Monday, March 19, 2018

WHY JUDGES MAY IGNORE YOUR DOCTOR'S OPINION

You have a Social Security hearing coming up on your disability claim.  You approach your doctor about filling out a form to support your claim.  The doctor is busy but offers to give you a letter, instead.  Here's an example of a doctor's letter:

"Mr. Joe Claimant has been a patient of mine for over 20 years.  He suffers from back pain, migraine headaches, high cholesterol, high blood pressure and depression.  In my opinion, Mr. Claimant is not able to work and is fully disabled."  Signed [John M. Doctor, MD].

Why Social Security judges will probably ignore this letter?

The letter draws a conclusion that only the Commissioner of Social Security is able to reach, under the law.  (20 CFR 404.1527).

Doctors are not permitted to decide who is disabled under the federal regulations.  The fact that your doctor believes you are disabled is not dispositive.

It would be far better if your doctor specified why you cannot work.  For example, if he provided your restrictions on such activities as sitting, standing, walking, bending, lifting, crawling, kneeling, crouching, paying attention, remembering, etc. Doctors are permitted to assess your individual functional limitations, but not to draw conclusions about whether you are disabled.

There is a form that I like to use for doctors.  It's called a Medical Source Statement.  Some people call it a Residual Functional Capacity form.  It nearly always carries more weight with Social Security decision makers, especially judges, than letters do.  The reason is obvious:  the form keeps doctors away from drawing conclusions and allows them to estimate functional restrictions, according to Social Security regulations.

I will provide this form free to anyone requesting it.
___________
THE FORSYTHE FIRM
Social Security Disability Representatives
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297

https://forsythefirm.wixsite.com/website 

  

SIGNS THAT YOU WON YOUR HEARING

In most cases, judges do not announce their decisions at the end of hearings.  They will say something like, "You've given me a lot to think about.  I will get a decision out to you in the mail as soon as possible."  Normally, it will take 2 or 3 months to get that decision.

Are there clues about whether you won your benefits at the disability hearing?  What are some of the clues?  ("Clues," not "guarantees"):

CLUE NO. 1:  The judge asked only 1 question of the vocational witness and the response was, "There would be no jobs available."  This is an excellent clue that the judge will find that you are not able to work.

CLUE NO. 2:  The judge asked 3 or 4 questions of the vocational witness.  In response to the first question, the witness replied that there would be jobs available.  But in response to questions 2 - 4, which contained more functional restrictions, the witness said, "No, there would not be any jobs available."  This leaves the judge plenty of room to approve your benefits.

CLUE No. 3:  You have a form from one of your treating doctors in your medical file that lists several restrictions that prevent you from working.  For example, your doctor states that you can stand and/or walk for no more than 2 hours in an 8-hour day; can sit less than 5 hours; you can lift less than 10 pounds occasionally, or you would be absent from work 3 or more days per month.  While Social Security judges aren't required to agree with the doctor's assessment, many times they will give the doctor's opinion great weight.

CLUE NO. 4:  You had a good judge.  If you appeared before a judge who pays above the national percentage rate (about 42 percent), it's a good sign.  There are websites where you can look up a judge's approval ratios.  For example, if the hearing office as a whole has an approval rate of 45 percent, but your judge averages an approval rate of 68 percent, that's a good sign that you have a reasonable judge who will make a fair decision.  On the other hand, if your judge pays only 12 percent of claims, it's not a good sign.

What if the judge didn't ask the vocational expert any questions at all?  This could mean that your case is so strong that it could be approved without any questions or that it is so weak that questions wouldn't help.  In this scenario, I fall back on the medical evidence in the case.  If the medical evidence is strong, and there are no other issues (drug or alcohol abuse), I tend to think no questions is a good sign.

Does anyone really know what your decision will be?  The truthful answer is, No.  Until the Notice of Decision arrives in the mail, nobody really knows what the decision will be.  Judges can be difficult to read and I'm certainly not perfect at trying to read their minds.  

Is it a good sign that the judge smiled and was nice during the hearing?  The answer is, not so much.  I've seen judges who were very friendly and cordial and denied the case.  I've seen others who were cold and argumentative and paid the case.  A judge's personality and demeanor during the hearing is often a poor indication of the outcome.
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The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297

SOCIAL SECURITY JUSTICE

 

OVER AGE 50? YOU HAVE AN ADVANTAGE IN SOCIAL SECURITY DISABILITY

Age plays a critical role in Social Security disability decisions.  Claimants age 50 and above have an advantage.  Those age 55 and over have an even better advantage.  Let me explain why?

Social Security regulations assume that younger individuals can do harder work and also that they can adapt more easily to different kinds of work.

There are 3 basic age categories in the regulations:
  • Ages 18 - 49   Younger Individuals
  • Ages 50 - 54   Closely approaching advanced age
  • Age 55 +         Advanced Age
A person in the age 18 - 49 category may be denied benefits if he or she is able to perform any full-time job found in the national economy.  So, a person who has worked as a concrete finisher (heavy work) who can transition to work as a sales attendant (light work) would not be found disabled.

However, at age 50, things change.   Individuals who are "closely approaching advanced age (50 - 54) are judged by their ability to perform their past relevant work, i.e., the work they have done during the most recent fifteen-year period. A person age 50 or above may meet a Medical-Vocational Guideline (also called "grid rules") that direct a finding of disabled.  Persons under age 50 cannot meet these rules.

At age 55, the grid rules will direct that a person who cannot perform his/her past relevant work is disabled, even if able to perform sedentary or light work.  Here again, age works in the claimant's favor.

Can younger individuals get Social Security disability?  The answer is, yes.  But their burden of proof is a bit higher.  Younger individuals must usually prove that their medical condition prevents them from being able to perform any full-time work that exists in the national economy--even sedentary or light work (the easiest categories of work).

Before reaching a decision about disability, the Government must establish a Residual Functional Capacity (RFC) for each claimant.  The RFC is merely a finding of the most that a claimant can do, based on age, education, past work history and medical impairment(s).  An RFC will find the claimant limited to one of the following 5 exertional categories, starting with the heaviest work and ending with the easiest:

  1. Sedentary work
  2. Light work
  3. Medium work
  4. Heavy work, or
  5. Very Heavy work
 
 A person who is able to perform Very Heavy work can also perform heavy, medium, light and sedentary work, thus would have no exertional restrictions.

The older a person is, the less likely that a judge or decision maker would expect him/her to perform heavy work.  And if all the claimant's past relevant work was medium, heavy or very heavy--and the claimant is now restricted to light or sedentary work--the grid rules will direct a finding of disability.

Therefore, a person may very well be legally disabled at age 50 but not disabled at age 49 or younger.
________________
The Forsythe Firm
Social Security Disability Representation
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297

Free Consultations - Never a fee unless you win!

https://forsythefirm.wixsite.com/website


 
 
  

 
 

Sunday, March 11, 2018

YOU CAN'T APPLY FOR SOCIAL SECURITY DISABIITY WHILE YOU ARE WORKING

If you are still working at 'substantial gainful activity' you cannot apply for Social Security disability.

It doesn't matter how sick you are or how unable to work you may be -- working a full-time job disqualifies you for SSDI benefits.  Generally, you have to quit work first then apply for Social Security disability.  

This puts many people in a bad financial position, especially since it may take months or years to get approved for Social Security.

Here is the specific rule about working:

In 2018, you are considered to working at 'substantial gainful activity' if you are earning wages, salary or commissions of at least $1,180 per month before tax. This also applies to self-employment income.  It does NOT apply to non-earned income (money you receive without working for it (alimony, child support, investment income, rent, disability or pension payments, etc.).

If you work part-time and earn less than $1,180 per month, you may still be able to apply for SSDI benefits.

QUESTION:  "I still work full-time and earn over $1,180 per month.  However, I work in tremendous pain and my doctor says I should quit work.  Can I apply for SSDI benefits?"

ANSWER:  No.  As long as you continue to work and earn the Substantial Gainful Activity (SGA) amount, you cannot apply for SSDI or SSI benefits.

QUESTION:  "If I can't keep working until my Social Security disability is approved, how am I to survive financially during the long SSDI application process?"

ANSWER:  There is no good answer.  But you cannot work and apply for SSDI at the same time.  If your employer offers a disability insurance program through your job, check to see if you could qualify for those benefits if you have to stop working.  Also, consider whether you can work part-time and earn less than the SGA limit ($1,180 per month).  That may allow you to apply for SSDI while working part time.

QUESTION:  "So, how long is it realistically going to take to get Social Security Disability benefits started?"

ANSWER:  The time will vary for each individual.  3 to 4 months to get the initial decision is average.  If an appeal (hearing) is required, it can take 2 more years due to the national backlog of appeals.  There are a few rare exceptions for dire need where hearings can be arranged sooner, such as in the case of terminal illness, homelessness and a few other exceptions.

My office will be glad to provide you with a free, no obligation consultation.  Perhaps we can give you more direction on your claim and some advice on how to proceed.  We never charge a fee unless (a) you appoint us to represent you, (b) you eventually win your claim, and (c) you are able to get past due benefits from Social Security.
___________________
THE FORSYTHE FIRM
Social Security Disability Representation
7027 Old Madison Pike NW - Suite 108
Bridge Street Area
PH (256) 799-0297

SOCIAL SECURITY JUSTICE: WEBSITE 

 

 

THE SOCIAL SECURITY APPLICATION FOR DISABILITY

Many people fail to understand the complexity of a Social Security disability application.  It is not a simple 1 or 2 page form.  

Should you complete the application yourself, let someone at Social Security help you, or get an attorney or advocate to do it for you (free)?  That's your choice but you should understand what's involved in the application process.

FORMS REQUIRED

  • Application (General Information) - The form I use for this is 4 pages long.
  • Disability Report - This is a 14-page form.
  • Function Report - This form is also 12 - 14 pages long and very detailed.
  • Employment History - The length varies based on how many jobs you've had.  There is one page for each job you've held during the past 15 years.  It asks a lot of questions about each job.
  • Depending on the medical condition that you claim to be disabling, there may be specific health questionnaires, such as headache, pain or seizure questionnaires. 
  • In some cases, you will be sent for a medical or psychological examination by Social Security.  This examination almost never helps your case.
YOUR ODDS WITH A DISABILITY APPLICATION

Once you complete all the forms and questionnaires, it will take about 4 months to get an initial decision.  In Alabama, about 70 percent of all applications are denied for one reason or another.  These will need an appeal and a hearing before an Administrative Law Judge (about 2 years away).

ATTORNEY OR ADVOCATE HELP WITH YOUR APPLICATION

You may choose to appoint an advocate or attorney to help you with your application process.  Generally, if all the advocate does is complete the application and forms for you, there will not be a charge (fee).  You cannot be charged a fee unless you receive back pay.  If your application gets approved at the initial level, there is often no pay involved, thus no attorney fee.  However, if you are denied and your appeal takes a lot more work, back pay may be involved and your advocate will charge a percentage of back pay collected (with limits on amounts of the fee imposed by the Government).

What an attorney or advocate may do to give your application a better chance of approval:

1)  The advocate fills out these forms every day.  He knows how to complete the application form completely, correctly and how to provide full pertinent information.

2)  The advocate will know how to describe each of your past jobs so the skill levels and exertion levels of each job are properly classified vocationally.  This is important.

3)  Advocates understand the importance of specifying clearly what your physical and mental limitations are in the Function Report.  Improper or incomplete Function Reports will nearly always result in a denial.

4)  Advocates may help in obtaining medical records from your doctors.  This may include obtaining special "Medical Source Statements" from your doctors that can help prove that you are unable to sustain full-time work.  Note:  Social Security will not obtain these opinions from your doctors; they will only order routine medical records.

5)  Your advocate will always be there to answer any questions you have about your claim.

6)  If your claim is denied, your advocate will already be on board, aware of your case and ready to file an appeal for you.  These days, most claims are won on appeal, not by application.

FEES FOR LEGAL REPRESENTATION:

You will not be charged a fee unless your claim is approved and results in payment of past due benefits (called back pay).  The fee will be a small percentage of your back pay.  There is not a charge for merely filing an application, talking to you, giving advice or filling out forms.
___________________
THE FORSYTHE FIRM
Social Security Disability Represenation
7027 Old Madison Pike - Suite 108
Bridge Street area
PH (256) 799-0297

SOCIAL SECURITY JUSTICE: OUR WEBSITE

Free consultations.  No fees until you win and receive back payments (lump sum settlement of past due benefits).
 

HIRING A DISABILITY ADVOCATE

You are disabled, hurting and bills are due.  Social Security is your best hope for income but they give you the run-around. Or they deny your application. You need a professional who knows how to help.  An advocate is an attorney or non-attorney professional skilled in presenting your case and handling details of a Social Security claim or appeal.

How to hire a disability advocate:

1.  Look for someone with experience in Social Security disability, preferably someone who specializes in that field.  This should be someone skilled at appearances before Administrative Law Judges (hearings).  

2.  Be sure the advocate is approved by the Social Security Administration for direct payment of fees.  This assures he/she meets demanding standards of the Government.

2.  You may want to look for a local advocate, not someone at the end of a distant 800 telephone number.  A local advocate knows the local judges and how they operate and is someone you will meet early in the process, not 30 minutes before your hearing.

3.  Meet with your advocate in his or her office before hiring him/her.  Most offer free initial consultations.  Get a free evaluation of your case.  No one can guarantee you will win but if there are obvious problems, find out right away.  You will have to meet the Government's legal requirements for disability.  Find out where you stand, legally.

4.  Get a contingency fee agreement that says you pay no fees unless you win.  These agreements will stipulate that any representative's fee will come out of your back pay settlement with Social Security.  If you don't receive any back pay, there will not be a fee.  This way, you take no risk as far as legal fees are concerned.  No back payments, no fee.
__________________

THE FORSYTHE FIRM
Social Security Disability Representation
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35896
PH (256) 799-0297

SOCIAL SECURITY JUSTICE: OUR WEBSITE

Sunday, March 4, 2018

WHAT HAPPENS AT A SOCIAL SECURITY DISABILITY HEARING BY VIDEO (VTC)?

The Social Security Administration has about 1 million hearings scheduled in the United States this year.  1200 administrative law judges work full-time to schedule and conduct these hearings.  Due to the backlog it is taking 20 to 24 months just to get a hearing scheduled.

To try to catch up, Social Security is trying to schedule more hearings by Video-Teleconference (VTC) instead of in-person hearings.  What's the diffference?

At an in-person hearing, the claimant appears in a room with the judge, who is about 10 feet away.  The judge will interview the claimant in person.  Also attending the hearing will the claimant's representative, a hearing clerk and usually a vocational witness, called by Social Security.

The judge will take oral testimony by asking the claimant a long series of questions, which will be recorded.  The claimant's representative or attorney will also ask a lot of questions.  Vocational testimony will then be taken by the vocational expert.  The claimant's representative can then make closing arguments.  The hearing usually lasts 45 to 60 minutes.

A Video-Teleconference follows exactly the same procedure.  The only difference is that the judge will not be in the same room as the claimant and attorney.  The judge may be 10 miles away or 1,000 miles away in another city.  You and the judge will talk to each other over a video communications link where the judge appears on a big screen television.

ADVANTAGES OF A VTC:  a VTC may reduce your wait time, but by only 1 or 2 months on average.  So, instead of waiting about 24 months for an in-person hearing, you may only wait 22 or 23 months.  VTCs do not drastically reduce wait times.

DISADVANTAGES OF A VTC:  

  • Most of the time they work fine but occasionally there are equipment or technical failures.  I have seen video links go down that delay hearings for hours.
  • In a VTC you are subject to getting a judge from a national processing office (Baltimore, Houston, Atlanta) which your representative may not be familiar with.  Think of this as a "hearing factory" where judges churn out video hearing after video hearing.
  • The judge will ask the same questions but may not be able to see the claimant as well as in an in-person hearing.  Likewise, the claimant may not see the judge as well, especially if the judge is one of those who hides behind his computer monitor and peeks out to ask questions.
  • AWARD RATES.  The question arises, which judges pay better, the local ones I would see during an in-person hearing or a distant judge I would see on a VTC?  The answer is that no two judges pay alike; some have higher award rates than others.  Some firms who represent claimants nationwide have estimated that they win about 5 percent more awards with in-person hearings than they do with VTCs.  However, if your hearing is scheduled in an office with a very low award rate, you might be even better off with a distant judge and a VTC.  This is a very hard call to make, especially since you don't know who your local judge will be until after it is too late to object to a VTC.

You have a right to opt out of a Video-Teleconference and demand an in-person hearing, but you must do so according to the rules and within the deadline.  This should be a discussion claimants have with their attorneys or representatives when they file a disability appeal.

THE FORSYTHE FIRM
Practice Limited to Social Security Disability
PH (256) 799-0297

 SOCIAL SECURITY JUSTICE: MAY WE HELP YOU?
 

 

DO YOU WANT A VIDEO HEARING IN A SOCIAL SECURITY DISABILITY CASE?

Responding to the severe backlog of hearings and the long wait time to get a hearing, Social Security is now doing a large percentage of their disability hearings by Video-Teleconference (VTC). 

But do you really want to have your hearing by VTC?

You have a choice.  You can opt out of video hearings, if you do so according to the rules.  (More on that later).

The major advantage of a video-teleconference is that it shortens the wait time for a hearing.  However, my research indicates that it only shortens the wait time by 1 or 2 months.  Therefore, you are waiting 20 months instead of 21 or 22 months, not a significant reduction.

What is the approval rate of VTC hearings vs. in-person hearings? Again, my research indicates that in-person hearings result in awards about 5 percent more often than video hearings.  A 5 percent increase may not sound like much, but it is significant.

What if you want to opt out of a VTC and insist on an in-person hearing where the judge is in the same room with you, not on a TV screen?  Here is the rule you must follow:

Social Security will send you a written notice that you they may schedule a hearing for you by Video-Teleconference.  This is normally in a packet of materials sent out a few months after you submit your appeal.  Once you receive this notice, you must object to a VTC in writing within 30 days of the date of notice.  A form is sent with the notice for this purpose.

There may be instances where attending a hearing by video-teleconference is a good idea.  An example would be if you are in a hearing office with very low award rates.  A video hearing may give you a better chance but there are, of course, no guarantees.

Need help with a Social Security disability claim or appeal?  Get a free consultations and case evaluation by calling the Forsythe Firm here in Huntsville.  (We work with clients all over Alabama and middle Tennessee).

  THE FORSYTHE FIRM
Practice Limited to Social Security disability 
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
(256) 799-0297

SOCIAL SECURITY JUSTICE - MORE INFORMATION 

DO YOU WANT A VIDEO HEARING IN A SOCIAL SECURITY DISABILITY CASE?

Responding to the severe backlog of hearings and the long wait time to get a hearing, Social Security is now doing a large percentage of their disability hearings by Video-Teleconference (VTC). 

But do you really want to have your hearing by VTC?

You have a choice.  You can opt out of video hearings, if you do so according to the rules.  (More on that later).

The major advantage of a video-teleconference is that it shortens the wait time for a hearing.  However, my research indicates that it only shortens the wait time by 1 or 2 months.  Therefore, you are waiting 20 months instead of 21 or 22 months, not a significant reduction.

What is the approval rate of VTC hearings vs. in-person hearings? Again, my research indicates that in-person hearings result in awards about 5 percent more often than video hearings.  A 5 percent increase may not sound like much, but it is significant.

What if you want to opt out of a VTC and insist on an in-person hearing where the judge is in the same room with you, not on a TV screen?  Here is the rule you must follow:

Social Security will send you a written notice that you they may schedule a hearing for you by Video-Teleconference.  This is normally in a packet of materials sent out a few months after you submit your appeal.  Once you receive this notice, you must object to a VTC in writing within 30 days of the date of notice.  A form is sent with the notice for this purpose.

There may be instances where attending a hearing by video-teleconference is a good idea.  An example would be if you are in a hearing office with very low award rates.  A video hearing may give you a better chance but there are, of course, no guarantees.

Need help with a Social Security disability claim or appeal?  Get a free consultations and case evaluation by calling the Forsythe Firm here in Huntsville.  (We work with clients all over Alabama and middle Tennessee).

  THE FORSYTHE FIRM
Practice Limited to Social Security disability 
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
(256) 799-0297

SOCIAL SECURITY JUSTICE - MORE INFORMATION