HUNTSVILLE DISABILITY GUIDE

Denials are about as much fun as Molly seems to be having in this photo!  They are unpleasant and difficult to face, especially since they can mean financial uncertainty.  Claimants often feel that when Social Security denies their disability or SSI claim, they are forced to subsist without proper medical care, housing or even food.   There is something you can do.  You don't have to take a denial letter from Social Security lying down! Contact us at the Forsythe Firm and we will be happy to discuss your options - with no cost or obligation.                                                          "I absolutely hate to be denied!" THE FORSYTHE FIRM   (256) 799-0297 for our Huntsville, AL office (615) 732-6159 for our Nashville, Tn office

No, I am not a prophet nor the son of one.  But with all the guessing, fear and uncertainty going around about the future of Social Security, I want to make a few "predictions" concerning Social Security disability insurance for 2014. Social Security will not go broke in 2014 and the program will remain functional.  All eligible beneficiaries will continue to get paid in full.  However, the margins of the trust funds will continue to shrink because of Congressional inaction and indecision. Thanks to the "Affordable" Care Act (laugh track heard here),  Social Security will not get the congressional attention it needs and the agency will remain underfunded and over-worked.   Social Security will be negatively impacted when the business mandates of "Affordable" Care begin.   (There is a laugh track each time "Affordable" Care is mentioned). The media, once champions of the poor and disadvantaged, will continue to unfairly criticize Social Secur

We spend a lot of time talking about medical evidence for a Social Security disability claim.  More should be said about preparing vocational evidence for Social Security.  What do I mean by vocational evidence?  It should include an understanding of the following factors. PAST RELEVANT WORK:  Social Security will consider past work performed during the past fifteen years if that work was performed long enough for the claimant to learn how to do the work. Concerning Past Relevant Work:  Was it skilled, semi-skilled or non-skilled?  What was the exertion level?  For how long was it performed?  Why can't the claimant do that work now? EDUCATION is part of vocational evidence.  A very limited education (7th grade or below) reduces the claimant's ability to transition to other work.  Conversely, a college degree may help the claimant to find skilled work and make a finding of disabled less likely. RESIDUAL FUNCTION CAPACITY:  This can be thought of in both me

Compassionate allowances permits Social Security to approve claims quickly (often in a week or less) for applicants suffering from one of 200 incurable diseases. On December 6, 2012, Social Security Commissioner Michael Astrue met in the Hart Senate Office Building in Washington D.C. to announce reaching the milestone of 200 diseases that now qualify for a speedy compassionate allowance approval. In order to qualify, an applicant must have one of the 200 illnesses on the list.  There are still many incurable and tragic diseases that are not on the list and thus do not qualify for the rapid award of benefits.  However, the program does provide very quick approval for thousands of applicants each year who suffer from one of the 200 conditions listed. To see the complete list of diseases which qualify for a speedy compassionate allowance disability award, go to the following website:   http://www.ssa.gov/ pressoffice/pr/compassionate- allowances200conditions-pr. htm

Social Security disability is an insurance plan mandated and paid for by the US Government under the Social Security Act.  Like any other insurance plan, it is funded by "premiums" or payments made to the Social Security Trust Funds.  In the case of disability insurance, it is paid for by FICA taxes.  The employee has taxes deducted from his/her wages, then the employer matches that tax and pays into the Social Security Disability Trust Fund.   In order to have current disability insurance with Social Security, the worker must have worked long enough and paid enough FICA taxes to be insured.  The worker must have accumulated a sufficient number of "Quarters of Work" to be insured.  For most workers over age 40, the worker must have worked at least 4 out of the last 10 years to be covered.  Rules are different for very young workers. Social Security disability insurance (SSDI) is often referred to as Title II (two).  SSDI does not require a claiman

A few months ago a client came to file an appeal on his unfavorable Social Security disability decision.  He had worked hard his entire life and had a legitimate disability.  Still, the examining agency had said, "We found that you are not disabled according to our rules." Llater I received an amazing telephone call.  Someone at the Office of Disability Adjudication and Review had reviewed the case, reversed the original decision and awarded full benefits, including more than $30,000 in back pay.  Social Security was calling me to verify bank account information to make a deposit into the claimant's checking account. That's why you can't afford to give up on a disability claim.  Just because someone at Social Security says you are not disabled doesn't mean that you aren't disabled.  I refer back to a recent study which found that 6 out of10 denied claims could have been approved if they'd had a different disability examiner.  The system is far fro

Many people assume that a Social Security disability case is over when the hearing has been held.  This isn't always the case.  Often there is post hearing work that should be done to achieve the best chance of a favorable decision. Everyone at a disability hearing works under pressure.  This includes the claimant, the representative, the vocational expert and even the administrative law judge.  Hearings are generally limited to less than one hour.  The judge will ask questions that place the claimant under stress to answer correctly.  The representative or attorney will be asked to respond to procedural issues or points of law that place him or her under pressure.  The judge must constantly conduct the hearing so that it follows Social Security laws, rules and regulations.  Further, the judge must form accurate hypothetical questions for the vocational expert based on the medical and vocational evidence in the file and upon the claimant's testimony.  The vocational expert th

There is usually a wait of several months to obtain a hearing after a Social Security disability appeal is filed.  However, there are plenty of reasons to submit all your evidence in the case as early as possible. I recently appealed a Social Security decision and asked for a hearing.  I filed the request for hearing in September in the routine manner.  In December the case was reviewed and approved without a hearing.  The appeal was thus resolved in less than 90 days and my client received a back pay settlement before Christmas!  It doesn't always happen that way, obviously, but when there is plenty of evidence, it is always best if you can submit it right away.  In fact, I find there are at least two advantages to submitting medical evidence early: One, it provides a more likely opportunity for an early review of the case.  Two, it gives the representative or attorney an opportunity to write a thorough brief for the Office of Disability Adjudication and Review (ODAR). Thi

In 2008, the average wait time for a Social Security disability hearing was 514 days.  In 2011, the wait time fell to 360 days.  By the end of fiscal 2013, the goal is further reduce the wait down to 270 days - or about nine months. My experience here in Alabama is that the Offices of Disability Adjudication and Review are frantically scheduling hearings and using every opportunity available to reduce the wait.  This means holding hearings at district offices, "satellite" locations and using video teleconferences.  I am actually seeing some hearings scheduled within the 9 month period already. Most of the claimants that I represent are in dire need of their disability benefits.  Some are virtually homeless, living with a friend or relative until they can get their disability case resolved.  Some are suffering home foreclosures.  Many cannot afford urgent medical care.   The reduced waiting times are good news for these claimants.

Starting November 19th, 2012 Social Security district offices will begin closing 1 hour earlier. (The Huntsville and Decatur offices have been closing at 3:00 PM for some time).  Beginning January 2, 2013 Social Security district offices will begin closing to the public each Wednesday at noon. Why the change?  There is a hiring freeze and overtime restrictions at Social Security. The district offices cannot afford to pay overtime necessary to maintain the hours or levels of service they provided in the past.   This means several things to the public who may have business with Social Security.  Expect to wait longer to see someone when you visit a district office and expect a longer on hold time when you call a Social Security office.  Employees will still work regular hours but the Social Security district offices will be closed to the public earlier each day.  Another problem may be delays in processing SSI claims and payments, since SSI payments are processed by the district of

I recently received a phone call from a lady who told me she had just walked out of a Social Security disability hearing.  She had gone in unrepresented and the judge suggested that she delay her hearing and find representation.  Good advice and most judges will either postpone the hearing to give the claimant a chance to hire a representative or they will have the claimant sign a waiver of representation. Here is what my client said about her experience with the hearing.  "It took me about five minutes to realize that I was in over my head.  I thought it was just a matter of going in and telling my story to the judge.  I found out it involves much more than that." Some of the things you will probably have to deal with in a Social Security disability hearing include: potentially adverse testimony from the vocational expert challenge to some of your evidence from the hearing judge Has your past work been properly classified? Are the judge's hypothetical questions

Posted by:  The Forsythe Firm, Social Security Disability Advocates (256) 799-0297   No Fee Due Unless We Win & Obtain Back Pay for You A question we often get is, "Will drug abuse (or alcoholism) qualify me for Social Security disability benefits?" Or, "Will drug abuse (or alcoholism) disqualify me for Social Security disability benefits?" The answer to both questions is, No. A person may not qualify for Social Security disability merely on the basis of alcoholism or other substance abuse.  On the other hand, a person should not be disqualified merely on the basis of alcoholism or substance abuse. The definitive legal ruling on that is found in 20 CFR §404.1535:  "The key factor we will examine in determining whether drug addiction or alcoholism is a contributing factor material to the determination of disability is whether we would still find you disabled if you stopped using drugs or alcohol." So an individual cannot qualify

Grid Rules is a term referring to the Medical-Vocational Rules found in CFR 20 404, Subpart P, Appendix II.  They guide a finding of either "disabled" or "not disabled" based on the claimant's exertional capacity* and vocational factors such as age, education and transferable skills. The "Grids" divide age into categories as follows: Advanced age (55 and over) Closely Approaching Advanced Age (50-54) Younger Individual (45 - 49) Younger Individual (18-44) As a Social Security disability case is being prepared, it is very important to refer to the Grid Rules. The judge who decides your case will likely use them as a guide if your medical condition does not meet a specific listing or your exertional capacity is sedentary or greater. Grid Rules do not apply to impairments caused by strictly  mental  disorders. *Exertional capacities are the classifications of work based on such factors as lifting, carrying, pushing, pulling, etc.  The clas

Earlier this year, the US Social Security Administration told US administrative law judges (ALJs) that they cannot use the internet to investigate disability claimants.  Senator Thomas Coburn (R-OK) responded by saying this ban removes a valuable tool to investigate fraudulent applications for disability benefits. Sen. Coburn used this example, which I have paraphrased.  Suppose an ALJ looks up an applicant on Facebook.  There he finds pictures and discussion of the applicant playing sports or participating in his bowling league.  If the applicant has claimed severe back problems on his application, his credibility is suddenly called into question. I caution my clients to stay off of Facebook and the social media and I believe that is still very good advice.  It remains probably the first place investigators look when trying to deny benefits (even for disability claims with private insurance companies). Use common sense but don't become paranoid.  For example, it's normally

Our firm frequently handles Social Security disability claims for individuals with a mental or emotional impairment.  I think there are 2 challenges to winning these type of claims for our clients. First, we should direct the claimant to good medical treatment.  Too often people will ignore psychological problems - sometimes because they are self-conscious, or perhaps because they think they can't afford treatment.  The lack of medical treatment not only hurts the ability to win a Social Security disability claim, it also results in the patient not getting better.  Our office will gladly provide you with non-profit clinics or mental health providers that may help at a fee you can afford to pay. The second challenge is, we have to show the results of the impairment in vocational terms.  How does this condition prevent the individual from working?  What mental functions are impaired?  Is it concentration, mood, memory, the ability to follow instructions, or the inability to get a

Here is a question that recently came across an advocate's desk via  a telephone inquiry: "I am disabled due to a serious disease.  However, I have a rather large balance in my savings account and I also receive a good income from investments I made years ago.  Can I still qualify for Social Security disability benefits?" The answer is, having money in the bank and investment income will not disqualify a person from receiving Social Security disability under Title II.  There is no means testing for a disability claim.  Simply put, a person could have a million dollars in the bank and if he or she meets the established requirements for disability, there is no reason they would not be approved. Now, if the "investment" income is being derived from owning a business where the claimant is still actively investing time and expertise, that may be a different matter.  But current income from stocks, bonds or most pension plans, for examples, would not disqualify

Here are a few important tips on how to improve your chances of getting a Social Security claim approved: Initial or Application Level Explain the exact duties of your past jobs (going back 15 years).  Use a Work History Report for this.  Be as specific as possible about your job duties. Explain how your illness or injury holds you back in day-to-day functions like walking, bending, doing yard work, concentration, etc. Have a close friend or family member complete a Third Party Function Report. Be sure to list all your doctors and medical providers with correct addresses. Complete and return any requested forms promptly. Keep any consultative exams arranged with doctors by Social Security. Appeal or Hearing Level Ask for an appeal in writing within 60 days of being denied (very important) Ask the hard questions of yourself:  Am I really unable to work?  Why?  Do I have enough medical evidence to prove it, or do I need to get more? Why is going to happen at the appeal

Fewer than 3 out of 10 initial applications for Social Security disability are approved.  Many truly disabled and deserving individuals are denied for any number of reasons.  The only solution is a timely appeal. In Alabama (and 9 other states), you may file a request for a hearing immediately upon being denied.  You only have 60 days, however, in which to request a hearing in writing.  A hearing refers to a personal appearance before a federal administrative law judge.  This judge is not bound by any previous Social Security decision and can evaluate all the evidence, including new evidence that you submit, and make a new decision. National award rates by administrative law judges were down during the final quarter of 2011--to 49 percent.  In Alabama and Tennessee, the award rates average closer to 60 percent.  Award (approval) rates vary from hearing office to hearing office and from judge to judge. In one of the hearing office where I represent clients, the judge with the highes

Medicare is a federal health insurance program for persons who receive Social Security disability OR who have attained their full retirement age (65 or 66 for many of us). If you are under your full retirement age and are awarded Social Security disability benefits, you will qualify for Medicare coverage 24 months after the date of your disability payment entitlement.  Keep in mind there is a 5 month "waiting period" before disability payments can begin.  For example: Mary is found to be disabled on March 1, 2012.  (Called the "established onset date") Her first entitled payment will be for August, 2012. She will become eligible for Medicare in August, 2014 (24 months after the first payment) There is a charge for Medicare coverage and it will be deducted from your Social Security check.  However, it is far less expensive than an equivalent private insurance plan. Medicare does not cover all health care costs, so a look at a supplemental policy may be advi

The charts above represent the types of disabilities that Social Security awards the most benefits for.  The largest category is muscuoskeletal impairments at 33.8%.  Mental impairments are the second largest category at 19.3%.  The types of mental impairments  are broken down in the second chart.  Of all mental impairments award benefits by Social Security, mood disorders make up the largest cause at 10.2%. Keep in mind that these numbers represent only Social Security's experience with claims in 2011.  They do not predict the chances of winning a claim based on any particular impairment.  For instance, the fact that 33.8% of all awards were for musuloskeletal problems, that does not imply that your chance of winning a claim based on musuloskeletal problems is only 33.8%.  It probably does imply that Social Security saw more claims for musuloskeletal impairments than for any other type condition. I continue to advise clients that it is nearly impossible to put a number on

Social Security regulations refer to evidence from "an accepted medical source."  What does that mean? There is a 5-step sequential process that Social Security uses to determine whether an individual is disabled.  At step 2 the claimant must show that he has a severe and medically determinable impairment.  This evidence must come from an "acceptable medical source." According to 20 CFR 404.1513(a) and 416.913(a), only the following are considered acceptable medical sources: Physicians, including doctors of medicine and doctors of osteopathy Licensed or certified psychologists, including school psychologists for purposes of determining mental retardation or borderline mental functioning only Licensed optometrists for measurement of visual acuity and visual field only; Title II claims may require a physician's diagnosis if other aspects of eye disease are involved Licensed podiatrists - only for an impairment of the foot or foot and ankle (dependin

In July 2012 Social Security issued Ruling SSR 12-2p on fibromyalgia.  This ruling states that fibromyalgia may be a medically determinable impairment when established by appropriate medical evidence and it can be the basis for a finding of disability.  Social Security has instructed all its administrative law judges and other adjudicators to follow SSR 96-7p to evaluate a claimant's statement about symptoms and functional limitations caused by fibromyalgia. For years, fibromyalgia was a little understood disorder and some Social Security judges did not consider it to be a "medically determinable impairment," for purposes of disability benefits. Therefore, thousands of claimants were denied disability benefits. Step 2 in Social Security's sequential process for determining disability requires that the claimant have a severe impairment.  Under SSR 12-2p, fibromyalgia may now satisfy the requirement of having a "serious, medically determinable impairment."

I recently received a question that involves what Social Security calls "subsidized work."  Generally, an individual who is working at substantial gainful activity (SGA) level would not be eligible to receive Social Security disability while working.  In 2012, SGA level is gross wages of at least $1,010 per month.  There are certain exceptions, however, and subsidized work is one of them. Subsidized work occurs when an individual is given a job just to help him get by and where the employer does not enforce the normal requirements of work activity.  Also, the employer would not hire someone else to perform this work.  Here is an example. Let's say that I have a favorite uncle who is not able to work and has a difficult time getting by. I offer him a job in my office as a "courier" and pay him $400 a week to putter around.  He is often unable to come to work and frequently leaves at lunch to go home and rest.  He can also take as many breaks as he wants.  I w

REPRESENTATIVE: HIRE ONE EARLY OR HIRE ONE LATER? Most people who file a Social Security disability claim end up hiring professional representation. Many claimants will wait until after their application has been denied to hire a representative.  Looking at that practice from the standpoint of fees or cost to the claimant, however, calls the practice into question. Since a representative cannot charge a feel until  after  a claim has been won, and since he/she can only charge a fee based on recovery of  back payments , the odds are that the fee won't vary a great deal, regardless of when the representative was hired.  The big difference is how much help the representative can be to the claimant.   If he or she can help get the claim approved in the initial stage, it avoids the need for an appeal and therefore reduces the fee drastically.  So I'm not so sure that delaying in appointing representation saves money.  In the long run, it may cost more money. In Alabama

Social Security rules state that all of your impairments must be considered, even impairments that are not severe.  While you must have at least one "medically determinable" impairment that is severe, there may certainly be additional physical or mental conditions that contribute to your disability.  For example, rheumatoid arthritis may be a severe condition that renders you unable to work.  But if you also have mental disorders, such as anxiety, depression, bipolar or panic disorder, these conditions must be considered in making a determination as to whether you are disabled under Social Security rules. It is important to remember that a mere diagnosis of a disorder is usually not enough to be awarded Social Security benefits.  Other factors that must be determined include:  severity, duration, vocational implications and functional limitations.  For example, you may be diagnosed with depression.  But to receive disability benefits for depression you need to show that i

To be successful in a Social Security disability claim the claimant must be proactive.  It isn't enough just to file the proper forms and wait on the process.  It is very much a hands-on process - at least for the successful claimants.  What should you be doing? INITIAL PROCESS:  You've filed all the papers, including all the forms that the Disability Determination Service sent you in the mail.  Call your doctors and other medical providers to let them know you have filed a claim.  Ask them to submit medical records and other information requested by DDS promptly.  Call your disability specialist at DDS about every 10 to 14 days to ask for a status report.  Find out if one or more doctors has not submitted medical records.  Follow up again with that doctor. APPEAL PROCESS:  If your claim is denied at the initial level, ask for an appeal within 60 days (in writing).  Your case will now shift back to Social Security from DDS.  A special unit called the Office of Disability Ad

Bipolar   Disorder  is a relatively recent term for what used to be called "manic depression."  It refers to an affective mood disorder characterized by periods of abnormally high energy level, cognition and mood, with or without one or more depressive episodes.  The term bipolar  refers to the cycling between high and low episodes (poles).  Some patients experience both manic and depressive episodes at the same time.  Many individuals experience "normal" moods that separate the high and low episodes.  If depressive and manic symptoms rapidly alternate, such a condition is referred to as "rapid recycling." Social Security has always recognized bipolar disorder as a potentially disabling mental disorder.  In order to obtain disability benefits the claimant must establish not only the diagnosis of bipolar disorder but also the severity and duration of symptoms and the fact that the ability to function is significantly limited.  It is extremely helpful to h

Mental disorders can be disabling just the same as physical disorders for purposes of Social Security disability.  The Forsythe Firm handles dozens of claims each year based on mental or emotional disorders - and we win a majority of the ones that we represent. The evidence in a disability case based on mental disorders can be a bit more subjective; however, Social Security requires a "severe impairment based on medically determinable evidence."  Obviously, you can't usually define mental impairments with X-rays, MRIs, CAT scans or laboratory studies.  So, what do you offer as proof of a severe impairment? First, I look for a diagnosis by either a clinical psychologist or psychiatrist.  Failing that, I look for a diagnosis by a primary care MD.  To establish a severe impairment for Social Security, you must have evidence from an "acceptable medical source," which would include the type of evidence I just mentioned.  You cannot establish the presence of a sev

Which of the following mental disorders can qualify for Social Security disability benefits? Anxiety Major Depressive Disorder Agoraphobia Post Traumatic Stress Disorder Paranoia Schizophrenia Bipolar Disorder Attention Deficit Disorder Personality Disorders Panic Disorder ANSWER:  All of the above.  And more.  Social Security will recognize any mental disorder that can be medically documented and which is severe enough to cause major limitations of social or cognitive functioning, including the inability to work.  The duration requirement is the same as for physical conditions; you must be unable to work (or expect to be unable to work) for 12 continuous months or more. With children under the age of 18, disability may be documented by the child's inability to function at school because of a medically determinable mental impairment. The Forsythe Firm specializes in obtaining Social Security disability benefits for individuals who cannot work because of mental, em

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A pre-hearing brief (also called a pre-hearing Memorandum) is a document prepared by your representative to succinctly explain the theory of your disability case to the judge who will hear it soon.  By "theory of the case" we mean the logical and legal argument as to why you are disabled under Social Security law and why you should be approved for benefits. As the name implies, a brief should be a short, concise document.  My briefs usually run 3 to 5 pages.  Its main purpose is to give the administrative law judge the nuts and bolts of your case in a document that he or she can read in ten minutes.  Your appeal file may contain 300 pages. Keep in mind that a Social Security judge will typically hear six cases per day.  There isn't time to read 300 pages of evidence and try to sort out the material facts.  Therefore, a 3 or 4 page document that exposes the key facts and tells where to look for details is valuable. In addition, a properly written brief will explain neg