DISABILITY BENEFIT RECOVERY

Social Security is changing the regulations concerning how they will consider medical evidence from doctors.  The new regulations may make it even harder for new claimants to receive Social Security disability benefits. Up until now, Social Security decision makers were required to give more weight to opinions from a claimant's treating physician. For new claims filed after March 27, 2017, this will no longer be true.  Now, Social Security decision makers may decide how much weight to give medial evidence, regardless of whether the doctor has treated the patient or not. What concerns me about this new rule is this:  Suppose my claimant has seen his doctor 4 or 5 times a year for the past 10 years.  This treating physician has ordered multiple tests and has examined the patient multiple times.  The patient then applies for disability and Social Security sends him to one of their doctors for a one-time examination.  At least in theory, Soci...

Only workers are covered by Social Security disability insurance (SSDI).  The chart below shows the earnings required in one quarter to receive credit for "one quarter of coverage" (QC). Insured status simply means that you have worked long enough and recently enough to be covered by the Social Security disability program. The minimum required QCs is 6.  Then, you generally need one QC per year after you turn 21. Social Security no longer routinely sends out letters telling you about your insured status.  But you can get this information by calling your local Social Security office. In Huntsville, call 1-866-593-0665. In Decatur, the number is 1-888-289-9185. Amount of earnings needed to earn one quarter of coverage Year Earnings 1978 $250 1979 260 1980 290 1981 310 1982 340 1983 370 1984 390 1985 410 1986 440 1987 460 1988 470 1989 500 1990 520 1991 54...

SHOULD YOU ASSUME THAT SOCIAL SECURITY DENIALS ARE CORRECT? NO.  THAT WOULD BE A MISTAKE! You applied for Social Security disability.  They sent you to a doctor for an examination, then denied your benefits.  They sent you a letter that says, "...You are not disabled according to our rules." Should you assume that Social Security made the correct decision?      No.  You should assume they made a mistake, because they probably did. In over one- half of all denials during the past ten years, an administrative law judge has reviewed the evidence and overturned the denial to award full benefits to the claimant.  In simple terms, Social Security got the first decision wrong. Never assume a denial by Social Security is correct.  Assume it is wrong and can be overturned. What is the biggest mistake you can make after being denied by Social Security?  Failing to appeal the denial within 60 days is the single biggest mista...

Persons who are age 50 or over tend to get approved for Social Security disability (SSDI) much easier than younger people.  Here 's why: The grid rules often provide a shortcut for a simple, quicker decision for persons age 50 and over.  These are also called Medical-Vocational Guidelines. If you are under age 50, you usually must prove that you aren't able to perform your past work OR any other work that is available in the US economy.  This is a very strict burden. However, when you hit the magic 50,  the rules change.  Now, you must only prove that you can't perform your "past relevant work," meaning the work you have done during the past 15 years before applying for disability.  This is a much easier burden. At a recent hearing, the vocational expert testified that a 47 year-old claimant could not perform his past work as a welder.  However, the expert testified that the claimant could perform such light jobs as document preparer, parkin...

Some of my clients who file for Social Security disability benefits have severe sleep problems.  One client recently told me that she sleeps only about 3 hours per night.  Her medical record indicates obstructive sleep apnea, insomnia and other unspecified sleep disorders. In most cases, a severe sleep disorder results in symptoms such as Fatigue Excessive Daytime Sleepiness Lack of Concentration Memory problems Irritability When developing a disability case where there are chronic and significant sleep disorders, I try to emphasize the fatigue and mental restrictions that come with not sleeping. Social Security uses vocational experts to guide them on work requirements--in areas like lack of concentration, persistence, pace, being off task, getting along with co-workers or supervisors, etc.  Normally, a vocational expert will testify that full-time work in today's economy means being on task around 90 percent of the time (which means being awake and alert)....

"The road to disability benefits runs through your doctor's office."   Even if Social Security believes that you are disabled, they cannot pay you benefits without medical proof of a disability.  This means you must have objective medical evidence from your doctor. Unfortunately, many people lose their health insurance when they become disabled.  They may not be able to pay for regular doctor's visits.  This will negatively impact a Social Security disability clam. Medical evidence must be current.  Doctor's records from a year or two ago may be useful but Social Security will require recent evidence (not more than 3 months old). If you are disabled and without health insurance, my office may be able to direct you to low cost or free medical clinics where you can afford to see a doctor.  This, in turn, may help you get approved for disability benefits, which can include Medicare or Medicaid.   Below is a list of clinics in Alabama that suppos...

Thinking of Social Security disability as if it were an onion can help you get paid.  May sound silly, but let me explain: LAYER 1 is the application level.  Up to 75% get denied here.  You have to get past the first layer.  So, peel the onion. LAYER 2 is the "reconsideration" stage where a second disability examiner takes a look at your application to see if the first examiner made a mistake.  95% of these "reconsiderations" also deny the claim.  By the way, this second layer is NOT used in Alabama.  We can go to layer 3. LAYER 3 is the appeal.  It is a hearing before an administrative law judge.  Here at layer 3 is your best chance to be approved.  To get here, you must appeal your denial within 60 days of the date on the denial letter. LAYER 4 is a review by the Appeals Council.  This happens if the hearing did not produce a favorable result.  The most common thing that happens in Layer 4 is a further denial.  A...