Under Social Security rules and regulations there are basically 3 ways to be approved for disability benefits:
1. Prove that you meet a Listing. Listings are published lists of medical impairments and extensive symptoms which are documented by acceptable medical evidence. Claimants of any age could meet a Listing.
2. Meet or equal a grid rule, also called a medical-vocational rule. It is possible to meet a grid rule only if
- You are age 50 or older and
- You have one or more exertional impairments in:
- Sitting
- Standing
- Walking
- Lifting
- Carrying
- Pushing, or
- Pulling
3. The third way you can get disability benefits is by proving that you are not able to
- Perform any of your past relevant work, which is any job your have done in the past 15 years, nor
- Perform any other work which exists in substantial numbers in the United States.
Social Security decision makers will take a step-by-step approach to analyze which of the above methods allows for an award of benefits. If neither of the 3 methods allows for an award, your claim will be denied.
I want to add that many claims are denied which should have been paid. There is an appeal system in place to catch those errors and fix them. This requires a hearing before an administrative law judge. If your claim is denied, you must file a written appeal and ask for a hearing within 60 days. While it will probably take about 18 to 24 months to get before a judge, you only have 60 days to request a hearing.
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Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across From Bridge Street"
PHONE (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
There are several reasons that you might not meet the technical requirements to file a Social Security disability claim. Here are a few of the more common disqualifying facts that we see:
1. You do not currently have insured status under the Social Security Act. Not everyone is covered by Social Security disability. Generally, you must have earned 40 quarters of work credits and 20 of them must have been earned during the last 10 years. So, your work credits must be recent enough. (Different rules apply to very young workers).
2. You are now working at substantial gainful activity (SGA). Social Security does not permit individuals who are still working and earning substantial wages to apply for disability, regardless of their age or medical condition. You are deemed to be working at substantial gainful activity if your salary, wages, tips or commissions total a gross of $1,180 per month. In short, if you are currently working and earning at least $1,180 per month you will not qualify for disability benefits.
3. You cannot demonstrate that you have a severe medically determinable impairment that has lasted for at least 12 consecutive months, is reasonably expected to last for 12 consecutive months, OR to end in death. Social Security has no short-term disability program. It does not pay for any disabling impairment which lasts for less than 12 consecutive months. An impairment is generally "medically determinable" if your doctor has diagnosed it with acceptable medical practices such as examinations, laboratory tests, imaging studies, etc.
NOTE: There is no requirement that you wait 12 months to file a claim after you become sick or injured. However, you must show by medical evidence that your impairment can reasonably be expected to have a duration of at least 12 months. If you are expected to be able to return to work within 12 months, you do not have a disability claim. This is called the Duration Requirement. Some medical conditions can reasonably be expected to last 12 months or more and others will not.
It is always a good idea to speak with someone who is knowledgeable about Social Security's rules and regulations as you try to decide your next step. This can save you a lot of time, wasted energy and maybe some heartache. Most attorney-advocates will provide you with free information and a free consultation in which your particular circumstances are analyzed to see how you should proceed. This can often be done with a simple 10 minute phone call, right from your home.
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Charles W. Forsythe
The Forsythe Firm
Social Security Disability Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 325806
CALL US: (256) 799-0297
EMAIL US: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
Claimants who are unrepresented for Social Security claims may inadvertently send 3 messages to the judge that can hurt the case.
1. You may send the message that your claim is so weak that you couldn't find an attorney-advocate to represent you. Over 90 percent of claimants are represented. Judges aren't accustomed to dealing with "unrepped" claimants.
2. The judge may not expect you to show up for your hearing if you are unrepped. A high percentage of claimants who don't have representatives don't bother to show up for their hearings. Claimants with representation nearly always show up. This places a negative stigma on unrepped claimants.
3. Your hearing will probably be delayed for a few months if you show up unrepresented. The judge will offer to delay the hearing to provide time for you to find counsel. If you refuse, you will be asked to sign a waiver stating that you were offered a delay to find an attorney and you declined to do so. Judges really don't like to deal with unrepresented claimants. Once your hearing has been postponed, it can take 3 to 6 months to get back on the docket again.
There are many fine claimant's representatives in North Alabama who would like to help you with your Social Security hearing. Most of them will provide a free consultation and case evaluation with no obligation. You will only pay a fee if your case is successful and results in a back pay award. (And who wouldn't be glad to pay a small legal fee under those conditions)?
If you have been denied Social Security disability benefits it doesn't mean that you have a bad claim or that you can't get paid. It means there is more work to be done on your case.
Let me illustrate it this way: Out of the last 100 Social Security claims that I have won, 8 of them were won at the application level and 92 were won with an appeal of a denied claim. Think about it. If those 92 individuals had given up because they got denied, none of them would have ever collected a dime.
If you've recently been denied Social Security disability, it does not mean that you have a bad claim. It certainly doesn't mean that it's time to give up. Here is what it does mean:
1. It's time to kick your claim up a level. Get it away from the Disability Determination Service and into the hands of an administrative law judge. This is where most claims finally get approved.
2. You need to have someone with experience review your case and decide what it needs to get approved. Does it need more medical evidence? Does your doctor need to present a treating source statement? How should you be prepared to face the judge when your hearing comes up?
3. You need encouragement as you wait up to 24 months to get a hearing. The wait is discouraging but remember that I may be able to get one month of benefits for you for each month you have to wait. So, you may walk away with a great deal of money, plus a monthly check.
I fear that too many claimants give up on their claims when they get that letter in the mail saying, "You are not entitled to benefits because you are not disabled according to our rules." THAT IS NOT A FINAL DECISION. A high percentage of those denials are overturned and the cases are paid.
Be aware of the 60 day rule. If you don't appeal your denial within 60 days, then the denial does become final and you have to start all over.
There is never a charge for me to look at your case (before or after you are denied). We will evaluate your claim to see what your next steps need to be--and if possible, we will help you take the next step.
I can also help you file your initial application for SSDI. You want a clean, complete application for two reasons:
1. You want the best chance possible of being approved right away, and
2. You want to lay the proper groundwork for an appeal in case your application is denied.
The Forsythe Firm works hard for hundreds of deserving disability claimants at all phases of the claims process. We can handle claims anywhere in the state of Alabama or in Middle Tennessee. We have also handled claims in Florida, Mississippi, Kentucky and Texas. Our work is always free until you win and collect back pay on your claim. And you always keep 100 percent of your monthly checks.
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Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
EMail Us: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
In our Social Security advocacy practice, we are often asked if it's a good idea to try to work while waiting on a disability decision. If I had to give a one-word answer, I would say, "No."
But it's a little more complicated than that. There is a technical answer and a practical answer. I will try to give both answers, because I realize people have to eat while they wait 2 years or more for Social Security to make up their minds.
THE TECHNICAL ANSWER:
Claimants are permitted to work at limited levels while pursuing an SSDI claim. If you are engaged in work which is not substantial gainful activity (SGA), it will not automatically disqualify you for SSDI benefits. In 2018, if your earnings are less than $1,180 per month, you are not engaged in substantial gainful activity.
THE PRACTICAL ANSWER:
With some judges, any work can jeopardize your case. Let's say you are working part-time and only earning $900 per month. That's well under the SGA limit of $1,180, so you have no problem, right? Not necessarily. Some judges will take the attitude that if you can earn $900 per month, you could earn $1,180 without much more effort. Their thought process goes something like this: "You're telling me that you can work enough to earn $900 a month, but you can't work enough to earn $1,180?"
I've actually had judges say to me, "In today's economy, a lot of jobs are part-time jobs. A person may be working a part-time job because that's the only job he can get, not necessarily because that's all he is able to do."
Let's say your part-time job requires you to be at work 8 hours per day each Monday, Wednesday and Friday. You are off Tuesdays and Thursdays. A judge may have a difficult time believing that you are able to work regularly and dependably on Mondays/Wednesdays/Fridays, but not on Tuesdays/Thursdays. So, I think there is more to look at than just the dollar amount of your earnings, although that's all the law addresses, technically.
So, while the written law permits you to earn up to $1,179 per month in wages, tips or commission and still be disabled, I'd much rather walk into a hearing with a claimant who isn't working at all than one who is earning $1,179 per month.
On the practical side, I think the rule of thumb is this: The closer you get to earning $1,180 per month, the bigger problem you may have with Social Security decision makers. Earning $500 per month may not cause any big issues, but earning $1,100 may create problems.
Each claimant has to decide for himself whether he needs the money a part-time job provides while they wait on Social Security to decide their claim. The same problem still exists after your disability case is approved. Persons who receive Social Security disability are also allowed to work below substantial gainful activity level. (Earning more than SGA wages will cause your disability check to be discontinued). What about earning $1,000 a month? Again, I think the rule is: The closer you come to SGA earnings, the bigger the potential for a problem you have.
Obviously, Social Security recognizes that people must eat while they wait months or years for a disability decision. I suppose that's why they allow limited, part-time work. But I have given you the truth of the matter here, as I have observed it during my years of work as a Social Security disability advocate. Be very informed about how working can affect your SSDI claim.
Here's a question we often get: "My insurance company found me to be disabled and is paying me a long term benefit. But Social Security says I am not disabled and will not pay me a benefit. How is this possible?"
It's possible for three reasons:
First, Social Security has their own definition of "disability." To them, it means 100 percent disability to the point of not being able to perform any type of full time work. If the SSA finds that you can still be a surveillance system monitor, a laundry folder or a ticket taker, they will deny your claim. Their definition of disability is the most restrictive of anyone I can think of. An insurance company may have a much less restrictive definition. To them it may simply mean that you are not able to continue doing the job to which you are prepared by education, training and experience. They don't expect you to switch careers and become a laundry folder or ticket taker.
Second, Social Security is entitled to make their own decision about who is disabled. They are not required to accept anyone else's decision, even decisions by other federal agencies. For example, you might be disabled under rules of the Veterans Administration but not under the rules of the Social Security Administration.
Third, Social Security requires 100 percent disability, while some other agencies and some insurance companies will approve disability benefits for less than 100 percent disability. For example, the Veterans Administration will award benefits for a partial disability. Workers Compensation may pay benefits for less than 100 percent disability. But Social Security will not.
It is proving that you are 100 percent totally unable to work ANY job listed in the Dictionary of Occupational Titles (DOT) that is so difficult with Social Security.
A very high percentage of SSDI claims get denied. The next step is to appeal the denial and ask for a hearing. The hearing is the best chance to win your claim, especially if you have professional representation who understands the complex set of regulations that Social Security employs.
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THE FORSYTHE FIRM
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL US: (256) 799-0297
EMAIL US: forsythefirm@gmail.com
Can a claimant present his or her own Social Security disability case before a judge. Yes, of course. But the pertinent question is this: "What tools are in your tool box?"
Unfortunately, many claimants will have to answer honestly, "My tool box is empty." Or, "I don't have a tool box."
If you set out to build or remodel a house, you must have a tool box - or perhaps a whole truck load of tools. Otherwise, you can't really expect to get the job done.
How can you expect to prevail at your own Social Security hearing if you don't have the tools to do the job?
Tools, in this example, means the knowledge of laws, rules, regulations and procedures used by the Social Security Administration to decide a case. Tools are the skills needed to handle problems and overcome objections to paying our claim. And, trust me, there will be objections and issues.
If the vocational witness testifies that you can perform sedentary work, do you have a "tool" to refute it? If not, you will lose your case then and there.
If the judge finds that your residual functional capacity allows for medium exertion level jobs, do you have the right tool to challenge that conclusion? If not, there goes your case.
If the judge questions whether you have been working at substantial gainful activity, do you know which tools you can use to get a favorable conclusion to that question?
I could go on and on and on. There are so many issues that can come up in a disability hearing that I can't count them all. The advantage of having a lawyer-advocate with you at the hearing is simply this: He or she will have a big bag full of tools that really work in handling these issues. At least, the attorney-advocate will have a much better chance than you will if you go in without a toolbox (or an empty one).
Just like a skilled carpenter can reach into his toolbox and get a tool to expertly fit a piece of trim, your advocate can pull out a tool and skillfully handle a problem in a way that conforms to the rules and regulations of the Social Security Administration. And this can mean the difference between losing and winning your benefits. In short, it can earn you about $500,000 in lifetime benefits, as opposed to losing all that money. It can make the difference between living pretty comfortably for the rest of your life or suffering.
Think about the question: WHAT IS IN YOUR TOOL BOX?
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Charles W. Forsythe, Partner
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Me: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
