June 9, 2016

Anatomy of a Social Security Disability Hearing Part III: The Decision

When the Administrative Law Judge (ALJ) makes a determination about your disability claim, he or she does not simply send you a letter that says “Congratulations! You have been found disabled!” or “Sorry, but you do not qualify for disability.”  The Social Security Administration (SSA) requires the ALJ to provide you with a thorough explanation of the decision.  When you get your hearing decision letter, the first part will briefly tell you whether you won or lost.  Attached to that letter will be the actual decision, which is typically about five to fifteen pages long.  The overall document is a little overwhelming, so here is a breakdown of the different parts: Jurisdiction and Procedural History This part of the decision summarizes the technical details about the case, including: The type of benefits for which you applied (Social Security Disability Insurance or Supplemental Security Income) The dates of your application, denials, and appeals requests The names of the attorney and any experts who appeared at the hearing A summary of anything that happened after the hearing (e.g., additional evidence added to the record) Any other procedural issues Issues This part of the decision recites the definition of disability according to Social Security’s rules.  If you have a Social Security Disability Insurance (SSDI) claim, it will also discuss your Date Last Insured (DLI).  The final sentence of this section is a statement of whether the judge did or did not find that you are disabled under Social Security’s rules. Applicable Law This part of the decision is complete “boilerplate” – that is, it is a generic description that doesn’t contain any details unique to your case.  Every decision from every ALJ contains this language.  This section describes the five-step sequential evaluation that the judge must follow in making a decision.  It also … Continued

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December 12, 2014

Consultative Exams: What Are They And Should You Go?

Many disability claimants are caught off guard when they receive a notice from the Social Security Administration (SSA) for a scheduled doctor’s appointment.   These doctor appointments are called consultative examinations (CE’s).  The SSA will sometimes send SSDI and/or SSI claimants to these examinations if they feel like more information is needed to determine a disabling condition.  It is important that the claimants attend these CE’s.  Failure to appear at a CE may result in the SSA denying the claim. Who are the doctors? The doctors that perform the CE’s are not employed directly by Social Security, but are private doctors that are contracted out by the SSA.  In my experience, this can be good and bad.  The good part is that since the doctors are independent physicians, they should be evaluating the claimant’s condition objectively.  The flip side of this is that since these physicians only see the claimants for a single short visit, (usually around 15 minutes) a thorough evaluation may not be performed. What is the purpose of these exams? The most likely purpose that a claimant is sent to a consultative examination is because of a lack of medical records.  If a claimant is claiming a disability, but there are not any or enough medical records to back it up, or the records are from a long time ago, the claimant’s case reviewer will most likely send the claimant out for a CE.  Hopefully the SSA will attempt to give the claimant a fair shot despite the lack of medical records, but it is usually best not to rely on a consultative examination to prove your disability.  Another scenario that my office sees is when the case reviewer or the judge wants a specific test done that they think could prove or disprove the claimant’s case. … Continued

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November 26, 2014

What Is The Timeline For My Social Security Disability Claim?

Many claimants wonder what the timeline looks like for a Social Security disability claim from start to finish.  The waiting time for a claim can depend on many factors and can vary greatly from case to case. Step 1: Initial Application In my experience, the average waiting time for a decision on the initial application is about 4 months, but this is only an estimate. This wait time can depend on multiple things.  One factor is how quickly your medical providers respond to the Social Security Administration (SSA)’s requests for medical records.  The SSA will request any relevant medical records from the medical providers you listed on your initial application.  In my experience, the turnaround time for medical records can range from one week to a few months.  Another factor that impacts the waiting time at this stage is how long it takes the SSA to obtain additional information it needs about your disabling conditions.  This additional information can come in the form of consultative exams (one-time assessments by doctors who examine you on the SSA’s behalf) or questionnaires about your work history and your activities of daily living.  Finally, the wait time can be longer or shorter based on the SSA’s current workload. Step 2: Request for Reconsideration In my experience, claimants wait approximately 3 months for a decision on a request for reconsideration, but this is only an estimate. The waiting time at this step has the greatest variation among my clients.  Some clients receive a decision within a few weeks, especially if they have not received any additional medical treatment since they completed their initial application.  Others wait months as their adjudicators work to obtain additional information, especially if the claimants have experienced big changes in their disabling conditions since completing the initial application.  Usually this step simply entails a medical records update and … Continued

Filed under: Appeals Process, Claims Process, Evaluation Process, Hearings Process, Social Security Disability Benefits Claims Process, Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI) || Tagged under:
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April 8, 2014

Initial Application Process for Social Security Disability Benefits

In my Indiana Social Security disability law practice, I receive many phone calls each day from people who want to know what they need to do to apply for Social Security disability benefits.  Many of them have worked their whole lives, and they are uncertain and afraid because they can no longer provide income for their families.  They need help figuring out whether they qualify for Social Security benefits and what they need to do to start the application process. My staff and I are happy not only to advise people about the application process; we also provide representation for people who are not sure they want to proceed with the initial application on their own.  Some people feel confident enough to go to Social Security’s website to complete the application on their own, or they are willing to wait a few weeks to get an appointment with their local Social Security office to start an application.  However, for those who want professional assistance from the very first step, an attorney or qualified representative can make sure that the application is completed quickly and completely. The majority of people who apply for Social Security disability receive a denial of their initial application.  However, the information you provide in your initial application is the foundation for your entire disability case, so it is important to be as thorough as possible.  Here is a list of a some of the important information you will need to provide in your initial application: Information about past and present marriages, including when you were married or divorced, and identifying information about your spouse(s) The names and addresses of your employers for the past two years How much you earned in wages for the past two years For each of your jobs in the past fifteen … Continued

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December 14, 2011

Social Security Disability Benefits For Children And The Indiana Appeals Process

Children suffering from a disabling condition may be entitled to Social Security disability benefits.  Many times, if income/resource restrictions are met the child can be entitled to Supplemental Security Income (SSI) benefits if the disabling condition is severe enough.  Indianapolis disability attorney Scott D. Lewis has found some Social Security disability attorneys in Indianapolis do not take on child disability claims.  This may be from a variety of reasons, but Mr. Lewis believes many of these cases can be won. While the underlying question of how severe the disability is can be similar to an adult disability case, the question of whether or not the individual can work is generally not an issue in a child Social Security disability claim.  Instead, the Social Security Administration (SSA) looks at six (6) different domains when determining a disabling condition for a child: Acquiring and using information. Attending and completing tasks. Interacting and relating with others. Moving about and manipulating objects. Caring for yourself. Health and physical well being. As you can see by these domains they address not only physical limitations, but mental limitations as well.  In Indianapolis disability attorney Scott Lewis’ experience it is very important to be able to provide medical records supporting the child’s disabling condition.  For instance, if your child suffers from a mental condition, a treating psychiatrist or therapist’s medical records may go a long way in proving a disability exists.  Also, if your child has problems at school an IEP or notes form a teacher detailing what special needs the child may require can also help document the presence of the disability. If you find your child is not performing at an age appropriate level and/or has a physical or mental disability that you believe should qualify him/her for disability payments contact Mr. Lewis for a … Continued

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October 25, 2011

Time Limits When Appealing Your Indiana Social Security Disability Claim

When Indianapolis disability attorney Scott Lewis finds out someone has been denied their Social Security disability benefits, one of the first things he asks them is what is the date on their denial letter.  The date on denial letters received from the Social Security Administration (SSA) can play an important part in the processing of a Social Security disability appeal.  This may be the difference between a valid ongoing disability claim and a claim that needs to be refiled in order to pursue your Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. If you find that you have been denied it is important to note the date of the denial letter.  You have sixty (60) days to file a “Request for Reconsideration” or “Request for a Hearing in front of an Administrative Law Judge”.  The Social Security Administration does allow additional days for mailing.  If you are unable to make this important deadline, the Social Security Administration may allow a late submission or untimely filing if you have a valid reason for turning the required paperwork in late.  Attorney Scott Lewis advises his client not to count on an untimely filing to be accepted, and as long as the Indiana Social Security disability process can take there is usually no benefits to drag your feet when appealing a denial. Indianapolis disability appeals attorney Scott D. Lewis attempts to keep his Indiana Social Security disability clients aware of how important it is to stay on top of important dates and time constraints. Mr. Lewis encourages his clients to call his office to make sure the appropriate paperwork has been received through the mail.  Mr. Lewis knows how important your disability claim is to you and your family when resources are scarce and bills are piling up.  If you or someone you know is … Continued

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November 13, 2010

I am Receiving VA Disability Compensation, Can I Also Receive Social Security Disability?

Many Indiana disabled veterans talk to Indianapolis Social Security Disability Attorney Scott Lewis about receiving Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability benefits when they are receiving disability compensation from the Veterans Administration (VA). At the present, there are many Indiana disabled veterans coming home from active duty with various disabling conditions; one prominent condition is Post Traumatic Stress Disorder (PTSD). There are several factors to take into consideration when talking about these two very separate programs. 1.  If I qualify for Veterans benefits, do I automatically qualify for Social Security benefits? No. These are two different government programs. An Indiana Social Security disability claimant with a VA rating of 70 percent or more may have a better chance that the Social Security Administration (SSA) will take into consideration the Veterans Administration has found you disabled at such a high rating, but there is no guarantee. 2.  Does the Social Security Administration (SSA) work on percentages like the Veterans Administration?  No, with the Social Security Administration it is all or nothing. They either find you 100% disabled or they don’t. 3.  When should I apply? As soon as you are unable to perform substantial gainful activity (SGA). If you are unable to work because of your disabling condition, you should apply for Indiana Social Security disability benefits immediately. One of the problems Indianapolis Social Security disability lawyer Scott Lewis runs into is that his disabled veteran clients wait too long to apply. Many Indiana veterans leave active duty in a disabled condition and start receiving VA compensation not knowing they are eligible for Indiana Social Security disability benefits. The problem here is that the clock starts ticking and these Indiana veterans don’t know they have a limited time to prove they are disabled before their date last … Continued

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January 28, 2010

Social Security’s 5-Month Waiting Period for Disability Benefits

After Indianapolis Social Security Disability Attorney Scott D. Lewis wins his client’s disability claim, he often finds himself explaining to the claimant why their benefits will not start immediately from their onset date. Although he’s not certain why the Social Security Administration (SSA) has a waiting period, he attempts to explain to his clients when they can expect their benefits to begin. Social Security claimants that are awarded Social Security Disability Insurance (SSDI) benefts, must wait five (5) consecutive full calendar months from the determined onset date of their disability. After the 5 month waiting period, the SSA will begin disability payments with the earliest full calendar month but not more than seventeen (17) months before the claimant filed their disability claim. For example, if the Administrative Law Judge (ALJ) decided that the claimant became disabled on April 15, 2009, after the five month waiting period, benefits would begin on October 1, 2009. Another example, if the claimant filed for disability on January 1, 2009, but alleged to be disabled since May of 2007, if the ALJ finds that the alleged onset date is correct, he is only allowed to grant an onset date 17 months prior to the filing date. So in this case, the actual onset date would be August 1, 2007. After the five month waiting period, this particular claimant would begin benefits on January 1, 2008. There are a few exceptions to this waiting period. Claimants that were previously entitled to disability beneftis and their disability benefits ended, but then they became disabled again within 5 years of their benefits ending, they would not need to exercise the waiting period. There is no waiting period for claimants that filed for Supplemental Security Income (SSI) benefits or for claimants that are entitled to Childhood Disability Benefits. If … Continued

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November 3, 2009

Acceptable Medical Sources for Social Security Disability

Are you an Indiana resident filing a claim for Social Security disability?  Are you seeing a medical doctor regarding your disability?  Is your treating physician a nurse practitioner?  It’s not uncommon for claimants to schedule their medical appointments with the medical office nurse practitioner rather than the doctor.  This may affect whether or not you will receive a favorable ruling on your disability claim.   When the Social Security Administration (SSA) evaluates a claim, they will review the medical evidence submitted by your medical sources.  Treatment notes, medical documentation or records must be submitted by “acceptable medical sources.”  The SSA has two categories of medical sources.  There are “acceptable medical sources” and other health care providers that are not “acceptable medical sources.”  It is important to submit medical evidence that was reported by “acceptable medical sources.” “Acceptable medical sources” may include: Licensed physicians Licensed or certified psychologists Licensed podiatrists Licensed optometrists Qualified speech-language pathologists Unfortunately, the SSA does not categorize nurse practitioners or chiropractors as being an “acceptable medical source.”  This means that the medical evidence from a chiropractor or nurse practitioner cannot establish your medical impairment.  Although, information from other sources can be used to support your claim. These other sources may include non-medical sources such as social workers and employers; and public and private social welfare agencies; and other medical practitioners, such as physician assistants, nurse practitioners, naturopaths, and chiropractors. Does this mean that your claim will be denied because you are not seeing an “acceptable medical source?”  Not always, the ultimate decision is in an Administrative Law Judge’s (ALJ) hands.  It is important for Indiana residents to keep in mind the medical sources that the SSA prefers may enhance your ability to receive a favorable ruling.  If you would like a free consultation with Attorney Scott D. Lewis to discuss your Social Security disability claim, call (317) 423-8888.

Filed under: Medical Treatment, Social Security Disability Benefits Claims Process
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May 15, 2009

Indiana Residents Filing a Request for Reconsideration

If your initial application for Social Security Disability Benefits has been denied and you disagree with this decision, you must file the following forms to keep the claims process moving forward: Request for Reconsideration (SSA-561-U2); Reconsideration Disability Report (SSA-3441-F6); and Authorization to Disclose Information to the Social Security Administration (SSA-827). This is the first level of appeal after your initial denial. In simple terms, by filing these forms you are saying to the Social Security Administration (SSA) that they have made a mistake by not granting you Social Security disability benefits and they need to take another look at your claim. It is important to note that the SSA states that you have 60 days from the date of the initial claim denial to file a Request for Reconsideration, although it’s assumed that you received the letter five days after it was dated so actually you have 65 days.  If an Indiana claimant is untimely in filing the Request for Reconsideration within that allotted time, chances are he will be forced to start at the initial claim stage over again.  There are exceptions to this 60 day requirement.  If you can show good cause as to why you have filed late, you must supply the SSA with a reasonable explanation as to why the Request for Reconsideration is being filed late. Filling the required forms is not difficult.  Once filed, a Disability Examiner evaluates the claim.  Social Security claimants should remember that the majority of these Requests for Reconsideration claims are denied and result at the hearing level in front of an Administrative Law Judge (ALJ). Remember, Social Security’s denial of your claim is not a personal attack on you.  The people who make these decisions do not know you or your case and most likely do not have all of the evidence they need to make a favorable decision.  It … Continued

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