Monthly Archives: January 2012

Consultative Examination – How long will it take for a SSA disability decision?

Many Social Security Disability Insurance and Supplemental Security Income claimants assume that if the Social Security Administration has sent them to a consultative examination that this is a good sign for their claim and they are on their way to getting approved for SSA disability benefits.

When will I be sent to a consultative examination?

The Social Security Administration will only send Social Security Disability Insurance and Supplemental Security Income applicants to a consultative examination if they do not have enough medical evidence to determine from the claimant’s own medical records that they are disabled, the treating doctors failed to send the claimant’s medical records or the claimant has not seen the right doctor.

So right from the start, if you are scheduled for a consultative examination it means that your case lacks something significant: the proper medical files for a Supplemental Security Income or Social Security Disability Insurance disability determination. Unfortunately, this is never good.

How long after the Consultative Examination will I have to wait for a disability decision?

This question is very difficult to answer. If you have seen the consultative examiner you may have submitted your Social Security Disability Insurance or Supplemental Security Income application as many as three months prior. It may take an additional 30 to 90 days after the consultative examination for the consultative examiner to complete their report and send it back to Social Security Administration.

Processing times throughout the United States can also vary widely. There may be parts of the country which have a significant backlog of claims that must be processed.

If after the Disability Determination Services office receives the consultative examination report and finds the claimant disabled, according to the Social Security Administration they must “complete any outstanding non-disability development, compute the benefit amount, and begin paying benefits.” Unfortunately, there generally is a backlog of applications to process at every step in the Social Security Administration process.

How can I avoid a consultative examination?

Social Security Disability Insurance and Supplemental Security Income claimants who do not understand the disability evaluation process are frequently asking when the Social Security Administration will send them to a consultative evaluation or “medical exam” to determine disability.

This is a question only someone without knowledge of the disability decision making process would ask. The right question to ask is, “How can I avoid being sent to a consultative examiner?”

Consultative examinations should not be considered “medical care.” They are very cursory (often lasting for less than 10 minutes), they are generally not helpful to claimants, and they in no way should substitute for great, consistent medical care from a claimant’s treating physician.

So how do you avoid an examination? Go to the doctor. What if you do not have medical insurance? Find a way to prioritize medical care and go to the doctor. What if you are not following your doctor’s treatment plan? Find a way to follow your doctor’s treatment plan.

The bottom line for every Social Security Disability Insurance and Supplemental Security Income claimant is to get the best medical care that you can for your health conditions and do what your doctor recommends. If, after having done all of this, you still are unable to work for at least 12 continuous months, at least you will know you have done all you to help your disability claim.

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Social Security Administration Disability Benefits, Alcoholism and Drug Addiction

How does drug abuse and alcoholism factor into the Social Security Administration disability decision?

Many Social Security Disability Insurance and Supplemental Security Income claimants are either drug addicts, alcoholics or recovering from a serious drug or alcohol addiction and they are wondering whether the drug and alcohol addiction is considered a disability, and if it is not, how will the Social Security Administration make their disability determination. Does the Social Security Administration automatically deny all claims from drug and alcohol addiction applicants?

According to the Social Security Administration, if you have history of drug abuse or alcoholism the Social Security Administration must determine whether the abuse is a contributing factor which they consider material to your impairment.

According to the Social Security Administration, “Drug addictions or alcoholism cannot be considered a “disability” on the basis of that diagnosis alone; on the other hand, a diagnosis of drug addiction or alcoholism should not have an effect on a Supplemental Security Income or Social Security Disability Insurance evaluation that is adverse to the applicant. Drug addicts and alcoholics are subject to all the ills that may affect any other applicant. Drug addiction and alcoholism are diagnostic terms; they do not denote impairment value or severity. It is necessary to evaluate the severity of the impairment which may be associated with, manifested by, result from, or coexist with these diagnoses.”

Determining a Supplemental Security Income or Social Security Disability claimant is disabled

The Social Security Administration uses a five step sequential evaluation process to determine if you are disabled. The most basic steps are listed below.

  1. Are you performing substantial gainful activity? Claimants who are working too much are automatically denied disability benefits.
  2. Is your disability or condition “severe”? Claimants who do not have a severe condition are automatically denied Supplemental Security Income and Social Security Disability Insurance.
  3. Is your condition found in the Social Security Administration’s Listing of Impairments?
  4. Can you perform your current job or any past relevant work?
  5. Can you retrain any other type of new work?

Determining disability for alcoholism and drug addictions

If you are determined disabled by the Social Security Administration, after they complete the “normal” five step sequential evaluation process if you are dependent on drugs or alcohol, they will add an additional sixth step.

  1. Would your disabilities continue to exist if the if substance-abuse issues were gone? If the answer is no, Social Security Disability Insurance or Supplemental Security Income benefits will be denied. If the disability would persist, regardless of your addiction, benefits will be approved.

Proving step six in the sequential evaluation process can be tough for addicts. Contact a disability lawyer if you need more information.

According to the SSA, the decision will depend on “the severity of the impairment, as properly documented by the required medical findings, and, for appropriate cases, the limitation of function imposed on the applicant by the impairment in conjunction with applicable vocational factors. An individual may be a drug addict or an alcoholic and not be disabled if the evidence fails to show inability to engage in substantial gainful activity.”

Treatment and Payment Requirements for alcoholism and drug addictions

If the Social Security Administration determines you are disabled due to a disability but you have an addiction issue, you must undergo and complete an addiction-treatment program prescribed by a medical professional.  A representative will also receive your Supplemental Security Income or Social Security Disability Insurance benefits and help you manage your money by assigning you a representative payee.

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Supporting yourself while you wait for Social Security Administration Disability

Many claimants who apply for either Supplemental Security Income benefits or Social Security Disability Insurance have been out of work for weeks or months and are facing a serious financial crisis. One common question we get on our forum is, “What do I do for money while I wait for disability benefits to be approved by the Social Security Administration?”

The answer to this question obviously depends on many factors, but this blog will discuss some of the basic steps that you can take to weather the weeks, months or years that you may end up fighting for Supplemental Security Income or Social Security Disability Insurance benefits.

Will I have to wait months to get approved for Social Security Administration disability benefits?

One of the first questions claimants have when evaluating how to survive until they get their benefits is how long the disability determination process will actually be. Do some claimants actually wait years to get approved? Is there a way to expedite claims? Does everyone who applies get Supplemental Security Income or Social Security Disability Insurance benefits?

Many claimants who apply for SSA disability benefits will not be approved. Either they do not have enough work credits (for Social Security Disability Insurance), their income and resources are too high (for Supplemental Security Income), their condition is considered not severe enough, or their condition will not last for 12 continuous months.

There are many claims that can be expedited and approved immediately (compassionate allowance, TERS, wounded warriors), but most claims will not be approved immediately, and the claimant will have to appeal at least one denial (sometimes mores). Filing multiple appeals is what can add substantial time to processing a disability claim.

Financial options while waiting for Social Security Administration disability benefits to start

Making the assumption that the disability process may take months or years, you are probably wondering what you can do if you are not able to work. You may have a spouse who is working who can relieve some of the financial stress but what if you are single? There are options, but unfortunately, they are limited.

  • Save money BEFORE you quit working

This sounds idealistic and many families are struggling to barely make ends meet while they are working, but with the understanding that it may take months to get Social Security Disability Insurance or Supplemental Security Income, it is imperative that you begin to save a little bit each month into a special account to prepare for the time when you are no longer able to work.

  • Borrow money from friends or family members

Often borrowing money is not a good idea, and even in this case it should be a last resort, but if you have a family member or friend who is willing to help you out, it may be your only option.

  • Take out a home equity loan or personal loan

If you own a home and you have equity in your home you may be able to refinance the home and take some of your equity out of your home to help sustain you for a few months.

  • Work VERY part-time

It may be possible to work a few hours a week and still get approved for Social Security Disability Insurance or Supplemental Security Income. Keep in mind, performing substantial gainful activity will automatically result in a denial of SSA disability benefits.

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Child Support and SSA Disability

Child support is provided to a child during their formative years. It is paid by one of the parents and is mandated by the court. The goal of child support is to ensure that if parents divorce or separate the child is able to maintain their current standard of living, which the court has determined should not substantially decrease due to the change in their living arrangement.

For example, if the custodial parent is unable to provide the financial support that the noncustodial parent enjoys, the assumption made by the court is that the noncustodial parent is responsible for paying an amount of child support that reflects their lifestyle. The courts often award child support as a percentage of the noncustodial parent’s income.

Child support may have to be paid by either the mother or the father and payments are made on a monthly basis. The optimum method of child support collection is done by payroll deduction prior to the parent receiving their wage. This type of payment structure has eliminated some of the law enforcement efforts that tend to be costly and time consuming.

How is child support paid if the paying parent is on SSA disability?

Many claimants want to know what will happen to their child support payments if the noncustodial parent becomes disabled and no longer has an earned income from employment, but is instead, relies on the Federal Government each month for financial support through either Supplemental Security Income or Social Security Disability Insurance. Whether or not your ex-spouse or partner’s disability benefits will be garnished for child support will depend on what type of disability payment they are receiving.

  • Social Security Disability Insurance

According to Social Security Ruling 79-4, “the Social Security Administration can withhold a percentage of a claimant’s Social Security Disability Insurance or SSDI benefits in an amount equal to what SSA could withhold to pay delinquent income tax debt.”

Prior to withholding any type of payment the Social Security Administration should notify the claimant 60 days in advance. So if your ex-spouse or partner is receiving Social Security Disability Insurance benefits the amount of payment could be reduced by the courts, especially if the monthly amount of SSDI benefits they are receiving is substantially lower than their prior wages, but you should continue to receive some type of child support payment.

  • Supplemental Security Income Benefits

Unfortunately, if your ex-spouse or partner does not qualify for Social Security Disability Insurance, which means that they have not been working and paying employment taxes and are not “insured” for SSDI benefits, assuming they are determined disabled by the Social Security Administration they will only be entitled to receive Supplemental Security Income (assuming they meet the income and resources requirements for SSI).

Supplemental Security Income is not generally seized for child support. The Supplemental Security Income payment is considered a “public welfare benefit” and is not derived from the claimant’s earnings record. Supplemental Security income is similar to other public benefits that are not seized such as food stamps.

So to answer the question, if your ex-spouse is receiving Social Security Disability Insurance, although the amount of child support paid may be reduced by the court, you should still receive some type of payment. If your ex-spouse is receiving Supplemental Security Income, you may not receive child support.

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Sleep Apnea and Disability

Can I get Social Security Disability Insurance or Supplemental Security Income for Sleep Apnea?

Sleep apnea causes a reduction of airflow during sleep. It is common in adults and generally treated through either surgical or nonsurgical means. The most common symptoms of sleep apnea are a break or loss of airflow which causes the sleeper to stop breathing, sometimes for as long as ten seconds.

The lack of oxygen, blood and breathing during sleep can lead to severe health issues. Resulting conditions can include high blood pressure, mood disorders, sleep, daytime drowsiness, anxiety, insomnia and headaches. Sleep apnea, if left untreated, can also lead to chronic heart failure.

How severe does my sleep apnea have to be to get SSD Benefits?

What does it mean to be disabled according to the Social Security Administration? Claimants must prove that they have a condition which is so severe that it does not allow the claimant to work for at least 12 continuous months.

Sleep apnea, although it can be severe, generally on its own does not qualify for disability benefits. What can happen, however, is claimants who have sleep apnea may also have other severe conditions, which in their totality may not allow them to maintain employment and perform what the Social Security Administration considers substantial gainful activity.

What conditions may help me qualify for disability benefits?

Claimants who have sleep apnea should also consider whether they may have additional conditions that contribute to their inability to work. For instance, does the claimant have hypertension, fibromyalgia, diabetes, mental conditions or chronic heart failure? These conditions, in addition to the sleep apnea, may be enough to convince the Social Security Administration that the claimant does not have the residual capacity to work.

Are you seeking the proper treatment for your sleep apnea?

Claimants must also get proper medical treatment for their condition. It will not be enough to claim that you do not have medical insurance or money to pay for a doctor. Claimants who have not been seeing a doctor or who have not followed the doctor’s treatment plan will not qualify for disability benefits. If a claimant does not follow the doctor’s treatment plan the Social Security Administration can very easily argue that if they were, they may be able to work.

Claimants who have sleep apnea must prove that they have tried the various methods of treatment, but these treatments have failed to cure their condition. Claimants need to have tried non-surgical options such as muscle relaxants, specialty sleep pillows, devices which help a sleeper avoid sleeping on their backs and weight loss (considered one of the most successful treatments for overweight claimants who have sleep apnea). Other more advanced treatment options may also need to be attempted including a CPAP, BIPAP, APAP or VPAP machines.

Hiring a Disability Lawyer

Claimants with severe sleep apnea, which has not improved after medical treatment, combined with other severe health conditions may be able to prove that they do not have the ability to work.

 

Claimants who do not understand what needs to be included on their Supplemental Security Income or Social Security Disability Insurance application should talk to a disability lawyer for more information.

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