Social Security's normal response to a new disability claim is to investigate for 4 or 5 months, then DENY the claim. A very small percentage of claims get approved on the application level. So, a denial is to be expected--unless you are over age 50 and have a catastrophic or terminal illness.
WHY IS THIS TRUE?
1. Because of Social Security's very narrow definition of disability. You are not disabled under Social Security's rules unless you are unable to perform all (and I do mean "all") work that is available in the US economy. If you can still perform an unskilled, sedentary (minimum wage) job, you are not considered disabled.
2. Because of Social Security's exacting rules of evidence. Social Security depends primarily on medical records from doctors, not nurse practitioners, social workers, counselors, chiropractors or healthcare professionals. And they prefer records from specialists. They also want objective evidence, such as X-rays, MRIs, CT scans or laboratory tests to prove your conditions. Many claimants simply don't have the medical evidence to convince Social Security that they cannot work at any job.
3. Because Social Security is a very skeptical agency. Social Security assumes that people will lie to them in order to get benefits. So, they don't take your word for anything. When there is a gray area, and the decision about disability is not cut-and-dried, the agency will rule against you and deny the claim. Their attitude seems to be, "If we are wrong, let the judge sort it out in the appeal."
4. Because many Social Security disability claims are weak to start with. When it comes time for an appeal, I examine disability claims to see what went wrong. You'd be amazed at what I find. Here are some typical problems.
- Social Security didn't get all the medical records.
- The claimant didn't fill out all his/her forms adequately or properly.
- The claimant's doctor did not provide his/her opinion about ability to work.
- Past relevant work was mis-classified.
- The claimant's residual functional capacity (RFC) was exxagerated by Social Security.
- The decision was made by a single decision maker and was never reviewed by a Social Security doctor.
Once Social Security has made a decision not to pay benefits (a denial), the claimant is present with a wonderful new opportunity--but only for 60 days. The claimant may file an appeal and point our why the denial is in error. New evidence may be submitted, including more evidence from doctors or healthcare providers. The claimant's attorney may point out errors of law or procedure made by the state's agency (DDS) in denying the claim. Finally, the claimant gets to appear in person before an administrative law judge to re-state his or her case an get a completely new decision. All of this depends, however, on filing an appeal within 60 days of the denial letter.
YOUR DENIAL MAY HAVE MORE HOLES IN IT THAN SWISS CHEESE. BUT THERE'S ONLY ONE WAY TO FIX IT: APPEAL AND ASK FOR A HEARING.
"Won't the hearing take a long time to schedule?" Yes. It takes months to get before a judge. However, if I represent you, I will ask the judge to pay you past due benefits ("back pay") for all the months since your disability began. So, while you must wait for your money, you don't actually lose any benefits.
Can you afford legal representation? Yes. Social Security has provided that no legal fees can be charged while you wait on the outcome of your case. In fact, you can't be charged a fee at all unless you win your appeal and also collect past due benefits.
If you've been denied for disability benefits within the past 60 days, or if you have a hearing scheduled, call me for a free consultation. Let me develop a plan to win your case and get you maximum benefits. I will obtain the necessary medical records (at my expense) and prepare for your day in court. And I will do this without asking you a cent before your case is paid.
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THE FORSYTHE FIRM
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL (256) 799-0297
"Across from Bridge Street"
Having a plan or strategy is very important to winning your Social Security disability appeal.
Judges
have very limited time to spend on a case. They are required to issue
up to 700 decision a year, or over 50 per month. One case may have
thousands of pages of medical records and other documents to review.
Your attorney or representative can help the judge, and your chance of
winning, by pointing out what the judge needs to know.
- Is this claimant insured for benefits?
- What kind of past work did the claimant do?
- Does he or she meet a Listing or grid rule?
- Are there any transferable skills?
- Does the medical record support the alleged onset date? If so, where?
These are things the judge must know to decide the claim.
A
good representative will read and analyze the medical records, which
are the foundation of every case. The important evidence will be
pointed out to the judge. Are there MRIs or imaging studies to prove
the alleged impairments? Where can they be found quickly?
Do
any of the treating doctors provide an opinion on the claimant's
ability to perform work-like activities? How do these opinions limit
the claimant's residual functional capacity?
Then
we come to the claimant's testimony. It's very important that the
claimant has been prepared and knows what to expect--and how to answer.
The testimony should match up with what the doctors say in the records.
Award
rates among Social Security judges are lower now than at any time in
the past 30 years. A lot of things have to line up and make sense for
the judge.
I
always provide the judge with a pre-hearing brief. That means that I
give her a step-by-step view of the case and why the federal regulations
allow benefits to be paid. The brief condenses hundreds (or thousands)
of pages of medical evidence into 3 or 4 pages that can be read in
about five minutes. So, I try to help the judge make efficient use of
his/her time.
A
lot of times I can answer difficult or technical questions for the
judge. This can also help to get a favorable decision out more quickly.
It's
risky to walk into a hearing and just hope for the best. Those kind of
hearings often don't go well for the claimant. It's much better to
have a legal roadmap of where you want to go and how to get there.
That's worth paying the attorney/representative a fee when your case is
successful.
So,
talk to a representative early in the process. I think most people who
appoint me to represent them decide after just a few minutes that I can
add value to their case. I have to think so, too, or I won't take the
case. The best of all worlds is when the claimant and representative
work well together as a team.
______________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike NW, Site 108
Huntsville, AL 35806
"Across from Bridge Street"
CALL (256) 799-0297
https://forsythefirm.wixsite.com/website
Can Creditors Seize Your Social Security Disability Benefits?
Generally speaking, the law protects your Social Security benefits from garnishment by creditors. There are exceptions, however. The law does not protect you from the federal government itself. If you default on a federally guaranteed loan, such as a student loan, your Social Security disability benefits may be garnished to pay for the delinquent debt.
Your benefits can also be garnished to pay for child support or past due alimony. However, you must have at least $750 per month left after any garnishment.
It's a different story if you owe federal income tax. The government may seize all of your money to satisfy a tax lien.
If you receive Supplemental Security Income (SSI), these benefits are totally exempt from garnishment by anyone, including the government.
Just because your Social Security check is not subject to garnishment doesn't mean that creditors won't try to seize your money. If they get their hands on it, you probably won't get it back, even if it was taken illegally. So, take some precautions now.
The best thing to do is put all of your Social Security income into a separate bank account and put no other money into that account--not even one cent. That way, it is easy to prove that all of the money in the account came from Social Security. This makes it much, much easier to defend against garnishments and seizures. Never mix Social Security money in the same bank account with any other income or funds.
If you think that a creditor may try to seize or garnish your bank account, notify an officer of the bank (not a teller, an officer) that all of the money in your account is Social Security money and that it is exempt from garnishment. Try to do this before the garnishment is attempted. That way, the bank is aware of the protection (hopefully) and will not allow your money to be frozen or seized in the first place.
__________
THE FORSYTHE FIRM
Social Security Justice
(256) 799-0297
A recent GAO study found that if your Social Security disability case is heard by a high paying judge, you have an 88 percent chance of winning benefits, vs. a 42 percent chance if your case is heard by a low paying judge.
The study found that the average allowance rate will vary 46 percent, depending on which judge hears the case.
Of course, we who represent claimants already knew this--or pretty close to the actual numbers.
So, who decides which judge hears your case? Judges are randomly assigned at the hearing office, so neither the claimant or the attorney has any say on who the judge will be.
I am providing a link to that GAO study in case anyone is interested in reading more:
https://www.gao.gov/assets/690/689209.pdf
In a nutshell, here's what you need to qualify for Social Security disability benefits:
1. A severe medical condition that has lasted at least 12 straight months, is expected to last for 12 straight months, OR to end in death.
2. Severe restrictions of function that make it impossible for you to work at any full-time job.
Also, you must have insured status with Social Security. In other words, you must have worked long enough, and recently enough, to be covered. The general rule is: You must have worked 5 years out of the past 10 years.
2 PRECAUTIONS ABOUT USING THE INTERNET TO DETERMINE ELIGIBILITY:
It is the age of internet information. However, I'm seeing a lot of people misled because they get on Google and start researching requirements for SSDI benefits. Be careful about the following:
1. When you Google something like "Get Social Security for heart disease," you will be directed to the Social Security listings for heart disease. Almost nobody will meet one of these listings. You will come away thinking, "I don't stand a chance." Almost nobody would qualify if you had to meet a Listing. But you don't. So, these internet sites give you just enough information to discourage you.
2. No website, including mine, can analyze your personal set of facts. That's why you need to speak to an experienced disability advocate or attorney who can piece together the complete picture and advise you what to do.
You will never be charged a fee unless your case is successful. A 15 minute phone call can make all the difference. And there's no cost or obligation for making the call.
_________________
THE FORSYTHE FIRM
CALL US: (256) 799-0297
SOCIAL SECURITY JUSTICE
I
have heard some of the most intriguing stories about Social Security
disability. Many of them are full of misstatements of fact and bad
advice. The odd thing is, they all came from family members or friends
of claimants who meant well and thought they were being helpful.
Most
people don't realize that every disability case is different.
Therefore, what happened in one case may have absolutely no bearing on your case.
It doesn't matter what happened to Uncle Albert's case. I guarantee you
there was something about Uncle Albert's case that is different from
your case: age, education, work experience, medical records, treatment,
date last insured, residual functional, capacity, onset date, grid
rules, severity of symptoms--a different judge.... lots of things can be different. And these can make all the difference!
You get the idea. Get YOUR case analyzed based on YOUR set
of facts.
Probably
the best 15 minutes you ever spend will be to call an experienced
attorney or disability advocate and get some advice about your claim.
Do not depend on what a relative, friend or
co-worker tells you. They all have stories. None of them probably
apply to your particular scenario. Get a free case evaluation by
someone who sits in front of an administrative law judge several times a
week, and who knows how to apply the law to your individual and unique set of
facts.
Here's
the best part. There is no cost for doing this. Any attorney/advocate
who practices in the area of Social Security disability will provide
you with a free consultation, a free case evaluation, and free advice.
If the advocate is hired and does a lot of work on your case, of course
he or she deserves to be paid. But they only get paid if you (a) win
your case, and (b) receive past due payments as a lump sum of money, and
(c) Social Security approves of the fee payment.
___________
THE FORSYTHE FIRM
Social Security Disability Counselors
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL US: (256) 799-0297
SOCIAL SECURITY JUSTICE
Will Social Security pay a disability benefit for fibromyalgia? Yes, it may--if the symptoms are severe enough to prevent the ability to perform any substantial gainful activity. Simply said, symptoms must be severe enough to prevent any full-time work, and must be medically demonstrated.
On July 25, 2012, Social Security issued SSR 12.02(P) which recognizes fibromyalgia as a medically determinable impairment and establishing guidelines by which the disease will be evaluated for Social Security benefits.
There are really two sets of medical criteria from the American College of Rheumatology for the diagnosis of fibromyalgia. The 1990 criteria require the finding of 11 specific tender points. The 2010 criteria do not require the finding of tender points. Both criteria require that other causes of the symptoms be ruled out--because there is no specific medical test for fibromyalgia.
In short, having a diagnosis of fibromyalgia is not sufficient to get a disability benefit. A claimant must use medical evidence to demonstrate that his/her symptoms are so severe as to prohibit the performance of any "substantial gainful activity." Generally, this means that the claimant is not able to perform any full-time work which exists in the national economy.
Frankly, fibromyalgia cases are somewhat difficult to win, especially in persons under age 50. What I look for is good medical evidence from a claimant's treating rheumatologist. Then, I try to get written statements from the treating doctor which specify the work-related activities that the claimant cannot perform.
The biggest obstacle in getting any disability case approved is the lack of medical treatment. Often, we have claimants who are treated by someone other than a medical doctor (MD or DO)--and these providers are not recognized by Social Security as "acceptable medical sources." Also, we see claimants with fibromyalgia who do not see a rheumatologist, which is the specialist best equipped to diagnose and treat fibromyalgia.
RECOMMENDATINONS
If you have fibromyalgia (or suspect you do), I would make these recommendations from the viewpoint of a Social Security disability claim:
- Get examined by a rheumatologist.
- Follow prescribed treatment if you can.
- Be sure the person who treats you is either an doctor of medicine (MD) or doctor of osteopath (D.O.). A rheumatologist will certainly be one or the other. Nurse practitioners (CRNPs), however, are not acceptable medical sources with Social Security.
- Try to see your doctor regularly (at least 3 or 4 times a year) for management.
If you want to read Social Security's ruling on how they evaluate fibromyalgia for disability, I recommend you check out this link:
SSR 12-2(P) on Fibromyalgia
For questions about disability or representation help--contact us at the Forsythe Firm. (256) 799-0297.
Responding
to the severe backlog of hearings and the long wait time to get a
hearing, Social Security is now doing a large percentage of their
disability hearings by Video-Teleconference (VTC).
But do you really want to have your hearing by VTC?
You have a choice. You can opt out of video hearings, if you do so according to the rules. (More on that later).
The
major advantage of a video-teleconference is that it shortens the wait
time for a hearing. However, my research indicates that it only
shortens the wait time by 1 or 2 months. Therefore, you are waiting 20
months instead of 21 or 22 months, not a significant reduction.
What
is the approval rate of VTC hearings vs. in-person hearings? Again, my
research indicates that in-person hearings result in awards about 5
percent more often than video hearings. A 5 percent increase may not
sound like much, but it is significant.
What
if you want to opt out of a VTC and insist on an in-person hearing
where the judge is in the same room with you, not on a TV screen? Here
is the rule you must follow:
Social
Security will send you a written notice that you they may schedule a
hearing for you by Video-Teleconference. This is normally in a packet
of materials sent out a few months after you submit your appeal. Once
you receive this notice, you must object to a VTC in writing within 30
days of the date of notice. A form is sent with the notice for this
purpose.
There
may be instances where attending a hearing by video-teleconference is a
good idea. An example would be if you are in a hearing office with
very low award rates. A video hearing may give you a better chance but
there are, of course, no guarantees.
Need
help with a Social Security disability claim or appeal? Get a free
consultations and case evaluation by calling the Forsythe Firm here in
Huntsville. (We work with clients all over Alabama and middle
Tennessee).
THE FORSYTHE FIRM
Practice Limited to Social Security disability
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
(256) 799-0297
SOCIAL SECURITY JUSTICE - MORE INFORMATION
