Social Security decision makers will deny most of the claims they look at in 2020, as they have in all past years. Only the claims that stand out as well developed, clear and complete will be marked "Approved."
If your medical record is even slightly unclear, if it isn't certain that your condition will last for at least 12 months, or even if your records are not received--the decision maker is instructed to deny your claim and let someone further along in the process make a decision.
In other words, when there is any doubt, deny first and reconsider later.
The claims that get paid early on are the ones that "check all the boxes" and leave no doubts unsettled.
Many claims that get denied will later be approved in the appeals process but that may be 24 months later. Meanwhile, the claimant is not being paid and may be in financial trouble.
Your best bet for an early Social Security approval?
1. Be sure to file a complete, accurate and thorough application, including all the later forms you will receive in the mail. This includes the Work History Report and Function Report.
2. List all of your doctors and other medical providers, giving complete addresses and telephone numbers.
3. Call your disability specialist at the Disability Determination Service after about 30 days to see if he/she is receiving all of your medical records from providers. If not, call the problematic providers and ask if they will send in your records.
4. Return all calls from Social Security and keep all appointments, such as consultative examinations with their doctor.
5. If you get a denial, remember that it's not unusual. This will require an appeal or "Reconsideration." Note that about 98 percent of Reconsideration requests are also denied, requiring a further appeal. Prior to your visit with an administrative law judge for a hearing, consider getting representation. It's probably time.
__________
The Forsythe Firm
Phone (256) 799-0297
Tuesday, January 14, 2020
WHAT TO EXPECT AT YOUR HUNTSVILLE DISABILITY HEARING
Most people will attend a Social Security disability hearing only once in their lifetime, if at all. Here's a brief idea of what to expect.
First, it is not a court appearance in the usual sense of the word. The Social Security Administration is an agency of the federal government, a part of the executive branch. So, the hearing isn't entirely like a proceeding at the courthouse. It's a bit less formal. The rules of evidence are a bit more relaxed but there are rules.
A hearing is a fact-finding process presided over by an administrative law judge (ALJ) who works for the federal government.
The claimant and representative will enter a small conference room (hearing room) and be seated around a table. After everyone is introduced, the judge will explain the process. Then the claimant and any witnesses will be placed under oath.
Next, the judge will usually ask the claimant a series of questions. Some judges ask nearly all the questions, while other judges want the claimant's representative to ask most of the questions.
Questions usually center around the claimant's past work, current medical conditions, activities of daily living and restrictions in function.
It's impossible to list all or even most of the questions to expect. Here are three questions you must always expect and be prepared to answer:
1. When was the date on which you last worked, even for one day? Be sure you know this.
2. In your own words, tell me why you stopped working on (date).
3. In your own words, tell me why you believe you are now unable to work.
After the ALJ and your attorney have asked all their questions, the judge will pose some hypothetical questions to the vocational expert. You probably won't understand all of this because it's an unfamiliar "language." Your attorney will deal with this final portion of the hearing.
The typical hearing will last 45 to 60 minutes. At it's conclusion, you may or may not know whether you were approved. It's common for judges not to announce their decisions but to send their written decisions in the mail, which may take 60 to 90 days from the hearing.
______________
The Forsythe Firm
Phone (256) 799-0297
First, it is not a court appearance in the usual sense of the word. The Social Security Administration is an agency of the federal government, a part of the executive branch. So, the hearing isn't entirely like a proceeding at the courthouse. It's a bit less formal. The rules of evidence are a bit more relaxed but there are rules.
A hearing is a fact-finding process presided over by an administrative law judge (ALJ) who works for the federal government.
The claimant and representative will enter a small conference room (hearing room) and be seated around a table. After everyone is introduced, the judge will explain the process. Then the claimant and any witnesses will be placed under oath.
Next, the judge will usually ask the claimant a series of questions. Some judges ask nearly all the questions, while other judges want the claimant's representative to ask most of the questions.
Questions usually center around the claimant's past work, current medical conditions, activities of daily living and restrictions in function.
It's impossible to list all or even most of the questions to expect. Here are three questions you must always expect and be prepared to answer:
1. When was the date on which you last worked, even for one day? Be sure you know this.
2. In your own words, tell me why you stopped working on (date).
3. In your own words, tell me why you believe you are now unable to work.
After the ALJ and your attorney have asked all their questions, the judge will pose some hypothetical questions to the vocational expert. You probably won't understand all of this because it's an unfamiliar "language." Your attorney will deal with this final portion of the hearing.
The typical hearing will last 45 to 60 minutes. At it's conclusion, you may or may not know whether you were approved. It's common for judges not to announce their decisions but to send their written decisions in the mail, which may take 60 to 90 days from the hearing.
______________
The Forsythe Firm
Phone (256) 799-0297
WHAT TO WEAR TO YOUR HUNTSVILLE SOCIAL SECURITY HEARING
Social Security hearings are rather informal. There is no set dress code. I tell my clients to be comfortable and respectful to the court. You shouldn't dress up too much but, at the same time, you shouldn't wear something that might be considered disrespectful.
Two words I often use are neat and casual.
I advise my male clients to consider khaki pants and a nice button down shirt, as opposed to a T-shirt. Women are advised to wear a blouse and skirt or dress style pants. It's best to avoid blue jeans, and definitely don't come to court wearing shorts or a tank top.
You will see attorneys wearing suits; however, I don't advise clients to dress in suits or ties. Attorneys are expected to dress more formally.
This is off subject (forgive me), but it's important to arrive early. If your hearing has been scheduled for 11 o'clock, arrive at 10. Nothing sets a hearing on its ear worse than arriving at the last minute or, heaven forbid, arriving a few minutes late.
Two words I often use are neat and casual.
I advise my male clients to consider khaki pants and a nice button down shirt, as opposed to a T-shirt. Women are advised to wear a blouse and skirt or dress style pants. It's best to avoid blue jeans, and definitely don't come to court wearing shorts or a tank top.
You will see attorneys wearing suits; however, I don't advise clients to dress in suits or ties. Attorneys are expected to dress more formally.
This is off subject (forgive me), but it's important to arrive early. If your hearing has been scheduled for 11 o'clock, arrive at 10. Nothing sets a hearing on its ear worse than arriving at the last minute or, heaven forbid, arriving a few minutes late.
WHY WILL SOCIAL SECURITY STOP YOUR DISABILITY CHECK?
Social Security reviews disability cases every few years to see if benefits should continue or be discontinued. These are called Continuing Disability Reviews (CDR).
Most cases are reviewed every 3 years. If a recipient is over age 50, or if the medical condition is unlikely to improve, the CDR may happen only every 7 years.
Sometimes, the administrative law judge who approves a claim after a hearing may believe that the claimant's condition will improve soon. The ALJ may require the case be reviewed in less than 3 years and will make this requirement as part of the written decision.
With reference to adults, there are 2 things that will cause a recipient to lose benefits:
1. There has been medical improvement to the point that the individual is no longer disabled according to agency rules, or
2. The person receiving benefits has returned to work at what Social Security considers substantial gainful activity. In 2020, that means work which produces gross wages or earnings of at least $1,260 per month.
Social Security monitors wages, since all wages have FICA tax deducted and reported to Social Security automatically. When a person reaches the $1,260 level, a computer spits out a notice to discontinue benefits pending a review.
This may not happen immediately. It's possible for an individual to begin working and continue to receive and cash Social Security checks improperly for a long time. This can happen for a year or two. However, when Social Security finally catches on (and they always do), they will demand their money back in one lump sum.
The rules for continuing disability reviews in children's cases are a bit different. Rules for Supplemental Security Income (SSI) cases are different, too. With SSI, benefits may be discontinued because the recipient's income or living arrangements have changed, making them ineligible for continued benefits.
Most cases are reviewed every 3 years. If a recipient is over age 50, or if the medical condition is unlikely to improve, the CDR may happen only every 7 years.
Sometimes, the administrative law judge who approves a claim after a hearing may believe that the claimant's condition will improve soon. The ALJ may require the case be reviewed in less than 3 years and will make this requirement as part of the written decision.
With reference to adults, there are 2 things that will cause a recipient to lose benefits:
1. There has been medical improvement to the point that the individual is no longer disabled according to agency rules, or
2. The person receiving benefits has returned to work at what Social Security considers substantial gainful activity. In 2020, that means work which produces gross wages or earnings of at least $1,260 per month.
Social Security monitors wages, since all wages have FICA tax deducted and reported to Social Security automatically. When a person reaches the $1,260 level, a computer spits out a notice to discontinue benefits pending a review.
This may not happen immediately. It's possible for an individual to begin working and continue to receive and cash Social Security checks improperly for a long time. This can happen for a year or two. However, when Social Security finally catches on (and they always do), they will demand their money back in one lump sum.
The rules for continuing disability reviews in children's cases are a bit different. Rules for Supplemental Security Income (SSI) cases are different, too. With SSI, benefits may be discontinued because the recipient's income or living arrangements have changed, making them ineligible for continued benefits.
HOW TO PROVE A PSYCHOLOGICAL DISABILITY CASE
The basic mental demands of competitive, remunerative, unskilled work
include the abilities (on a sustained basis) to understand, carry out,
and remember simple instructions; to respond appropriately to
supervision, coworkers, and usual work situations; and to deal with changes in a routine work setting.
To prove that you cannot perform even unskilled work based on a mental impairment, you must show that you can't perform one or more of these basic demands.
Notice that these demands are to be performed "on a sustained basis," which means 8 hours a day, 5 days a week or on an equivalent schedule.
Proving that a claimant is unable to meet these demands on a sustained basis can be challenging. Since a mental disability is being alleged, it's best to have a specialist's support, in this case, a psychiatrist or licensed psychologist.
It will be necessary for the specialist to examine the claimant, preferably to treat him/her, over a period of time. In doing so, the doctor will conclude what psychological conditions the person has, their severity and how they respond to treatment.
Claimants who have no treatment by a specialist will have a difficult time proving disability.
Individuals who get approved for disability payments based on a mental condition are more often those who....
1. have a treating psychiatrist or psychologist,
2. are taking medications and/or counseling therapy,
3. are refractory towards treatment, i.e., are not improving even with treatment, and
4. have required periods of hospitalization or inpatient treatment.
In attempting to prove disability due to psychological impairment, I always try to get the treating doctor to provide a medical source statement. This is a detailed checklist of what the patient can and cannot do in terms of work-related functions.
_________________
The Forsythe Firm
PHONE (256) 799-0297
To prove that you cannot perform even unskilled work based on a mental impairment, you must show that you can't perform one or more of these basic demands.
Notice that these demands are to be performed "on a sustained basis," which means 8 hours a day, 5 days a week or on an equivalent schedule.
Proving that a claimant is unable to meet these demands on a sustained basis can be challenging. Since a mental disability is being alleged, it's best to have a specialist's support, in this case, a psychiatrist or licensed psychologist.
It will be necessary for the specialist to examine the claimant, preferably to treat him/her, over a period of time. In doing so, the doctor will conclude what psychological conditions the person has, their severity and how they respond to treatment.
Claimants who have no treatment by a specialist will have a difficult time proving disability.
Individuals who get approved for disability payments based on a mental condition are more often those who....
1. have a treating psychiatrist or psychologist,
2. are taking medications and/or counseling therapy,
3. are refractory towards treatment, i.e., are not improving even with treatment, and
4. have required periods of hospitalization or inpatient treatment.
In attempting to prove disability due to psychological impairment, I always try to get the treating doctor to provide a medical source statement. This is a detailed checklist of what the patient can and cannot do in terms of work-related functions.
_________________
The Forsythe Firm
PHONE (256) 799-0297
SIGNS YOU WON YOUR DISABILITY HEARING
Most judges do not announce their decisions at the end of a hearing for disability benefits. However, there are telltale signs that you may have won.
1) The vocational expert was present but was not asked to testify. This doesn't always mean that you won, but it may indicate that the judge didn't need the vocational witnesses' input to pay your claim.
2) The vocational witness testified and every time the judge asked if there would be any work available, the witness replied, "No work would be available," or "That would preclude all work."
3) The judge tells you or your attorney that a grid rule applies. The judge says something like, "Counselor, it appears that grid rule 201.01 applies." This means that based on a claimant's age, education, past work experience and residual functional capacity, a finding of disabled is directed by the rules.
4) The judge or a medical expert present at the hearing states that the claimant "meets or equals a Listing." Meeting a Listing means approval at Step 3 of the sequential process. When this occurs, the hearing may be very short and end abruptly; in this case, a good thing.
5) The judge says something like, "I don't think this will take very long, I just need to ask a few questions and we'll be finished." This indicates that the judge has his/her mind made up, pretty much. A good thing unless the judge has made up his/her mind to deny the claim. However, they are not likely to say this, even if that's the case.
6) The judge says, "I am going to review you in about 2 or 3 years to see how you're doing." There would be no need for a review if you were not receiving benefits.
Of course, nothing is final until you get a written decision in the mail. No one has a working crystal ball and any guess we make about the outcome of a hearing could be wrong. Written decisions are mailed about 90 days following the hearing.
1) The vocational expert was present but was not asked to testify. This doesn't always mean that you won, but it may indicate that the judge didn't need the vocational witnesses' input to pay your claim.
2) The vocational witness testified and every time the judge asked if there would be any work available, the witness replied, "No work would be available," or "That would preclude all work."
3) The judge tells you or your attorney that a grid rule applies. The judge says something like, "Counselor, it appears that grid rule 201.01 applies." This means that based on a claimant's age, education, past work experience and residual functional capacity, a finding of disabled is directed by the rules.
4) The judge or a medical expert present at the hearing states that the claimant "meets or equals a Listing." Meeting a Listing means approval at Step 3 of the sequential process. When this occurs, the hearing may be very short and end abruptly; in this case, a good thing.
5) The judge says something like, "I don't think this will take very long, I just need to ask a few questions and we'll be finished." This indicates that the judge has his/her mind made up, pretty much. A good thing unless the judge has made up his/her mind to deny the claim. However, they are not likely to say this, even if that's the case.
6) The judge says, "I am going to review you in about 2 or 3 years to see how you're doing." There would be no need for a review if you were not receiving benefits.
Of course, nothing is final until you get a written decision in the mail. No one has a working crystal ball and any guess we make about the outcome of a hearing could be wrong. Written decisions are mailed about 90 days following the hearing.
Saturday, January 11, 2020
NEWSPAPER SAYS SSA WILL GUT ITS DISABILITY PROGRAM SOON
1/11/2020 The Wal Street Journal says today that Social Security is about to gut its disability program. (They use the nicer word, "eviscerate").
It will do so by cutting the guts out of the Grid Rules, the charts that helped over 500,000 Americans qualify for benefits in 2019.
Social Security has shown its desire to clamp down on disability benefits for nearly a decade, starting in 2010.
In 2010, most claimants got denied, just as they do today. But by appealing and attending a hearing before a judge, 62 percent eventually won their benefits. By 2018, that was down to 42 percent.
There has reportedly been a lot of pressure from SSA for their judges to trim benefits on their own, and most of them have done so.
And every time Social Security comes up with a new rule to "improve the integrity of our program," watch out: they have just made getting benefits harder and slower (again).
Now, the new commissioner, Andrew Saul, wants to disembowel Social Security. No more cutting with a sharp knife; he intends to take a wrecking ball to it.
Saul's thinking, according to the Wal Street Journal, is based on changing demographics. People today are better educated and live longer. They don't work blue collar jobs in mines or factories--but they work in banks, stores, hospitals and offices. In short, they just don't need disability benefits the way they once did. Besides that, we can't afford it.
That's not the truth, of course. But it's the myth based on partial truth and changing social crusades, which don't include the disabled so much.
The new, eviscerated program will probably roll out within two years (maybe sooner). Individuals with the most catastrophic impairments will still be covered; however, the type of things they pay benefits for today won't be approved.
Sure, if an individual has both arms and both legs amputated, that will still be covered. But the more common impairments that are being paid for today--they will be long gone. So, forget about a claim based on herniated discs, radiculopathy, neuropathy or the inability to stand or walk. The good old days of easy money are gone, according to Mr. Saul.
Medicare will be gone, too, for most people. When SSDI goes away, so does Medicare coverage. Without one, you can't get the other.
If the Wall Street Journal has it right (and they say they've seen the goods),hard times are ahead for America's disabled--especially those above 50. Without the grid rules, the denial rates will triple.
I expect you won't hear much of this one the news, now or then. It will be done very quietly, without announcement or fanfare. Suffering is nearly always done quietly.
It will do so by cutting the guts out of the Grid Rules, the charts that helped over 500,000 Americans qualify for benefits in 2019.
Social Security has shown its desire to clamp down on disability benefits for nearly a decade, starting in 2010.
In 2010, most claimants got denied, just as they do today. But by appealing and attending a hearing before a judge, 62 percent eventually won their benefits. By 2018, that was down to 42 percent.
There has reportedly been a lot of pressure from SSA for their judges to trim benefits on their own, and most of them have done so.
And every time Social Security comes up with a new rule to "improve the integrity of our program," watch out: they have just made getting benefits harder and slower (again).
Now, the new commissioner, Andrew Saul, wants to disembowel Social Security. No more cutting with a sharp knife; he intends to take a wrecking ball to it.
Saul's thinking, according to the Wal Street Journal, is based on changing demographics. People today are better educated and live longer. They don't work blue collar jobs in mines or factories--but they work in banks, stores, hospitals and offices. In short, they just don't need disability benefits the way they once did. Besides that, we can't afford it.
That's not the truth, of course. But it's the myth based on partial truth and changing social crusades, which don't include the disabled so much.
The new, eviscerated program will probably roll out within two years (maybe sooner). Individuals with the most catastrophic impairments will still be covered; however, the type of things they pay benefits for today won't be approved.
Sure, if an individual has both arms and both legs amputated, that will still be covered. But the more common impairments that are being paid for today--they will be long gone. So, forget about a claim based on herniated discs, radiculopathy, neuropathy or the inability to stand or walk. The good old days of easy money are gone, according to Mr. Saul.
Medicare will be gone, too, for most people. When SSDI goes away, so does Medicare coverage. Without one, you can't get the other.
If the Wall Street Journal has it right (and they say they've seen the goods),hard times are ahead for America's disabled--especially those above 50. Without the grid rules, the denial rates will triple.
I expect you won't hear much of this one the news, now or then. It will be done very quietly, without announcement or fanfare. Suffering is nearly always done quietly.
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