Two-thirds of all Social Security disability claims get denied. That's about 67 out of 100. Why?
Claims get denied for many reasons. Generally, your denial letter will state, "You are not disabled according to our rules."
Social Security's definition of disability is very severe: they expect you to be totally unable to work at any full-time job for at least 12 consecutive months. And they want objective medical evidence to prove it.
Here is why many claims are denied:
- There simply wasn't enough medical evidence.
- All the medical evidence wasn't received.
- Your past relevant work was light or easy; therefore, they believe you can still perform it.
- Social Security sent you to one of their doctors who was a "warm body" in a lab coat. No help!
- Social Security didn't properly consider the opinion of your own treating doctor.
- They found that while you cannot perform some jobs, there are still a number of jobs in the national economy that you can do, despite your medical impairments.
What Should You Do?
Appeal your denial within 60 days. Seek and submit additional medical evidence. Get a statement from your own doctor (on a form acceptable to Social Security). Probably, you need to consider an attorney or non-attorney advocate--someone trained in federal appeals and winning denied claims.
- You cannot be charged a legal fee if you don't win.
- Initial consultations are free with no obligation.
- Attorney's fees are paid directly by Social Security.
- It will cost you nothing to file an appeal.
- The odds of winning at appeal are better, although no one can predict or guarantee the results.
SOCIAL SECURITY JUSTICE WEBSITE
Call for a Free Consultation: (256) 799-0297
HUNTSVILLE, AL / January 1, 2020
Attention Veterans: Social Security will pay billions of dollars to veterans in 2020.
If you served in any branch of the US military between 1954 and 2020, and are disabled prior to reaching retirement age--you may be entitled to monthly Social Security disability income.
Even if you are now on active duty but are unable to perform your regular military duties, you may qualify under the Wounded Warrior program.
Social Security can pay up to $3,011 per month. This is the maximum amount; few claimants will qualify for that much. SSDI benefits are in addition to any VA retirement or VA disability benefits paid.
The Social Security disability process is separate and quite different from the VA process. For one thing, Social Security requires a "full disability"; there are no benefits for a partial disability, as there may be with the VA.
If you are a veteran needing help with a Social Security claim, denial or appeal, please call me at the Forsythe Firm here in Huntsville. We handle SSDI claims and appeals all over Alabama and sometimes in Georgia, Mississippi, Tennessee, Kentucky and other states.
Free consultations and we will never ask you for money. If your claim is decided favorably after we represent you, Social Security will pay our agreed upon fee directly. If you do not win or do not recover back pay, we will never charge a fee.
Call us at (256) 799-0297
VISIT OUR WEBSITE: SOCIAL SECURITY JUSTICE
Social
Security uses an obsolete publication to identify jobs that a
disability claimant may be able to do. These jobs, in turn, are often
used to deny disability claims. The publication required by Social
Security decision makers is The Dictionary of Occupational Titles (DOT),
first published in the 1930s and last updated in 1993. The DOT
describes 12,569 jobs. Many of them are obsolete, from a bygone era.
Here are a few of the more ridiculous jobs found in the DOT. The DOT
code number is given, to prove this is no joke.
- Horse Identifier DOT Code 153.387-010
- Horse and Wagon Driver 919.664-010
- Butter Melter 523-585-010
- Animal Impersonator 159.047-018
- Bucket Chucker 664.685-014
- Side Splitter 525-684-018
- Bowling Ball Weigher 732.487-010
And my personal favorite....
- Coach
Driver, DOT Code 349.677-014. The DOT job description reads: "May
clean or polish vehicle such as a carriage, wagon or cart."
If you are judged physically and
mentally able to perform one of these archaic jobs (or any other job in the
DOT) you may be denied benefits at Step 5 of the sequential decision
making process, where most denials occur.
The
US Department of Labor considers the DOT to be obsolete. However, the
Social Security Administration considers it their primary vocational
resource--the definitive guide to jobs in the modern age. Judges are required to confirm that any vocational testimony "confirms to the DOT." Social Security has even taken "administrative notice" of the DOT, which makes it difficult to challenge it. Social Security's attitude: If it's in the DOT, it's Gospel.
This could be one reason your disability claim was denied: reliance upon such outdated data as the DOT. Some federal courts have taken notice of denials based on DOT data and have reversed the decisions on appeal.
I think Social Security is moving in the direction of allowing other occupational data to be used; however, no one knows how long that will take.
In
our experience with Social Security disability claims, there are some
factors that seem to increase a claimant's odds of being approved for
benefits. Here are some of them:
- a long, steady employment history;
- being age 50 or above (though not required to get benefits);
- failed work attempt(s) after the disability onset, demonstrating the desire to continue working;
- proper written statements from one or more treating doctors (not just any statement, the proper statement)
Doctors
may provide 2 types of evidence. One is objective evidence, the other
is opinion evidence. Most Social Security cases go to trial with only
the routine medical records from the doctors. This can't be relied on
to produce an award. Opinion evidence, on the other hand, provides the
doctor's opinion about how the claimant is limited in the ability to
perform work activities (sitting, standing, walking, lifting,
bending, concentrating, remembering, regular attendance, etc.). Opinion
evidence is a little harder to come by and is sadly lacking in most
cases that get denied. It can make a huge difference.
For instance, it isn't enough to have medical records proving that the claimant has arthritis.
The claimant is required to prove that his or her medical condition is
severe enough to prevent full-time, remunerative work on a full-time
basis.
We
often see useless doctor's statements like this: "Mr. Charlie Brown
has been a patient of mine for 10 years and it is my opinion that he is
disabled and cannot work at any job." The problem with such a
pronouncement is that it actually violates the federal regulations. The
conclusion about disability is reserved to the Commissioner of Social
Security and doctors may not determine who is disabled (20 CFR 404.1527; 416.927, etc.).
What may properly be stated by a doctor?
The answer is, his or her opinions as to the patient's specific
limitations or restrictions. How long the patient can sit, stand or
walk; how much can he/she can lift? What limitations are there in such
things as concentrating, remembering, making decisions, reaching,
stooping, kneeling, bending, etc. How many days per month would the
patient be expected to miss work because of a medical impairment? These
are examples of things that are permitted and the doctor's
opinion in these specific areas are admissible as evidence (although
Social Security is not bound by the doctor's opinion). But the doctor
may not conclude that a person is disabled or make a vague statement like, "He is not able to work."
In
Huntsville, the Forsythe Firm has helped hundreds of claimants get
Social Security disability payments. We offer free initial
consultations and evaluations without obligation. We are full service
disability advocates and can be involved in every stage of your Social
Security disability claim--from application through appeal. We never
charge a fee unless you win and receive back pay.
PHONE: (256) 799-0297
https://forsythefirm.wixsite.com/website
1)
At what age may I apply for Social Security disability (SSDI)?
Answer: Adults may apply any time before your full retirement age. (If
you were born in 1948, for example, your full retirement age is 66).
Children may apply any time prior to age 18. There are special rules for adults who became disabled prior to age 22.
2)
What monthly benefit may I expect from SSDI? Answer: The benefit
amount will vary based on your average wages and work history. The
maximum monthly benefit in 2020 is $3,011. The average monthly benefit
is $1,257.
3)
Can my spouse or dependent children also receive benefits? Answer:
Yes, dependents may qualify for benefits based on the wage earner's
disability. Dependent grandchildren may also be eligible. A spouse who is caring for a disabled wage earner's dependent children under age 16 may also qualify.
4)
Will I get Medicare insurance with my disability benefits? Answer:
Yes but there is a waiting period. Medicare starts 29 months after the
official onset date of disability for SSDI claims. Note that this is 29 months from the disability onset, not from the date of your decision. SSI beneficiaries get Medicaid and there is no waiting period for Medicaid.
5)
If my doctor tells me I am disabled and cannot continue working, are
disability benefits automatic? Answer: No. You must still apply and
prove to Social Security that you are disabled according to their rules. Many times, such individuals are denied and must appeal in order to get benefits. Appeals must be filed within 60 days of denial.
6)
I saw my doctor today and he does not think I will be able to continue
working much longer. May I apply for Social Security disability now and
keep working until I am approved? I want to have my claim approved
before I stop working. Answer: No, the system does not permit this.
You must not be working at substantial gainful activity when you
apply for disability benefits. If you are, you will be denied at Step
1, regardless of the medical evidence.
7)
I am 64 years old and retired. I worked for more than 40 years. I've
been receiving Social Security early retirement benefits for about 2
years. I've been healthy until now. Recently, however, I was diagnosed
with a severe illness for which there is no cure. Since I am already
receiving Social Security retirement, may I file a disability claim?
Answer:
Yes, you may. You are under full retirement age and it appears you
have adequate work credits to support a claim. Also, I assume your
recent impairment will last for 12 months or more (the duration requirement), so you may file a disability claim and try to prove
disability. As long as you are not working, your present income does not
matter for a Title 2 (SSDI) claim. If your claim is successful, your monthly benefit will be increased to the amount you would have received at full retirement age (payable from the onset date of your disability).
Also, you may qualify for earlier Medicare coverage, in the event you
are not yet 65 when your case is decided. You may continue to receive
your retirement benefits while your disability claim is being decided.
Even if you eventually do not get a favorable decision on the disability
claim, it will have no impact on your retirement benefits, which you
will continue to receive. So, you risk nothing by filing for
disability. A final thought: At age 62, it may be easier to win a
disability claim, compared to a younger individual, thanks to the
medical-vocational guidelines.
________
If
you have a Social Security disability question that was not answered
here, or on one of our many blog posts, please call the Forsythe Firm in
Huntsville, AL at (256) 799-0297.
There is no charge or obligation for a consultation.
Before
awarding an SSDI benefit, Social Security must convince itself that you
are not able to sustain full-time work 8 hours a day, 5 days a week, 52 weeks per year.
Of
course, the physical demands of work vary a great deal from job to
job. Social Security recognizes 5 exertion levels in today's workforce:
- SEDENTARY
WORK requires mostly sitting with lifting no more than 10 pounds at a
time, the ability to occasionally lift and carry files or small tools;
occasional standing and walking (less than 2 hours per day).
- LIGHT
WORK requires lifting no more than 20 pounds at a time (occasionally),
frequent lifting and carrying objects weighing up to 10 pounds; frequent
walking or standing or sitting while pushing arm or leg controls.
- MEDIUM
WORK involves lifting up to 50 pounds occasionally and frequently
lifting or carrying objects weighing up to 25 pounds. It also requires
frequent standing/walking. If you can do medium work, you can also do
light work.
- HEAVY
WORK requires lifting no more than 100 pounds occasionally and lifting
and carrying objects weighing up to 50 pounds frequently. It requires
frequent standing/walking. If you can do heavy work, you can also do
medium work.
- VERY
HEAVY WORK involves lifting objects weighing no more than 100 pounds at
a time and frequently lifting and carrying objects that weight more
than 50 pounds. Frequent standing/walking required. If you can perform
very heavy work, you can also perform heavy work.
Q. If I can perform Light work, can I also perform sedentary work? The answer is yes, usually. There are 2 exceptions:
If
a claimant has difficulty sitting for prolonged periods of time, or has
difficulty performing fine manipulations with the hands (feeling,
fingering, pinching), the person might be found capable of performing
Light work but not Sedentary work.
The
above limitations are only exertional. They do not take into account
postural limitations such as reaching, bending, crouching, squatting,
kneeling, balancing, climbing). They also do not take into account any
mental limitations (memory, focus/concentration, decision making,
etc.). All jobs do have certain mental functional abilities which are
required.
For claimants under the age of 50, Social Security will usually deny claimants if they are found able to perform jobs at any exertion
level. For those over age 50, the rules are a little more relaxed and
the Medical-Vocational Guidelines can be helpful.
___________
The Forsythe Firm
(256) 799-0297
https://forsythefirm.wixsite.com/website
Lyme
Disease is transmitted to humans by the bite of the black legged tick,
commonly called a "deer tick." The infectious agent is a little
bacterium called Borrelia burgdorferi. Symptoms can include a
rash (but not always), fatigue, dizziness, neurological symptoms, joint
aches, and sometimes a fever. Getting a correct diagnosis for Lyme
Disease may be difficult because the symptoms of Lyme Disease are quite
similar to many other illnesses and doctors often have never encountered
a case of Lyme. Lyme is usually curable with a few weeks of
antibiotics. However, if the disease goes untreated, it can cause
severe symptoms, including joint inflammation (Lyme arthritis), heart
problems, disorders of the central nervous system, and more.
There
is no specific listing for Lyme Disease in the Social Security blue
book. If there are severe associated symptoms, a claimant may meet a
listing for another body system: nervous system disorder, heart
impairment, etc. If that is not the case, the claimant must prove that
the combined symptoms of the disease are so severe that full-time work
cannot be maintained.
I
have recently won cases involving Lyme Disease. Here is a little of
what I have learned with regard to Lyme Disease and Social Security.
1)
Try to see out a specialist to confirm the diagnosis. Specialists are
few and far between. Social Security will be skeptical that symptoms
are being caused by Lyme Disease. It is essential to get a firm
diagnosis by a doctor who understands the disease. Many doctors will
tell you that there is no such thing as chronic Lyme Disease, or that it
is impossible to diagnosis it accurately. Some will try to send you
off to a psychiatrist because they think it is a mental impairment.
2)
Be sure your doctor ties the cause of symptoms to the yme Disease. In
other words, the doctor should confirm that such symptoms as chronic
fatigue, dizziness, nausea, palpitations, cognitive problems, etc. are
being caused by the late affects of Lyme Disease, not something else.
3)
If possible, get a medical source statement or residual capacity form
from your doctor (specialist) which specifies your physical and mental
limitations. Have the doctor address the work-like activities that you
are not able to perform, and to state the severity or degree of each
impairment.
4)
Be sure to follow prescribed treatment to the extent possible. If you
have a complicated case of Lyme, especially one that was not treated
early, treatment may take months or years. It's easy to get discouraged
and give up. Find a doctor who will support you and stay with it.
5)
Try to find an attorney or advocate to represent you who has experience
with Social Security disability cases based on Lyme Disease. Some of
the basics of good representation apply to these cases, however, there
are things about Lyme cases that are approached differently.
https://forsythefirm.wixsite.com/website
-----------
The
Forsythe Firm in Huntsville is available for free consultations for any
impairment leading to a Social Security disability claim. We will meet
with you without cost or obligation. If we agree to represent you, you
do not owe a fee unless you win your claim and collect past due
benefits. We can be reached at (256) 799-0297.
