#1 REASON SOCIAL SECURIY DENIES DISABILITY CLAIMS

 

Only about 27 percent of Social Security disability (SSDI) claims get approved at the application stage. While there can be several reasons for a denial, the number one reason is

Your impairment is not severe enough to qualify for disability

Basically, the Social Security rules require you to have a severe disability which makes you totally unable to work (at any job). Unlike many other programs, Social Security has no partial disability benefit. It is 100 percent or nothing.

It is rather difficult to prove that you are totally unable to perform any full-time job.

Also, a doctor is not allowed to certify that you are disabled or that you cannot work. These decisions by law are reserved for the Commissioner of Social Security. So, only Social Security can determine who is disabled or who is unable to work.

It's common for denial letters to state something like this: We have determined that you have some severe impairments. "You cannot perform the work you have done in the past. However, based your age, education and functional capacity, you are able to perform certain types of work."

Social Security's definition of 'disability' is very difficult to meet.

Individuals who are at least 50 years old have a better chance of being found 'disabled' by Social Security. Claimants age 55 and over have an even better chance. However, even these older claimants often have to "fight" through the long appeals process to get approved.

HOW TO GET DISABILITY BENEFITS (PAY) $$$$

 

If you look at thousands of successful Social Security disability claims, here are the things that stand out. Maybe you should consider these ideas of you're trying for disability pay:

1. Get a tried and proven Social Security attorney or advocate. Probably a waste of time without one.
2. See your doctor early and often and follow his/her treatment recommendations.
3. Get as many objective medical tests as you can (MRI, X-Ray, Ultrasound, labs, etc .).
4. Be careful not work and earn near $1,300 per month (gross). It disqualifies you.
5. Don't draw unemployment benefits if you can do without them. They hurt your case.
6. You will likely get unfavorable decisions (denials) along the way. Appeal them within the 60 day (strict) time limit.
7. Never, ever go before a judge alone. Never, ever. Take a good attorney/advocate with you. No exceptions.

Doing all these things won't guarantee success. However, failing to do these things will set you up for probable failure. It's all about increasing your chances. The above things give you the best chance to be approved and to get maximum benefits from your case, including thousands of dollars in retroactive pay (back pay).

IS IT TIME TO FILE FOR SOCIAL SECURITY DISABILITY?

 

One out of 4 Americans will suffer from total disability prior to reaching their retirement age. Disability may happen suddenly or it may come on gradually. But even young people can and often do become disabled.

When should you consider filing for disability benefits with Social Security? Here are some signs that you are ready to file:

1. You can no longer work a full 8-hour day. You may find yourself calling in sick, leaving work early or checking out before your shift is over. It may due to pain, fatigue, weakness or other reasons. But full workdays for you are becoming fewer and fewer.
2. Your doctor tells you that you have a severe medical condition that is not going to improve within the next year. Social Security has no short term benefits--but if you expect to be unable to do your work for a year or more in the future--it may be time to file.
3. Changing to an easier job won't allow to work full-time due to pain, fatigue, weakness or other medical problems. If you are under age 50, Social Security will want you to consider easier work before you start getting disability benefits.
4. You have either stopped working, or you have reduced your hours to a very part-time basis due to medical or mental impairments.
5. You are diagnosed with a medical condition that can result in death within the next year.

Social Security disability was designed for those who cannot work a full time job, 8 hours a day, 5 days per week--or an equivalent schedule because of a severe medical or mental impairment.

If you feel you meet such criteria, you should file for disability and enter the long process to being approved. Some individuals are approved within 6 months. Most, however, may require up to 12 months to be approved. Most claimants will need to go through the complicated appeals process before they can receive their benefits.

Can you continue working full-time and apply for disability before you stop work? No, unfortunately Social Security does not permit it. You should check with your employer to see if they have a disability plan through your work that may pay a benefit if you stop working. It may be possible to rely on those benefits until the Social Security application process can be completed.

If you need deciding whether it's time to apply for Social Security disability--or if you simply have questions--we invite to contact the Forsythe Firm in Huntsville at (256) 799-0297. The consultation is free. If we represent you, we never charge a fee unless we win your case and get Social Security back pay for you.

UNDERSTANDING YOUR DISABILITY DENIAL LETTER

 

If you've ever applied for Social Security disability, chances are you have received a denial letter.

At first glance the letter seems like a lot of legal mumbo jumbo. It may not make sense.

However, you need to read the letter thoroughly to find out why Social Security denied your claim. Understanding why the claim was denied is the first step to a successful appeal.

In most denial letters, the reason for the denial is given on the last page of the letter, and often in the final paragraph.

After 20 years in Social Security practice, we have found the 3 main reasons that disability claims are denied:

1. We find that you do have some impairments and you are not able to perform your past work. However, there is other work in the national economy that you could do.

This is a Step 5 denial. It most often occurs with claimants who are under age 50. Perhaps your past work was really demanding and you can no longer sustain it. However, if there are other, easier jobs in the national economy that you theoretically could perform, Social Security will deny the claim. Younger individuals are only disabled in Social Security's thinking if they are unable to do any type of full-time work.

2. We find that you have some impairments; however, you are still able to perform one or more of your past relevant jobs.

This is a Step 4 denial. Social Security believes that you are able to perform at least one of the jobs you have performed in the past 15 years. In this case, they will usually consider the easiest job you had within the 15 year period. For instance, if you had a desk job with very little walking, standing or lifting--Social Security will find that you could still perform that job.

3. You state that you are unable to work because of (list of conditions). We have been unable to obtain sufficient medical evidence to make a favorable decision on your claim.

Here, it is likely that you are being denied for one of two reasons:

a) Your application didn't list doctors or other providers who have records to verify your severe medical conditions, OR

b) The doctors you listed simply did not respond to Social Security's request for records.

Social Security will usually contact medical providers twice (usually by mail) to request records. If the records do not arrive within a few months, the claim is denied. It is important that you check with the Disability Determination Service (DDS) in your state to be sure that records from your medical providers have been sent in. Often, you (the patient) can contact the doctor or hospital and convince them to send the records in. Don't just assume that Social Security got all the records they need to make a decision. Often they do not.

The Forsythe Firm represents individuals who need disability benefits. One of our jobs is to make certain that the medical evidence needed to get a fair, accurate decision is submitted to Social Security. We work with doctors and other providers to obtain these records in a timely manner.

IS IT TIME TO FILE FOR SOCIAL SECURITY DISABILITY?

Social Security is an insurance program for workers that is sponsored by the US government. It covers most US workers while they are still working, and for a few years after they stop working.

Is Social Security disability right for you? Do you qualilfy? Should a disability application be your next step? It isn't right for everyone and it isn't possible for everyone. Answer these questions to see if disability through Social Security is right for you?

1. Have you stopped working because of a severe, debilitating medical condition?
2. Do you expect to be able to return to work within 12 months of disability onset?
3. If you are still working part-time, do you earn less than $1,310 per month (gross)? (If you earn at least $1,310 per month in gross earnings, you do not qualify).
4. Is your medical condition expected to last at least 12 straight months OR to end in death? (If not, your condition is not covered by Social Security).

Social Security disability (SSDI) is meant to provide some income to individuals with a sold work history who have become totally unable to work-- and this disability is either permanent or long-term. Long term is defined as lasting 12 straight months or more, is expected to last 12 consecutive months or more, OR is expected to end in death. Short term disability benefits are never provided by Social Security.

Another question you must ask yourself, "Can I financially survive for at least 6 months, maybe longer, if I stop working and apply for Social Security benefits? Under ideal conditions, Social Security will not pay a benefit for 6 months after the proven onset of your disability. This is because the law requires a 5 month waiting period, during which no benefits can be paid. Then, Social Security pays one month in the arrears. So, if your 5-month waiting period ends in June, you will be due a benefit check in July. But, the July payment won't occur until the following month. In other words, your first benefit payment will arrive in August. If you case has to go into appeals, it may be one year or more before you get your first payment.

Finally, you must consider your medical treatment. Are you current with medical treatment and in compliance with what your doctors have recommended? Are medical records available that prove the severity of your condition(s) and show that you cannot perform any type of full-time job (and this condition has lasted or will last for 12 straight months)? Without medical records, your claim will go nowhere. Do you need to establish medical treatment before you file a disability claim? The most brilliant attorney in the world cannot get benefits approved without medical evidence that is clear and convincing (and current).

What is the deal on "work credits" and whether or not you are covered by SSDI?

In general terms, you must have worked at least 5 out of the most recent 10 year period. Since you can earn up to 4 work credits per year, working for 5 consecutive years would give you 20 work credits. This is required for most SSDI disability claims. An individual who stopped working (for any reason) more than 5 years ago, may not have insured status with Social Security, even if he/she is fully disabled. It is possible to meet the "medical requirements" for SSDI but fail to meet the "non-medical requirements."

A short, free consultation with one of our disability advocates can help clear all this up for you, and tell you whether or not an SSDI claim is possible for you. We can also provide you with an individual case evaluation and help you understand the strengths and weakness of your case.

Contact the Forsythe Firm at (256) 799-0297. The consultation is free with no obligations.

 

SOCIAL SECURITY DISABILITY: MEDICAL AND NON-MEDICAL REQUIREMENTS

 

When you apply to receive a Social Security disability benefit (SSDI), you must meet both the medical and non-medical rules.

THE MEDICAL RULES. You must prove that you are totally unable to perform either previous work or any other full-time work which exists in the national economy. Social Security will require objective medical data from your doctor(s) to prove this.

THE NON-MEDICAL EVIDENCE. You must show that you are a US citizen or legal resident. You must show that you are not currently working at Substantial Gainful Activity (SGA). Most importantly, you will need to have the required number of work credits associated with your Social Security account. Generally, a claimant must have worked at least 5 years out of the most recent 10-year period to be covered.

Work credits earned more than 5 years ago may have expired, leaving you uninsured for Social Security disability benefits.

One of the services provided by disability attorneys is a review of your case to see if you meet the rules to get a benefit. Most attorneys/advocates perform this review free of any cost or obligation.