Social Security disability hearings only happen if you were denied and then filed an appeal. The hearing is the government's response to your appeal. They will appoint a federal administrative law judge (ALJ) to listen to your evidence and render a new decision.
The hearing will last less than one hour on average but it may be the most important hour of your life, financially speaking. How do you get ready for it?
1. Be certain that all of your medical records have been ordered and placed in your Social Security file. Most cases these days have electronic files. If you are unrepresented, Social Security is supposed to order your medical records, but they will only order the records you tell them about. It is imperative that you review your file about 3 months prior to your hearing and see if the records from each treating medical provider are included in your file. If not, you will need to obtain these records and submit them. If you have an attorney, he or she is responsible for obtaining all these records. Incomplete records will either result in a postponement of your hearing or possibly a denial.
2. Figure out the exact date you last worked, even if it was for just one day. Step 1 of the hearing will be to determine when you last worked. You will be asked this question and you should know the answer. Judges determine this first because the law doesn't allow a disability benefit to be paid for months in which you worked at "substantial gainful activity," no matter how sick they were.
3. Medical records are essential but they alone often aren't enough to get an award. Try for opinion evidence from your doctor. Specifically, try to get a form called a "Medical Source Statement" completed by your doctor that details the limitations in your work-related functions: sitting, standing, walking, bending, lifting, etc.
4. Be able to explain why you can't hold a full-time job--from a health or disability point of view. Be able to articulate your functional limitations that prevent you from working. Speak in specific terms: "I can't sit longer than ___ minutes. I can only stand for about ____ minutes, etc."
5. Research the technical issues involved in your case. These include:
- Do you meet one of the published Listings?
- Will a grid rule direct a finding of disability at your age?
- Does your application date allow Social Security to pay back to your alleged onset date?
- Did you have substantial earnings after your alleged onset date?
- Do you need to amend your alleged onset date?
- When is (was) your Date Last Insured? Can you prove disability onset prior to that date?
- Classify each job you have held during the 15 year period prior to filing for disability. Be familiar with the the classifications of sedentary, light and medium work.
6. Research questions that you should ask Social Security's vocational expert. Nearly all adult hearings will include testimony by a vocational expert who has been called by the government to testify.
7. Read your medical records. Make a note of where to find each of your major illnesses or impairments in the record. For example, "My bulging lumbar disc is medically documented by an MRI report in Exhibit 4F, page 16." Or, "My severe depression is noted by Doctor Feelgood in Ex. 9F, pgs. 3, 9 and 15; and in 11F, 6, 11 and 17).
8. If Social Security sent you to one of their doctors for a consultative examination (CE), read and study that report, which will be in your file. Note what that doctor said concerning your physical and/or mental limitations and how those limitations restrict your ability to do work-like functions. Sometimes, these reports actually help you win.
9. Prepare yourself to speak Social Security lingo. If the judge uses terms you don't understand, ask him or her to explain what they mean.
10. Here are common sense tips I give to all my clients before they set foot in a hearing room:
- Always tell the truth.
- Tell the truth, then stop. Don't say too much.
- Never answer a question that you do not understand.
- Avoid generalities such as: sometimes, once in a while, a little bit, not very often, pretty bad, not much.
- Answer questions with defined words, using terms like: days, hours, minutes, feet, yards, etc. Example: "I can sit for about 15 minutes before my legs no numb." Better than, "I can only sit a little while before my legs go numb." ("A little while" is not defined).
Do You Need Help?
Many people will benefit from hiring an attorney or experienced disability advocate to prepare the hearing and attend with them. In the first place, it will save you enormous time and hard work. In the second place, it increases the odds that you will be awarded benefits. Finally, it may save you untold frustration and anxiety--just having someone who knows what it's all about sitting beside you, and having prepared for all the angles.
___________________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across From Bridge Street"
CALL (256) 799-0297
SOCIAL SECURITY JUSTICE - WEBSITE
Free Consultations - Never a Fee Unless You Win
I assume that you have a legitimate long-term disability that basically meets the rules and regulations for a Social Security check. You are not working now at a job which plays at least $1,180 per month. Your impairment is expected to last at least 12 straight months. Those are the starting points.
What do you have to do?
First, file an application with the Social Security Administration: go online to www.socialsecurity.gov and file, call or visit a Social Security office and file, or find an attorney or disability advocate who is willing to help you file an application. You will wait 4 to 6 months to get a decision, which is often a denial.
Why Most Benefits Are Initially Denied
The denial letter will disguise the reason they denied your claim. However, it usually boils down to one of two reasons:
1. They find that you can perform at least one of your past jobs (called a Step 4 denial) OR
2. They find that if you can't perform any past jobs, there is other work in the national economy that you could perform (called a Step 5 denial).
Neither of these assumptions by Social Security may be true. The truth is, they probably rated your ability to work much higher than it really is. (The technical term for the ability to work is residual functional capacity). So, the denial isn't fact-based, it's error-based.
What Do You Have to Do If Denied?
File an appeal within 60 days of the date on the denial letter. This is the second step and the most important step.
Gather additional medical evidence from your doctors and medical providers that prove how severe your symptoms are and how your impairment makes it impossible for you to work a full-time job. Be prepared to make an impregnable argument before the administrative law judge who will preside at your hearing.
Will You Need an Attorney or Legal Representative?
Well, you are headed to a judge who will decide your case based on complicated rules and regulations of the federal government, specifically based on 20 Code of Federal Regulations, Part 404. If you aren't familiar with the Code or the burden of proof required to be awarded federal benefits in an appeal case, you may want help.
Also, keep in mind that preparing an appeal is a time consuming affair. Not only must you order and then read all your medical records, you must annotate them with notes that you use at your hearing to tell the judge where the medical records indicate that you are unable to work. Some cases that I work on have 4,000 pages of medical records (or more), which can takes weeks just to read.
Then, there is the problem of the hearing itself. You will be confronted by a vocational expert, or jobs expert, who is likely to testify that there are indeed thousands of jobs available which you could still perform. You will need to refute this idea with pointed questions to the VE if you want to win. And the regulations will let you ask some questions, not others. Some questions are helpful, while others can hurt your case. So, you must prepare to ask the right questions.
Finally, there are the technical issues of the case: alleged onset date, date last insured, listings, medical-vocational rules, acceptable medical sources, etc. Should you amend your alleged onset date if the judge suggests it, or should you hold firm?
All things considered, I think legal representation is a good idea and worth what it costs (which is nothing unless you win).
Many Medicare recipients enroll in a prescription drug plan (called Part D) and just assume that the plan continues to remain the same year after year. But, that isn't at all true. Medicare Part D plans change almost every year. What was the best plan for you in 2018 may be a terrible plan for 2019.
You have until December 7th this year to change your plan. After that, you're stuck with it for another year.
Some changes that drug plans make each year incude:
- Increasing the monthly premium
- Eliminating some of the drugs that they cover (formulary changes)
- Increasing co-pays
- Increasing annual deductibles
- Raising your out-of-pocket annual costs
If you simply stay with the same drug plan you had last year, without comparing other plans, it may cost you hundreds of dollars in increased drug costs for 2019.
Here's What You Should Do
Go to Medicare's official website at
https://www.medicare.gov/find-a-plan/results/planresults/plan-compare.aspx
This link takes you to the official government website for Medicare. [CAUTION: www.medicare.com, once operated by Medicare, is no longer a government website].
Once on this site, look for the blue tab in the upper left corner of the screen that says "Sign Up/Change Plans." Click this tab, then on the left side of the screen, click "Find Health and Drug Plans." Then, follow the cues.
You will be able to enter your information and type in each of the prescription drugs that you take regularly. Be sure to enter the correct dosage and number of pills or capsules that you buy each 30-day or 90-day period. (*Mail order drugs will save you up to 50 percent compared to buying at a local pharmacy, and your prescriptions will come from a Medicare-approved mail order pharmacy).
Another caution: There are dozens of websites run by insurance companies that look like Medicare websites. They are not. I had to search for 20 minutes just to find the official government website (in the link above). The insurance companies have agents that want to sell you insurance. So, avoid the sales pitches and go straight to the official Medicare website. Compare premiums, co-pays and deductibles for 2019. This website will actually let you customize your prescription use and tell you which Part D plan has the lowest out-of-pocket cost for you.
By way of disclaimer, I'd like to say that neither I or anyone at the Forsythe Firm are licensed insurance agents and we do not sell or recommend insurance plans to anyone. We do think you need to compare Part D drug plans every year to be sure you're getting the best deal. It takes about 30 minutes on your computer to be sure. And the deadline to change plans this year is December 7th.
________________
The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
(256) 799-0297
*Please do not call us about insurance related questions. However, if you have a Social Security disability question, we welcome your call. We offer free consultations.
SOCIAL SECURITY JUSTICE - WEBSITE
A couple of years ago Laura Kwerel wrote an article in the Atlantic Monthly titled "The Hell of Applying for Government Benefits." The link to the article is given below:
https://www.theatlantic.com/politics/archive/2016/06/social-security-administration/486410/
Ms.
Kwerel had attempted to get Social Security benefits for her daughter.
She describes how the government bureaucracy battled her every step of
the way.
Anyone considering applying for Social Security disability or SSI benefits should read this article first.
It
explains why there is a huge national industry of lawyers who do
nothing but help claimants applying for Social Security and other
government benefits.
You
may be told that you can do it yourself, you don't need a lawyer. And
while that is technically true, you must be prepared to spend countless
hours entangled in frustrating bureaucratic red tape, complications,
delays and confusing regulations. If the system worked the way it ought
to, lawyers or advocates would not be required. But the system doesn't
work that way.
The
article by Laura Kwerel is sad but fascinating--worth reading by anyone
who wants the real story of how difficult it is to deal with Social
Security yourself.
_____________
THE FORSYTHE FIRM
Social Security Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
(256) 799-0297
When you go in for a Social Security disability hearing the Government will have an expert or two on hand to testify.
There is always a vocational expert (VE). This professional is called by the judge to provide expert opinion about the claimant's past work and also about other work that exists in the national economy. This expert will testify in terms of technical matters, such as DOT codes, SVP factors, etc. If you are unrepresented, you will be at a real disadvantage. There are questions that must be asked of this witness. Failure to adequately challenge the VE's testimony may cause the case to be lost with all the benefits.
The second witness that may appear at your hearing is a medical expert, usually an MD or a psychologist. Not all hearings will use a medical expert, but some will. This individual has been called to address the judge's questions about your medical conditions, their severity and whether or not they meet one of the Listings. The judge may also ask the doctor what limitations you have on the ability to work an 8-hour day. Again, unfavorable testimony needs to be challenged by someone who knows how to do so.
I hope you see that walking into a hearing unrepresented and trying to handle these experts by yourself is a really bad idea. I have attended hundreds of successful hearings where I am convinced that if no claimant representative had been present the decision would have been unfavorable.
Here are common questions the judge will pose to the vocational expert:
- Please classify the claimant's past relative work.
- Are there any transferable skills?
- If the claimant were limited to light exertion level, would any jobs be available?
- If the claimant cannot perform his past relevant work, what other jobs may be available, based on my hypothetical questions?
The medical doctor may be asked such questions as.....
- Does the claimant meet or equal any listed impairment?
- Would you summarize the claimant's medical record?
- In your opinion, does the medical record support the claimant's complaints of pain or other symptoms?
If you are about to face one of these hearings, it is imperative that you get legal help in dealing with these experts.
____________
The Forsythe Firm
Huntsville, AL
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE WEBSITE
If you applied for Social Security disability benefits and were told you are not eligible, we strongly urge you to contact us for help.
Denials are very common but can usually be overturned on appeal. When you file an appeal your case goes before a federal administrative law judge for a hearing. Most of the cases that are won today are won at this level.
Here is what one of our experienced Social Security advocates will do for you:
- Analyze your case and set a strategy
- Gather evidence from doctors
- Prepare you to testify at the hearing
- Question the expert witnesses
- Answer the judge's technical questions
- Explain your case in terms of Social Security's regulations
WHAT ARE OUR FEES?
We do all the work on your case with no money upfront. We never ask you for a fee. If your case is successful, Social Security will withhold our fee out of your back pay and pay us directly. If your case does not result in back pay, we will not charge you a fee--ever.
And you always keep 100 percent of your monthly benefits--forever.
A Social Security denial is not the end. It marks an opportunity to take your case in a new direction. Contact us and get the help you need to turn a denial into victory and a claim paid!
_________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike
Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
PHONE: (256) 799-0297
SOCIAL SECURITY JUSTICE WEBSITE
