BEWARE OF SOCIAL SECURITY DEADLINES

Social Security has very strict deadlines for most filings.  The deadline to file an appeal on a denial, a partially favorable decision--or any other unfavorable decision--is 60 days.  This is a regulatory deadline and you cannot miss it.

This is important because the appeal process is where most disability claims are finally won.  Miss the deadline and you've missed the best chance you had for victory.

There are lots of excuses for missing a deadline.  But Social Security won't accept most of them.  So, if there is a decision you don't agree with, file an appeal within the deadline!

HOW UNEMPLOYMENT COMPENSATION AFFECTS A SOCIAL SECURITY DISABILITY CLAIM

Many judges frown on a claimant who has received Unemployment benefits since becoming disabled.  I've seen judges either deny claims or amend the onset date to the date unemployment benefits were stopped, costing a lot of money in back pay.  I even had one judge insist that the claimant repay unemployment benefits as a condition to getting SSDI benefits approved.

What Should Your Representative Argue Regarding Unemployment Benefits?

1)  Unemployment Compensation is not Substantial Gainful Activity because it does not involve work.  Therefore, it should not interfere with Social Security disability benefits.

2)  In the words of former Chief Administrative Law Judge Frank A. Cristaudo, "an individual need not choose between applying for unemployment insurance and Social Security disability benefits..." since the Social Security disability process can take months or years.

In a memo to all administrative law judges in 2010, Chief ALJ Cristaudo reminded judges that receipt of unemployment benefits does not preclude the receipt of SSDI benefits in many cases.  (Chief Administrative Law Judge Memorandum 10-1258, August 9, 2010).

3.  There is no clear rule in the federal regulations which prohibits receiving unemployment benefits and Social Security disability benefits at the same time.

It should be noted that many judges will use the issue of unemployment benefits to question the claimant's credibility.  While unemployment payments require an individual to be able to work, available for work and looking for work--Social Security disability requires that an individual prove that he/she is not able to work, at least at some exertion levels.  Unemployment and SSDI rules seem to contradict each other.  A claimant tells unemployment officials that he is able to work but tells Social Security that he is not.

So, the issue of unemployment benefits will usually come up in Social Security disability appeals or hearings.  I've had a few judges that didn't bring up the issue but most will.  Your representative will need to deal with it at the hearing level.

Is it better not to receive unemployment benefits after you allege disability?  Yes, that is better--but it may not be possible.  I tell my clients frankly, "It's better not to receive unemployment benefits; however, your first concern is not starving to death or losing your home while you're waiting on Social Security.  So do what you must do."

NO INSURANCE. NO DOCTOR. CAN YOU GET DISABILITY BENEFITS?

I often encounter individuals who need disability benefits but they have no doctor because they don't have health insurance and can't afford doctors.

It's a problem because Social Security always requires medical evidence to approve a disability claim. You can explain to them why you have no doctor but it doesn't solve the problem of no medical evidence.

What I recommend is to seek out one of the free medical clinics in North Alabama.  There are a number of doctors and clinics that will treat individuals with no health insurance, either without a fee or with a greatly reduced fee that is affordable.

Can you just go ahead and apply for benefits without seeing a doctor?  Yes, of course you can.  However, your case probably won't make it through the five-step process.  You will most likely stall out at Step 2:  no evidence of severe medically determinable impairment.

Won't Social Security send you to see one of their doctors?  They might but there's no guarantee.  If they do, there is still a big problem.  In a vast majority of cases, the consulting doctor from Social Security will not provide information that helps get your claim approved.  Most often, this doctor's exam will result in a denied claim.

You are nearly always better off to depend on your own doctor, not a Social Security consulting doctor.

How do you get a list of free or lower cost medical clinics?  My office provides that list free.  Using it, you may be able to find a doctor you can afford or a clinic right in your community, or close by.

HELP! WHERE ARE MY DISABILITY BENEFITS - ALABAMA EDITION

I frequently get calls from individuals who say, "I've applied for disability benefits 3 times and still can't get approved."  This is a common problem.  And right away, I can see where the problem lies.

This individual has been re-applying or filing a new application after each denial.  He believes the next application will have a better outcome than the one before.  The problem is, the same agency will look at the same information and reach the same decision--another denial.

Most of the time, it simply does no good to keep filing new applications.  This is NOT the way to deal with denied claims.

You can't "wear down" Social Security's resistance by asking them for a benefit over and over again.  Once they say No, the answer will be NO until:  (1) There is some material change in your situation:  new age category, new medical evidence, etc., or (2) You kick the denied claim into the appeal process and get someone at a higher level to review it.  This will be an administrative law judge (ALJ).

The dangers of simply filing a new claim after each denial are:

1.  You are spinning your wheels within the same agency, going nowhere.

2.  Your Date Last Insured (DLI) is running out.  Yes, disability benefits come with expiration dates.  You may reach a point where you can't file a new claim because your work credits have expired.

Once your disability claim has been denied, there are TWO appeals that should be filed (not at the same time).

A.  Reconsideration:  This is the next required step where the state agency that denied your claim gets a chance to "reconsider" it.  They will deny the claim again in 95 percent of cases, so don't expect much from "Reconsideration."  It's just a step you must use.

B.  Hearing before an Administrative Law Judge (ALJ).  Once you are denied at "Reconsideration," you may request a hearing before an administrative law judge.  This is the step that usually resolves the case.  This is also the step at which you have the best chance of approval.  Once your claim has been denied, the hearing is really where you want to go.  There are just steps you must follow to get there.  Reconsideration first, then a hearing.

The government only allows 60 days to file an appeal.  After that your claim dies.  Application denied?  60 days to file a request for "Reconsideration."  Denied at "Reconsideration"?  60 days to file an appeal.  

So, the moral of my story is this:  In most cases, do not file a new claim when you get denied.  File an appeal and keep the original claim alive, moving up the chain-of-command.  This preserves all your potential benefits under your original claim and it provides the best chance of getting an approval.  At least up until the hearing before a judge.  After a hearing, it's a hard choice on whether to appeal or file a new claim.  But until you get to a judge and a hearing....appeal, appeal, appeal.

It's a fact that claimants who are represented by counsel are more likely to be approved than those who go it alone.

I use this example:  Who has a better chance of safely landing a Jumbo 747?  A pilot who has flown the 747 for 20 years, or a passenger who has never flown before?

The passenger trying to land a 747 scares me.  (It happens in the movies but nowhere else)!  Give me the experienced pilot every time.

Trying to "land" your Social Security disability appeal alone is equally difficult and equally important to you.  Consider a professional!

WHO YOU MAY ENCOUNTER IN DEALING WITH SOCIAL SECURITY DISABILITY

Who are you likely to encounter in trying to get Social Security disability?

• The Social Security Field Office.  This is your local Social Security office.  It is responsible for collecting all the forms and pieces of the application for benefits.  It can also answer basic questions for you.

• The Disability Determination Service (DDS).  This is a state agency that works under contract with Social Security to process disability claims.  The DDS will order your medical records, review them and make the initial decision about whether you meet the rules to get a disability benefit.

• Disability Specialist - This is a state employee who works for the Disability Determination Service and manages your claim while at the DDS level.  You may get mail from this person or speak to them on the phone.

• Office of Hearings Operations (OHO).  This is the office that handles your appeal if your claim is denied at the initial level and at Reconsideration, and you file an appeal. 

• Administrative Law Judge (ALJ).  This judge works for the Social Security Administration and conducts hearings when your claim for benefits has been denied. You have a right to appear before this judge in person and you may be represented by legal counsel (who may appear with you).  Most claims get resolved here.  You must file a timely appeal to get a hearing.

• Vocational Expert (VE).  A vocational rehabilitation counselor who is called by Social Security to testify at a hearing.  The VE will classify each of the claimant's past relevant jobs and will answer a series of hypothetical questions posed by the administrative law judge concerning the ability to work under various restrictions.  The VE's testimony is very pertinent to the decision that will be rendered by the ALJ.

• Payment Processing Center.  After your claim has been approved, it goes to a payment processing center where benefits are calculated and checks are written to the claimant and representative (if any).

• The Appeals Council (AC) - is the group of administrative law judges in Falls Church, Virginia which reviews hearing decisions on appeal.  This is the final administrative appeal. There is no hearing and neither the claimant or representative appears before the AC for this appeal.  The Council will review the administrative law judge's handling of your hearing to see if it properly considered all the evidence and applied the rules of the Social Security Administration correctly.  The AC does not try to re-examine whether the claimant is disabled.

• Federal District Court (DC) - may review a denied claim upon appeal by the claimant--after the case has been denied by both an administrative law judge and the Appeals Council.  Only about 1 percent of all Social Security disability claims go to this level.  A federal district court challenge involves a federal lawsuit by the claimant against the Commissioner of Social Security.
  

DISABILITY: WHAT YOUR DOCTOR CAN AND CANNOT DO

I see a lot of misinformation about the role of doctors in the disability process.  I just read a post on the internet that said a note from your doctor can help you get disability benefits.  That's not entirely wrong but it is misleading.

A "note" from the doctor indicates a short or simple statement.  This generally is not admitted as evidence by Social Security judges.  Statements like, "This patient cannot work," or "This patient is totally disabled" are totally useless.  Why?  They don't explain in detail WHY the patient is disabled.  Social Security loves, loves detail and hates it when doctors draw conclusions.

What doctors may provide is a very detailed statement of your residual functional capacity (RFC).  The form I use has 6 pages of questions.  It asks the doctor to estimate the patient's function:  things like, sitting, standing, walking, lifting, stooping, kneeling, reaching, handling....etc.

I don't mean this to disparage doctors.  But most doctors don't know how detailed their statements need to be.  Social Security has very particular rules and it needs very precise and detailed functional information.  That's why we use forms and discourage letters or "notes" from doctors.

Of course, doctors will be asked to provide the patient's routine medical records.  But medical records alone are often not sufficient to prove disability.  And no medical record contains a residual functional capacity.

So, a note from your doctor won't do much good unless it uses Social Security's standards for determining disability.  And, again, doctors are not permitted to draw conclusions about who is disabled and who is not.

If a doctor writes:  "Mr. Claimant is limited to lifting no more than 5 pounds occasionally, is limited to sitting no longer than 30 minutes at one time or not more than 3 hours per 8-hour day.  He can stand only about 15 minutes at one time and  is limited to standing no more than 2 hours in an 8-hour workday.  He will be off task more than 20 percent of a workday due to back pain and probably will be absent at least 4 days per month."  Social Security may use this information to conclude that Mr. Claimant cannot work full-time at any exertion level and find him to be disabled. But that conclusion must be made by Social Security, not by the doctor.

One final thought:  Your doctor probably does not have a Residual Functional Capacity (RFC) form in his/her office.  You probably need to obtain this form from your attorney or representative, not from your doctor.  If you go to the doctor's office asking for a Residual Functional Capacity statement, the doctor may not know what you need.  I recommend that you get the form from your attorney, then take the form to your doctor and request that it be filled out.

WHAT KIND OF INCOME AFFECTS MY SOCIAL SECURITY DISABILITY BENEFIT?

Income from inheritance, pensions, retirement funds or court settlements will generally not affect Social Security disability (SSDI) benefits because SSDI is not a needs based or income based program.

In short, your eligibility for SSDI is not restricted by your income, as long as it is not earned income produced by your work (wages, salary, tips, commissions, self-employment income, etc.).

The only type of income to worry about if you are receiving SSDI (also called Title 2) is income from working.--whether working for yourself or someone else.  It's really not the income that is a problem, it's the work.  By working, you simply prove that you are not disabled according to Social Security's rules.

One word of clarification:  Social Security also operates a program known as SSI or Supplemental Security income, which is needs based and income restricted.  Almost any type of income can affect eligibility for SSI. So, be certain what type of benefit you are receiving before relying on any information on this site.  SSI requirements are very different from SSDI requirements.

ONE SINGLE KEY TO SOCIAL SECURITY DISABILITY

The single biggest secret to Social Security disability is:  Never resign yourself to failure.  Keep on until you get approved.  The appeal process is your friend, especially if you know how to use it.

Many people apply and get denied.  In fact, 67 percent of all applications nationwide are denied.  In Alabama, the denial rate is even higher.

By the time a person has completed all the forms, questionnaires and inquiries--they may be just too tired or frustrated to continue.  If you allow this to happen to you, Social Security has won.  Don't let them.

Steps to take if you were denied SSDI benefits within the past 60 days:

1.  Ask for Reconsideration in writing.  You may do this online.  Expect this to be denied, too because there is a 97 percent denial rate at Recon.

2.  When Reconsideration fails, appeal again.  Ask for a hearing before an administrative law judge.  This is your best chance.  Just be sure that your case is well prepared and all medical evidence is submitted prior to your hearing date.

3.  Consider appointing an attorney or non-attorney specialist in Social Security to help with your appeal.  They will not charge you anything unless you win.

The claimants who WIN with Social Security disability are the ones who don't give up.  They move their claim UP the chain of command until someone gives them a fair hearing.  Again, preparation and good medical evidence are a must!  P.S.  filing a new claim over and over will not help.  You need to be in the appeals process, not starting over with a new claim.

IMPORTANT:  There is a strict limit of 60 days to appeal any unfavorable decision.

_________________

The Forsythe Firm

Social Security Representation

7027 Old Madison Pike    Suite 108

Huntsville, AL 35806

CALL (256) 799-0297

SHORT TERM DISABILITY, LONG TERM DISABILITY, AND SOCIAL SECURITY

I bet you don't think much about disability.  Yet, 1 out of 4 persons will become disabled before they retire.  So, there's a good chance you and your family will find yourselves out of work, out of income, and with all the regular expenses still pressing down on you.

No problem, there's always Social Security, right?

Well, not exactly.  

Social Security disability (SSDI) doesn't pay the first 5 months of disability due to the waiting period.

On top of that, Social Security is very difficult to get--and takes a long time to get approved.  It's a bureaucratic nightmare.  Some people wait 2 years or longer to get a check and some never get one.  The rules to qualify for Social Security disability are the hardest of any disability program in the world.

So, let's talk about other types of private disability insurance that could tide you over, at least until you get Social Security.

SHORT TERM DISABILITY (STD)

Short Term Disability (STD) insurance is usually provided by your employer.  Not all employers offer it, but many do.  If your employer pays all the cost of STD premiums, you may not even be aware that you have it.  Depending on the policy your employer has purchased, STD may pay up to two-thirds of your salary if you become disabled.  These payments may continue for 3 to 6 months, depending on the terms of the policy.  

Some things to be aware of with Short Term Disability at work:

• You usually must apply for benefits and get your doctor to submit forms
• STD is often easier (and faster) to get started than Social Security.
• STD is sold by private insurance companies, usually to businesses, to cover their employees.  Many insurance companies sell it.
• Receiving STD will not hinder Social Security claims and will not make you ineligible for SSDI.

LONG TERM DISABILITY (LTD)

Long-Term disability is also sold by private insurance companies to employers who want to protect their employees.  LTD kicks in when Short Term Disability has maxed out (usually after 3 to 6 months).  Long term disability may be a bit harder to qualify for than STD was.  However, most LTD benefits are easier to get than Social Security disability (SSDI).  Some employers may only offer STD and not LTD.  Others may have both STD and LTD.  

Some points to consider about Long Term Disability (LTD) at work:    (These are general statements and may not apply to everyone.  See Disclaimer below).

• Coverage may be offered free by your employer or you may have to request enrollment and contribute to the cost to be covered.
• You generally cannot enroll in LTD after a disability strikes.  (You must get it before you need it, like all insurance).
• Each employer has a policy from the insurance company which spells out coverage terms and conditions.
• Most LTD policies require the worker to file for Social Security Disability (SSDI) benefits as soon as LTD benefits start to pay.
• You, the disabled employee, are responsible for filing for SSDI and your LTD company will generally require you to appeal a denial by Social Security in order to keep STD payments.
• You may hire your own advocate or attorney to represent you with Social Security; you don't have to us the insurance company's lawyer.
• If you eventually get Social Security benefits (SSDI), your LTD company will usually reduce its payments by the amount of the SSDI award.
• Getting LTD payments will NOT interfere with your ability to receive SSDI benefits.
• Be careful about voluntarily giving up any LTD benefits, even after you start getting an SSDI benefit.  
• Obligations of the LTD company may not completely end when you get approved for Social Security disability.  They may still owe you payments, depending on your policy's terms.

SOCIAL SECURITY DISABILITY (SSDI)

Social Security Disability Insurance (SSDI) is a government program provided by the 1935 Social Security Act. (The disability provision wasn't added until 1956).  It is paid for by a payroll withholding tax called FICA.  Individuals become covered under SSDI by working and contributing FICA taxes from their paychecks.  You must work a certain amount of time to earn enough work credits to be covered.  Generally, a person must have worked at least 5 years out of the most recent 10 -year period.  Young workers may need fewer work credits. Individuals who have not worked recently may not be covered by Social Security disability. Find out by calling your local Social Security office.  By the way, Social Security calls their disability plan "Title 2" because it's covered under Title 2 of the Social Security Act.

General Requirements to Get SSDI:  (1) You have earned enough work credits to be covered by Title 2.  (2) You have not yet reached full retirement age.  (3)  You have a medically determinable impairment which has lasted at least 12 consecutive months, is medically expected to last at least 12 straight months, OR will end in death.  (4) You are not currently working at substantial gainful activity.

Even though you may feel that you are disabled and qualify for SSDI, Social Security will often dispute your claim.  Approximately 70 percent of all SSDI claims will be denied on the initial application.  The proper response is to file an appeal right away.  Also, there is a 5-month waiting period for SSDI, meaning that Social Security will not pay the first 5 full months of an SSDI claim, starting with the date of disability onset.  For example:  If Social Security agrees that you became disabled on March 12th, your waiting period will run from April through August.  You would not be eligible for a payment until September.  Since payments are one month in the arrears, the September payment would arrive in October.  So, if everything goes well with Social Security, you're on your own for almost 7 months!  That's if you get approved as quickly as the law allows and no appeal is required.

If your SSDI claim requires an appeal, it can take an additional 12 months or more.  So, you can see why Short Term Disability and/or Long Term Disability from another source could be very, very helpful while you wait on the painfully slow Social Security process.

DISCLAIMERS

The Forsythe Firm does not give legal advice concerning insurance policies, companies or insurance matters.

We are not licensed insurance agents.

Statements herein are general in nature and are not to be taken as legal advice in any situation.

We have obviously not read your STD or LTD policy and our general statements may or may not apply to all policies or plans of insurance, including yours.

Your or your employer's  insurance policy/contract governs all benefits, terms, payments, qualifications and stipulations. Get a copy and read it carefully.

SOCIAL SECURITY WIDOWS OR SURVIVORS BENEFITS

SOCIAL SECURITY MAY PROVIDE FINANCIAL SUPPORT FOR A SURVIVING DIVORCED SPOUSE

If your ex-spouse dies and you were married at least 10 years you may be eligible for Social Security survivor’s payments on your ex-spouse's earnings record. Basically, Social Security treats you like a widow or widower if you were in a marriage for at least 10 years.. This reflects the reality that the economic circumstances of any marriage that lasts at least a decade probably will have a financial impact on the standards of living for the rest of the spouses’ lives.

ELIGIBILITY

To determine eligibility for benefits under an ex-spouse's work record,, the Social Security Administration (SSA) applies a formula. SSA considers how many work credits the deceased worker earned as well as the deceased’s spouse's age at time of death.

If a surviving divorced spouse cares for a biological or adopted child of their deceased ex-spouse, and that child is either disabled or under age 16,  they may be eligible even if the marriage lasted less than 10 years.

My firm recently represented a widow in just this type of situation.  She had been married more than 10 years, her husband had passed away a couple of  years ago, and the woman herself (over 50) is unable to work.  She had applied for Social Security survivor's benefits but was denied, which happens all too often.  She came to my office in desperation, wandering how she was going to survive financially with no Social Security support.  It became apparent to me that she had been unjustly denied survivor's benefits.  I filed a petition for appeal and the case wound up before a federal administrative law judge.  During a one-hour hearing, the judge found that my client was eligible for Social Security survivor's benefits based on her deceased husband's work record.  The judge not only allowed monthly payments to begin, but also approved retroactive pay back to the date of the original claim.

I fear that many women, especially, find themselves in this situation after the death of a spouse.  They have not worked sufficiently to get benefits under their own work record.  Their spouse supported the family until his death.  When the woman applies for Social Security disability, she is told that she doesn't have enough work credits for SSDI or Title 2. Or, She may be told that she is not disabled "according to the rules of the Social Security Administration."  In either event, her benefits are denied.

This is time to get competent representation and take the case higher up the chain of command to a judge.  This can easily be done with no upfront cost.

_____________________

The Forsythe Firm

7027 Old Madison Pike - Suite 108

Huntsville, AL 35806

Consultations by phone or by appointment only

(256) 799-0297

I LIVE IN HUNTSVILLE AND NEED DISABILITY BENEFITS. GUESS WHO I FOUND WHO COULD HELP?

Consider hiring an attorney on a contingency basis to help get your Social Security disability started.  There is no upfront cost and you may never pay an attorney's fee.  Let me explain how a "contingency fee" works.

A contingency fee only comes due when a certain contingency occurs.  In this case, the fee is contingent upon getting your disability approved and paid.  If this happens, you will pay a fee.  If it doesn't, you will not owe a fee.

Social Security adds one other stipulation to their contingency fee:  There must be back-pay or retroactive payments before a fee becomes due.  So, if there is no back-pay payable on your case, you still don't owe a legal fee.

This may sound to good to be true.  It isn't.  The US government protects Social Security claimants and beneficiaries when it comes to fees that can be charged on a disability claim.  In most cases, there can be no money charged up front and the amount of any eventual fee is limited by the government.

So, if you need disability payments but have been denied (or just don't know how to start), call one of the specialists in the Huntsville area for help.

____________________

Sponsored by:

The Forsythe Firm

7027 Old Madison Pike - Suite 108

Huntsville, AL 35806

PH (256) 799-0297

TOGETHER WE GET YOUR SOCIAL SECURITY DISABILITY BENEFITS!

Like most government programs, Social Security can be difficult to deal with.  There are applications you don't understand, questions you don't know how to answer, and procedures that are baffling and frustrating.  Often, the result of all this confusion is denial of your benefits.

We know how to take your denial letter and take it up the chain of command.  Over half of these denials can be overturned and won on appeal.

But to win you need a plan, a legal strategy--and an understanding of the reason you were denied in the first place.

When you bring your case to the Forsythe Firm, here is what will happen:

1.  We listen to your story over the phone and find out where you are in the disability process.

2.  We bring you into our Huntsville office (if needed) to gather information we need to fight for you.

3.  Our advocate will file whatever forms and paperwork that may be need to get your case reconsidered or appealed.

4.  Our office begins the work of getting new and stronger evidence to support your case.

5.  We get your case before a federal Administrative Law Judge (ALJ) for a new decision.

6.  We help direct your case to one of the payment processing centers for payment, including back pay that may be due.

Wow!  How Much Does All This Cost?

• You pay nothing upfront, no fee, no deposit, nothing.
• If your case wins, you still owe us nothing unless we collect back pay for you.
• If there is back pay, Social Security will approve and pay a small percentage of the back pay to cover our fee.

Call the Forsythe Firm at (256) 799-0297

WHO ULTIMATELY DECIDES DISABILITY CASES?

Most Social Security disability cases are ultimately decided by a federal administrative law judge (ALJ).

   
A hearing, which lasts about one hour, considers your testimony, your attorney's arguments, the medical evidence, and the testimony of a vocational witness.

Specific factors which play a large part in the judge's decision include:

• Age of the claimant
• Education
• Past work experience (over the past 15 years only)
• Medical Evidence
• Residual Functional Capacity
• Transferable Skills from past work

I will discuss Residual Functional Capacity (RFC) here, since the other factors are self-explanatory.

RFC is the maximum that an individual can still do in terms of work-related activity.  In short, can much can the individual lift and carry?  How long can he/she stand, walk and sit?  How often can the claimant reach, bend, squat, kneel or balance?  In terms of the mental demands of work, what is the claimant's restrictions on understanding, remembering and carrying out simple instructions?  How much of the time will the individual be off task due to problems with concentration or focus?

How will these limitations affect the ability to perform jobs at the various exertion levels:  very heavy, heavy, medium, light and sedentary?  Will the claimant be able to perform skilled, semi-skilled or unskilled work?  How many jobs are there in the national economy that fits the claimant's Residual Functional Capacity?  (A question for the vocational expert).

From a practical point of view, most claims are decided on the claimant's ability to perform either light or sedentary level jobs at the unskilled level. 

There are so many technical issues that go into a Social Security disability appeal that I'm surprised that anyone would undertake this venture without representation. (I think many claimants do so because they don't know what they are getting into).

It is far from just telling your story to the judge.  It's more about proving that you meet all of the technical demands of Social Security's regulations.  

You need an understanding of medical evidence, grid rules, Social Security Listings, transferable skills and exertion levels--just to name a few things.  You will also need to know how to question (cross examine) the government's vocational expert.  If the expert gives unfavorable testimony, as they often do, it leaves your decision lingering in critical condition between life and death.  Asking the right questions can be the life-saver of your claim.

The judge who hears your case will require proof, not just a good story.










ADMINISTRATIVE LAW JUDGES CAN BE VERY SKEPTICAL!

ARDMORE DISABILITY - HOW TO GET APPROVED

ARDMORE, AL
ARDMORE, TN

What Is Social Security?

Social Security is a function of the federal (US) government.  It is a plan of mandatory federal disability insurance for workers, who pay into the Social Security fund by payroll deduction.  The withholding tax is called FICA for (Federal Insurance Contributions Act).  The law was passed in 1935 and is mandatory for most US workers.  Workers currently pay 7.65 percent of their pay into this trust fund and their employers match the contribution.  So for every dollar you earn, over 15 cents goes into the Social Security and Medicare trust fund. This funds the disability program.


What are the basic requirements to start disability benefits from the Social Security Administration?

1.  You have worked and paid into Social Security long enough and recently enough to have coverage.  Credits do expire over time.  Not everyone is covered for SSDI.

2.  You have a serious medically determinable impairment that (a) has lasted at least 12 straight months, (b) is expected to last at least 12 straight months, OR (c) is expected to end in death.

3.  You must have medical records of treatment that will establish the impairment's onset, severity, and duration.

WHAT ARE THE USUAL STEPS TO APPLY FOR BENEFITS?

• File a new application with the Social Security office.
• Wait 4 to 6 months for a decision.
• If denied (as many are), file an appeal within 60 days.
• Expect to go before an Administrative Law Judge (ALJ) for a hearing.
• Consider getting a specialist to assist with your appeal or hearing.

Claimants with professional representation are more likely to get benefits approved.  Honestly, Social Security will deny almost 80 percent of claims filed in 2020.  The appeal process is arduous and complicated.  However, if done correctly, the appeal can produce payment of benefits.

A professional representative cannot charge you a fee for his or her services until.....

A.  Your benefits have been approved, and also....

B.  You are paid past due or retroactive benefits.

Call (256) 799-0297 for a free disability consultation.

*During the COVID-19 crisis, our firm provides free telephone consultations for those who do not wish to visit our office.  If you do make an appointment to visit us, we will try to limit your exposure to others during your visit (as much as possible).  We currently only accept visits on in-person consultation by appointment, one person at a time, due to COVID-19 concerns.

ARDMORE AL DISABILITY ADVOCATES

Ardmore, AL and Ardmore, TN are served by the Forsythe Firm, helping Ardmore residents get the Social Security disability benefits they deserve.

Sure, you could go to an out of town firm and hire someone you will never meet.  But why not hire an expert who lives and works near your home?  

We offer:

1) Local appointments right here in north Alabama.

2)  Free consultations by phone or in person.

3)  Contingency Fee:  You pay us nothing up front, and never pay us a fee until your benefits are paid.

4)  One advocate who will stay with you and your case until it is resolved.

5)  The ability to reach your managing advocate with one phone call.  Yes, we will answer you call.  Yes, we do return calls if you miss us.  We'll be here for you!

Some things Ardmore residents should know about Social Security Disability Insurance (SSDI):

1.  Denials are very common and do not mean that you can't get a benefit.

2.  Most claims are approved in the appeal process, not by filing an application alone.

3.  Most claimants choose to get professional help when trying to get benefits.

4.  You cannot be charged a legal fee if unless you win your claim.  Any fee charged by your attorney/advocate must come out of your back pay.  No back pay, no fee.

5.  If you initial claim is denied, you only have 60 days to appeal.

CONTACT THE FORSYTHE FIRM AT (256) 799-0297.

EMAIL US AT forsythefirm@gmail.com

DISABILITY BENEFITS IN THE COVID CRISIS

It is still possible to be considered for new disability benefits, even during the 2020 COVID-19 crisis.  However, you must apply online or by phone.  Social Security offices are temporarily closed to the public.

The Forsythe Firm is offering free telephone consultations at no obligations.  We can help you decide if you may qualify, or give you advice on how to proceed with a claim or appeal.  (256) 799-0297.

THINGS A JUDGE WILL CONSIDER

Most people who apply for Social Security disability will wind up before a judge, who must decide if they qualify for benefits.  What type of things will the judge consider?

In addition to your medical record, there are several factors that judge will look into:

1.  Your Work Record.  Judges like to see claimants who have a long, steady work history.  This gives the claimant a great deal of credibility.

2.  Are Other Family Members on Disability?  Judges don't like to see a household where multiple members of the family are on disability benefits.

3.  Have You Tried to Keep Working?  Judges will ask how you have tried to stay in the workforce.  They want to know about medical treatment, physical therapy, rehabilitation or looking for an easier job that you may still be able to perform.

4.  What Are Your Hobbies and Recreational Activities?  You say you are not able to work, but how do you spend your time?  Do you go to ballgames, hunt, fish, travel or engage in other hobbies?  Do these recreational activities indicate inconsistency with the idea that you are disabled?

5.  Do You Have Unreported Wages?  Judges want to know if you have worked "under the table."  They usually view this as dishonesty because no FICA or federal tax were paid on these earnings.  Such work may also indicate that a person really isn't disabled, since they have been working.

THE REALITY TEST

When you apply for disability, Social Security will send you a  lot of forms.  These forms will ask you about every facet of your everyday life.  They take the answers on these forms very seriously.

When you complete your disability forms, have a relative or friend review them with you.  Do the Reality Test.  Are my answers really accurate?  Have I under-stated or exaggerated any of my answers?  Strive for absolute honesty.

Often, I interview claimants with a spouse present.  As the claimant is telling me what they can and cannot do, the spouse is very often incredulous.  Their expression says, "You certainly can't do that!" Or, "Are you kidding me?"

We tend to minimize our inabilities and downplay our limitations.  Our family members may notice our limitations more than we do.

When filling out Function Reports, address your worst days--not your best days.  If you can trim the grass two days out of an average week but you cannot do it five days out of the week, then you have a severe limitation. 


The reality test simply asks, "Is this a true reflection of what I can do, day in and day out?  

Keep in mind, too, that just because you can do something once or twice around the house, performing that same function on the job all day is a different matter.  Can you lift 10 pounds?  You say, "Sure, I can lift 10 pounds with no problem."  If I rephrase the question, Can you do a job all day that requires lifting 10 pounds? the answer might be totally different.


The same might be true with a simple thing like sitting.  Around the house you sit in a recliner and read or watch TV.  At work, however, you would sit in a much less comfortable chair with both feet on the floor, not elevated.  How long can you sit in those conditions?

Perform the reality test.  I also recommend having your spouse or family member review your answers.  He/she may look at what you have written and say, "Are you kidding me?"

SSI vs. SSDI: 2 VERY DIFFERENT PROGRAMS

The US Social Security Administration (SSA) operates two basic disability programs--which have some similarities and some differences.

SSDI

• Called "Title 2" because it was created under Title 2 of the Social Security Act.
• SSDI stands for Social Security Disability Insurance (Yes, it is insurance).
• Requires a claimant to have worked and paid FICA taxes for a number of years
• Poses no income or resource restrictions to get a benefit
• Requires that the claimant be medically disabled
• Has a 5-month waiting period (no benefits for the first 5 months of disability)
• Comes with Medicare after 29 months of continuous disability
• Requires a disability lasting at least 12 straight months or expected to end in death.
• Maximum 2020 benefit is $3,011 per month; the average benefit is $1,258 per month.

SSI

• Called Supplemental Security Income
• Also called "Title 16" because it's covered by Title XVI of the Act.
• Does not require any work history to qualify.
• Has severe income and resource restrictions.
• Requires that the claimant be medically disabled or at least age 65.
• Has no waiting period; benefits available the month after the application.
• Comes with Medicaid with no Medicaid waiting period.
• Requires a disability lasting at least 12 straight months or expected to end in death.
• Maximum 2020 benefit is $783 per month (non-blind) but may be less. 
• Living arrangements and household income affect eligibility and benefits.
• *benefits for a blind individual may be higher

You will hear a lot of people talking about getting "a Social Security disability check."  You never know if they are talking about SSDI or SSI.  

I hear people say, "He gets a disability check but he never worked a day in his life."  Of course, that's absolutely impossible with SSDI but could be possible under SSI.

Which do you want to apply for, SSDI or SSI?  

You want SSDI in most cases because it potentially has a much larger monthly benefit.  It also has no financial restrictions.  But if you can't qualify for SSDI because you didn't pay enough in FICA (withholding) taxes, you should try for SSI.  In some cases, a person can get both SSDI and SSI benefits.  This would occur in cases where the combined SSDI and SSI benefits do not exceed $783 per month.

The medical requirement to get SSDI and SSI is exactly the same.  The big differences are in the financial restrictions for SSI and the larger benefit possible under SSDI.