WHY YOUR NEIGHBOR GOT DISABILITY BENEFITS BUT YOU DIDN'T

 We have all heard the stories.  My neighbor was approved for SSDI benefits and gets a check in his mailbox every month.  I applied around the same time and was denied.  I am more disabled than my neighbor!  Why wasn't I approved?  This perplexes almost everyone who has lost a claim.

There could be a million reasons.  Some of them make sense, some of them don't.  

Let's look at some of the things that may have affected your denied claim.

• What is your age?  What is your neighbor's age.  If you are  under 50 and your neighbor is 50 or older, you are playing with two very different sets of rules.  So, age is my first question. 

• What is your medical impairment?  What is your neighbor's  impairment?  Some impairments are much more likely to be approved than others.  Cancer, heart failure, COPD, etc. are much more likely to be paid than fibromyalgia, anxiety or  back trouble.

• Who was the judge?  Judges pay rates (averages) are not the same--not even close.  Judge Alpha in Room 1 may pay 14 percent of her claims, while Judge Beta in Room 2  may  pay 70 percent. And we don't pick the judge. I don't think this inequity is right, but nobody asked me.  You see how luck figures into it?    

• Did your doctor get involved?  Did you get your doctors get involved?  Did you ask your physician to complete a Medical Source Statement which states your degree of limitation concerning work related  activities?  If not, it may have hurt your chances. 

My point is:  there are literally dozens of factors that help determine how a claim is decided.  Each case has dozens of variables:  different age, education, past work history, medical record, witnesses, transferable skills--not to mention the difference in judges. Then, there's how well the claimant testified at the hearing.  

The important point, I think is:  How to respond to a denied claim.  In most cases, the best thing is to appeal within the allowed 60 day time limit.  A recent study suggests that about 50 percent (yes, one half) of denied claims can be approved on appeal.  So, get yourself a lawyer or Social Security advocate-specialist--and appeal the daylights out of your denial.  It will probably pay off.

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The Forsythe Firm   7027 Old Madison Pike   Huntsville, AL

CALL US for a free consultation:  (256) 799-0297

*Free  consult for Social Security disability cases only.

DISABILITY CLAIM IN ALABAMA? WHAT YOUR DOCTOR CAN DO TO HELP GET APPROVED

 Your doctor may hold the key to getting your Social Security disability claim approved.  But you must know what to ask your doctor to do.  

First, a word about what doctors may not do.  A doctor may not render an opinion about whether a patient is disabled.  He may not state that an individual is not able to work.  Why?  Under the law, these opinions are reserved only to the Commissioner of Social Security.  A doctor may not draw a conclusion reserved for the Commissioner.

So, other than routine medical records, what may your doctor provide to help your claim?

The technical name for what you want from your doctor is a Residual Functional Capacity Opinion.  These are also called Medical Source Statements.

This is a specific form used by Social Security.  Doctors do not have the form; you need to obtain it from your attorney or representative, and take it to your doctor for completion.

 Your doctor may offer to simply write a letter for you, instead. You should decline this offer and ask for the Medical Source Statement (form).  Why?  The doctor's letter will invaribly make statements that are not admissible as evidence (reserved to the Commissioner).  The doctor's letter is always fail to give specific data that Social Security requires to make a favorable decision.  Thus, use the form, not a letter.

A properly completed Medical Source Statement from your treating doctor can be a good tool to support your disability claim.

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THE FORSYTHE FIRM

Social Security Counselors

Huntsville, AL 35806

CALL US (256) 799-0297 

Email Us:  forsythefirm@gmail.com

 

 

HOW TO HANDLE A SOCIAL SECURITY DISABILITY DENIAL

 

 

 The usual result of filing a disability application is not payment, but denial.  You need to know how to deal with a disability denial.

If you are denied, you have 60 days (a firm deadline) to file an appeal.  This is the correct action.  Most claims do not get paid at the application stage; they are paid at the appeal stage. You may file an appeal online, by calling the local Social Security field office, or though an attorney or Social Security disability advocate.

I know this sounds crazy, but 95 percent of appeals will be denied initially, in the "Reconsideration" process.  I consider "Reconsideration,"(the first appeal) just a hoop you must jump through to get to the next level."  You can't skip it, so file an appeal asking for "Reconsideration."  Expect to be denied again.

Within 60 days after your "Reconsideration" is denied, you must file the "real appeal."  This appeal requests a hearing before a US Administrative Law Judge (ALJ).  The hearing is where most claims get paid, if they ever do.  It's your absolute best chance to get a fair hearing and get approved.

I recommend an attorney or non-attorney disability specialist at the beginning of an appeal process.  There is evidence that having a specialist involved in your claim increases your chance of winning by up to 75 percent.  You only get one hearing, so there is no chance to go back and do something over if you fail the first time.  

Since you are going before a federal judge, it makes sense to be represented by a professional who has been there hundreds (or thousands) of times and knows what to expect.  Your representative also knows what must be proven, and how to prove it.

You can talk to an attorney or advocate for free.  Even if you "hire" a representative to help you, you cannot be charged any fee or expenses unless you WIN and collect BACK PAY from Social Security.  When that happens, Social Security will pay the attorney directly, using a small percentage of your back pay.  You will keep 100 percent of future benefits forever.  If you don't receive any back pay, the attorney gets no pay--and his/her service has been free, according to the law.

So, let's recap the following points of how to deal with Denials:

1.  Appeal within 60 days.  This will not be extended.  60 days.

2.  If denied again, appeal again and ask for a Hearing.  Same 60 day rule here.

3.  Appoint an attorney or advocate to build your case and represent you--going with you to the hearing to protect your rights.  The attorney gets paid only if you receive back pay.  If you don't win, you don't pay.

It usually takes 2 appeals to get a Social Security disability claim paid.  It's a process that can be long, difficult and technical.  It is beyond the ability of most claimants without some help.  Remember, you can call and talk to a professional representative at no cost, no obligation. 

__________________

The Forsythe Firm    7027 Old Madison Pike  Suite 108   Huntsville

CALL US:  (256) 799-0297

EMAIL US:   forsythefirm@gmail.com

https://forsythefirm.wixsite.com/website

 

 

HOW BEING AGE 50+ HELPS YOU GET DISABILITY BENEFITS

Social Security uses 3 sets of rules to determine if a person is "disabled" under their regulations.  

RULE 1 is for persons under age 50, call "Younger Individuals."  This is the most difficult set of rules.

RULE 2 is for persons between ages 50 and 54, called "Approaching Advanced Age."  These rules are bit easier than the above rule, but still challenging.

RULE 3 is for persons age 55 or over, called "Advanced Age."  These are the easiest set of rules.

Social Security uses "Grid Rules," which combine age, education, past work experience, and residual functional capacity to decide eligibility for persons age 50 and over.  Here's the basic impact:

YOUNGER INDIVIDUAL:  Must prove that he/she cannot perform any work which exists in the US economy, even the easiest, unskilled sedentary (sit down) job.  So, if a younger individual can perform ANY type of full-time work, they are not disabled.

ADVANCED AGE INDIVIDUAL:  Must only prove that they cannot perform any of their past relevant work, meaning any of the full-time jobs they have held during the past 15 years.  It doesn't matter if they can perform other types of work, they can still be found disabled.

So , claimants over age 50 have a decided advantage.  But nothing is automatic.  Social Security usually denies claims before they approve them.  Most claims are won in the appeal process, which can be  long, challenging, and frustrating.

If you are age 50 or over, let an experienced Social Security disability advocate review and evaluate your claim for FREE.  Get an idea of whether you can qualify for up to $3,011 per month in disability benefits.  P.S.  Choose a local representative that you can sit down and talk to across the desk, rather than an out-of-state firm that you know nothing about and will not see until the day of your hearing.  Local is better and won't cost you a cent more.  In fact, we won't ask for a cent unless you are approved and qualify for past due benefits (usually paid in a lump sum)!  If you don't win, you don't pay.

__________________

The Forsythe Firm

7207 Old Madison Pike    Suite 108    Huntsville, AL 35806

CALL US FREE (256) 799-0297  (Social Security claims only)

E-mail us:   forsythefirm@gmail.com

https://forsythefirm.wixsite.com/website 

CAN MY CHILDREN RECEIVE DISABILITY BENEFITS? WHAT ABOUT MEDICARE?

 If you qualify for Social Security disability benefits, will your dependent children also get a benefit?  The answer is yes.  Most likely your dependent children who are still in school and under the age of 19 will also qualify for a monthly check.

What about Medicare?  Disabled persons usually have need for ongoing medical treatment.  This can be expensive, even prohibitive due to the cost.  When a person qualifies for SSDI (Social Security disability), Medicare is always included.  Medicare pays a majority of doctor bills, hospital charges and diagnostic tests.  You may purchase a supplement (called Part C), which picks up most of the co-pays and deductibles not paid by Medicare.  Add Part D, and prescription drugs can be covered, too. Medicare is a valuable part of SSDI benefits.  It can save you thousands of dollars per year in medical expenses.

Is it easy to qualify for SSDI?  No, it isn't.  Social Security has a very restrictive definition of "disability."  You must prove that you meet all of their rules and regulations, which is very difficult and time consuming.

It will help you to get a disability representative or attorney to help prove your case.  When Social Security denies your benefits (as they often do), your attorney/representative will go to work on appeals to get your denial overturned and your case approved.

Most cases wind up before a federal Adminstrative Law Judge (ALJ) for a hearing.  Here, your attorney/representative can be of enormous help to you--because he or she understands the laws, rules and procedures.  Knowing the burden of proof and how to meet it, your attorney/representative knows how to proceed with the case to give you the best chance to win and be approved.  There is no cost for an attorney unless you win your case and also recover past due benefits.  Attorney's fees are paid out of past due benefits.  If you don't win, you don't pay.

SSDI benefits, once approved, can last until your full retirement age, then convert to Social Security retirement benefits.  Medicare will continue for your lifetime if your disability doesn't end prior to age 65.

SSDI and Medicare is the most valuable financial benefits that most Americans will ever get!  It takes effort to be approved, but it's well worth it.  The average SSDI case is worth over $500,000 in benefits, and that's not counting the benefits of Medicare.

Delay costs you money and may result in "expired" benefits.  If you have worked at least 5 out of the past 10 years, have a severe disability that has lasted (or is expected to last at least 12 straight months or more)--you should apply immediately.  

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The Forsythe Firm

Social Security Disability Counselors

Huntsville, AL 35806

CALL (256) 799-0297

E-Mail US:  forsythefirm@gmail.com

https://forsythefirm.wixsite.com/website

DISABILITY: YOUR VITAL LIFELINE TO NORMAL FINANCIAL FUNCTIONING

 Disability - a word we never think about.  It will never happen to us.  Yet, one in four Americans will face long term disability before they reach retirement age.

What happens when your pay check suddenly stops but the rent or mortgage keeps right on going?  How do you buy groceries, pay the utilities, the insurance, the car payment?  When the pay suddenly stops, you realize you have a dozen bills you never even thought about before.

The program that most disabled Americans fall back on is Social Security Disability Insurance (SSDI).  It's a program you paid into by payroll deduction (FICA) during all the years you worked.  You can usually file a claim for benefits within 5 years of the date you stopped working.  After that, your coverage probably has expired.  

The maximum benefit from Social Security disability is $3,011 per month for an individual.  The exact amount is based on your lifetime earnings and FICA paid.  Most people will get at least $1,200 per month, some a lot more.  The benefit is individualized to your account and work record.

Some things you need to know about Social Security disability:

1.  It does not provide any benefit for temporary disability; you must be unable to work for at least 12 straight months.

2.  It does not pay for the first 5 months of disability.

3.  You must have enough recent work credits to be covered.  Generally, you should have worked at least 5 out of the past 10 years.

4.  You must have a severe medical condition that prevents your ability to work a full-time job, and this must be proven with objective medical evidence from your doctor.

5.  The odds are your claim will be denied at the initial step and will require months of appeals to be approved.  It takes around 5 to 6 months to get the initial decision back.  Up to 80 percent of these are denials (often in error).  The following 6 to 12 months will be spend in appeals.

6.  You may proceed on your own (without an attorney) but this is risky.  The appeals process is technical, requiring you (the claimant) to prove that you meet the rigid and technical rules of the Social Security Act and all its appurtenant regulations.  Representation will increase your chance of being approved, and the representative can't charge you a fee until after you win and receive your back pay.

SOME WAYS TO PROTECT YOURSELF

• Put aside some regular savings to cover a few months of disability--to give you time to get Social Security started.  It isn't quick or easy.
• Enroll in your employer's group disability plan if you can.  Get short term disability (STD) and long term disability (LTD) if offered.
• At least consult with a disability advocate or attorney before you file your Social Security claim.  Often, this can save you countless mistakes and delays--and it won't cost you a penny.
• Don't depend on advice from a relative, neighbor, friend or co-worker.  They mean well, but no two SSDI claims are alike.  They are different in at least 15 ways.  No "one size fits all," and advice based on someone else's claim may be the absolute wrong advice for your claim.  Talk to an expert, a professional.

__________________

THE FORSYTHE FIRM

7027 Old Madison Pike, Suite 108

Huntsville, AL 35806

CALL (256) 799-0297

E-Mail Us:   forsythefirm@gmail.com

https://forsythefirm.wixsite.com/website 

HOW SOCIAL SECURITY DISABILITY REALLY WORKS

 If you can see a disability claim in your future, you owe it to yourself to find out how Social Security's disability program really works.  Don't depend on information from family, friends or co-workers because there are so many misunderstandings about disability benefits--and this misinformation can cost you a lot of money and cause needless delays.

Here's how SSDI (Social Security Disability Insurance) actually works:

1.  It is disability insurance purchased through the US Government.  Each day you worked, your employer deducted roughly 7.5 percent of your pay and paid it to the Social Security trust fund.  The employer matched each dollar deducted with $1 of his own and contributed for you.  So, roughly 15 percent of your pay has gone into the Social Security trust fund to buy this mandated insurance.  No everyone is covered.  You must have worked at least 5 years out of the most recent 10 years to have coverage.  These are called "Quarters of Coverage."

2.  You must become unable to work while you are a covered (insured) individual.  If you are under age 55, the definition of "disabled" means you cannot perform any full-time work which exists in the national economy.  If you are 55 or over, "disabled" usually means that you cannot perform any of the work you have done during the most recent 15-year period.  So, the definition is very strict and based partly on your age at the time of application.

3.  You must submit a long, complicated and meticulous application for benefits and wait an average of  five months for it to be processed.  About 70 percent of these applications are denied.

4.  If denied, you must ask for "Reconsideration," where your claim goes back to the same state agency that denied it.  They will review your claim again, and in 95 percent of cases, will deny it again.  This is just a hoop you have to jump through on the road to getting benefits.

5.  If denied at Reconsideration, you will appeal again and ask for a hearing before a US Administrative Law Judge.  This is where most claims actually get approved.  You will want an attorney or experienced advocate with you at this hearing because it is highly technical and involves issues you won't understand.  

Representation during this long process won't cost you anything unless (A) you win your case, and (B) you collect past due benefits.  If this happens, Social Security will pay your representative directly out of money they have withheld for that purpose.  If you do not collect past due benefits, no fee can be charged.

If you need assistance with a Social Security disability claim in north Alabama or middle Tennesee, please contact the Forsythe Firm in Huntsville, AL at (256) 799-0297.