DISABILITY APPLICATIONS: DEALING WITH SOCIAL SECURITY & THE DDS

The Disability Determination Service (DDS) is located in Birmingham, AL.  This is a state run agency contracted by Social Security to examine disability claims and make the initial decision as to whether a claimant meets the rules for disability benefits.  Here are some of the things DDS typically does with a new claim:

• Order records from doctors and other medical providers
• Analyze medical records to determine what conditions/impairments you have
• Schedule any medical exams that they feel you need
• Obtain your past work history and classify your past relevant jobs
• Determine what your Residual Functional Capacity (RFC) is
• Decide whether you are eligible for benefits under Social Security rules
• Deny a majority of claims that they review (About two-thirds of all claims)

Here is why DDS will usually deny a claim at the first stage of the process:

1. DDS will allege that you can perform some other work, even if they admit that you cannot sustain any of your past relevant work.
2. DDS will assign more weight to the opinion of their own medical consultant than they will to the opinion of your treating doctors--even though this contradicts both federal regulations and Social Security's rules.
3. DDS will assign you an unreasonable residual functional capacity that will still permit certain kinds of work. While they usually admit that you have certain severe impairments, they will not make the leap that these impairments prevent all types of work, which is the requirement for awarding disability.

A key idea that we try to communicate here at the Forsythe Firm is:  A denial by the DDS is not the end of the claims process, it is just the beginning.  We hope for the best but prepare for the worst, realizing that DDS is a denial machine--churning out denials to even well qualified claimants in wholesale numbers.  That's what we're here for.  Contact us as soon as you are denied and we will begin an immediate appeal to the next level, helping to preserve your rights, obtain an approval of your claim and collect the back pay you deserve.  There are no upfront fees for our help.

There is no fee for any service we provide unless you win your claim and collect back payments dating back to the date you first became disabled (your alleged onset date or amended onset date).  We are LOCAL Social Security disability advocates, located across from the Bridge Street Town Centre in Huntsville.  Call us locally at (256) 799-0297 or visit https://forsythefirm.wixsite.com/website

STILL WORKING BUT CONSIDERING SOCIAL SECURITY DISABILITY?

Quite often we hear from individuals who are still working, but struggling, and considering Social Security disability benefits.  Here are some "must knows" if you are still working and thinking about a disability claim:

First, there is no disability benefit available from Social Security if you are working and earning more than $1,260 per month (the 2020 number). You must have stopped working to apply--or at least be earning less than $1,260 per month if working part-time.

Second, Social Security does not pay a benefit for the first full 5 months of disability.  At a minimum, you must be prepared for at least 6 months of no income after you stop working.  Getting approved within 6 months is, honestly, pretty much of a miracle.  It often takes much longer.

Third, not being able to perform your past work is not enough, in most cases, to qualify for Social Security disability benefits.  If you are under age 50, Social Security will look at your ability to perform other work, including jobs that are unskilled, sedentary and simple, routine jobs.   
Finally, you must be able to prove you have functional limitations that prevent you from working with significant medical evidence, preferably from your treating doctor(s), and preferably one of those doctors will be a specialist.

Social Security disability today is a hard row to hoe.  If you are working, I would encourage you to continue working as long as possible.  When you come to the point where you can no longer work because of medical reasons, only then is it time to apply for Social Security disability.

If you need our help with getting benefits, please call for a free consultation at no obligation.

WHAT IS A "PARTIALLY FAVORABLE" DISABILITY DECISION?

You attended a hearing on your Social Security disability claim.  A few weeks later, you receive a Notice of Decision in the mail that says you have received a Partially Favorable decision.  Does this mean that you are only partially disabled, not fully disabled?

ANSWER:  No.  Social Security does not make awards for partial disability.  You are either disabled or not disabled.  There is no such category as "partially disabled" within Social Security law.

A "partially favorable" decision means that the administrative law judge has found you to be disabled.  However, he or she has changed some material fact in your application.  Most often, this change involves the established onset date--the date you were found to have become disabled.  For example, in your application you may have alleged that you became disabled on June 1, 2012.  After reviewing the facts of the case, the judge may have decided that you did not become disabled until September 1, 2012.  Therefore, he will amended the onset date to September 1, a material change in the application.

This change will affect the amount of your back pay.  In short, you will not be paid for the months June - August, 2012, a loss of 3 months of  benefits.The amount of your monthly benefit will not be affected.  You are still considered disabled, but for not as long a period as you originally claimed.  Since you lost part of your period of disability, thus part of your back pay, the decision is partially favorable.  In other words, it is not as favorable to you as it would have been if the judge had found that you became disabled in June instead of September.

I often encounter well meaning public officials who believe that a "partially favorable" decision means that the claimant is only "partially disabled."  This is not the case because, as I have said, Social Security never makes any award for a "partial disability."  You are either disabled or you are not disabled - nothing in between.  The date on which you became disabled is an example of why a decision might be "partially favorable.:"

The confusion is complicated by the fact that some agencies, such as the Veterans Administration, do make partial disability awards.  A VA claim decision may find that a veteran is 50 percent disabled, or 80 percent disabled, for example.  However, Social Security will never make such an award.  With Social Security, it is all or none.

DISABILITY CLAIMS: WHAT YOU WISH YOU HAD KNOWN

You Must File a Timely Application.  You must apply for Social Security disability benefits within 5 years after you stop working.  Your insured status will expire, making a new claim impossible.  If there are gaps in your work history, you may have even less time to file a new claim.  Don't wait too long to file after you stop working.

You Must Have Enough Quarters of Work.  You become an insured person under the Social Security Act by working and paying FICA taxes.  Most adults need 20 quarters of work to be covered.  These 20 quarters generally must have been accumulated within the most recent 10 year period prior to filing a claim.  Very young individuals might need less than 20 quarters of work.

Your Disabling Condition Must Last At Least 12 Months.  Short term disability lasting less than 12 consecutive months is not covered by Social Security.  You must have an impairment that has lasted, or can be reasonably expected to last at least 12 months.

You Cannot Be Working When You Apply.  You may not be working at "substantial gainful activity" during the period you wish to receive disability benefits.  In 2015, Social Security classifies substantial gainful activity as earnings/wages of at least $1,090 per month.

You Must Have Medical Treatment.  Under Social Security regulations, a disabling impairment must be medically determinable.  Medical records must be available to support the impairment.  Medical treatment should be consistent and recent.

You Cannot Depend on a Social Security Doctor's Examination.  Social Security may send you to a doctor with whom they contract to perform an examination.  This exam will be brief and superficial.  In our experience, these exams fail to help the claimant 99% of the time.  Social Security will use this exam to deny your claim.

You Need Support From Your Own Doctor.  According to Social Security regulations, much weight will be given to opinions of your own treating doctor(s).  Your doctor should provide support and this includes more than just routine medical records. Try to get your doctor to provide you with a Medical Source Statement that lists your functional limitations, such as restrictions in sitting, standing, lifting, bending, kneeling, etc.  Mental restrictions, such as concentration and memory, should also be documented.

You May Need To Be Examined By a Specialist.  20 CFR 404.1527 provides that extra consideration may be given to a doctor who is a specialist practicing in his/her field of medicine.  For instance, if you have a bad back you may need an orthopedic specialist.  For arthritis or fibromyalgia, you would need to consult a rheumatologist.

You Must File An Appeal Within 60 Days If You Are Denied.  Only about 30 percent of applications are approved by Social Security at the initial level.  The other 70 percent must be appealed.  The 60 day deadline is absolute.  If you do not appeal within the 60 days your claim dies and there is no appeal.  Do not wait on medical evidence or anything else.  File your appeal immediately, then work on whatever needs to be done to shore up the case.

Most Appeals Are Handled By a Professional Disability Advocate or Attorney.  Social Security appeals comprise a highly specialized field and require knowledge, skill and experience.  Contact a professional advocate, such as the Forsythe Firm, to help you with the appeal.  We offer free claims evaluation and never charge a fee unless you win.  We will also help insure that you receive maximum benefits, including back payments. Reach us at (256) 799-0297.

https://forsythefirm.wixsite.com/website

VETERANS MAY GET EXPEDITED DISABILITY PAYMENTS.

Veterans may get expedited claim processing for Social Security disability benefits.

To get expedited processing, veterans must self identify and have a 100 percent permanent disability rating from the Veterans Administration.

By "self identify," we mean that the veteran must inform Social Security of their 100 percent VA disability rating at the time the application is filed.  We recommend sending a copy of both your DD-214 form and your VA awards letter that shows the percentage of disability award.

Does a 100% VA disability award guarantee approval of Social Security benefits?  No.  While a VA award does not automatically qualify for Social Security disability benefits, it does qualify for a much faster processing time--that is, a much quicker answer.  And, since the VA disability evaluation is similar to the Social Security evaluation process, the VA award can work in your favor.

If a vet receives Social Security disability benefits, will it reduce the VA benefits?  No.  Veterans paid into the Social Security trust fund during their military careers and may be entitled to Social Security benefits in addition to VA benefits.

What about veterans with a less than 100% VA award?  May they still be eligible for Social Security disability benefits?  Yes, of course.  

What if a veteran is not able to perform military duties but is still on active duty and is receiving full military pay?  He or she may still be eligible for Social Security disability benefits.  The key issue is whether or not the individual is able to perform the job, not whether he or she is receiving military pay.  Thus, a veteran should apply immediately for Social Security disability and not wait for a discharge from military duty, which would waste unnecessary time and lose benefits.

The Forsythe Firm is honored to review disability cases for veterans and help them decide the best course of action to receive Social Security disability benefits.  Consultations are absolutely without cost or obligation.  We only charge a fee if we represent you, win your case, and also recover past due or retroactive benefits (in a lump sum).  Please contact Charles Forsythe in Huntsville at (256) 799-0297.

Our office is located at the intersection of Old Madison Pike and Governors West directly in front of the Bridge Street Town Centre, near Arsenal Gate 2.