new application goes to the same people who denied it previously. The same people make the same decision again. Another denial. Spinning your wheels, getting nowhere.
The 3 must do rules for a denied claim are:
1. Appeal
2. Appeal
3. Appeal
A lot of people get into trouble with Social Security by taking benefits they are not entitled to. This can go on for several years before Social Security catches on. Then, the government demands that you pay the money back. Probably, the money has been spent. You just don't have it to pay back. This is a serious problem.
How do people get themselves into this fix? By taking money that they are not entitled to.
It usually happens this way. An individual gets approved for disability and receives an SSDI check each month. After a couple of years, he feels better and decides he can go back to work. He does so but doesn't notify Social Security that he is working. So, Social Security keeps sending the monthly disability checks, which the beneficiary is no longer entitled to. But the checks keep getting cashed, creating a huge over-payment.
This may go on for up to two or three years. It appears that everything is fine because nobody has screamed about it.
However, Social Security has multiple ways of knowing when people get checks they are not entitled to. Eventually, they will find out. They always do. Then, they will demand their money back.
Of course, the money has already been spent. That doesn't matter. Social Security wants their money back, no excuses.
I get five or six calls a month from individuals in this situation. "I've spent the money, I don't have it any more, and now they want it back. Can you get me out of this?"
The short answer is, "No, I can't." If you take money you are not entitled to, you will have to pay it back.
I do realize that earning a paycheck and getting a disability check too is tempting. But it is also illegal.
Here is my recommendation to anyone receiving a benefit from Social Security:
Realize your reporting responsibilities. If you go back to work, either full-time or part-time, immediately notify Social Security in writing. Telephone calls are nearly impossible to prove and never make a good record. If Social Security doesn't respond, don't just assume that cashing their checks is OK. Keep contacting them until you get the right information. Ultimately, cashing checks that you're not entitled to cash only gets you into trouble. There is never an acceptable excuse and there are no loopholes. When in doubt, don't cash the check!
Fighting fraud is Job 1 at Social Security these days. If outright dishonesty or misrepresentation is involved, you may be subject to arrest and criminal prosecution--in addition to paying back the money you took. It isn't worth it to put yourself in that position. If you go back to work, report it. If they send you a check anyway, return it.
There are a very limited number of situations where a person might be entitled to keep getting a check after returning to work. An example would be a person participating in the Ticket to Work program. But this is a formal program where a person works with the permission of Social Security and there are rules and limits.
TOP 10 SOCIAL SECURITY DISABILITY MISTAKES
Social
Security has its own rule book. To get benefits, you have to know
their rules and play by them. Other rules just don't work. Here are my
Top Ten Mistakes that can cause you problems with SSDI:
1.
Trying to file when you haven't worked enough. You must have worked
enough to accumulate the minimum Quarters of Coverage. Without the
required work history, your claim will automatically be denied. And
this type of denial can't be successfully appealed. Check this with the
Social Security office before you begin an SSDI claim. The question
you need to ask: "Do I have enough work credits to support a new Title 2
claim?"
2.
Filing a claim while you are still working. If you work enough to earn
substantial wages, you will be given a denial at the first step in the
process. In 2018, wages of at least $1,180 per month will get you
denied. You must stop working or reduce wages to below the maximum before filing.
3.
Alleging an onset date in the past but Social Security finds that you
were still working on that date. For example, you allege disability
began on 4/14/17 but you were still at working at substantial gainful activity (SGA) on that date. You should amend your alleged onset date to a later date after you stopped earning SGA wages.
4.
You have a serious condition but it isn't expected to last at least 12
consecutive months. Short term disabilities that won't last for at least
1 year are not covered unless they are expected to end in death.
5.
Failure to get your own doctor's support. Your doctor knows you better
than anyone. He or she can give you a form called a "medical source
statement" that can help you get approved. You have to seek out this
from your doctor; Social Security won't do it.
6.
Depending on Social Security's doctor to help you will always let you
down. They have consulting doctors that often do examinations for
persons who file claims but lack medical evidence from their own doctors. These exams seldom help get a favorable
decision and most often doom the case to a denial.
7.
Failing to get medical treatment is a big mistake. Social Security
bases its decision on what is in your medical file. It is crucial to
have consistent treatment from your doctor(s). Claiming to have a
disabling impairment without medical evidence for it is a waste of time. For many conditions, treatment by a medical specialist is a really good idea. By the way, nurse practitioners are not considered acceptable medical sources by Social Security. They want a doctor (MD or DO). Records from a nurse practitioner won't take you very far with Social Security.
8.
Waiting too long to file a claim can hurt you. Every worker's Social
Security disability coverage comes with a "Date Last Insured," which is
the time limit for filing a new claim. When you stop working, for any
reason, your Date Last Insured begins to creep up on you. Don't wait
too long to file an SSDI claim or you may find yourself uninsured at
Social Security.
9.
Failure to file an appeal in a timely manner. Up to 70 percent of SSDI
claims will be denied at the first stage. It's just expected. You
have 60 days to file an appeal. After 60o days passes and you do not
appeal, the claim is dismissed and can't be reinstated in most cases.
Don't let the 60 days pass. (Appeals are where most cases are won).
10. Failure to get legal representation. Social Security is one of those places where you may
represent yourself. However, this is a really bad idea. There are
complex books of regulations that govern Social Security disability.
You need someone who knows the system and understands how to get cases
approved. You only pay your representative if you win and if you
collect past due benefits. Social Security will deduct the amount of
the fee you have agreed on and pay the representative directly. There
are reasonable maximum fees set by Social Security and you will never
pay more than these amounts by law. You never have to pay anything up
front.
____________
THE FORSYTHE FIRM
Social Security Disability Representatives
7027 Old Madison Pike NW, Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE: OUR WEBSITE
Social Security disability benefits are unique to the individual. The amount of your monthly benefit depends on your age, how long you have worked and how much you have earned.
The maximum SSDI benefit can be over $2,700 per month. That would be for an individual with many years of high earnings.
The average SSDI check in 2018 is around $1,170 per month.
SSDI benefits are not "means tested." Benefits are not reduced because you have other income, property, savings, etc.
Supplemental Security Income (SSI) is a totally different program and its maximum benefit is $750 per month. That amount can be reduced based on household income, living arrangements and other factors because SSI is for low income individuals or families.
Social Security no longer mails estimates of benefits, as they once did. However, you can call your local Social Security office and ask about your estimated monthly benefit in case of disability.
Keep in mind that SSDI beneficiaries also get Medicare insurance, which is a valuable benefit. (SSI recipients get Medicaid).
A small percentage of claimants who have catastrophic or life-threatening illness may get Social Security disability benefits pretty easily. Most people, however, will be denied and will require legal assistance to be approved.
What Kind of Legal Help Will You Need?
1. THE APPLICATION. Most claimants apply on their own. But the denial rate on these applications is almost 80 percent. Again, unless you have a catastrophic or fatal disease, the odds are you will be denied, especially if you are under age 50. Using an experienced attorney-advocate to file the application doesn't guarantee approval but it will eliminate many of the common mistakes that bring about denials.
2. THE APPEAL. Most people who finally get approved for Social Security disability benefits will do so after they file an appeal. They will go to a hearing before an administrative law judge (ALJ). These individuals need help in gathering evidence that meets the government's standards. They will also require assistance in presenting their case effectively to the judge. While representation is not required, it is your best chance at having a favorable resolution to your case. This hearing is to resolve a dispute with the US Government, who says that you are not disabled. The burden of proving that you are disabled rests upon you. You get a one-time chance at the hearing.
Specifically, here are some of the things that a good disability attorney-advocate will do for you:
- Gather and analyze medical records from doctors and other providers
- Analyze your past relevant work and how it impacts the claim
- Determine if you meet or equal one of the published Listings
- Determine whether a Grid argument can be made to get approval
- Develop another legal theory of the case to explain why you should be approved
- Solve flaws or problems in the case before it goes to hearing
- Petition for expedited processing, if appropriate, to get a decision faster
- Deal with pre-hearing motions from the judge
- Write a brief to explain why the case is sound legally and should be paid
- Prepare you, the claimant, for what will happen at the hearing ahead of time
- Appear at the hearing to present the case before the judge
- Object to testimony or rulings that are not in your best interest
- Cross examine Social Security's vocational expert at the hearing
- Make final arguments at the close of the hearing
- Monitor the payment process to be sure you collect the maximum benefits
- Decide whether any unfavorable decisions should be further appealed
- File any further appeals that are appropriate
- Answer your questions as the case progresses so you understand the process
All of this should cost you nothing until a favorable decision has been reached and you have been awarded past due benefits.
_______
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail me at forsythefirm@gmail.com
The goal of a Social Security disability claim is to convince the Government that you are not able to work. The obvious evidence you need is medical evidence: records from your doctor that show how severe your symptoms are.
But there is always non-medical evidence that enters into your claim, which may help you get approved or weaken your case and turn the direction toward denial.
Claimants often fail to see the advantages of non-medical evidence, or may see certain facts as harmful to their case. Here are a few examples.
You have changed jobs several times in recent years; therefore, you don't have a long history of just one job. This can be positive. If you had to change jobs because you couldn't perform the tasks of your old job, you are merely showing a commitment to keep working. Getting an easier job, or one with less demanding duties, demonstrates your need to work and your desire to keep working.
You were fired or "let go" from a your most recent job. This is usually considered negative. However, in a disability case, it may demonstrate that you were simply no longer able to dependably perform your job. If you were missing excessive days of work due to your health, it shows that your impairment is severe and interfered with your ability to work consistently. If your employer had to make accommodations to help you do your job, it shows how your health negatively affects your ability to keep working.
I recommend that claimants get a written statement from their former employer or supervisor, if possible. The statement should explain how long you worked for the company and that you were a good employee. It should go on to state observations your employer made about your work after you became sick. For example, you began to need extra time to complete job tasks; you had to miss work 3 or 4 days per month for illness; or, your job duties were changed in some way to help you continue working. The more specific the statement is, the more it will help you. For example, it is much better to say, "Mr. Employee was missing 3 or 4 days of work per month," than to say, "Mr. Employee sometimes missed work due to illness." The word "sometimes" is very vague and non-defined.
A good attorney or hearing representative will help you build non-medical evidence. Since I have stood before administrative law judges in hundreds of hearings, I know which evidence can help your claim. I can help you obtain this evidence prior to the hearing. Then, I can use the evidence during the hearing to help get a favorable decision in many cases.
The quest for Social Security disability benefits is difficult, with the average judge awarding (paying) about 42 percent of cases at hearings. The 42 percent (winners) are generally those who have the best evidence, presented in the best way, by the best representatives.
If you think you may have a Social Security disability claim, please call us for a free consultation. We will ask you some questions to help analyze your case. If we represent you, we will help you build a good case using both medical and non-medical evidence. You will never pay us a fee until your case is settled in your favor. At that time, the government will approve the fee we have agreed upon and pay us directly. You will receive 100 percent of your monthly benefits and your past due settlement will be reduced slightly to pay for our legal services. (The typical fee is 25 percent of past due benefits, not to exceed $6,000).
Example: Your past due settlement is $24,000. Our fee is $6,000. You keep $18,000 plus all your monthly checks.
Example: Your past due settlement is $80,000. Our fee is $6,000. You keep $74,000 and all your monthly checks.
Example: Your past due settlement is $12,000. Our fee is $3,000. You keep $8,000 and all of your monthly benefits.
----------------
The Forsythe Firm
Huntsville, AL
PHONE (256) 799-0297
Under Social Security rules and regulations there are basically 3 ways to be approved for disability benefits:
1. Prove that you meet a Listing. Listings are published lists of medical impairments and extensive symptoms which are documented by acceptable medical evidence. Claimants of any age could meet a Listing.
2. Meet or equal a grid rule, also called a medical-vocational rule. It is possible to meet a grid rule only if
- You are age 50 or older and
- You have one or more exertional impairments in:
- Sitting
- Standing
- Walking
- Lifting
- Carrying
- Pushing, or
- Pulling
3. The third way you can get disability benefits is by proving that you are not able to
- Perform any of your past relevant work, which is any job your have done in the past 15 years, nor
- Perform any other work which exists in substantial numbers in the United States.
Social Security decision makers will take a step-by-step approach to analyze which of the above methods allows for an award of benefits. If neither of the 3 methods allows for an award, your claim will be denied.
I want to add that many claims are denied which should have been paid. There is an appeal system in place to catch those errors and fix them. This requires a hearing before an administrative law judge. If your claim is denied, you must file a written appeal and ask for a hearing within 60 days. While it will probably take about 18 to 24 months to get before a judge, you only have 60 days to request a hearing.
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Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across From Bridge Street"
PHONE (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
There are several reasons that you might not meet the technical requirements to file a Social Security disability claim. Here are a few of the more common disqualifying facts that we see:
1. You do not currently have insured status under the Social Security Act. Not everyone is covered by Social Security disability. Generally, you must have earned 40 quarters of work credits and 20 of them must have been earned during the last 10 years. So, your work credits must be recent enough. (Different rules apply to very young workers).
2. You are now working at substantial gainful activity (SGA). Social Security does not permit individuals who are still working and earning substantial wages to apply for disability, regardless of their age or medical condition. You are deemed to be working at substantial gainful activity if your salary, wages, tips or commissions total a gross of $1,180 per month. In short, if you are currently working and earning at least $1,180 per month you will not qualify for disability benefits.
3. You cannot demonstrate that you have a severe medically determinable impairment that has lasted for at least 12 consecutive months, is reasonably expected to last for 12 consecutive months, OR to end in death. Social Security has no short-term disability program. It does not pay for any disabling impairment which lasts for less than 12 consecutive months. An impairment is generally "medically determinable" if your doctor has diagnosed it with acceptable medical practices such as examinations, laboratory tests, imaging studies, etc.
NOTE: There is no requirement that you wait 12 months to file a claim after you become sick or injured. However, you must show by medical evidence that your impairment can reasonably be expected to have a duration of at least 12 months. If you are expected to be able to return to work within 12 months, you do not have a disability claim. This is called the Duration Requirement. Some medical conditions can reasonably be expected to last 12 months or more and others will not.
It is always a good idea to speak with someone who is knowledgeable about Social Security's rules and regulations as you try to decide your next step. This can save you a lot of time, wasted energy and maybe some heartache. Most attorney-advocates will provide you with free information and a free consultation in which your particular circumstances are analyzed to see how you should proceed. This can often be done with a simple 10 minute phone call, right from your home.
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Charles W. Forsythe
The Forsythe Firm
Social Security Disability Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 325806
CALL US: (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
Claimants who are unrepresented for Social Security claims may inadvertently send 3 messages to the judge that can hurt the case.
1. You may send the message that your claim is so weak that you couldn't find an attorney-advocate to represent you. Over 90 percent of claimants are represented. Judges aren't accustomed to dealing with "unrepped" claimants.
2. The judge may not expect you to show up for your hearing if you are unrepped. A high percentage of claimants who don't have representatives don't bother to show up for their hearings. Claimants with representation nearly always show up. This places a negative stigma on unrepped claimants.
3. Your hearing will probably be delayed for a few months if you show up unrepresented. The judge will offer to delay the hearing to provide time for you to find counsel. If you refuse, you will be asked to sign a waiver stating that you were offered a delay to find an attorney and you declined to do so. Judges really don't like to deal with unrepresented claimants. Once your hearing has been postponed, it can take 3 to 6 months to get back on the docket again.
There are many fine claimant's representatives in North Alabama who would like to help you with your Social Security hearing. Most of them will provide a free consultation and case evaluation with no obligation. You will only pay a fee if your case is successful and results in a back pay award. (And who wouldn't be glad to pay a small legal fee under those conditions)?
If you have been denied Social Security disability benefits it doesn't mean that you have a bad claim or that you can't get paid. It means there is more work to be done on your case.
Let me illustrate it this way: Out of the last 100 Social Security claims that I have won, 8 of them were won at the application level and 92 were won with an appeal of a denied claim. Think about it. If those 92 individuals had given up because they got denied, none of them would have ever collected a dime.
If you've recently been denied Social Security disability, it does not mean that you have a bad claim. It certainly doesn't mean that it's time to give up. Here is what it does mean:
1. It's time to kick your claim up a level. Get it away from the Disability Determination Service and into the hands of an administrative law judge. This is where most claims finally get approved.
2. You need to have someone with experience review your case and decide what it needs to get approved. Does it need more medical evidence? Does your doctor need to present a treating source statement? How should you be prepared to face the judge when your hearing comes up?
3. You need encouragement as you wait up to 24 months to get a hearing. The wait is discouraging but remember that I may be able to get one month of benefits for you for each month you have to wait. So, you may walk away with a great deal of money, plus a monthly check.
I fear that too many claimants give up on their claims when they get that letter in the mail saying, "You are not entitled to benefits because you are not disabled according to our rules." THAT IS NOT A FINAL DECISION. A high percentage of those denials are overturned and the cases are paid.
Be aware of the 60 day rule. If you don't appeal your denial within 60 days, then the denial does become final and you have to start all over.
There is never a charge for me to look at your case (before or after you are denied). We will evaluate your claim to see what your next steps need to be--and if possible, we will help you take the next step.
I can also help you file your initial application for SSDI. You want a clean, complete application for two reasons:
1. You want the best chance possible of being approved right away, and
2. You want to lay the proper groundwork for an appeal in case your application is denied.
The Forsythe Firm works hard for hundreds of deserving disability claimants at all phases of the claims process. We can handle claims anywhere in the state of Alabama or in Middle Tennessee. We have also handled claims in Florida, Mississippi, Kentucky and Texas. Our work is always free until you win and collect back pay on your claim. And you always keep 100 percent of your monthly checks.
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Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
EMail Us: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
In our Social Security advocacy practice, we are often asked if it's a good idea to try to work while waiting on a disability decision. If I had to give a one-word answer, I would say, "No."
But it's a little more complicated than that. There is a technical answer and a practical answer. I will try to give both answers, because I realize people have to eat while they wait 2 years or more for Social Security to make up their minds.
THE TECHNICAL ANSWER:
Claimants are permitted to work at limited levels while pursuing an SSDI claim. If you are engaged in work which is not substantial gainful activity (SGA), it will not automatically disqualify you for SSDI benefits. In 2018, if your earnings are less than $1,180 per month, you are not engaged in substantial gainful activity.
THE PRACTICAL ANSWER:
With some judges, any work can jeopardize your case. Let's say you are working part-time and only earning $900 per month. That's well under the SGA limit of $1,180, so you have no problem, right? Not necessarily. Some judges will take the attitude that if you can earn $900 per month, you could earn $1,180 without much more effort. Their thought process goes something like this: "You're telling me that you can work enough to earn $900 a month, but you can't work enough to earn $1,180?"
I've actually had judges say to me, "In today's economy, a lot of jobs are part-time jobs. A person may be working a part-time job because that's the only job he can get, not necessarily because that's all he is able to do."
Let's say your part-time job requires you to be at work 8 hours per day each Monday, Wednesday and Friday. You are off Tuesdays and Thursdays. A judge may have a difficult time believing that you are able to work regularly and dependably on Mondays/Wednesdays/Fridays, but not on Tuesdays/Thursdays. So, I think there is more to look at than just the dollar amount of your earnings, although that's all the law addresses, technically.
So, while the written law permits you to earn up to $1,179 per month in wages, tips or commission and still be disabled, I'd much rather walk into a hearing with a claimant who isn't working at all than one who is earning $1,179 per month.
On the practical side, I think the rule of thumb is this: The closer you get to earning $1,180 per month, the bigger problem you may have with Social Security decision makers. Earning $500 per month may not cause any big issues, but earning $1,100 may create problems.
Each claimant has to decide for himself whether he needs the money a part-time job provides while they wait on Social Security to decide their claim. The same problem still exists after your disability case is approved. Persons who receive Social Security disability are also allowed to work below substantial gainful activity level. (Earning more than SGA wages will cause your disability check to be discontinued). What about earning $1,000 a month? Again, I think the rule is: The closer you come to SGA earnings, the bigger the potential for a problem you have.
Obviously, Social Security recognizes that people must eat while they wait months or years for a disability decision. I suppose that's why they allow limited, part-time work. But I have given you the truth of the matter here, as I have observed it during my years of work as a Social Security disability advocate. Be very informed about how working can affect your SSDI claim.
Here's a question we often get: "My insurance company found me to be disabled and is paying me a long term benefit. But Social Security says I am not disabled and will not pay me a benefit. How is this possible?"
It's possible for three reasons:
First, Social Security has their own definition of "disability." To them, it means 100 percent disability to the point of not being able to perform any type of full time work. If the SSA finds that you can still be a surveillance system monitor, a laundry folder or a ticket taker, they will deny your claim. Their definition of disability is the most restrictive of anyone I can think of. An insurance company may have a much less restrictive definition. To them it may simply mean that you are not able to continue doing the job to which you are prepared by education, training and experience. They don't expect you to switch careers and become a laundry folder or ticket taker.
Second, Social Security is entitled to make their own decision about who is disabled. They are not required to accept anyone else's decision, even decisions by other federal agencies. For example, you might be disabled under rules of the Veterans Administration but not under the rules of the Social Security Administration.
Third, Social Security requires 100 percent disability, while some other agencies and some insurance companies will approve disability benefits for less than 100 percent disability. For example, the Veterans Administration will award benefits for a partial disability. Workers Compensation may pay benefits for less than 100 percent disability. But Social Security will not.
It is proving that you are 100 percent totally unable to work ANY job listed in the Dictionary of Occupational Titles (DOT) that is so difficult with Social Security.
A very high percentage of SSDI claims get denied. The next step is to appeal the denial and ask for a hearing. The hearing is the best chance to win your claim, especially if you have professional representation who understands the complex set of regulations that Social Security employs.
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THE FORSYTHE FIRM
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL US: (256) 799-0297
EMAIL US: forsythefirm@gmail.com
Can a claimant present his or her own Social Security disability case before a judge. Yes, of course. But the pertinent question is this: "What tools are in your tool box?"
Unfortunately, many claimants will have to answer honestly, "My tool box is empty." Or, "I don't have a tool box."
If you set out to build or remodel a house, you must have a tool box - or perhaps a whole truck load of tools. Otherwise, you can't really expect to get the job done.
How can you expect to prevail at your own Social Security hearing if you don't have the tools to do the job?
Tools, in this example, means the knowledge of laws, rules, regulations and procedures used by the Social Security Administration to decide a case. Tools are the skills needed to handle problems and overcome objections to paying our claim. And, trust me, there will be objections and issues.
If the vocational witness testifies that you can perform sedentary work, do you have a "tool" to refute it? If not, you will lose your case then and there.
If the judge finds that your residual functional capacity allows for medium exertion level jobs, do you have the right tool to challenge that conclusion? If not, there goes your case.
If the judge questions whether you have been working at substantial gainful activity, do you know which tools you can use to get a favorable conclusion to that question?
I could go on and on and on. There are so many issues that can come up in a disability hearing that I can't count them all. The advantage of having a lawyer-advocate with you at the hearing is simply this: He or she will have a big bag full of tools that really work in handling these issues. At least, the attorney-advocate will have a much better chance than you will if you go in without a toolbox (or an empty one).
Just like a skilled carpenter can reach into his toolbox and get a tool to expertly fit a piece of trim, your advocate can pull out a tool and skillfully handle a problem in a way that conforms to the rules and regulations of the Social Security Administration. And this can mean the difference between losing and winning your benefits. In short, it can earn you about $500,000 in lifetime benefits, as opposed to losing all that money. It can make the difference between living pretty comfortably for the rest of your life or suffering.
Think about the question: WHAT IS IN YOUR TOOL BOX?
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Charles W. Forsythe, Partner
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Me: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
