Sometimes technical matters prevent disability claims from being paid. These are matter-of-fact, objective facts that render a claim ineligible for SSDI or SSI benefits.
What are some of these technical problems?
1. You don't have enough work credits to be covered by SSDI. In short, you haven't worked and paid enough into Social Security to be covered by the disability program; you are uninsured. If you haven't worked recently, the problem may be that your work was too long ago and your work credits have expired.
2. You waited too long to file an appeal. In most cases, only 60 days are allowed for filing an appeal on a denied application. If you wait too long, an administrative law judge will dismiss the appeal because of an untimely filing.
3. You are still working at substantial gainful activity on the date you allege disability. In 2020, earnings of at least $1,260 per month will disqualify an individual from getting benefits because of work. In 2019, that amount was $1,240 per month.
4. Your disabling impairment does not meet the duration requirement; that is, your condition isn't expected to last at least 12 straight months OR to end in death. Social Security does not cover short term disabilities which last fewer than 12 consecutive months.
If you feel a mistake has been made in your denial, the way to fix it is to file an immediate appeal. If your work credits are involved, you may be able to check your work credits through the Social Security office.
No matter how many times you call Social Security and discuss your problem with your denied claim, the only sure way to protect your rights under the claim is by filing a formal, written appeal within 60 days of the denial.
Never let 60 days pass without filing an appeal. When in doubt, appeal first and discuss later.
Sunday, January 26, 2020
BEFORE APPLYING FOR SSDi: 3 THINGS TO DO
It may be time for you to apply for Social Security Disability benefits (SSDI). The government may pay you a monthly benefit for the disability which prevents you from working.
There are 3 things you should do before applying for disability:
1. Check Your Earnings History. Most individuals need at least five years of recent work history (within the past ten years) to be eligible for SSDI. If you don't have the required work history, your benefits are at risk even before you apply.
2. Talk to Your Doctor. You will need strong medical evidence to support your claim that you're unable to work. Your doctor can help you by placing detailed information in your medical charts. Each time you go to the doctor, tell him or her that you are thinking of filing for disability and tell them why.
3. Check with a Social Security Disability Attorney. You may or may not decide to hire an attorney/representative right now. However, the information you can gather with a free phone call may be invaluable and help you avoid costly and time killing mistakes. Be sure to choose a representative who is knowledgeable and experienced in Social Security disability; not everyone is.
There are 3 things you should do before applying for disability:
1. Check Your Earnings History. Most individuals need at least five years of recent work history (within the past ten years) to be eligible for SSDI. If you don't have the required work history, your benefits are at risk even before you apply.
2. Talk to Your Doctor. You will need strong medical evidence to support your claim that you're unable to work. Your doctor can help you by placing detailed information in your medical charts. Each time you go to the doctor, tell him or her that you are thinking of filing for disability and tell them why.
3. Check with a Social Security Disability Attorney. You may or may not decide to hire an attorney/representative right now. However, the information you can gather with a free phone call may be invaluable and help you avoid costly and time killing mistakes. Be sure to choose a representative who is knowledgeable and experienced in Social Security disability; not everyone is.
Friday, January 24, 2020
JUDGE'S QUESTIONS AT YOUR HEARING
A disability hearing is a fact finding venture designed to help the administrative law judge make a fair, new decision on your request for benefits, which has been denied previously.
The judge's questions will focus on 5 areas:
1. Personal Information
2. Work History
3. Medical History
4. Medical Treatment
5. Daily Activities
As for daily activities, here are some things the judge will probably ask:
One of the most important things you can achieve at your hearing is to come across with credibility. That is, the judge feels that he can believe what you have said.
The judge's questions will focus on 5 areas:
1. Personal Information
2. Work History
3. Medical History
4. Medical Treatment
5. Daily Activities
As for daily activities, here are some things the judge will probably ask:
- How do you spend an average day?
- Do you have any hobbies?
- Are you able to dress and bathe yourself?
- Do you prepare your own meals? If not, who does?
- Do you take care of your child(ren)?
- Can you shop? Clean your house or apartment? Do your laundry?
- Are you able to climb stairs?
- How long can you sit? Stand? Walk?
- Any problem with kneeling or stooping?
- Do you drive?
- Have you taken an out of town vacation in the last 2 years? Where?
- Do you smoke or drink?
- Have you ever used any street drugs or recreational drugs?
- Are you able to read and do simple adding and subtracting? Make change?
- Have you looked for any work since your last job? Why not?
One of the most important things you can achieve at your hearing is to come across with credibility. That is, the judge feels that he can believe what you have said.
EARLY RETIREMENT BENEFITS AND SSDI
If you are at least age 62 you can receive early retirement benefits from Social Security and also apply for disability or SSDI.
However, you will receive reduced retirement benefits prior to your full retirement age. For persons born between 1950 and 1955, full retirement age is 66. That means you can receive retirement benefits with no reduction when you reach 66. Reduced benefits are available beginning at age 62.
Can a person who is at least age 62 receive early retirement benefits and apply for disability at the same time? Yes. You can apply for disability benefits any time before reaching your full retirement age. You can receive your early retirement benefit while a decision is being made on your disability application.
If your disability application is approved, your monthly benefit will be increased to the amount of your full retirement benefit, starting with the onset date of disability. This may involve some back pay.
If your disability application is denied (never approved), you will continue to receive the reduced early retirement benefit for the remainder of your life. You may receive periodic cost of living increases. When you reach your full retirement age, however, your benefit will not increase because you began taking it early, so the reduced benefit is "locked in."
In summary, receiving an early retirement benefit really has no impact on a Social Security disability application. The disability application will be processed just like it would if you were not getting early retirement benefits.
There is no disability benefit available after you reach full retirement age because you are already receiving the maximum benefit.
However, you will receive reduced retirement benefits prior to your full retirement age. For persons born between 1950 and 1955, full retirement age is 66. That means you can receive retirement benefits with no reduction when you reach 66. Reduced benefits are available beginning at age 62.
Can a person who is at least age 62 receive early retirement benefits and apply for disability at the same time? Yes. You can apply for disability benefits any time before reaching your full retirement age. You can receive your early retirement benefit while a decision is being made on your disability application.
If your disability application is approved, your monthly benefit will be increased to the amount of your full retirement benefit, starting with the onset date of disability. This may involve some back pay.
If your disability application is denied (never approved), you will continue to receive the reduced early retirement benefit for the remainder of your life. You may receive periodic cost of living increases. When you reach your full retirement age, however, your benefit will not increase because you began taking it early, so the reduced benefit is "locked in."
In summary, receiving an early retirement benefit really has no impact on a Social Security disability application. The disability application will be processed just like it would if you were not getting early retirement benefits.
There is no disability benefit available after you reach full retirement age because you are already receiving the maximum benefit.
YOUR HEARING: SOME STATEMENTS TO AVOID
Most disability applications are denied and the claimant must wait a year or longer to get a hearing before a judge. At the hearing, you will be asked a lot of questions. It is in your best interest to answer truthfully, give details, avoid rambling or getting off subject and be as specific as possible.
Unless, you are asked, there are some topics that you shold avoid altogether:
- You live in a region where no jobs are available at this time.
- You have family members who are currently receiving disability payments.
- You can't get to work because you don't have transportation or can't drive.
- You have a criminal background
- You have failed to follow the instructions or orders given by your doctor
- You have failed to take the medication prescribed by your doctor
- You haven't really tried to get recent medical treatment.
- You have had problems with alcohol or drugs
- You quit your most recent job for a non-medical, non-disability reason.
- You believe there are some jobs you could do if you could only find one.
- You are more entitled to a benefit than many other people who are getting one.
The judge will want you to speak in terms of how your medical condition prevents the ability to do work related functions. How does your condition keep you from sitting, standing, walking, lifting, paying attention, using your arms, feet or hands, etc.
It is not necessary for you to address your conditions in medical or diagnostic terms. The judge has your medical records and knows all of your conditions and diagnoses. Don't bother to tell the judge that you have spinal stenosis, degenerative disc disease or type 2 diabetes, for example. Talk about how your conditions affects your ability to do things you would have to do at work: stand, walk, lift and carry, reach above your head, or stoop/bend.
One of the things your attorney will do for you is meet with you in advance of the hearing and prepare you to testify. That way, you go into the hearing knowing what to expect.
4 THINGS SOCIAL SECURITY CONSIDERS
According to the federal regulations, there are 4 things that Social Security must consider when determining whether a person is disabled under their rules:
1. RESIDUAL FUNCTIONAL CAPACITY (RFC): What is the maximum that a person is able to do in terms of work-like activity or function? This is based on medical evidence. The most restrictive RFC is sedentary work.
2. PAST RELEVANT WORK (PRW): What full-time work has the claimant performed in the past 15 years. This is especially important to claimants who are at least 50 years old. SSA will consider skill level and exertion level of all past relevant work. If a person has done skilled work or sedentary work, it may make approval more difficult.
3. AGE: The most difficult age category for approval is "younger individuals," those who are below age 50. Social Security assumes that persons under age 50 can more easily adapt to new or different kinds of work. Ages 50 - 54 fall "in between" in a category of "Approaching Advanced Age." Claimants age 55 and over are in the "Advanced Age" category, which gives them the greater advantage of the medical-vocational guidelines or "grid rules," as they're sometimes called.
4. EDUCATION: Social Security will consider how much education a claimant has and how it effects the ability to work. Generally, the more education a person has, the more likely he/she will be to adapt to new types of work.
So, the "perfect" claimant (if there is such a person) would have an RFC limited to sedentary work, would have past work at the heavy or very heavy RFC, would be at least age 55 and have a limited education.
On the other hand, the most difficult case would involve a person under age 50, who can perform medium to heavy work, has an advanced education, and who has performed sedentary, highly skilled past work (with transferable skills).
Of course, almost nobody meets all of the favorable characteristics. Most claimants will meet one or two of them, not all 4. Some claimants don't meet any of the 4.
What's the best advice for someone thinking about Social Security disability? It's best to talk to a Social Security attorney or representative to get a free case evaluation. That can give a pretty good idea of the odds of meeting the basic requirements. There is never a charge for this service.
1. RESIDUAL FUNCTIONAL CAPACITY (RFC): What is the maximum that a person is able to do in terms of work-like activity or function? This is based on medical evidence. The most restrictive RFC is sedentary work.
2. PAST RELEVANT WORK (PRW): What full-time work has the claimant performed in the past 15 years. This is especially important to claimants who are at least 50 years old. SSA will consider skill level and exertion level of all past relevant work. If a person has done skilled work or sedentary work, it may make approval more difficult.
3. AGE: The most difficult age category for approval is "younger individuals," those who are below age 50. Social Security assumes that persons under age 50 can more easily adapt to new or different kinds of work. Ages 50 - 54 fall "in between" in a category of "Approaching Advanced Age." Claimants age 55 and over are in the "Advanced Age" category, which gives them the greater advantage of the medical-vocational guidelines or "grid rules," as they're sometimes called.
4. EDUCATION: Social Security will consider how much education a claimant has and how it effects the ability to work. Generally, the more education a person has, the more likely he/she will be to adapt to new types of work.
So, the "perfect" claimant (if there is such a person) would have an RFC limited to sedentary work, would have past work at the heavy or very heavy RFC, would be at least age 55 and have a limited education.
On the other hand, the most difficult case would involve a person under age 50, who can perform medium to heavy work, has an advanced education, and who has performed sedentary, highly skilled past work (with transferable skills).
Of course, almost nobody meets all of the favorable characteristics. Most claimants will meet one or two of them, not all 4. Some claimants don't meet any of the 4.
What's the best advice for someone thinking about Social Security disability? It's best to talk to a Social Security attorney or representative to get a free case evaluation. That can give a pretty good idea of the odds of meeting the basic requirements. There is never a charge for this service.
WHAT "DISABILITY" MEANS TO SOCIAL SECURITY
In reality, the term "disabled" doesn't mean anything to the Social Security Administration. It's a term used by individuals, doctors and lawyers but not used by Social Security, as surprising as this may sound.
Everyone who files a claim with Social Security believes they are "disabled." This doesn't mean that they will qualify for a benefit.
So, what is important to decision makers at Social Security?
They want to know whether a person has the capacity to perform any type of full time work which is available in the United States economy. For individuals under age 50, this usually means "Can you perform even a simple, unskilled minimum wage, sedentary job on a full-time basis? If so, they won't pay benefits.
Here are some common things that do not qualify for benefits:
Federal regulations require that a claimant meet very specific requirements to get a benefit. Social Security requires proof in a form acceptable to them.
In fact, benefits are getting more difficult to get with every passing year. Award rates have fallen by about 20 percent since 2010 and will probably continue to fall in the future.
One of the best services a disability attorney or representative can perform is to evaluate a case to see if the basic requirements are met. Our office will perform this evaluation free of charge.
Everyone who files a claim with Social Security believes they are "disabled." This doesn't mean that they will qualify for a benefit.
So, what is important to decision makers at Social Security?
They want to know whether a person has the capacity to perform any type of full time work which is available in the United States economy. For individuals under age 50, this usually means "Can you perform even a simple, unskilled minimum wage, sedentary job on a full-time basis? If so, they won't pay benefits.
Here are some common things that do not qualify for benefits:
- I am working but I'm not really "able" to be working.
- I can't perform my past work, but I can do other work.
- Nobody will hire me.
- There are no jobs available where I live.
- I can't live on the minimum wage job I could get.
Federal regulations require that a claimant meet very specific requirements to get a benefit. Social Security requires proof in a form acceptable to them.
In fact, benefits are getting more difficult to get with every passing year. Award rates have fallen by about 20 percent since 2010 and will probably continue to fall in the future.
One of the best services a disability attorney or representative can perform is to evaluate a case to see if the basic requirements are met. Our office will perform this evaluation free of charge.
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