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"ACCEPTABLE MEDICAL SOURCES" IN DISABILITY

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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...

NEW FIBROMYALGIA RULING FROM SOCIAL SECURITY

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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...

"SUBSIDIZED WORK" IN A DISABILITY CASE

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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 w...

REPRESENTATIVE: HIRE ONE EARLY OR HIRE ONE LATER?

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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, i...

Social Security Disability: Multiple Impairments

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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...

PROACTIVE DISABILITY PROCESS

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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. ...

BIPOLAR AND DISABILITY BENEFITS

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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 ext...