SOCIAL SECURITY DISABILITY APPROVAL RATES - 2015

The following chart shows Social Security disability award (approval) rates at various stages of review:


 
 Award rates are down at all levels.  Here is how awards by administrative law judges (hearings) have taken a free fall since 2010.  Award rates by year:

2010    62%
2011    58%
2012    53%
2013    48%
2014    45%
2015    42%*

No one knows why the award rates bottomed out or if the free fall is over.  The usual suspects are Congressional pressure and hostile media coverage.
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2015 rates are estimated.  

HOW TO GET A FREE DISABILITY CLAIM EVALUATION NOW

The Forsythe Firm in Franklin, TN and Huntsville, AL is offering free, no obligation evaluations of Social Security disability claims.  We will evaluate your claim before you file, recommend the best approach and tell you the strengths and weaknesses of your claim.  Every claim is different.

Factors that must be considered in any claims analysis include:

1. Your age
2. Your education
3. Your past work history and experience
4. Your medical conditions - both physical and mental
5. How much medical treatment you have received and are now receiving?
6.  Do you meet a Listed Impairment (not required)?
7.  Can you qualify for a Compassionate Allowance and faster approval?
8.  Are you a disabled veteran?

How does a free case evaluation work?  First, we will speak with you on the telephone and take some basic information.  Next, we will probably set up a free office consultation at our Huntsville Office (near Bridge Street).  We will review your medical and job information and help you make a decision whether you have a viable claim for Social Security benefits.  We will not pressure you in any way.  We will explain your options, how we work, how long it will take, etc.  If you decide for us to represent you, and if we decide to take your case, you will only pay us a fee if you win your claim and collect past due benefits.  If you lose or if you collect no past due or retroactive benefits, you never pay us a dime, no matter how much we worked on your case.

You may start by telling us about your condition by answering a few simple questions on our website.  This information is confidential, to be reviewed only by one of our trained advocates or partners.  Just click the link below and answer a few basic questions.  We will contact you for more information.

Click HERE to go to our website.    Then, click on the "Tell Us About Your Claim" tab in the center of our home page.

You may also call us in Franklin, TN at (615) 732-6159 or in Huntsville, AL at (256) 799-0297.

GETTING DISABILITY - THE MEDICAL EVIDENCE

The federal regulations reserve Social Security disability benefits to individuals who an prove disability with objective medical evidence.  Generally, you must be able to provide medical records from doctors, psychologists, clinics, hospitals or other acceptable medical professionals that show.......

• the existence of impairments
• the severity of impairments
• the duration of impairments (how long symptoms have lasted)

There are two types of medical evidence.  Objective medical evidence may include imaging studies, laboratory reports, EKG, and comprehensive examinations by a qualified doctor.  Subjective medical evidence refers to opinions of professionals who have viewed the objective evidence and given a professional opinion concerning your symptoms, diseases or injuries.

It isn't enough for a claimant to allege back pain, for instance.  It isn't enough for a doctor to make a note in her chart that the patient has complained of back pain.  Most helpful would be an X-ray or MRI study showing the probable source and cause of back pain, such as a bulging or herniated disc, foraminal canal stenosis,  degenerative disc disease, etc.  Then, your doctor might offer an opinion as to how the disease (or injury) would limit your ability to sit, stand, walk, bend, crouch, crawl, lift, etc.

"It is really by demonstrating significant limitations on the ability to perform common work related activities that you qualify for disability benefits."

How severe must the limitations be?  The answer lies in the combination of several key facts:  the claimant's age, level of education and past work experience.  For most claimants under the age of 50, the impairment must prevent the ability to perform any full-time work.  The rules are somewhat less stringent for persons over age 50. For example, a claimant who is over age 55, has a limited education and past relevant work that is unskilled may only have to demonstrate that he cannot perform any of his past work.  A younger individual will likely have to prove the inability to perform any and all work which exists in the US economy.

If you are suffering from a medical condition that you feel may lead to disability, it is extremely important to get prompt medical attention, continue to see your doctor(s) regularly and try to follow the recommended treatment plan. It is also important to tell the doctor(s) about all your symptoms and explain any problems you are having with such things as prolonged sitting, standing, walking, bending, lifting, concentration, fatigue....etc. 

 

UNDERSTANDING SOCIAL SECURITY'S DEFINITION OF "WORK" - ANSWERING THE QUESTION "CAN I WORK?"

Is there work that you are able to do?  If so, you are probably not disabled under Social Security rules.  So, let's consider what Social Security means by the term 'work.'

Work refers to the ability to sustain work activity for 8 hours a day, 5 days per week, or an equivalent schedule.  Anything less than that is not work under Social Security rules.

You are unable to work, for example, if you can......

• work 5 or 6 hours a day but not 8 hours
• work 3 or 4 days a week but not 5 days
• work part-time but not full-time
• work for a few weeks but then have to miss several days due to a flareup
• work for several months but then have to miss a month or two due to illness on a persistent, regular basis
• report to work 5 days a week but have to leave early several times a month because of illness, pain, depression, etc.
• work most days but often have to come in late due to sickness
• work most days but will be absent 3 or more days per month due to illness.

So, the real issue with Social Security is this:  Are you able to work full-time, 8 hours a day, 5 days a week, 52 weeks a year--without missing more than 1 or 2 days per month on a persistent basis?  In other words, can you sustain full time work?  If the answer is no, you are disabled.

Keep in mind that there are many different kinds of work, ranging from very easy work to very difficult work.  Social Security classifies work by its exertion requirement--from sedentary (sitting) to very heavy (lifting 100 pounds or more).  Work is also classified by the skill level required to perform the work:  unskilled, semi-skilled or skilled.

Therefore, it's very difficult to speak of "work" without asking, "What kind of work?"  You may be unable to do some kinds of work but able to do other kinds of work.  Individuals under the age of 50 generally must prove that they cannot perform ANY work available in the national economy.  Persons over the age of 50 may be only be required to show that they are unable to perform their past relevant work (work they performed during the past 15 years).

Other factors that will enter into a decision about your ability to work will include:  education, past work experience, your residual function capacity, and as we just mentioned, your age.

WHAT IS A "PARTIALLY FAVORABLE" SOCIAL SECURITY DECISION?

You attended a hearing on your Social Security disability claim.  A few weeks later, you receive a Notice of Decision in the mail that says you have received a Partially Favorable decision.  Does this mean that you are only partially disabled, not fully disabled?

ANSWER:  No.  Social Security does not make awards for partial disability.  You are either disabled or not disabled.  There is no such category as "partially disabled" within Social Security law.

A "partially favorable" decision means that the administrative law judge has found you to be disabled.  However, he or she has changed some material fact in your application.  Most often, this change involves the established onset date--the date you were found to have become disabled.  For example, in your application you may have alleged that you became disabled on June 1, 2012.  After reviewing the facts of the case, the judge may have decided that you did not become disabled until September 1, 2012.  Therefore, he will amended the onset date to September 1, a material change in the application. 

This change will affect the amount of your back pay.  In short, you will not be paid for the months June - August, 2012, a loss of 3 months of  benefits.The amount of your monthly benefit will not be affected.  You are still considered disabled, but for not as long a period as you originally claimed.  Since you lost part of your period of disability, thus part of your back pay, the decision is partially favorable.  In other words, it is not as favorable to you as it would have been if the judge had found that you became disabled in June instead of September.

I often encounter well meaning public officials who believe that a "partially favorable" decision means that the claimant is only "partially disabled."  This is not the case because, as I have said, Social Security never makes any award for a "partial disability."  You are either disabled or you are not disabled - nothing in between.  The date on which you became disabled is an example of why a decision might be "partially favorable.:"

The confusion is complicated by the fact that some agencies, such as the Veterans Administration, do make partial disability awards.  A VA claim decision may find that a veteran is 50 percent disabled, or 80 percent disabled, for example.  However, Social Security will never make such an award.  With Social Security, it is all or none.

SOCIAL SECURITY DISABILITY: WHAT YOU WISH YOU HAD KNOWN

You Must File a Timely Application.  You must apply for Social Security disability benefits within 5 years after you stop working.  Your insured status will expire, making a new claim impossible.  If there are gaps in your work history, you may have even less time to file a new claim.  Don't wait too long to file after you stop working.

You Must Have Enough Quarters of Work.  You become an insured person under the Social Security Act by working and paying FICA taxes.  Most adults need 20 quarters of work to be covered.  These 20 quarters generally must have been accumulated within the most recent 10 year period prior to filing a claim.  Very young individuals might need less than 20 quarters of work.

Your Disabling Condition Must Last At Least 12 Months.  Short term disability lasting less than 12 consecutive months is not covered by Social Security.  You must have an impairment that has lasted, or can be reasonably expected to last at least 12 months.

You Cannot Be Working When You Apply.  You may not be working at "substantial gainful activity" during the period you wish to receive disability benefits.  In 2015, Social Security classifies substantial gainful activity as earnings/wages of at least $1,090 per month.

You Must Have Medical Treatment.  Under Social Security regulations, a disabling impairment must be medically determinable.  Medical records must be available to support the impairment.  Medical treatment should be consistent and recent.

You Cannot Depend on a Social Security Doctor's Examination.  Social Security may send you to a doctor with whom they contract to perform an examination.  This exam will be brief and superficial.  In our experience, these exams fail to help the claimant 99% of the time.  Social Security will use this exam to deny your claim.

You Need Support From Your Own Doctor.  According to Social Security regulations, much weight will be given to opinions of your own treating doctor(s).  Your doctor should provide support and this includes more than just routine medical records. Try to get your doctor to provide you with a Medical Source Statement that lists your functional limitations, such as restrictions in sitting, standing, lifting, bending, kneeling, etc.  Mental restrictions, such as concentration and memory, should also be documented.

You May Need To Be Examined By a Specialist.  20 CFR 404.1527 provides that extra consideration may be given to a doctor who is a specialist practicing in his/her field of medicine.  For instance, if you have a bad back you may need an orthopedic specialist.  For arthritis or fibromyalgia, you would need to consult a rheumatologist.

You Must File An Appeal Within 60 Days If You Are Denied.  Only about 30 percent of applications are approved by Social Security at the initial level.  The other 70 percent must be appealed.  The 60 day deadline is absolute.  If you do not appeal within the 60 days your claim dies and there is no appeal.  Do not wait on medical evidence or anything else.  File your appeal immediately, then work on whatever needs to be done to shore up the case.

Most Appeals Are Handled By a Professional Disability Advocate or Attorney.  Social Security appeals comprise a highly specialized field and require knowledge, skill and experience.  Contact a professional advocate, such as the Forsythe Firm, to help you with the appeal.  We offer free claims evaluation and never charge a fee unless you win.  We will also help insure that you receive maximum benefits, including back payments.

VETERANS MAY GET EXPEDITED PAYMENTS

Veterans may get expedited claim processing for Social Security disability benefits.

To get expedited processing, veterans must self identify and have a 100 percent permanent disability rating from the Veterans Administration.

By "self identify," we mean that the veteran must inform Social Security of their 100 percent VA disability rating at the time the application is filed.  We recommend sending a copy of both your DD-214 form and your VA awards letter that shows the percentage of disability award.

Does a 100% VA disability award guarantee approval of Social Security benefits?  No.  While a VA award does not automatically qualify for Social Security disability benefits, it does qualify for a much faster processing time--that is, a much quicker answer.  And, since the VA disability evaluation is similar to the Social Security evaluation process, the VA award can work in your favor.

If a vet receives Social Security disability benefits, will it reduce the VA benefits?  No.  Veterans paid into the Social Security trust fund during their military careers and may be entitled to Social Security benefits in addition to VA benefits.

What about veterans with a less than 100% VA award?  May they still be eligible for Social Security disability benefits?  Yes, of course.  

What if a veteran is not able to perform military duties but is still on active duty and is receiving full military pay?  He or she may still be eligible for Social Security disability benefits.  The key issue is whether or not the individual is able to perform the job, not whether he or she is receiving military pay.  Thus, a veteran should apply immediately for Social Security disability and not wait for a discharge from military duty, which would waste unnecessary time and lose benefits.

The Forsythe Firm is honored to review disability cases for veterans and help them decide the best course of action to receive Social Security disability benefits.  Consultations are absolutely without cost or obligation.  We only charge a fee if we represent you, win your case, and also recover past due or retroactive benefits (in a lump sum).  Please contact Charles Forsythe in Huntsville at (256) 799-0297.

Our office is located at the intersection of Old Madison Pike and Governors West directly in front of the Bridge Street Town Centre, near Arsenal Gate 2.