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.


 

WHEN SHOULD I FILE FOR DISABILITY?

Why it Matters When You File

People often ask whether it matters when you file for disability.   The answer is yes.  When you file for Social Security disability, SSA will ask if your medical condition has lasted or can be expected to last for 12 months or more.   If the answer is no, your application will be denied.  Social Security provides no benefits for short term disability that lasts less than one year.  
Does that mean that you must wait 12 months from the date you become disabled to file your claim?  Absolutely not.  If you expect your condition will last at least 12 months into the future, go ahead and file for benefits.  It is in your best interest not to wait too long, for a number of reasons. 

Let's look at an example.  A worker named Joe has an injury and becomes unable to work on January 1, 2013.  Social Security has a 5 month waiting period, so the earliest he could possibly qualify for benefits would be May 1, 2013.   Social Security allows you to claim disability as far as one year before your application was filed.  But Joe is busy and he doesn't get around to filing his application until October 1, 2014.  Since benefits can only go back one year, he can only receive payment back to October 1, 2013, at the earliest.  The payments that he could have received from May to October have been lost.  This could potentially amount to thousands of dollars in benefits that can never be recovered.  

Another reason not to wait is the simple fact that claims take so long to process.  Progressing from initial application through the appeals phase to a decision can easily take 18 months or more.  Those months of waiting don't start until the initial application is filed.  The sooner you file, the sooner you can get a decision from SSA.  

Have other questions about filing for disability?   Give our local office a call today.  We will be happy to offer you our best guidance at no cost to you.  

(256) 799-0297     
Huntsville, AL office      

(615) 732-6159
Franklin, TN (Nashville) office  
 

YOUR DISABILITY 'SAFETY NET' (615) 732-6159

Losing the ability to work is one of the most frightening experiences of our lives.  Work means security, peace of mind, an assurance of being able to provide for our basic needs.  Loss of that ability can be very worrisome because most of us haven't prepared for that contingency.

Fortunately there is a "safety net" for disability that is provided by the US Government for most Americans.  It's called Social Security Disability Insurance (SSDI).  We pay for it by taxes deducted from our paychecks, matched by taxes from our employers.  Most Americans who work are covered by SSDI.

Social Security disability can pay a disabled person up to about $2,500 per month.  The actual amount is based on how long you worked and your average wages.

To receive benefits, you must prove that you are no longer able to perform full-time work due to blindness or other disability.  The disability can be from physical or mental impairments or a combination of both.

The rules for a finding of disability are rigid and complex.  70 percent of individuals who apply will be denied because they "do not meet our rules for disability."  These decisions are often made in error and go against the very purpose of Social Security disability programs.  Often, the unfavorable rulings can be reversed with appropriate appeals.

A disability advocate is a professional who is trained in the Social Security laws and regulations.  He or she knows how to evaluate a case, prepare it for appeal, and walk it through a legal process with the optimum chance of success.  An advocate or representative may not charge you a fee until you win your case and collect past due benefits.  There are no charges for office or phone consultations, advice, opinions, etc.

If you would like to explore options about a Social Security disability claim, please contact one of our offices listed below:

The Forsythe Firm                          The Forsythe Firm
Huntsville, AL                                 Nashville, TN
(256) 799-0297                            (615) 732-6159

NASHVILLE DISABILITY - YOUR SOCIAL SECURITY DISABILITY OPTIONS

We are experienced Social Security disability advocates in the Nashville area.  If you need to file for disability, appeal a decision, or just want to explore your options--please contact the Forsythe Firm for a free consultation.

For most people who can no longer work, there is a great deal of uncertainty that makes life very uncomfortable.  We understand that.  We know how important it is to get some direction and security back into your life as quickly as possible.  That's why our team is dedicated to working hard for you and doing all we can to make the Social Security system work for you.

Best of all, there is no cost to you until we win your case and put money in your account.  Peace of mind is priceless.  Stop worrying and let our professional disability advocates develop a plan to get you the income and medical care insurance that you need and have paid for.  We work in many middle Tennessee communities, such as Nashville, Franklin, Pulaski, Columbia, Spring Hill and Murfreesboro, to name a few.

The Forsythe Firm
725 Cool Springs Blvd.
Franklin, TN 37607
Phone (615) 732-6159