What to Expect at a Hearing for Disability Benefits

The hearing for disability benefits will take place as follows:

• The ALJ will start the record and go over preliminary issues such as swearing in all witnesses.

• The ALJ or your social security attorney will elicit your testimony, which will take up the bulk of the hearing. Whether or not it is the ALJ or your social security attorney depends on the ALJ’s preference. Your social security attorney will have an opportunity to ask you additional questions if necessary.

• If present, the ALJ will ask a medical expert to testify about the severity of your condition. Note that many hearings for disability benefits do not have medical experts. This is neither “good” nor “bad.” Often, it just has to do with the ALJ’s preference.

• If present, the ALJ will ask a vocational expert to classify your past work and whether he/she believes you are able to return to it or any other jobs that exist in the national economy. Again, whether or not a vocational expert is present likely has to do with the judge’s preference.

• The judge will close the hearing for disability benefits.

Your Testimony


Either the judge or your social security attorney will elicit your testimony at the hearing. For purposes of this analysis, we will assume the judge is the one asking the questions. The types of questions asked at your hearing will vary, but will fit into the following basic outline:


· Your basic information (age, living situation, etc).
· Your highest level of education
· Your work history over the last 15 years
· Your disabling conditions
· Your medical treatment/medications & side effects
· Your daily activities/how you spend your day
· Your RFC assessment


Your Work History


It is important to note you should be as accurate as possible in describing your past work. You need not know the name of each employer, or exact dates of employment. Further, if you had several jobs but all in the same line of work (i.e., customer service), it’s enough to say “I worked in customer service” for “x” amount of years.


What is especially important, however, is how you performed your jobs. Think of what level of exertion was needed to do your past work. Did you sit all day at your job? Or did you stand most of the day? Was a mix of standing and sitting required? Were you required to lift heavy objects? What was the heaviest object you were required to lift? Above all else, think about why you wouldn’t be able to return to these jobs. Then, think of the easiest job you ever had and why you wouldn’t be able to do that now. At your hearing, this is exactly what you will need to prove.


Remember, whether or not you are able to find work is irrelevant. The process the judge will use to determine whether you’re disabled asks only whether any jobs exist that you might be able to do after figuring in your age, education, and any skills earned from past work.


One final note on working: if you attempted to work at any time during the application process, please make sure to discuss the specifics of the work attempt with your social security attorney. He/she will need to know for how long you worked, how much you made at your job, and the general duties that were required in order to perform the work. Prepared with this information, your social security attorney will be able to advise you as to whether or not you have a viable claim, and if so, how to argue your case effectively.


Your Disabling Conditions


Don’t forget to describe to the ALJ all of your conditions. Describe symptoms in detail, i.e., where the pain is, what is feels like, how often you feel it, its level of intensity with and without medication, on good and bad days, and how many bad days you have in a month. If you have mental and physical conditions, take time to describe each. Don’t forget other non-exertional symptoms like fatigue, difficulty concentrating, poor memory, fear of dealing with the public, etc.


Above all else, your hearing is not a time to be brave. Many claimants are hesitant to talk about a condition that is embarrassing to them. Remember, the judge as well as your social security attorney and any experts in the room are accustomed to hearing this sort of testimony. Do not be ashamed if you become emotional. Claimants who do not get emotional when talking about things that are difficult may seem disingenuous. Your candor and emotional vulnerability will not hurt your claim. One of the main purposes of the hearing is to give the ALJ and opportunity to gauge whether or not you are telling the truth. Thus, providing the most candid and honest answers is of key importance.


Your Medical Treatment


The judge may ask questions about past surgeries, medical tests performed, specialists you’ve seen, physical therapy you’ve tried, whether you’ve been given a cane or walker to help you walk, etc. The judge will want to know what you’ve tried to do in order to get better. The judge will also want to know what medications you’re currently on, and possibly what others you’ve tried. Don’t forget to talk about side effects from your medications as they can be very important. For instance, if pain medication reduces your pain, but makes it so that you are very drowsy and can’t remember to do simple tasks, this is an important detail. It means, while you can do something to help improve your condition, doing so comes with its own repercussions that further affect your ability to function normally.

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Social Security Disability and Obesity

SSR 02-1p, effective September 12, 2002, provides guidance on SSA policy concerning the evaluation of obesity in Social Security disability claims. This ruling came about as a response to the deletion of listing 9.09 for Obesity, which had once been a part of the Listing of Impairments in 20 CFR, subpart P, appendix 1.

Listing 9.09 first required that a claimant filing a Social Security disability claim exceed a certain weight based on his or her height. Once this requirement was met, the claimant would have had to exhibit one of the five following impairments:

• History of pain and limitation of motion in any weight-bearing joint or spine…
• Hypertension with diastolic blood pressure persistently in excess of 100 mm
• History of congestive heart failure manifested by past evidence of vascular congestion…
• Chronic venous insufficiency with superficial varicosities in a lower extremity with pain on weight-bearing and persistent edema
• Respiratory disease with total forced vital capacity equal to or less than the value specified…

As of October 25, 1999 when the deletion became effective, a person filing for disability benefits could no longer claim obesity as stated above. However, pursuant to SSR 02-1p, obesity must still be considered in the evaluation process. Listing 9.09 was deleted because Social Security felt the listing’s criteria “were not appropriate indicators of listing-level severity.” In other words, the criteria set forth in listing 9.09 “did not represent a degree of functional limitation that would prevent an individual [applying for disability benefits] from engaging in any gainful activity.”

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Why You Should Hire a Social Security Disability Lawyer

Why Should You Hire a Social Security Disability Attorney?

For many people, filing for Social Security Disability benefits can be a complicated and confusing process. Many applicants wonder if they should hire an attorney to help guide them through that process. Social Security (SSA) does not require you to have an attorney, and, in fact, people have won their cases on their own. But, does having an attorney make a difference in whether an applicant wins or loses Social Security disability benefits? During Congressional testimony, California Congressman Robert T. Matsui stated:

“Professional representation is a valuable, and indeed vital, service. The disability determination process is complex. Claimants without professional representation appear to be far less likely to receive the benefits to which they are entitled. For example, in 2000, 64% of claimants represented by an attorney, but only 40% of those without one, were awarded benefits at the hearing level.”

Simply put, at the hearing level, you can improve your odds of winning your Social Security Disability case by more than 50% if you are represented by an attorney. Many people have never hired an attorney before and the decision to hire one can be daunting. Naturally, you will have many questions. If you are considering hiring an attorney to help you with your Social Security Disability case, here is some basic information to help with that decision.
How Can I Afford to Pay An Attorney?

Many people applying for SSA Disability benefits, especially those who have been denied at the initial application level, have not worked for a while. Therefore, the number one question on people’s minds is, How can I afford to pay an attorney when I am not working?” The answer is simple: you only pay an attorney’s fee if you win your case. Generally, a disability attorney will represent clients on a contingency basis. That means you do not pay an attorney anything in advance and you do not pay an attorney a fee if you do not win your case.

The SSA and federal law set attorney’s fees in disability cases. The standard fee agreement most disability attorneys use states that the attorney’s fee is contingent upon winning your case. The fee is 25% of all past due benefits, up to a maximum of $6,000, or whichever is less. Thus, depending on the amount of your past due benefits, the attorney’s fees are usually only a small portion of the benefits you receive.
How Can A Disability Attorney Help Me?

There are several ways a disability attorney can help you. A disability attorney will help you understand the SSA Disability process. Filing a claim is just the first step in what is often a long and frustrating process. There is a lot of paperwork to fill out, deadlines to meet, and documentation to assemble. Claims are often denied because paperwork was not completed properly, a deadline was missed, or evidence was not obtained or reviewed. A disability attorney will guide you through each step in the process.

A disability attorney will also help you develop a strategy that both of you should follow to win your case. Many SSA Disability claimants file an application and then simply do whatever SSA tells them to do. This is often not enough to win disability benefits. It is important to understand what is necessary to prove your case and how you will go about winning it. The sooner you know this, the sooner you and your attorney can work together to execute the strategy and increase your chances of winning.
Conclusion

If you are contemplating filing a claim for SSA Disability benefits, it is wise to consult with an attorney. The consultation shouldn’t cost you anything except your time. And, by understanding the SSA Disability benefits process and having a strategy, you can significantly improve your chances of winning your case. .

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Long Term Disability Insurance

Although it is less well known than life insurance, most experts agree that disability insurance is just as important. And while most people have insurance that covers their medical expenses in the event they become sick or injured, they are not prepared for the lost wages that accompany the inability to work.

Though the terms of each plan vary depending upon the policy, disability insurance is a contract-based program intended to protect future income in the event the insured becomes disabled or unable to perform the duties of his or her occupation.

There are generally two types: short-term disability, for injuries or illnesses lasting less than 6 months, and long-term disability. Many experts contend that long term disability (LTD) insurance is the most important insurance one can own.

Potential sources of such programs include employers, unions, banks and credit unions, credit cards, and other forms of insurance policies available through private brokers. The terms of most such policies are governed by the Employee Retirement Income Security Act (ERISA). Oversight is regulated by the Employee Benefits Security Administration, under the auspices of the U.S. Department of Labor.

Typical LTD insurance replaces 50-70% of predisability earnings, usually with a monthly maximum that reduces the overall percentage of salary received. Some policies provide for up to 80% of monthly earnings. The payment amount is set at the time the policy is purchased.

As with any other form of insurance, insurance companies often try to get out of paying a claim. Many LTD litigators are of the opinion that some policy language is intentionally vague, and that certain categories of contention are built in. For example, mental illness, or certain conditions diagnosed by only subjective conditions, such as Fibromyalgia or chronic fatigue syndrome, may be points of contention.

Unlike the regulations that govern Social Security disability findings, the opinion of a treating physician in an LTD case is afforded no special consideration. Courts have ruled that reliance upon the opinion of an independent medical examiner is perfectly acceptable. Other arguable points may center around pre-existing medical conditions, or injuries from dangerous activities, as these are usually excluded from coverage.

Most policies define disability in terms of “own occupation,” “any occupation,” or “partial disability.”

“Own occupation” provisions usually state that a person unable to perform his or her own occupation due to sickness, injury, or pregnancy may collect benefits for up to 2 years until able to return to work.

“Any occupation” policies usually contain language to the effect that the disabled policy owner must return to work when able, even if not in the same capacity as before. In other words, the policy owner must be disabled from all occupations. The length of payout varies by policy, some for 5 to 10 years, and some up to age 65, with the latter being preferable.

A partial disability results if a person is working at their own occupation but unable to earn more than the “own” or “any” levels.

Still another point of contention lies in the definition of “own occupation,” because many policies provide that it is not limited to a specific job with an employer, nor to even a specific area of specialization, interest or expertise within the general occupation. Instead they look to the essential tasks, skills, knowledge and abilities generally required to engage in a particular occupation.

There may be other provisions that affect benefit amounts. A person who works while disabled may still be entitled to benefits, but subject to offset. Most policies also provide for an offset for other forms of income, including Social Security Disability, State or Disability, workers’ compensation or other group insurance coverage.

If a claim is denied, the policy owner has certain appeal rights. The first thing he or she must do is obtain copies of the plan details and all of the documents upon which the insurer relied in denying the claim. There are certain penalties if the plan administrator fails to provide the plan documents in a timely manner.

There are statutes of limitations, which may differ according to State legislation, or even contained within the contract itself. Certain medical examinations may be required to overcome the denial decision. The terms of the policy can be complicated, especially to persons who have recently become disabled, and may not be in the best position to fight for their rights. At these times a knowledgeable attorney is indispensable in developing the case and getting the denial reversed.

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Social Security Administration Improvements: 2010 Update

Michelle Nevarez, Esq.


The Obama Administration has committed to helping our fellow Americans in need by allocating more of the Nation’s budget to the preservation and improvement of the Social Security disability insurance approval process. In response to increased application in addition to existing backlog of claims, SSA has committed to increasing their processing capacities in a number of ways.


Extended Service Team(EST) are new centralized units that tasked to assist in with hearing backlog in flood areas that experienced increased applications. The purpose of these teams is explained by SSA Commisioner Astrue, “These centralized units have reduced the hearings backlog and improved processing times at some of the hardest-hit hearing offices....”

In FY 2010, SSA plans to place 280 new employees in four States (Virginia, Arkansas, Oklahoma , and Mississippi ) to help staff the teams that will be able to quickly take cases from the hardest hit States.
DDS Federal Units in each of the ten regions are tasked with assisting the DDSs in processing cases. In FY 2010, we plan to provide 237 additional hires in these units. The increases at the DDA level also include more medical consultants in order to prevent expensive and much dreaded consultative examination.

Virtual Screening Units have been erected with senior attorneys tasked to review the disability hearing backlog for potential awards.SSA believes that the screening methodology and the electronic folder to move work to the members of the virtual unit will identify about 14,600 on-the-record, fully favorable awards this year without a hearing.

SSA eligibility and processing requirements are in constant flux, for this reason you should take a moment to update yourself on the changes in 2010 eligibility requirements.

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Not Giving Up On Your Claim Proves Rewarding For Applicants

Jason Cook


A recent CBS News Investigation report revealed that of the nearly one and a half million people who were denied at the initial application level for Social Security Disability Benefits in 2006, two-thirds – or approximately one million applicants – decided not to appeal the denial. But the decision not to pursue an appeal is often a mistake, considering that most claims are not approved before a hearing is conducted.

Statistics show that only 30% of claims at the initial application level are approved. If an appeal is made, the next step is a request for reconsideration. Unfortunately, the numbers are actually worse with only 15% of the claims being awarded.

However, persistence pays off at the next level known as the hearing stage. It is here that the claimant will be able to sit before the individual deciding their claim for the first time, an Administrative Law Judge. For those claimants who decide to go forward and request a hearing, at least half will be approved for social security benefits. That number goes up even more for claimants who have a representative at the hearing.
Often claimants will decide not to appeal their case, but then at a later time, to file a new application for benefits. This is not the proper course of action for several reasons. First, those individuals have to start the whole process all over again. This, of course, means that there is a 70% chance the claim will be denied at the initial level and an 85% chance the claim will be denied on reconsideration.

The second problem with filing a new application is that the claimant’s opportunity to be heard by a Judge – where there is a real chance of winning the case- is only further delayed. Considering that it often takes 2 years or more from the time a request for a hearing is filed to when the hearing is scheduled, the time spent completing and awaiting a ruling on the subsequent application (and the request for reconsideration) add months to the seemingly endless wait time.

The third problem with filing a new application instead of appealing the previous denial is the possibility that the claimant may have inadvertently forfeited benefits that he or she would have been previously entitled to. A denial at any stage of the process that is not appealed is considered a final judgment as of the date of the denial. The practical effect of this is that a claimant who wins their case on a subsequent application cannot, with limited exceptions, receive retroactive benefits prior to the date of the previous denial.

A hypothetical example may help clarify this. John Worker became disabled on May 1, 2002. On May 1, 2003, he filed his initial application for social security disability benefits but was denied. He then filed a request for reconsideration. However, this request too was denied in a letter dated May 1, 2004. John considered requesting a hearing but was fed up with the Social Security system. After a year, John reconsidered his decision but the time had passed to appeal the previous decision. Thus John filed another initial application, this one dated May 1, 2005. This time John pursued his case all the way to the hearing stage. The Judge ruled in his favor and also found that John was entitled to retroactive benefits. However, the back pay could only go back to May 1, 2004 because of the previous denial. Thus by not pursuing the original claim, John lost out on benefits from May 1, 2002 until May 1, 2004, which could equal thousands in lost benefits.

Social Security is undoubtedly a lengthy and frustrating process, especially when seemingly strong cases are denied at the initial stages. But it pays to be patient. By appealing all the way to the hearing stage, the claimant may actually be approved quicker and receive more benefits!

Does My Family Receive Any SSDI Benefits?

Once you are approved for SSDI benefits, certain members of your family may also be entitled to payments. SSDI benefits, based on your earnings record, may be available for your spouse, your former spouse, and your children.

Your spouse may be eligible for payments upon your award of SSDI benefits, if the spouse is (i) caring for your child, or (ii) age 62 or older. To receive benefits for caring for your child, the child must either be under age 16, or disabled and receiving Social Security benefits. Benefits for a spouse caring for your child under age 16 will end once that child reaches age 16. Similarly, when your spouse reaches age 62, he/she will be eligible for benefits based on your earnings record. However, the monthly amount your spouse will receive at age 62 will be less than if he/she waits until full retirement age to receive the benefit. If your spouse is eligible for SSDI benefits based on his/her own earnings record, your spouse will receive either that amount or the amount based on your record, whichever is higher.

A spouse you have divorced will be eligible for SSDI benefits based on your earnings if he/she is (i) at least 62 years old; (ii) unmarried; (iii) was married to you for at least 10 years; and (iv) is not eligible for a higher benefit amount on his/her own.

Finally, your child will be eligible for SSDI benefits if the child is unmarried and (i) under age 18; or (ii) 18 or 19 and a full-time elementary or high school student; or (iii) 18 or older wtih a disability that began before age 22. For the child under age 18, the benefit will stop when he/she reaches age 18. For the full-time student, the benefit ends upon graduation or 2 months after the child's 19th birthday, whichever comes first. For the disabled child, the benefit will last for the duration of the disability. An eligible child may be biological, a step-child, adoptee, or dependent grandchild.

As far as the amount of SSDI benefits your family members are entitled to, each may receive up to half of your benefit amount, but there is a limit on the amount SSA will pay family members in total. The limit depends on your benefit amount and the number of family members who qualify based on your record, but the total is generally around 50 to 80 percent of your benefit amount.


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Budget Cuts in California Adversely Affecting the Disabled

Budget cuts and layoffs have seriously affected many citizens in California over the past year. Even our state’s disabled individuals are now feeling the pressure of this turbulent economic time. On February 20th, California Governor Schwarzenegger signed a spending plan that included proposed cuts to programs that assist the disabled such as IHSS (In Home Support Services) and SSI (Supplemental Social Security). These already limited programs will see further cut backs if California doesn’t receive $11 billion in federal funds to bridge the state’s budget gap.

IHSS is a program that helps individuals over 65 years of age, or disabled and blind individuals. The program provides various services such as housecleaning, meal preparation, laundry, grocery shopping, personal care services (such as bowel and bladder care, bathing, grooming and paramedical services), accompaniment to medical appointments, and protective supervision for the mentally impaired.


SSI is a federal income supplement program funded by general tax revenues which is designed to help aged, blind, and disabled people who have little or no income. It provides individuals who meet the strict qualification requirements with cash to meet basic needs for food, clothing and shelter.

A spokesperson for the San Francisco regional office of the Social Security Administration, Lowell Kepke, stated, "The real question is whether or not California will cut SSI." Although the State Controller's Office is delaying payments for many human services programs beginning this month, according to Mr. Kepke, "SSI/SSP payments will be unchanged for March and April. As far as all future dates, California will have to make a request for a change." It remains to be seen whether the state will request a cut to these payments in May.

For disabled individuals living in the state of California, the idea of more cut backs is frightening. Take for example the case of Michelle Sanchez, a woman living in Sonoma County who is diagnosed with a disabling neurological disorder. She uses a wheel chair for ambulation and also utilizes the assistance of a service dog. Michelle lives in a special facility for disabled adults. Her monthly living expenses are covered in part by SSI, and she relies on caregivers who assist with cooking, cleaning and Michelle’s personal hygiene, paid for by IHSS. Michelle says, “I certainly hope the cuts don’t pass.” For Michelle, and those disabled individuals like her who depend heavily on government assistance, any cuts to SSI and IHSS will affect their quality of life.

Another aspect of the system that will be adversely affected by budge cuts is advocacy. Organizations such as the Mendocino County Health and Human Services Agency (MCDSS) hire advocates that assist disabled individuals apply for benefits. Pam Partee, a Social Security Advocate, works with the Temporary Assistance for Needy Families (TANF) and CalWORKS. Both are programs that provide Welfare-to-Work services and temporary cash grants to those who qualify. “It’s trying to get people back on their feet,” says Pam. “Many have never felt plugged into life. They’ve gotten used to feeling marginalized.” Pam says there is a considerable backlog of severely disabled people who were not on Social Security or General Assistance. She says that she assesses their cases and helps them get the benefits they need.

If SSI/SSP cuts go through, more than 1.3 million Californians will be affected. Particularly in Mendocino, 4,170 recipients stand to lose a total of $4,260,000 in grant payments. A reduction in funding for IHSS may cause a large set back in policy goals that aim to increase independent living for disabled individuals.

“It breaks our heart when [our clients] depend on us and we fail them,” says Pam. “If we can help them along, we help the community.”

APPEALING THE SOCIAL SECURITY ADMINISTRATION DECISION

You should not become discouraged if your claim is initially denied. In a recent year roughly 60% of claims were denied. An SSDI attorney will be able to determine what documentation and evidence will strengthen your claim.

LEVEL 1: RECONSIDERATION OF YOUR INITIAL CLAIM
You must request a reconsideration of your claim within sixty days of receipt of the denial letter. Reconsideration is a complete review of your claim by someone who did not take part in the first decision. They will look at all the evidence submitted when the original decision was made, plus any new evidence.
After approximately four to six months a decision will be reached on the reconsideration request. The case will either be granted benefits or denied again. In some states, this process may vary.

LEVEL 2: HEARING BY AN ADMINISTRATIVE LAW JUDGE
If your claim is denied after reconsideration, you have 60 days to request an informal hearing. This will be in front of an administrative law judge who had no part in the first decision or the reconsideration of your case. The judge will listen to witnesses, review medical evidence, and decide your case. An SSDI appeal lawyer will help you prepare for the hearing and represent you at the hearing.
The Judge will not announce a decision at the administrative hearing. It usually takes at least two to three months after the hearing to receive the decision, if not longer. If the decision is favorable, you should receive your first check about eight to twelve weeks after the decision.

LEVEL 3: REVIEW BY THE APPEALS COUNCIL
If the Judge's decision is not in your favor, the next step is to request a review by The Appeals Council. This must be done within sixty days after you have received the hearing decision. You should be represented by an experienced SSI/SSDI lawyer to ensure you have the best chance of winning the appeal.
A failure to appeal by the deadline will result in having to start an entirely new claim unless you can demonstrate good cause for not filing the appeal prior to the deadline. Good cause includes illness, hospitalization, comprehension problems due to mental infirmity, or other circumstances beyond your control.
The Council looks at all requests for review, but it may deny a request if it believes the hearing decision was correct. If the Appeals Council decides to review your case, it will either decide your case itself or return it to an administrative law judge for further review.
If the Appeals Council denies your request for review, you will receive a letter explaining the denial. If the Appeals Council reviews your case and makes a decision itself, you will receive a copy of the decision. If the Appeals Council returns your case to an administrative law judge, you will receive a letter and a copy of the order.

LEVEL 4: FEDERAL COURT
If the Appeals Council denies your appeal and/or refuses to review your case, you have 60 days to file a lawsuit in a federal district court. After reviewing the record from your hearing, the Federal judge can (1) award disability benefits, (2) deny disability benefits, or (3) send your case back to a lower court for an additional hearing. It is critical to have good legal representation to give you the best chance of winning the appeal.

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Social Security Disability: How to Prove your Anxiety Disorder Prevents you from Working

Social Security Disability: How to Prove Your Anxiety Disorder Prevents you From Working

By: John M. FitzGerald

As a practical matter, every applicant for disability benefits must either meet the listings or prove inability to work in any significant capacity.

The listings are just what they sound like. Inability equates to disability. So the issue is not whether anyone would hire you, or whether there are factories where you live, but whether a hypothetical person with your limitations can do any type of work that exists in significant numbers in the national economy.

As with exertional impairments, proving disability on the basis of a psychological disorder requires documentation of a severe medically determinable impairment, and an assessment of the degree to which said impairment limits ability to perform work related activity for a period of at least twelve months.

To prevent a person from working, any impairment must be "severe," and psychological impairments are no different.

As with all impairments, the first question is: are you working now? Because if you are working, the likelihood is you are not disabled. If you are not working, the question becomes whether your impairment is severe. If your impairment is not severe, you are not disabled.

To determine whether a mental impairment is severe, SSA looks at 4 criteria: (a) activities of daily living; (b) maintaining social functioning; (c) concentration, persistence and pace; and (d) episodes of decompensation.

With regard to the first three criteria, a person can either have no limitation, moderate limitation, a marked limitation, or an extreme limitation. Any two of the criteria must fall into the "marked" range for an impairment to be considered "severe." If the impairment is severe, the analysis proceeds to step 3, the listings. If it is not severe, the degree of limitation must still be considered in assessing a claimant's residual functional capacity (RFC).

The fourth criteria--episodes of decompensation--is a medical term describing an exacerbation of a claimant's symptoms to the point where further medical intervention is required. If, for example, medications fail to keep a mental condition reasonably well controlled to the point where a patient must be hospitalized or further medicated, then one can say that the patient has lost some measure of composure. Obviously, the more this occurs, the more it interferes with ability to work.

Step 3, the listings, is a claimant's earliest opportunity to win. There are 14 bodily systems represented in the listings, with mental impairments enumerated in section 12.

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Disability Benefits and the Diabetes Listing

Disability Benefits and the Diabetes Listing

by Rachel Slocombe

It is important to have a disability attorney handle your claim for disability benefits because disability attorneys understand the way claims are analyzed by a judge. Claims are decided per a five-step sequential analysis. One way a claimant can win disability benefits is on the third step of the analysis. At this step, the claimant’s disability is compared to Social Security’s listing of impairments. If the claimant’s condition rises to the level of severity described in the listings, the claimant will win. Disability attorneys work with the listings on a daily basis and understand what is necessary in order to satisfy them.

In order to be found eligible for disability benefits per Social Security’s listing for diabetes (9.08), an adult claimant must establish:

A. Neuropathy demonstrated by significant and persistent disorganization of motor function in two extremities resulting in sustained disturbance of gross and dexterous movements, or gait and station (see 11.00C); or
B. Acidosis occurring at least on the average of once every 2 months documented by appropriate blood chemical tests (pH or pC02 or bicarbonate levels); or
C. Retinitis proliferans; evaluate the visual impairment under the criteria in 2.02, 2.03, or 2.04.

Neuropathy
Neuropathy is considered disabling if it causes severe and lasting limitations in the use of the hands, arms, legs or feet. The listing uses the language “persistent disorganization of motor function.” This can be attributed to paralysis, tremor, ataxia, sensory disturbances, or any other involuntary movements. Whether or not the interference is enough to satisfy the requirements of the listing depends on the degree to which the impairment interferes with the claimant’s ability to ambulate effectively or use his/her fingers, hands and arms. Also, according to the language of the listing, two extremities must be involved.

Acidosis
The claimant must suffer from acidosis on average at least every two months, and this acidosis must be established by the chemical tests described in the listing. It is also important to note that if a claimant suffering from acidosis is not following a prescribed course of treatment in order to regulate his/her diabetes, he/she will have difficulty satisfying the listing. Well controlled diabetes is not a disabling condition, therefore, a claimant must at least try to regulate his or her condition through medical treatment. If the condition cannot be regulated in such a way despite a claimant’s best efforts to treat the condition, then the condition may rise to the level described in the listing.

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ARE YOU DISABLED? THE 5 QUESTIONS THE SOCIAL SECURITY ADMINISTRATION (SSA) WILL ASK YOU