December 24, 2014

Time Constraints on Appealing Your Indiana Social Security Disability Case

All too often, people call me for help in appealing their Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) claims, only to find out they have waited too long.  If Social Security denies your claim for Social Security disability benefits, you have sixty days to appeal that decision.  (Actually, Social Security allows five extra days for mailing time, so you have a total of sixty-five days from the date of your denial letter.)  If you have not submitted the appropriate forms before the deadline, Social Security will very likely dismiss your claim.  If that happens, you will probably have to start all over with another initial application. There can be times when the Social Security Administration (SSA) will accept an appeal filed after the deadline, but they will only do so if there is “good cause” for the late filing.  If you forgot the deadline, lost the paperwork, or just didn’t get the forms filled out on time, Social Security probably will not find that you have good cause.  On the other hand, if you were hospitalized, had a death in your immediate family, or never received the denial letter because Social Security sent it to the wrong address, there is a good chance that the SSA will accept your late filing.  Social Security makes a decision about good cause on a case-by-case basis.  The best thing to do is to file the appeal as soon as possible after you receive the denial. How can you make sure you don’t miss Social Security’s filing deadlines?  Here are some tips: Keep your Social Security office informed about changes in your address and/or telephone number. Follow up with Social Security regarding your claim.  In my office, we follow up about once a month during the initial application and reconsideration stages … 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

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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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