DISABILITY BENEFIT RECOVERY

The Disability Determination Service (DDS) is located in Birmingham, AL.  This is a state run agency contracted by Social Security to examine disability claims and make the initial decision as to whether a claimant meets the rules for disability benefits.  Here are some of the things DDS typically does with a new claim: Order records from doctors and other medical providers Analyze medical records to determine what conditions/impairments you have Schedule any medical exams that they feel you need Obtain your past work history and classify your past relevant jobs Determine what your Residual Functional Capacity (RFC) is Decide whether you are eligible for benefits under Social Security rules Deny a majority of claims that they review (About two-thirds of all claims) Here is why DDS will usually deny a disability claim at the first step: DDS will usually find other work you are capable of doing, even if it is not your past relevant work. DDS will nearly always assign

I am sickened when I hear journalists or critics of the Social Security disability program making outrageous statements.  One of the current hot buttons is the claim that Social Security disability has become "a shadow unemployment benefit program."  This is just such hogwash! Social Security disability is governed by a complex system of federal regulations, consisting not only of the Social Security Act but Parts 1-99 of the 20 Code of Federal Regulations (20 CFR).  These regulations have set up mandatory processes and rules of evidence which absolutely prohibit disability benefits to anyone who is not (a) a worker insured under the Social Security Act (b) unable to work at any substantial gainful activity (c) disabled for at least 12 consecutive months and (d) able to provide objective medical evidence proving the disabling condition.   From the time of application, the typical process to get approved for Social Security disability can take 24 to 36 months or longe

Disability is very difficult to plan for.  It is almost as depressing as pre-planning your own funeral, so it's no wonder that most people just don't think about it.  However, the time to plan for disability is now--before it happens to you.  Some facts to consider: First, you can't gradually transition from work to Social Security disability benefits.  If you are working an d earning more than $1,090 per month, there is no disability benefit from Social Security.  You have to quit working to apply. Second, the first 5 full calendar months of disability are not covered by Social Security.  That means you need to be prepared for a minimum of 6 months of no income. Third, short-term disabilities that are expected to last less than 12 consecutive months are not covered by Social Security.   Fourth, about two-thirds of all Social Security disability applications are denied.  The appeal process will probably take between 12 and 24 months, during which time you are not re

You attended a hearing on your Social Security disability claim.  A few weeks later, you receive a Notice of Decision in the mail that says you have received a decision that is PARTIALLY FAVORABLE.  Does this mean that you are only partially disabled, not fully disabled? ANSWER:  No.  Social Security does not make awards for partial disability.  You are either disabled or not disabled.  There is no such category as "partially disabled" within Social Security law. A "partially favorable" decision means that the administrative law judge has found you to be disabled.  However, he or she has changed some material fact in your application.  Most often, this change involves the established onset date--the date you were found to have become disabled.  For example, in your application you may have alleged that you became disabled on June 1, 2012.  After reviewing the facts of the case, the judge may have decided that you did not become disabled until Sept

An "expert" is anyone with a briefcase who is at least 50 miles from home.  There are millions of "experts" on Social Security disability these days.  Everywhere you look someone has a new "report" about Social Security disability and a new theory about how easy disability benefits are to get and how the Government is just handing out benefits to one and all. I can't respond to each and every myth, rumor or lie about disability benefits.  But I have chosen two or three that especially burn my biscuits. MYTH, RUMOR OR LIE # 1.  It's quick and easy to get Social Security disability benefits.  The truth is, even if you have a legitimate disability that can be medically proven, and even if you meet all the requirements set forth in the Social Security Act, the 20 Code of Federal Regulations, etc., it will probably take 18 to 24 months to get on disability.  You will be questioned, examined, poked, prodded and interrogated until you almost wish you

Use This Link to Contact a Disability Advocate   You Must File a Timely Application.  You must apply for Social Security disability benefits within 5 years after you stop working.  Your insured status will expire, making a new claim impossible.  If there are gaps in your work history, you may have even less time to file a new claim.  Don't wait too long to file after you stop working. You Must Have Enough Quarters of Work.  You become an insured person under the Social Security Act by working and paying FICA taxes.  Most adults need 20 quarters of work to be covered.  These 20 quarters generally must have been accumulated within the most recent 10 year period prior to filing a claim.  Very young individuals might need less than 20 quarters of work. Your Disabling Condition Must Last At Least 12 Months.  Short term disability lasting less than 12 consecutive months is not covered by Social Security.  You must have an impairment that has lasted, or can be reasona

Veterans may get expedited claim processing for Social Security disability benefits. To get expedited processing, veterans must self identify and have a 100 percent permanent disability rating from the Veterans Administration. By "self identify," we mean that the veteran must inform Social Security of their 100 percent VA disability rating at the time the application is filed.  We recommend sending a copy of both your DD-214 form and your VA awards letter that shows the percentage of disability award. Does a 100% VA disability award guarantee approval of Social Security benefits?  No.  While a VA award does not automatically qualify for Social Security disability benefits, it does qualify for a much faster processing time--that is, a much quicker answer.  And, since the VA disability evaluation is similar to the Social Security evaluation process, the VA award can work in your favor. If a vet receives Social Security disability benefits, will it reduce the VA

If you were recently the subject of a disability hearing, the administrative law judge and the vocational witness probably used the term SVP quite a few times.  What is it and what does it mean? SVP stands for Specific Vocational Preparation - and it defines the amount of time required to train for and learn a specific job.  The higher the SVP number, the more time time required to prepare for how to perform the job; therefore, the more skilled the job is.  For instance, the job of silverware wrapper has an SVP of 1, while the job of brain surgeon has an SVP of 9. At Step 5 of the decision making process, the judge will ask the vocational expert to respond to a certain set of hypothetical questions regarding the claimants age, education, past work experience and residual functional capacity.  The expert will often respond with examples of jobs that he or she feels are appropriate for the hypothetical situations.  If the judge agrees that the claimant can still perform one or more o

The general answer to this question is, No.  A person may not receive Social Security disability benefits if he/she is currently working full-time. According to 20 Code of Federal Regulations 404.1520(b) , if an individual engages in Substantial Gainful Activity, she is not disabled regardless of how severe her age or the severity of her medical impairments.  SGA level work is disqualifying at Step 1 of the sequential process and no other factors will be considered.  It does not matter why a claimant is working. Social Security defines "substantial gainful activity" as activity that is substantial and gainful.  Work will generally be deemed SGA if it produces gross wages of at least $1,170 per month (This is the 2017 amount). Caution:  It is the work , not the income that disqualifies.  Non-earned income, such as income from investments, pensions, insurance, etc. does not disqualify SSDI benefits. Another question arises:  May I work part-time and receive So

Does it matter how much money you have in the bank or how much monthly income you have when filing a disability claim?  Read our answer carefully. Whether income matters or not depends on what type of claim you intend to file. No, it does not matter how much money you have for a regular Title 2 disability or SSDI claim.  Disability claims under Title 2 are not means tested.  You do not have to be poor or have limited income to qualify.  However, you may not be working and earning wages that are above Substantial Gainful Activity (presently $1,090 per month).  It is the work , not the income that is disqualifying.  Simply put, you cannot be disabled and working at SGA level at the same time under Title 2 or SSDI regulations.  For example, a person may be medically disabled, but if he is working full-time he would not qualify for SSDI benefits because of the work. Yes, household income does matter if you are filing an SSI claim, also known as Title XVI.  SSI is a program designed

Your attorney gives you a form to have your family doctor complete to support your disability claim.  Your doctor refuses, saying, "I don't ever complete these forms for my patients."  Can you get a new doctor to complete the form for you? The answer is, Yes you can, but it may not do any good. 20 CFR  404.1527 stipulates how much weight will be given to a doctor's opinion.  The following factors are considered by the decision maker on your claim:  A doctor's opinion may not be manufactured out of broadcloth.  It must be supported by objective data, such as laboratory tests, X-rays, MRIs or other imaging studies. 1.  Supportability .  Is this doctor's opinion supported by his or her own medical evidence and by objective medical evidence from other doctors in your medical record? 2.  Nature and Extend of the Treating Relationship.  If this doctor has seen you only one time (to complete the form), he or she does not have a treatment relationship with yo

WHICH DISABILITIES ARE NOT COVERED BY SOCIAL SECURITY? The Social Security Act covers a wide range of physical and psychiatric impairments which may result in disability payments if they are severe. However, there are certain impairments which are not covered by the Social Security Act.  Here are 4 examples. (1) Short-term impairments that will not last at least 12 consecutive months.   A condition that is not reasonably expected to last for at least 12 consecutive months is not covered by Social Security. (2)  You have a severe impairment but are still working on a full-time basis or engaging in substantial gainful activity.   If you are now working at substantial gainful activity (SGA) such as a full-time job, you are not eligible for disability benefits, regardless of your age or the severity of your impairments.  In short, you may not engage in substantial gainful activity (SGA) and apply for Social Security disability at the same time.  (You may need some help in defining

Social Security analyzes a new claimant's ability to perform certain activities.  This helps them to decide whether the claimant is disabled according to their rules.  They use a form called "Function Report - Form SSA-3373-BK" or one very much like it.  Be careful how you answer the questions on this form.  Strive to be accurate but also descriptive.  Try to give a real picture of how your pain or other symptoms limit your daily activities--such as shopping, driving, doing housework, socializing, etc. Here are just a few of the questions on the Function Report, as samples of the type of information being collected from each applicant who files a new claim for benefits: Do you take care of anyone else such as a wife/husband, children, parents, friend, other?  ( If you do, and do not show that you have significant problems in doing so, Social Security may judge that you are quite able to perform other activity, like working). How often do you prepare food or meals? 

Filing a Social Security disability claim is a complex matter.  The Forsythe Firm offers this checklist to help claimant's properly file their claim for best potential results: Initial Application (First Time Filing) - You will need to complete the following forms Application for Benefits (online or at a Social Security office) Disability Report (Adult/Child) - Form SSA-3368 BK Function Report - Form SSA-3373-BK Work History Report - Form SSA-3369 BK Authorization to Release information to the Social Security Administration (SSA-827)  Additional forms may be sent to you by the Disability Determination Service after your application is submitted. Appeal / Request for Hearing by Administrative Law Judge - You need the following: Request for Hearing by Administrative Law Judge - Form HA-501 Disability Report (Appeal) - Form SSA-3441 Authorization to Release Information to the Social Security Administration - Form SSA-827  Some Important Information You Will Need t

Some important terms stand out in Social Security disability regulations.   Here is what they mean. Alleged Onset Date (AOD) .   This is the date the claimant alleges to have first become disabled.   If it becomes the Established Onset Date (EOD), meaning that the Social Security Administration agrees that the claimant did indeed become disabled on that date, benefits may be paid back to that date.   So the AOD/EOD affects how many months of back pay or past due benefits the claimant is entitled to receive. Waiting Period .   The waiting period for all Title 2 (regular disability) claims is 5 full calendar months.   This is really an elimination period.   5 months of benefits will be subtracted from the Established Onset Date.   For example, if you are found to have become disabled on March 15 th , your waiting period will include the months of April –August and your first benefit payment eligibility will be for the month of September.   This does not necessarily mean yo

#1 - Obtain Help From a Disability Advocate or Attorney Who Knows the System and the Process.  The majority of claimants whose claims are approved are assisted by a Social Security disability advocate or attorney with experience in filing federal disability claims or handling appeals.  What does this representation cost?  The answer:  Nothing unless you win and receive back payments.  Representation is available on a "pay only if you win" or contingency basis.  There is no risk.  You never pay a fee unless you win your claim and receive a past due award settlement (back pay). #2 - File your own claim and do your own paperwork and prep.  CAUTION:  Up to 75 percent of initial applications are denied and require an appeal.  Most of these claimants will end up getting professional help with the appeal.  You may want to consider getting professional help at the beginning.  In many cases, representation will cost you nothing -- even if you win.  Here is why: There i

In a criminal trial, the accused person walks into a courtroom under the presumption of innocence:  in short, he is not guilty of any crime until the state can prove guilt.  The defendant does not have to prove that he is innocent.  The state must prove that he is not. In a Social Security disability case, just the opposite is true.  The claimant is assumed not to be disabled until he can prove that he is. Social Security does not have to prove that the claimant is not disabled.  The claimant must prove that he is.  So, the burden of proof rests mostly upon the claimant, not upon Social Security. I have frequently tried to explain the importance of objective medical evidence in a Social Security disability case, especially at the appeal level.  Allow me to elaborate a little more on what I mean by the term objective medical evidence and how critical it is to the success of a disability claim. First, there is non-objective evidence.  This might include claims or allegations mad

In a recent hearing, my client Brenda told the administrative law judge, "I have severe anxiety and panic attacks that don't let me get out of the house much." The ALJ asked, "How often do you have these attacks?"  Brenda replied, "Almost every day.  At least 4 or 5 times a week." The ALJ asked, "Have you had any mental health treatment for this problem?"  Brenda replied, "No, not really.  My primary care doctor gives me Lexapro but doesn't help much." Two months later the ALJ issued a denial decision.  In the decision he noted that Brenda claims to have severe panic attacks but that he found her testimony only partially credible because she did not seek any mental health treatment. In short, her report of severe symptoms could not be supported by the examination or treatment of a clinical psychologist or psychiatrist.  The fact that Brenda's primary doctor had prescribed Lexapro did not convince the judge that she had