DISABILITY BENEFIT RECOVERY

When Social Security doesn't have enough medical evidence to make a decision on a disability case, they usually order a consultative examination.  The claimant will be sent to a doctor who is in private practice but performs Social Security examinations under contract (for a fee).  My experience has been that in about 90 percent of cases, the consultative examination will not support a disability claim.  There are several factors involved, which I will state briefly (in my opinion). The doctor has never seen the patient before. This is their first meeting. The doctor's time is very limited.  Some doctors spend as little as 15 minutes on a consultative exam. The doctor may have a conflict of interest since he/she is being paid by Social Security, not by the claimant. The doctor may only be looking for obvious signs of disability which cannot be discerned in a brief examination with no X-rays, lab tests or other diagnostic support. The doctor will not listen to t...

There are basically three ways to win a Social Security disability claim.  One way is to meet or equal one of the listings.  The "listings" refer to the Code of Federal Regulations, Part 404, Subpart P, Appendix I (often called "Appendix I" or simply "the listings."  This appendix classifies impairments according to fifteen body systems, with each impairment given detailed criteria for the severity required for disability.  It is often very difficult to meet or equal a listing because they are so precise and defined. The second way to win a disability claim is to qualify under a "grid rule."  Grid rules refer to Appendix 2 of the same section of law referred to above.  The "grid" considers the claimant's residual functional capacity (what he/she can still do in terms of physical limitations/ability), age, education and skill level. When all of these factors combined direct a finding of disabled , the case has been won.  I have fou...

Suppose you are receiving Social Security disability benefits but you are improving and thinking of going back to work.  How can you venture back into employment if you are unsure whether you will be successful?  What is your condition worsens and you have to go back on disability later? Social Security has the answer for this situation.  It's called "Ticket to Work."  Very generally, here is what Ticket to Work offers.  You may continue receiving full disability benefits while you attempt to work.  When you accumulate 9 months of "successful work activity," (the 9 months do not have to be consecutive) - your disability check will be discontinued.  However, you may elect to keep receiving Medicare benefits for several years, even while working.  If you become disabled again within a certain period of time, you may resume your disability benefits. Ticket to work provides a safety net for people who are disabled but recovering - and want to retu...

The Forsythe Firm understands that denials are likely - but disturbing.  We want you to know there are options when your Social Security disability or SSI claim is denied.  In Alabama, there is a relatively streamlined appeal process.  Our firm can explain that process and we can file the paperwork for you, too.  We will obtain additional medical evidence, prepare your case for hearing, then go with you to make your case before an administrative law judge who has the authority to award your benefits. No cost to you unless we win!  Our "baby," Molly with her "I'm not happy" face If you would like a free, frank discussion of your options after a Social Security denial, please contact me at the Forsythe Firm.  We win a majority of the disability cases we represent.  There is never a fee for our service until you have collected past due benefits.  "We don't get paid until you do."  Log on to our Website here to view real testimonials ...

If there were three fundamental statements I could make about Social Security disability claims, I would choose these 3 statements: There is a good chance that your initial disability claim will be denied. You should always appeal a denial promptly. Good representation for your appeal is money well spent. You actually don't spend any money for good representation.  You pay no money up front and you pay no fee until you collect a cash settlement on your back pay.  Thus, for every one dollar you pay your representative, you are guaranteed to receive $4 for yourself - since his fee is limited to 25 percent of your back pay. If you pay your representative $100, you must first collect $400 for yourself. That's about as risk free as it gets. Call my firm if you feel we can be of help to you in obtaining the Social Security disability benefits you deserve. You can reach me directly at (256) 799-0297.    

Compassionate allowances permit Social Security to approve claims quickly (often in a week or less) for applicants suffering from one of 200 incurable diseases. On December 6, 2012, Social Security Commissioner Michael Astrue met in the Hart Senate Office Building in Washington D.C. to announce reaching the milestone of 200 diseases that now qualify for a speedy compassionate allowance approval. In order to qualify, an applicant must have one of the 200 illnesses on the list.  There are still many incurable and tragic diseases that are not on the list and thus do not qualify for the rapid award of benefits.  However, the program does provide very quick approval for thousands of applicants each year who suffer from one of the 200 conditions listed. To see the complete list of diseases which qualify for a speedy compassionate allowance disability award, go to the following website:   http://www.ssa.gov/ pressoffice/pr/compassionate- allowances200conditions-pr. html ...

The fee charged by a representative is regulated by Social Security and must be approved by the judge who awards disability benefits.  In most cases the fee has been agreed upon in a contingency fee agreement.  Even so, the judge must still approve of the agreement before a charge can be made. To put fees into perspective, take a look at how much a representative may charge a client for Social Security disability representation - in relation to the amount of back pay the claimant receives. Amount of Back Pay           Maximum Fee $5,000                             $1,250 $15,000                            $3,750 $30,000                            $6,00...

Your representative will ask you several questions during your Social Security disability hearing.  Sometimes claimants want to know, "Why are you asking me all these questions?" There is a simple reason why I ask questions of my claimant at a disability hearing.  The claimant is sworn  and able to provide testimony.  I am not.  I cannot give testimony about pain levels, trouble walking or bending, or the ability to follow instructions, for example.  But he or she can give that testimony.  Therefore, I ask questions that give the claimant an opportunity to enter testimony into the record that I believe will help their case and get them a fair decision. For example, I recently asked a client during her hearing, "Do you experience difficulty finishing things that you start?"  I knew the answer to that question because I had read her file.  But I wanted her, the claimant, to testify that her concentration was less than it should be.  If...

Here's a question from our mailbag this week:   I hear people speak of a "closed period" disability claim with Social Security.  What is that?" A "closed period" of disability simply means that the disability began on a certain date and ended on a certain date.  A closed period could award back pay for a disability that was in the past but would award no future or continuing benefits. Let's say that Clem Claimant hurt his back at work and had to stop working for back surgery.  Let's say he stopped working on June 1, 2011 and recovered, then he began working again on July 1, 2012.  Since Clem was off work for the required 12 months minimum, he could seek benefits beginning June 1, 2011 and ending June 30, 2012.  If approved, he would receive back pay for the 13 months - minus the 5 month waiting period.  (In this example he would actually receive pay for 8 months, 13 months minus the 5 months). Since Clem has gone back to work ...

Social Security disability is an insurance plan mandated and paid for by the US Government under the Social Security Act.  Like any other insurance plan, it is funded by "premiums" or payments made to the Social Security Trust Funds.  In the case of disability insurance, it is paid for by FICA taxes.  The employee has taxes deducted from his/her wages, then the employer matches that tax and pays into the Social Security Disability Trust Fund.   In order to have current disability insurance with Social Security, the worker must have worked long enough and paid enough FICA taxes to be insured.  The worker must have accumulated a sufficient number of "Quarters of Work" to be insured.  For most workers over age 40, the worker must have worked at least 4 out of the last 10 years to be covered.  Rules are different for very young workers. Social Security disability insurance (SSDI) is often referred to as Title II (two).  SSDI do...

I work in Nashville regularly.  No, I'm not in the country music industry.  I'm a Social Security disability advocate. I drive over to Cumberland Bend or down to Franklin regularly to help clients in Social Security disability hearings.  That's because 7 out of 10 disability applications filed in Nashville and Middle Tennessee will be denied.  You will very likely have to appeal your case in order to get benefits. My firm will provide you with an experienced advocate to develop your case then attend the hearing with you.  We win a majority of the Social Security disability cases that we represent. And there is no upfront cost and no fee unless you win your case and collect back pay in the process.  So the process has no risk for the claimant. For more information on collecting Social Security disability in Nashville or Middle Tennessee, please click on the link below.  It will take you to our website for Music City USA and explain ho...

Many people assume that a Social Security disability case is over when the hearing has been held.  This isn't always the case.  Often there is post hearing work that should be done to achieve the best chance of a favorable decision. Everyone at a disability hearing works under pressure.  This includes the claimant, the representative, the vocational expert and even the administrative law judge.  Hearings are generally limited to less than one hour.  The judge will ask questions that place the claimant under stress to answer correctly.  The representative or attorney will be asked to respond to procedural issues or points of law that place him or her under pressure.  The judge must constantly conduct the hearing so that it follows Social Security laws, rules and regulations.  Further, the judge must form accurate hypothetical questions for the vocational expert based on the medical and vocational evidence in the file and upon the cl...

There is usually a wait of several months to obtain a hearing after a Social Security disability appeal is filed.  However, there are plenty of reasons to submit all your evidence in the case as early as possible. I recently appealed a Social Security decision and asked for a hearing.  I filed the request for hearing in September in the routine manner.  In December the case was reviewed and approved without a hearing.  The appeal was thus resolved in less than 90 days.   It doesn't always happen that way, obviously, but when there is plenty of evidence, it is always best if you can submit it right away.  In fact, I find there are at least two advantages to submitting medical evidence early: One, it provides a more likely opportunity for an early review of the case.  Two, it gives the representative or attorney an opportunity to write a thorough brief for the Office of Disability Adjudication and Review (ODAR). Often, the early bi...