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How Can You Prove a Social Security Disability Case?

Monday, August 23rd, 2010

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.

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

Friday, August 20th, 2010

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.

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What are the Steps for Applying for Social Security Disability?

Thursday, August 19th, 2010

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.

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Will the Social Security Administration consider me disabled?

Monday, August 16th, 2010

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.

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How are Medical Records Gathered by the Social Security Administration?

Friday, August 13th, 2010

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.

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Requirements for Disability Benefits

Wednesday, August 11th, 2010

The United States Federal government has created two benefit programs for individuals who are unable to work. The first program, Social Security Disability Insurance (SSDI), was created in 1956 as an expansion of the Federal Insurance Contributions Act (FICA). SSDI was created as “insurance” for disabled workers who were not able to work due to a mental or physical health condition. Employees now pay taxes each pay period to fund the SSDI program. Employees who become disabled and they have contributed enough in taxes, may receive Social Security Disability Insurance benefits.

Requirement for Social Security Disability Insurance

How do disabled employees qualify for Social Security Disability Insurance? “Work credits” must be accrued by working and paying employment taxes. The amount of work credits needed for each employee will vary, but most workers over the age of 30 will need at least 40 work credits. Credits can accrue at a rate of 4 credits per year.

Employees must also be determined disabled by the Social Security Administration (SSA). Unfortunately, the disability determination process is a bit more complicated than bringing a doctor’s note to the SSA. Qualifying mental and physical impairments must be considered severe and be expected to last at least 12 months or result in death. Social Security Disability Insurance is not awarded for short-term disabilities or partial disabilities.

Widows, widowers, dependants (under the age of 18) and disabled dependants (over the age of 18 who were determined disabled prior to the age of 22) of an insured worker may also receive Social Security Disability Insurance.

Full Criteria for SSDI Benefits

  • The Social Security Administration must determine you are disabled.
  • You must be disabled prior to your full retirement age.
  • Your disability must be expected to last least 12 months or be expected to result in your death.
  • You must be legally allowed to work in the United States.
  • You must be a United States’ citizen.
  • If you are 31 years of age or older you must have paid payroll taxes and worked for 5 of the last 10 years.  If you are younger than 31 years of age there are other qualifications.

Requirements for Supplemental Security Income Benefits

Before 1972, most disability benefits for the aged and blind were managed at the state level. The Social Security Administration, in an effort to standardize care, created the Supplemental Security Income program. Unlike Social Security Disability Insurance, to qualify for SSI benefits the claimant does not have to earn work credits or contribute toward payroll taxes. They must, however, be aged (65 years or older), blind or disabled and have limited income and resources. Limited resources is defined as having liquid assets (stocks, bonds, extra cars, cash) which are less than $2,000 (for an individual) and $3,000 (for a couple).

Determining a claimant is disabled is similar for both the SSI and the SSDI program. Claimants may not be engaged in substantial gainful activity which in 2010 is making more than $1,000 per month for a non-blind disabled individual.

Full Criteria for Supplemental Security Income benefits:

  • Claimants may receive SSI benefits if they are aged (over the age of 65) and have limited income and resources.
  • Have a Social Security Disability blindness which is defined as vision of 20/200 or less with corrective procedures.  Claimants may also qualify if they have severe limitations on their peripheral vision such as a visual field of 20 degrees or less.
  • Disabled claimants must be determined disabled by the Social Security Administration which means their mental or physical condition must last at least 12 months or be expected to result in death. The claimant may also not be allowed to engage in substantial gainful activity.
  • Claimants can not be a fugitive felon.
  • Claimants can not be in prison.
  • Claimants must be a United States’ citizen.
  • Claimants can not leave the United States for extended periods of time.
  • Claimants can not reduce their income or resources in an attempt to qualify for SSI benefits.

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What If I Lose My Social Security Disability Case?

Tuesday, August 3rd, 2010

The majority of Social Security Disability requests are denied at the initial application phase. The Social Security Administration will notify the claimant if they have been denied and explain the process to appeal the decision. Appeals may be done within 60 days from the date the Social Security Disability denial letter has been received by the claimant. Under very limited conditions the Social Security Administration may allow an extension to file the Social Security Disability appeal.

Social Security Disability appeals may be completed online or the claimant may visit the nearest Social Security office. For more information about the SSD appeal’s process it is a good idea to contact a Social Security Disability attorney. The Social Security Administration also provides additional information on their website and claimants may also contact the Social Security Administration toll-free at 1-800-772-1213, 7 a.m. to 7 p.m. Monday through Friday. People who are deaf or hard of hearing may call the Social Security Administration’s toll-free TTY number, 1-800-325-0778.

The Social Security Disability process is comprised (for most SSD claimants) of four levels, each level requiring the claimant, if they are denied, to complete the appropriate forms to move to the next level. Some states skip the reconsideration phase which means that claimants who are denied at the Social Security Disability application level and appeal the denial will move directly to the hearing level.

  • Reconsideration – Most claimants who appeal the initial denial can request Reconsideration. Under Reconsideration the claimant’s Social Security Disability application will be completely reviewed by another person who was not involved in the first Social Security Disability application denial. All original medical evidence and any new submitted information will be considered to render a new decision. Up to 80% of Reconsiderations are denied. Claimants who wish to pursue their Social Security Disability claim after a denial at the Reconsideration level may file a request for a Social Security Disability Heatin
  • Social Security Disability Hearing - Claimants who have been denied at the Reconsideration level may request a hearing before a Social Security Disability Administrative Law Judge (ALJ). Claimants generally hire a Social Security Disability lawyer to act as their representative and argue their Social Security Disability case at their hearing. The ALJ reviews all the medical information which the Social Security Administration (SSA) has gathered and any additional information the SSD attorney presents at the case and makes their decision. Claimants can review the (Form HA-520-U5) Request for Review of Decision/Order of Administrative Law Judge which can be downloaded from the SSA website to appeal an Administrative Law Judge’s decision.
  • Appeals Council - Claimants denied at the hearing level may appeal their SSD denial and request a review by the Appeals Council. The Appeals Council reviews the Social Security Disability claim and can either 1)make their own decision 2) remand the Social Security Disability case back to the Administrative Law Judge for additional review 3) allow the Administrative Law Judge’s decision to remain in affect. The Appeals Council will send the information about their action to the claimant.
  • Federal court review - Claimants who do not agree with the decision of the Appeals Council may file a civil lawsuit in the Federal District Court.

Hiring a Social Security Disability Lawyer

Most Social Security Disability applications are denied at the initial application level. 80% of Reconsiderations are denied. Hiring a Social Security Disability lawyer is one of the best ways to increase your chances for receiving Social Security Disability benefits. Social Security Disability attorneys can review your initial application, gather medical records and present your Social Security Disability case before the Administrative Law Judge.

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How to find a Social Security Disability Attorney

Friday, July 30th, 2010

Applying for Social Security Disability Insurance and Supplemental Security Income does not have be a complicated process, especially with the help of a professional Social Security Disability Attorney. The Social Security Disability evaluation process, unfortunately, can require multiple steps if the application is denied including: filing the Social Security Disability application, filing the Social Security reconsideration appeal (if the initial application is denied) and requesting a hearing (if the reconsideration is denied).

Most Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) applications will be denied the first time they are submitted to the Social Security Administration.  By hiring a SSDI lawyer and understanding the process, applicants can drastically increase the chances that they will eventually receive Social Security Disability benefits. Although most SSDI or SSI lawyers will not complete the Social Security Disability application and submitted it to the Social Security Administration for their clients, they do perform a wide variety of very important actions. Social Security Disability attorneys can do the following:

  • If the claimant has been denied the Social Security Disability lawyer can review the initial SSDI or SSI application to ensure it was accurate and complete.
  • Gather and review the claimant’s medical information.
  • Make sure the Claimant’s most recent medical Information has been sent to the Administrative Law Judge prior to the Claimant’s Hearing date.
  • Argue the claimant’s case before the Social Security Administrative Law Judge.

While a Social Security Disability attorney can not guarantee they can get their claimants SSDI or SSI benefits the experience attorneys have gained from the hundreds of Social Security Disability claims they have handled each year can help them determine if a client has a winnable Social Security Disability case. Social Security Disability lawyers understand SSD laws and can evaluate their client’s medical evidence to determine their work limitations.

Most Social Security Disability attorneys take cases on a contingency fee basis which means SSD attorneys do not get paid unless they win their SSD client’s case. This can be great news for SSD claimants, many of whom do not have the extra $150 to $200 per hour which most attorneys charge for legal assistance. Social Security Disability attorneys make every effort to take SSI and SSDI cases they think they can win. Losing a case means the Social Security Disability lawyer may have spent hours or days preparing for a case without making a profit.

How can a claimant help their Social Security Disability lawyer? Claimants must continue to receive medical treatment for their condition and make sure their attorney has all of their medical records. Claimants are responsible for partnering with their Social Security Disability lawyer by answering phone calls and sending all requested information as soon as possible.

Contingency fee contracts can be a great way for claimants who are filing for Social Security Disability benefits to receive competent legal counsel with no up-front costs. Prior to signing any type of contract the claimant should understand exactly what types of services the Social Security Lawyer is providing and how much it will cost. Social Security Disability attorneys who win a Social Security Disability claim may receive up to 25% of the claimant’s past due benefits. This is paid to the Social Security Disability attorney regardless of the amount of work they did for the Social Security Disability claim.

Most Social Security Disability lawyers are hardworking professionals who do their best to get the best results for their clients. Claimants can receive strong legal counsel with little up-front cost, and the Social Security Disability attorney receives a fair payment if they win the claimant’s case. Talk to friends, do adequate research and make sure all fees and expectations are outlined before signing a contract with a Social Security Disability lawyer.

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What is A Disabling Health Condition?

Thursday, July 29th, 2010

The Social Security Administration may consider any health condition to be disabling if it is expected to last at least 12 months or more or may result in the individual’s death. The mental or physical health condition also must be so severe that it prevents an individual from performing “substantial gainful activity” which the Social Security Administration considers as making more than $1,000 per month in 2010 or working a regular 40 hour per week work schedule (or the equivalent work schedule).

While any condition which severely limits a claimant to the extent that they can not perform any job at a level to be considered gainful and substantial can be considered disabling, the Social Security Administration does have standards which are referred to as The Listing of Impairments which they use to evaluate a claimant’s disabling health condition.

The Listing of Impairments specifically describes common medical conditions the Social Security Administration automatically considers disabling. Claimants who “meet the listing” or have a condition which is specifically outlined in the Listing of Impairments (with the same limitations and symptoms) will frequently receive Social Security Disability Insurance or Supplemental Security Income benefits at the initial application level. If an applicant does not meet a listing the Social Security Administration evaluates the severity of the condition, if the physical or medical health condition limits the individual’s ability to work and if the condition leaves any residual functional capacity (RFC) for the claimant to continue working.

Residual functional capacity or RFC is the amount of activity an individual can perform in spite of their physical or mental health conditions. Standard physical residual functional capacity can include the claimant’s ability to stand, walk, sit, lift, bend or stoop. Mental residual functional capacity can include the claimant’s ability to work well with others, follow directions, get along with co-workers, attend work and maintain standards of cleanliness, pace and concentration.

After the Social Security Disability examiner determines the claimant’s RFC or residual functional capacity they can determine if the claimant can work full-time at any job they have had previously (examiners generally evaluate the claimant’s last 15 years of employment), and if not, if they can be retrained to work in a new job. A claimant’s ability to retrain for a new job is based not only on their RFC but also other factors such as their age, work experience and their educational level. The Social Security Administration may determine a claimant has a disabling health condition if they can not perform any past jobs or their residual functional capacity is so limiting they can not be retrained for any new type of work.

Medical records, doctor’s statements, physical and mental assessments and other documentation may be used by the Social Security Administration to evaluate a claimant’s residual functional capacity. Impairments by themselves may not be completely disabling, but the Social Security Administration will evaluate the combined effects of all listed health conditions when considering a claimant’s RFC.

It is not unusual for claimants to ultimately receive Social Security Disability benefits because both the mental and physical conditions, when considered together, leave the claimant with very little residual functional capacity. Unfortunately, given the subjection nature of evaluating Social Security Disability claims which do not meet a listing, many claims are not awarded benefits until the Hearing level when the Administrative Law Judge is able to truly evaluate the claimant in person and offer a more subjective conclusion of their ability to continue to work.

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Understanding The Social Security Disability Appeals Process

Thursday, October 1st, 2009

In my previous post I explained the need for quick action if your application for Social Security Disability Benefits has been denied. When you appeal the decision, your case will move through a process that has three levels. Below I explain what will happen in each of the steps of the appeals process.

Hearing

If you disagree with the Social Security Administration’s initial decision, you may ask for a hearing on the “disability” issues of your claim, such as whether or not you are disabled, when your disability began or whether or not it has ended. An administrative law judge who had no part in the first decision of your case will conduct the hearing.

It is usually conducted within 75 miles of your home. A notification of the time and place of the hearing will be sent to you and your attorney. You will be given an opportunity to explain your case in person and provide new information about your claim. Witnesses in the case will be questioned by the administrative law judge, your attorney and/or you.

The administrative law judge will question you and any witnesses at the hearing. You or your representative also may question the witnesses.

It is usually to your advantage to attend the hearing, but it is not required. If you don’t wish to attend, you must notify the Social Security Administration in writing that you don’t want to attend. Unless the judge believes your presence is necessary in order for a decision to be made, he or she will make a decision based on all the information in your case, including any new information presented in the appeal.

The administrative law judge will take into consideration the evidence presented at the hearing and notify you by mail of their decision.

Appeals Council

If you disagree with the hearing decision, you may ask for a review by Social Security’s Appeals Council.

The Appeals Council looks at all requests for review, but it may deny a request if it believes the administrative law judge’s hearing decision was correct. If the council decides to review your case, it will either decide your case itself or return it to the judge for further review. You will receive either a copy of the Appeals Council’s decision or order sending it back to an administrative law judge.

Federal Court

If you disagree with the Appeals Council’s decision or if the Appeals Council decides not to review your case, you may file a lawsuit in a federal district court.

An experienced disability lawyer can guide you through the appeals process and offer advice on the process that is involved in appealing a decision by the Social Security Administration. A claimant with an attorney or advocate will get a better understanding of the Social Security System and their own claim through the advice of an attorney.

Anyone who has filed a claim for Social Security disability benefits should seriously consider the advantages of having an attorney to represent them in the case.

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