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Showing posts from April, 2012

DISABILITY - ONE OVERLOOKED BENEFIT

We often concentrate on the cash benefits of Social Security disability - the monthly check and the lump sum retroactive benefit.  Another of the very important benefits of Social Security disability, however, is Medicare coverage. An individual becomes eligible for Medicare 24 months after the established date of onset.  For example, if you had a disability hearing today in which the hearing officer found you to be disabled as of August 1, 2010, you would become eligible for Medicare on August 1, 2012. This is one more reason why proving that early onset date is important to you.  For someone who has struggled with the weight of medical bills without health insurance Medicare is a tremendous blessing!  Even if you are fortunate enough to have private medical insurance, Medicare may allow you the option to discontinue the private insurance and the expensive premiums that come with it.  If a claimant qualifies for Supplemental Security Income (SSI), as opposed to Title II disabi

PROVING DISABILITY - THE 5 STEPS

Social Security has established a 5-step sequential process to determine if a claimant is disabled.  These steps must occur in sequential order.  A claimant must satisfy one step before going on to the next.  In very brief order, here are those 5 steps. Step 1.  Is the claimant engaged in significant gainful activity?  If the claimant is working at SGA level, then he is not disabled. Step 2.  Does the claimant have a severe ailment that is medically determinable? Step 3.  Does the claimant meet one of the Listings in Appendix I to Subpart P of Part 404 - Code of Federal Regulations?  If no listing is met, the hearing officer must use the medical evidence to formulate a "Residual Function Capacity" or RFC - which is a statement of what the claimant can do, in spite of his or her restrictions, in light of age, education, and past relevant experience. Step 4.  Can the claimant perform any of his/her past relevant work?  Past relevant experience will consider jobs the cla

ARE YOU DISABLED?

Part of Social Security's definition of being "disabled" includes significant restrictions in the ability to perform work related activities.  Social Security will look at the functional limitations imposed by your impairment(s) and will place you in one of 5 "exertional" categories of work. (1) Sedentary work (2) light work (3) medium work (4) heavy work, or (5) very heavy work In most cases, I have to prove that my client is not capable of even unskilled sedentary work.  (If a claimant is capable of "very heavy work," then he or she is capable of performing all 4 of the categories below very  heavy work). You might think that it's fairly easy to prove that you cannot perform unskilled sedentary work. But it usually isn't.  That is because there are so many types of unskilled sedentary work in the national economy and vast numbers of workers performing in each occupation. A little vocational research reveals that there are 1,600 sedent

FULLY FAVORABLE DECISIONS

Fully favorable decisions are those which award the claimant everything he or she asked for. In a fully favorable decision, the claimant is found disabled from the date alleged in the application for benefits.  In other words, the "alleged onset date" stated in the application becomes the "established onset date" set by the judge or adjudicating officer.  The result is retroactive or back pay for the claimant. A fully favorable decision will also provide access to Medicare coverage sooner.  A claimant becomes eligible for Medicare 24 months after his or her disability begins.  So, if your established disability onset date was January of 2010, you could receive Medicare in January of 2012. A partially favorable decision finds the claimant to be disabled - but moves up the alleged onset date to a later date than alleged in the application.  For instance, a claimant states that he became disabled on June 10, 2009 but the administrative law judge finds the actual &q

RELEVANCE OF EDUCATION TO DISABILITY

"Ordinarily, even a high school education or more which was completed in the remote past will have little positive impact on a vocational adjustment unless relevant work experience reflects use of such skills."  (20 Code of Federal Regulations, 404 (P)(202.00)(c). As a person becomes older, it becomes more difficult for them to adjust to new work.  Education or skills that may have been relevant 20 years ago may not be useful today.    Social Security usually considers age to be a positive influence on work ability until age 45, where it becomes a disadvantage. Individuals who are 45 or older and restricted to a sedentary exertion level, have no transferable job skill, have no relevant past work that they can still perform and have no skills that will allow them to enter skilled work will normally qualify as disabled.  An advanced level of education, however, would suggest that the claimant might find skilled or semi-skilled work that he can still perform. Under age 45,