DISABILITY BENEFIT RECOVERY

On what date did you first become disabled? That question is very important in a Social Security disability claim.  When you file your application for benefits, Social Security requires you to give that specific date as month/day/year.  Benefits can potentially be  paid back to that date. The date you became disabled is called the "alleged onset date" in the application process.  Once the date is accepted by Social Security, it is called the "established onset date." If your disability was caused by a car wreck, stroke or on the job injury, the date may be obvious.  However, if the disability is from illness which came on gradually, the date may be more subjective. You may consider the date you stopped working as your "alleged onset date."  However, many people struggle to keep working even after they are really disabled.  If you cut back to only part-time work, that could be a good indicator of the date your disability actually began.  (Note:  in

Grid Rules are published as part of the 20 Code of Federal Regulations and are also called Medical-Vocational Guidelines.  The grids combine your age, education, past work skills and residual functional capacity to form a guide to determine if you are disabled. If you combine all the above factors and the grids point to "disabled," you should qualify for benefits.  However, you may still qualify even if the grids do not point that way.  You could still qualify by proving that a combination of all your impairments make you unable to perform any work available in the local, regional or national economy. Many advocates and attorneys will refer to the grids before deciding whether to take a case.  I prefer to dig a little deeper than the grids.  One example of where the grids are of no help is a case involving mental impairments.  Mental impairments are not measured by "exertion levels" and, therefore, the grid rules do not apply. For strictly physi

A successful disability application has several vital components.  An application should not be quickly "thrown together," for it is a complicated process, especially if it is to have a chance to be successful.  Here are some points to consider for a successful Social Security disability application in Alabama: Severity Requirement .  You must show that your illness or impairment is severe.  You also must prove that it results in more than moderate restrictions of function.  Duration Requirement.  You must demonstrate that your severe impairment has lasted--or is expected to last 12 consecutive months or more - OR that it is expected to end in death (terminal). Insured Status.  It will be necessary to have insured status under Title II disability insurance.  This requires a sufficient work history to have accumulated the required "quarters of coverage." Medical Support.  Your claim should be supported by both objective medical evidence (records) and

Social Security offers a number of disability benefits.  I want to talk about 2 of the most common--typically applied for. SSDI - Title 2 Disability.  I refer to this as the run-of-the-mill, ordinary disability program at Social Security.  Title 2 is based on employment.  When you work you pay FICA tax which covers you for disability insurance once you have earned enough "quarters of coverage."  You do not have to be poor or have limited assets to qualify for Title 2 benefits. SSI or Supplemental Security Income.  This is a program for poverty level individuals with very limited assets and income.  No previous work is needed to qualify for SSI.  The monthly benefit is usually less than for Title 2 benefits.  In some cases, a person may receive both Title 2 and SSI. Both of these programs have the same basic requirement.  To qualify for either one, you must be disabled or blind or have a condition that is expected to end in death.  A "disabling impairment" is o

Many times, after you apply for Social Security disability, SSA will write you and ask you to report to a certain doctor for a consultative examination.  At this exam, paid for by Social Security, a doctor working under contract with the SSA, will perform an examination to determine the extent of your medical impairments. Many claimants wrongly assume that this doctor will find evidence of an impairment that will help win their case.  Not likely.  Unless you are paralyzed, confined to a wheelchair, require oxygen 24/7, or have some other catastrophic, obviously serious impairment, the consulting doctor will probably fail to find any disabling conditions. Here are some of the factors that I generally assign to explain the fallacy of consultative examinations by Social Security doctors.  I say in general because there are exceptions.   The doctor will probably spend 5 to 15 minutes with you.  He turns out patients like an assembly line.  Unlikely he will find whatev

The Social Security disability process has been streamlined in Alabama.  You no longer have to go from denial to reconsideration.  You can skip reconsideration and ask for a hearing before an administrative law judge.  This has cut about 4 months off the appeal process, compared to the 40 other states that still use reconsideration.  However, the appeal process is still long (about a year on average). The initial decision on your Social Security disability claim is made by an Alabama state agency called the Disability Determination Service (DDS).  DDS is under contract with Social Security but is manned by state employees, not federal employees.  They deny just over 70 percent of all disability applications that they review. Most denials are what we call "Step 5" denials.  DDS will often find that the claimant cannot perform any past relevant work (Step 4).  The final step, or Step 5 is this:  Is there ANY OTHER work that exists in the local, national or regional economy

Social Security Disability Secrets - May Help You Win Benefits Posted on 2013-10-29 20:21:37 What you don't know about Social Security disability can hurt you. Do you know that Social Security does not make the yes or no decision on your application? That's correct.  They farm out the process to state agencies staffed by state employees.  Typically, these state run agencies are called "Disability Determination Services" or some similar name.  A state employee reviews your evidence and makes a decision about whether or not you are "disabled according to our rules."  If your claim is denied, the letter will come from Social Security.  But they are not the ones who decided. Knowing that prevents the mistake of refiling your application for disability benefits.  Re-applying will probably get you the same result--another denial. All you're doing by re-applying is wasting valuable time.  The same stage agency will review the same evidence again and reach

Waiting too long to file your application for disability benefits can result in finding you have no disability insurance coverage.  About 4 years after you stop working, your Social Security disability insurance will expire because you are no longer paying into the system.  The date your insurance expires is called "Date Last Insured."  When this date rolls around, you can no longer file a new claim under Social Security disability (Title 2, it's called).  It doesn't matter how sick you are, or how unable to work, you no longer have insurance.  It's like trying to collect on your homeowners insurance after it expires.  You can't.  Social Security disability insurance has an expiration date.  If you think you are disabled, file now while you still have the insurance.  Individuals come into my office regularly who say, "I worked for 23 years, then stopped working in 2003.  I went back to work in 2007 and quit again in 2010."  (Or some ver

If you intend to file a claim for Social Security disability benefits, there are some roadblocks that you need to be aware of.  These are simply things that can block approval of your claim.  I mention a few things below: You can't be working when you apply.  In 2013, regulations provide that any earned income over $1,040 per month is substantial gainful activity. While you can technically work part-time earning less than $1,040 per month, any work is likely to hurt your disability claim.  If you earn at least $1,040 per month before tax, you are automatically disqualified.  You cannot win disability without seeing a doctor to establish your medical or mental impairments.  You need to be treated by your own doctor. Your doctor cannot find you to be disabled.  Social Security has its own rules about who is disabled.  Your doctor will be useful in the process, but he or she does not have the power to declare you disabled. The Social Security doctor who examines you will not fin

Nearly all Social Security disability claims have to go before a judge to win.  So, what convinces a judge to pay your disability claim?  Judges may consider a lot of factors, but after representing disability claimants hundreds of times in several states, the following factors stand out in my mind. #1 - The judge will pay your claim if you have a solid work record.  Judges like to see individuals who have worked when they were able to work, made solid employees and acted responsibly.  Judges are not impressed with persons who appear to be wanting a handout. #2 - The judge will pay your claim if you have impairments that are well documented.  You need medical records where you have consistently been treated by a doctor, or doctors, over a period of time.  It helps to have objective medical evidence, such as X-rays, MRIs, lab reports, other tests, etc. #3 - The judge will pay your claim if the medical records are consistent with your testimony at the hearing.  Judges will consider

As a Social Security disability advocate I frequently meet people who believe that they must be poor and have very limited assets to qualify for Social Security disability (SSDI) benefits. For example, a client recently told me that he could not qualify for Social Security disability because he had money in the bank and owned property.  This is not true at all.  Well meaning people sometimes say, "That person is getting Social Security disability, and he's got more money than I have.  Just look at the kind of truck he drives and the clothes he wears!  Why, he's got a lot more than most people!"  The truth is, however, that workers pay for Social Security disability insurance and they are not required to be poor in order to collect on the benefits they paid for all the years they worked.  Just like you would not have to be poor to collect a claim on your homeowners insurance that you paid for for years before filing the claim!  You would not need to be poor to collec

If the wage earner in a family becomes disabled and qualifies for Social Security disability (SSDI) or Supplemental Security Income (SSI) benefits, dependents may also be eligible for SSI payments.  Here are the basic requirements for dependents to receive SSI benefits: The Household must meet strict income/resource limits. Dependents must be under the age of 18 OR age 18 or 19 if full-time students in the 12th grade or below (cannot be college students). A disabled dependent age 18 or overwho is disabled but not a full-time student, may qualify as an adult claimant, but not as a dependent.   (He/She would need to file his/her own claim as an adult). Supplemental Security Income is a program designed to help individuals and families with very low income and resources to meet basic necessities of living.   Social Security disability (SSD) is a separate program which does not limit an individual's or family's income or assets in order to receive benefits.  Under SSD (Tit

October 8, 2013 Englewood Cliffs, NJ --A hearing held by the Senate Homeland Security and Government Affairs Committee yesterday examined troubling allegations regarding what appear to have been concerted fraudulent actions by a Huntington, West Virginia attorney and a former Administrative Law Judge. The National Organization of Social Security Claimants' Representatives (NOSSCR) applauds the individuals who stepped forward, as well as the diligence of the Senate investigators. The allegations are nothing short of appalling, and if true, further investigation should be vigorously pursued and all individuals prosecuted to the fullest extent of the law. Thankfully, the Committee found no evidence that what was uncovered in Huntington is more than an isolated incident. As noted by Committee Chairman Tom Carper, “While we don't have any evidence that this is more than an isolated case, one example of inappropriate actions of this nature is one too many. I am

If Social Security denies your disability claim, you only have 60 days in which to appeal and ask for a new decision.  If you pass that 60 day deadline, you must file a new claim and start all over.  This has several non-desirable affects: Your filing date is moved up to the date of the new application, which is nearly always several months later than the original application date. You are allowed to claim benefits up to 12 months prior to the application date; however, the 12 month period now starts with the date of the new application.  So, several months of potential benefits may have been lost. The appeal process is held up until Social Security acts upon your new application (that is, until they deny it again). This usually results in both a loss of time and money. If you receive a denial letter, get someone to help you file an appeal right away.  Only by filing a written appeal do you protect your rights under the original application and preserve your original filing dat

Judge Judy Sheindlin has added her two cents worth to the controversy about Social Security.  Judge Judy appeared on a Fox News program hosted by Megan Kelly and said she was tired of people getting Social Security disability because they were "alcoholics and drug addicts," adding to the popular myth that SSDI is "going broke" because of dead beat drug users who refuse to work.  Fox News did nothing to set the record straight. The truth is that by law individuals cannot qualify for SSI or SSDI benefits based on either alcohol or drug addiction/abuse. In 1996, Congress passed Public Law ( P.L. ) 104-121—which terminated benefits for Supplemental Security Income ( SSI ) and Disability Insurance ( DI ) beneficiaries whose primary impairment was drug addiction, alcoholism, or both. As a result of the 1996 legislation, those individuals became ineligible for benefits, effective January 1, 1997. Social Security will currently not award benefits to persons becau

"If 60 Minutes had done 30 Minutes of research, their program would have been far different." In October 2013, 60 Minutes aired a program about Social Security titled "Disability USA."  In the program, 60 Minutes made some sensational statements about Social Security disability in the United States.  However, there were some fundamental facts that CBS forgot to tell you. CBS forgot to say that Social Security is a self-financing program paid for by payroll taxes collected from workers and their employers.  It is off budget, meaning that Social Security benefits are not part of the US Government's budget and never have been. CBS forgot to say that the Social Security trust fund is supposed to have $2.6 trillion dollars in it. CBS forgot to say that, over the years, Congress has "borrowed" or "stolen" that $2.6 trillion to pay other bills, and that is why there is little money in the trust fund. The "crisis" now is that

Social Security disability is an insurance policy - just as certain as your homeowners, auto insurance or hospitalization plan is insurance.  Like all insurance, you pay a premium to be covered.  You have a "policy" that defines what benefits you may receive under what conditions.  The insurance coverage has a "term," that is, a start date and end date. Here are some important points to keep in mind concerning Social Security disability benefits: Premiums (the cost of disability insurance) are paid by most workers in the United States.  These premiums are called FICA taxes and are deducted from each payroll check you earn.  Your employer must match the amount of tax you pay.  So, you pay to be covered by Social Security Disability Insurance (SSDI)--just as certain as you pay to be covered by your homeowners or auto insurance policies. The Policy , the document that describes your benefits and the conditions under which you may receive benefits, is more compli

For purposes of a Social Security  disability claim, "work" is always defined in terms of full-time work--8 hours per day, 5 days per week, or an equivalent schedule. If an individual is not able to perform full-time work, a finding of disability ordinarily obtains. Thus, if you are able to work 6 hours per day you are disabled.  Also, if you can only work 3 or 4 days per week, you are disabled. Individuals must be able to stay on task up to 2 hours at a time without a break.  If you have a physical or mental condition that requires more frequent breaks, you may be disabled on that basis because most jobs will not accomodate extra breaks. During a hearing in Florence, I asked the vocational witness about absences from work.  The expert testified that ordinarily no absences are tolerated during the 90 day probationary period. After the probationary period the worker cannot consistently be absent more than about 1 day per month.  My client was found disabled because she

Why it Matters When You File People often ask whether it matters when you file for disability.   The answer is yes.  When you file for Social Security disability, SSA will ask if your medical condition has lasted or can be expected to last for 12 months or more.   If the answer is no, your application will be denied.  Social Security provides no benefits for short term disability that lasts less than one year.   Does that mean that you must wait 12 months from the date you become disabled to file your claim?  Absolutely not.  If you expect your condition will last at least 12 months into the future, go ahead and file for benefits.  It is in your best interest not to wait too long, for a number of reasons.  Let's look at an example.  A worker named Joe has an injury and becomes unable to work on January 1, 2013.  Social Security has a 5 month waiting period, so the earliest he could possibly qualify for benefits would be May 1, 2013.   Soci al Security allo

The Social Security Advisory Board helps to advise the President and the Congress on Social Security policy issues.  In September, 2012, the Advisory Board issued a report about the effects of professional representation on Social Security Disability cases and Supplemental Security Income (SSI) cases. Represented cases, the Board found, have higher allowance rates, with significantly higher allowance rates for SSI cases.   The Board also found that there is little difference between the result of representation by attorneys vs. non-attorney representatives. To read the entire Advisory Board Report, click on the link below:   http://www.ssab.gov/reports/Third-Party-2012-Full.pdf -------------------------------------------------- The Forsythe Firm is one of Alabama's foremost Social Security Disability advocate firms.  When your claim is denied by Social Security, you have 2 choices:  give up or fight.  We are here for those who won't give up. Call us at (256) 799-0

I recently appeared in a Social Security disability hearing where the client had what should have been a clear cut disability case.   He had a severe medical condition that had lasted for many months.  His condition did not respond to treatment and was expected to last indefinitely.  Finally, he had seen his family doctor in Huntsville several times per month and his medical file showed unmistakable evidence of the extent and severity of his condition.  Unfortunately, the client had been receiving unemployment benefits after leaving his previous job.   Applying for unemployment benefits is something most people do automatically after losing a job, almost without thinking about it.  Unfortunately, filing for unemployment insurance can have serious consequences if you are also filing for Social Security disability.      Why?  Because of the weekly certification requirements.  Each week when you file for unemployment benefits, you certify to the state that you are ph

If action is not taken, the Disability Insurance trust fund will not be able to pay full scheduled benefits by 2016. Workers and employers pay for disability protection through FICA taxes, deducted from wages and matched by the employer.  The total tax is 6.2 percent of earnings (with ceilings).  5.3 percent of that tax goes into the Old-Age and Survivors Insurance (OASI) trust fund, sometimes call the retirement fund.  The remaining 0.9 percent goes into the Disability Insurance trust fund. The Disability Insurance trust fund is expected to be depleted in 2016.  After that date, taxes coming into the Disability trust fund would cover only about 76 percent of scheduled benefits.  The trust fund has faced such emergencies before and Congress has never allowed the benefits to drop. A typical fix would be to temporarily allocate more of the 6.2% tax from the OASI (retirement) fund to the Disability fund.  That would mean that both funds could pay full benefits to the year 2033.  Aft

Fibromyalgia is a real disease that poses real limits on the ability to work.  Still, Social Security continues to have some problems in awarding benefits based on fibromyalgia. Social Security now recognizes that Fibromyalgia can be a disabling impairment.  Federal court cases continue to support that finding.  In Sublett v. Astrue, 856 F.Supp.2d 614 (W.D.N.Y. 2012 ), the District Court awarded benefits in a case where the hearing judge had rejected the opinion of the treating doctors in a case involving Fibromyalgia. The court ruled that, "the decision denying benefits is reversed and the plaintiff is awarded disability benefits." As with most Social Security disability cases, the key is persistence.  The correct decision will not be made at all levels.  So appeal unfavorable decisions to the next level when you believe your case has merit.  

If you're about to go to a Social Security disability hearing, be prepared to answer dozens of questions.  Be aware that some of these may be "trap questions."  Here are a few trap questions that I've heard during my years of Social Security disability representation. "Can you lift your five-year old grandson?"  May translate as, "You tell me you have a bad back but you can lift 60 pounds?" "Do you still like to go fishing?"  May translate as, "The claimant is well enough to fish, he's probably well enough to work." "How is your golf score holding up these days?"  May translate to:  "If the claimant can play golf, don't tell me she can't bend, reach, stoop or kneel with the best of them." Obviously, some of these questions may be valid.  Just as obviously, the claimant needs to tell the truth.  I advise my clients never to lie or exaggerate.  I also tell them to try to give a complete and

If a claimant gets an unfavorable decision with the administrative law judge (hearing level), he or she may appeal the case to the Appeals Council.  The Appeals Council will only consider "new evidence" if it meets the following criteria: The evidence was not part of the claims evidence at the date of the hearing. It is relevant, i.e., directly related to issues adjudicated by the ALJ. The evidence relates to the period on or before the date of the ALJ decision. There are instances where evidence dated after the ALJ decision is pertinent to the period prior to the date of the hearing decision. If you are trying to untangle the knots of a Social Security disability case, you may want to consider professional help.  Our firm will look at your case for free.  No charge will be made for our services unless we agree to represent you AND you win your case and collect past due benefits.  You pay no fees upfront and never a fee unless you win.  We handle cases in Al

Not everyone is covered by Social Security disability insurance.  Like all insurance, you have to pay premiums to keep your coverage.  Social Security disability is paid for by taxes deducted from your pay check and matched by your employer.  These are called FICA taxes--after "Federal Insurance Contribution Act." When an individual stops working, FICA taxes are no longer paid.  After a number of years (usually 4 years) the individual stops being "insured" under Title 2 disability.  As with any other insurance, you cannot file a claim after you become uninsured.  The last date you are insured under Social Security is called "date last insured."   Another program called "Supplemental Security Income" or SSI, operates under different rules and does not require work to be covered.  It does have strict income and resource limitations, however.

The Forsythe Firm is very pleased to announce the opening of our new office in Franklin, TN. We are located at 725 Cool Springs Boulevard in Franklin - giving us the capacity to serve clients in the Brentwood, Nashville, Franklin, Columbia and Spring Hill areas of middle Tennessee. As with our other offices, the Forsythe Firm practices exclusively in the field of Social Security disability. We offer free consultations and case evaluations. How do we get paid?  When your case is won and your benefits are deposited into your bank account, Social Security will withhold the fee approved for our representation and pay us directly.  The fee is a percentage of the "back pay" we are able to get for you.  If you do not win there is no fee for our services. Call today for a free office consultation.  Let's talk about your Social Security disability claim! THE FORSYTHE FIRM 725 Cool Springs Blvd. Franklin, TN 37067 Phone:  (615) 732-6159

For many years, the Forsythe Disability Firm has been serving the disabled in northern Alabama, helping them to get Social Security disability benefits.  We have enjoyed a high success rate for the claimants we represent. Now, we are also helping claimants in middle Tennessee, especially in the areas around Franklin, Cool Springs, Columbia and Spring Hill.   There is never a fee to speak with us.  There is no fee for our help until we win your case and obtain back payments for you. We are conveniently located in the Cool Springs area just off Interstate 65 in Franklin. The Forsythe Firm is delighted to be local members of the National Organization of Social Security Claimants Representatives (NOSSCR) - an organization of over 4,000 attorneys and other disability advocates fighting for the rights of millions of disabled Americans who need Social Security disability or SSI benefits. Contact us for a free, no obligation evaluation of your Social Security disability claim.  The cal

An "on-the-record" (OTR) decision is one issued on an appealed claim without a hearing. These decisions are always fully favorable.  That means that the adjudicating official has accepted the date you claim to have first become disabled and is paying any benefit accordingly.   Fully favorable on-the-record decisions can be issued by administrative law judges or by attorneys who work for administrative law judges.   These decisions are relatively rare and occur mostly in cases that are "cut and dried."  An OTR decision reduces the waiting time and gets the claimant paid faster since no hearing is involved.  OTR decisions may come about as a result of a request from the claimant's representative or they may be initiated by the hearing official. ------------------------- For a free consultation about your Social Security disability claim, please contact the Forsythe Firm, serving all of northern Alabama and middle Tennessee. www.Get-SS.com Alabama - Call

It is unlikely that a person will qualify for both Social Security disability (SSDI) and Supplemental Security Income (SSI) at the same time, but it is possible. That could happen if your SSDI monthly benefit was very low (below $710 per month).  In that case, SSI could add to your benefit, up to the maximum of $710 per month in 2013.  SSDI benefits could be low because you haven't worked recently or because you made low wages. Social Security disability payments count toward income for purposes of SSI eligibility.  If your SSDI benefit is $710 per month or greater, it will disqualify you for SSI payments. SSI also has resource restrictions, which are $2,000 for an individual or $3,000 for a couple. Certain types and amounts of resources may be excluded. Applying for both SSDI and SSI is called a "concurrent claim."  Your local Social Security office can tell you which type of benefit you may qualify for based on wages, income and resources. SSI claimants must meet

Sometimes we get questions about a partial disability award from Social Security.   The VA will often award veterans a 30 percent disability, etc.  Some workers compensation claims are awarded on the basis that an individual suffers from less than 100 percent disability but still has some partial loss. In Social Security, however, it is "all or none."  You are either disabled or you are not.  There is no such thing as 30 percent or 50 percent disability.  You have to be 100 percent disabled or you not disabled - nothing between. What is the definition of "disabled" for Social Security?  You have to be disabled by a mental or physical impairment which is medically determinable.  You have to have such a severe impairment that you cannot perform any of your past relevant work (the work you have done during the last 15 years) - or any other work which exists in significant numbers in the national economy. There is also a duration requirement.  Your