November 24, 2014

The Social Security Administration’s Five Step Process

Curious as to how the Social Security Administration (SSA) makes their decision on whether a claimant is disabled or not?  The SSA uses a five-step process, called the “sequential evaluation process,” to evaluate whether claimants’ disabilities are severe enough to prevent them from working.  The steps of the process are as follows: Are you working? Yes: If you are working at the time you apply and your earnings are above “substantial gainful activity,” the SSA will find you not disabled. “Substantial gainful activity” means that your gross earnings average more than $1070 a month (or $1800 per month if you are blind), Social Security generally will not consider you disabled.  The amount per month changes from year to year. Note that Social Security is looking only at your earnings, not at your total income.  If you receive money for something other than work activity, like insurance benefits or investment income, Social Security does not consider it at this step. No: If you are not working, or if your gross earnings average less than $1070 per month (or $1800 per month if you are blind), the evaluation proceeds to step two. Is your medical condition “severe?” Yes: Your medical condition is “severe” under Social Security’s rules if: It is a “medically determinable impairment.”  Typically, you must have a diagnosis from a doctor with medical evidence supporting that diagnosis; an explanation from you of the symptoms you experience is not enough. It meets the duration requirement.  Your condition must have lasted or be expected to last at least twelve consecutive months, or it must be expected to end in death. It significantly limits your physical or mental abilities to do basic work activities. No: If your condition has no more than a minimal effect on your ability to basic work activities, the SSA will find you not disabled. Does your … Continued

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November 20, 2014

Appealing Your Indiana Social Security Disability Claim for Cirrhosis of the Liver

Many people find that their initial application for Social Security disability benefits has been denied, even though they have a medical condition, such as cirrhosis of the liver, that may be very severe.  Statistically, you are more likely to be turned down for disability benefits on your initial application than you are to be approved.  Therefore, it is important to follow through with an appeal of  the denial of your claim to improve your chances of obtaining Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits. The Social Security Administration (SSA) identifies cirrhosis of the liver as a disabling condition that may entitle you to disability payments.  The SSA addresses this condition in its Listing of Impairments at Listing 5.05: Chronic Liver Disease.  This Listing spells out the criteria that allow a patient with cirrhosis of the liver to be found disabled.  If your medical records show that you have certain complications stemming from your diagnosis of cirrhosis, and if medical imaging and testing have severe enough results, you could meet Social Security’s criteria based on your medical records alone.  For more specific details of Listing 5.05, see this blog post. Even if your medical records do not show the specific conditions and test results required to meet the Listing, you may still be disabled under Social Security’s rules if you show that your cirrhosis of the liver symptoms and treatments prevent you from maintaining full time employment.  These symptoms can include, but are not limited to: Fatigue Jaundice or yellowing of the skin Weight loss Nausea Obviously, symptoms may vary from individual to individual, but the effects of these symptoms can powerfully affect your ability to work.  Further, if you have additional medical conditions that cause additional symptoms, the combined effects of all of your medical conditions may prevent you from being able to … Continued

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November 17, 2014

Will My Doctor Be At My Social Security Disability Appeals Hearing?

It is highly unlikely  that your treating physician will attend your Social Security disability hearing.  Unless your doctor is a personal friend you can convince to attend your hearing, your doctor in almost all cases will not be there. First, the Social Security Administration (SSA) does not require your doctor to attend.  Although some judges do call physicians to testify at hearings, those physicians are Medical Experts (MEs) paid by the SSA to examine your medical records and evaluate whether your condition is disabling under Social Security’s rules.  Will the ME at your hearing ever have examined you?  No.  Will this ME ever have even met you?  No.  The ME is supposed to give an impartial opinion regardless of the fact the SSA is paying him/her a fee to review the case and testify.  In my experience, there are good MEs and bad MEs, just like there are people who do a good job and people who do a bad job in any other profession.  In a perfect world, your doctor would be able to sit down with the judge and explain your impairments and how they affect you, but that’s most likely not going to happen. Second, your doctor is busy.  Even if you have a doctor who is kind and helpful, it is unrealistic to expect him or her to take time away from practicing medicine to attend your hearing. So what can you do to ensure the judge has good information from your treating physicians? Get the medical treatment you need.  Your explaining to the SSA that you have a bad back is not enough to show that you are disabled under its rules.  Social Security expects to see objective testing like x-rays or MRIs, progress notes from doctor visits, and records of medications you are taking. Make sure the SSA … Continued

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November 11, 2014

Epilepsy and Social Security Disability Benefits

A diagnosis of epilepsy can be unsettling and quite scary for most individuals.  Unpredictable symptoms and uncertainty regarding the patient’s prognosis create many stressors for the patient’s family.  Financial strains result from the added cost of medications and treatments, not to mention loss of income if epilepsy leads to the loss of a job.  It is helpful to know that Social Security disability benefits are available for people who have been diagnosed with epilepsy. Some individuals can experience seizures from epilepsy with some or all of the following symptoms: Uncontrollable jerking Loss of consciousness Staring Confusion Many individuals state that after a seizure, they experience severe fatigue and loss of energy for an extended period of time. Social Security recognizes epilepsy and seizure disorders as disabling conditions in its Listing of Impairments.  If you have been diagnosed with either convulsive or non-convulsive epilepsy, your symptoms are evaluated under Listing 11.02 and 11.03 respectively.  If your child has been diagnosed with convulsive epilepsy, the symptoms are evaluated under Listing 111.02; if your child has non-convulsive epilepsy, the symptoms are evaluated under Listing 111.03. Regardless of the type of epilepsy you experience, your medical records must contain certain types of evidence for your condition to meet Social Security’s Listings.  These include: An established diagnosis of epilepsy (or, in some cases, seizure disorder) Documentation of a detailed description of a seizure pattern, including the type, frequency, duration, and sequelae of the patient’s seizures by the patient’s treating physician Documentation that the patient has complied with prescribed treatment for at least three months Medical evidence to help prove your diagnosis of epilepsy includes EEG test results, PET scans, or MRIs of your brain.  Receiving regular evaluation and treatment from a neurologist is important as well; a statement from your treating neurologist regarding your symptoms, prognosis, and limitations can … Continued

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October 30, 2014

Indiana SSDI Benefits and Your Date Last Insured

The Social Security Administration’s eligibility requirements for Social Security Disability Insurance (SSDI) can be confusing.  If you have applied for SSDI benefits, you may have been told about your Date Last Insured (DLI).  Your DLI is one of the first things Social Security checks when determining whether you are eligible for disability benefits. Most workers either have Social Security taxes deducted from their paychecks or pay them when they file their tax returns on self-employment income.  For each quarter (three-month period) that you earn enough money, Social Security awards you a credit for that quarter.  You must accumulate enough work credits to be eligible for Social Security’s different programs. For Social Security Disability Insurance, not only must you have enough work credits, but you must have enough of them in the last ten years in order to qualify.  Social Security’s formula for calculating the required number of credits is complicated; the number of credits you need varies depending on your age.  However, if you are over the age of thirty you generally need to have worked and earned credits for five of the last ten years.  (If you are younger than age thirty, you generally need to have work credits for about half the time since you turned twenty-one.) Therefore, as time passes after you stop working and earning credits, the fewer of your work credits count toward your eligibility for disability.  Eventually you will reach the point at which you no longer have enough work credits to qualify for disability.  This point is your Date Last Insured.  If it has been several years since you have worked, your DLI may be in the past.  If this is the case, you may still be eligible for SSDI, but you will have to show that you became disabled before your DLI.  If you stopped … Continued

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October 20, 2014

Social Security Administration’s Disability Hearings By Video

With a backlog of pending disability cases in Indiana and across the country, many people have received notices informing them their Social Security disability hearing might be held by video teleconference.  You have the opportunity to object to the use of video teleconferencing; if you do Social Security must arrange a hearing for you in which you meet the Administrative Law Judge (ALJ) face-to-face.  There are various factors to consider in deciding whether or not to object to a video hearing. The pros to having an in-person hearing: You are in the same room as the ALJ.  It is possible that in person, the ALJ can better observe your physical and mental condition.   The ALJ can observe you entering and exiting the courtroom; if you use an assistive device the judge will be able to see it.  Further, in-person hearings may allow participants to observe facial expressions and body language the video screen may not be able to portray as clearly. Local ALJs are more likely to know about the local healthcare system.  When a judge who lives five states away looks at your medical records, he or she may not recognize your medical providers or even know what type of doctors they are.  A local ALJ is also more likely to know if it is difficult to access free or reduced-cost healthcare in your community.  In my experience, a local judge probably has seen records from the same local healthcare providers on numerous occasions and understands the quality and quantity of healthcare available at those facilities. Expert witnesses are more likely to appear in person as well.   If a judge takes testimony from a Medical Expert (ME), the ME typically appears either by telephone or in the ALJ’s courtroom.  The ME at your hearing has never seen you in … Continued

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October 14, 2014

Can I get Social Security disability benefits if I have problems using my hands?

In my Indiana Social Security disability law practice, I see a very wide variety of disabling conditions.  Many of my clients have conditions that affect  their overall physical ability to work; that is, those clients are unable to sit, stand, and walk long enough in combination to complete an eight-hour work day.  Others, though, have impairments that affect specific areas of functioning.  For example, some of my clients have impairments that limit their ability to use their hands.   Even if you can sit or stand for an entire work day without difficulty, the inability to use your hands to pick things up, handle small parts, or manipulate objects might seriously limit the kinds of work you can perform.  In my experience almost all work requires at least the occasional use of  the worker’s hands.  The Social Security Administration (SSA) recognizes this limitation, and many times my clients who are significantly limited in the use of their hands are found disabled based on that limitation. Many types of medical problems may cause a person to lose full use of his hands, including arthritis, neuropathy, carpal tunnel syndrome, or amputation, to name a few.  If you have problems with your hands, Social Security evaluates your ability to work based on your ability to perform the following types of movements: Reaching: extending your hands and arms in any direction Handling: seizing, holding, grasping, turning, or otherwise performing movements that require you to use your whole hand Fingering: picking, pinching, or otherwise performing movements with your fingers If you have difficulties writing, typing, buttoning, zipping, or keeping your grip on things you are holding in your hands, you would likely have difficulty performing work activities that require you to reach, handle, and finger.  These limitations are usually magnified if you have to use your hands for any … Continued

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October 2, 2014

Lupus and Your Indiana Social Security Disability Claim

As an attorney representing many individuals across Indiana in their Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) claims, I see a wide variety of disabling conditions.  Recently I have encountered more individuals diagnosed with lupus than before.  I would like to discuss some of the symptoms of lupus and how the Social Security Administration (SSA) addresses these symptoms when evaluating how lupus affects a person’s ability to work. Lupus is an autoimmune disease that can affect many parts of the body.  While it is considered a chronic disease, the severity can differ from individual to individual.  Symptoms of lupus can include, but are not limited to: Joint pain or swelling Oral ulcers Severe fatigue Fever Chest pain Rash Sensitivity to sun or light Anemia Involuntary weight loss The SSA does recognize lupus in its Listing of Impairments.  If your symptoms meet or equal the requirements in Listing 14.02: Systemic Lupus Erythematosus, you may be granted Social Security disability benefits.  Another way to win your disability claim with the SSA is to show that your “physical residual functional capacity” is so low you simply cannot work.  You may not be able to sit, stand, or walk long enough at a time or lift enough weight to be able to perform a substantial number of jobs in the national economy.  The pain and fatigue you experience from lupus may also prevent you from staying on task, working a full eight hour day, or making it to work every day.  If you are unable to perform work tasks adequately and consistently for eight hours per day, five days per week, you may meet Social Security’s definition of disability because you are unable to perform a full-time job. In my experience, comprehensive, up-to-date medical records from a specialist can greatly enhance … Continued

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September 12, 2014

Social Security Disability Benefits for HIV/AIDS

Acquired Immunodeficiency Syndrome (AIDS) is a disease that affects the body’s immune system.  AIDS is the last stage of the infection caused by the human immunodeficiency virus (HIV).  By attacking the immune system, HIV hinders the body’s ability to fight off infections.  HIV can be transmitted through sexual contact, exposure to infected bodily fluids, childbirth, or breastfeeding. Some symptoms of HIV infection may include a flu-like illness appearing two to four weeks after exposure to the virus.  After this illness, there is usually a latency period, typically lasting from 3 years to over 20 years, in which the patient will have very few, if any, symptoms.  Near the end of the latency period, fever, weight loss, gastrointestinal problems, and muscle pains may occur. Once HIV infection progresses to AIDS, more symptoms may occur.  These could include pneumocystis pneumonia, cachexia (HIV wasting syndrome), esophageal candidiasis, or respiratory tract infections.  People with AIDS also have a greater chance of contracting infections, viruses, and cancers. In order to meet the Social Security Administration (SSA)‘s listing for HIV infection, you must  have documentation of laboratory testing showing you are infected.  You also must be able to show that you suffer from one of the following: Bacterial infections: mycobacterial infections, nocardiosis, or salmonella (recurrent non-typhoid); or multiple recurrent bacterial infections requiring hospitalization or intravenous antibiotic treatment three or more times in a twelve (12) month period Fungal infections: aspergillosis, candidiasis (at a site other than the skin, urinary tract, intestinal tract, or oral or vulvovaginal mucous membranes), cocidiodomycosis (at a site other than the lymph nodes),  cryptococcosis (at a site other than the lungs), histoplasmosis (at a site other than the lungs or lymph nodes), mucormycosis, or pneumonia (or extrapulmonary infection) Protozoan or helminthic infections: cryptospridiosis, isosporiasis, or microsporidiosis, with diarrhea lasting for one (1) month or longer; extra-intestinal strongyloidiasis, or toxoplasmosis of an organ other than the liver, spleen, or lymph nodes Viral … Continued

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September 5, 2014

Brain Injury and Social Security Disability Benefits

Practicing Social Security disability law in Indiana has brought me into contact with a variety of disabling conditions and brain injuries are no exception.  This type of disability may result in the inability to work due to physical and/or mental impairments.  Your inability to sustain a forty (40) hour work week can result in qualifying for disability payments. The Social Security Administration (SSA) does recognize neurological impairments in its Listing of Impairments.  While Traumatic Brain Injuries (TBIs) do not a have a listing it is given mention in this listing.  A specific listing of 11.18 Cerebral Trauma may be of interest when examining brain injury.  It is important to note the listings under 11.00 may also be of interest considering the facts of each case. Do all brain injuries meet or equal one of the listings the SSA recognizes?  No, and that does not necessarily mean you will not be found disabled.  The SSA also recognizes the fact that your residual functional capacity may be at a level that you cannot perform substantial gainful activity.  This means that you are physically or mentally unable to perform work like activity on a full time basis.  Many of my clients with TBI’s have difficulty staying on task, fatigue, and memory issues that simply make it impossible for them to engage in a competitive work atmosphere. With any Social Security disability case medical records are usually the key to a successful outcome.  MRI’s of the brain and other objective testing can greatly enhance the chance of a favorable outcome with the SSA.  In my experience, statements from treating physicians especially those who specialize in a certain field as in neurology in these claims can be very beneficial. At my law office I represent individuals with many disabling conditions including but not limited to … Continued

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