2 PROGRAMS AT THE SOCIAL SECURITY ADMINISTRATION

The U.S. Social Security Administration (SSA) not only administers retirement benefits to older Americans, but it also provides disability benefits under 2 entirely different programs:

SSDI - (Social Security Disability Insurance), is for individuals who have worked at least 10 years and paid FICA withholding.  Maximum benefit in 2020 is $3,011 per month.*

SSI (Supplemental Security Income) - is for very low income individuals who have not worked enough to get SSDI.  Maximum benefit in Alabama is $771 per month for an individual.

While the maximum SSDI benefit is $3,011 per month for an individual, the actual benefit is determined by the claimant's lifetime earnings. 

The road to getting benefits under either SSDI or SSI is a long haul. 

Every time the government announces changes to the disability programs ("improvements"), you can bet on one thing:  they're making benefits harder to get.

When we opened our office nearly two decades ago, the average approval rate at a hearing was 62 percent nationwide.  Today, it is down to 42 percent.

Hiring an advocate to represent you increases your chance of being approved.  Relatively few claimants attempt SSDI or SSI on their own (unrepresented).  This usually involves going before a judge who will demand proof that you meet the rules and regulations for a benefit.

HOW TO GET SOCIAL SECURITY DISABILITY BENEFITS

PREPARE & PERSIST

Anyone under full retirement age can apply for Social Security Disability Insurance (SSDI) benefits.  Persons who are at full retirement age are already eligible for full Social Security benefits by virtue of their age.

There are 3 sets of criteria used by Social Security to determine eligibility.

1.  For younger individuals under the age of 50 (strictest)

2.  For persons approaching advanced age (50 through 54)

3.  For persons of "advanced age" (the most relaxed rules).

Here, briefly, is the process most individuals must follow to get a benefit.  Of course, exceptions apply.

1.  File a complete application with all requested forms.  (70% denial rate at this stage).

2.  If denied, file for "Reconsideration."  (95% denial rate).

3.  Appeal and ask for a hearing with an administrative law judge.

Here are some key points to cover in your SSDI process:

• Tell Social Security about all your doctors and medical providers.  They only look at the ones you tell them about.
  
• List all of your medical impairments, not just the most severe ones.
• Return all questionnaires and forms on time, fully completed.
• Appeal any unfavorable decision within the 60 day deadline.
• Prepare for the hearing.  Find out what questions will likely be asked and how to answer or explain each one.
• Seriously consider a lawyer or representative who has prepared for hundreds of hearings and knows the law, the judge and the process.  This may give you up to a 75% increase in your odds of winning your benefits.

You hear people describe the SSDI process as "a fight."  It usually is.  The government pays 20 percent fewer claims in 2020 than they paid in 2010.  Hearing  award rates have tumbled from around 62 percent a few years ago to about 42 percent today.

The claimants who win today are those that are well prepared, supported by strong objective medical evidence, and are willing to fight it out through the various appeals process (at least 2 appeals).

How long does all this take?  It takes 3 to 5 months to get the initial decision on your application.  In Alabama, "Reconsideration" decisions are usually given within 90 days.  It will take 6 to 8 months to get a hearing decision (from the date of the second appeal).

PREPARE & PERSIST

ADAPTING TO TELEPHONE HEARINGS

With the COVID-19 pandemic spreading, Social Security has closed all hearing offices.  They are trying to keep up with their hearing schedule by using telephone hearings.

A telephone hearing is held with the claimant at home.  The attorney is in his/her office and the judge is usually at his or her home.  Each party is placed in a conference call on the telephone.

Telephone hearings operate basically like other hearings.  The one big difference is technology.  It all depends on being able to hear each other over the phone.

The most important thing is to prove your disability according to the rules of the Social Security Administration.  This is never easy and depends heavily on objective medical evidence from your doctors and other treating sources.  Of course, you must know what the rules are before you can hope to meet them.

Telephone hearings last about 45 minutes, a bit longer if there are technical problems (someone's phone cuts off or drops a call).  No decision is usually announced at the hearing; that comes later in a written decision.

My office has adapted well to telephone hearings.  I call or meet with my client (their choice) about a week prior to the hearing.  I explain what to expect, what our case is based on, and answer the client's questions.  Hopefully, then, nothing comes as a surprise during the hearing.

Social Security has been using telephone hearings since March, 2020.  As far as we can tell, judges are awarding benefits at about the same rate as they were during in-person hearings.

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The Forsythe Firm

7027 Old Madison Pike, Suite 108

Huntsville, AL 35806

Call:  (256) 799-0297

Our email address:   forsythefirm@gmail.com

https://forsythefirm.wixsite.com/website

ADVOCATE

Advocate (n)

Latin:  Advocare

Greek:  Paraklete.....

One called alongside to help, to plead.

Also translated "counselor."

Your advocate represents your point of view, your interests and your wishes.

In a Social Security disability hearing there are usually 5 people present:  the claimant, the advocate, the judge, the vocational witness and the hearing clerk.

1.  The Judge presides.   He/she is a finder of fact, neither for you or against you.  A decision maker.  But the judge cannot be your advocate.

2.  The Vocational Witness.  This is a jobs expert who has been called by Social Security to give testimony about jobs that exist in the national economy and how certain limitations can restrict the ability to work.  This witness is supposed to be neutral, but certainly cannot be your advocate.

3.  The Hearing Clerk is there to make a proper record of the hearing.  For the most part, he/she is silent during the hearing.

4.  The Advocate.  Sitting at your left elbow is your advocate, counselor or representative.  This person represents your interests before the judge and strives diligently to help you be approved for benefits.  This is the only person who is 100 percent for you.

Prior to the hearing, of course, your advocate has done a lot to get ready for the hearing:  finding and submitting evidence, interpreting evidence, making arguments, writing briefs for the judge, preparing you to testify, etc.  He or she has looked for problems that may arise and has sought to solve them.  You advocate has given you a lot of advice and counsel.  

HOW LONG IS THE SOCIAL SECURITY DISABILITY PROCESS?

The first stage of the Social Security disability process is called the Application Stage.  You submit an application and wait 3 to 5 months to get a decision.  The Social Security office sends your file to a state agency called the Disability Determination Service (DDS) to make a decision.  The time required depends on how long it takes to get all of your medical records, among other factors.

If you are denied at the Application Stage (most claimants are), you appeal and go into the "Reconsideration Phase." Here the state agency assigns a new person to review their previous decision to see if it was correct.  The decision is changed in only about 5 cases out of 100.  In Alabama, "Reconsideration" usually takes 30 to 60 days.  In Tennessee, it can take 6 to 12 months.

The third stage is the Hearing.  You appeal again and ask that your case be heard by an Administrative Law Judge (ALJ).  While it once took up to 2 years to get a hearing, you may now get one scheduled in 6 to 8 months from the time of filing your request.

So, if your case requires all of these steps, Application through Hearing, you will easily spend 1 year or more waiting for a final decision.  Social Security disability is a slow, deliberate process that usually does not move quickly, except for very severe cases of obvious disability (such as a terminal illness or one a Compassionate Allowance).

HOW MANY TIMES CAN YOU APPLY FOR SSDI?

It is often possible to apply for Social Security disability more than one time.  In fact, some claimants file several applications.

However, do not file a new application just because you were denied.  This is not the correct response to a denial.  Usually, the most productive response to a denial is to appeal.  An appeal kicks the  claim up to a higher level of authority for a new review.  Most successful claimants will file 2 appeals before they win.

There may be an unusual situation that calls for starting over with a new application.  But not generally.

Also, be aware that Social Security disability has a "shelf life."  You reach a point when you are not able to file new claims.

You eventually reach a date called your "Date Last Insued" or DLI.

Your DLI is usually about 5 years after you stopped working.  When you stop paying into Social Security the clock begins to tick toward your DLI.  When you reach that date, it is difficult if not impossible to file new claims.

That being said, there is no rule against filing a new SSDI claim as long as you have not reached your DLI and lost your insured status with Social Security.

We advise speaking to a Social Security disability advocate/attorney about filing a new claim vs. filing an appeal.  If you take the wrong path here you will waste a lot of time and a lot of money.  With most attorneys this conversation will be free. 

WHAT IF SOCIAL SECURITY TURNS YOU DOWN?

Social Security denies most claims.  In fact, it sometimes seems like a denial machine.  Just because you were denied doesn't mean you aren't qualified for a disability benefit.  It means you have to move to the next level--with an appeal.

The first appeal, after the denial, is called "Reconsideration."  You can expect it to be denied, also.  The denial rate at this stage is over 95 percent, so very little hope at "Reconsideration."

The second appeal takes your case before a judge--called an Administrative Law Judge.  His or her job is to give your case a thorough, personal review and determine if you meet the federal requirements for a disability benefit.  The approval rate at hearings averages around 45 percent.  Much better odds.

What Can You Do To Help Yourself When You've Been Denied?

1.  File your appeal within the 60 day deadline.  This is a strict deadline.

2.  Keep seeing your doctors regularly and follow medical advice.  Keep taking your medications and follow all recommended treatment.

3.  Be sure the office handling your appeal receives copies of all your medical records.  If you are not represented, it is your responsibility to notify Social Security of your ongoing treatment, then check to be sure all medical records are turned in.

4.  Gather as much additional non-medical evidence as you can.  If you had trouble performing your last job due to medical issues, ask your prior supervisor to write a letter detailing the problems you experienced. 

5.  Try to research and understand what your burden of proof is.  Discover how age, past work and education will affect your decision.

6.  If you decide to use an advocate or attorney to help you with your hearing, don't wait until the last minute to get one.  Putting together a good case for hearing can take 6 months or longer.  You hurt yourself if you wait too long to bring your representative on board.

Finally, keep your representative up to date on your medical treatment, employment (if you work part-time) or anything that might affect your case.

______________________

The Forsythe Firm

7027 Old Madison Pike, Suite 108

Huntsville, AL 35806

"Across from Bridge Street"

CALL (256) 799-0297

Email Us:   forsythefirm@gmail.com

https://forsythefirm.wixsite.com/website