August 26, 2014

What Should I Say At My Social Security Disability Hearing?

When I prepare my Indiana neighbors for their day in front of an Administrative Law Judge (ALJ), the majority of the conversation revolves around what type of questions the ALJ will ask them.  I have represented clients in front of many different judges, and I have found that each ALJ has a unique style of asking questions – some ask a lot of questions; others prefer to have the representative take most of the client’s testimony.  Therefore, I try to tailor each of my clients’ preparation to be ready for the particular judge who will be hearing the case.  In spite of their differences, though, in my experience most judges cover the same general topics in their hearings. Many, but not all, judges are going to check your credibility.  While objective test results can prove that you have a certain medical diagnosis, the severity of the pain or other symptoms you experience due to that diagnosis can only be explained by you.  Therefore, the judge will likely ask you to explain your symptoms, rate your pain, or describe the ways your pain or other symptoms limit your ability to perform certain tasks.  If a judge believes you are exaggerating or lying about these things, you may find yourself with an unfavorable outcome.  I try to always tell my clients to be truthful yet realistic about what they can or cannot do.  In my experience, credibility is especially important for my clients whose disabilities cannot be diagnosed with objective testing, like mental illness, fibromyalgia, or migraines. Most judges will ask you about your activities of daily living.  These can include but are not limited to cleaning your home, doing dishes, laundry, yard work, bathing or showering, dressing yourself, taking care of children, shopping, using the computer, hobbies, and going out with friends and … Continued

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August 21, 2014

What is a closed period of disability?

In order to qualify for disability benefits, you must have a disability that has lasted or is expected to last at least twelve months.  Although, sometimes I work with clients whose health problems lasted more than twelve months, but they have recovered and are now able to return to work.  Even though they are relieved to be able to return to full-time employment, these clients want to know if they can receive disability benefits for that time period in which their conditions kept them from being able to work. In cases like these, we ask the Social Security Administration (SSA) for a “closed period of disability.”  In other words, we acknowledge that the client does not presently meet Social Security’s definition of disabled, but we argue that the client did meet that definition in the past.  For example, Betty had to stop working in October of 2012 after she injured her back.  She spent nine months trying different types of treatments, from physical therapy to injections, but nothing helped.  Finally, her doctor scheduled her for back surgery in August of 2013.  It took another six months of recovery and rehabilitation, but Betty was finally able to return to work full-time in February of 2014. Assuming that Betty met Social Security’s requirements for disability from the time of her injury in October 2012 until she returned to work in February 2014, she could receive benefits for a closed period from October 2012 to February 2014. An applicant for a closed period of disability must meet two criteria: Her impairments must have prevented her from performing substantial gainful activity for at least twelve continuous months; and She must have applied for disability either before her disability ended or within fourteen months of her disability ending. Most of my cases involving closed periods of … Continued

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August 8, 2014

Social Security Disability Benefits for Learning Disabilities

Many of the children I represent in claims for Supplemental Security Income (SSI) have been diagnosed with some type of learning disability.  While Social Security Administration (SSA)‘s Listing of Impairments does not specifically address learning disabilities, its evaluation process does consider the effects of learning disabilities on a child’s ability to function. Some of the children I represent have learning disabilities related to mental impairments such as attention deficit hyperactivity disorder (Listing 112.11), mood disorders (Listing 112.04), anxiety disorders (Listing 112.06), or intellectual disabilities (Listing 112.05).  Other children have learning disabilities that are less easy to categorize, so Social Security evaluates them differently.  Once Social Security determines that a child’s impairments do not medically meet or equal one of its Listings, it then evaluates the child’s combination of impairments to see if he or she “functionally equals the listings.”  If the child has marked impairments in acquiring and using information,  attending and completing tasks, interacting and relating to others, moving about and manipulating objects, caring for himself, or health and physical well-being, Social Security may find the child meets its definition of disability. In order to show Social Security that your child is disabled, you first must show that he or she has a medically determinable impairment.  Helpful evidence includes: Medical diagnoses and treatment notes Therapy/counseling notes Clinical test results Other medical findings Next, you must show how your child’s medically determinable impairments keep him or her from functioning at an age-appropriate level.  Evidence of these limitations includes: Individual Education Plans (IEPs) School grades Results of standardized testing Evaluations and treatment notes from occupational and physical therapy or other types of rehabilitation School or day care discipline reports Written comments from teachers regarding the child’s ability to work at grade level, complete assignments, work without supervision, and behave appropriately in a classroom environment … Continued

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July 24, 2014

Social Security Disability Benefits for Hepatitis C

Hepatitis C (HCV) is a medical condition in which the patient’s liver is inflamed.  In some cases, HCV can lead to cirrhosis (replacement of liver tissue with scar tissue) of the liver.  Hepatitis C is usually spread via organ transplants, transfusions, intravenous drug use, or poorly sterilized medical equipment.  HCV was only proven to be a different condition from hepatitis A and hepatitis B in 1989.  HCV only infects humans and chimpanzees. Chronic infection occurs in about 80% of HCV patients.  A chronic infection is characterized by the presence of viral replication for more than six months.  Most patients with chronic HCV infection exhibit few symptoms, if any, during the first few decades after their initial infection.  Early symptoms may include fatigue or mild cognitive problems.  After several years of an individual being infected, hepatitis C may lead to cirrhosis or liver cancer.  Some other symptoms may include: Joint pain Belly pain Itchy skin Sore muscles Dark urine Jaundice Traditionally, the typical treatment for hepatitis C has been interferon injections.  Unfortunately, though, these injections tend to cause flu-like side effects.  New drugs are being introduced to replace interferon treatment, and if a patient’s HCV symptoms are not severe, his doctor may recommend waiting for the new drugs to be released rather than enduring interferon treatment.  Patients with hepatitis C are typically advised to avoid alcohol and any type of medication or drug that is harmful to the liver. The Social Security Administration (SSA) has a listing for chronic liver disease in its Listing of Impairments at Section 5.05. Simply being diagnosed with hepatitis C is not enough on its own to meet the criteria to receive Social Security disability benefits.  Your medical records must also show that you have complications such as hepatorenal or hepatopulmonary syndrome, internal bleeding, or fluid in the peritoneal or pleural cavity. Even if you do … Continued

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July 10, 2014

How Do Drugs And Alcohol Use Affect My Disability Claim?

Your social security disability claim may be denied due to alcohol or drug use.  The way this information usually gets to the Social Security Administration (SSA) is through the medical records.  Most doctors offices ask questions concerning drugs and alcohol when patients go in for a check up.  Some hospitals will conduct drug tests while patients are in for a procedure. Below is a paraphrased version of what the SSA’s Federal Regulation 416.935 says concerning drugs and alcohol: If the SSA finds that you are disabled, they must determine if your drug or alcohol addiction is a contributing factor to your disability.  This does not apply to claimants when applying because of blindness. If you stopped using drugs or alcohol, would the SSA still find you disabled? Would your current physical or mental limitations remain if you stopped using drugs or alcohol? If the SSA determines that your remaining limitations (after removing the drug or alcohol use) would not be disabling, you may not receive benefits. If the SSA determines that your remaining limitations (after removing the drug or alcohol use) are still disabling, you may be found favorable for benefits. How the SSA looks at drug and alcohol use varies from case to case.  In cases where the claimant is claiming mental health issues, the SSA will look and determine, in their opinion, if the claimant stopped using drugs or alcohol, would the condition still exist?  This can be a gray area with mental health cases because far too often I see drugs or alcohol become a coping mechanism for mental issues. If you have drug or alcohol issues, your case may be harder to win, but this does not mean that it is impossible.  We must prove to the SSA that the drug or alcohol issues are independent … Continued

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July 9, 2014

Social Security Disability Benefits for Fibromyalgia in Indiana

Fibromyalgia is a condition where a person experiences widespread pain and painful responses to pressure.  Fibromyalgia may also be associated with depression, anxiety, and other stress related disorders.  Other symptoms may be, but are not limited to the following: Fatigue Sleep disturbances Joint stiffness Bowel/bladder issues Numbness/tingling Cognitive dysfunction Difficulty swallowing The cause of fibromyalgia is unknown.  Currently, it is believed to involve a combination of genetic, environmental, psychological, and neurobiological factors.  There is some evidence that certain genes increase the risk of developing fibromyalgia.  These happen to be the same genes that are associated with other functional somatic syndromes and depression. Lifestyle may also contribute to developing fibromyalgia.  Stress is believed to be a factor in developing fibromyalgia.  Lifestyles like such as smoking, obesity, or lack of physical activity may also increase the risk in developing fibromyalgia. A single test to diagnose fibromyalgia does not exist.  Most doctors diagnose patients with a process called a differential diagnosis.  This means that the doctors take into consideration the patient’s age, gender, symptoms, medical history, and other factors to narrow down the diagnosis to the most likely option. The American College of Rheumatology (ACR) defines fibromyalgia with the following criteria: A history of widespread pain lasting more than 3 months, affecting all 4 quadrants of the body (both sides, above and below the waist). Tender points – there are 18 designated tender points (even though a person may feel pain in other areas).  However, a diagnosis is not based on the tender points alone. Fibromyalgia is not degenerative or fatal, but the chronic pain is persistent.  Most patients report that their pain does not improve over time.  There is no universally accepted treatment or cure for fibromyalgia.  Some doctors do recommend psychological therapy, medication, and/or exercise to help with the symptoms. The Social Security … Continued

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May 29, 2014

Social Security Disability Benefits for Traumatic Brain Injuries (TBI)

A traumatic brain injury (TBI)  occurs when an external mechanical force causes damage to the brain.  These injuries may occur as a result of vehicle accidents, firearms, falls, construction accidents, or sports injuries.  A TBI may cause temporary or permanent impairment of brain functioning and might cause structural damage to the brain as well.   Symptoms from TBIs vary depending on the severity of the injury.  In moderate or severe cases, unconsciousness may occur within seconds or minutes.    Milder injuries may cause symptoms including but not limited to: headaches, vomiting/nausea, dizziness, balance problems, and fatigue.  Some common long term symptoms of moderate to severe TBIs may include but are not limited to: changes in appropriate social behavior; problems with sustained attention, processing speed, and executive functioning; and alexithymia.  Alexithymia is a condition in which an individual has problems identifying, understanding, processing, and describing emotions. the Journal of Clinical and Experimental Neuropsychology reports that 60.9% of patients diagnosed with TBI suffer from alexithymia. The Social Security Administration (SSA) recognizes traumatic brain injuries in its Listing of Impairments at Section 11.18 – Cerebral Trauma.  In evaluating whether your TBI meets a listing, though, the SSA refers to other listings that address the specific body systems affected by your injury.  For example, if you suffer psychological or behavioral symptoms resulting  from your TBI, you may meet Listing 12.02 - Organic Mental Disorders.  If your TBI leads to seizures, you may meet listing 11.02 - Convulsive Epilepsy or 11.03 - Nonconvulsive Epilepsy. In order to meet Social Security’s definition of disability, your impairment must have lasted or be expected to last at least twelve months.  TBIs can be difficult to evaluate under Social Security’s standard because their long-term prognoses can be difficult to forecast accurately.  Some TBIs cause very severe symptoms at first but gradually improve, while others grow worse over time.  Therefore, it is very important in your Social Security disability case … Continued

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May 22, 2014

Is My Initial Consultation Really Free?

Your initial consultation with our office is free, and there are many reasons why.  When you call our office to initially discuss your claim, you will probably have many questions.  So will we.  We will need to talk to you to get an idea of whether you qualify for one of Social Security’s disability programs.  Also, during this first interaction with you we can get pertinent information that will give us a better “feel” for how we can help you.  Some of the questions we will probably ask you include, but are not limited to:  Are you still working?  It is possible to qualify for Social Security disability benefits even if you are working, but there are limits on the number of hours you can work and the amount of monthly gross income you can earn. When is the last time you worked?  What is your household income?  The Social Security Administration (SSA) has two disability programs: eligibility for Social Security Disability insurance (SSDI) is based on the number of work credits you have earned in the past ten years; Supplemental Security Income (SSI) is based on your household income and financial resources. What medical conditions do you have that keep you from being able to work?  These conditions can be mental, physical, or a combination of both; Social Security typically requires medical evidence showing that you have been diagnosed with these conditions and are receiving treatment for them. There are many other factors involved in a Social Security disability claim, including your age, education, and prior work experience.  You may wonder why these things are important.  The SSA determines your ability to work based on many things.  In some cases, Social Security takes into account the fact that there are fewer job opportunities in the economy for people over the age of fifty. … Continued

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May 20, 2014

Heart Disease According to the Social Security Administration

The Social Security Administration (SSA) recognizes many cardiovascular impairments as disabling conditions.  Many people use the term heart disease interchangeably with cardiovascular impairments.  The SSA defines a cardiovascular impairment as  “any disorder that affects the proper functioning of the heart or the circulatory system (that is, arteries, veins, capillaries, and the lymphatic drainage).  The disorder can be congenital or acquired.”  The SSA lists cardiovascular impairments under Section 4.00 in the Listing of Impairments.  The Listings define certain diagnoses, clinical findings, and symptoms that the SSA considers disabling.  If you can provide appropriate medical evidence showing that your impairment meets the definitions set out in the Listings, you might be found disabled without having to demonstrate how your impairment keeps you from being able to work. Below are a few cardiovascular impairments that the Social Security Administration addresses in its Listing of Impairments. Chronic Heart Failure Chronic heart failure occurs when the heart is unable to pump enough blood to meet the needs of the body.  Some signs and symptoms of heat failure may include: increased rate of breathing, increased difficulty for normal breathing, pulmonary edema, cardiac asthma (wheezing), and/or apex beat or gallop rhythm.  Heart failure stems from the myocardium muscle losing efficiency, which is usually caused by damage or or overloading of the muscle.  The leading cause of chronic heart failure is coronary artery disease.  The SSA recognizes chronic heart failure in Section 4.02 of the Listing of Impairments.  To meet this listing you must be able to show certain levels of systolic or diastolic failure, severe symptoms as a result of your heart failure, or multiple episodes of acute congestive heart failure. Ischemic Heart Disease  Ischemic heart disease is more commonly known as coronary artery disease.  This condition happens when blockages in the arteries reduce blood flow.  Ischemia is defined as “reduced blood supply.”  The leading cause of ischemic heart disease … Continued

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May 7, 2014

Social Security Disability Benefits for Pancreatitis

The pancreas is a large gland located behind the stomach.  It is part of the endocrine and nervous systems.  The pancreas produces many important hormones that circulate in the blood.  It also produces digestive enzymes that help break down food.  Pancreatitis occurs when the pancreas becomes inflamed.  Damage to the pancreas can occur when pancreatic enzymes activate before they are secreted.   There are two main types of pancreatitis: Acute pancreatitis happens over a very short period of time.  This type of pancreatitis is usually caused by gallstones or heavy drinking.  Symptoms may include: Fever Nausea/vomiting Upper abdominal pain/swollen or tender abdomen Increased heart rate Chronic pancreatitis usually results after a case of acute pancreatitis.  Chronic pancreatitis can ultimately stem from gallstones, hereditary disorders, cystic fibrosis, certain medicine, or heavy alcohol use.  Symptoms may include: Any symptoms of acute pancreatitis Weight loss Diabetes In order to be eligible for Social Security disability benefits, you must have a disability that has lasted at least twelve months, is expected to last at least twelve months, or is expected to end in death.  If you have chronic pancreatitis, you may be eligible for Social Security disability benefits if you can show that your condition is disabling according to Social Security’s rules. One of the first things you must do in a Social Security disability claim is to show that you have a “medically determinable impairment.”  In other words, your condition must be diagnosed using acceptable medical clinical or laboratory techniques.  It is important to see a specialized physician such as a gastroenterologist or endocrinologist if you are diagnosed with pancreatitis.  Not only will a specialist be most likely to accurately diagnose and treat your condition, medical records from a specialized physician are likely to be given more weight by Social Security’s disability evaluators … Continued

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