Recent Blog Posts

Terminal Illness or TERI cases and Social Security Disability - One of the unfortunate realities of my job is that some of my clients are diagnosed as terminal. While being diagnosed with a terminal illness may seem like an obvious favorable decision for the Social Security Administration (SSA) to make, that may not always be the case. Even with this diagnosis the SSA may need more information and can be slow in making a determination.  Hopefully your medical provider, family, and Social Security attorney or representative can gather the information to make it easier for the SSA to make the right decision quickly.   The Social Security Administration avoids the words “terminal illness” and instead calls these cases TERI cases. The SSA defines a TERI case as “a medical condition that is untreatable and expected to result in death.”  Once this type of designation exists, the SSA attempts to expedite the case in the early and later stages of processing.  The SSA has guidelines for identifying these cases and processing them in a particular way.   Getting a medical source statement from your treating physician can be very important. Not only a statement saying the individual is terminal, but also supporting medical evidence establishing a clear diagnosis.  Objective testing and progress notes should be submitted to the SSA to show the severity of the condition.  Many physicians are hesitant to make such statements until all medical avenues have been exhausted.  If you find yourself in this situation it may be in your best interest to let your physician know you are dealing with the Social Security Administration.   If you or a family member finds themselves in this situation, I urge you to contact the SSA as soon as possible to start this process. Qualified Social Security disability attorneys and representatives can also provide guidance on filling out paperwork and … Continued
Social Security Disability and the Durational Requirement - As a Social Security Disability Attorney, I see the Social Security Administration (SSA) turn people down for a variety of reasons. One of the common ways you may be turned down for Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) is because the SSA states you do not meet its Durational Requirement.  This is a fairly easy way for them to turn down your claim, but you can appeal this decision and many times find yourself with a favorable outcome in the long run.   What is the “Durational Requirement”? The language the SSA uses requires that you must have an impairment lasting or expected to last at least 12 months.  As you can tell, this can be a pretty subjective standard.  The SSA makes this determination on the current medical records they have on hand.  Unfortunately, your medical record may be incomplete when they make this determination.  You can appeal this decision and if you believe you are unable to work and will continue to be unable to work it is most likely in your best interest to file a Request for Reconsideration or Request for Hearing to move your case along.  You have approximately 60 days to file these appeals and it is very important to do so in a timely manner so you do not have to file another initial application.   It is also important to note your impairment must prevent you from performing Substantial Gainful Activity (SGA) for at least 12 months in a row. What this essentially means is that you cannot receive disability benefits when your wages are over SGA.  This is a monetary amount establishing a cap you cannot go over.  Many of my clients have difficulty grasping this concept when they are holding down a full time job while … Continued
Digestive Problems and Social Security Disability - The impact of digestive problems can be very disabling. I have seen a large increase in the amount of these cases in my practice.  Whether it is due to better detection by physicians or an ever increasing amount of individuals suffering from these disorders, it is obvious these conditions can make a huge impact on a person’s life. While it may seem to you that the Social Security Administration (SSA) does not understand the difficulties you are experiencing, they do acknowledge these disorders in its Listing of Impairments. Listing 5.00 Digestive System-Adult may address a condition you are experiencing.  The Listing of Impairments is a guideline the SSA uses to establish criteria they acknowledge as disabling.  The SSA will usually not only send you to a consultative examination, but obtain and review your medical records from treating physicians to determine if you meet these guidelines.  Unfortunately, in my experience, many individuals are not found disabled on initial application and find themselves appealing their Social Security Disability (SSDI) and/or Supplemental Security Income (SSI) claim. The SSA should determine your Residual Functional Capacity (RFC). Your RFC is basically what your limitations are after your impairments are taken into account. I find many of my clients have symptoms such as, but not limited to: Diarrhea Constipation Abdominal pain Nausea Vomiting Bloating Bleeding Obviously, these are only a representative sample of symptoms. The severity of these symptoms vary greatly among my clients.   The SSA may find you disabled because of the severity of these symptoms. Your symptoms could cause you to be off task too often to compete in a work environment.  You may also have too many absences due to your health to maintain employment.  Digestive issues can create a number of problems that make you unable to work.   I represent … Continued
Should I Be Nervous About My Social Security Disability Hearing? - Clients often tell me they are very nervous and anxious about their upcoming Social security Disability Insurance/Supplemental Security Income hearing. It is pretty easy to understand why.  Some people have never been to a hearing and others are so worried about the outcome they cannot even sleep the night before the hearing date.  Hopefully, this blog will shed a little light on what the atmosphere is at a Social Security disability hearing.   These hearings are considered informal. What that means is there are usually not any strict trial rules and the atmosphere is not that of a criminal or civil trial.  Many Administrative Law Judges (ALJ’s) will let you know that at the very beginning of the hearing.  Although I say it is informal, interrupting others may not be in your best interest and waiting your turn to answer questions may be advisable.  Most hearings have a predictable pattern and if you have an attorney or representative they can usually tell you what that pattern is.  I try to prepare my clients for each individual ALJ that will hear their case.  Different Judges think different things are important.  I believe it is helpful to make things easy for your Judge by being prepared and sticking to what they are interested in.  It would be a rare occasion that making a Judge angry would benefit you in any way.  Don’t get me wrong, all of your information needs to be presented, but as I said it should be done in a manner the court will respect and listen to.  In my experience, most hearings last around forty-five minutes to one hour.  Of course this can vary depending on the complexity of the case and each individual Judge.   Being nervous is normal and should be expected when the stakes are … Continued
Should I Bring a Cane To My Social Security Disability Hearing? - Many of my clients need an assistive device to get around more easily. The need for a cane, crutches, walker, or wheelchair may be necessary to walk even the shortest of distances.  Asking if you need to bring one of these items to your Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) hearing should not even be a question.  You either need this type of assistance or you do not.  The inability to ambulate effectively is necessary to fulfill a wide variety of jobs above the sedentary (Sitting) exertional level.  The need for such an item can erode the job base and can enhance your chances of winning your claim. Is it good enough just to go pick up a cane at the local pharmacy without a prescription or maybe borrow one from a relative? Many Administrative Law Judges (ALJ’s) will require you to have a prescription for an assistive device from your treating physician in order to recognize it as being medically necessary.  Many judges will not acknowledge the need for a cane without a physician stating it is necessary even though you may have been using it for years.  Documentation from treating sources can be key in a successful Social Security disability claim. Any medical source statements showing your inability to stand or walk for any extended duration may also convince the SSA that you are unable to perform certain types of occupations. As you age, and at the same time, have never engaged in or acquired transferable skills to a sitting occupation the SSA may find you disabled pertaining to medical vocational guidelines they use to make a finding of disability.  In Social Security’s world you inability to walk and stand can be a major factor in a finding of disability. In summary, this blog … Continued
Do You Know Why You Are Disabled? - That seems like a strange question doesn’t it? My clients tell me they are disabled, but many have a hard time saying it in a way the Social Security Administration (SSA) understands. Many people have Social Security disability questions.  There can be many reasons why it is hard to explain your inability to work.  You may have a rare condition the SSA is not very familiar with; you may have a combination of impairments that, all added together, make you unable to work; you may have to argue you meet special rules the SSA recognizes; or you may just simply be unable to work a full time job.  Trust me, claiming you are disabled to the SSA can be confusing and difficult, or it can be as easy as they want to make it for you.  That’s why knowing what to tell them can possibly create a make or break situation.   In my experience, you need to be careful how you phrase things to the Social Security Administration. First of all, being disabled is not a joke.  Going to physical and mental examinations the SSA sends you to and taking it lightly may result in that particular examiner noting your attitude to the SSA.  All the way through the process, you need to express accurately to the SSA what you are experiencing.   Fill out the forms the SSA gives you truthfully and in their entirety. Some claims can be processed favorably without much human interaction by giving the SSA ALL of the information they request.  Be proactive in your claim, especially at the initial level, to ensure the SSA gets all pertinent information.  Unfortunately, after initial denials, while waiting for a hearing, your claim may not be looked at again until you find yourself in front of an Administrative Law … Continued
“Off task” at work – does it matter at my Social Security disability hearing? - Social Security disability hearings can be confusing – the Administrative Law Judge (ALJ), your attorney, and the experts use a lot of jargon that may make it sound like they are speaking a completely new language.  The basic issue that all of these people are discussing is whether you can perform the duties of a full-time job.  However, Social Security’s rules require that the ALJ provide a detailed explanation of why he or she thinks you can or cannot work.  The ALJ must determine your “residual functional capacity” (RFC), which is a description of what kinds of work-like activities, if any, you are able to perform in spite of your impairments.  The judge must specifically address all the different physical and mental limitations you have. The elements of your physical residual functional capacity – your ability to sit, stand, walk, lift, reach, stoop, etc. – are pretty self-explanatory.  The judge must assess how much of an eight-hour work day you are able to do each of these things.  However, as you probably know well, your medical conditions cause problems in many more areas than just your ability to do physical activities.  If you have pain, mental health diagnoses, or medication side effects, you likely have difficulty with mental tasks as well.  Your skills in concentrating, solving problems, and interacting with others are just as vital to your ability to keep a job as your physical capabilities are. Unfortunately, though, it can be difficult to describe how mental limitations affect your ability to work.  Here are some ways you may notice that your mental limitations affect your daily life: You have difficulty sitting through an entire TV show or reading a whole magazine article because your back pain bothers you so much. You start lots of projects, but you never finish … Continued
If I Had a Stroke, Can I Receive Social Security Disability? - The Social Security Administration (SSA) can determine whether or not you can receive disability payments for the after-effects of a stroke.  While there are two separate disability programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), the medical requirements to receive payments are the same.  The mental and physical residuals from a stroke can make it difficult, if not impossible, to maintain full time employment. Your first step is to file an initial application.  Some individuals who have suffered a stroke may have difficulty even starting the application process due to difficulties with communication, memory, and typing or writing.  Get help from a friend or family member to start the application if you need to; Social Security recommends that you designate a “third party” whom they can contact if they need additional information.  The application process is designed by Social Security to be completed by an individual without the assistance of an attorney or representative.  However, I have helped many clients file an initial application because they preferred to have the help of someone familiar with the process.  For someone dealing with memory loss, difficulty speaking, and problems getting around, it can be helpful to have an attorney or representative take charge of the case to make sure everything gets submitted on time and to patiently assist with the completion of Social Security’s forms and questionnaires. How does the SSA evaluate individuals suffering from a stroke when determining disability?  First, they decide whether you “meet a listing.”  The SSA publishes a Listing of Impairments that details the information they consider for each specific condition.  Stroke is covered in the listing for neurological impairments under Section 11.04.  What happens if you do not meet or equal the listing for stroke?  Social Security then evaluates whether your residual functional capacity … Continued
What is a Contingent Fee Agreement? - If you have applied for Social Security disability benefits and have been denied, you may have been advised to hire an attorney to help you appeal your case.  However, you might be worried that you can’t afford an attorney – after all, aren’t lawyers famous for charging high hourly rates for every second they spend on each case?  Fortunately, if you hire an attorney or representative to help you with your disability appeal, your case will be handled with a “contingent fee agreement.” The Social Security Administration (SSA) has rules about how attorneys can charge clients for disability appeals.  Basically, if an attorney wants Social Security to approve his or her fee agreement, it must meet the following criteria: 1. You (the client) only have to pay the attorney if your claim is granted (if you “win” your appeal). 2. If you win, the attorney receives 25% of any back pay you receive. (“Back pay” is the money you receive from Social Security to cover the benefits you should have received while you were waiting for your claim to be processed and/or your appeal to go through.) 3. If your claim is granted at the initial application, request for reconsideration, or hearing level, the attorney can receive no more than $6,000, no matter how much back pay you receive. 4. If you lose at the hearing level and have to appeal your case to the Appeals Council or file a claim in federal court, most attorneys have a slightly different fee structure. Typically in those cases, the attorney receives 25% of your back pay without the $6,000 cap.  However, the attorney will likely have to submit a statement (called a “fee petition”) showing how much time he or she spent on your case in order for the fee to be approved. In … Continued
Do I have a good Social Security disability case? - I hear this question probably more than any other question from my clients.  When I was in law school, one of my professors told me, “The facts always matter,” and a Social Security disability case is no exception.  It’s also important to know how Social Security applies its rules to the facts of your case when you are trying to show that you are unable to work.  While there are many variables that affect your chances of winning your claim, I have found that some factors are more important than the others. Medical treatment: One of the first things I ask potential clients is whether or not they are seeing doctors.  In order to find that you are disabled, Social Security must be able to find that you have a medically determinable impairment that affects your ability to work.   You must also have medical records that support the statements you make about how badly your symptoms affect you.  You can’t assume that the Administrative Law Judge (ALJ) at your hearing will know that you are a trustworthy person who doesn’t exaggerate.  Even if the ALJ does find that you are a credible person, he or she will still want to see objective testing (like x-rays or MRIs) and/or progress notes from your physician that back up your testimony.  The ALJ will want proof that you are being treated by doctors who specialize in your type of impairments – for example, that you are seeing an orthopedic doctor if you have degenerative disc disease, a rheumatologist if you have fibromyalgia, a psychiatrist if you have bipolar disorder, or a neurologist if you have migraine headaches.  If your doctor is willing to provide a written statement about your work-related limitations, it can also improve your chances of a favorable outcome. Age, education, and work experience: … Continued