"I have heard that there is no such thing as a partial disability with Social Security. However, I just received a decision that says NOTICE OF DECISION - PARTIALLY FAVORABLE. What does this mean?
You are correct that Social Security does not grant any benefit for a partial disability. A claimant is either disabled or not disabled, nothing between. However, Social Security does issue two types of favorable decisions:
FULLY FAVORABLE - Means that benefits are awarded exactly as applied for in the application with no changes made by decision makers, such as the administrative law judge. This usually involves the date of disability onset, which affects the amount of back pay. For example, you claim that you became disabled on July 10, 2015. Social Security agrees and awards benefits back to that date. Your decision is, therefore, Fully Favorable with no changes.
PARTIALLY FAVORABLE - Means you were found to be disabled, but some fact in the application was changed to make the decision less favorable than the one you wanted. You will get a monthly benefit but some other part of the decision is unfavorable to you. This usually involves a change in the established onset date. For example, you claimed in the application that you became disabled on July 20, 2015 and asked for benefits back to that date. The decision maker found, however, that you did not meet the requirements for disability benefits until January 1, 2017. You get your monthly benefit but your back pay will be reduced because of the later onset date. Therefore, the decision is only partially favorable to you. It gives you part of what you asked for, but not all.
I might emphasize that the claimant in both of these examples is fully disabled. It's not the disability which is partial, it's the decision. In the case of a partially favorable decision, the claimant is fully disabled but the full disability didn't begin on the date that he/she alleged. Because the beginning date (onset) of disability got moved, back pay was reduced. So, it's a full disability but a partially favorable decision. (The monthly benefit is the same in both cases, only the back pay is affected).
SOCIAL SECURITY JUSTICE
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, January 5, 2019
HOW LONG WILL IT TAKE TO GET A SOCIAL SECURITY DISABIILTY HEARING...?
How long will it take to get a Social Security disability hearing?
Typically, it takes 18 to 24 months from the date you file your appeal/request for hearing. About 25 percent of claims will be approved without an appeal; the other 75 percent must appeal and wait. The wait is due to a huge backlog in the Social Security Administration.
How long will I have to wait for a decision after my hearing has been held?
The wait varies from judge to judge and office to office. 60 to 90 days is common. Fully favorable decisions are the quickest because they are the least complicated to write.
Once I get my favorable decision, how long will I have to wait to get paid?
The time varies. Most people wait 30 to 45 more days to receive their first check. Back pay may take even longer. If a Supplemental Security Income (SSI) claim was also filed, the wait will be longer because the SSI paperwork must be processed first and that requires an interview with the claimant.
Can I receive any emergency benefits while I wait for Social Security to decide my case or to pay me?
No. Unfortunately, Social Security has one speed for almost everyone and it does not include any special advances or funds to cover emergencies.
Can anything speed up my disability case?
There are three things that might get expedited (faster) processing for a Social Security disability claim:
1) Critical case designation. if the claimant has a terminal illness and is expected to live no more than 12 months, the case may be declared a critical case and acted on more quickly.
(2) Dire Need. If the claimant is homeless and has no way to provide food or shelter. If the claimant needs emergency medical treatment which he/she cannot afford or obtain, Social Security may designate a case as "dire need" and speed up the process.
2) Disabled veterans who have a 100 percent permanent, total VA disability rating may get expedited claim processing with Social Security.
Obviously, there are some things that all applicants should do to avoid needless delays in their claims. Try to file a complete, accurate application--and this applies to all the questionnaires and reports that go with the application. Attend all interviews or examinations as directed. If denied, file an immediate appeal--because hearings are assigned in the order in which appeals were filed.
________
The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
"Across From Bridge Street"
CALL (256) 799-0297
Free consultations - We never ask you for money.
SOCIAL SECURITY JUSTICE - WEBSITE
Typically, it takes 18 to 24 months from the date you file your appeal/request for hearing. About 25 percent of claims will be approved without an appeal; the other 75 percent must appeal and wait. The wait is due to a huge backlog in the Social Security Administration.
How long will I have to wait for a decision after my hearing has been held?
The wait varies from judge to judge and office to office. 60 to 90 days is common. Fully favorable decisions are the quickest because they are the least complicated to write.
Once I get my favorable decision, how long will I have to wait to get paid?
The time varies. Most people wait 30 to 45 more days to receive their first check. Back pay may take even longer. If a Supplemental Security Income (SSI) claim was also filed, the wait will be longer because the SSI paperwork must be processed first and that requires an interview with the claimant.
Can I receive any emergency benefits while I wait for Social Security to decide my case or to pay me?
No. Unfortunately, Social Security has one speed for almost everyone and it does not include any special advances or funds to cover emergencies.
Can anything speed up my disability case?
There are three things that might get expedited (faster) processing for a Social Security disability claim:
1) Critical case designation. if the claimant has a terminal illness and is expected to live no more than 12 months, the case may be declared a critical case and acted on more quickly.
(2) Dire Need. If the claimant is homeless and has no way to provide food or shelter. If the claimant needs emergency medical treatment which he/she cannot afford or obtain, Social Security may designate a case as "dire need" and speed up the process.
2) Disabled veterans who have a 100 percent permanent, total VA disability rating may get expedited claim processing with Social Security.
Obviously, there are some things that all applicants should do to avoid needless delays in their claims. Try to file a complete, accurate application--and this applies to all the questionnaires and reports that go with the application. Attend all interviews or examinations as directed. If denied, file an immediate appeal--because hearings are assigned in the order in which appeals were filed.
________
The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
"Across From Bridge Street"
CALL (256) 799-0297
Free consultations - We never ask you for money.
SOCIAL SECURITY JUSTICE - WEBSITE
Friday, January 4, 2019
WHAT'S IMPORTANT IN YOUR DISABILITY HEARING (SOCIAL SECURITY)?
There are several important "ingredients" in your Social Security disability hearing--things that will influence your decision (approval/denial). Here is my list of things, the most important being on top:
1. Medical Evidence - The law requires objective medical evidence from doctors, hospitals or other treatment providers. Medical evidence must prove the existence of one or more severe and medically determinable impairments which have lasted at least 12 straight months or are expected to last at least that long OR to end in death. Without medical evidence, there is no hope of getting Social Security disability benefits.
2. Your Age. Persons below age 50 are considered younger individuals. This is the most difficult age for Social Security because younger individuals do not meet any medical-vocational guidelines or 'grid rules' that help get a favorable decision. The standard burden for these individuals is to prove that they are not physically and or mentally able to sustain any full-time job which exists in the national economy. This is the highest burden of all. It gets a little easier at ages 50-54, and easier yet at age 55.
3. Past Relevant Work. Social Security looks at all the full-time jobs you have held in the past 15 years. The crucial question is: "Are you able to perform any of your past relevant jobs?" If the answer is yes, you will be denied. For example, you are 48 years old and you held a full-time job in 2007 as an office manager, which is sedentary work with not much lifting, standing, walking, bending, etc. If Social Security finds that you can still perform this work, your claim is denied.
4. Your education. Education plays a role in whether or not you can meet a medical-vocational guideline or grid rule. Having a high school diploma or GED can sometimes prevent you from meeting a grid rule and therefore cause you to be denied. Also, persons with a lot of education, such as college or a certificate in a skilled trade may have transferable skills to other work which can hurt a disability claim.
There are a great many "cut-and-dried" facts to be considered. As a friend of mine says, "It is what it is." You are a certain age, you held certain jobs, you have a certain amount of education...etc. It can't be changed.
To a certain extent, the medical evidence "is what it is," also. Yet, there is some interpretation involved in medical evidence. Primarily, what limitations are imposed by the medical impairments? For example, if a claimant has asthma, what are the severe symptoms? Shortness of breath on exertion, fatigue, weakness...? What restrictions are caused by the asthma? Inability to stand or walk for prolonged periods? Inability to left, bend or stoop? Need to take frequent rest breaks? Need to use inhalers, nebulizers or other medical intervention frequently? How would a workday be disrupted by the asthma? These questions may not be "cut-and-dried" in the doctor's records, so an interpretation is called for.
In short, does the claimant's documented medical conditions impose such severe functional restrictions that he/she cannot work 8 hours a day, 5 days per week on a regular and consistent basis? If the answer is Yes, Social Security probably will award benefits.
A final question: Does Social Security consider non-exertional limitations, such as depression, anxiety, fatigue, pain, etc.? The answer is, yes. All documented medical impairments are considered.
Exertional activities include such things as sitting, standing, walking, pushing, pulling, and lifting.
Postural activities include such things as stooping, reaching, kneeling, crouching and crawling.
Mental requirements of work include such things as concentration, remembering and understanding simple directions, carrying out directions and completing tasks, interacting appropriately with co-workers, supervisor or the general public.
All of these should be considered by Social Security decision makers. However, there must be medical evidence to support the probability of functional limitations. You can't just claim that you have difficulty remembering or concentrating. You need a doctor, preferably, a licensed psychologist or psychiatrist, to say that.
Here's the take-away: A Social Security claim is a terribly complex legal maneuver. Certain facts have to be proven with objective evidence. Then, certain conclusions must be drawn based on that evidence. The claimant must prove that he/she meets the federal regulations that allow a disability benefit. Telling the judge a good story (even if true) simply won't be enough. "Where's the beef?" is better translated, "Where's the evidence?"
______________
The Forsythe Firm
Social Security Disability Specialists
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
Free Consultations - Never a Fee Unless You Win!
SOCIAL SECURITY JUSTICE
1. Medical Evidence - The law requires objective medical evidence from doctors, hospitals or other treatment providers. Medical evidence must prove the existence of one or more severe and medically determinable impairments which have lasted at least 12 straight months or are expected to last at least that long OR to end in death. Without medical evidence, there is no hope of getting Social Security disability benefits.
2. Your Age. Persons below age 50 are considered younger individuals. This is the most difficult age for Social Security because younger individuals do not meet any medical-vocational guidelines or 'grid rules' that help get a favorable decision. The standard burden for these individuals is to prove that they are not physically and or mentally able to sustain any full-time job which exists in the national economy. This is the highest burden of all. It gets a little easier at ages 50-54, and easier yet at age 55.
3. Past Relevant Work. Social Security looks at all the full-time jobs you have held in the past 15 years. The crucial question is: "Are you able to perform any of your past relevant jobs?" If the answer is yes, you will be denied. For example, you are 48 years old and you held a full-time job in 2007 as an office manager, which is sedentary work with not much lifting, standing, walking, bending, etc. If Social Security finds that you can still perform this work, your claim is denied.
4. Your education. Education plays a role in whether or not you can meet a medical-vocational guideline or grid rule. Having a high school diploma or GED can sometimes prevent you from meeting a grid rule and therefore cause you to be denied. Also, persons with a lot of education, such as college or a certificate in a skilled trade may have transferable skills to other work which can hurt a disability claim.
There are a great many "cut-and-dried" facts to be considered. As a friend of mine says, "It is what it is." You are a certain age, you held certain jobs, you have a certain amount of education...etc. It can't be changed.
To a certain extent, the medical evidence "is what it is," also. Yet, there is some interpretation involved in medical evidence. Primarily, what limitations are imposed by the medical impairments? For example, if a claimant has asthma, what are the severe symptoms? Shortness of breath on exertion, fatigue, weakness...? What restrictions are caused by the asthma? Inability to stand or walk for prolonged periods? Inability to left, bend or stoop? Need to take frequent rest breaks? Need to use inhalers, nebulizers or other medical intervention frequently? How would a workday be disrupted by the asthma? These questions may not be "cut-and-dried" in the doctor's records, so an interpretation is called for.
In short, does the claimant's documented medical conditions impose such severe functional restrictions that he/she cannot work 8 hours a day, 5 days per week on a regular and consistent basis? If the answer is Yes, Social Security probably will award benefits.
A final question: Does Social Security consider non-exertional limitations, such as depression, anxiety, fatigue, pain, etc.? The answer is, yes. All documented medical impairments are considered.
Exertional activities include such things as sitting, standing, walking, pushing, pulling, and lifting.
Postural activities include such things as stooping, reaching, kneeling, crouching and crawling.
Mental requirements of work include such things as concentration, remembering and understanding simple directions, carrying out directions and completing tasks, interacting appropriately with co-workers, supervisor or the general public.
All of these should be considered by Social Security decision makers. However, there must be medical evidence to support the probability of functional limitations. You can't just claim that you have difficulty remembering or concentrating. You need a doctor, preferably, a licensed psychologist or psychiatrist, to say that.
Here's the take-away: A Social Security claim is a terribly complex legal maneuver. Certain facts have to be proven with objective evidence. Then, certain conclusions must be drawn based on that evidence. The claimant must prove that he/she meets the federal regulations that allow a disability benefit. Telling the judge a good story (even if true) simply won't be enough. "Where's the beef?" is better translated, "Where's the evidence?"
______________
The Forsythe Firm
Social Security Disability Specialists
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
Free Consultations - Never a Fee Unless You Win!
SOCIAL SECURITY JUSTICE
Monday, December 31, 2018
DISABILITY BENEFITS FOR SEIZURES
We frequently represent individuals with Epilepsy or seizures in the attempt to get Social Security disability benefits.
While a seizure disorder may certainly be disabling under Social Security's rules, this isn't always the case. Social Security will evaluate the disorder based on it's nature (type of seizures), frequency and medical treatment.
Here is what you will need to be approved and paid:
Besides medical care, the one thing that will help your case the most is a diary or written record of your seizure activity, kept by a third party who can document the type of seizures, what activity accompanies a seizure and how often they occur. You can't just depend on doctors or emergency room records because by the time you get to the ER or doctor's office, the seizure has already long passed. Also, many people don't go to the doctor or ER every time they have a seizure.
The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
Free evaluations and consultations
While a seizure disorder may certainly be disabling under Social Security's rules, this isn't always the case. Social Security will evaluate the disorder based on it's nature (type of seizures), frequency and medical treatment.
Here is what you will need to be approved and paid:
- a diagnosis of epilepsy or other seizure disorder
- a detailed description of your typical seizure, including all pre- and post-seizure symptoms
- a statement from your doctor corroborating your account of the nature and frequency of your seizures
- a description of your seizures from a third-party witness
- a record indicating the frequency of your past seizures
- results of an EEG, and
- a detailed treatment history, including medications and other treatments that you’ve tried and your response to them.
Besides medical care, the one thing that will help your case the most is a diary or written record of your seizure activity, kept by a third party who can document the type of seizures, what activity accompanies a seizure and how often they occur. You can't just depend on doctors or emergency room records because by the time you get to the ER or doctor's office, the seizure has already long passed. Also, many people don't go to the doctor or ER every time they have a seizure.
The Forsythe Firm
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
Free evaluations and consultations
Tuesday, November 27, 2018
HOW TO PREPARE FOR A SUCCESSFUL SOCIAL SECURITY DISABILITY HEARING
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:
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:
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
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.
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
NEED SOCIAL SECURITY DISABIITY MONEY? HERE'S WHAT YOU HAVE TO DO
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).
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).
Monday, November 26, 2018
MEDICARE DRUG COVERAGE IS CHANGING FOR 2019. ACT BEFORE DEC. 7TH FOR THE BEST PLAN
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:
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
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
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
Sunday, November 18, 2018
"THE HELL OF APPLYING FOR GOVERNMENT BENEFITS" BY LAURA KWEREL
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
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
Friday, November 16, 2018
WHAT EXPERTS WILL SOCIAL SECURITY HAVE AT YOUR HEARING?
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:
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
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?
- 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
TURNING DENIAL INTO APPROVAL
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:
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
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
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
Sunday, October 21, 2018
WHAT WILL A TIMELY APPEAL DO FOR YOU IF YOU'VE BEEN DENIED?
Let's face it. 7 out of 10 applications for disability will be denied for one reason or another. Very few people get approved with an application.
You must appeal the denial within 60 days. What does the appeal do for you?
First, the appeal keeps your claim alive. It protects your back pay, your disability onset date and other benefits under the original claim. If the appeal is eventually decided in your favor, benefits can go back to the original onset date of your disability. This can pay you tens of thousands of dollars in past due benefits or back pay.
Second, a timely appeal puts you on track to appear at a hearing before a US Administrative Law Judge (ALJ). It will take a long time to get there, however, the appeal is the same thing as a Request for a Hearing.
Third, the appeal gives you time to gather new or additional evidence. You should keep seeing your doctor(s) and submitting the new records to your file.
Finally, the appeal allows you to appear in person before a judge who will give you a new decision without being bound by the negative decision already made on your claim. The judge will review all the facts in your case, including new evidence, including your testimony, including your attoney's arguments. You are entitled to be represented at these hearings and you should be. It won't guarantee a victory but it will increase your chances of winning.
I come in contact with claimants who have been denied three, four or even five times. They keep filing new claims and getting denied over and over again. This is the worst way to approach an SSDI claim. A new application goes to the same people who denied it previously. The same people make the same decision again. Another denial. Spinning your wheels, getting nowhere.
The 3 must do rules for a denied claim are:
1. Appeal
2. Appeal
3. Appeal
You must appeal the denial within 60 days. What does the appeal do for you?
First, the appeal keeps your claim alive. It protects your back pay, your disability onset date and other benefits under the original claim. If the appeal is eventually decided in your favor, benefits can go back to the original onset date of your disability. This can pay you tens of thousands of dollars in past due benefits or back pay.
Second, a timely appeal puts you on track to appear at a hearing before a US Administrative Law Judge (ALJ). It will take a long time to get there, however, the appeal is the same thing as a Request for a Hearing.
Third, the appeal gives you time to gather new or additional evidence. You should keep seeing your doctor(s) and submitting the new records to your file.
Finally, the appeal allows you to appear in person before a judge who will give you a new decision without being bound by the negative decision already made on your claim. The judge will review all the facts in your case, including new evidence, including your testimony, including your attoney's arguments. You are entitled to be represented at these hearings and you should be. It won't guarantee a victory but it will increase your chances of winning.
I come in contact with claimants who have been denied three, four or even five times. They keep filing new claims and getting denied over and over again. This is the worst way to approach an SSDI claim. A new application goes to the same people who denied it previously. The same people make the same decision again. Another denial. Spinning your wheels, getting nowhere.
The 3 must do rules for a denied claim are:
1. Appeal
2. Appeal
3. Appeal
OVER PAYMENTS MUST BE RETURNED TO SOCIAL SECURITY
A lot of people get into trouble with Social Security by taking benefits they are not entitled to. This can go on for several years before Social Security catches on. Then, the government demands that you pay the money back. Probably, the money has been spent. You just don't have it to pay back. This is a serious problem.
How do people get themselves into this fix? By taking money that they are not entitled to.
It usually happens this way. An individual gets approved for disability and receives an SSDI check each month. After a couple of years, he feels better and decides he can go back to work. He does so but doesn't notify Social Security that he is working. So, Social Security keeps sending the monthly disability checks, which the beneficiary is no longer entitled to. But the checks keep getting cashed, creating a huge over-payment.
This may go on for up to two or three years. It appears that everything is fine because nobody has screamed about it.
However, Social Security has multiple ways of knowing when people get checks they are not entitled to. Eventually, they will find out. They always do. Then, they will demand their money back.
Of course, the money has already been spent. That doesn't matter. Social Security wants their money back, no excuses.
I get five or six calls a month from individuals in this situation. "I've spent the money, I don't have it any more, and now they want it back. Can you get me out of this?"
The short answer is, "No, I can't." If you take money you are not entitled to, you will have to pay it back.
I do realize that earning a paycheck and getting a disability check too is tempting. But it is also illegal.
Here is my recommendation to anyone receiving a benefit from Social Security:
Realize your reporting responsibilities. If you go back to work, either full-time or part-time, immediately notify Social Security in writing. Telephone calls are nearly impossible to prove and never make a good record. If Social Security doesn't respond, don't just assume that cashing their checks is OK. Keep contacting them until you get the right information. Ultimately, cashing checks that you're not entitled to cash only gets you into trouble. There is never an acceptable excuse and there are no loopholes. When in doubt, don't cash the check!
Fighting fraud is Job 1 at Social Security these days. If outright dishonesty or misrepresentation is involved, you may be subject to arrest and criminal prosecution--in addition to paying back the money you took. It isn't worth it to put yourself in that position. If you go back to work, report it. If they send you a check anyway, return it.
There are a very limited number of situations where a person might be entitled to keep getting a check after returning to work. An example would be a person participating in the Ticket to Work program. But this is a formal program where a person works with the permission of Social Security and there are rules and limits.
How do people get themselves into this fix? By taking money that they are not entitled to.
It usually happens this way. An individual gets approved for disability and receives an SSDI check each month. After a couple of years, he feels better and decides he can go back to work. He does so but doesn't notify Social Security that he is working. So, Social Security keeps sending the monthly disability checks, which the beneficiary is no longer entitled to. But the checks keep getting cashed, creating a huge over-payment.
This may go on for up to two or three years. It appears that everything is fine because nobody has screamed about it.
However, Social Security has multiple ways of knowing when people get checks they are not entitled to. Eventually, they will find out. They always do. Then, they will demand their money back.
Of course, the money has already been spent. That doesn't matter. Social Security wants their money back, no excuses.
I get five or six calls a month from individuals in this situation. "I've spent the money, I don't have it any more, and now they want it back. Can you get me out of this?"
The short answer is, "No, I can't." If you take money you are not entitled to, you will have to pay it back.
I do realize that earning a paycheck and getting a disability check too is tempting. But it is also illegal.
Here is my recommendation to anyone receiving a benefit from Social Security:
Realize your reporting responsibilities. If you go back to work, either full-time or part-time, immediately notify Social Security in writing. Telephone calls are nearly impossible to prove and never make a good record. If Social Security doesn't respond, don't just assume that cashing their checks is OK. Keep contacting them until you get the right information. Ultimately, cashing checks that you're not entitled to cash only gets you into trouble. There is never an acceptable excuse and there are no loopholes. When in doubt, don't cash the check!
Fighting fraud is Job 1 at Social Security these days. If outright dishonesty or misrepresentation is involved, you may be subject to arrest and criminal prosecution--in addition to paying back the money you took. It isn't worth it to put yourself in that position. If you go back to work, report it. If they send you a check anyway, return it.
There are a very limited number of situations where a person might be entitled to keep getting a check after returning to work. An example would be a person participating in the Ticket to Work program. But this is a formal program where a person works with the permission of Social Security and there are rules and limits.
Monday, October 15, 2018
TOP 10 MISTAKES ON A DISABILITY CLAIM
TOP 10 SOCIAL SECURITY DISABILITY MISTAKES
1. Trying to file when you haven't worked enough. You must have worked enough to accumulate the minimum Quarters of Coverage. Without the required work history, your claim will automatically be denied. And this type of denial can't be successfully appealed. Check this with the Social Security office before you begin an SSDI claim. The question you need to ask: "Do I have enough work credits to support a new Title 2 claim?"
2. Filing a claim while you are still working. If you work enough to earn substantial wages, you will be given a denial at the first step in the process. In 2018, wages of at least $1,180 per month will get you denied. You must stop working or reduce wages to below the maximum before filing.
3. Alleging an onset date in the past but Social Security finds that you were still working on that date. For example, you allege disability began on 4/14/17 but you were still at working at substantial gainful activity (SGA) on that date. You should amend your alleged onset date to a later date after you stopped earning SGA wages.
4. You have a serious condition but it isn't expected to last at least 12 consecutive months. Short term disabilities that won't last for at least 1 year are not covered unless they are expected to end in death.
5. Failure to get your own doctor's support. Your doctor knows you better than anyone. He or she can give you a form called a "medical source statement" that can help you get approved. You have to seek out this from your doctor; Social Security won't do it.
6. Depending on Social Security's doctor to help you will always let you down. They have consulting doctors that often do examinations for persons who file claims but lack medical evidence from their own doctors. These exams seldom help get a favorable decision and most often doom the case to a denial.
7. Failing to get medical treatment is a big mistake. Social Security bases its decision on what is in your medical file. It is crucial to have consistent treatment from your doctor(s). Claiming to have a disabling impairment without medical evidence for it is a waste of time. For many conditions, treatment by a medical specialist is a really good idea. By the way, nurse practitioners are not considered acceptable medical sources by Social Security. They want a doctor (MD or DO). Records from a nurse practitioner won't take you very far with Social Security.
8. Waiting too long to file a claim can hurt you. Every worker's Social Security disability coverage comes with a "Date Last Insured," which is the time limit for filing a new claim. When you stop working, for any reason, your Date Last Insured begins to creep up on you. Don't wait too long to file an SSDI claim or you may find yourself uninsured at Social Security.
9. Failure to file an appeal in a timely manner. Up to 70 percent of SSDI claims will be denied at the first stage. It's just expected. You have 60 days to file an appeal. After 60o days passes and you do not appeal, the claim is dismissed and can't be reinstated in most cases. Don't let the 60 days pass. (Appeals are where most cases are won).
10. Failure to get legal representation. Social Security is one of those places where you may represent yourself. However, this is a really bad idea. There are complex books of regulations that govern Social Security disability. You need someone who knows the system and understands how to get cases approved. You only pay your representative if you win and if you collect past due benefits. Social Security will deduct the amount of the fee you have agreed on and pay the representative directly. There are reasonable maximum fees set by Social Security and you will never pay more than these amounts by law. You never have to pay anything up front.
____________
THE FORSYTHE FIRM
Social Security Disability Representatives
7027 Old Madison Pike NW, Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE: OUR WEBSITE
Wednesday, October 3, 2018
HOW MUCH WILL MY SSDI CHECK BE?
Social Security disability benefits are unique to the individual. The amount of your monthly benefit depends on your age, how long you have worked and how much you have earned.
The maximum SSDI benefit can be over $2,700 per month. That would be for an individual with many years of high earnings.
The average SSDI check in 2018 is around $1,170 per month.
SSDI benefits are not "means tested." Benefits are not reduced because you have other income, property, savings, etc.
Supplemental Security Income (SSI) is a totally different program and its maximum benefit is $750 per month. That amount can be reduced based on household income, living arrangements and other factors because SSI is for low income individuals or families.
Social Security no longer mails estimates of benefits, as they once did. However, you can call your local Social Security office and ask about your estimated monthly benefit in case of disability.
Keep in mind that SSDI beneficiaries also get Medicare insurance, which is a valuable benefit. (SSI recipients get Medicaid).
The maximum SSDI benefit can be over $2,700 per month. That would be for an individual with many years of high earnings.
The average SSDI check in 2018 is around $1,170 per month.
SSDI benefits are not "means tested." Benefits are not reduced because you have other income, property, savings, etc.
Supplemental Security Income (SSI) is a totally different program and its maximum benefit is $750 per month. That amount can be reduced based on household income, living arrangements and other factors because SSI is for low income individuals or families.
Social Security no longer mails estimates of benefits, as they once did. However, you can call your local Social Security office and ask about your estimated monthly benefit in case of disability.
Keep in mind that SSDI beneficiaries also get Medicare insurance, which is a valuable benefit. (SSI recipients get Medicaid).
Sunday, September 23, 2018
TRYING TO GET DISABILITY BENEFITS? WHAT LEGAL HELP WILL YOU NEED?
A small percentage of claimants who have catastrophic or life-threatening illness may get Social Security disability benefits pretty easily. Most people, however, will be denied and will require legal assistance to be approved.
What Kind of Legal Help Will You Need?
1. THE APPLICATION. Most claimants apply on their own. But the denial rate on these applications is almost 80 percent. Again, unless you have a catastrophic or fatal disease, the odds are you will be denied, especially if you are under age 50. Using an experienced attorney-advocate to file the application doesn't guarantee approval but it will eliminate many of the common mistakes that bring about denials.
2. THE APPEAL. Most people who finally get approved for Social Security disability benefits will do so after they file an appeal. They will go to a hearing before an administrative law judge (ALJ). These individuals need help in gathering evidence that meets the government's standards. They will also require assistance in presenting their case effectively to the judge. While representation is not required, it is your best chance at having a favorable resolution to your case. This hearing is to resolve a dispute with the US Government, who says that you are not disabled. The burden of proving that you are disabled rests upon you. You get a one-time chance at the hearing.
Specifically, here are some of the things that a good disability attorney-advocate will do for you:
_______
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail me at forsythefirm@gmail.com
What Kind of Legal Help Will You Need?
1. THE APPLICATION. Most claimants apply on their own. But the denial rate on these applications is almost 80 percent. Again, unless you have a catastrophic or fatal disease, the odds are you will be denied, especially if you are under age 50. Using an experienced attorney-advocate to file the application doesn't guarantee approval but it will eliminate many of the common mistakes that bring about denials.
2. THE APPEAL. Most people who finally get approved for Social Security disability benefits will do so after they file an appeal. They will go to a hearing before an administrative law judge (ALJ). These individuals need help in gathering evidence that meets the government's standards. They will also require assistance in presenting their case effectively to the judge. While representation is not required, it is your best chance at having a favorable resolution to your case. This hearing is to resolve a dispute with the US Government, who says that you are not disabled. The burden of proving that you are disabled rests upon you. You get a one-time chance at the hearing.
Specifically, here are some of the things that a good disability attorney-advocate will do for you:
- Gather and analyze medical records from doctors and other providers
- Analyze your past relevant work and how it impacts the claim
- Determine if you meet or equal one of the published Listings
- Determine whether a Grid argument can be made to get approval
- Develop another legal theory of the case to explain why you should be approved
- Solve flaws or problems in the case before it goes to hearing
- Petition for expedited processing, if appropriate, to get a decision faster
- Deal with pre-hearing motions from the judge
- Write a brief to explain why the case is sound legally and should be paid
- Prepare you, the claimant, for what will happen at the hearing ahead of time
- Appear at the hearing to present the case before the judge
- Object to testimony or rulings that are not in your best interest
- Cross examine Social Security's vocational expert at the hearing
- Make final arguments at the close of the hearing
- Monitor the payment process to be sure you collect the maximum benefits
- Decide whether any unfavorable decisions should be further appealed
- File any further appeals that are appropriate
- Answer your questions as the case progresses so you understand the process
_______
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail me at forsythefirm@gmail.com
USING NON-MEDICAL EVIDENCE IN YOUR SOCIAL SECURITY DISABILITY CLAIM
The goal of a Social Security disability claim is to convince the Government that you are not able to work. The obvious evidence you need is medical evidence: records from your doctor that show how severe your symptoms are.
But there is always non-medical evidence that enters into your claim, which may help you get approved or weaken your case and turn the direction toward denial.
Claimants often fail to see the advantages of non-medical evidence, or may see certain facts as harmful to their case. Here are a few examples.
You have changed jobs several times in recent years; therefore, you don't have a long history of just one job. This can be positive. If you had to change jobs because you couldn't perform the tasks of your old job, you are merely showing a commitment to keep working. Getting an easier job, or one with less demanding duties, demonstrates your need to work and your desire to keep working.
You were fired or "let go" from a your most recent job. This is usually considered negative. However, in a disability case, it may demonstrate that you were simply no longer able to dependably perform your job. If you were missing excessive days of work due to your health, it shows that your impairment is severe and interfered with your ability to work consistently. If your employer had to make accommodations to help you do your job, it shows how your health negatively affects your ability to keep working.
I recommend that claimants get a written statement from their former employer or supervisor, if possible. The statement should explain how long you worked for the company and that you were a good employee. It should go on to state observations your employer made about your work after you became sick. For example, you began to need extra time to complete job tasks; you had to miss work 3 or 4 days per month for illness; or, your job duties were changed in some way to help you continue working. The more specific the statement is, the more it will help you. For example, it is much better to say, "Mr. Employee was missing 3 or 4 days of work per month," than to say, "Mr. Employee sometimes missed work due to illness." The word "sometimes" is very vague and non-defined.
A good attorney or hearing representative will help you build non-medical evidence. Since I have stood before administrative law judges in hundreds of hearings, I know which evidence can help your claim. I can help you obtain this evidence prior to the hearing. Then, I can use the evidence during the hearing to help get a favorable decision in many cases.
The quest for Social Security disability benefits is difficult, with the average judge awarding (paying) about 42 percent of cases at hearings. The 42 percent (winners) are generally those who have the best evidence, presented in the best way, by the best representatives.
If you think you may have a Social Security disability claim, please call us for a free consultation. We will ask you some questions to help analyze your case. If we represent you, we will help you build a good case using both medical and non-medical evidence. You will never pay us a fee until your case is settled in your favor. At that time, the government will approve the fee we have agreed upon and pay us directly. You will receive 100 percent of your monthly benefits and your past due settlement will be reduced slightly to pay for our legal services. (The typical fee is 25 percent of past due benefits, not to exceed $6,000).
Example: Your past due settlement is $24,000. Our fee is $6,000. You keep $18,000 plus all your monthly checks.
Example: Your past due settlement is $80,000. Our fee is $6,000. You keep $74,000 and all your monthly checks.
Example: Your past due settlement is $12,000. Our fee is $3,000. You keep $8,000 and all of your monthly benefits.
----------------
The Forsythe Firm
Huntsville, AL
PHONE (256) 799-0297
But there is always non-medical evidence that enters into your claim, which may help you get approved or weaken your case and turn the direction toward denial.
Claimants often fail to see the advantages of non-medical evidence, or may see certain facts as harmful to their case. Here are a few examples.
You have changed jobs several times in recent years; therefore, you don't have a long history of just one job. This can be positive. If you had to change jobs because you couldn't perform the tasks of your old job, you are merely showing a commitment to keep working. Getting an easier job, or one with less demanding duties, demonstrates your need to work and your desire to keep working.
You were fired or "let go" from a your most recent job. This is usually considered negative. However, in a disability case, it may demonstrate that you were simply no longer able to dependably perform your job. If you were missing excessive days of work due to your health, it shows that your impairment is severe and interfered with your ability to work consistently. If your employer had to make accommodations to help you do your job, it shows how your health negatively affects your ability to keep working.
I recommend that claimants get a written statement from their former employer or supervisor, if possible. The statement should explain how long you worked for the company and that you were a good employee. It should go on to state observations your employer made about your work after you became sick. For example, you began to need extra time to complete job tasks; you had to miss work 3 or 4 days per month for illness; or, your job duties were changed in some way to help you continue working. The more specific the statement is, the more it will help you. For example, it is much better to say, "Mr. Employee was missing 3 or 4 days of work per month," than to say, "Mr. Employee sometimes missed work due to illness." The word "sometimes" is very vague and non-defined.
A good attorney or hearing representative will help you build non-medical evidence. Since I have stood before administrative law judges in hundreds of hearings, I know which evidence can help your claim. I can help you obtain this evidence prior to the hearing. Then, I can use the evidence during the hearing to help get a favorable decision in many cases.
The quest for Social Security disability benefits is difficult, with the average judge awarding (paying) about 42 percent of cases at hearings. The 42 percent (winners) are generally those who have the best evidence, presented in the best way, by the best representatives.
If you think you may have a Social Security disability claim, please call us for a free consultation. We will ask you some questions to help analyze your case. If we represent you, we will help you build a good case using both medical and non-medical evidence. You will never pay us a fee until your case is settled in your favor. At that time, the government will approve the fee we have agreed upon and pay us directly. You will receive 100 percent of your monthly benefits and your past due settlement will be reduced slightly to pay for our legal services. (The typical fee is 25 percent of past due benefits, not to exceed $6,000).
Example: Your past due settlement is $24,000. Our fee is $6,000. You keep $18,000 plus all your monthly checks.
Example: Your past due settlement is $80,000. Our fee is $6,000. You keep $74,000 and all your monthly checks.
Example: Your past due settlement is $12,000. Our fee is $3,000. You keep $8,000 and all of your monthly benefits.
----------------
The Forsythe Firm
Huntsville, AL
PHONE (256) 799-0297
Wednesday, September 19, 2018
3 WAYS TO BE APPROVED FOR SOCIAL SECURITY DISABILITY
Under Social Security rules and regulations there are basically 3 ways to be approved for disability benefits:
1. Prove that you meet a Listing. Listings are published lists of medical impairments and extensive symptoms which are documented by acceptable medical evidence. Claimants of any age could meet a Listing.
2. Meet or equal a grid rule, also called a medical-vocational rule. It is possible to meet a grid rule only if
I want to add that many claims are denied which should have been paid. There is an appeal system in place to catch those errors and fix them. This requires a hearing before an administrative law judge. If your claim is denied, you must file a written appeal and ask for a hearing within 60 days. While it will probably take about 18 to 24 months to get before a judge, you only have 60 days to request a hearing.
__________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across From Bridge Street"
PHONE (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
1. Prove that you meet a Listing. Listings are published lists of medical impairments and extensive symptoms which are documented by acceptable medical evidence. Claimants of any age could meet a Listing.
2. Meet or equal a grid rule, also called a medical-vocational rule. It is possible to meet a grid rule only if
- You are age 50 or older and
- You have one or more exertional impairments in:
- Sitting
- Standing
- Walking
- Lifting
- Carrying
- Pushing, or
- Pulling
- Perform any of your past relevant work, which is any job your have done in the past 15 years, nor
- Perform any other work which exists in substantial numbers in the United States.
I want to add that many claims are denied which should have been paid. There is an appeal system in place to catch those errors and fix them. This requires a hearing before an administrative law judge. If your claim is denied, you must file a written appeal and ask for a hearing within 60 days. While it will probably take about 18 to 24 months to get before a judge, you only have 60 days to request a hearing.
__________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across From Bridge Street"
PHONE (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
TECHNICAL DENIALS: WHY SOME PEOPLE WILL NOT QUALIFY FOR SSDI
There are several reasons that you might not meet the technical requirements to file a Social Security disability claim. Here are a few of the more common disqualifying facts that we see:
1. You do not currently have insured status under the Social Security Act. Not everyone is covered by Social Security disability. Generally, you must have earned 40 quarters of work credits and 20 of them must have been earned during the last 10 years. So, your work credits must be recent enough. (Different rules apply to very young workers).
2. You are now working at substantial gainful activity (SGA). Social Security does not permit individuals who are still working and earning substantial wages to apply for disability, regardless of their age or medical condition. You are deemed to be working at substantial gainful activity if your salary, wages, tips or commissions total a gross of $1,180 per month. In short, if you are currently working and earning at least $1,180 per month you will not qualify for disability benefits.
3. You cannot demonstrate that you have a severe medically determinable impairment that has lasted for at least 12 consecutive months, is reasonably expected to last for 12 consecutive months, OR to end in death. Social Security has no short-term disability program. It does not pay for any disabling impairment which lasts for less than 12 consecutive months. An impairment is generally "medically determinable" if your doctor has diagnosed it with acceptable medical practices such as examinations, laboratory tests, imaging studies, etc.
NOTE: There is no requirement that you wait 12 months to file a claim after you become sick or injured. However, you must show by medical evidence that your impairment can reasonably be expected to have a duration of at least 12 months. If you are expected to be able to return to work within 12 months, you do not have a disability claim. This is called the Duration Requirement. Some medical conditions can reasonably be expected to last 12 months or more and others will not.
It is always a good idea to speak with someone who is knowledgeable about Social Security's rules and regulations as you try to decide your next step. This can save you a lot of time, wasted energy and maybe some heartache. Most attorney-advocates will provide you with free information and a free consultation in which your particular circumstances are analyzed to see how you should proceed. This can often be done with a simple 10 minute phone call, right from your home.
__________
Charles W. Forsythe
The Forsythe Firm
Social Security Disability Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 325806
CALL US: (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
1. You do not currently have insured status under the Social Security Act. Not everyone is covered by Social Security disability. Generally, you must have earned 40 quarters of work credits and 20 of them must have been earned during the last 10 years. So, your work credits must be recent enough. (Different rules apply to very young workers).
2. You are now working at substantial gainful activity (SGA). Social Security does not permit individuals who are still working and earning substantial wages to apply for disability, regardless of their age or medical condition. You are deemed to be working at substantial gainful activity if your salary, wages, tips or commissions total a gross of $1,180 per month. In short, if you are currently working and earning at least $1,180 per month you will not qualify for disability benefits.
3. You cannot demonstrate that you have a severe medically determinable impairment that has lasted for at least 12 consecutive months, is reasonably expected to last for 12 consecutive months, OR to end in death. Social Security has no short-term disability program. It does not pay for any disabling impairment which lasts for less than 12 consecutive months. An impairment is generally "medically determinable" if your doctor has diagnosed it with acceptable medical practices such as examinations, laboratory tests, imaging studies, etc.
NOTE: There is no requirement that you wait 12 months to file a claim after you become sick or injured. However, you must show by medical evidence that your impairment can reasonably be expected to have a duration of at least 12 months. If you are expected to be able to return to work within 12 months, you do not have a disability claim. This is called the Duration Requirement. Some medical conditions can reasonably be expected to last 12 months or more and others will not.
It is always a good idea to speak with someone who is knowledgeable about Social Security's rules and regulations as you try to decide your next step. This can save you a lot of time, wasted energy and maybe some heartache. Most attorney-advocates will provide you with free information and a free consultation in which your particular circumstances are analyzed to see how you should proceed. This can often be done with a simple 10 minute phone call, right from your home.
__________
Charles W. Forsythe
The Forsythe Firm
Social Security Disability Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 325806
CALL US: (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
3 MESSAGES YOU DON'T WANT TO SEND
Claimants who are unrepresented for Social Security claims may inadvertently send 3 messages to the judge that can hurt the case.
1. You may send the message that your claim is so weak that you couldn't find an attorney-advocate to represent you. Over 90 percent of claimants are represented. Judges aren't accustomed to dealing with "unrepped" claimants.
2. The judge may not expect you to show up for your hearing if you are unrepped. A high percentage of claimants who don't have representatives don't bother to show up for their hearings. Claimants with representation nearly always show up. This places a negative stigma on unrepped claimants.
3. Your hearing will probably be delayed for a few months if you show up unrepresented. The judge will offer to delay the hearing to provide time for you to find counsel. If you refuse, you will be asked to sign a waiver stating that you were offered a delay to find an attorney and you declined to do so. Judges really don't like to deal with unrepresented claimants. Once your hearing has been postponed, it can take 3 to 6 months to get back on the docket again.
There are many fine claimant's representatives in North Alabama who would like to help you with your Social Security hearing. Most of them will provide a free consultation and case evaluation with no obligation. You will only pay a fee if your case is successful and results in a back pay award. (And who wouldn't be glad to pay a small legal fee under those conditions)?
1. You may send the message that your claim is so weak that you couldn't find an attorney-advocate to represent you. Over 90 percent of claimants are represented. Judges aren't accustomed to dealing with "unrepped" claimants.
2. The judge may not expect you to show up for your hearing if you are unrepped. A high percentage of claimants who don't have representatives don't bother to show up for their hearings. Claimants with representation nearly always show up. This places a negative stigma on unrepped claimants.
3. Your hearing will probably be delayed for a few months if you show up unrepresented. The judge will offer to delay the hearing to provide time for you to find counsel. If you refuse, you will be asked to sign a waiver stating that you were offered a delay to find an attorney and you declined to do so. Judges really don't like to deal with unrepresented claimants. Once your hearing has been postponed, it can take 3 to 6 months to get back on the docket again.
There are many fine claimant's representatives in North Alabama who would like to help you with your Social Security hearing. Most of them will provide a free consultation and case evaluation with no obligation. You will only pay a fee if your case is successful and results in a back pay award. (And who wouldn't be glad to pay a small legal fee under those conditions)?
Monday, September 17, 2018
I WAS DENIED. DO I HAVE A BAD CLAIM?
If you have been denied Social Security disability benefits it doesn't mean that you have a bad claim or that you can't get paid. It means there is more work to be done on your case.
Let me illustrate it this way: Out of the last 100 Social Security claims that I have won, 8 of them were won at the application level and 92 were won with an appeal of a denied claim. Think about it. If those 92 individuals had given up because they got denied, none of them would have ever collected a dime.
If you've recently been denied Social Security disability, it does not mean that you have a bad claim. It certainly doesn't mean that it's time to give up. Here is what it does mean:
1. It's time to kick your claim up a level. Get it away from the Disability Determination Service and into the hands of an administrative law judge. This is where most claims finally get approved.
2. You need to have someone with experience review your case and decide what it needs to get approved. Does it need more medical evidence? Does your doctor need to present a treating source statement? How should you be prepared to face the judge when your hearing comes up?
3. You need encouragement as you wait up to 24 months to get a hearing. The wait is discouraging but remember that I may be able to get one month of benefits for you for each month you have to wait. So, you may walk away with a great deal of money, plus a monthly check.
I fear that too many claimants give up on their claims when they get that letter in the mail saying, "You are not entitled to benefits because you are not disabled according to our rules." THAT IS NOT A FINAL DECISION. A high percentage of those denials are overturned and the cases are paid.
Be aware of the 60 day rule. If you don't appeal your denial within 60 days, then the denial does become final and you have to start all over.
There is never a charge for me to look at your case (before or after you are denied). We will evaluate your claim to see what your next steps need to be--and if possible, we will help you take the next step.
I can also help you file your initial application for SSDI. You want a clean, complete application for two reasons:
1. You want the best chance possible of being approved right away, and
2. You want to lay the proper groundwork for an appeal in case your application is denied.
The Forsythe Firm works hard for hundreds of deserving disability claimants at all phases of the claims process. We can handle claims anywhere in the state of Alabama or in Middle Tennessee. We have also handled claims in Florida, Mississippi, Kentucky and Texas. Our work is always free until you win and collect back pay on your claim. And you always keep 100 percent of your monthly checks.
__________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
EMail Us: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
Let me illustrate it this way: Out of the last 100 Social Security claims that I have won, 8 of them were won at the application level and 92 were won with an appeal of a denied claim. Think about it. If those 92 individuals had given up because they got denied, none of them would have ever collected a dime.
If you've recently been denied Social Security disability, it does not mean that you have a bad claim. It certainly doesn't mean that it's time to give up. Here is what it does mean:
1. It's time to kick your claim up a level. Get it away from the Disability Determination Service and into the hands of an administrative law judge. This is where most claims finally get approved.
2. You need to have someone with experience review your case and decide what it needs to get approved. Does it need more medical evidence? Does your doctor need to present a treating source statement? How should you be prepared to face the judge when your hearing comes up?
3. You need encouragement as you wait up to 24 months to get a hearing. The wait is discouraging but remember that I may be able to get one month of benefits for you for each month you have to wait. So, you may walk away with a great deal of money, plus a monthly check.
I fear that too many claimants give up on their claims when they get that letter in the mail saying, "You are not entitled to benefits because you are not disabled according to our rules." THAT IS NOT A FINAL DECISION. A high percentage of those denials are overturned and the cases are paid.
Be aware of the 60 day rule. If you don't appeal your denial within 60 days, then the denial does become final and you have to start all over.
There is never a charge for me to look at your case (before or after you are denied). We will evaluate your claim to see what your next steps need to be--and if possible, we will help you take the next step.
I can also help you file your initial application for SSDI. You want a clean, complete application for two reasons:
1. You want the best chance possible of being approved right away, and
2. You want to lay the proper groundwork for an appeal in case your application is denied.
The Forsythe Firm works hard for hundreds of deserving disability claimants at all phases of the claims process. We can handle claims anywhere in the state of Alabama or in Middle Tennessee. We have also handled claims in Florida, Mississippi, Kentucky and Texas. Our work is always free until you win and collect back pay on your claim. And you always keep 100 percent of your monthly checks.
__________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
EMail Us: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
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