One of the big things a Social Security decision maker must do is determine the claimant's capacity to perform different levels of work. In other words, can he perform very light work or harder work?
Social Security considers 5 levels of work.
Very Heavy work. This is very physical work which may require lifting 100 pounds or more. Very few people can perform this work for 8 hours per day.
Heavy Work. This requires lifting more than 50 pounds regularly and up to 100 pounds occasionally.
Medium Work requires lifting at least 25 pounds frequently and up to 50 pounds occasionally.
Light Work would require lifting more than 10 pounds frequently but no more than about 25 pounds occasionally.
Sedentary Work is the easiest. It can be performed mostly from a seated position and may require standing/walking for only about 2 hours per day. Sedentary work only requires lifting up to 10 pounds occasionally.
WHO DECIDES A CLAIMANT'S CAPACITY?
In a hearing, the administrative law judge will decide how much capacity the claimant has. This is based primarily on a review of the medical records, although claimant testimony is taken into account IF supported by the medical record.
A doctor may provide his or her opinion about capacity. That's why a claimant's attorney/representative may provide a form for the claimant's doctor to complete. The form will ask about the patient's ability to sit, stand, walk, bend, kneel, lift, etc. The purpose of this form is to help Social Security properly determine how much capacity for work the claimant has, in spite of his/her impairments.
WHAT IS THE REQUIRED STANDARD FOR APPROVAL?
If under the age of 50, claimants must show that they are restricted to less than sedentary work capacity. In other words, they are not able to sit at least 6 hours out of an 8-hour day, to stand/walk at least 2 hours per 8-hour day, and cannot lift at least 10 pounds occasionally. This is why it is so difficult to get approved if you are below age 50.
Who Can Evaluate Your Case and Determine the Strength of Your Disability Claim?
An experienced attorney or disability advocate can review your claim and evaluate whether you meet the basic requirements of Social Security disability.
P.S. If there are restrictions from mental impairments (depression, PTSD, anxiety, etc.), these are evaluated independent of exertion restrictions.
Saturday, November 10, 2018
WHY YOU NEED RECORDS FROM YOUR OWN DOCTOR?
In Social Security disability claims, it is infinitely better to have medical records from your own doctor(s).
Decision makers want to see at least 12 months of recent medical treatment. In cases where this treatment doesn't exist, Social Security may send you for a special consultative examination (CE), performed by a doctor under contract with Social Security to furnish these exams.
Maybe a CE is better than no evidence at all, maybe not. My experience is that consultative exams usually do not help get claims approved.
There are some things that your own doctor can provide that a consulting doctor cannot:
Here are some further suggestions as you seek medical treatment, with regard to how the treatment may affect your chances with Social Security:
________________
Charles W. Forsythe
The Forsythe Firm
Social Security Disability Represention
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
FREE CONSULTATIONS: (256) 799-0297
SOCIAL SECURITY JUSTICE
Decision makers want to see at least 12 months of recent medical treatment. In cases where this treatment doesn't exist, Social Security may send you for a special consultative examination (CE), performed by a doctor under contract with Social Security to furnish these exams.
Maybe a CE is better than no evidence at all, maybe not. My experience is that consultative exams usually do not help get claims approved.
There are some things that your own doctor can provide that a consulting doctor cannot:
- History of treatment; what has worked, what hasn't.
- Medications and therapy that has been tried.
- Response to treatment.
- Prognosis - What course is your illness likely to take?
- Opinion with regard to your physical/mental limitations.
Here are some further suggestions as you seek medical treatment, with regard to how the treatment may affect your chances with Social Security:
- Try to see a physician (MD or DO), or a Physician's Assistant (PA), as opposed to a nurse practitioner.
- Follow doctor's orders (treatment plan) as closely as possible.
- Try to see your primary care doctor at least twice a year.
- Seek a specialist if you have a condition that requires it (for example, a cardiologist, orthopedic specialist, neurologist, etc.).
- If possible, get imaging studies or laboratory testing to verify the diagnosis and severity of your condition. An MRI, CT scan or even a simple X-ray, in some cases, may be good as gold.
________________
Charles W. Forsythe
The Forsythe Firm
Social Security Disability Represention
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
FREE CONSULTATIONS: (256) 799-0297
SOCIAL SECURITY JUSTICE
Friday, November 2, 2018
DDS: THE DISABILITY DENIAL SERVICE. GET OUT OF THERE!
The official name for DDS is the Disability Determination Service. But attorneys refer to them as the "Disability Denial Service." That's because they deny such a huge percentage of claims at the initial, application level. Their award rates are dismal.
DDS is the state agency which makes the initial decision on Social Security disability applications. They will order your medical records, review them, determine if they support your claim and issue a decision. There is a 75 percent chance you will be denied by this state agency.
By filing an appeal on the denial, however, you move your claim away from the state level and into the federal arena. The appeal puts you in the Office of Hearings and Appeal, a strictly federal agency within Social Security. It's a more productive place to be, although the waiting time can be quite lengthy (down to about 6 or 7 months now, less than it has been).
The appeal heads your claim toward a hearing with a US Administrative law judge. There are two advantages to the appeal forum vs. the application forum at DDS:
1. You get an in-person hearing with a judge.**
2. You get to take your attorney/representative to the hearing.
A vigorous appeal can be your best chance to get paid.
Charles W. Forsythe
Social Security Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH. (256) 799-0297
Serving all of North Alabama and Middle Tennessee
DDS is the state agency which makes the initial decision on Social Security disability applications. They will order your medical records, review them, determine if they support your claim and issue a decision. There is a 75 percent chance you will be denied by this state agency.
By filing an appeal on the denial, however, you move your claim away from the state level and into the federal arena. The appeal puts you in the Office of Hearings and Appeal, a strictly federal agency within Social Security. It's a more productive place to be, although the waiting time can be quite lengthy (down to about 6 or 7 months now, less than it has been).
The appeal heads your claim toward a hearing with a US Administrative law judge. There are two advantages to the appeal forum vs. the application forum at DDS:
1. You get an in-person hearing with a judge.**
2. You get to take your attorney/representative to the hearing.
A vigorous appeal can be your best chance to get paid.
Get a good representative for your appeal. You will pay nothing unless you win and all fees are regulated by the Social Security Administration.
** Since the COVID-19 pandemic, all hearings are held via telephone conference call. But your attorney can be on the line with you and ask the same questions. No one knows when in-person hearings will resume.
___________Charles W. Forsythe
Social Security Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH. (256) 799-0297
Serving all of North Alabama and Middle Tennessee
Friday, October 26, 2018
THE LOGICAL APPROACH TO GETTING SSDI BENEFITS
Luck has very little to do with getting approved for a Social Security disability check. Logic, law and the grid rules have a lot more to do with it.
Logic, in the sense that the case must make sense to the administrative law judge who handles your appeal. (Forget about getting approved merely by filing an application; those days are gone--unless you have a terminal or catastrophic illness). The narrative about why you can't work must make sense to the judge. And judges think differently than claimants. Believe me--they do.
Law, in the sense that no judge is going to pay a benefit unless the law directs it. You basically have to show a judge that the federal regulations dictate that you qualify for benefits. You meet all the rules, so the judge will be upholding the law when you are approved. Short of this, no benefit will ever be paid.
Grid rules can help you if you are age 50 or over and have a physical or exertional impairment. An exertional impairment is a physical impairment that restricts your ability to sit, stand, walk, lift or push/pull. Grid rules do not apply to mental impairments. The grids often make it much easier to prove disability for persons age 50 and over, especially those who are 55 or over.
I approach a disability appeal with a thorough fact finding session. I want to know your medical background, your past work history, you education level and any doctor's opinion about your ability to perform specific work related activities. Note: It isn't enough for your doctor to make a general statement like, "This patient has heart trouble and is totally disabled and should not attempt to work." While this sounds like it would do the trick, it will not because it violates one of Social Security's legal principles. That principle says, "Only the Commissioner of Social Security may determine who is disabled." It is not the doctor's role. Therefore, this kind of testimony is not admissible.
We can provide forms to help your doctor give admissible testimony about your medical impairments--which Social Security may accept.
Getting an SSDI claim approved is a lot like putting together a complicated legal jigsaw puzzle. Piece by piece. And only someone who has experience and skill in this area can be expected to do it well.
HOW TO DISABILITY REPRESENTATIVES GET PAID?
A representative can only charge you a fee if you win your case and recover some back pay (also called "past due benefits"). Social Security will withhold a percentage of your back pay--which cannot exceed 25 percent--and pay your representative directly. Not all representatives are eligible for direct payment but those who have met stringent requirements are. The Forsythe Firm is eligible for Direct Payment of Fees from Social Security.
If you don't win your case, or if you win but don't get any back pay, there is never a fee. You will always keep 100% of your monthly benefits.
- - - - - - - - - - - - -
THE FORSYTHE FIRM
Social Security Representation
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE (WEBSITE)
"We handle nothing but Social Security cases."
Logic, in the sense that the case must make sense to the administrative law judge who handles your appeal. (Forget about getting approved merely by filing an application; those days are gone--unless you have a terminal or catastrophic illness). The narrative about why you can't work must make sense to the judge. And judges think differently than claimants. Believe me--they do.
Law, in the sense that no judge is going to pay a benefit unless the law directs it. You basically have to show a judge that the federal regulations dictate that you qualify for benefits. You meet all the rules, so the judge will be upholding the law when you are approved. Short of this, no benefit will ever be paid.
Grid rules can help you if you are age 50 or over and have a physical or exertional impairment. An exertional impairment is a physical impairment that restricts your ability to sit, stand, walk, lift or push/pull. Grid rules do not apply to mental impairments. The grids often make it much easier to prove disability for persons age 50 and over, especially those who are 55 or over.
I approach a disability appeal with a thorough fact finding session. I want to know your medical background, your past work history, you education level and any doctor's opinion about your ability to perform specific work related activities. Note: It isn't enough for your doctor to make a general statement like, "This patient has heart trouble and is totally disabled and should not attempt to work." While this sounds like it would do the trick, it will not because it violates one of Social Security's legal principles. That principle says, "Only the Commissioner of Social Security may determine who is disabled." It is not the doctor's role. Therefore, this kind of testimony is not admissible.
We can provide forms to help your doctor give admissible testimony about your medical impairments--which Social Security may accept.
Getting an SSDI claim approved is a lot like putting together a complicated legal jigsaw puzzle. Piece by piece. And only someone who has experience and skill in this area can be expected to do it well.
HOW TO DISABILITY REPRESENTATIVES GET PAID?
A representative can only charge you a fee if you win your case and recover some back pay (also called "past due benefits"). Social Security will withhold a percentage of your back pay--which cannot exceed 25 percent--and pay your representative directly. Not all representatives are eligible for direct payment but those who have met stringent requirements are. The Forsythe Firm is eligible for Direct Payment of Fees from Social Security.
If you don't win your case, or if you win but don't get any back pay, there is never a fee. You will always keep 100% of your monthly benefits.
- - - - - - - - - - - - -
THE FORSYTHE FIRM
Social Security Representation
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE (WEBSITE)
"We handle nothing but Social Security cases."
Saturday, October 20, 2018
SOCIAL SECURITY: AN INSURANCE BENEFIT, NOT AN ENTITLEMENT
HISTORY: Congress passed the Social Security Act in 1935 as a pension program for elderly Americans, allowing them to draw an "old age pension" when they reached 65 years of age. The purpose was to help reduce poverty among America's aging population. The original act provided for no disability benefit.
In 1955, Congress took note of hundreds of thousands of workers who became disabled prior to age 65 but had no disability insurance to help ease the hardship of lost wages. A debate began concerning adding a disability benefit to Social Security.
THE PROBLEM: Congress realized that the strained federal budget could not support another entitlement program paid for by federal dollars. What they came up with was an entirely separate disability trust fund, not supported by federal tax dollars at all. The trust fund would be supported by specific taxes on workers and their employers. Under the new Federal Insurance Contributions Act (FICA), each worker would have a percentage of his wages withheld and paid into the federal trust fund. The employer would also be required to pay an equal or matching amount into the fund. When a disability claim occurred, the benefit would be paid out of the trust fund, not out of the US treasury. So, no treasury tax dollars would be spent.
THE SOLUTION: The Social Security Administration (SSA) collected money from workers, much the same way that a private insurance company would. They pooled this money in a disability trust fund and distributed money to disabled beneficiaries, just like an insurance company would do. The difference between SSDI and private insurance is that SSDI withholding is mandatory (you can't avoid it), while paying private insurance premiums is optional (your choice).
WHAT YOU NEED TO GET DISABILITY BENEFITS
1. You must have worked enough to accumulate the minimum quarters of coverage. Most workers need 20 quarters of coverage accumulated during the past 10 years. Stated simply, you need to have worked at least 5 years out of the the past 10 years.
2. You cannot be currently working at substantial gainful activity. You cannot hold a substantial job and apply for SSDI at the same time. A job is substantial if your gross earnings or self-employment income are at least $1,180 per month.
3. You must have a medically determinable impairment that has (a) lasted for at least 12 consecutive months, (b) is expected to last for at least 12 consecutive months, OR (c) is expected to end in death. This is called the duration requirement.
4. Your medical impairment must be severe enough to prevent you from performing any full-time work activity, not just the job you are accustomed to or trained for. (Rules are a bit different for persons over age 50).
A Final Thought
Social Security denies over 70 percent of all disability claims--even some that meet the rules and should be paid. Mistakes are frequent. Nearly everyone who eventually gets a benefit must appeal their denied claim and appear before a US administrative law judge for a hearing. Your chances at the hearing are much better, particularly if you have an experienced disability advocate who knows how to prepare and present you case to meet the federal rules. So, the biggest mistake you can make is failing to appeal your denial, or waiting too long to file the appeal. You must appeal within 60 days of the denial decision. This is a strict deadline.
__________
by Charles W. Forsythe
Social Security Disability Representative
The Forsythe Firm
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
Across from Bridge Street
PHONE US: (256) 799-0297
EMAIL ME: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
In 1955, Congress took note of hundreds of thousands of workers who became disabled prior to age 65 but had no disability insurance to help ease the hardship of lost wages. A debate began concerning adding a disability benefit to Social Security.
THE PROBLEM: Congress realized that the strained federal budget could not support another entitlement program paid for by federal dollars. What they came up with was an entirely separate disability trust fund, not supported by federal tax dollars at all. The trust fund would be supported by specific taxes on workers and their employers. Under the new Federal Insurance Contributions Act (FICA), each worker would have a percentage of his wages withheld and paid into the federal trust fund. The employer would also be required to pay an equal or matching amount into the fund. When a disability claim occurred, the benefit would be paid out of the trust fund, not out of the US treasury. So, no treasury tax dollars would be spent.
THE SOLUTION: The Social Security Administration (SSA) collected money from workers, much the same way that a private insurance company would. They pooled this money in a disability trust fund and distributed money to disabled beneficiaries, just like an insurance company would do. The difference between SSDI and private insurance is that SSDI withholding is mandatory (you can't avoid it), while paying private insurance premiums is optional (your choice).
WHAT YOU NEED TO GET DISABILITY BENEFITS
1. You must have worked enough to accumulate the minimum quarters of coverage. Most workers need 20 quarters of coverage accumulated during the past 10 years. Stated simply, you need to have worked at least 5 years out of the the past 10 years.
2. You cannot be currently working at substantial gainful activity. You cannot hold a substantial job and apply for SSDI at the same time. A job is substantial if your gross earnings or self-employment income are at least $1,180 per month.
3. You must have a medically determinable impairment that has (a) lasted for at least 12 consecutive months, (b) is expected to last for at least 12 consecutive months, OR (c) is expected to end in death. This is called the duration requirement.
4. Your medical impairment must be severe enough to prevent you from performing any full-time work activity, not just the job you are accustomed to or trained for. (Rules are a bit different for persons over age 50).
A Final Thought
Social Security denies over 70 percent of all disability claims--even some that meet the rules and should be paid. Mistakes are frequent. Nearly everyone who eventually gets a benefit must appeal their denied claim and appear before a US administrative law judge for a hearing. Your chances at the hearing are much better, particularly if you have an experienced disability advocate who knows how to prepare and present you case to meet the federal rules. So, the biggest mistake you can make is failing to appeal your denial, or waiting too long to file the appeal. You must appeal within 60 days of the denial decision. This is a strict deadline.
__________
by Charles W. Forsythe
Social Security Disability Representative
The Forsythe Firm
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
Across from Bridge Street
PHONE US: (256) 799-0297
EMAIL ME: forsythefirm@gmail.com
SOCIAL SECURITY JUSTICE WEBSITE
Sunday, October 14, 2018
FASTER TRACKS TO SOCIAL SECURITY DISABILITY
It's well known that disability claims in the Huntsville, AL are take up to 2 years. Claims are usually denied at the first stage and require a hearing. But there are certain circumstances that your attorney or advocate can use to speed up your claim and drastically cut wait times:
1) Compassionate Allowance. Social Security recognizes approximately 300 diseases that automatically qualify for SSDI or SSI benefits. If you have one of these diseases, your attorney can ask for a compassionate allowance and get benefits approved right away.
2) Dire Need. If you can show that you can't pay your rent or mortgage and would be homeless without assistance, you might qualify for a faster dire need decision. If you need urgent medical care that you cannot obtain, you might qualify for dire need consideration. A dire need does not necessarily get you approved; it simply gets you a hearing much faster.
3) On-the-Record (OTR) decision. In some circumstances, your attorney or representative may ask a judge to make a review of your case on the record, meaning a documentary review without a hearing, and make a decision. This can save several months off the process. However, OTR decisions are not right for every case.
4) Disabled Veterans with a 100 percent VA disability rating may qualify for expedited processing. In some circumstances, this can cut the processing time in half, or it could even be faster than that.
Aside from one of these four circumstances, your representative can keep your case moving by completing applications and forms promptly and properly.
1) Compassionate Allowance. Social Security recognizes approximately 300 diseases that automatically qualify for SSDI or SSI benefits. If you have one of these diseases, your attorney can ask for a compassionate allowance and get benefits approved right away.
2) Dire Need. If you can show that you can't pay your rent or mortgage and would be homeless without assistance, you might qualify for a faster dire need decision. If you need urgent medical care that you cannot obtain, you might qualify for dire need consideration. A dire need does not necessarily get you approved; it simply gets you a hearing much faster.
3) On-the-Record (OTR) decision. In some circumstances, your attorney or representative may ask a judge to make a review of your case on the record, meaning a documentary review without a hearing, and make a decision. This can save several months off the process. However, OTR decisions are not right for every case.
4) Disabled Veterans with a 100 percent VA disability rating may qualify for expedited processing. In some circumstances, this can cut the processing time in half, or it could even be faster than that.
Aside from one of these four circumstances, your representative can keep your case moving by completing applications and forms promptly and properly.
Friday, October 12, 2018
CHECKLIST FOR YOUR SSDI HEARING: HERE'S WHAT YOU NEED
So, you have waited two years or more and are finally scheduled to appear for your Social Security disability hearing. You are understandably nervous and expectant. For most people, this is their first appearance before a judge.
Prior to your hearing, there are things you need to prepare. Here's a short checklist:
___ Be certain the judge has all of your pertinent medical records, including records of any recent treatment or hospitalization. It is your responsibility to submit medical evidence.
___ Do you know the exact date you last worked? The judge must ask.
___ Prepare a list of all prescription medications you take.
___ Have an answer for the question, "Why do you believe you are unable to work?" Think in terms of symptoms, not just diseases.
___ Try to understand Social Security's definition of disability. Note: There is one definition for persons under 50, another for persons 50 and over.
___ Look at your "alleged onset date." Why is this the appropriate date for the onset of your disability? Be able to explain.
___ Try to formulate a "legal theory" of your case. In other words, why do you meet the rules and regulations that define disability?
___ Be sure you understand the difference between unemployment and disability. Unemployment means you can't find a job. Disability means you are not able to perform the duties of a job.
___ Check out general Do's and Dont's:
Prior to your hearing, there are things you need to prepare. Here's a short checklist:
___ Be certain the judge has all of your pertinent medical records, including records of any recent treatment or hospitalization. It is your responsibility to submit medical evidence.
___ Do you know the exact date you last worked? The judge must ask.
___ Prepare a list of all prescription medications you take.
___ Have an answer for the question, "Why do you believe you are unable to work?" Think in terms of symptoms, not just diseases.
___ Try to understand Social Security's definition of disability. Note: There is one definition for persons under 50, another for persons 50 and over.
___ Look at your "alleged onset date." Why is this the appropriate date for the onset of your disability? Be able to explain.
___ Try to formulate a "legal theory" of your case. In other words, why do you meet the rules and regulations that define disability?
___ Be sure you understand the difference between unemployment and disability. Unemployment means you can't find a job. Disability means you are not able to perform the duties of a job.
___ Check out general Do's and Dont's:
- Avoid vague terms like sometimes, not very often, a little bit...
- Don't answer questions you don't understand; ask for clarification.
- Always answer questions truthfully.
- Remember, a voice recording will be made, so speak up.
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