DISABILITY BENEFIT RECOVERY

Doctors can be mean when it comes to helping their patients prove that they are disabled.  Some doctors are unwilling to "get involved" in the disability adjudication process at all. Most doctors will provide medical records, a bare minimum necessity.  However, medical records alone are not enough to prove disability because they don't address any functional limitation. My firm will usually ask the client's doctor to provide a professional opinion about functional limitations, using such forms as HA-1151-bk.  If the doctor will complete this form it is often an enormous help in proving the disability claim. We never ask a doctor to state that the patient is disabled.  That decision is reserved to the Commissioner of Social Security.  We do ask the doctor for certain medical opinions based on treatment history, examinations, imaging studies, laboratory reports, prognosis, etc.   What can you do if your doctor will not complete any paperwork for you?  You may

The Social Security disability program is really a government-sponsored disability insurance program.  You get it by working and having FICA taxes deducted from your pay.  However, you are not immediately insured when you begin working and you may stop being insured if you stop working. A "quarter of coverage" is the basic unit used to determine whether a worker is insured under the Social Security disability program, or Title II.  So, what is a "quarter of coverage"?  You will hear these informally called "Social Security credits," too.  Until 1978, a "quarter of coverage" was awarded to workers who earned $50 or more in a calendar quarter.  After 1978, the amount of wages required to earn one quarter of coverage changed automatically each year based on the National Average Wage Index. In 2015 you must earn at least $1,220 in a quarter to receive one quarter of coverage.  However, you cannot earn more than four quarters of coverage per y

Many times a person hasn't worked long enough, or hasn't worked recently enough to be eligible for Title II disability benefits under his or her own work record.  Another venue to check would be widow's benefits. Reduced retirement benefits may be available to widows at age 60.  Disability benefits may be available at age 50. Basic requirements for widow's disability benefits are: You were married to the worker for at least 10 years. Your disability began before or within 7 years of the worker's death. You are at least 50 years of age. You meet the same definition of disability as would be required of a worker. Survivor's benefits may be available at any age if you take care of the deceased worker's child who is under the age of 16 OR the child is disabled and receives a benefit under the deceased worker's record. Remarriage after age 50 does not affect disability benefits.  Remarriage after age 60 will not affect retirement benefits. You mu

Applying for Social Security disability is a big step.  It usually means a life changing event has recently occurred in your life.  Big adjustments are ahead.  There are some very important questions that should be answered before you file a claim for disability.  There are 2 reasons why I say this: The amount of benefits you will collect may be drastically affected by information in your application.  This could determine whether you will receive $40,000 or more in back pay, no back pay, or some smaller amount than you qualify for. Information in your application will determine whether your disability claim is approved or denied.  Period. You should probably speak to a professional disability advocate or counselor before you apply.  Short of that, let me provide some very general (and incomplete) checks that should be made before filing your application: Determine when you first became disabled .  This is called the Alleged Onset Date (AOD). This date will determine how far bac

The reentitlement period is a safety net for Title II disability recipients who return to work.  The reentitlement period begins at the end of the 9-month trial work period and lasts for 36 months. If you cannot continue working at the SGA level* due to your disability during the 36-month reentitlement period, you do not have to go through the disability application process all over again.  You just notify Social Security that you are unable to work and they will restart your disability benefits quickly.  This safety net is intended to encourage people on disability benefits to try to return to work. You only get one 9-month trial work period and only one reentitlement period. Trial work and reentitlement are for Title II disability recipients only--not for SSI (Supplemental Security Income) beneficiaries.  Also, if you are awarded a "closed period" of disability benefits, there is no reentitlement period. -------- * SGA level in 2015 refers to earning at least $1,090

The trial work period applies to persons who are already receiving Title II Social Security disability benefits. Trial work allows persons to try to return to work without giving up their disability benefits right away.  There are some traps concerning trial work that you need to be aware of.  Definition of a "trial work month."  If you work and earn at least $780 in a month (2015), you have completed one trial month period. You are allowed 9 months of trial work without danger of losing your benefits.  These months are not necessarily consecutive.  So a  few months of part-time of work here and there can count up and 9 months can sneak up on you.  If you reach SGA level earnings ($1,090 a month in 2015), and have completed your 9th month of trial work (even if the months were not consecutive) your benefits can be stopped because you have returned to work. Rolling Period .  Social Security looks at a rolling five-year period for trial work, so you may complete your 9th mo

The Social Security Act provides benefits for long term disability.  It does not provide benefits for unemployment or the inability to get a job.   Here are some examples of employment problems which have nothing to do with disability or Social Security:  Nobody will hire me. My job skills are ancient. The economy has tanked. The jobs I used to do have now moved to Mexico or overseas. The jobs I could once do are now done by machines. There are no jobs in my field (or in my hometown, etc.) The above statements have nothing to do with Social Security and will never result in a Social Security benefit.  They are not disability issues, they are unemployment issues. We need to focus on why you are disabled, not why you can't get a job. We have to focus on specific limitations in the ability to perform work related activity.  These limitations, for example, could include a restriction in the ability to: sit for prolonged periods stand/walk for prolonged periods

When Social Security decision makers consider medical or psychiatric evidence, they assign certain "pecking order" to the doctors who provide the evidence.  There are generally 4 levels of weight that may be ascribed to a doctor's medical opinion under the federal regulations: Little weight may be given to a doctor who has not examined or treated the claimant.  For example, this might be a doctor employed at Social Security who simply reviewed the claimant's application and/or medical records but never examined the claimant. Substantial weight may be given to a doctor who has examined the patient, especially if his or her findings are consistent with the other medical evidence in the record. Great weight should be accorded to a doctor who has both examined the patient and has had a treating relationship.  The longer the doctor has treated the claimant, the more weight decision makers will usually give the doctor's opinions. Controlling weight may be give

Social Security must consider all of a claimant's impairments and their affect on the ability to perform work related activities.  This includes mental impairments. According to SSR 85-15, all work requires certain mental demands, such as (on a sustained basis):  the ability to understand, remember and carry out simple instructions; to respond appropriately to co-workers, supervisors and usual work situations; and to deal with changes in a routine work setting.  A substantial loss of ability to meet any iof these basic work-related activities would severely limit the potential occupational base [and]...would justify a finding of disability. Mental impairments or their symptoms and effects are not governed by the Medical-Vocational guidelines or "grid rules."  For example, if an individual is young, has a college education and several years of skilled work experience, (s)he will not ordinarily be found disabled due to physical impairments under a grid rule.  However, i

An advocate is a trained person that you appoint to represent you before the US Social Security Administration.  The advocate will be the only person besides yourself at the hearing who is totally dedicated to getting your disability benefits approved. Here is how a professional advocate or representative can help you: Screen your application to be sure it is complete, accurate and compelling.   We find that many disability applications are denied on some technical point or simply because of an error in the application forms. Gather appropriate evidence.  The law requires your claim be supported by "objective medical evidence" from an approved medical source. The number one reason for denial of benefits is failure to meet this burden of proof.  Your advocate can help obtain, evaluate and submit the required evidence to support your claim.  Without it, you're going nowhere. Develop a legal theory of your case that can be approved.  Winning a Social Secur

The most important piece of information used to decide your Social Security disability claim will be your doctor's progress notes.  I hate to say be careful what you say to your doctor - but be careful what you say to your doctor.  Your conversation will often end up in your medical chart notes and will be carefully reviewed by decision makers at Social Security, especially by an administrative law judge if you go to a hearing. Decision makers must use Social Security Rule 95-7p to evaluate the credibility of the claimant.  In short, they have to decide whether you are telling the truth, whether you are exaggerating or trying to make your symptoms more severe than your doctor says they are.  The information you provide in your application forms will be compared to the information in your medical progress notes. I had a claimant who told his doctor that he was helping a neighbor remodel his home.  The doctor noted this in his progress report without further explanation. T