Applying for Social Security disability benefits can often be an intimidating and time-consuming process. Understanding how the Social Security disability system works can make the difference between winning or not winning the disability benefits and back pay to which a person is entitled. To that end, following are some common Social Security disability myths and misconceptions.
Myth: The Social Security Administration denies everyone the first time they apply for disability.
This is absolutely not true! The Social Security Administration has no social security law (regulation, policy, or formula) that influences the disability system in such a way that every first application for social security disability benefits is automatically denied. It is easy to see, however, why people would believe that such a policy exists. Nationwide, about seventy percent of all disability claims are denied on the first application filed. Seventy percent is not a small number! Your social security lawyer can be helpful to prevent unnecessary denials. Because of the amount of paperwork that associated with these claims, often times, claimants are denied because they do not comply with request for documentation by the Social Security disability reviewer. It is the role of the attorney to ensure that this does not occur.
Myth: The Social Security Administration will deny you a certain number of times before you are approved.
Also not true! Just as social security disability cases are not automatically denied on the very first application, neither are thy denied a certain number of times before they are approved. But with seventy percent of initial claims being denied, what can you do to improve the chances of getting approved? Many people simply file applications over and over again, hoping to be approved. This is not the answer. If you continue to file and initial application for disability benefits, and continue to get denied at first stage, you are denying yourself the right to having those decisions appealed. It is the role of the disability lawyer to make sure that you follow the appeals process up to the highest level of appeal. The social security attorney is also responsible for making sure that you do so in a timely manner, meeting all deadlines.
Myth: The best way to appeal a Social Security claim denial is to file a brand new application.
No. In fact, filing a new claim is often the worst thing you can do. Why? Remember that almost seventy percent of initial applications are denied. Most disability claimants will be denied on the initial application. Repeated new applications will most likely be denied, and for the same reasons. Further, historically, and statistically, if a disability case is not approved at the initial claim level, it will probably also be denied at the reconsideration level (in some states, the reconsideration step has been suspended as part of a test project) and eventually have to be heard by an administrative law judge to be approved for disability benefits. As noted above, a social security disability claim, however, will never get that far in the process if a claimant continually files new applications instead of pursuing right to appeal.
In short, to improve your chances of winning your disability case, you should:
1) Follow the appeals process; and
2) Find representation.
Myth: Certain medical conditions or mental health problems can get you automatically approved for benefits.
The answer to this is both yes and no. Certain impairments are singled out and specified in the Social Security Administration’s Impairment Listing Manual. Claimants, who have listed medical problems at the level specified in the manual, can be approved for benefits somewhat easier than those who do not. The disability evaluation process, however, even for listing level impairments, is never automatic. All claims are evaluated according to the medical evidence; gathered first by the Disability Determination Services at the initial claim and reconsideration levels, and then by a staff attorney or Judge at the hearing level. Claims are decided by the information held by medical providers.
It is important to remember, therefore, that disability claimants should seek regular medical treatment throughout the entire time their claim is pending. This is to ensure proper documentation for evaluation purposes. Disability cases in which the medical evidence is scant and doctor visits are sporadic, will, generally, have little chance of approval. Conversely, claimants who get regular medical care will usually have more solid cases and a better chance of obtaining social security disability benefits.
Myth: You cannot get Social Security Disability if you have used drugs or alcohol.
This is not true. It will depend on the extent of the use and how recent the use was. Currently, it is not possible to receive disability benefits based solely on addiction. But, whether such use will affect a claimant’s eligibility for benefits depends on materiality. If a claimant’s drug or alcohol abuse is found to be material, in other words relevant, to the case, the case will not win.
For example, a claimant applies for disability based on liver dysfunction and hepatitis. The claimant also has a history of alcohol abuse, some of it recent. Is the claimant contributing to their own illness by abusing alcohol abuse? Are the claimant’s symptoms due to alcohol abuse or drug abuse or to their impairment?
If the claimant’s liver damage were so pronounced that ceasing alcohol use completely would make no difference to the claimant’s medical condition, then alcohol abuse would be immaterial, or irrelevant, to the case. Conversely, if ceasing alcohol use would result in medical improvement, then the alcohol abuse is material to the disability case and the claim would be denied. Simply put, Social Security will not pay benefits to claimants whose disabling conditions are brought on and exacerbated by, drug and alcohol abuse. Claimant’s who have a history of abuse but who are not currently using substances should carefully review their medical records before filing for disability.
Further, medical doctors and mental health professionals will often indicate “suspected use” in their treatment notes. Such indications, proven or not, can have a damaging effect on a disability case. Claimants, whose disabling conditions are psychiatric in nature, should especially heed this since mental cases are more likely to be denied when substance abuse is involved.
Each case is different but it is certainly true that the applicant has a better chance of obtaining benefits if they have maintained at least six month of sobriety.
You may have many questions as the process and or perhaps why you are being denied. It is advisable that you contact a disability lawyer to help you navigate this process. While there are many myths about the Social Security claim process that are untrue, the process does include a fair amount of rules and regulations to navigate that are better suited for a social security attorney.
Showing posts with label disability qualifications. Show all posts
Showing posts with label disability qualifications. Show all posts
Thursday, December 9, 2010
Tuesday, November 30, 2010
Disability Benefits and Mental Retardation
To win a claim for disability benefits, a claimant applying for social security benefits must have a severe medically determinable condition.
Listing 12.06 for mental retardation indicates below-average intellectual functioning as a medically determinable condition. The listing defines mental retardation as “significantly sub-average general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period…[or before age 22].”
To determine whether or not an individual applying for social security benefits has impaired intellectual functioning severe enough to be disabling, standardized tests for measuring intelligence quotient (IQ) and/or evidence that the claimant is incapable of taking care of one’s own personal needs may be required to establish disability per the listing.
To win disability benefits per listing 12.06, an IQ test will likely be required. Standardized intelligence tests such as the Wechsler Adult Intelligence Scale are used to determine intelligence quotient. These tests should be administered and interpreted by a psychologist or psychiatrist who is qualified to evaluate the exam.
If an IQ test is not feasible given the claimant’s severely limited mental functioning, then the severely diminished level of functioning must be established through evidence that indicates claimant is unable to care for such personal needs as using the bathroom, dressing, and bathing. In this instance, medical reports and teacher evaluations describing an individual’s diminished intellectual, social and physical functioning will be helpful to establish the existence of a severe impairment.
When an IQ test is feasible, any claimant with an IQ of 59 or less will satisfy the listing and therefore be eligible for disability benefits. If the individual’s IQ is between 60 and 70, the claimant can satisfy the listing and win disability benefits by proving he or she has an additional mental or physical impairment that causes significant work-related limitations. If this is not the case, the claimant will have to establish “marked” difficulties in at least two of the following parameters:
a. Ability to perform activities of daily living
b. Ability to maintain social functioning
c. Ability to maintain concentration, persistence or pace.
If only one of the above is satisfied, the claimant can still satisfy the listing if he or she experiences extensive and repeated episodes of decompensation.
It is important to note that “marked” means “seriously limited, but not totally precluded.” Further, a “repeated episode” of decompensation lasting for “an extended period,” is generally four or more episodes within a year, each lasting two weeks or more.
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Listing 12.06 for mental retardation indicates below-average intellectual functioning as a medically determinable condition. The listing defines mental retardation as “significantly sub-average general intellectual functioning with deficits in adaptive functioning initially manifested during the developmental period…[or before age 22].”
To determine whether or not an individual applying for social security benefits has impaired intellectual functioning severe enough to be disabling, standardized tests for measuring intelligence quotient (IQ) and/or evidence that the claimant is incapable of taking care of one’s own personal needs may be required to establish disability per the listing.
To win disability benefits per listing 12.06, an IQ test will likely be required. Standardized intelligence tests such as the Wechsler Adult Intelligence Scale are used to determine intelligence quotient. These tests should be administered and interpreted by a psychologist or psychiatrist who is qualified to evaluate the exam.
If an IQ test is not feasible given the claimant’s severely limited mental functioning, then the severely diminished level of functioning must be established through evidence that indicates claimant is unable to care for such personal needs as using the bathroom, dressing, and bathing. In this instance, medical reports and teacher evaluations describing an individual’s diminished intellectual, social and physical functioning will be helpful to establish the existence of a severe impairment.
When an IQ test is feasible, any claimant with an IQ of 59 or less will satisfy the listing and therefore be eligible for disability benefits. If the individual’s IQ is between 60 and 70, the claimant can satisfy the listing and win disability benefits by proving he or she has an additional mental or physical impairment that causes significant work-related limitations. If this is not the case, the claimant will have to establish “marked” difficulties in at least two of the following parameters:
a. Ability to perform activities of daily living
b. Ability to maintain social functioning
c. Ability to maintain concentration, persistence or pace.
If only one of the above is satisfied, the claimant can still satisfy the listing if he or she experiences extensive and repeated episodes of decompensation.
It is important to note that “marked” means “seriously limited, but not totally precluded.” Further, a “repeated episode” of decompensation lasting for “an extended period,” is generally four or more episodes within a year, each lasting two weeks or more.
Friday, November 19, 2010
Reasons Why You May Not Get Social Security Supplemental (SSI) Benefits For Which You Are Otherwise Eligible
This article intends to help applicants avoid the pitfalls that cause their ineligibility for payment in spite of their qualifying disability. As codified by the Code of Federal Regulations, the following are the top reasons why applicants may not receive benefits in spite of their eligibility.
You do not give Social Security Administration (SSA) permission to contact financial institutions.
Because SSI is a need-based program, SSA must be able to determine your eligibility by reviewing financial information on your resources and assets. Therefore, upon application, you must authorize the SSA permission to review records from banks, credit cards, loan companies, trust companies, savings associations, and any other source that would reveal the current state of your financial status. Permission in certain circumstances may include access to financial information by other relevant persons, i.e. your spouse or others living in your household. Social Security disability attorney may help you navigate these rules. However, applicant for social security benefits should be prepared with bank records or other financial information to make available to your reviewer upon request. Requesting records beforehand can significantly reduce any delays on your payments.
You leave the United States.
Put simply, you lose your eligibility for SSI benefits for any month during all of which you are outside of the United States. If you are outside of the United States for 30 days or more in a row, you are not considered to be back in the United States until you are back for 30 days in a row. You may again be eligible for SSI benefits in the month in which the 30 days end if you continue to meet all other eligibility requirements (CFR 416.215). During the application process itself, you may be required to fill out supplemental information regarding your daily activities and medical treatment. If you are outside the United States you may miss an opportunity to respond to such inquiries and consequently be denied. While your social security attorney may help you keep abreast of any deadlines, your participation is still material to the outcome of your case.
You do not apply for other benefits.
If you do not apply for other benefits then you may be denied or your payments suspended. Other benefits include any payments for which you can apply that are available to you on an ongoing or one-time basis of a type that includes annuities, pensions, retirement benefits, or disability benefits. For example, "other benefits" includes veterans' compensation and pensions, workers' compensation payments, Social Security insurance benefits and unemployment insurance benefits (CFR 416.210). You may consult with your social security attorney to determine what types of benefits might be available to you. The most obvious, Social Security Disability Insurance (SSDI), can be available if you have earned enough work credits through your contributions. In these cases, Social Security disability insurance benefits may be higher and entitle you to Medicare versus the Medicaid provided by SSI.
You are disabled and drug addiction or alcoholism is a contributing factor material to the determination of disability.
Drug addiction and alcoholism are major impediment to your initial award of benefits. Most judges are very careful to evaluate whether the severity of your disability is a result of your addiction. In which case, judges may deny benefits based citing non-compliance with medical treatment. If you receive benefits because you are disabled and drug addiction or alcoholism is a contributing factor material to the determination of disability (CFR 416.935), you must avail yourself of any appropriate treatment for your drug addiction or alcoholism at an approved institution or facility when this treatment is available and make progress in your treatment. You are not eligible for SSI benefits beginning with the month after the month you are notified in writing that we determined that you have failed to comply with the treatment requirements. If your benefits are suspended because you failed to comply with treatment requirements, you will not be eligible to receive benefits until you have demonstrated compliance with treatment for a period of time. As a general rule, social security applicants that have not remained sober for a period of six months should be apprised of consequences related to their addiction. For more detail, such applicant should consult with a social security attorney.
Social Security application process is riddled with rules. Applicants should seek legal advice from a social security attorney before they proceed with an application.
VISIT SOCIAL SECURITY LAW TODAY
You do not give Social Security Administration (SSA) permission to contact financial institutions.
Because SSI is a need-based program, SSA must be able to determine your eligibility by reviewing financial information on your resources and assets. Therefore, upon application, you must authorize the SSA permission to review records from banks, credit cards, loan companies, trust companies, savings associations, and any other source that would reveal the current state of your financial status. Permission in certain circumstances may include access to financial information by other relevant persons, i.e. your spouse or others living in your household. Social Security disability attorney may help you navigate these rules. However, applicant for social security benefits should be prepared with bank records or other financial information to make available to your reviewer upon request. Requesting records beforehand can significantly reduce any delays on your payments.
You leave the United States.
Put simply, you lose your eligibility for SSI benefits for any month during all of which you are outside of the United States. If you are outside of the United States for 30 days or more in a row, you are not considered to be back in the United States until you are back for 30 days in a row. You may again be eligible for SSI benefits in the month in which the 30 days end if you continue to meet all other eligibility requirements (CFR 416.215). During the application process itself, you may be required to fill out supplemental information regarding your daily activities and medical treatment. If you are outside the United States you may miss an opportunity to respond to such inquiries and consequently be denied. While your social security attorney may help you keep abreast of any deadlines, your participation is still material to the outcome of your case.
You do not apply for other benefits.
If you do not apply for other benefits then you may be denied or your payments suspended. Other benefits include any payments for which you can apply that are available to you on an ongoing or one-time basis of a type that includes annuities, pensions, retirement benefits, or disability benefits. For example, "other benefits" includes veterans' compensation and pensions, workers' compensation payments, Social Security insurance benefits and unemployment insurance benefits (CFR 416.210). You may consult with your social security attorney to determine what types of benefits might be available to you. The most obvious, Social Security Disability Insurance (SSDI), can be available if you have earned enough work credits through your contributions. In these cases, Social Security disability insurance benefits may be higher and entitle you to Medicare versus the Medicaid provided by SSI.
You are disabled and drug addiction or alcoholism is a contributing factor material to the determination of disability.
Drug addiction and alcoholism are major impediment to your initial award of benefits. Most judges are very careful to evaluate whether the severity of your disability is a result of your addiction. In which case, judges may deny benefits based citing non-compliance with medical treatment. If you receive benefits because you are disabled and drug addiction or alcoholism is a contributing factor material to the determination of disability (CFR 416.935), you must avail yourself of any appropriate treatment for your drug addiction or alcoholism at an approved institution or facility when this treatment is available and make progress in your treatment. You are not eligible for SSI benefits beginning with the month after the month you are notified in writing that we determined that you have failed to comply with the treatment requirements. If your benefits are suspended because you failed to comply with treatment requirements, you will not be eligible to receive benefits until you have demonstrated compliance with treatment for a period of time. As a general rule, social security applicants that have not remained sober for a period of six months should be apprised of consequences related to their addiction. For more detail, such applicant should consult with a social security attorney.
Social Security application process is riddled with rules. Applicants should seek legal advice from a social security attorney before they proceed with an application.
Monday, November 15, 2010
Social Security Disability and Unemployment
To be eligible for Social Security Disability benefits, a claimant must not be able to return to past relevant work, nor to do any other work that exists in significant numbers in the national economy. A disability must last at least 12 months or be expected to result in death.
An application for Social Security Disability benefits is an affirmation of your belief that you are entitled to benefits under the above definitions – in other words, that you are not able to work. In signing your application, you affirm, under penalty of law, that you are making no false statements on your application.
Persons who apply for unemployment insurance must also affirm, under penalty of law, that they are making no false statements on their application. Persons who collect unemployment insurance affirm having looked for work each week, and that, if work was found, they would be ready, willing and able to accept it.
Furthermore, there is another fundamental difference between the two programs. State unemployment agencies expect you to look for work only in your field. They do not expect, for example, an accountant to accept work as a truck driver. But Social Security asks whether you can perform any work that is within your ability, regardless of the fact that you have never done it before. Collecting unemployment insurance may be an indication that you are only looking for work in your own field.
On the other hand, SSA recognizes unsuccessful work attempts. This is when a person tries to go back to work but their disability precludes a successful transition. So, for example, if the accountant, rather than collecting unemployment insurance, tried to take work as a cashier but found after a month or so that he just wasn’t able to do it because of his physical or mental limitations, it demonstrates a willingness to try to work at other jobs. Such unsuccessful work attempts tend to strengthen credibility and show you are not just trying to work the system.
In conclusion, an unemployment claim is tantamount to saying “I am able to work,” while an SSA disability claim is stating “I am not able to work.” Both statements are made under penalty of perjury, but both cannot be true, and it may affect your credibility in one or both forums.
VISIT SOCIAL SECURITY LAW TODAY
An application for Social Security Disability benefits is an affirmation of your belief that you are entitled to benefits under the above definitions – in other words, that you are not able to work. In signing your application, you affirm, under penalty of law, that you are making no false statements on your application.
Persons who apply for unemployment insurance must also affirm, under penalty of law, that they are making no false statements on their application. Persons who collect unemployment insurance affirm having looked for work each week, and that, if work was found, they would be ready, willing and able to accept it.
Furthermore, there is another fundamental difference between the two programs. State unemployment agencies expect you to look for work only in your field. They do not expect, for example, an accountant to accept work as a truck driver. But Social Security asks whether you can perform any work that is within your ability, regardless of the fact that you have never done it before. Collecting unemployment insurance may be an indication that you are only looking for work in your own field.
On the other hand, SSA recognizes unsuccessful work attempts. This is when a person tries to go back to work but their disability precludes a successful transition. So, for example, if the accountant, rather than collecting unemployment insurance, tried to take work as a cashier but found after a month or so that he just wasn’t able to do it because of his physical or mental limitations, it demonstrates a willingness to try to work at other jobs. Such unsuccessful work attempts tend to strengthen credibility and show you are not just trying to work the system.
In conclusion, an unemployment claim is tantamount to saying “I am able to work,” while an SSA disability claim is stating “I am not able to work.” Both statements are made under penalty of perjury, but both cannot be true, and it may affect your credibility in one or both forums.
Tuesday, July 6, 2010
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.
Read Full Article
http://socialsecuritylaw.com/blogs/Anxiety-Disorder-Prevents-Work.php
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.
Read Full Article
http://socialsecuritylaw.com/blogs/Anxiety-Disorder-Prevents-Work.php
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