YOUR OPTIONS AFTER SOCIAL SECURITY DENIES DISABILITY

 It may come as a surprise to many that Social Security denies most disability claims.  In fact, the agency denies about 70 percent or 7 out of 10 applications.  However, a denial is not the end of the matter.  The following appeals are available: and must be done in sequential order:

1.  Reconsideration.  This is the first appeal and must be done first.  This written appeal must be made within 60 days of the denial. This sends your claim back to the state "disability determination service" that made the decision to deny.  It asks them to review or "reconsider" their action.  Sadly, the agency will probably deny your claim again at this stage, as the denial rate at "Reconsideration" is between 95 and 98 percent.

2.  Hearing Before an Administrative Law Judge (the Hearing);  

Within 60 days of denial at Reconsideration, an another appeal should be filed asking to appear at a hearing before an Administrative Law Judge (ALJ).  This step in the process has the highest chance for an award of benefits (about 45 percent on average).  A hearing requires a lot of preparation and expertise.  The odds of winning without an attorney or advocate is about 33 percent.  With an attorney/advocate, the odds of winning are 60 percent.  Obviously, we advise never going to a hearing without representation.

3.  APPEALS COUNCIL (AC).  If the hearing produces another denial, you have the right to ask the Appeals Couincil to review your case.  This is a body of administrative law judges headquartered in Falls Church, Virginia-near Washington, DC.  You will not appear for this review.  A judge will be assigned to review your hearing and testimony to determine if further action is needed.  The AC may take any of the following 3 actions:  (1)  Refuse to review your case, leaving the denial in place, which happens about 78 percent of the time.  (2) Remand your case, sending it back to the administrative law judge (ALJ) who first heard it, requesting a new hearing or further action (about 15 of the time).  (3) Reverse the denial and award benefits, which happens no more than 5 percent of the time.

4.  SUIT IN FEDERAL DISTRICT COURT.  Within 60 days of an unfavorable action by the Appeals Council the claimant may file a complaint in the Federal District Court where he/she lives or where his or her principal place of business is located.  A filing fee must be paid unless the court waives the fee based on inability to pay. The Social Security Administration is exempt from lawsuits; however, a suit may be filed against the current Commissioner of Social Security.  The Commissioner's name will appear on the complaint as the defendant.  The Commissioner will file an "answer" to the court, explaining why benefits were denied and arguing that it was proper.  There will be some back and forth between the claimant and Social Security's lawyers, usually in the form of written comments to the court.  The claimant will be represented by an attorney, who will handle this process.  The court may take any of 3 actions:  (1) Overturn the denials and pay the claim.  (2) Deny the claim and let the previous denials stand.  (3) Remand the case back to Social Security for further review.

A denial in US District Court usually ends a claim, since there is no further practical appeal.  It is technically true that Social Security claims may be adjudicated by the US Supreme Court; however, this isn't practical.  The Supreme Court may hear a rare Social Security case about once per decade  but usually only cases involving important principles of law that extend beyond the normal issues in a routine Social Security claim.  And since there are hundreds of thousands of denials every year, that doesn't give a claimant much access to the Supreme Court.  So, practically, the case ends at the Federal District Court.

At any point along the way, a claimant may dismiss an appeal, or refuse to file an apeal, and file a new application with Social Security.  Before choosing the option to file a new application and start over, the claimant must assess 2 important factors:

1.  Has the Date Last Insured already passed?  If so, it may severely limit the ability to win a new claim.  Every individual has a date upon which Social Security Disability Insurance or SSDI expires for new claims.  Check to see what this date is.

2.  Is there material new evidence or material change in the claimant's circumstances since the most recent decision?  If not, it may be very difficult to prevail with a new application.

In every case, advise by an attorney or qualified advocate can be of tremendous value in guiding a clailmant through the appeal process, or in making decisions about what action to tqke next.

_________

The Forsythe Firm    7027 Old Madison Pike NW      Suite 108      Huntsville, AL 35806

Phone:  (256) 799-0297        Email:  forsythefirm@gmail.com

 Forsythe Firm Website

WHEN SOCIAL SECURITY TREATS YOU LIKE A CRIMINAL

 You walk into to a room for a Social Security disability hearing with your representative.  A person called an administrative law judge begins the hearing.  These hearings are supposed to be fact finding, nonadversarial and non-confrontational.  Unfortunately, not all are.  In fact, some judges may treat you more like you're a criminal than someone who is merely trying to collect on a legitimate insurance claim.

The judge swears you in.  The questioning begins, perhaps pretty calmly.

"Tell me why you think you are unable to work."  You explain.

"Have you tried to find any other work that you might be able to do?"  No, you say.

"Why not."  You say you don't think you're able to work.

"Have you been to the state rehabilitation service to see if they can help you get a job you CAN do?" You say no.

"Why not?"

Then, your representative introduces a detailed medical source opinion from your doctor.  In it, your doctor says you have severe medical conditions.  The doctor lists a number of specific reductions in function that would not permit you to hold a full-time job.

The judge begins to abuse  the doctor's statement:

Did the doctor do any tests to determine these limitations or did he just make them up?

Were you present when the doctor filled out this form?

Did you tell him what to write down?

Did you tell the doctor how much you can lift or how long you can sit or walk?

Then how does he know?

Where is there any objective evidence to support these limitations?

It says here that you "may" need extra time to complete your work, it doesn't say you WILL.

The medical record says that you were able to walk into the doctor's office without any assistive device, could sit in the chair while he talked to you with no signs of pain or discomfort, and could climb on and off the exam table without assistance."

As you try to explain your symptoms, the judge just keeps reciting reasons why he/she is going to deny your claim:

It says you have a 4 year-old daughter; can you lift your daughter?

Well, how much does your daughter weigh?

Are you able to take care of your child?  Who prepares her meals?

You can you can't drive very far, do you drive to the doctor's office?

When you get a hearing like this, it really means one thing.  The judge has probably made up his/her mind to deny your claim and nothing you or anyone else says is going to change it.  This judge has a bias, probably against all claimants, not just you.  He or she will keep questioning until they find some reason to deny your benefits.  You never had a chance.

Fortunately, not all judges conduct their hearings this way.  But if you get one who does, you may as well pack up and go home because your claim isn't going to get paid.

It's ironic that in the same building, one judge pays 70 claimants out of 100 claimants who appear over a period of time; another judge may only pay 12 or 13. They like to talk about "uniformity," but in reality there is none.  It depends on the judge you get.

In reality, Social Security judges use a two-step system to adjudicate claims:

1.  Can we pay this claim?

2.  Do we want to?

Congress needs to overhaul the Social Security disability system.  It should not take 12 to 36 months to get your claim decided.  And most claimants should not need attorneys or advocates to get their benefits.  The fact that they do indicates a serious problem in the system. 

By the way---Never, Ever go before any judge without representation.  Never, Ever. 

 

YOUR CHANCES AT THE FLORENCE HEARING OFFICE

When your Social Security disability claim is denied you appear before an administrative law judge for a hearing.  Most hearings in our area are assigned to an administrative law judge in the Office of Hearings Operations (OHO) in Florence, AL.

 You chance of getting paid does not depend all that much on the type of disability you have, the medical evidence, or the opinion of your doctors.  It depends, as much as anything else, on the judge who is assigned to hear your case.  Judges have different personalities, different styles and apparently different views about disability.

Some judges may pay over 70 percent of the cases they hear, while others may pay as as low as 19 percent of their hearings.

Do some judges hear essentially different types of cases so that fact would account for the radically different award rates?  No, since cases are assigned at random on an equal basis to all judges in the office.  It's not like one judge is hearing cancer cases and another is only hearing less serious medical impairments.  They all hear the same type of cases over a period of a year or two.

Based on data provided by OpenGov@Social Security, here are the recent award (approval) rates of judges in the Florence hearing office, highest to lowest:

Judge A     84 percent     (awarded 168 out of 221 cases)

Judge B     76 percent     (awarded 371 out of 441 cases)

Judge C     68 percent     (awarded 271 out of 398 cases)

Judge D     53 percent     (awarded 83 out of 257 cases)

Judge E     35 percent     (awarded 108 out of 305 cases)

Judge F      20 percent     (awarded 64 out of 316 cases)

Judge G      19 percent     (awarded 42 out of 221 cases)

So, if you are coming up for a hearing, the single biggest factor seems to be which judge will be assigned to your case.

As you can see, there is little uniformity among the judges.  As Dirty Harry would ask, "Do you feel lucky?"

So on a lucky day you could walk into a hearing with judge B and have a much higher chance of approval compared to appearing before judge F or G on the unluckiest day of your life.

 

 

 

 

HOW TO TELL IF YOUR DISABILITY HEARING WENT WELL

 

Since most Social Security disability claims are WON at the hearing level, it pays to take the hearing seriously and prepare well. You only get one hearing.

At the end of the hearing, which lasts about 45 minutes, you are wondering, "How did I do? Did that go well? Did I win?"

Sometimes, judges will simply announce their decision at the end of the hearing, which is called a bench decision.

But more often, judges will leave you dangling with something like, "Thank you for coming in today, and I will get my decision in the mail as soon as possible." Expect it to take between 3 and 8 weeks to get that Notice of Decision in the mail. You can't call anyone to get an early answer.

Can you tell if you had a winning hearing and will be awarded benefits? That's tough and there's no sure way to know if the judge doesn't tell you. But there are some very good indicators that you may have won or been approved:

1. It is stated by a medical expert that you meet or equal a certain Listing level impairment, which means that approval should be automatic. (There isn't a medical expert at every hearing).
2. In response to the judge's hypothetical questions, the vocational witness stated that you cannot perform any of your past work and that there are no other jobs in the national economy that you could perform. Note: Most judges ask several hypothetical questions, and very often the vocational expert's answers are a mixed bag. To question 1, there is no work. To question 2, there is no work. But to question 3, the expert finds examples of 3 jobs that you could perform. Now, you don't know which answer the judge will use to form the decision.

What can you do following the hearing? Not much. Continue to follow medical treatment. Don't drive yourself crazy checking the mailbox every day. Your attorney/representative will probably contact you about your decision before the letter comes in the mail because the attorney gets advance notice of the decision (about 5 days before you get it).

Remember, most claims are won at the hearing level, not before. Take every precaution to have a good hearing and put forth your best evidence. This probably means appointing a lawyer or qualified disability advocate to help you prepare and to attend the hearing with you. There are studies that show you are 3 times more likely to win if you are represented. That is significant!

 

INFORMATIVE WEBSITE 

YOU CAN APPLY FOR RETIRMENT AND DISABILITY AT THE SAME TIME

 

If you are about to reach age 62, then Social Security retirement benefits are available to you (at a reduced amount compared to full retirement age). You really don't have to do anything, except file an application to start receiving early retirement benefits. It will be automatically approved based on the fact that you are 62 years old. You should apply about 4 months before your 62nd birthday because it takes a while to process paperwork.

Now the question: If you file for early retirement benefits at 62, can you still file for disability benefits? Why would you want to?

Yes, you can file for Social Security disability insurance (SSDI) benefits any time before reaching your full retirement age (around 66 or 67 for most individuals). Why would you want to if you're already getting early retirement?

Because early retirement at age 62 gives you a reduced benefit, while Social Security disability gives you the full benefit. In short, disability benefits pay more than early retirement. In fact, if you take early retirement at 62, your benefit will be reduced by approximately 30 percent compared to your benefit at full retirement age. So, you get it early but you take a reduction. And the reduced benefit never goes up--even after reaching your full retirement age.

Let's use a simple example, using a fictitious person we will call "Jack.

Jack will turn 62 on October 13, 2019. He needs some income, so he files for Social Security retirement about 4 months prior to his birthday. His retirement check will start in October.

Jack begins to think about the fact that he is not really able to work. In fact, his doctor has told him several times that he couldn't do any full-time work. Jack decides to also file a Social Security disability claim.

Jack's disability claim is denied at first because Social Security does not find that his medical conditions meet their requirements for disability. Jack gets a lawyer and appeals his denial; however, the claim drags on for over a year in appeals.

In October, Jack begins receiving his early retirment check from Social Security (because he just turned 62). His reduced check is for $1,120 per month.

About a year later, however, Social Security approves Jack's disability claim. What happens now.

Social Security will retroactively pay Jack the higher amount for disability, dating back to the date he became disabled (not the date the claim settled). So, let's say Jack's disability benefit is $1,480 per month. Social Security raises his check from $1,120 per month (his early retirement amount) to $1,480 per month (his disability benefit). He will receive the higher monthly payment permanently. At full retirment age (66 or 67), the benefit automatically converts to a retirement benefit but the amount does not change. It never will, except for small cost-of-living (COLA) adjustments.

SUMMARY: If you need the money, go ahead and apply for early retirement at age 62. Start getting that income each month. If you feel you are medically unable to work,. also file a Social Security disability claim. If you never win the disability claim, you keep getting early retirement benefits. If you eventually win your disability claim, your benefit amount will increase.

Yes you CAN file for both early retirement and SSDI at the same time! And maybe you should.

COVID LINGERS....BUSINESS GOES ON....WHAT CAN WE DO?

Everyone is taking COVID seriously.  But life must go on.  For those needing disability benefits, it is especially  essential that business go on and claims get paid.  So, as our vital mission continues....what can we do to assure safety?

Here are a things the Forsythe Firm is doing to ensure safety:

1.  More telephone consultations when possible.

2.  Sanitize the offices and common areas frequently

3.  Schedule visitors or guests one at a time; no crowded lobbies

4.  Practice social distancing and use masks when possible

5.  Avoid  large group meetings; only 2 guests for any meeting 

6.  Keep hand sanitizer and complimentary masks available

7.  Take special care with elderly or chronically ill persons

COVID-19 is slowing down the process of applying for Social Security disability benefits.  If your claim is stuck somewhere in the process, our job is to get it moving again--hopefully toward approval.  In doing that urgent business, we will be careful to protect health and safety.

If you're planning a visit to our office, please feel free to tell us about any special health concerns you have, or safety considerations that will make you feel more safe and protected during your visit.

But, please, if you are disabled, don't wait and do nothing for fear of COVID-19.  It looks like COVID is going to be with us for quite a while  and you need to receive your benefits.  You can be safe and pursue your SSDI benefits at the same time.

 Call us at (256) 799-0297.  The consultation is free.

Or...check our informative website:  Disability Website Huntsville

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 NO FEE FOR OUR HELP UNLESS YOU GET PAST DUE BENEFITS.  YOU WIN OR YOU NEVER PAY.

 

ALL YOUR QUESTIONS ABOUT SOCIAL SECURITY DISABILITY (YES, WITH ANSWERS)!

 We've been disability advocates for decades.  And we recently put our heads together to answer questions that almost everyone wants to know before they apply for disability benefits.

Of course, space here is limited, so we haven't given excessive details.  So, if you need a specific question answered--or you need more detailed answers--we are always happy to get your free phone call.  Here are the questions:

Who Qualifies for Social Security Disability?

• 1.  You have worked at least 5 out of the most recent 10-year period and accumulated enough work credits to have insured status (applies to SSDI, not SSI).
• 2. You are not presently working, or at least not working at "substantial gainful activity" due to verifiable and severe medical condition, physical or mental. If you earn at least $1,260 in gross wages per month, you are working and can't get benefits.
• 3. Your severe medical condition has lasted, or is reasonably expected to last, 12 straight months or more.  There is no short term disability benefit with Social Security.
• 4.  This is sort of an unwritten rule but you must have objective medical evidence (from a doctor) to prove the severity and duration of your impairment(s).

How Much Will My Monthly Benefit Be?

The amount is based on your lifetime earnings.  The average monthly benefit is around $1250 per month, but the maximum can be as much as $3,011 for an individual.  You can call your local Social Security office to get your estimated amount.  They call it the "PIA" or Primary Insurance Amount.

Does it Take a Long Time to Get Approved?

Yes, unfortunately, it often does.  It takes about 5 months to get the initial decision on your application.  This decision will be a denial in approximately 73 percent of cases.  The required appeal process will take about 10 to 12 more months, but may give you a much better result and you may get back pay for waiting.

Are There Specific Medical Problems that Always Pay a Benefit?

Any disabling impairment (other than substance abuse) may pay a benefit if it is severe and makes the claimant truly unable to work at any full-time job.  If a claimant has a end-of-life illness, it usually qualifies for prompt approval.  If the symptoms are so severe that they meet or equal a "Listing," a payment may be possible faster.  Social Security also has "compassionate allowances" for certain incurable diseases that post very severe restrictions on the claimant's ability to function.  However, the average claimant will not meet these extreme requirements and must wade through the determination process, and often the appeals process, too.

The claimant's age and past work history plays a large part in how quickly he or she can be approved.  Claimants age 50 and over, especially 55 and over, who have a history of difficult physical work, may meet one of the Medical-Vocational allowances for quicker approval.  Even these claims often must be appealed, however.

Why Isn't Every American Insured by Social Security?

Basically because Social Security (SSDI) insures workers, not non-workers.  To have "insured status," an individual must have worked and paid into Social Security through payroll deductions called FICA.  The general rule:  you must have worked at least 5 out of the past 10 years or less, and paid FICA tax on your earnings.  Even self-employment can count if the FICA tax was paid and other work requirements re met.  Individuals who have not worked in approximately 5 years do not have coverage under SSDI, even if they are severely disabled.  (They might qualify under Supplemental Security Income, SSI, however).

What's the Difference Between SSDI and SSI?

They are entirely different programs which insure different people, although both are administered through the Social Security Administration.  Key differences:

SSDI - Social Security Disability Insurance (Also Called Title II)

• Must be paid for by workers who have contributed work related FICA tax
• Has no financial or resource restrictions, however, you cannot be working.
• Monthly benefit is based on lifetime earnings/wages; $3,011 per month is maximum)
• Has a 5-month waiting period (Will not pay the first 5 months of disability)
• Covers disabled individuals who are under full retirement age
• Automatically comes with Medicare insurance after a 29-month waiting period

SSI - Supplemental Security Income (Also called Title XIV)

• Designed to provide essential needs of the elderly or disabled
• Has strict income and financial resources limitations
• Requires no work history and nothing is paid into the program by the claimant
• Requires the same medical evidence as SSDI for disability (or, you meet age requirement)
• Claimants can also be eligible due to age (65 or over)
• Maximum monthly benefit is currently $783.
• Has no waiting period (can pay the month following your application)
• Automatically comes with Medicaid insurance.

    

WHY THIS MAY BE THE LAST DISABILITY SITE YOU WILL EVER NEED

Is there one website that provides all the information you need on Social Security disability?  Yes.  The following site is consistently listed as one of the top Social Security websites in the nation by feedspot.com.

SOCIAL SECURITY JUSTICE

•  Who may apply?
• When can you apply?
• What are your chances?
• What to do if you are denied?
• Resources and help with applications or appeals
• Pitfalls to avoid
• General questions

There's a response form on the website where you can request assistance or ask questions directly to a Social Security disability advocate-specialist.

The site is free and confidential.  Advice is free and without obligation.  If you appoint an advocate or attorney to represent you, you won't be charged anything until your claim or appeal is won, paid, and your past due benefits are approved for payment.

You may be one of the thousands of Americans who need and deserve Social Security disability benefits.  You may also be one the thousands tied up in government delays, red tape, stalls and shut-downs.  You may need some help just getting the process moving again--and in the right direction.

Click the link.  Ask the questions.  Fight for your benefit check.

SOCIAL SECURITY JUSTICE

Or telephone (256) 799-0297

YOU CAN'T WIN DISABILITY CASES WITHOUT AN APPEAL

 As a general rule, you can't get approved for Social Security disability without a hearing.  It's just the way the system is designed: Most applications are denied rather mechanically.  Decisions get "re-thought" at a hearing.

We speak to people every day who are disappointed, discouraged and ready to give up because their disability got denied.  Many have the attitude, "I'm not going to get my benefits, so I should just give up."  

In reality, a denial is when you really begin to fight, and where the best work can be done.  Your odds for approval actually increase when you get denied (if you appeal and ask for a hearing).

 

Here are some approximate numbers that may put Social Security disability in perspective:

27 percent are approved at the application stage (just filing an application).

4 percent are approved at "Reconsideration," the first appeal.

45 percent or more are approved at their hearing (before a judge)

What this tells you?  Don't expect to be approved by filing an application because most applications are rather mechanically denied. 

The first appeal (called "Reconsideration") is a waste of time, but required.

The hearing is where your real hope and best chance resides.

___________

The Forsythe Firm

Social Security Disability Counselors

Huntsville, AL 35806   Call (256) 799-0297

     Free Consultations.  No fee unless you win!

 Free Disability Information

 

 

 

 

 

YOU CAN APPEAL A DISABILITY DENIAL - OFTEN WITH GOOD RESULTS

 You can appeal a Social Security disability denial, often with positive results.  On average, about 50 percent of denied applications get approved and paid on appeal.  So, everyone should appeal--especially if denied on medical grounds -- when Social Security says "You are not disabled according to our rules."  This is often boilerplate nonsense which will be overturned by a judge on appeal.

 But it can take up to a year to get a final decision on appeals.  109,725 claimants died while waiting on a final decision between 2008 and 2019.  1.2 percent of claimants during the same time period filed for bankruptcy.

 The good news is, if you can wait it out you can often get paid for all the months it takes Social Security to get it right.  This is called "back pay."  Back pay accumulates each month while a claimant waits on Social Security to finish the appeal process or have a hearing.

In Title 2 (SSDI) claims, if a claimant dies before a favorable decision is made, their heir or next of kin may be paid the past due benefits. They file a petition asking the government to allow them a "substitute party" designation.  Unfortunately, no substitution of party is allowed in Supplemental Security Income (SSI) claims. 

I don't think the appeal system was originally intended to be the way most claims get decided.  However, it has turned into that.  If you are denied there are 3 important things to do:  Appeal, Appeal, Appeal.

You can get an attorney or advocate to handle your appeal (highly recommended) with no upfront cost or obligation.  The lawyer gets paid only if you win, and only if you collect some back pay.  Social Security limits the legal fee that can be charged, which is always a small percentage of the back pay.  If you don't get back pay, you don't pay.

___________________

The Forsythe Firm   Huntsville, AL   CALL (256) 799-0297  Free Consult

                     Appeal   Appeal   Appeal   Appeal   Appeal  App...

 

WHY HAVING AN ATTORNEY HELPS YOU GET DISABILITY

WHY AN ATTORNEY OR ADVOCATE HELPS YOU GET DISABILITY BENEFITS

 

Sure, you can try for Social Security disability without an attorney or "representative."  But just because you can doesn't mean you should.  Most judges will advise you to postpone your hearing and come back with representation.  That is because judges realize that having an attorney or representative is in your best interests.

I think some claimant's reluctance to get representation is because they don't realize what a representative can do for them.  Let's talk about a few of the important things a representative will do (things that probably will not be done if you represent yourself).

1.  A representative will analyze the technical aspects of your case and decide on the best legal theory (approach) to win.  Can you meet or equal a Listing?  Do you meet one of the Medical-Vocational Rules?  So you need to go all the way to Step 5 in the process and prove that there is no job in America that you could do?  How's the best way to prove that?  How can your doctor help prove it?

2.  A representative will obtain and analyzie your medical records to find proof for your claim. Sure, Social Security will attempt to get your medical records.  They may or may not get them all.  But they won't analyze them the way your advocate will.  And they may not go the extra mile to be sure all the evidence is obtained.

3.  Your representative will write a legal brief--outlining succintly why your case meets all the rules and regulations to be paid.  Judges use these briefs to get a 15-minute summary of the medical, vocational and legal view of your case.  If there are legal problems with your case, they can be explained or clarified here-and perhaps the problem can be solved even before the hearing begins.

4.  Your representative will solve problems that could have got you denied.  There are few perfect claims.  Most of them have problems that stand in the way of getting approved.  A representative recognizes the problems and works to solve them as early in the process as possible.

5.  A representative will answer the judge's questions.  Let's say the judge has questions about the alleged onset date.  Or meeting a Listing?  Or about unemployment benefits, or drug or alcohol issues...or part-time work.  There are a hundred questions that can come up during a hearing, and how they are answered may depend on whether you get an approval or denial.

6.  Your representative can cross examine the vocational expert (VE).  All hearings for an adult claimant  will include testimony by a job's expert (VE).  The VE will usually propose jobs that the claimant can still perform, thus suggesting a denial of benefits.  A skilled representative can question the VE and hopefully mitigate the damage created by his'/her testimony.  This can literally snatch victory out of the jaws of defeat.

7.  Your representative will seek all the back-pay available. You want to get the most pay available out of your claim.  Back payments depend on the date you first became disabled (onset date) and other factors.  Your representative will keep your back-pay in view as he or she helps to settle your claim.

8  Your representative is a vital source of solid, reliable information.  You can ask questions and expect dependable answers about your claim.

Attorney/representatives do not charge you a fee unless.....

A)  You win your case, and

B)  You are awarded back-pay or past due payments

You do not pay any money upfront.  All services are without cost to you--from the first call to the payment of back pay by the government.

___________

Call Us:  (256) 799-0297

Email Us:  forsythefirm@gmail.com

Visit Our Detailed Webpage:    DISABILITY WEBSITE

 

 

SOCIAL SECURITY DISABILITY: SOME TECHNICAL STUFF

 The Social Security disability program is part of the federal government.  It is governed by the Social Security Act, the Act as amended in 1974, and thousands of pages of rules and regulations in the Code of Federal Regulations.  Also, there are dozens of federal court rulings and Social Security rules (SSRs) that govern exactly what, when, and how things happen.

Obviously, we can only deal with a few technical high points here.  But here are a few things you will always encounter when you file a Social Security claim.

DATE LAST INSURED (DLI) - This is the date on which your coverage under Social Security disability expired (past) or will expire (future).  If you stopped working more than 5 years ago, you probably are no longer covered by the government's disability program.  Like all insurance plans, you must pay into Social Security to continue coverage.  You pay into it by payroll deduction (FICA tax).  Check to see if your DLI has already occurred before you file.  Note: Supplemental Security Income (SSI) is a type of welfare plan and does not require any work history at all.

ALLEGED ONSET DATE (AOD) - This is the date that you allege disability began.  This is probably the date you will ask Social Security to pay benefits back to.  Some points to consider when choosing your AOD:

• You were not working at substantial gainful activity at the AOD.
• You have not worked at substantial gainful activity since the AOD.
• You had a disabling medical impairment at the time of the AOD.
• The AOD should be more than 12 months prior to filing the application.

SUBSTANTIAL GAINFUL ACTIVITY (SGA) - This is how Social Security defines full-time work.  It is defined in the regulations as "activity that is substantial and gainful."  That's creative!  In 2020, work is "substantial and gainful" if you earn at least $1,060 per month (gross).  A job with this amount of earnings disqualifies you from any disability benefit.  So, your AOD cannot be in any period where you wee earning $1,260 or more each month from employment or self-employment.

THE DURATION TEST - Social Security will not pay for any short term disability.  Any disability lasting less than 12 straight months is exempt.  So, only file for disabling conditions that are expected to make you unable to work any job for at least 12 straight month.  (You do not have to wait 12 months to file).

 WHAT DOES 'DISABILITY' MEAN TO SOCIAL SECURITY?  For individuals under the age of 50, "disability" means the inability to work any job for 8 hours per day, 5 days per week.  It doesn't matter if you can't work your regular job or any of your past jobs.  If Social Security believes you can adapt to an easier job, with less standing, lifting, bending, etc., they will find you not disabled.  For example, your regular job was in construction where you were on your feet 8 hours a day and lifted up to 100 pounds.  You can't do that work any more.  However, Social Security may find that you can do the work of a document preparer, sorter, hand packager, garment tagger, or food and beverage order clerk.  Thus, they would deny the claim.  For persons over age 50, you may only have to prove that you cannot perform any of the work you have done during the most recent 15 year period (the relevant period).

THE WAITING PERIOD.  Social Security pays no SSDI benefit during the first 5 months of a qualified disability.  For example, if you are found to have become disabled on June 5, 2020 your first payment won't be due until December, 2020.  The check won't arrive until January, 2021 because they pay one month in the arrears.

DECISIONS RESERVED TO THE COMMISSIONER. Only the Commissioner of Social Security may say whether a claimant is disabled or whether he or she is able to work.  Doctors often make these statements, but they are found inadmissible because the decision is reserved exclusively to the Commissioner.  It's better if your doctors states your functional limitations - how long you can sit, stand, walk; lifting limits, restrictions of bending, kneeling, reaching, handling, etc.  Doctors should avoid statements like, "It is my opinion that this patient is disabled and cannot work."

Social Security disability is terribly complex and technical.  Knowing how to prove that you meet all the regulations and rules is important if you win your case.  That's why unrepresented claimants have such a hard time.  

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THE FORSYTHE FIRM IN HUNTSVILLE

CALL (256) 799-0297