Monthly Archives: August 2010

How Can You Prove a Social Security Disability Case?

Do you suffer from a physical or mental health condition which is considered severe? Are you unable to work? If your condition is expected to last at least 12 months or result in death you may be able to receive Social Security Disability benefits.

Some applicants assume getting Social Security Disability benefits is as simple as producing a doctor’s note which states they are disabled. If only it were that simple. Unfortunately, the process can be cumbersome and complex. Claimants may be denied Social Security Disability benefits multiple times before they are eventually approved.

How can you prove you are disabled and unable to work? You must get medical care and accumulate medical records which can prove your condition. Many claimants do not have a job or medical insurance thus making it nearly impossible to get good medical records. Unfortunately, without medical records claimants filing for Social Security Disability benefits are unable to prove to the Social Security Disability Determination Services (DDS) that they are disabled and will be denied Social Security Disability benefits.

What can a claimant do if they do not have medical documentation for their condition? This question is asked everyday, “How do I see the doctor if I do not have any money?” It can be difficult, but it is not impossible. If you have ever had medical coverage and seen a doctor for the conditions you are filing for you may be able to establish your alleged onset date. Current medical records may be obtained by visiting free local clinics in your area, and claimants may be able to request the same doctor for each visit to establish a doctor/client relationship. Visiting an emergency room would also be a last resort for diagnosing a condition.

Claimants who file for Social Security Disability Insurance or Supplement Security Income benefits without medical records may be sent for consultative exams by the disability examiner who is reviewing their Social Security Disability claim. Social Security Disability claims have been won based on the recommendations of the consultative examiners, but this is unlikely to occur if the claimant’s condition does not meet or equal a listing found on the Social Security Administration’s List of Impairments. Consultative examiners are not offering treatment for claimants but rather simply identifying impairments. Their ability to diagnosis a claimant will be limited by their lack of historical medical information and their lack of a patient/doctor relationship.

What if you have solid medical evidence of your severe medical condition but Social Security Disability benefits have still been denied? What else can you do? Winning Social Security Disability benefits may be as simple as hiring a competent Social Security Disability lawyer to plead your Social Security Disability case. Social Security Disability attorneys can review all of your medical records, gather residual functional capacity forms from your doctor and argue your case before the Administrative Law Judge at your Social Security Disability hearing.

A solid diagnosis, complete medical records, evidence establishing you are unable to work at your current job or be retrained for any other job is just the first step in the Social Security Disability process. It is time to talk to a Social Security Disability attorney and put the finishing touches on your Social Security Disability claim.

Can You Win Social Security Disability Without Going to a Hearing?

Winning Social Security Disability Insurance or Supplemental Security Income Benefits at the application level and avoiding a Social Security Disability hearing is not impossible, but it can be difficult. How can you increase your chances of winning benefits at the Social Security Disability application level? The best way is to understand the Social Security Disability process and how the Social Security Administration will make the determination about whether or not you are disabled and unable to work.

The Social Security Administration uses a five-step approach called the Sequential Evaluation Process to determine if claimants are disabled and unable to find a job given their current physical or mental limitations. Under the Sequential Evaluation Process the Social Security Administration will ask:

  • Are you working? Work (as defined by the Social Security Administration) is making more than a certain amount every month. The amount is updated periodically but for 2010 the claimant is allowed to make $1000 per month (blind individuals can make $1,640 per month)
  • Is your medical condition severe? Severe medical conditions are those which will last at least 12 months and do not allow or severely limit a claimant’s ability to perform basic work activities.
  • Is your medical condition on the List of Impairments? The List of Impairments is maintained by the SSA and describes groups of mental and physical health conditions which are so severe that a claimant is unable to work. If the claimant’s condition is not on the List of Impairments the SSA will continue to step 4.
  • Can you do the work you did before? If the claimant’s medical condition is too severe to perform their current job the SSA will continue to step 5. If the condition enables them to continue working Social Security Disability Benefits are denied.
  • Can you do any other type of work? If a claimant’s condition is too severe for the claimant to continue in their current line of work the SSA evaluates whether or not there is any other job they would be qualified to perform in the current economy. The SSA will make this determination by evaluating the claimant’s age, medical health condition, education, past work experiences and any additional skills the claimant possesses. Claimants who can be retrained for other types of employment are denied Social Security Disability benefits. Claimants who can not perform their current job and can not be retrained for any other type of employment are considered disabled and given Social Security Disability Benefits. Whether or not the claimant qualifies for SSDI (Social Security Disability Insurance) will depend on whether or not they have enough work credits. The amount of credits and the amount of Social Security Disability benefits paid will depend on how old you are and when you became disabled. Claimants who do not qualify for Social Security Disability Income may qualify for Supplemental Security Income benefits if they meet the Social Security Administrations income and resource requirements.

Understanding the determination process, understanding the List of Impairments and documenting your mental or physical health conditions clearly and concisely can greatly increase your chances of having your Social Security Disability application approved at the first level and avoiding a hearing. The Social Security Administration is responsible for gathering current and accurate medical records but following-up and sending medical records you already have can also be helpful. Many claimants also increase their chances of getting Social Security Disability benefits by hiring a competent Social Security Disability lawyer who can follow and review the process every step of the way.

What are the Steps for Applying for Social Security Disability?

If you have become disabled and unable to work you may qualify to receive Social Security Disability payments.  The Social Security Administration manages two programs for individuals who are no longer able to work and meet their definition of disabled. Unfortunately, it takes more than a doctor’s note to qualify for disability benefits. The SSA considers an individual disabled if they do not have “the ability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or … has lasted or can be expected to last for a continuous period of not less than 12 months.”  The Social Security Administration does not provide disability benefits for short-term disabilities which will last for less than 12 months.

Applying For Social Security Disability

The Social Administration has made it easier than ever to apply for Social Security Disability benefits. Applicants may apply in person, over the phone or online.

  • Fill out the Social Security Disability Application:

Applying online

For those who have basic computer skills filling out the SSD application online may be the easiest method to use. An applicant can access the Social Security Administration’s website from the convenience of their home with their personal computer and will avoid long lines and unscheduled delays at the Social Security Administration office. Applicants can apply for Social Security Disability Insurance online if they are over the age of 18, have worked and paid Social Security taxes long enough to qualify for Social Security Disability Insurance and they have a mental or physical health condition which does not allow them to work and is expected to last for 12 months or longer. Applicants must also live in the United States or one of its territories.

Applying in Person

Applicants who would prefer to apply in person can call the Social Security Administration Office and request a meeting in person or over the telephone.   The Social Security Administration Office number is 1-800-772-1213.  In-person or telephone interviews may be more difficult and time consuming but applicants may be able to ask questions and have help completing their Social Security Disability application. It is important to maintain a call log of the names of people you have spoken with and the dates and the times of each conversation.

All applicants will need to provide the following documents:

Copies of all work history information for the past 15 years
Copies of your most recent W-2 forms
All medical information including: doctors, hospitals, and clinics names, phone numbers and addresses
The Social Security Number for the person applying for Social Security Disability Insurance
A valid birth certificate
Information regarding medications taken and laboratory tests performed
All information regarding marriages and dependants (names, ages and birthdates)
Any other information about other public benefits that an individual is receiving

  • Claim Is Approved

It generally takes the Social Security Administration several months to evaluate a claimant’s Social Security Disability application and determine if they qualify for SSDI (Social Security Disability Insurance) or SSI (Supplemental Security Income) benefits. The Social Security Administration will notify the claimant in writing if they are awarded Social Security Disability benefits and the disability notice will contain the benefit amount and the date the Social Security Disability benefits will officially begin. Under some conditions, claimants may receive retroactive payments. Talk to a Social Security Disability lawyer for more information.

  • Social Security Disability Review Process

Receiving Social Security Disability benefits is not the final step. Due to advancements in medical technology, it is not uncommon for some claimants to eventually become physically and mentally healthy enough to start working again. The Social Security Disability office will periodically perform a Continuing Disability Review (CDR) to determine if an individual is still disabled. Individuals who have a high probability for improvement may have to submit to a review every 6 to 18 months. Other claimants who have a low chance of improvement may have their Social Security Disability case reviewed approximately every 7 years. Reviews are done by mail, in person or over the telephone.

  • Social Security Disability Claim is denied

Most Social Security Disability claims are denied. If you receive a denial you have several choices 1) file a request for a Social Security Disability appeal (the first appeal in most states is the reconsideration) 2) file another Social Security Disability application 3) do not pursue a Social Security Disability claim.

  • Request for Reconsideration

Claimants who file a request for reconsideration must do so within 60 days from the date of receiving the Social Security Disability denial letter. Claimants who do not meet the appeal deadline will have to reapply and start the process again.

Applicants have about a 20% chance of receiving an approval at the reconsideration level. The approval or denial may take from 30 days up to 8 months depending on the case load for your region.

  • Request for a Social Security Disability Hearing

Applicants who have not already hired a Social Security Disability lawyer generally do so prior to requesting a Social Security Disability hearing. A Social Security Disability Hearing is a chance for you to argue your case before the Administrative Law Judge. This will be your best opportunity to present all relevant medical evidence and prove you are disabled. Hiring a professional who has experience gathering medical records, developing a case and strategically arguing your claim can greatly improve your chances of receiving Social Security Disability benefits. The Social Security Disability attorney can fully review claim and identify any misconceptions or subjective conclusions which were erroneously made when your Social Security Disability case was initially reviewed by the Social Security Administration. The Administrative Law Judge will review the evidence and make a decision for your case.

If your claim is denied at the Administrative Hearing Level a claimant may request an appeal to the Appeals Counsel and another subsequent appeal can be made in Federal Court.  Social Security Disability attorneys can review your denial and determine the next best step for your Social Security Disability claim.

Will the Social Security Administration consider me disabled?

Social Security Disability Insurance or Supplemental Security Income benefits are not short-term disability benefits. Individuals who are substantially gainfully employed who are making more than $1,000 per month or whose mental or physical health conditions are not expected to last for at least 12 months need not apply. Medical conditions must also be supported by medical evidence.

The Social Security Administration defines “disabled” as the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment(s) which can be expected to result in death or … has lasted or can be expected to last for a continuous period of not less than 12 months.”

To determine if an adult (over the age of 18) is disabled the Social Security Administration will evaluate their mental and physical health conditions (as evidenced by the claimant’s medical records) using a five-step Sequential Evaluation Process:

  1. Is the claimant engaged in substantial gainful activity (SGA)? The Social Security Administration considers substantial gainful activity in 2010 as making more than $1,000 per month or working a regular 40 hour per week work schedule (or the equivalent work schedule). If a claimant is able to make this much money each month the SSA will consider them not disabled, regardless of their mental or physical health condition, their education, their work experience or their age.
  2. Is the claimant’s mental or physical condition severe? The claimant’s ability to do work should be severely limited for at least 12 months or more. If the claimant’s mental or physical health condition is not severe the claimant will be determined not disabled. If the claimant’s condition is severe the Social Security Administration will continue to step 3.
  3. Is the claimant’s mental or physical condition listed on the Social Security Administration’s “List of Impairments”? The List of Impairments is a document which identifies conditions that are so severe that the claimant who has these conditions will be determined automatically disabled. If the claimant’s conditions meets or equals one of the listings documented on the Social Security Administration’s List of Impairments the SSA will determine the claimant is disabled, if not the Social Security Administration will continue to step 4.
  4. Can the claimant perform the work they have done before? The Social Security Administration will evaluate if the claimant can do any of the previous jobs they have done in the past (the SSA generally evaluates jobs held in the last 15 years). The Social Security Administration will make this evaluation by analyzing the claimant’s residual functional capacity or RFC. RFC can be physical and can include the claimant’s ability to sit, stand, walk, bend or lift, or it can be mental and include the claimant’s ability to follow directions, get along with co-workers, regularly attend work and maintain standards of cleanliness, pace and concentration.
  5. Can the claimant perform any other type of work which is found in the general economy? If a claimant is unable to perform a past job the Social Security Administration will evaluate if there is any type of work they could do given their age, their medical condition, their past job experience and any other residual skills. If the SSA determines the claimant can not do any other work they will be determined disabled. If the claimant could be retrained to do some type of job they will be determined not disabled.

Additional non-medical requirements exist for claimants to qualify for either SSDI (Social Security Disability Insurance) or SSI (Supplemental Security Income). Talk to a qualified Social Security Disability lawyer for more information about Social Security Disability requirements.

How are Medical Records Gathered by the Social Security Administration?

Winning Social Security Disability benefits can be an arduous process but with a little information and effort there are some simple things the claimant can do to facilitate the process. One of the most time consuming tasks for the Social Security Administration is gathering medical records for each Social Security Disability applicant. Understanding the data gathering process and helping out where possible can expedite the Social Security decision making process.

  1. The first step in the Social Security Disability application process is for the applicant or claimant to submit their Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) application to the Social Security Administration. Applications can be completed over the phone, in person or online. Claimants who wish to meet a Social Security Representative in person will go to the Social Security Administration’s nearest field office. Appointments should be made in advance.
  2. The claimant’s SSDI or SSI application will evaluated by the Social Security Administration. In most states the agency who evaluates a Social Security Disability Insurance or Supplemental Security Income claim is called the DDS or Disability Determination Service.
  3. At the Disability Determination Service office the SSI or SSDI claim is assigned to a disability examiner. The disability examiner is responsible for sending out requests to all of the applicant’s medical providers who were listed on the application for medical information for the claimant. The M.E.R. requests or medical evidence of record requests should be completed by each doctor, clinic and hospital as soon as possible and sent back to the Social Security Administration for review. It is extremely important that the disability claimant provide an accurate and complete list of all medical personnel and clinics that have provided medical care for their disabling health conditions.
  4. The claimant’s disability case is considered “on hold” until the medical records are received and the evaluation for the Social Security Disability case can continue. Unfortunately, gathering medical records can be the most time-consuming part of the disability evaluation process and can take weeks or months. The disability examiner, who is evaluated on the number of cases they can get closed, generally makes every effort to gather records as fast as possible. Claimants who are able to provide their own medical records to the examiner may eliminate this step and expedite the decision for Social Security Disability benefits.
  5. After the disability examiner receives the claimant’s medical records they will begin to evaluate the claimant’s Social Security Disability claim and make a determination of whether or not they are physically or mentally impaired and unable to work.

Every claimant wants to know “what can I do?” The answer is very simple, do everything you can to make sure the disability examiner has accurate and complete medical records to make your disability determination. If you have copies of your medical records they can be sent to the disability examiner. Review your medical records and make sure they accurately reflect your current medical condition. Hiring a Social Security Disability attorney may also help. Social Security Disability lawyers can gather medical records and request statements from your doctors which outline your medical conditions and any residual function capacities you may have to continue working.

Do not stop going to the doctor. Receiving Social Security Disability benefits can be a lengthy process. Keep going to the doctor for your mental and physical health conditions. Continuous medical care is imperative and can provide evidence that your condition is serious and you are dedicated to getting the medical treatment you need.