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February 23, 2017

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

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October 7, 2015

Can I Receive Social Security Disability Payments For Fibromyalgia?

The short answer is yes, you can receive Social Security disability benefits if you have fibromyalgia.  In my experience, though, you may face some obstacles along the way.  Although doctors have been diagnosing fibromyalgia for many years, it was not until 2012 that the Social Security Administration (SSA) issued guidelines addressing fibromyalgia as a disabling condition in policy ruling SSR 12-2p. While SSR 12-2p requires that a diagnosis of fibromyalgia be made by a licensed physician, it has been my experience that having a diagnosis from a rheumatologist greatly improves the likelihood that the SSA will accept that diagnosis as valid.  As with any type of impairment, Social Security gives greater weight to the diagnoses and clinical findings of a physician who specializes in treating your disabling condition. SSR 12-2p states that a diagnosis of fibromyalgia alone is not sufficient proof of a disabling condition.  Social Security will review the doctor’s treatment notes to make sure that the doctor’s clinical findings and treatment notes over time show that your physical strength and functional abilities are limited enough to be disabling.  A short summary of the criteria the SSA considers in determining whether your diagnosis of fibromyalgia is disabling includes: 1.  A history of widespread pain that has persisted for at least three months 2.  At least one of the following: a.  At least eleven positive tender points on examination b.  Repeated manifestation of at least six fibromyalgia signs or co-occurring conditions, especially fatigue, cognitive or memory problems, waking unrefreshed, depression, anxiety disorder, or irritable bowel syndrome 3.  Evidence ruling out other disorders that could cause these symptoms If you have fibromyalgia, you probably know that this short summary cannot begin to convey how completely your symptoms affect your life.  The pain you experience on a daily basis and the other … Continued

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March 28, 2014

Expedited Social Security Disability Hearings for Veterans

“Starting March 17, 2014, veterans who have a VA compensation rating of 100% permanent and total (P&T) may receive expedited processing of applications for Social Security disability benefits.” This is a direct quote from the Social Security Administration’s website. This is great news for 100% disabled veterans.  In my Indiana law office, we have already seen the results of this rule.  Social Security has called us to schedule expedited hearings for several of my clients who are disabled veterans, in some cases cutting months off of their expected waiting time for their hearings. Unfortunately, I have had to explain to my clients that just because the VA has assigned them a disability rating of 100% permanent and total, it does not mean that Social Security is required to find them disabled as well.  The Veteran’s Administration and Social Security have different rules and different definitions of disability, so they do not always reach the same conclusion after evaluating the same person.  While your VA disability rating letter is important evidence in your Social Security disability claim, it does not guarantee you will be found disabled.  The only advantage this rule gives to veterans with a 100% VA rating is a faster processing time for their claims. There are a few ways to apply for Social Security Disability benefits: Complete your application online. Call the Social Security Administration at 1-800-772-1213 (TTY 1-800-325-0778 for deaf or hard of hearing). Call or visit your local Social Security Administration office. If you want to apply in person, it is best to call beforehand to schedule an appointment. To receive the expedited hearing: Identify yourself as a “veteran rated 100% P&T” If you apply in person or over the phone, inform the Social Security representative that you have a veteran rating of 100% P&T. If … Continued

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January 23, 2014

Back Pain and Social Security Disability Benefits

In my Indianapolis Social Security disability practice, most of my clients include back pain as an impairment that keeps them from working.  If you have ever suffered from back pain, you may understand why these individuals claim they are simply in too much pain to perform even the most simple tasks.  You can receive disability benefits for back pain, but it will take more than simply claiming that your back hurts.  In my experience, you are going to need medical records that support your claim.  In this blog I will describe what I find helpful in proving your case. Objective testing – Tests such as MRIs and x-rays can show the severity of your condition.  In my experience these tests, especially MRIs, can make a big difference in proving that your pain is caused by a severe medical impairment.  Some findings that indicate severe impairments include nerve root impingement and severe stenosis. Medical procedures –  What are you doing to try to resolve the problem?  If you are not receiving treatment for your back pain, or if you are resisting the treatment options presented by your doctor, Social Security may conclude that your pain does not bother you that much.  Some of the procedures doctors recommend for back pain include surgery, injections, and physical therapy. Medical source statements –  Sometimes winning your disability claim requires an extra push and some support from your medical provider.  My office strives to get our client’s treating physicians to complete medical source statements.  These statements include Physical Residual Functional Capacity Assessments and questionnaires regarding whether you meet or equal Social Security’s Listing of Impairments as described below. One of the ways Social Security can find you disabled is if you meet or equal its Listing of Impairments.  Listing 1.04 details how an individual can … Continued

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January 13, 2014

Medical Records and Being Prepared For Your Social Security Disability Hearing

In my practice as an Indianapolis Social Security disability attorney, I find that good communication is essential for me to provide the best possible representation for my clients.  My office takes pride in responding promptly and attentively to our clients’ calls, emails, and letters.  However, I am often surprised by clients who do not hold up their end of the deal!  My office mails several types of forms to our clients to help us collect the information we need to build a good case, and when clients do not return those forms promptly, it can really hurt our ability to prepare for their hearings. One of my office’s most important jobs in preparing for your hearing is submitting medical records that show the nature and extent of your disabilities.  We strive to work quickly and efficiently to request, follow up, and submit your medical records, but we cannot do any of those things unless you tell us where you have been receiving treatment.  As soon as we know when your hearing is scheduled, we will ask you to provide a complete list of your medical providers.  It can take weeks – sometimes over a month – for medical offices to process our requests for records, so if you wait to give us this information until a few days before your hearing, we probably won’t have all of your records submitted before the hearing is held. In my opinion, not having complete medical records available at your hearing will put you at a distinct disadvantage.  First, most of the Administrative Law Judges (ALJs) who decide Social Security disability appeals review the claimant’s file before the hearing.  The ALJ wants to know if you have been receiving consistent treatment, if you have been hospitalized for your condition, and if you have had any surgeries or other invasive treatments.  In short, the ALJ wants to make sure that your medical records provide objective evidence to support your … Continued

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January 9, 2014

Is Chronic Pain Syndrome Recognized as a Qualifying Disability?

Even though the Social Security Administration’s (SSA) listing of impairments is relatively long, chronic pain syndrome is not specifically listed. But this does not mean that you cannot receive Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) for your condition.   The SSA’s listing of impairments is very detailed and has listings for most health issues. There are a handful of listings that might be related to your back pain.  They may include but are not limited to: 1.00 Musculoskeletal System 5.00 Digestive System 11.00 Neurological 12.00 Mental Disorders 14.00 Immune System Disorders If you have chronic pain due to any of the conditions on the SSA’s listing of impairments, it is possible that the SSA will approve your claim in the initial application or the reconsideration stages.  However, this is rarely the case.  It is normal for a claim to go all the way to the hearing stage, which usually takes about a year. In my experience, to have the best possible chance at winning your disability claim, you need to have as thorough and up to date medical records as possible.  No matter how severe your chronic back pain is, it does not qualify by itself for Social Security Disability benefits.  We must prove to the judge that even though you do not meet listing exactly, your limited functionality keeps you from working a normal eight hour per day job.   If your case does meet a listing exactly, we must prove that you have a “residual functioning capacity ” (RFC) low enough that you cannot work a normal eight hour job.  In determining your RFC the Social Security Administration may look at a few things including but not limited to: Sitting, standing, and walking limitations Lifting and carrying limitations Postural limitations Limitations of manipulation of your hands If you have … Continued

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January 8, 2014

Can I Receive Social Security Disability Benefits for Autism?

In my Indiana Social Security disability practice I am seeing a growing number of cases involving autism. Autism is a developmental disorder that is usually diagnosed within the first three years of a person’s life. It mainly hinders an individual’s communication and social interaction skills. Both children and adults can receive Social Security disability benefits for autism. Autism is diagnosed based on the patient’s behavior. According to many medical sources an individual must display at least six symptoms to be diagnosed as autistic. Of these six symptoms two must be impairments in social interaction, one must be an impairment in communication, and one must be restricted and repetitive behavior. Some examples of these symptoms include: not making friends with children of the same age, problems starting or participating in conversations, and insisting on always taking the same route to a destination. Autism is classified as a pervasive developmental disorder (PDD). Autism and other PDDs are defined by irregular social interactions and communication as well as very limited interests and highly repetitive behavior. PDDs are not characterized by any emotional problems, sickness, or fragility. Social Security defines adult autism in its Listing of Impairments under section 12.10 – Autistic Disorder and Other Pervasive Developmental Disorders. The Social Security Administration (SSA) requires two types of evidence to show that a claimant meets this listing. First, the claimant must demonstrate medical findings to support his or her diagnosis. Second, the claimant must show a certain level of impairment in functioning. Below is the listing for adult autism from the SSA’s Listing of Impairments. Medically documented findings of all of the following: Qualitative deficits in reciprocal social interaction Qualitative deficits in verbal and nonverbal communication and in imaginative activity Markedly restricted repertoire of activities and interests Resulting in at least two of the following: … Continued

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January 7, 2014

Is the Social Security Administration Helping Me With My Disability Claim?

If you have applied for SSDI (Social Security Disability Insurance) or SSI (Supplemental Security Income) I think it is a good idea to ask yourself whether you are receiving enough help from the Social Security Administration as your claim progresses.  There can be many frustrating and confusing areas of Social Security disability law that the Social Security Administration (SSA) may or may not help you with.  Many claimants in Indiana and nationwide do not realize they can hire an attorney or representative to answer many of their questions, help them with paperwork, and provide legal representation at their hearings on a contingency basis.  What are some ways an attorney can help to make the Social Security disability appeals process easier for you? Filing paperwork on a timely basis – There are certain deadlines in Social Security disability cases, and while the SSA may notify you about these time constraints, they are probably not going to help you make sure that you meet them.  An attorney or representative can help identify your limited time to appeal your claim and help you make sure you provide all the information the SSA has requested by the filing deadlines. Providing timely responses to your questions – Unfortunately for disability claimants SSA staff members are very busy.  Social Security’s reduced hours and limited staff make it difficult for many claimants to receive a timely response to their questions or to even get a chance to speak to a field office worker.  Have you ever sat on hold with a Social Security office for a very long time just to ask a very simple question?  My staff and I strive to respond to our clients in a timely manner in order to answer questions they may have regarding their claim.  We also follow up regularly with the … Continued

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January 3, 2014

Social Security Disability Benefits for Children with Disabilities

Social Security’s process for evaluating children with disabilities is a little different than its process for evaluating adults. However, building a successful case for either an adult or a child requires the same elements: a solid history of consistent medical treatment, strong evidence of difficulties in daily functioning, and lots of patience. Raising a disabled child can be expensive. Between medical treatment, prescriptions, and specialized education, footing all the bills can be difficult. You may be having difficulty holding a job because caring for your child causes you to miss a lot of work. If you have a disabled child and are struggling to pay bills, you may want to look into applying for disability for your child. Disabled children typically qualify for benefits under SSI (Supplemental Security Income). SSI is a needs-based program; Social Security will ask you about your household income and resources to determine whether you meet their financial guidelines. Once Social Security determines that a child’s household meets its financial criteria, it considers whether the child’s impairments meet Social Security’s definition of disability. A child may be found disabled due to physical conditions (such as asthma, diabetes, epilepsy, or heart defects), mental conditions (such as ADHD, autism, Tourette’s syndrome, or depression), or a combination of physical and mental impairments. The Social Security Administration (SSA) will first look to see if you child’s disability meets a listing in its Listing of Impairments – Children. If your child does not meet the specific criteria of a listing, Social Security will then evaluate whether he or she “functionally equals the Listings.” To do so, the SSA looks at your child’s ability to function in six different domains. “Domains” are broad areas of functioning used to evaluate whether your child can function at an age-appropriate level in all aspects of … Continued

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December 26, 2013

Chronic Obstructive Pulmonary Disease (COPD) and Social Security Disability Benefits

Does a breathing disorder keep you from working a full time job? It is possible to receive Social Security Disability benefits for Chronic Obstructive Pulmonary Disease (COPD) and other breathing disorders. With a well-documented medical history that shows how your COPD affects your ability to work, a good claim can be made for Social Security Disability benefits. COPD is an obstructive lung disease that is characterized by very poor airflow. Many people who suffer from COPD have emphysema or chronic bronchitis. Currently there is no cure for COPD, and unfortunately studies show that it usually worsens over time. Most treatments for COPD aim to stop the progression of the disease, not to cure it. It is important that individuals with COPD do not contract any other lung or airway condition, as these can be very detrimental to your health. The most common symptoms of COPD include sputum (mucus) production, coughing, and shortness of breath. COPD can be caused by: Smoking Air Pollution Occupational Exposures Dust Chemicals Fumes Genetics To diagnose your COPD, your doctor will most likely look at your past medical history, record your symptoms, and conduct some lung function tests. The Social Security Administration appreciates a thorough medical history with well documented diagnoses. As part of the application process, Social Security may send you for a pulmonary function test to measure the effect of your COPD on your breathing capacity. Chronic Obstructive Pulmonary Disease is classified in the Listing of Impairments under section 3.00 – Respiratory System. COPD falls under section 3.02 – Chronic Pulmonary Insufficiency. In this section there are a few tests that look at lung force and volume. The results will depend on your height, but if your pulmonary function testing falls within certain ranges, you may be eligible for Social Security Disability benefits. Even … Continued

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