HUNTSVILLE DISABILITY GUIDE

You have filed an application for Social Security disability benefits.  You've been told it will be 90 to 120 days before a decision is reached.  Let's go inside Social Security for a closer, partial look at what is happening with your application. After the local Social Security field office has gathered all the forms and papers associated with your initial claim, the file will be sent to the Disability Determination Service (DDS) in Birmingham.  The DDS is a state agency that will investigate your claim and decide whether you meet the rules to get disability payments.  Your application will probably spend 3 to 4 months at DDS being processed. DDS will assign a case worker, called a "disability specialist" to herd your application through the process. This person will probably call you early on to introduce himself/herself and briefly explain the process to you. DDS will now order medical records from each doctor, hospital or other provider that you listed in y

A little under 30 percent of applications for Social Security disability benefits are approved at the first level.  The others must file an appeal. If you have a terminal illness, are in a nursing home or on life support, there's a good chance of being approved by filing an application.  If not, you could be approved an yway--but there is an excellent chance that you will be denied.  You may get a letter stating that you are "not disabled according to our rules."  You now enter the appeal phase of your claim. The following refers to the appeal process in the state of Alabama.  Other states may use a different process. Note that these steps must be followed in order.  You can't skip a step along the way. REQUEST FOR HEARING BY ADMINISTRATIVE LAW JUDGE This is a request to appear before a special judge who hears disputes between claimants and the US Government, in this case, the Social Security Administration. It currently averages about 16 months of waiting to

Medicare changes every year.  Here are some changes for 2017 that will impact all Medicare users. Part A (hospital) deductible will increase to $1,316 for each admission period.   Part B (outpatient) annual deductible will increase to $183.   Per Day Hospital Cost Sharing for days 61-90 is $329   Per Day Hospital Cost Sharing days 91 & after is $658 Cost sharing for nursing home days 21 to 100* is $164.50 per day. If you have a supplemental policy, most or all of these deductibles may be covered by the policy. When you are approved for Social Security disability under Title II (the regular SSDI disability program), you will become eligible for Medicare insurance after receiving disability payments for 24 months.  Note:  Back pay will reduce the 24 month wait because Medicare eligibility begins on the date you first became eligible for a disability payment.  __________ * Some Medicare supplement policies cover the daily cost sharing for days 21-100 in a skilled

The Forsythe Firm in Huntsville specializes in Social Security disability.  Here are some common questions and answers about SSDI. 1.  Who decides whether I can receive SSDI (disability) benefits? The Social Security Administration decides eligibility.  There is a lengthy application process.  It takes 90 to 120 days to get a decision. 2.  What are the basic requirements for SSDI? A medically severe impairment lasting at least 12 consecutive months which imposes a serious limitation on the ability to perform full-time work.  Also, the claimant must have enough recent work credits to be insured by Social Security.  Usually, a person needs 2 0 quarters of coverage during the past 10 year period. 3.  How long does it take to get a decision on my application? 90 to 120 days.  Nothing Social Security does is fast. 4.  On average, what are the odds of approval of my application? Slightly under 30 percent of applications are approved without an appeal.  Don't be surprised

The Forsythe Firm is one of North Alabama's most sought after claimant's advocates in dealing with Social Security claims.  With thousands of successful cases under its belt and one of the highest success rates in the profession, it's no wonder disabled individuals turn to the Forsythe Firm for help in getting their Social Security disability benefits started. Here is what you may not know about government disability: 1.  You must prove disability by medical standards.  It must be proved according to Social Security's complex and confusing rules. 2.  There are certain things your doctor(s) must provide before you can be approved. 3.  Certain technical factors must be in place:  how long and how recently you worked; the exact date when you first became unable to work; the affect of unemployment benefits or worker's compensation, for example. 4.  You must prove (medically) that you impairment is severe, prevents the ability to perform all work on a full-time

Social Security is required to consider psychological or mental impairments when evaluating applications for disability benefits.   However, the decision maker at Social Security will probably NOT be a psychologist or mental health professional and may not understand the complex nature of a psychological based illness--such as depression, anxiety, panic disorder, PTSD, etc. In fact, decisions are often made by "single decision makers" (SDM) who have absolutely no training in mental health matters.  Social Security has ruled that opinions offered by SDMs are not medical opinions and must not be treated as such.  This makes for fertile ground in the appeals process. A skilled advocate or attorney may be able to challenge the conclusions of single decision makers, or even doctors who have never examined the claimant.  This may lead to a reversal of a denied claim, clearing the way for payment of benefits. We can go a step further.  Social Security will sometimes sen d t

 At our firm, you will meet your disability advocate on your very first consult at our office.  He will listen to your situation and decide the best course of action.  Then, he will assist you personally in completing forms, gathering medical evidence and getting supporting statements from your doctors concerning your functional limitations.  He will most likely work on your case for months before Social Security finally gives you a decision. You will NOT meet your advocate just two or three days before your hearing date.  By the hearing date, you will be on a first name basis with your advocate and he will have a close personal knowledge of you and your case. However, you will meet with your advocate to prepare for the hearing. The hearing process will be explained.  You will be told what to expect.  You will be given instructions concerning the testimony you will need to provide, the types of questions you may be asked and potential problems that could arise during the hearing.

It's extremely likely that your Social Security disability application will be denied.  It's just as likely that the denial will be overturned by the appeals process. Social Security disability claims are a process that goes back and forth--from the original decision makers to the appeals judges.  The judges have the final say. In my experience, denials get overturned and paid most often because of the following facts : 1.  The decision to deny the claim was made by a single decision maker (SDM) at Social Security and a doctor may never have looked at the medical evidence , OR 2.  The doctor who looked at the medical evidence had never examined the claimant; therefore, his opinion is entitled to very little weight. 3.  New medical evidence was submitted after the denial which demonstrates the inability to perform full-time work related a ctivity.   This would happen at the appeal hearing. 4.  The judge finds that Social Security failed to recognize how the clai

Veterans who served in any branch of the US armed forces after 1955 are covered by the Social Security disability program and may receive benefits in addition to any VA and/or military disability or retirement benefit. If you became disabled while on active duty, you are quite possibly eligible for up to $2,600 per month in Social Security disability payments.  It does not matter if your disability is not related to your military service.  The disability may be for any reason. It is possible to qualify for benefits while receiving active duty military pay IF you are disabled and cannot perform your military job. My firm helps hundreds of veterans to get Social Security benefits.   Free no-risk consultations and case evaluations Never a fee until you win Pay no fee if you do not receive back payments We front all costs for medical reports and evidence Local firm with a proven track record Experienced advocates Office located adjacent to Redstone Arsenal PHONE (256) 799-0

Besides the obvious impact of becoming unable to work, disability carries significant emotional burdens, as well. Many clients tell me that being disabled makes them feel bad about themselves.  Some tell me that work is what defined them.  Since they can no longer work, they don't seem to have a purpose in life. Since we spend at least 40 hours a week at work, and have done so for years, it is understandable that a sudden inability to work and continue our routines would take an emotional toll.  Of course, there is the added stress of reduced income, difficulty paying the bills...sometimes even little ability to get housing or medical care.  Depression can easily follow.   I'm not a psychologist or professional counselor, so I can't recommend a fix for all these problems.  However, I've seen a lot of clients who have told me a lot of things.  Here are some things that may be useful for individuals who struggle with the emotional affects of disability. Find so

A very high percentage of denied claims for Social Security disability benefits can be won on appeal.  Statistics show that almost one-half of denials can be reversed on appeal and paid, often with past due benefits paid. While you are not required to have a professional representative, having one greatly increases your odds of overturning the denial and receiving a check.  Competent legal counsel may also help you obtain back pay for the illegitimate delay in getting your benefits.  This can often amount to thousands of dollars.  Our firm recently won a Social Security appeal in which the claimant received over $70,000 in back payments. No one can guarantee victory in a Social Security claim or appeal, of course.  But you should give it your best shot.  A representative can help you do so. PHONE (256) 799-0297    www.Get-SS.com  

There are a few changes to Social Security in 2017. The cost of living increase will be 0.3% for persons receiving Social Security checks.  This will amount to about $5 per month for the average beneficiary. The amount of earnings needed to count as one quarter of coverage will increase to $1,300. This primarily affects non-retired, non-disabled persons who are still working. Are you disabled and need to receive a Social Security disability check?  Have you applied for disability but been denied?  You should consider using a professional to represent you and try again.  You may be entitled to benefits, even if you've been denied recently.  It will cost you nothing to try again.  You never pay your representative unless you win and collect past due benefits.  (Representative's fees must be paid out of past due benefits). Almost one-half of all denials are errors which can be reversed and benefits paid (often including back pay). For help, call (256) 799-

You applied for Social Security disability.  They sent you to a doctor for an examination, then denied your benefits.  Should you assume that Social Security made the correct decision?    No.  You should assume they made a bad decision because they probably did. In more than 40 percent of denials which are appealed, a judge will review the evidence and overturn the denial to award full benefits to the claimant.  In simple terms, Social Security got the first decision wrong. Never assume a denial by Social Security is correct.  Assume it is wrong and can be overturned. What is the biggest mistake you can make after being denied by Social Security?  Failing to appeal the denial within 60 days is the single biggest mistake you can make. What are the risks if I appeal and lose?  There is no risk.   In an appeal, you have everything to win and nothing to lose.  If you do not win the appeal, your legal representation is free.  You cannot be charged a representative&#

Medicare is a very valuable part of getting Social Security disability benefits.  Medicare is government health insurance which pays for in-hospital and out patient healthcare services. Individuals who get approved for Title II Social Security disability benefits automatically qualify for Medicare , subject to a waiting period.  There is a 24 month waiting period, starting with the date your monthly benefits become payable.   For example, if your first benefit is due for the month of January, 2014, you will receive Medicare in January, 2016.  (This is not to be confused with the date your first check arrives; it's the date benefits first became due).  If you were awarded back pay or past due benefits, you could be eligible for Medicare immediately, depending on the onset date of disability. Medicare prevents you from spending your own money for medical care and makes care available to persons who otherwise might not be able to afford care. Med icare has two primary parts,

When individuals apply for disability, Social Security will often refer them to one of their contract doctors for a consultative examination.  More often than not, the doctor will not find any disabling impairment.  As a result, Social Security will deny benefits. However, the opinions of these doctors are often easily refuted in court and claims that were denied on the basis of their "examinations" may be over turned and approved. Here is what you should know about these superficial consultative exams by Social Security: 1)  The exams are usually brief, superficial and insufficient to determine if you are able to work. 2)  The law requires that more weight be given to the opinions of your own doctor than those of the consultative doctor. 3) A one-time examination is often legally insufficient to form a conclusion about disability. 4)  Social Security's doctor is seldom a specialist, and even if he is, not a specialist in your disabling impairment.  For exam

You Must File a Timely Application.  You must apply for Social Security disability benefits within 5 years after you stop working.  Your insured status will expire, making a new claim impossible for an impairment that began later.  If there are gaps in your work history, you may have even less time to file a new claim.  Don't wait too long to file after you stop working. Denials Are Common But Almost Half of Them Can Be Won on Appeal.  Around 70 percent of all disability claims will be denied.  Social Security will tell you that you do not meet their rules to get benefits.  A high percentage of these decisions are made in error and can be reversed and the claim paid with an appeal.  An appeal has a fresh (and better trained) pair of eyes review the evidence in your case .  Often, the new decision is better. You Must Have Enough Quarters of Work.  You become an insured person under the Social Security Act by working and paying FICA taxes.  Most adults need 20 quarters

Social Security disability benefits (Title 2) are not means tested, meaning that a claimant does not have to have limited income or financial resources to receive SSDI benefits.   However, if the claimant has income that looks like he or she is working, the source of that income will be questioned and verified.  Phillip, for example, is a retired partner in a small professional firm. He owns 25 percent of the firm he worked for.  He stopped working in 2015 but, as part-owner, he still receives a share of the profits generated by the firm. Social Security will make sure that Phillip's income is not wages, salary, commissions or other work-related income.  As long as he is doing no work, the income is not a factor in his disability claim.  Working tends to convince Social Security that a person is not disabled (especially if earning at least $1,130 per month, their definition of "substantial gainful activity").  However, income from sources that do not involve work won&

You often hear people speak about getting "back pay" or "past due benefits" in Social Security disability claims.  How does this happen ?   Actually, it is very common and happens in two ways, which I will explain: First, you can often be paid all the way back to the date on which you first became disabled.  This date is called the "established onset date."  You may "back date" your claim up to 1 year prior to the application date.  For example, if you file your application on 10/1/16, you may claim disability back to 10/1/15 if you were disabled that far back.  You can also recover your waiting period, which is 5 additional months.  So that makes 17 months possible as retroactive pay , covering a period BEFORE you filed. Second, you can recover payments for waiting in line while Social Security decides your case.  This is payment for months of disability AFTER you filed the ap plication.   For example, if you filed your application on 10

Social Security does provide disability benefits for qualifying mental health disorders.  There are 3 ways to win a disability case involving psychological or mental disorders: 1)  Meet a Listing.   Provide medical evidence from your doctor that your mental impairment is of such severity that it meets one of the published Listings in the Social Security regulations.  Most claimants will not meet a Listing but still may qualify for benefits.  Section 12 of the "Bluebook" considers impairments under the following categories: 12.02 organic disorders 1203 Schizophrenic, Paranoid, other Psychotic Disorders 12.04 Affective Disorders 12.05 Intellectual Disorders 12.06 Anxiety Related Disorders 12.07 Somatoform Disorders 12.08 Personality Disorders 12.09 Substance Addiction Disorders (prescribed substances) 12.10 Autistic Disorders 2)  Use a Medical-Vocational Guideline as a framework for a finding of disability.  If you are age 50 or above, the guidelines may help you

Denials are common with Social Security disability claims.  Denial rates are over 70 percent.  Unfortunately, most people stop trying when they get the denial letter and just give up.  In reality, the denial letter may have just set them up to win their benefits--if they would only follow up. The follow up is to request an in-person hearing.  At the hearing, an administrative law judge, trained in Social Security law, will listen to your testimony, review the medical evidence and make a new decision. "APPEAL FIRS T. ASK QUESTIONS LATER." After a hearing, a large portion of denials become awards (paid approvals).  You will probably get paid a lump sum settlement dating back to the original denial--or even before.  When you get denied....appeal first....ask questions later. Representation by an experienced Social Security disability advocate will give you an advantage.  The representative can speak to the judge on your behalf and make pleadings, motions and arguments.

Social Security disability benefits are paid as long as the beneficiary is disabled.  If he or she has medical improvement to the point of no longer being disabled and this happens prior to retirement age, then benefits may be terminated.  (At full retirement age, disability benefits convert to retirement benefits and cannot be terminated ). Social Security often does Continuing Disability Reviews (CDRs) to determine whether a beneficiary is still disabled.  They will look at the medical records to see if substantial medical improvement has taken place since the person was awarded benefits.  Individuals under the age of 60 are more likely to have a review. The nature of their medical impairment also has a lot to do with it.  Some conditions are more likely to improve than others. Fortunately, people who get SSDI or SSI benefits usually get Medicare or Medicaid to make medical treatment affordable.  Therefore, regular visits to the doctor and treatment may be more likely for persons

Individuals considering a Social Security disability claim should be aware of the following regulation: "If you are working and the work you are doing is substantial gainful activity, we will find that you are not disabled regardless of your medical condition, age, education or past work experience."  (20 CFR 4 04.1520(b )) . This is called a Step 1 denial because the denial happens at the first step of the consideration process, before even the medical conditions are evaluated.  In short, a person who is working at 'substantial gainful activity' cannot be disabled according to Social Security's rules. What is 'substantial gainful activity'?  Usually it refers to wages, salary, commissions or tips (earnings) totaling at least $1,130 per month (gross).  The dollar amount changes year to year to reflect inflation.  $1,130 is the amount used in 2016. I must point out that this is NOT a means test or financial test.  It is a work test.  The limit of $

I'm a Social Security disability advocate.  I have attended hundreds of hearings and observed things that help a disability case and things that hurt a disability case. There are some things the claimant can do to help the case--to increase the odds of being approved and paid.  Here are a few of those helpful things. 1)  Obtain a Medical Source Statement from one or more of your treating doctors.  Use the correct form. 2)  Make certain that the Social Security decision maker has all of your medical records before a decision is made.  Incomplete files are your enemy. (3) Submit very complete, very accurate forms that supplement your application for benefits.  These forms include the Function Report and Work History Report. 3)  Before you appear at a hearing, make sure you know what will happen at the hearing and what your part in the hearing will be.  Have someone prep you; don't just show up and hope for the best. 4)  Emphasize how your medical conditions limit your