The Social Security Administration speaks to itself in its own language which is foreign to most claimants. When you attend a disability hearing, the following abbreviations will be tossed around freely. I'm giving you a sort of dictionary of common Social Security terms and what they mean.
ALJ - Administrative Law Judge - is the person who presides over hearings and who will decide if you can receive benefits.
AOD - Alleged Onset Date - is the date on which a claimant says he/she first became disabled. Often, benefits can be paid back to this date.
DDS - Disability Determination Service - is the name of a state agency contracted with Social Security to process new disability claims and make the initial determination as to whether the claimant is entitled to benefits. DDS denies over 75% of all claims.
DLI - Date Last Insured - is the date on which a claimant's coverage for disability benefits will expire. This date is usually 5 years after he/she stops working. It can be very difficult to file a new claim after the DLI.
DOT - Dictionary of Occupational Titles - a standardized data base of jobs listing the job description, exertion level and the level of skill required to do the job. Published in the 1930s, the DOT was last updated in the 1990s but has become the "Bible" of work for the Social Security Administration, even though it is grossly out of date.
ME - Medical Expert - a doctor who may be asked by Social Security to review a claimant's medical records and/or appear at a hearing to advise the administrative law judge on such issues as whether a claimant meets a medical Listing, etc.
OTR - On the Record Decision - is a fully favorable decision issued by an administrative law judge or senior legal advisor without a hearing. This is issued when the evidence in the record overwhelmingly supports a decision of disabled.
PFD - Protected Filing Date - is the date a claimant first contacts the Social Security Administration and expresses an interest in filing a disability claim. The PFD may be earlier than the application date. This date often determines the earliest date a claimant may begin getting SSI benefits.
PRW - Past Relevant Work - is the work you have performed in the past 15 years, which (a) was performed at Substantial Gainful Activity level and (b) was performed long enough to learn how to do the job.
RFC - Residual Functional Capacity - is the most a person is able to do in terms of work-like activity. It measures whether a person is capable of exertion at the sedentary, light, medium, heavy or very heavy categories (ranging from easiest to most difficult).
SGA - Substantial Gainful Activity - is the level of work which is considered enough to (a) disqualify a person for SSDI benefits and (b) count as past relevant work in a claimant's past work history. In 2018, if you work and earn at least $1,180 per month, you are engaged in SGA. The number increases slightly each year due to inflation.
SSDI - Social Security Disability Insurance (Income) - is the name of the Title II disability program, funded by FICA taxes withheld from a worker's pay and paid into the government's trust fund. Only workers earn SSDI coverage. SSDI benefits are usually quite a bit higher than SSI benefits.
SSI - Supplemental Security Income - is a government program for elderly and disabled individuals who have very low household incomes and few financial resources. Unlike SSDI, it does not require work history to be covered. Currently the maximum SSI benefit is $750 per month.
VE - Vocational Expert - sometimes shown as "VW" for Vocational Witness. This is a jobs expert called by Social Security to attend hearings. The VE answers the judge's questions about how certain functional limitations impact the ability to perform work in the national economy. Nearly all hearings on adult disability cases will have a VE present.
Understanding some of these terms may make Social Security a bit less confusing. Of course, it won't make you an expert. So you may want to consider getting an expert to help you file and pursue your claim for benefits.
______________
By: Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
THE FORSYTHE FIRM: 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.
Thursday, September 13, 2018
WHAT DISEASES WILL QUALIFY FOR DISABILITY BENEFITS?
What medical conditions will qualify me for Social Security disability?
The answer is, any medical impairment may qualify you for benefits, as long as the following are met:
1. The condition is medically determinable. This means your doctor knows what causes it and has taken steps to diagnose your exact problem.
2. The condition has lasted 12 consecutive months, is expected to last for 12 consecutive months, OR is expected to end in death.
3. It is a severe medical condition with symptoms so severe that it prevents you from being able to work.
Number 3 is the most difficult to prove. Merely being diagnosed with a medical condition will usually not show that you are disabled. For example, you may have migraine headaches but if you can still work you are not disabled. You may have diabetes but if you can still work you are not disabled. It is the severity of the condition that may be disabling.
And this all boils down to medical evidence. Your doctor holds the key. When you file a disability claim, be sure that Social Security obtains all your medical records from every doctor, hospital, clinic, emergency room or other provided who has treated you. You must report the name, address and telephone number of each doctor on your application. Social Security will pull the records (but only the ones you tell them about).
Evaluating a Social Security disability claim is pretty complex. There are several factors, other than medical history, that must be considered. These include age, past work history and education. All of these factors will influence the medical-vocational guidelines or "grid rules" and affect the probable outcome of your claim.
Finally, you should know that Social Security is prone to deny over 75 percent all applications right off the bat. So, be prepared for a denial. Respond with an appeal within the 60 day deadline. The appeal is your best chance to be approved.
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
The answer is, any medical impairment may qualify you for benefits, as long as the following are met:
1. The condition is medically determinable. This means your doctor knows what causes it and has taken steps to diagnose your exact problem.
2. The condition has lasted 12 consecutive months, is expected to last for 12 consecutive months, OR is expected to end in death.
3. It is a severe medical condition with symptoms so severe that it prevents you from being able to work.
Number 3 is the most difficult to prove. Merely being diagnosed with a medical condition will usually not show that you are disabled. For example, you may have migraine headaches but if you can still work you are not disabled. You may have diabetes but if you can still work you are not disabled. It is the severity of the condition that may be disabling.
And this all boils down to medical evidence. Your doctor holds the key. When you file a disability claim, be sure that Social Security obtains all your medical records from every doctor, hospital, clinic, emergency room or other provided who has treated you. You must report the name, address and telephone number of each doctor on your application. Social Security will pull the records (but only the ones you tell them about).
Evaluating a Social Security disability claim is pretty complex. There are several factors, other than medical history, that must be considered. These include age, past work history and education. All of these factors will influence the medical-vocational guidelines or "grid rules" and affect the probable outcome of your claim.
Finally, you should know that Social Security is prone to deny over 75 percent all applications right off the bat. So, be prepared for a denial. Respond with an appeal within the 60 day deadline. The appeal is your best chance to be approved.
SOCIAL SECURITY JUSTICE: THE FORSYTHE FIRM
HOW TO GET THE MOST MONEY OUT OF YOUR SOCIAL SECURITY DISABILITY CASE
You have a Social Security claim in the making. Of course, you want the maximum money out of it. You won't get it automatically; you will have to fight for it. There are things you can do to maximize your benefits. Here are some of them:
1. Take your alleged onset date (AOD) back as far as possible. In other words, claim that your disability began as far back as possible. This will increase the amount of your back pay. You can actually claim disability up to one year before you file your application under some circumstances. The judge will challenge your onset date, so you must be prepared to defend it.
2. Be sure that your medical evidence goes back to the alleged onset date. Most people think in terms of proving that they are disabled now. But in reality, you want to prove to prove that you were disabled then, i.e., at your alleged onset date in the past. You must present medical evidence to prove that. So, for example, if you claim to have become disabled on July 1, 2015, you need medical records going back at least to that date.
2. Be sure all of your past work has been properly reported to the Social Security Administration. Most of the time it has, but I've seen cases where a year or more of work is missing. That can affect the amount of the monthly benefit.
3. Consider using an attorney-advocate who knows how to maximize your benefits. Believe me, it's really easy to get a disability claim derailed and either lose it outright, or let thousands of dollars in past due benefits slip away. A professional knows exactly how much to push for more back pay but he also knows when to step back and not jeopardize the case with the judge. As the claimant, you are simply not able to do this for a variety of reasons, be it intimidation, inexperience or simply not knowing what the rules allow you to do. Get a free professional evaluation before you strike out for the courtroom alone.
_____________
The Forsythe Firm
7027 Old Madison Pike
Suite 108
Huntsville, AL 5806
"Across from Bridge Street"
PHONE (256) 799-0297
E-mail us: forsythefirm@gmail.com
1. Take your alleged onset date (AOD) back as far as possible. In other words, claim that your disability began as far back as possible. This will increase the amount of your back pay. You can actually claim disability up to one year before you file your application under some circumstances. The judge will challenge your onset date, so you must be prepared to defend it.
2. Be sure that your medical evidence goes back to the alleged onset date. Most people think in terms of proving that they are disabled now. But in reality, you want to prove to prove that you were disabled then, i.e., at your alleged onset date in the past. You must present medical evidence to prove that. So, for example, if you claim to have become disabled on July 1, 2015, you need medical records going back at least to that date.
2. Be sure all of your past work has been properly reported to the Social Security Administration. Most of the time it has, but I've seen cases where a year or more of work is missing. That can affect the amount of the monthly benefit.
3. Consider using an attorney-advocate who knows how to maximize your benefits. Believe me, it's really easy to get a disability claim derailed and either lose it outright, or let thousands of dollars in past due benefits slip away. A professional knows exactly how much to push for more back pay but he also knows when to step back and not jeopardize the case with the judge. As the claimant, you are simply not able to do this for a variety of reasons, be it intimidation, inexperience or simply not knowing what the rules allow you to do. Get a free professional evaluation before you strike out for the courtroom alone.
_____________
The Forsythe Firm
7027 Old Madison Pike
Suite 108
Huntsville, AL 5806
"Across from Bridge Street"
PHONE (256) 799-0297
E-mail us: forsythefirm@gmail.com
Wednesday, September 12, 2018
SOCIAL SECURITY OVERPAYMENT: "YOU MEAN I HAVE TO PAY THEM BACK?"
I've had about 5 calls during the last 30 days from people who owe money back to Social Security and they are calling me to see if there is some way to avoid repaying the money.
This happens when someone accepts benefits from Social Security that they were not entitled to. They just keep cashing the checks. Eventually, Social Security catches on and demands their money back. And this puts the beneficiary in a really bad fix.
An individual called me recently (not one of my clients) because Social Security was demanding repayment of $68,000. Apparently, this individual had qualified for a disability payment, then sometime later she went back to work. She worked and kept cashing her Social Security checks for a few years. Social Security can be really slow and it may take them a while to catch on. But eventually they do--and they will then demand the money be repaid.
Can a lawyer get you out this mess? Probably not. If you take money from Social Security that you are not entitled to, you probably will have to pay it back.
This usually happens when someone goes back to work and keeps on cashing Social Security checks. This is just never, never a good idea!
If you are getting an SSDI or SSI benefit and decide to go back to work, you must report your earnings to the Social Security Administration. I recommend you do so in writing and keep a copy of the letter. (Individuals tell me, "I called Social Security and told them I was working and they just said it was OK"). This will not fly when the government comes looking for it's money back!
There could be some instances where an individual could work and still be legally entitled to a Social Security check. The Ticket to Work program would be an example, but it has rules and limits. Be sure Social Security knows about your job, how much you work and how much you make. And again, put it in writing. You simply cannot prove that a telephone call took place or what was said. Besides that, telephone calls do not entitle anyone to violate federal laws.
Stay out of trouble. You don't want the government knocking on your door, looking for money back. If you take money you are not entitled to, you cannot get away with it. Eventually the sleepy old Social Security dinosaur will wake up, realize that there's a fire under its tail, and come looking for you. And it will hurt!
This happens when someone accepts benefits from Social Security that they were not entitled to. They just keep cashing the checks. Eventually, Social Security catches on and demands their money back. And this puts the beneficiary in a really bad fix.
An individual called me recently (not one of my clients) because Social Security was demanding repayment of $68,000. Apparently, this individual had qualified for a disability payment, then sometime later she went back to work. She worked and kept cashing her Social Security checks for a few years. Social Security can be really slow and it may take them a while to catch on. But eventually they do--and they will then demand the money be repaid.
Can a lawyer get you out this mess? Probably not. If you take money from Social Security that you are not entitled to, you probably will have to pay it back.
This usually happens when someone goes back to work and keeps on cashing Social Security checks. This is just never, never a good idea!
If you are getting an SSDI or SSI benefit and decide to go back to work, you must report your earnings to the Social Security Administration. I recommend you do so in writing and keep a copy of the letter. (Individuals tell me, "I called Social Security and told them I was working and they just said it was OK"). This will not fly when the government comes looking for it's money back!
There could be some instances where an individual could work and still be legally entitled to a Social Security check. The Ticket to Work program would be an example, but it has rules and limits. Be sure Social Security knows about your job, how much you work and how much you make. And again, put it in writing. You simply cannot prove that a telephone call took place or what was said. Besides that, telephone calls do not entitle anyone to violate federal laws.
Stay out of trouble. You don't want the government knocking on your door, looking for money back. If you take money you are not entitled to, you cannot get away with it. Eventually the sleepy old Social Security dinosaur will wake up, realize that there's a fire under its tail, and come looking for you. And it will hurt!
5 GUARANTEED WAYS TO LOSE YOUR DISABILITY BENEFITS
Unfortunately, a lot of people who call me have already lost their disability hearing. Often, by the time they call me it's too late to help. There's often a common thread that runs through our conversations. Here are some common things that I see which will almost guarantee a denial of your Social Security benefits.
1. Working after your alleged onset date, especially if you had gross earnings of over $1,180 per month. This will always get you a step 1 denial.
2. Lying to the judge about anything. I don't know why people do this. They always get caught. And chances are, if they had told the truth it wouldn't have hurt their case, anyway. Claimants may lie about anything but favorite topics to lie about include smoking, drinking, being arrested and not being able to drive.
3. Quitting work for some reason other than being disabled. There may be a lot of good reasons to quit your job but Social Security won't pay for most of them. They only pay a benefit if you stopped working because of a physical and/or mental condition that made it impossible to keep working. They do not pay for quitting to go to school, caring for a sick child or relative, plant closings, layoffs, moving or family problems.
4. Failure to get or comply with medical treatment. The claimant has the burden of proof and that proof must consist of records from an acceptable medical source, which usually means a doctor. Failure to get regular treatment and medical evaluations will get a claim denied as fast as anything. I realize many people who can't work don't have insurance or money for doctors. If you are in that situation, try to find a community free clinic who will treat you. There are low cost options out there. My office can provide a list.
5. Failure to show up for your hearing. Believe it or not, a lot of people wait 2 years or longer to get a hearing, then just don't show up. When this happens, the judge will most likely dismiss the case. That means, "Goodbye. File a new claim if you wish but you will have to wait 2 more years to get a new hearing scheduled." And judges take very few excuses for now showing up at hearings. Best advice: If you have a real emergency that prevents you from attending a hearing, first notify your attorney or representative. If you are not represented, call the judge's office as soon as you know you won't be able to attend and explain why. If you have a true emergency, the judge can issue a "Show Cause" order, giving you the right to explain why you had to miss the hearing. If this is accepted, your hearing may be simply rescheduled within 2 or 3 months and you don't have to reapply and start over.
1. Working after your alleged onset date, especially if you had gross earnings of over $1,180 per month. This will always get you a step 1 denial.
2. Lying to the judge about anything. I don't know why people do this. They always get caught. And chances are, if they had told the truth it wouldn't have hurt their case, anyway. Claimants may lie about anything but favorite topics to lie about include smoking, drinking, being arrested and not being able to drive.
3. Quitting work for some reason other than being disabled. There may be a lot of good reasons to quit your job but Social Security won't pay for most of them. They only pay a benefit if you stopped working because of a physical and/or mental condition that made it impossible to keep working. They do not pay for quitting to go to school, caring for a sick child or relative, plant closings, layoffs, moving or family problems.
4. Failure to get or comply with medical treatment. The claimant has the burden of proof and that proof must consist of records from an acceptable medical source, which usually means a doctor. Failure to get regular treatment and medical evaluations will get a claim denied as fast as anything. I realize many people who can't work don't have insurance or money for doctors. If you are in that situation, try to find a community free clinic who will treat you. There are low cost options out there. My office can provide a list.
5. Failure to show up for your hearing. Believe it or not, a lot of people wait 2 years or longer to get a hearing, then just don't show up. When this happens, the judge will most likely dismiss the case. That means, "Goodbye. File a new claim if you wish but you will have to wait 2 more years to get a new hearing scheduled." And judges take very few excuses for now showing up at hearings. Best advice: If you have a real emergency that prevents you from attending a hearing, first notify your attorney or representative. If you are not represented, call the judge's office as soon as you know you won't be able to attend and explain why. If you have a true emergency, the judge can issue a "Show Cause" order, giving you the right to explain why you had to miss the hearing. If this is accepted, your hearing may be simply rescheduled within 2 or 3 months and you don't have to reapply and start over.
ALABAMA VS. TENNESSEE SOCIAL SECURITY BENEFITS
I advocate for disability claimants in Alabama and Tennessee. The question often comes up, is the Social Security process the same for both states? Surprisingly, it is not.
While Social Security is a federal program, the initial decision making process is handled by the state. The program is a little more complicated in Tennessee and a little more streamlined in Alabama.
This is because Tennessee using a process called Reconsideration and Alabama does not. Reconsideration simply means that if your application is denied, you have to re-submit it and have it reviewed again by the same state agency that denied it the first time. This takes about 4 to 6 months and you nearly always get the same decision second time around. It's basically just a time waster. After the second denial, you can file an appeal with an Administrative Law Judge, where something might finally get approved.
In Alabama, you can file the appeal with the judge right after the first denial. You eliminate the time-wasting "Reconsideration" phase. So, while the disability process in Alabama can take 24 months or more, it is several months faster than it is in Tennessee.
Some people who live in Alabama may still have their appeals sent to a judge in Tennessee. Some of my clients get their appeals sent to a judge in Franklin, TN, even though the claimants live in Alabama. When this happens, you will follow Alabama rules. You don't have to mess with Tennessee's "Reconsideration" as long as you are an Alabama resident.
Social Security disability is so tricky these days, I'd recommend you start with an attorney or advocate who knows the law and the process. Whether you live in Alabama or Tennessee, talking to an attorney will be well worth your time.
_____________
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
(256) 799-0297
The Forsythe Firm
725 Cool Springs Boulevard
Franklin, TN 37067
While Social Security is a federal program, the initial decision making process is handled by the state. The program is a little more complicated in Tennessee and a little more streamlined in Alabama.
This is because Tennessee using a process called Reconsideration and Alabama does not. Reconsideration simply means that if your application is denied, you have to re-submit it and have it reviewed again by the same state agency that denied it the first time. This takes about 4 to 6 months and you nearly always get the same decision second time around. It's basically just a time waster. After the second denial, you can file an appeal with an Administrative Law Judge, where something might finally get approved.
In Alabama, you can file the appeal with the judge right after the first denial. You eliminate the time-wasting "Reconsideration" phase. So, while the disability process in Alabama can take 24 months or more, it is several months faster than it is in Tennessee.
Some people who live in Alabama may still have their appeals sent to a judge in Tennessee. Some of my clients get their appeals sent to a judge in Franklin, TN, even though the claimants live in Alabama. When this happens, you will follow Alabama rules. You don't have to mess with Tennessee's "Reconsideration" as long as you are an Alabama resident.
Social Security disability is so tricky these days, I'd recommend you start with an attorney or advocate who knows the law and the process. Whether you live in Alabama or Tennessee, talking to an attorney will be well worth your time.
_____________
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
(256) 799-0297
The Forsythe Firm
725 Cool Springs Boulevard
Franklin, TN 37067
Sunday, September 9, 2018
BACK PAIN AND SOCIAL SECURITY DISABIITY
The 33 moving parts of the human spine cause major problems, especially as we age. We can develop a natural process called degenerative disc disease. Social Security awards more payments for back and musculoskeletal impairments than for any other disorder.
But what will you need to be successful with a Social Security disability claim for back pain?
First, you will need for a doctor to diagnoses why you are having pain. An orthopedic doctor is best. The diagnosis should be based on X-rays, MRI or other imaging studies. You cannot get a disability benefit with a subjective complaint of back pain.
Second, Social Security will want to see where your doctor has described your symptoms. When did they start, how have they progressed and how severe are they? What type of medical treatment or intervention has our doctor tried to make you better? Medications? Injections? Physical therapy? Surgery?
Third, how do your medical symptoms translate into work restrictions? How does the back pain affect your specific ability to sit, stand, walk, lift, carry, push and pull? Since most routine medical records do not address these functional areas, you should ask you doctor to complete a Residual Functional Capacity form.
HOW SEVERE MUST YOUR FUNCTIONAL LIMITATIONS BE IN ORDER TO GET A DISABIILTY CHECK?
Answer: It depends on your age.
Age 50 and younger: You generally must be unable to perform any type of work which exists in the U.S. economy on a full-time basis. This includes the inability to do the easiest of all jobs, which would be jobs at the sedentary exertion level.
Age 50 and older: You must be unable to perform any of your past relevant work, i.e., the work you have done during the most recent 15 year period.
So, your past work history plays a very important role in determining whether you are found disabled. (Question: Did you do a good job filling out your Work History Report back when you first applied for benefits? Most people don't and it comes back to hurt them here).
Frankly, you should consider getting an attorney before you touch a Social Security disability application. Many people try it alone and by the time they find out that wasn't a good idea, it is too late.
_______
THE FORSYTHE FIRM
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Us: forsythefirm@gmail.com
But what will you need to be successful with a Social Security disability claim for back pain?
First, you will need for a doctor to diagnoses why you are having pain. An orthopedic doctor is best. The diagnosis should be based on X-rays, MRI or other imaging studies. You cannot get a disability benefit with a subjective complaint of back pain.
Second, Social Security will want to see where your doctor has described your symptoms. When did they start, how have they progressed and how severe are they? What type of medical treatment or intervention has our doctor tried to make you better? Medications? Injections? Physical therapy? Surgery?
Third, how do your medical symptoms translate into work restrictions? How does the back pain affect your specific ability to sit, stand, walk, lift, carry, push and pull? Since most routine medical records do not address these functional areas, you should ask you doctor to complete a Residual Functional Capacity form.
HOW SEVERE MUST YOUR FUNCTIONAL LIMITATIONS BE IN ORDER TO GET A DISABIILTY CHECK?
Answer: It depends on your age.
Age 50 and younger: You generally must be unable to perform any type of work which exists in the U.S. economy on a full-time basis. This includes the inability to do the easiest of all jobs, which would be jobs at the sedentary exertion level.
Age 50 and older: You must be unable to perform any of your past relevant work, i.e., the work you have done during the most recent 15 year period.
So, your past work history plays a very important role in determining whether you are found disabled. (Question: Did you do a good job filling out your Work History Report back when you first applied for benefits? Most people don't and it comes back to hurt them here).
Frankly, you should consider getting an attorney before you touch a Social Security disability application. Many people try it alone and by the time they find out that wasn't a good idea, it is too late.
_______
THE FORSYTHE FIRM
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Us: forsythefirm@gmail.com
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