Here are a few of the more commonly mis-understood things about Social Security disability (SSDI).
1. Everyone is covered by Social Security disability.
Actually not everyone is. You have to accumulate a minimum number of work credits to be covered by the Title II program. Also, the work credits must be recent enough.
2. Once you work enough to be covered by Social Security disability, you are always covered.
Also not true. Work credits must be recent enough. As a rule, work credits expire about 5 years after you stop working, after which you are no longer covered for Social Security disability.
3. Social Security denies everyone at first.
It may seem that way but they actually approve about 25 percent of claims initially. Still, a denial rate of nearly 75 percent is very high. The truth is that most disability claims are won during the appeal, not just with an application.
4. The Social Security office will help me with my claim, so I won't benefit from an attorney/representative.
A dangerous half-truth. Social Security will provide you with the correct forms and provide general information about its programs and services. They will not become your advocate. They will not fight to help you get benefits. It will be up to you to prove that you are disabled. The burden of proof always rests on the claimant. Claimants who are represented have a higher success rate than those who are not.
--The Forsythe Firm
Huntsville, AL 35806
PH (256) 799-0297
WEBSITE FOR MORE INFORMATION
HELPING HONEST, HARD WORKING PEOPLE GET THE DISABILITY BENEFITS THEY DESERVE. WE WORK TO GET YOU MAXIMUM BENEFITS AS QUICKLY AS POSSIBLE. Phone (256) 799-0297.
Saturday, June 30, 2018
FACTS THAT HAVE AN AFFECT ON DISABILITY CLAIMS
Social Security disability is one of the most regulated, codified and legislated programs in the country. It's rules are found in the Social Security Act, the 20 Code of Federal Regulations, numerous Social Security Rulings (SSRs) and hundreds of federal court cases.
The following facts will play a major role in whether an individual can qualify for disability benefits:
EXPLANATION OF TERMS
* Residual Functional Capacity (RFC) means the most that a person can do, in spite of his or her impairment(s). For example, how long can the claimant sit, stand, walk; how much can he/she lift, carry, etc.? What is the claimant's exertional limitation: very heavy, heavy, medium, light or sedentary?
**Past Relevant Work (PRW) refers to substantial work that the claimant performed within the most recent 15-year period prior to filing a disability claim. Only work during the most recent 15 year period is counted as PRW. This rule usually favors the claimant because skilled work that he/she performed 20 or 30 years ago will not be used to deny the claim at Step 4 of the sequential process.
*** Work Credits. To be covered by the Social Security Act, Title II, a person usually needs to have worked at least 5 years out of the most recent 10-year period, or to have accumulated at least 40 quarters of covered work. This rule may vary for young individuals who aren't old enough to have accumulated 40 quarters of work. Your local Social Security office can tell you whether you have enough work credits to be covered by Title II (Two).
The following facts will play a major role in whether an individual can qualify for disability benefits:
- Age at the time of disability onset
- Residual Functional Capacity*
- Types of past relevant work**
- Sufficient work credits to be covered***
- Level of education and training
- Availability of medical records
EXPLANATION OF TERMS
* Residual Functional Capacity (RFC) means the most that a person can do, in spite of his or her impairment(s). For example, how long can the claimant sit, stand, walk; how much can he/she lift, carry, etc.? What is the claimant's exertional limitation: very heavy, heavy, medium, light or sedentary?
**Past Relevant Work (PRW) refers to substantial work that the claimant performed within the most recent 15-year period prior to filing a disability claim. Only work during the most recent 15 year period is counted as PRW. This rule usually favors the claimant because skilled work that he/she performed 20 or 30 years ago will not be used to deny the claim at Step 4 of the sequential process.
*** Work Credits. To be covered by the Social Security Act, Title II, a person usually needs to have worked at least 5 years out of the most recent 10-year period, or to have accumulated at least 40 quarters of covered work. This rule may vary for young individuals who aren't old enough to have accumulated 40 quarters of work. Your local Social Security office can tell you whether you have enough work credits to be covered by Title II (Two).
WAIT 1 YEAR BEFORE APPLYING? NO.
Do you really have to be disabled for 1 year before you can apply for Social Security disability? The answer is: No, No and No.
Must you be off work for 1 year before applying for disability? The answer is: No, No and No.
This is a misunderstanding of the duration rule. The rule says that you must have a medical impairment that has lasted for at least 12 consecutive months, is expected to last for 12 consecutive months, OR to end in death.
What does this actually mean? It means that Social Security does not pay for short term injury or sickness that will probably not last for at least 12 months. So the question becomes: How long is my condition expected to last? If the answer is 1 year or longer, go ahead and apply for disability benefits. If the answer is "Certainly less than a year," then you should not apply.
Here are some examples of cases that Social Security will not approve because of the duration rule:
EXAMPLE 1: Jennifer breaks her right arm in a car accident and it requires extensive orthopedic surgery to repair damage. She can't work because her right arm is going to be in a cast for about 3 to 4 months. However, her doctor says that after about 4 months, he will release her to return to work. Jennifer will not qualify for SSDI because she is not going to be disabled for at least 12 consecutive months.
EXAMPLE 2: Arthur is having surgery for a heart condition that is expected to keep him off work for about 6 months. But, his doctors expect him to recover fully and be able to return to his job as a customer service supervisor at a department store. Arthur does not qualify for SSDI because his impairment is not expected to last for at least 12 consecutive months.
EXAMPLE 3: Mr. Citizen has just been diagnosed with multiple sclerosis and severe neuropathy in his legs and feet. This obviously is going to be a long-term problem and Mr. Citizen does not believe he can continue working as a heavy equipment operator. He should apply for disability. Although he has only been off work for 2 weeks, his medical condition is not expected to improve within 1 year to a point that he can go back to work. He meets the 12 month duration rule.
There is NEVER a requirement that an individual must wait 1 year to file for SSDI. The question is: Will the disabling impairment last for at least 1 year (even if that one year is in the future)? If there is a probability that it will, then a disability application should be filed right away (not a year from now).
Any unnecessary waiting to file an application for disability benefits may cost the claimant money, in some cases a lot of money. There is also a danger that SSDI eligibility (work credits) may expire if you wait too long.
If your disabling condition is medically expected to last at least 12 consecutive months, file now.
One final thought. The rule says that the disabling condition must last for 12 CONSECUTIVE MONTHS. It can't be intermittent or on-and-off disability. And it can't be a combination of different conditions that begin at different times. Let me illustrate with one more example:
EXAMPLE OF NON-CONSECUTIVE IMPAIRMENT:
McKinsey had to have a kidney removed in January. She was unable to work for 7 months, then recovered fully. However, just before she went back to work after the kidney surgery, she had a wreck and injured her neck. The neck injury kept her off work another 5 months. Taken together, both impairments disabled her for 12 months. However, this does not meet the 12 month rule because there was no single impairment which lasted for 12 CONSECUTIVE months. McKinsey has 2 short-term impairments that were not related.
I realize that Social Security rules are confusing. That's why we are here--to help you make sense of it, answer your questions, and guide you in filing for benefits. I like to speak to people who have potential claims, whether I actually end up representing them or not. And I will answer your questions free without any obligation. To contact me, simply pick up the phone and call my office.
___________________
Charles W. Forsythe
Social Security Disability Consultant
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street
PHONE (256) 799-0297
Consultations are Free!
VISIT MY WEBSITE
Must you be off work for 1 year before applying for disability? The answer is: No, No and No.
This is a misunderstanding of the duration rule. The rule says that you must have a medical impairment that has lasted for at least 12 consecutive months, is expected to last for 12 consecutive months, OR to end in death.
What does this actually mean? It means that Social Security does not pay for short term injury or sickness that will probably not last for at least 12 months. So the question becomes: How long is my condition expected to last? If the answer is 1 year or longer, go ahead and apply for disability benefits. If the answer is "Certainly less than a year," then you should not apply.
Here are some examples of cases that Social Security will not approve because of the duration rule:
EXAMPLE 1: Jennifer breaks her right arm in a car accident and it requires extensive orthopedic surgery to repair damage. She can't work because her right arm is going to be in a cast for about 3 to 4 months. However, her doctor says that after about 4 months, he will release her to return to work. Jennifer will not qualify for SSDI because she is not going to be disabled for at least 12 consecutive months.
EXAMPLE 2: Arthur is having surgery for a heart condition that is expected to keep him off work for about 6 months. But, his doctors expect him to recover fully and be able to return to his job as a customer service supervisor at a department store. Arthur does not qualify for SSDI because his impairment is not expected to last for at least 12 consecutive months.
EXAMPLE 3: Mr. Citizen has just been diagnosed with multiple sclerosis and severe neuropathy in his legs and feet. This obviously is going to be a long-term problem and Mr. Citizen does not believe he can continue working as a heavy equipment operator. He should apply for disability. Although he has only been off work for 2 weeks, his medical condition is not expected to improve within 1 year to a point that he can go back to work. He meets the 12 month duration rule.
There is NEVER a requirement that an individual must wait 1 year to file for SSDI. The question is: Will the disabling impairment last for at least 1 year (even if that one year is in the future)? If there is a probability that it will, then a disability application should be filed right away (not a year from now).
Any unnecessary waiting to file an application for disability benefits may cost the claimant money, in some cases a lot of money. There is also a danger that SSDI eligibility (work credits) may expire if you wait too long.
If your disabling condition is medically expected to last at least 12 consecutive months, file now.
One final thought. The rule says that the disabling condition must last for 12 CONSECUTIVE MONTHS. It can't be intermittent or on-and-off disability. And it can't be a combination of different conditions that begin at different times. Let me illustrate with one more example:
EXAMPLE OF NON-CONSECUTIVE IMPAIRMENT:
McKinsey had to have a kidney removed in January. She was unable to work for 7 months, then recovered fully. However, just before she went back to work after the kidney surgery, she had a wreck and injured her neck. The neck injury kept her off work another 5 months. Taken together, both impairments disabled her for 12 months. However, this does not meet the 12 month rule because there was no single impairment which lasted for 12 CONSECUTIVE months. McKinsey has 2 short-term impairments that were not related.
I realize that Social Security rules are confusing. That's why we are here--to help you make sense of it, answer your questions, and guide you in filing for benefits. I like to speak to people who have potential claims, whether I actually end up representing them or not. And I will answer your questions free without any obligation. To contact me, simply pick up the phone and call my office.
___________________
Charles W. Forsythe
Social Security Disability Consultant
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street
PHONE (256) 799-0297
Consultations are Free!
VISIT MY WEBSITE
Friday, June 29, 2018
TAX WITHHELD FROM YOUR SOCIAL SECURITY CHECK?
Social Security does not automatically withhold federal income tax from benefit checks. But they will if you ask them to.
If you would like to have federal income tax withheld from either a pension or disability check, simply contact your local Social Security office and file a W-4 form.
You may choose the rate you want to be deducted: 7%, 10%, 12% or 22%.
You can also increase or reduce the tax withholding at any time by filing an amended W-4. You can even choose to discontinue the withholding.
Social Security benefits are generally taxable for individuals with total annual income of at least $25,000 and for couples who have annual income of at least $32,000.*
_______________
*Tax information is given for general information only and is provided in Social Security public statements; not intended as tax advice. For information or specific advice on your tax situation, you should consult an accountant, CPA, tax attorney or other tax professional.
If you would like to have federal income tax withheld from either a pension or disability check, simply contact your local Social Security office and file a W-4 form.
You may choose the rate you want to be deducted: 7%, 10%, 12% or 22%.
You can also increase or reduce the tax withholding at any time by filing an amended W-4. You can even choose to discontinue the withholding.
Social Security benefits are generally taxable for individuals with total annual income of at least $25,000 and for couples who have annual income of at least $32,000.*
_______________
*Tax information is given for general information only and is provided in Social Security public statements; not intended as tax advice. For information or specific advice on your tax situation, you should consult an accountant, CPA, tax attorney or other tax professional.
SOCIAL SECURITY'S FINANCIAL FUTURE
If Social Security income is a key source of your retirement or disability income, you need to know the financial health of the Social Security trust funds.
There are actually two trust funds that pay benefits: the retirement or pension trust fund and the disability trust fund. Together, they are called the combined trust fund.
Social Security has just released the financial report card for these trust funds.
The Disability Trust Fund (DI Fund) is projected to deplete it's resources in 2032 (just 14 years away). After that date, however, 97 percent of benefits would still be available through current FICA tax income.
The combined fund is projected to become depleated in 2032, with only 79 percent of benefits payable after that date.
This assumes, of course, that no action is taken by the government to change course--such as higher withholding tax, increase in the eligibility age for retirement benefits, etc.
Social Security has asset reserves totaling $2.89 trillion as of 2017 with an annual increase of $44 billion in 2017.
The financial health of the disability trust fund depends partly on how many people file new claims in the coming years. For the first time in ten years, new claims actually declined slightly in 2017.
Also, Social Security has tightened the screws, making it increasingly more difficult to get new disability benefits. Ten years ago 69 percent of claimants who appealed their denials were eventually paid benefits. Today, that percentage has dropped to about 42 percent. That's based on national averages.
Factors that continue to force approval rates downward, I believe, are as follows:
1. Social Security's obsessive fear of fraud. Talk to any government official, elected representative or Social Security employee, and fraud prevention is the first thing on their minds. That's one of the reasons it takes 2 or 3 years to get approved. And that long waiting period is by design.
2. Social Security's declining trust fund and the projected future difficulty in making benefit payments. It's belt tightening time.
3. A media assault. The media constantly shell us with the message that Social Security is "the new welfare," that fraud and abuse is rampant, and Social Security is giving away trillions of dollars to persons who don't deserve it...etc., etc. Politicians and bureaucrats fight back by making it slow and very difficult for qualified and deserving claimants to collect on their I.O.U. from Social Security. The waiting times have become obscene and, honestly, Social Security could significantly reduce waiting times if they really wanted to. They don't.
There are actually two trust funds that pay benefits: the retirement or pension trust fund and the disability trust fund. Together, they are called the combined trust fund.
Social Security has just released the financial report card for these trust funds.
The Disability Trust Fund (DI Fund) is projected to deplete it's resources in 2032 (just 14 years away). After that date, however, 97 percent of benefits would still be available through current FICA tax income.
The combined fund is projected to become depleated in 2032, with only 79 percent of benefits payable after that date.
This assumes, of course, that no action is taken by the government to change course--such as higher withholding tax, increase in the eligibility age for retirement benefits, etc.
Social Security has asset reserves totaling $2.89 trillion as of 2017 with an annual increase of $44 billion in 2017.
The financial health of the disability trust fund depends partly on how many people file new claims in the coming years. For the first time in ten years, new claims actually declined slightly in 2017.
Also, Social Security has tightened the screws, making it increasingly more difficult to get new disability benefits. Ten years ago 69 percent of claimants who appealed their denials were eventually paid benefits. Today, that percentage has dropped to about 42 percent. That's based on national averages.
Factors that continue to force approval rates downward, I believe, are as follows:
1. Social Security's obsessive fear of fraud. Talk to any government official, elected representative or Social Security employee, and fraud prevention is the first thing on their minds. That's one of the reasons it takes 2 or 3 years to get approved. And that long waiting period is by design.
2. Social Security's declining trust fund and the projected future difficulty in making benefit payments. It's belt tightening time.
3. A media assault. The media constantly shell us with the message that Social Security is "the new welfare," that fraud and abuse is rampant, and Social Security is giving away trillions of dollars to persons who don't deserve it...etc., etc. Politicians and bureaucrats fight back by making it slow and very difficult for qualified and deserving claimants to collect on their I.O.U. from Social Security. The waiting times have become obscene and, honestly, Social Security could significantly reduce waiting times if they really wanted to. They don't.
Wednesday, June 27, 2018
TESTIMONY BY A FAMILY MEMBER, FRIEND
Social Security will often allow you to bring a friend, family member, or even a co-worker to give testimony at your hearing. Sometimes this can help your case. But not always.
I have some of my own guidelines I use when deciding whether having a witness to testify is potentially more helpful than damaging:
1. Testimony of a close family member can be useful if the claimant is a child, a person with severe mental impairments or who has a difficult time expressing themselves.
2. How well does the witness know the claimant and what is their relationship? Is the witness in a position to have observed the claimant closely and regularly?
3. Does the witness know what will be expected?
4. Is the witness going to be credible?
5. What are possible ways testimony by the witness can backfire or hurt the case?
6. Do we really need a witness to win this case?
In short, there needs to be a reason for calling a witness to testify. I need to understand the reason for having a witness. I also need to spend enough time with the witness to verify credibility and help them understand their role in the hearing.
Not every hearing needs testimony from a spouse, family member or friend. The judge is also going to be thinking, "Why do we need this witness?" Unless there is a clear answer, a witness probably should not be called.
I have some of my own guidelines I use when deciding whether having a witness to testify is potentially more helpful than damaging:
1. Testimony of a close family member can be useful if the claimant is a child, a person with severe mental impairments or who has a difficult time expressing themselves.
2. How well does the witness know the claimant and what is their relationship? Is the witness in a position to have observed the claimant closely and regularly?
3. Does the witness know what will be expected?
4. Is the witness going to be credible?
5. What are possible ways testimony by the witness can backfire or hurt the case?
6. Do we really need a witness to win this case?
In short, there needs to be a reason for calling a witness to testify. I need to understand the reason for having a witness. I also need to spend enough time with the witness to verify credibility and help them understand their role in the hearing.
Not every hearing needs testimony from a spouse, family member or friend. The judge is also going to be thinking, "Why do we need this witness?" Unless there is a clear answer, a witness probably should not be called.
SIGNS YOUR HEARING WENT WELL
Administrative law judges don't usually announce their decisions at the end of a hearing. Yet, there are some sure signs that your hearing went well.
1. The vocational witness did not list any jobs that you are capable to performing as a result of the judge's hypotheticals.
2. The judge didn't ask any questions of the vocational witness OR the judge only asked about your past relevant work. While this isn't always a good sign, it often means that the judge has enough evidence without vocational testimony.
3. All or most of the judge's questions to the vocational witness resulted in the opinion that "no work would be available."
How long does it take to get a decision? The judge can take as long as needed to reach a decision. There is no time limit. After a decision has been reached, the case goes to a decision writer, where more time is required to write the decision. It may take 3 to 6 months following a hearing to get a written Notice of Decision in the mail. The delay is caused by the high volume of cases handled and shortage of help at the hearing offices.
Is there anything you can do to speed up a decision? No, the process simply isn't designed to move quickly and it doesn't. Calling the hearing office, calling your attorney or other measures simply doesn't have any useful affect on getting a decision issued. It is a waiting game entirely with the ball in Social Security's court. Patience is the virtue that counts here.
Monday, June 25, 2018
WORRY, WORK & WAITING
The 3 W's come with a Social Security disability claim:
Worry
Work
Waiting
Few things are as frustrating as dealing with the Social Security Administration.
They have thousands of rules, regulations, deadlines and stipulations that make no sense to the average American. They use terms and acronyms that have no meaning to most people.
My firm is dedicated to reducing the worry, work and waiting associated with a disability claim.
We will help you file the initial application forms. This takes hours, however, we feel our involvement in the initial application is a valuable part of what we offer our clients.
We will help you gather the medical and vocational evidence required to give your application the best chance of success. And we will help you deal with the government throughout the entire process--start to finish.
HOW WE GET PAID:
When you appoint us to represent you, you will sign a fully disclosed fee agreement form. This agreement allows us to charge a fee ONLY if your case is successful and you receive back payments from Social Security. The amount of our fee will be a small percentage of your back pay. You will keep 100 percent of monthly benefits now and forever.
What's the first step?
Call us for a free consultation. We will speak with you at no cost or obligation and determine how best to proceed with your claim or appeal.
_________
THE FORSYTHE FIRM
7027 Old Madison Pike NW
Suite 108
Huntsville, AL 35806
PH (256) 799-0297
FORSYTHE FIRM WEBSITE
Worry
Work
Waiting
Few things are as frustrating as dealing with the Social Security Administration.
They have thousands of rules, regulations, deadlines and stipulations that make no sense to the average American. They use terms and acronyms that have no meaning to most people.
My firm is dedicated to reducing the worry, work and waiting associated with a disability claim.
We will help you file the initial application forms. This takes hours, however, we feel our involvement in the initial application is a valuable part of what we offer our clients.
We will help you gather the medical and vocational evidence required to give your application the best chance of success. And we will help you deal with the government throughout the entire process--start to finish.
HOW WE GET PAID:
When you appoint us to represent you, you will sign a fully disclosed fee agreement form. This agreement allows us to charge a fee ONLY if your case is successful and you receive back payments from Social Security. The amount of our fee will be a small percentage of your back pay. You will keep 100 percent of monthly benefits now and forever.
What's the first step?
Call us for a free consultation. We will speak with you at no cost or obligation and determine how best to proceed with your claim or appeal.
_________
THE FORSYTHE FIRM
7027 Old Madison Pike NW
Suite 108
Huntsville, AL 35806
PH (256) 799-0297
FORSYTHE FIRM WEBSITE
DISABIITY FOR VETERANS
Social Security disability gives some perks to veterans who have become disabled while on active duty. For one thing, if there is a 100 percent VA disability rating (total and permanent), veterans will qualify for expedited processing. This often reduce the processing time from a few years down to a few months.
Social Security is not obligated to accept the Veterans Administration decision about disability. They have their own rules and regulations. However, the fact that another government agency has examined the individual and found them to be disabled can carry a lot of weight with Social Security.
Another advantage the veteran has is the abundance of medical records. The military provides excellent medical care and documents everything. This is very helpful in a Social Security disability case.
That being said, there are some pitfalls to watch for and avoid in veterans cases:
1) A high percentage of applications will be denied, just as they are in the civilian population, and an appeal may be required.
2) Care must be taken to present the case to Social Security in a manner that meets all of their particular regulations--which are different from the Veterans Administration and other agencies.
3) Social Security is "all or none." They do not award disability by percentages. A claimant is totally disabled, or not disabled at all. Therefore, you must go in with a full coordinated effort.
4) Most veterans still have a high burden of proof: usually it is necessary to prove that you can't perform any type of work that is available in the national economy. This will include unskilled, low wage work--or minimum wage jobs.
My firm is experienced with veterans disability claims and we enjoy working with vets. If you need to apply for Social Security disability, please contact me. If you have recently applied and been denied (all too common), please call me. Consultations are free and we never charge a fee unless you get favorable results.
______
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
Next to Arsenal Gate 9
PH (256) 799-0297
OUR WEBSITE - MORE INFORMATION
Social Security is not obligated to accept the Veterans Administration decision about disability. They have their own rules and regulations. However, the fact that another government agency has examined the individual and found them to be disabled can carry a lot of weight with Social Security.
Another advantage the veteran has is the abundance of medical records. The military provides excellent medical care and documents everything. This is very helpful in a Social Security disability case.
That being said, there are some pitfalls to watch for and avoid in veterans cases:
1) A high percentage of applications will be denied, just as they are in the civilian population, and an appeal may be required.
2) Care must be taken to present the case to Social Security in a manner that meets all of their particular regulations--which are different from the Veterans Administration and other agencies.
3) Social Security is "all or none." They do not award disability by percentages. A claimant is totally disabled, or not disabled at all. Therefore, you must go in with a full coordinated effort.
4) Most veterans still have a high burden of proof: usually it is necessary to prove that you can't perform any type of work that is available in the national economy. This will include unskilled, low wage work--or minimum wage jobs.
My firm is experienced with veterans disability claims and we enjoy working with vets. If you need to apply for Social Security disability, please contact me. If you have recently applied and been denied (all too common), please call me. Consultations are free and we never charge a fee unless you get favorable results.
______
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
Next to Arsenal Gate 9
PH (256) 799-0297
OUR WEBSITE - MORE INFORMATION
Sunday, June 24, 2018
TELLING THE JUDGE A GOOD STORY
Telling the judge a good story about your disability, even if it is a true story, will not get you disability benefits.
Even if the judge believes you when you say you can't work, it will not get you approved. It can't according to federal regulations.
An approval for disability benefits requires PROOF. There are thousands of federal regulations governing Social Security disability and you must meet those regulations in a very technical sense.
Here is the most likely scenario for losing your disability hearing:
"I know I am disabled. I've tried to work and I can't. I can make the judge believe me."
If that's all you have, it's a sure fire formula for denial.
What's missing here? Medical evidence.
There must be objective medical evidence of symptoms so severe that they prevent the claimant from performing the sitting, standing, reaching, bending, lifting, carrying, concentration, persistence and pace of full-time work.
"My doctor will give me a letter stating that I can't work and that I am totally disabled."
This, too, is a sure fire formula for denial. Why?
Because the decision about who can work and who can't, who is disabled and who is not, cannot be made by doctors. Under federal law, this decision is "reserved to the Commissioner of Social Security." The doctor is trying to do something that only the Commissioner of Social Security, or her agent, is allowed to do. The judge will, therefore, reject the doctor's opinion.
What your doctor should do is provide a specific list of your functional abilities: how long you can sit, stand, walk? How many pounds you can lift and carry? How much would you be off task during an 8-hour day? How many days would be absent from work? Social Security can use these opinions to draw their own conclusions about whether you are disabled.
I'm not saying that the claimant's testimony is not important because it is. The claimant should be able to articulate his or her symptoms, limitations and impairments. But that alone will not be enough. It must be supported by objective medical evidence (records) - and should ideally be supported by opinion evidence (not just a statement saying that you are disabled).
If you are very astute and have hundreds of hours to gather data, records and do the research needed, you may be able to successfully represent yourself. But I'd say it's one in a hundred claimants who can, or will, do that. For most folks, it is well worth their money to appoint an experienced representative who knows how to present a Social Security disability case. And a representative cannot charge you a dime if you don't win your case and also collect back pay. The fee will be a small percentage of the back pay. For example, if a claimant collects $10,000 in back pay, his lawyer/representative's fee will be $2,500.
ABOUT LEGAL REPRESENTATION
Call (256) 799-0297 Free consultations
Even if the judge believes you when you say you can't work, it will not get you approved. It can't according to federal regulations.
An approval for disability benefits requires PROOF. There are thousands of federal regulations governing Social Security disability and you must meet those regulations in a very technical sense.
Here is the most likely scenario for losing your disability hearing:
"I know I am disabled. I've tried to work and I can't. I can make the judge believe me."
If that's all you have, it's a sure fire formula for denial.
What's missing here? Medical evidence.
There must be objective medical evidence of symptoms so severe that they prevent the claimant from performing the sitting, standing, reaching, bending, lifting, carrying, concentration, persistence and pace of full-time work.
"My doctor will give me a letter stating that I can't work and that I am totally disabled."
This, too, is a sure fire formula for denial. Why?
Because the decision about who can work and who can't, who is disabled and who is not, cannot be made by doctors. Under federal law, this decision is "reserved to the Commissioner of Social Security." The doctor is trying to do something that only the Commissioner of Social Security, or her agent, is allowed to do. The judge will, therefore, reject the doctor's opinion.
What your doctor should do is provide a specific list of your functional abilities: how long you can sit, stand, walk? How many pounds you can lift and carry? How much would you be off task during an 8-hour day? How many days would be absent from work? Social Security can use these opinions to draw their own conclusions about whether you are disabled.
I'm not saying that the claimant's testimony is not important because it is. The claimant should be able to articulate his or her symptoms, limitations and impairments. But that alone will not be enough. It must be supported by objective medical evidence (records) - and should ideally be supported by opinion evidence (not just a statement saying that you are disabled).
If you are very astute and have hundreds of hours to gather data, records and do the research needed, you may be able to successfully represent yourself. But I'd say it's one in a hundred claimants who can, or will, do that. For most folks, it is well worth their money to appoint an experienced representative who knows how to present a Social Security disability case. And a representative cannot charge you a dime if you don't win your case and also collect back pay. The fee will be a small percentage of the back pay. For example, if a claimant collects $10,000 in back pay, his lawyer/representative's fee will be $2,500.
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HOW TO GET DISABILITY BENEFITS APPROVED
This post will explain the best way to get Social Security disability approved.
Disability benefits are difficult to get approved--and getting more difficult all the time as Social Security tightens down the rules to keep people off the rolls. There are things you need to know to get approved.
# 1: Being convinced that you are disabled does not matter. Everyone who applies for disability is absolutely convinced that they are disabled and entitled to a benefit. Most of these individuals are denied. So, what matters? Medical evidence is really the only thing that matters.
#2: Medical records may not be enough. If you are age 50 or over and have very serious impairments documented by long-standing medical records, that may be enough. But if you are the average claimant, under age 50 and do not have a catastrophic illness or injury, you probably will need more. See # 3 below.
#3: You need a Medical Source Statement (MSS). This is a specific form signed by your doctor which gives the doctor's opinion about your ability to perform specific work related activities, such as sitting, standing, walking, lifting, carrying, reaching, pushing-pulling, etc. A good MSS form will cover exertional and non-exertional functions, including time off task, need for extra breaks, absences, ability to concentrate, etc. This form can make all the difference.
#4: Even with the best medical evidence, you will probably still be denied at the initial (application) level. Statistics show that up to 75 percent of applications are denied. This is because Social Security decision makers believe that most applicants are not disabled according to their rules. When in doubt, they deny--and let the appeals process sort out their mistakes later.
#5: An "appeal" is the same thing as a "request for hearing before an administrative law judge," at least in Alabama. You may read on the internet about the "Reconsideration" process. But in Alabama there is no such thing. From an initial denial, you go straight to a hearing by an administrative law judge. This is a good thing because less than 5 percent of denials are changed by "Reconsideration" in the 40 states that still use that useless process. Reconsideration is a waste of time.
#6: Even with good medical support, you must be prepared to actively engage Social Security at your hearing--using their own rules and regulations to prove that you are legally entitled to benefits. It is a dangerous myth to believe that showing up and telling a good story to the judge will get you approved. Believing you are disabled and PROVING you are disabled are two different things entirely. A hearing is a legal and technical event where a skeptical judge will examine facts ("just the facts") and apply hundreds of federal regulations to determine the outcome of your case. Just because the judge believes that you are disabled will not be enough to get you approved. You have to show how the federal regulations support approval.
Some people read that a hearing is "non-adversarial" and "informal" and believe that a good story is all you need to convince the judge. Not true. Most judges will look for holes in your story, contradictions, and application of complicated rules to find a way to deny your claim. The successful claimant will overcome all these obstacles and win anyway. That's why the award rates are so low. Today, only 42 percent of hearings turn out with an award for the claimant. 58 percent are denied, on average. That number, by the way, has fallen by 27 percent since 2009, and continues to fall every year.
Judges who have high award rates (pay too many claims) are being "re-trained" to reduce their award rates. Face the facts and realize that winning your disability hearing will require skill, expertise and knowledge. That's why over 90 percent of claimants at the hearing level have legal representation. And that's why they should. It is foolhardy to walk into a legal proceeding by yourself where the odds are so heavily stacked against you. Even the judge will offer to postpone your hearing so you can obtain legal representation. There's a reason for that.
"I don't want to run up a big legal bill, then lose my appeal anyway."
You won't. You can't. Federal law prohibits and attorney or representative from charging you a fee unless:
a) Your case is approved, and also
b) You are awarded back pay.
The legal fee comes out of the back pay. If there is no back pay, there cannot be a fee.
Are you convinced that you are disabled? That's the first step. The next, most important step, is to put together a legal case that will convince a judge with medical, vocational and legal FACT.
HOW TO GET DISABILITY BENEFITS
Disability benefits are difficult to get approved--and getting more difficult all the time as Social Security tightens down the rules to keep people off the rolls. There are things you need to know to get approved.
# 1: Being convinced that you are disabled does not matter. Everyone who applies for disability is absolutely convinced that they are disabled and entitled to a benefit. Most of these individuals are denied. So, what matters? Medical evidence is really the only thing that matters.
#2: Medical records may not be enough. If you are age 50 or over and have very serious impairments documented by long-standing medical records, that may be enough. But if you are the average claimant, under age 50 and do not have a catastrophic illness or injury, you probably will need more. See # 3 below.
#3: You need a Medical Source Statement (MSS). This is a specific form signed by your doctor which gives the doctor's opinion about your ability to perform specific work related activities, such as sitting, standing, walking, lifting, carrying, reaching, pushing-pulling, etc. A good MSS form will cover exertional and non-exertional functions, including time off task, need for extra breaks, absences, ability to concentrate, etc. This form can make all the difference.
#4: Even with the best medical evidence, you will probably still be denied at the initial (application) level. Statistics show that up to 75 percent of applications are denied. This is because Social Security decision makers believe that most applicants are not disabled according to their rules. When in doubt, they deny--and let the appeals process sort out their mistakes later.
#5: An "appeal" is the same thing as a "request for hearing before an administrative law judge," at least in Alabama. You may read on the internet about the "Reconsideration" process. But in Alabama there is no such thing. From an initial denial, you go straight to a hearing by an administrative law judge. This is a good thing because less than 5 percent of denials are changed by "Reconsideration" in the 40 states that still use that useless process. Reconsideration is a waste of time.
#6: Even with good medical support, you must be prepared to actively engage Social Security at your hearing--using their own rules and regulations to prove that you are legally entitled to benefits. It is a dangerous myth to believe that showing up and telling a good story to the judge will get you approved. Believing you are disabled and PROVING you are disabled are two different things entirely. A hearing is a legal and technical event where a skeptical judge will examine facts ("just the facts") and apply hundreds of federal regulations to determine the outcome of your case. Just because the judge believes that you are disabled will not be enough to get you approved. You have to show how the federal regulations support approval.
Some people read that a hearing is "non-adversarial" and "informal" and believe that a good story is all you need to convince the judge. Not true. Most judges will look for holes in your story, contradictions, and application of complicated rules to find a way to deny your claim. The successful claimant will overcome all these obstacles and win anyway. That's why the award rates are so low. Today, only 42 percent of hearings turn out with an award for the claimant. 58 percent are denied, on average. That number, by the way, has fallen by 27 percent since 2009, and continues to fall every year.
Judges who have high award rates (pay too many claims) are being "re-trained" to reduce their award rates. Face the facts and realize that winning your disability hearing will require skill, expertise and knowledge. That's why over 90 percent of claimants at the hearing level have legal representation. And that's why they should. It is foolhardy to walk into a legal proceeding by yourself where the odds are so heavily stacked against you. Even the judge will offer to postpone your hearing so you can obtain legal representation. There's a reason for that.
"I don't want to run up a big legal bill, then lose my appeal anyway."
You won't. You can't. Federal law prohibits and attorney or representative from charging you a fee unless:
a) Your case is approved, and also
b) You are awarded back pay.
The legal fee comes out of the back pay. If there is no back pay, there cannot be a fee.
Are you convinced that you are disabled? That's the first step. The next, most important step, is to put together a legal case that will convince a judge with medical, vocational and legal FACT.
HOW TO GET DISABILITY BENEFITS
Thursday, June 21, 2018
BEST WAY TO GET DISABIITY BENEFIT
What is the best way to get Social Security disability?
You may have heard that since 2008, Social Security has tightened down its rules to make it more difficult to get benefits. This is correct. Between 2008 and 2017, the award rate at appeal hearings has dropped from 69 percent to 42 percent. That a fall of 27 percentage points in 9 years.
So, what's the best way to get disability benefits if you are legitimately disabled?
ANSWER: Provide evidence from your doctor that will convince a skeptical decision maker that you can't sustain full-time work 8 hours a day, 5 days a week, 52 weeks per year.
The younger you are, the more difficult this is to accomplish. If you are under age 50, Social Security considers you to be a "younger individual." Denial rates are higher in this age group. You will need medical evidence to show that you cannot sustain ANY work that exists in the national economy, and this includes low-paying minimum wage jobs, many of which are unskilled and can be performed at the light or sedentary level. In short, your impairment and ability to function in the work environment must be very severe.
More and more, cases that get approved come down to what your doctor says about your ability to function in the workplace.
Every claimant feels that they are disabled. However, it doesn't matter how the claimant feels. It boils down to what the claimant's doctor says.
So, what's the best way to get disability benefits in 2018? Get your doctor to provide objective medical evidence of impairments that severely restrict your ability to perform ANY type of work.
It goes without saying that if you are not seeing a doctor regularly, you don't have much of a chance. Also, if you once saw a doctor for a severe impairment but stopped a few years ago, you don't have much of a chance. It will be necessary to have current medical evidence and show that you are compliant with treatment.
Social Security wants to see claimants who are being treated by a qualified doctor, are compliant with recommended care, and are still unable to work.
You may have heard that since 2008, Social Security has tightened down its rules to make it more difficult to get benefits. This is correct. Between 2008 and 2017, the award rate at appeal hearings has dropped from 69 percent to 42 percent. That a fall of 27 percentage points in 9 years.
So, what's the best way to get disability benefits if you are legitimately disabled?
ANSWER: Provide evidence from your doctor that will convince a skeptical decision maker that you can't sustain full-time work 8 hours a day, 5 days a week, 52 weeks per year.
The younger you are, the more difficult this is to accomplish. If you are under age 50, Social Security considers you to be a "younger individual." Denial rates are higher in this age group. You will need medical evidence to show that you cannot sustain ANY work that exists in the national economy, and this includes low-paying minimum wage jobs, many of which are unskilled and can be performed at the light or sedentary level. In short, your impairment and ability to function in the work environment must be very severe.
More and more, cases that get approved come down to what your doctor says about your ability to function in the workplace.
Every claimant feels that they are disabled. However, it doesn't matter how the claimant feels. It boils down to what the claimant's doctor says.
So, what's the best way to get disability benefits in 2018? Get your doctor to provide objective medical evidence of impairments that severely restrict your ability to perform ANY type of work.
It goes without saying that if you are not seeing a doctor regularly, you don't have much of a chance. Also, if you once saw a doctor for a severe impairment but stopped a few years ago, you don't have much of a chance. It will be necessary to have current medical evidence and show that you are compliant with treatment.
Social Security wants to see claimants who are being treated by a qualified doctor, are compliant with recommended care, and are still unable to work.
WHAT DOES IT MEAN TO "SUSTAIN" WORK
Social Security regulations use a very important word that often goes overlooked by the layman seeking disability benefits. That important word is "SUSTAIN."
If the claimant cannot "sustain" full-time work, he or she is disabled under the regulations.
To "sustain" work means you have the ability to work 8 hours per day, 5 days per week, 52 weeks per year. If you are able to work sometimes but sometimes you can't, you cannot sustain full-time work.
What are some things that may suggest that an individual cannot "sustain" full-time work?
(1) Excessive absences due to a medical condition. Employers normally tolerate one day of absence per month. If you would consistently miss 2 or 3 or more days per month, you are not able to sustain full-time work. Example: You can work for several days but then must be absent a few days due to an exacerbation of your symptoms.
(2) Inability to concentrate. Being "off task" more than about 10 percent of a workday generally is considered excessive. This inattention must be due to a medically determinable medical impairment, such as pain, depression, anxiety, panic disorder, or some other medically determinable impairment.
(3) Need for frequent rest breaks. Most jobs come with a half-hour lunch break and two 15-minute rest breaks during the day. If you require more breaks because of a medical impairment, you may not be able to "sustain" full-time work.
(4) Extra time to complete work tasks. Every job expects a certain pace--that is, a certain amount of work must be done in a certain time frame. The inability to maintain pace (keep up) may demonstrate an inability to sustain work.
(5) Psychological Limitations. These limitations can include things such as.....
These are only a few examples of limitations that may prove that you cannot "sustain" work.
It isn't enough for you to allege these limitations or restrictions. They must be based on solid medical evidence from a licensed medical doctor (MD, DO) or licensed psychologist (Phy.D or Ph.D.).
It's important for the claimant to know that it doesn't matter how you feel about your conditions or limitations. What's important is showing objective medical evidence to support your claims. As a colleague of mine explains: "It's not what you or I say, it's what your doctor says."
I walk into a hearing and tell the judge, "Your Honor, my client is disabled because he can only sit for 20 minutes, stand for 10 minutes and walk for 5 minutes. He has trouble concentrating and following directions. He would be absent 4 or 5 days per month because of his arthritis pain and migraine headaches." The judge will look at me and say, "Mr. Forsythe, can you show me where that is supported in the medical record?" If it isn't there, I should have saved my breath.
So, your case wins or loses on what your doctor says. Medical documentation is so very important in winning a Social Security disability case.
_______
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
"Across from Bridge Street"
DISABILITY HELP WEBSITE
If the claimant cannot "sustain" full-time work, he or she is disabled under the regulations.
To "sustain" work means you have the ability to work 8 hours per day, 5 days per week, 52 weeks per year. If you are able to work sometimes but sometimes you can't, you cannot sustain full-time work.
What are some things that may suggest that an individual cannot "sustain" full-time work?
(1) Excessive absences due to a medical condition. Employers normally tolerate one day of absence per month. If you would consistently miss 2 or 3 or more days per month, you are not able to sustain full-time work. Example: You can work for several days but then must be absent a few days due to an exacerbation of your symptoms.
(2) Inability to concentrate. Being "off task" more than about 10 percent of a workday generally is considered excessive. This inattention must be due to a medically determinable medical impairment, such as pain, depression, anxiety, panic disorder, or some other medically determinable impairment.
(3) Need for frequent rest breaks. Most jobs come with a half-hour lunch break and two 15-minute rest breaks during the day. If you require more breaks because of a medical impairment, you may not be able to "sustain" full-time work.
(4) Extra time to complete work tasks. Every job expects a certain pace--that is, a certain amount of work must be done in a certain time frame. The inability to maintain pace (keep up) may demonstrate an inability to sustain work.
(5) Psychological Limitations. These limitations can include things such as.....
- inability to understand and remember simple or complex instructions
- inability to get along with supervisors, co-workers or in some cases, the general public
- inability to complete simple tasks
These are only a few examples of limitations that may prove that you cannot "sustain" work.
It isn't enough for you to allege these limitations or restrictions. They must be based on solid medical evidence from a licensed medical doctor (MD, DO) or licensed psychologist (Phy.D or Ph.D.).
It's important for the claimant to know that it doesn't matter how you feel about your conditions or limitations. What's important is showing objective medical evidence to support your claims. As a colleague of mine explains: "It's not what you or I say, it's what your doctor says."
I walk into a hearing and tell the judge, "Your Honor, my client is disabled because he can only sit for 20 minutes, stand for 10 minutes and walk for 5 minutes. He has trouble concentrating and following directions. He would be absent 4 or 5 days per month because of his arthritis pain and migraine headaches." The judge will look at me and say, "Mr. Forsythe, can you show me where that is supported in the medical record?" If it isn't there, I should have saved my breath.
So, your case wins or loses on what your doctor says. Medical documentation is so very important in winning a Social Security disability case.
_______
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
"Across from Bridge Street"
DISABILITY HELP WEBSITE
USE IMPAIRMENTS TO SHOW DISABILITY
Unless you have a terminal or catastrophic illness, getting disability benefits is not about having a particular disease. It is about how your impairments limit your ability to function in the workplace.
Social Security considers impairments in two broad categories: exertional impairments and non-exertional impairments.
(a) Exertional limitations (sometimes called "strength" limitations) are: sitting, standing, walking, lifting, carrying, pushing and pulling.
Social Security considers impairments in two broad categories: exertional impairments and non-exertional impairments.
(a) Exertional limitations (sometimes called "strength" limitations) are: sitting, standing, walking, lifting, carrying, pushing and pulling.
When the limitations and restrictions imposed by your impairment(s) and related symptoms, such as pain, affect only your ability to meet the demands of jobs other than the strength demands, Social Security considers that you have only nonexertional limitations or restrictions. While you may still be found disabled, you will not meet any of the grid rules with non-exertional impairments.
Some examples of nonexertional limitations or restrictions include the following:
(i) You have difficulty functioning because you are nervous, anxious, or depressed;
(ii) You have difficulty maintaining attention or concentrating;
(iii) You have difficulty understanding or remembering detailed instructions;
(iv) You have difficulty in seeing or hearing;
(v) You have difficulty tolerating some physical feature(s) of certain work settings, e.g., you cannot tolerate dust or fumes; or
(vi) You have difficulty performing the manipulative or postural functions of some work such as reaching, handling, stooping, climbing, crawling, or crouching.
(2) If your impairment(s) and related symptoms, such as pain, only affect your ability to perform the nonexertional aspects of work-related activities, you will not be considered under the Medical-Vocational Guidelines of Appendix 2, Subpart P. That is, you cannot meet a grid rule.
If I am representing you, I will determine whether you have exertional (strength) limitations that may meet one of the grid rules and, therefore, direct a finding of disability. This will apply to claimants who are at least fifty years of age.
I will also determine if you have non-exertional limitations--postural, psychological or environmental--that may limit your ability to sustain full-time work.
In many cases, a claimant has a combination of both exertional and non-exertional limitations.
If exertional (strength) limitations alone allow disability under one of the grid rules (only for ages 50 or above), I will try to use these limitations to get an award.
If you are under age 50, or if your primary limitations are non-exertional, I will try to show that the combination of your limitations are so severe that you cannot sustain any full-time work that is available in the national economy.
Social Security decision making is a very technical and complicated business. In order to map out a possible route to success, you need to know the rules of the road.
____________
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
PH (256) 799-0297
Wednesday, June 20, 2018
SOCIAL SECURITY QUIETLY MAKES IT HARDER TO GET BENEFITS
A new study confirms what we already knew: Social Security has quietly made it much more difficult to get disability benefits, including Medicare.
"If you make it harder, people just run out of gas," said Richard Browdie, chief executie of the Benjamin Rose Institute on Aging in Cleveland. "There are a whole bunch ofnew impediments, and I think the process has become overly restrictive," Browdie says.
Starting around 2010, Social Security singled out the better paying judges, the ones who awarded a higher percentage of claims on appeal, and "retrained" them. In fact, these judges were taught how to deny claims instead of approving them. The result was that awards dropped from 69 percent in 2008 to 49 percent in 2015. This re-education program cost claimants billions of dollars in lost benefits.
By 2017, the approval rate for appeals dropped to 42 percent--a whopping 27 percent decline in approvals in the ten-year period.
In addition to "retraining" administrative law judges (teaching them how to deny claims), Social Security also adopted more restrictive regulations and policies designed to give judges more power to deny claims.
For example, the old rules required that a claimant's treating doctor's opinion be given more weight than the opinion of a doctor who had never seen or treated the claimant, i.e., a Social Security doctor. Effective May 27, 2017, the rule was revised to allow the administrative law judge discretion to accept the opinion of any doctor--even one who has never met or examined the claimant.
I am now presenting opinions from claimants doctors who have treated them for 15 or 20 years and say that their medical restrictions prevent them from being able to work, only to have judges accept the opinion of a Social Security who have examined the claimant one time, briefly at that, and say the claimant has "no restrictions" and can work at 300,000 different jobs. These doctors are paid by Social Security.
All this to say that Social Security is in a fiscal panic, fueled by two things: (1) Actuaries who predict that the Social Security trust fund will lose its ability to pay out full benefits by 2027, and (2) media outcries that Social Security is full of fraud and abuse and that it has become "the new welfare." Politicians and bureaucrats get scared silly when the media cries wolf! They react by illogical reactions, such as gutting the Social Security disability program--the only lifeline for millions of poorly educated, poorly trained Americans who depend on unskilled manual labor to earn a meager living. When these individuals become unable to perform arduous physical work because of medical impairments, they have nothing left but Social Security disability.
We lose sight of one fundamental truth in all this: that Social Security disability is a government mandated insurance program that workers actually pay for. A Social Security tax (called FICA) is deducted from every paycheck a worker earns at a rate of approximately 7.5 percent of gross wages. The employer matches it with another tax of 7.5 percent. So, for every dollar a worker earns--during his or her entire working lifetime--15 cents of it is contributed to the Social Security trust fund. When a worker becomes disabled, he is not asking for a handout, or welfare, or a free government benefit. He is asking the federal government to pay up on an insurance policy they forced him to purchase and pay for.
The government is glad to take 15 percent of the worker's wages but has become increasingly reluctant to give any promised benefit in return. It's equivalent to an insurance company taking hour premiums for 30 years, then refusing to pay off when you have a legitimate claim under the policy.
How do you fight back? You do just that, you fight. When your claim is denied, you lawyer up--and file a legal appeal. In Alabama, you have the following 3 legal appeals available to you when Social Security refuses to pay your disability claim:
APPEAL 1: Ask for a hearing by an administrative law judge. True, the award rate here has fallen from 69 percent in 2008 to a mere 42 percent in 2017 but this is still your best chance of getting your benefit.
APPEAL 2: If the retrained judge denies your claim, ask for a review by the Appeals Council (AC). There are still some rules that judges must follow and if they fail to do so, your case may be remanded by the AC.
APPEAL 3: If the Appeals Council will not give you relief, you have the right to file a lawsuit in Federal District Court against the Commissioner of Social Security. This is really your last practical appeal.
The tightening of Social Security rules has had a trickle down effect on disability attorneys and advocates--legal champions who fought to get their clients benefits. For example, the largest advocacy group in the nation, Binder and Binder in New York filed for bankruptcy and laid off most of its staff. Hundreds of other attorneys simply stopped handling Social Security cases because it became so difficult to win a case and get paid.
But...there are still some good advocates and attorneys who will fight for the rights of the disabled--and there always will be. Make no mistake, the effort to get disability benefits is a fight. You must realize this and go into the process with the best disability advocate you can find.
"If you make it harder, people just run out of gas," said Richard Browdie, chief executie of the Benjamin Rose Institute on Aging in Cleveland. "There are a whole bunch ofnew impediments, and I think the process has become overly restrictive," Browdie says.
Starting around 2010, Social Security singled out the better paying judges, the ones who awarded a higher percentage of claims on appeal, and "retrained" them. In fact, these judges were taught how to deny claims instead of approving them. The result was that awards dropped from 69 percent in 2008 to 49 percent in 2015. This re-education program cost claimants billions of dollars in lost benefits.
By 2017, the approval rate for appeals dropped to 42 percent--a whopping 27 percent decline in approvals in the ten-year period.
In addition to "retraining" administrative law judges (teaching them how to deny claims), Social Security also adopted more restrictive regulations and policies designed to give judges more power to deny claims.
For example, the old rules required that a claimant's treating doctor's opinion be given more weight than the opinion of a doctor who had never seen or treated the claimant, i.e., a Social Security doctor. Effective May 27, 2017, the rule was revised to allow the administrative law judge discretion to accept the opinion of any doctor--even one who has never met or examined the claimant.
I am now presenting opinions from claimants doctors who have treated them for 15 or 20 years and say that their medical restrictions prevent them from being able to work, only to have judges accept the opinion of a Social Security who have examined the claimant one time, briefly at that, and say the claimant has "no restrictions" and can work at 300,000 different jobs. These doctors are paid by Social Security.
All this to say that Social Security is in a fiscal panic, fueled by two things: (1) Actuaries who predict that the Social Security trust fund will lose its ability to pay out full benefits by 2027, and (2) media outcries that Social Security is full of fraud and abuse and that it has become "the new welfare." Politicians and bureaucrats get scared silly when the media cries wolf! They react by illogical reactions, such as gutting the Social Security disability program--the only lifeline for millions of poorly educated, poorly trained Americans who depend on unskilled manual labor to earn a meager living. When these individuals become unable to perform arduous physical work because of medical impairments, they have nothing left but Social Security disability.
We lose sight of one fundamental truth in all this: that Social Security disability is a government mandated insurance program that workers actually pay for. A Social Security tax (called FICA) is deducted from every paycheck a worker earns at a rate of approximately 7.5 percent of gross wages. The employer matches it with another tax of 7.5 percent. So, for every dollar a worker earns--during his or her entire working lifetime--15 cents of it is contributed to the Social Security trust fund. When a worker becomes disabled, he is not asking for a handout, or welfare, or a free government benefit. He is asking the federal government to pay up on an insurance policy they forced him to purchase and pay for.
The government is glad to take 15 percent of the worker's wages but has become increasingly reluctant to give any promised benefit in return. It's equivalent to an insurance company taking hour premiums for 30 years, then refusing to pay off when you have a legitimate claim under the policy.
How do you fight back? You do just that, you fight. When your claim is denied, you lawyer up--and file a legal appeal. In Alabama, you have the following 3 legal appeals available to you when Social Security refuses to pay your disability claim:
APPEAL 1: Ask for a hearing by an administrative law judge. True, the award rate here has fallen from 69 percent in 2008 to a mere 42 percent in 2017 but this is still your best chance of getting your benefit.
APPEAL 2: If the retrained judge denies your claim, ask for a review by the Appeals Council (AC). There are still some rules that judges must follow and if they fail to do so, your case may be remanded by the AC.
APPEAL 3: If the Appeals Council will not give you relief, you have the right to file a lawsuit in Federal District Court against the Commissioner of Social Security. This is really your last practical appeal.
The tightening of Social Security rules has had a trickle down effect on disability attorneys and advocates--legal champions who fought to get their clients benefits. For example, the largest advocacy group in the nation, Binder and Binder in New York filed for bankruptcy and laid off most of its staff. Hundreds of other attorneys simply stopped handling Social Security cases because it became so difficult to win a case and get paid.
But...there are still some good advocates and attorneys who will fight for the rights of the disabled--and there always will be. Make no mistake, the effort to get disability benefits is a fight. You must realize this and go into the process with the best disability advocate you can find.
Tuesday, June 19, 2018
DENIED? FILING A NEW APPLICATION IS A MISTAKE
Social Security disability applications are reviewed and approved/denied by the Disability Determination Service, or DDS for short. The DDS reviews your medical records, work history and other information and decides whether you meet the rules to receive benefits. They deny about 7 out of 10 applications.
If you get denied, it makes no sense to file a new claim. The same agency (DDS) that denied you will look at the same information, apply the same rules, and deny you again. Each application you file will waste 3 to 5 months of your time and you are no closer to being approved than you were to start with.
So, what's the better way?
The better way is to appeal as soon as you are denied. The goal is to get your claim OUT of the DDS and before a judge. This requires an appeal.
CAUTION: The law only gives you 60 days to appeal. After that, you cannot appeal unless you can show good cause for filing a late appeal--and this is very difficult to do.
A denial by the Disability Determination Service (DDS) is unfortunate but it is also an opportunity. It is an opportunity to get out of DDS completely and before an administrative law judge, where there are better odds of approval.
An appeal puts you in line for a hearing, which will probably be about 2 years in the future. If your claim is eventually approved, you may be able to receive back pay for the time you waited.
Filing new application after new application is spinning your wheels. You are stuck and getting nowhere. File an appeal, move up the chain of command and increase your odds of being approved.
If you get denied, it makes no sense to file a new claim. The same agency (DDS) that denied you will look at the same information, apply the same rules, and deny you again. Each application you file will waste 3 to 5 months of your time and you are no closer to being approved than you were to start with.
So, what's the better way?
The better way is to appeal as soon as you are denied. The goal is to get your claim OUT of the DDS and before a judge. This requires an appeal.
CAUTION: The law only gives you 60 days to appeal. After that, you cannot appeal unless you can show good cause for filing a late appeal--and this is very difficult to do.
A denial by the Disability Determination Service (DDS) is unfortunate but it is also an opportunity. It is an opportunity to get out of DDS completely and before an administrative law judge, where there are better odds of approval.
An appeal puts you in line for a hearing, which will probably be about 2 years in the future. If your claim is eventually approved, you may be able to receive back pay for the time you waited.
Filing new application after new application is spinning your wheels. You are stuck and getting nowhere. File an appeal, move up the chain of command and increase your odds of being approved.
Monday, June 18, 2018
DENIALS AND THE NEXT MAJOR STEP
It is certainly discouraging to apply for disability benefits and be denied. But it happens to over 75 percent of claimants.
Filing a new application will just get you denied over and over. Your goal is to eventually get your case in the hands of a judge who can make a new and more favorable decision.
How do you do that? Appeal the denial within 60 days of the date on the denial letter. Request a hearing before an Administrative Law Judge (ALJ). After 60 days you lose the right to appeal. In some cases, you may also lose the right to file a new claim.
Filing an appeal is a relatively easy task that most people can do. Ask the Social Security office for form SSA-501 - "Request for Hearing By An Administrative Law Judge." It's a one-page form that can be completed in 3 minutes.
Once you file the appeal (Request for Hearing), there is a lot of work to be done. Now, you have to figure out how to win your hearing. That involves keeping your medical records updated and figuring out how to use Social Security regulations to win your case.
IMPORTANT: If your application is denied, do not file a new claim. File an appeal.
Your Goal: Get your case before a judge. This is where most Social Security disability cases are awarded.
Need help? Call us at (256) 799-0297.
Filing a new application will just get you denied over and over. Your goal is to eventually get your case in the hands of a judge who can make a new and more favorable decision.
How do you do that? Appeal the denial within 60 days of the date on the denial letter. Request a hearing before an Administrative Law Judge (ALJ). After 60 days you lose the right to appeal. In some cases, you may also lose the right to file a new claim.
Filing an appeal is a relatively easy task that most people can do. Ask the Social Security office for form SSA-501 - "Request for Hearing By An Administrative Law Judge." It's a one-page form that can be completed in 3 minutes.
Once you file the appeal (Request for Hearing), there is a lot of work to be done. Now, you have to figure out how to win your hearing. That involves keeping your medical records updated and figuring out how to use Social Security regulations to win your case.
IMPORTANT: If your application is denied, do not file a new claim. File an appeal.
Your Goal: Get your case before a judge. This is where most Social Security disability cases are awarded.
Need help? Call us at (256) 799-0297.
WHY SOME DOCTORS WON'T HELP YOU WITH A DISABILITY CLAIM
Why do so many doctors take this unhelpful approach with their patients?
REASON 1: Doctors don't understand how important their input is to Social Security. They often assume that supplying their routine medical records is all that is needed. It isn't, because medical records say nothing about the patient's ability to lift, sit, stand, bend, reach, push, pull or walk.
REASON 2: Doctors often think that the form requested will require a long, complicated or special examination. This is not true. What Social Security wants is the doctor's professional opinion, based strictly on his/her treatment, past examinations and observations.
REASON 3: Doctor's mistakenly think that Social Security may subpoena them or call them to come in and attend a hearing or provide more testimony. This is an unfounded fear. Social Security never (and I mean "never") calls in doctors. If they want a doctor to come in, they have their own medical experts who are paid by Social Security.
REASON 4: Doctors have an unreasonable, illogical fear of all things about Government. One doctor told one of my clients, "I can't afford to risk losing my medical license." Reality: No doctor has ever been put at risk of losing a medical license by expressing an honest opinion about his or her patient's symptoms or limitations. There is no risk at all. Social Security may ignore the doctor's opinion but unless there has been a clear crime (a doctor is paid a bribe to render an opinion)--there is no risk of penalty to the doctor.
REASON 5: The doctor simply doesn't want to take the time to fill out a form, even if it means his patient will not be able to get health insurance and monthly payments that he or she has paid for during their entire working life. In short, and this is blunt: The doctor doesn't give a ____ whether the patient gets a disability benefit or not.
Fortunately, some doctors really care about their patients and will complete paperwork needed for a fair disability review, especially if you take time to explain why this is needed and that there is no risk to the doctor beyond a little of his or her time.
THE AGE 50 "SWEET SPOT" FOR SOCIAL SECURITY DISABIILTY
Below age 50? It's very difficult (not impossible) to get approved for Social Security disability benefits.
Age 50 or above? Your odds of getting approved just got a lot better.
Why does age make so much difference to Social Security?
The answer is the grid rules, officially known as the Medical-Vocational Guidelines.
Without going into complicated explanations of grid rules, here's the basic logic:
BELOW AGE 50: a claimant will go all the way to Step 5 in the five-step decision making process. The question will be: Is there any work in the national economy that this claimant could perform?
"Any work" includes entry level, low paying, unskilled jobs that require no specific education, training or experience. Jobs like silverware wrapper, laundry folder, small parts sorter or hand packager. The ability to do this type of work is enough to get you denied if you are under age 50 -- "a younger individual."
AGE 50 OR OVER (Qualify for the grid rules): At 50, your age category changes. At ages 50-54, you are no longer a "younger individual." You have entered the age category called "Closely Approaching Advanced Age." These claimants often only go to Step 4 of the five-step sequential process. The question is "Can the claimant perform any of his/her past relevant work?" If the answer is no, you may be found disabled. If your past work was at the medium exertion level, it doesn't matter that you can still perform light or sedentary work. So, it doesn't matter if you can be a silverware wrapper, laundry folder or hand packager.
Because of the grid rules, your attorney or representative must do the following things at your hearing:
1. Get the vocational witness to properly classify your past work as far as (a) skill level and (b) exertion level.
2. Present evidence to help the judge properly establish your 'residual functional capacity' or RFC. Your RFC is the maximum you can still do in terms of work related functions: sitting, standing, walking, lifting, bending, reaching, crouching, crawling, kneeling, etc. Medical records should be used to show that you have limitations in these functions that limit you to, say, sedentary work--so that you cannot perform light, medium or heavy work.
3. Evaluate the grid rules to make them work for you.
The goal for persons age 50 and over is to show that you are not able to perform the demands of your past relevant work (work you have done during the most recent 15-year period). The grid rules, if used properly, may actually direct the judge to a finding that you are disabled according to Social Security's rules and regulations.
_____________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
Age 50 or above? Your odds of getting approved just got a lot better.
Why does age make so much difference to Social Security?
The answer is the grid rules, officially known as the Medical-Vocational Guidelines.
Without going into complicated explanations of grid rules, here's the basic logic:
BELOW AGE 50: a claimant will go all the way to Step 5 in the five-step decision making process. The question will be: Is there any work in the national economy that this claimant could perform?
"Any work" includes entry level, low paying, unskilled jobs that require no specific education, training or experience. Jobs like silverware wrapper, laundry folder, small parts sorter or hand packager. The ability to do this type of work is enough to get you denied if you are under age 50 -- "a younger individual."
AGE 50 OR OVER (Qualify for the grid rules): At 50, your age category changes. At ages 50-54, you are no longer a "younger individual." You have entered the age category called "Closely Approaching Advanced Age." These claimants often only go to Step 4 of the five-step sequential process. The question is "Can the claimant perform any of his/her past relevant work?" If the answer is no, you may be found disabled. If your past work was at the medium exertion level, it doesn't matter that you can still perform light or sedentary work. So, it doesn't matter if you can be a silverware wrapper, laundry folder or hand packager.
Because of the grid rules, your attorney or representative must do the following things at your hearing:
1. Get the vocational witness to properly classify your past work as far as (a) skill level and (b) exertion level.
2. Present evidence to help the judge properly establish your 'residual functional capacity' or RFC. Your RFC is the maximum you can still do in terms of work related functions: sitting, standing, walking, lifting, bending, reaching, crouching, crawling, kneeling, etc. Medical records should be used to show that you have limitations in these functions that limit you to, say, sedentary work--so that you cannot perform light, medium or heavy work.
3. Evaluate the grid rules to make them work for you.
The goal for persons age 50 and over is to show that you are not able to perform the demands of your past relevant work (work you have done during the most recent 15-year period). The grid rules, if used properly, may actually direct the judge to a finding that you are disabled according to Social Security's rules and regulations.
_____________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
Sunday, June 17, 2018
WHY YOUR DISABILITY ODDS ARE BETTER AT THE APPEAL LEVEL
A Social Security disability case falls into one of 2 broad categories: the application stage - and the appeal stage.
The application stage is where a state-run agency looks at your medical evidence and makes a decision about whether you are eligible to receive a benefit payment. This process takes 3 to 4 months and results in denials of almost 8 out of 10 applications.
Once denied, the claimant must file a written appeal, moving the claim to a different department within the Social Security Administration known as the Office of Hearings Operation (OHO). Here, eventually, an administrative law judge (ALJ) will hold a hearing, look at all the evidence and render a new decision. The appeal process normally takes about 2 years.
Here's Why You Have a Better Chance With The Appeal:
Of all hearings held in the United States, an average of 42 percent will result in awards (approval of benefits). Most of these awards will include payment of past due benefits or "back pay."
Award rates, however, vary from office to office and from judge to judge. There may one judge in a certain hearing office who awards 65 percent of cases but another judge in the same office who only awards 17 percent. But the national average for 2017 was 42 percent favorable decisions.
So, here are two very simple conclusions to bring away from this:
1. It's very common for a disability application to be denied. Happens about 80 percent of the time.
2. If denied, appeal immediately. The appeal process is your best chance for getting paid. It never costs you money to file an appeal. If an attorney or qualified advocate assists you, they cannot charge you a fee until AFTER you have won the appeal--and only then if you receive back pay or past due benefits. The fee must be a percentage of the past due benefits that you have agreed upon in your written Fee Agreement. Fees are strictly regulated by the Social Security Administration.
The application stage is where a state-run agency looks at your medical evidence and makes a decision about whether you are eligible to receive a benefit payment. This process takes 3 to 4 months and results in denials of almost 8 out of 10 applications.
Once denied, the claimant must file a written appeal, moving the claim to a different department within the Social Security Administration known as the Office of Hearings Operation (OHO). Here, eventually, an administrative law judge (ALJ) will hold a hearing, look at all the evidence and render a new decision. The appeal process normally takes about 2 years.
Here's Why You Have a Better Chance With The Appeal:
- You will get a face-to-face meeting with a judge, a man or woman with a law degree and experience adjudicating legal matters.
- You will get to bring your lawyer or legal representative with you to the hearing.
- You will get to explain your disability.
- Your representative will get to present legal arguments why you meet qualifications for a disability benefit.
- You will get to submit any new medical evidence available.
- You will be able to present your doctor's opinion (if available) at the hearing.
Of all hearings held in the United States, an average of 42 percent will result in awards (approval of benefits). Most of these awards will include payment of past due benefits or "back pay."
Award rates, however, vary from office to office and from judge to judge. There may one judge in a certain hearing office who awards 65 percent of cases but another judge in the same office who only awards 17 percent. But the national average for 2017 was 42 percent favorable decisions.
So, here are two very simple conclusions to bring away from this:
1. It's very common for a disability application to be denied. Happens about 80 percent of the time.
2. If denied, appeal immediately. The appeal process is your best chance for getting paid. It never costs you money to file an appeal. If an attorney or qualified advocate assists you, they cannot charge you a fee until AFTER you have won the appeal--and only then if you receive back pay or past due benefits. The fee must be a percentage of the past due benefits that you have agreed upon in your written Fee Agreement. Fees are strictly regulated by the Social Security Administration.
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