DISABLED VETERANS AND SSDI BENEFITS

According to the United States Census Bureau, almost 3.8 million US Veterans currently experience some form of disability. Of these, around 1.1 million have a VA disability rating of 70% or higher, meaning their condition prevents them from working.

During their years of military service, personnel paid into the Social Security disability insurance program (SSDI).  Therefore, SSDI benefits may be available in addition to VA benefits.

VA benefits provide monthly payments based on the degree of disability, from 10 percent to 100 percent.  However, Social Security or SSDI pays a benefit to individuals who are totally unable to work.

SSDI must be applied for separately; it does not automatically come with VA benefits.  The process is quite different.

Once approved, however, SSDI may add a substantial amount of money to the veteran's monthly disability benefit.  In some cases, the SSDI benefit may be as much as the VA benefit, if not more.

Here is a question we often get:  "Will receiving SSDI benefits reduce or delay my VA benefit in any way?"  The answer is no.  SSDI benefits are strictly in addition to any VA or military benefit, whether retirement or disability.

Veterans who have a VA disability rating of 70 or higher should immediately apply for SSDI benefits.  If denied, the decision should be appealed within 60 days because many SSDI cases must be appealed before they can be paid.  It's just the way the system works.

The Forsythe Firm provides free case evaluations and consultations, with no obligation. 

Although VA benefits are designed to provide monthly supplements in proportion to your disability, some veterans with severe conditions require extra assistance. In this case, Social Security disability benefits may be an option. Veterans can qualify for both VA benefits and Social Security disability insurance (SSDI).

Continue below to learn how you may qualify for SSDI while receiving VA benefits.

WHAT IT TAKES TO GET DISABILITY BENEFITS

The following are required before you can be approved for disability benefits.

SEVERE IMPAIRMENT - 

This is a medical condition which is severe enough to case a loss of function in at least one area of work related activity.

DURATION REQUIREMENT

You must have at least one severe impairment which has lasted, or is expected to last at least 12 straight months OR is expected to end in death.

INABILITY TO WORK

For persons under age 50, you must be unable to perform any type of full time work; this includes an entry level, unskilled minimum wage job at the sedentary level.

3 THINGS TO HELP YOU GET SSDI BENEFITS

While getting Social Security disability benefits is never going to be easy, here are 3 things you can do to increase your chances for approval.

1.  Update Your Medical Information 

Social Security always bases their decisions primarily on what is contained in your medical records.  When completing your application, be sure to list and provide the full address for every doctor, clinic, hospital, psychologist or other medical provider you have seen for any long-term medical condition.  Social Security obtains medical records only from the medical providers you list on the application.  If you omit a doctor, hospital or other provider, the records are not obtained.  

2.  Have Your Doctor List Specific Restrictions

Most doctors use a standard form for recording patient information.  There are 4 categories on most of the reporting forms that doctors use:

• Complaints
• Examination
• Diagnosis
• Treatment

There is no space on most doctor's forms to note restrictions of daily activities or limitations in work related activities.  In short, the doctor usually will not make a record of what you can and cannot do functionally.  For example, he or she will not state that you cannot lift more than 10 pounds, reach overhead or stand more than 1 hour at a time.  It takes an effort on the patient's part to get this information into the doctor's records.  But this is exactly the type of information Social Security wants when deciding whether you qualify for disability benefits.

If your records do not contain restrictions, you may ask your doctor to list your restrictions by providing a Medical Source Statement (form) or a Residual Functional Capacity opinion (form).

3.  Hire a Laywer 

In 2012, the Social Security Advisory Board found that people who hired an attorney to help them with their initial application were more likely to be awarded benefits.  A Government Accounting Office study in 2003 determined that people represented by an attorney at their hearing were more likely to win their case.  It just makes sense that a professional who is trained in Social Security regulations and who has handled hundreds of hearings can be expected to add value to a hearing.  Of course, having an attorney or representative never guarantees the outcome of an application or a hearing.  But you are looking at increased odds, not guarantees.

3 SETS OF DISABILITY RULES BASED ON AGE

How difficult is it to get Social Security disability?  That depends to a large degree on age.  As I've mentioned in earlier posts, Social Security has 3 sets of rules, based on the claimant's age.  While age is the big factor, they also consider the following additional factors:

• past work experience, including
• transferable skills
• education
•  residual functional capacity (level of exertion you can do)

While the medical-vocational rules or "grid rules" are complex, here is the gist of what they will direct.

Ages 18-49.  The grid rules do not apply to these "younger individuals."  It doesn't matter whether these claimants can perform any of their past relevant work or not.  Even if they cannot perform any past work, they must be unable to perform "any other work," which includes sedentary, simple, unskilled, entry level or minimum wage jobs.  In other words, if a younger claimant cannot do any past job but can change to a very simple, entry level job as a copy machine operator, a finding of "not disabled" will be entered.  In short, there must be no job in the US economy that this person is capable of performing.

Ages 50 - 54.  This is a borderline age category called "Closely Approaching Advanced Age."  If a claimant has less than a high school education, no work history or only a history of unskilled work, and is limited to Sedentary exertion, the grids find him disabled.  However, this same individual, if able to perform work at the Light exertion level will be found not disabled, as long as he can communicate in English.

Ages 55 or Above.  Generally, if this individual is unable to perform any of his/her past relevant work, a finding of disabled will be entered.  In short, an older claimant is not expected to adapt to new work and, if required to do so, will be judged disabled.  

I have simplified the grid rules tremendously here in order to give a very general idea of how they work.  You should consult with a disability attorney about your case to see exactly how the rules may apply to your particular circumstances.  Every case is different because no two sets of facts are exactly the same.

IS IT TIME TO FILE FOR DISABILITY?

Filing for disability benefits is a last resort.  An individual should file for disability when it becomes evident that they are either never going to be able to work again or that they will be unable to work for at least 12 straight months.  When I speak of "work," I'm using the term to mean a full-time job of around 40 hours per week.

Unfortunately, there come times in our lives when we know it's time to file for disability benefits.  Some of those times or events include:

• You have a major health crisis which will prevent you from working for a year or more: 

• Your doctor tells you that it's time to file for disability.

• The doctor has diagnosed you with a terminal condition.

• Your doctor states you have reached "maximum medical improvement" and you still can't work any job.

• You have tried easier jobs but have not been able to sustain even lighter work.

• You can't think of an easy, sedentary unskilled job that you could perform 40 hours a week.  (Not "find" this type of job, "perform" this type of job).

I'd be remiss if I didn't say that there are really 3 sets of rules for Social Security disability.  One set is for younger individuals ages 18 - 49.  One set is for individuals ages 50 - 54.  The final set of rules applies to persons ages 55 and over.

18 - 49     You must prove that you are unable to perform                      even unskilled, sedentary, minimum wage jobs.

50 - 54      You probably must prove the same standard above; however, some claimants may only have to prove that they can't perform any of their past work.

55+           You need to prove that you cannot perform any of the jobs you've held within the past 15 year-period.

ADDING NEW EVIDENCE FOR DISABILITY

Many people make the mistake of not adding new evidence as they wait for their disability hearing.  

Some claimants believe that once they file their appeal, all they need to do is wait until the hearing date arrives.  Actually, there is a lot more that must be done.

A claimant who is seeing a doctor or other healthcare provider on a regular basis is accumulating medical evidence constantly.  Each time you see a doctor, you have created new medical evidence.  This evidence needs to be submitted to the Social Security decision maker.  

New evidence can and should be submitted right up until the hearing date to keep the file up to date.  Failure to do so may result in a denied claim or a postponed hearing while the judge waits to get the new evidence.

If You Are Represented

If you are represented, your attorney or representative is responsible for updating your medical evidence.  Notify your representative each time you see a new or different doctor/provider, have a major diagnostic test, such as MRI--have surgery or are hospitalized.  Your representative can only order records you make him aware of.  

If You Are Unrepresented

If you are unrepresented, you must keep your medical file updated yourself.  Don't depend on Social Security to do so.  You should take the following steps:

• Notify the Office of Hearings Operations (OHO) of each new doctor or provider, along with dates of consultation.
• Notify the OHO of any hospitalization, surgery, or major diagnostic testing, such as X-rays, MRI or CT scans.
• Tell the OHO if you are diagnosed with any new conditions after you filed your last update.

In short, you must keep Social Security advised of how your medical condition and treatment is changing so they can keep your medical records updated.  They order records only from the doctors/providers you tell them about.  They have no way to "automatically" update your medical records.

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The Forsythe Firm

Representing Social Security Claimants in Alabama

7027 Old Madison Pike, Suite 108

Huntsville, AL 35806

CALL US:   (256) 799-0297

Email me:  forsythefirm@gmail.com

WEBSITE: SOCIAL SECURITY JUSTICE

BE DESCRIPTIVE AT YOUR HEARING

I've found it doesn't help to tell the judge which diseases you suffer from.  Claimants often want to say, "I have osteoarthritis," or "My doctor diagnosed me with migraine headaches."

It's much more helpful to describe the effects or symptoms of the disease, then describe how these symptoms limit your ability to perform work-like activities.  Let me share a couple of examples:

"My osteoarthritis causes constant pain in my lower back, hips and legs.  This causes prevents me from standing more than about 20 minutes at a time, sitting more than 1 hour at a time or bending repeatedly."

In the case of migraine headaches, it's best to describe how many migraines you have per week (on average) and how they affect your day.  Do you lie down when a headache occurs?  For how long?  Do the headaches otherwise interfere with your daily activities?

Judges simply do not award benefits based on a diagnosis.  There are thousands of people who work every day with migraine headaches or arthritis pain.  You need to explain why you are not one of those people who can work in spite of the pain.  

Function, or limitation of function, is the key to a Social Security disability claim.