Social Security Disability benefits recipients (SSDI and SSI benefits receipients) are getting a raise in 2013

Some good news for recipients of Social Security Disability benefits (SSDI and SSI): The Social Security Administration announced that all beneficiaries will get a 1.7 percent increase to account for higher costs of living.  This pay increase is known as COLA ("cost of living adjustment").  The pay raise will take effect on December 31, 2012. 

For more information visit: http://www.socialsecurity.gov/pressoffice/factsheets/colafacts2013.htm

When will the Administrative Law Judge hearing my Social Security Disability case tell me that my case is approved?

One of the more frequently asked questions from my clients is – “Will the Administrative Law Judge tell me that my Social Security Disability (SSDI or SSI) case is approved at the hearing?”  Unfortunately, this is not a question I can answer until the end of the hearing for my client's Social Security Disability claim.  Some Administrative Law Judges will tell you at the end of your hearing that they are going to approve your Social Security Disability case.  Many will not.  If an Administrative Law Judge does not indicate that they are going to approve your case, you will have to wait to receive the decision.  In my practice this means waiting anywhere from 2 weeks to 4 months.  It is important to note that just because the Judge does not approve you for Social Security Disability benefits at the hearing does not mean that he/she will deny your claim.  There are some Judges that never approve cases verbally at the hearing.  There are also some Judges that will approve some cases at the hearing and some cases after the hearing.

If you are represented by an attorney at the hearing that is experienced in handling Social Security Disability cases, they can often give you some indication as to how they believe the judge will rule.  This is however just an educated guess as it is impossible to predict with complete certainty the way a judge will rule on your particular case - unless, of course, they state their decision at the hearing on the record.

This is NOT legal advice. This blog provides general information about Social Security Disability cases. To discuss your particular circumstances and claim, please contact a lawyer in your area.

How will drug and/or alcohol addiction affect my Social Security Disability case?

A common question I get asked by my clients is how alcohol or drug addiction can impact their application for Social Security Disability (SSD) benefits. Alcohol or drug dependence is a major issue facing millions of Americans. For some, alcohol or drug addiction, itself, can be debilitating to the point of creating a disability. For others, alcohol or drugs can lead to other medical problems (such as liver disease) which, in turn, can cause disability. For still others, alcohol or drug dependence can be a part of a disabling mental illness such as depression or anxiety. In this post I will review how the Social Security Administration (SSA) approaches drug addiction when evaluating claims for SSD benefits. I will do this by separately addressing three different scenarios in which alcohol or drug addiction may play a role in creating a disability.

Can you receive Social Security Disability benefits solely based on your addiction to drugs and/or alcohol?
No. While, alcohol or drug addiction, itself, can certainly disable people to the point of preventing normal functioning and the ability to work, the SSA will not grant SSD benefits solely based on an addiction to drugs and/or alcohol. This policy is due to the Right To Work Act. Through this law, enacted in 1996, Congress eliminated alcoholism (and drug addiction) as a basis for obtaining Social Security Disability benefits. So does that mean that drug or alcohol addiction will prevent you from getting SSDI benefits? This is where things get a little more complicated.

If you are addicted to drugs and/or alcohol, can you still receive Social Security Disability benefits?
The answer to this question is that it depends. While the Right to Work Act prevents the SSA from granting SSDI benefits specifically for alcohol or drug dependence, it does not necessarily disqualify people with other disabilities from receiving SSD benefits just because they are also addicted to drugs or alcohol. In other words, the SSA is not supposed to penalize you for being addicted to drugs or alcohol.

If the Social Security Administration determines that you are addicted to drugs and/or alcohol, they must determine whether the drug addiction or alcoholism significantly contributes to your disability. To determine this, SSA will first consider whether all of your other medical conditions qualify you as disabled per their guidelines. If SSA determines that you are, indeed, disabled based on your medical condition(s), the next step is to determine whether you would still be disabled if you stopped using drugs and/or alcohol. If SSA determines that you would not be disabled once you stopped using drugs or alcohol, then SSA will determine that you are not disabled and not eligible for SSD benefits. If SSA determines that you would still be disabled even if you stopped using drugs and/or alcohol, then they will award you Social Security Disability benefits. For example, lets suppose that you suffer from both depression and alcohol addiction. If you can demonstrate that you would be disabled from depression even if you overcame your alcohol dependence, the SSA would grant you SSDI benefits.

My use of alcohol and/or drugs caused a disabling medical condition. Can I receive Social Security Disability benefits for this condition?
If your disability was caused by alcohol and/or drugs, the SSA will first determine whether you are disabled per Social Security’s regulations using the same method as discussed above. That means if you would still be disabled if you stopped using drugs and/or alcohol then you will be considered disabled and would be awarded SSD benefits. For example, lets suppose that you developed alcoholic cirrhosis of the liver from an alcohol addiction and this condition has disabled you. When you apply for SSD benefits, SSA will first determine whether the cirrhosis is severe enough to classify you as disabled. If you are deemed disabled, SSA will then determine if the disability caused by the cirrhosis would persist if you were to stop drinking. If they determine that your cirrhosis is advanced to the point that the disability it causes cannot be reversed even if you stop drinking, you will be granted SSD benefits.

Take Home Message
While alcohol and drug dependence, in and of itself, does not qualify you for SSD benefits, it also does not preclude you from these benefits. To be eligible for SSDI benefits, you must demonstrate that your medical condition disables you independent of any concurrent drug or alcohol dependence. It is also important to note that while this is the process for determining whether a claimant is eligible for SSD benefits if he/she is addicted to drugs and/or alcohol, in reality many judges do not like to see that a claimant is addicted to drugs and/or alcohol in the time period they are applying for SSD benefits. If you do have medical records which state that you are addicted to drugs and/or alcohol, you should consult with an attorney experienced in Social Security Disability regarding your particular claim.

This is NOT legal advice. This blog provides general information about Social Security Disability cases. To discuss your particular circumstances and claim, please contact a lawyer in your area.

Does depression qualify you for Social Security Disability benefits?

Depression is one of the most common mental disorders affecting people in the United States. One recent study estimated that nearly 15 million Americans suffer from Major Depressive Disorder or clinical depression. That means that nearly 7% of Americans aged 18 and older are affected by depression during any given year. While most people can overcome the condition through therapy and/or medical treatment, many Americans are disabled by depression. In fact, according to the World Health Organization, depression is the leading cause of disability for Americans aged 15-44. So what can you do if depression had disabled you to the point that you are no longer able to work? For many, the answer is Social Security Disability benefits (SSD) – either Social Security Disability Insurance benefits (SSDI) or Supplemental Security Income (SSI). Social Security Disability benefits can provide a financial lifeline for those disabled by depression. However, not all people suffering from depression qualify for SSD benefits. In this post, I will review the criteria necessary to meet a medical listing for depression and, thus, qualify for SSDI benefits. It is important to note that you can still qualify for SSD benefits even if your depression does not meet the level of the medical listing. In that case you will have to demonstrate that your depression (and any other medical conditions) would prevent you from sustaining full time work – 8 hours a day, 5 days a week.

Medical Listing

 

As I mentioned in the post, a medical listing is a collection of medical criteria created by SSA. If your condition meets the criteria in the medical listing, you will meet the medical requirements necessary for receiving Social Security Disability benefits. In the case of depression, meeting a medical listing requires fulfilling two conditions. Lets look at these two requirements separately.

Condition 1: Does your condition meet the criteria for Depressive Syndrome?

 

When you apply for SSD benefits because of depression, the first step the SSA will take to determine if you meet the medical listing is to determine if your condition actually qualifies as a true Depressive Syndrome. After all, there is a big difference between just being depressed and having clinical Depression. The SSA provides very specific criteria to determine whether your condition qualifies. According to the SSA, a Depressive Syndrome is a medically documented condition (which is either constantly present or is intermittent) with at least four of the following characteristics:

1. Anhedonia: a persistent loss of interest in nearly all activities.
2. Loss of appetite with change in weight
3. Sleep disturbances: either lack of sleep or too much sleep
4. Psychomotor agitation or retardation:
1. Psychomotor agitation is characterized by repeated purposeless and unintentional activities that seem to stem from some sort of mental tension or disturbance. Examples of these include wringing hands repeatedly or pacing. 
2. Psychomotor retardation is the noticeable slowdown of physical or mental activity also due to some mental disturbance.
5. Decreased energy 
6. Feelings of guilt or worthlessness
7. Difficulty with concentration or thinking
8. Thoughts of suicide
9. Hallucination, delusions, or paranoid thinking: seeing visions, hearing voices, thinking that people are plotting against you, etc.

 Condition 2: Does your condition cause severe functional limitations?

 The second consideration is whether your condition is severe enough to limit you from working. You can satisfy this guideline in one of two ways:

  

1. Demonstrate that the condition is significantly limiting your ability to function by meeting two of the following criteria:

a. Marked restriction of activities of daily living: these are the activities that people do on a daily basis that allow them to independently live their lives. These activities include grooming and hygiene, using a telephone, cleaning your home, paying bills, and using public transportation. In evaluating your ability to perform activities of daily living, the SSA will also determine the extent to which you can perform them. In other words, the SSA will determine if you can perform these activities independently, appropriately, effectively, and for extended periods of time. Through this evaluation, the SSA will determine the extent to which your condition limits your ability to function on a daily basis.

b. Marked difficulties in maintaining social functioning: this describes your ability to interact effectively with other people. To determine this, the SSA will look for any history of altercations, evictions, termination of employment, avoidance of relationships and other signs that your condition prevents you from establishing and maintaining social interactions and relationships necessary for a functional role in both the workplace and society.

c. Marked difficulties in maintaining concentration, persistence, or pace: this describes the ability to maintain enough concentration to successfully complete tasks commonly performed in the workplace. Such limitations are usually demonstrated through psychological testing (mental status examination), prior work evaluations or both.

d. Repeated episodes of decompensation, each of extended duration: this describes periods of exacerbation in which your depression becomes so severe that you experience the marked functional limitations described above. These periods of decompensation are usually identified in the medical record as times when medications or treatments need to be significantly altered and/or documentation is present expressing the need for a more structured psychological support system (hospitalization, for example). The SSA defines the “repeated episodes of decompensation, each of extended duration” as three periods within 1 year (or an average of once every 4 months) , each lasting for at least 2 weeks.

 OR

  

2. Demonstrate a medically documented history of depression that has lasted at least 2 years and caused more than a minimal limitation of ability to do basic work and that is currently controlled with medication or therapy but demonstrates 1 of the following:

a. Repeated episodes of decompensation, each of extended duration: see 1d, above.

b. The condition is so unstable that even a minimal increase in mental demand or a change in environment would predictably lead to a decompensation.

c. A history of 1 year or more in which the condition leads to an inability to function outside a “highly supportive living arrangement”: the condition only allows you to be functional in very select living environments such as a psychiatric hospital, halfway house, or a highly structured household.

  

The Importance of Documentation

  

In previous posts, I have mentioned the importance of documentation in submitting a claim for SSD benefits. While documentation is important for SSD claims for physical disabilities, it is even more vital for claims based on mental disabilities like depression. For physical disabilities, most documentation needs to come from the notes of a treating physician, imaging studies, and labs. For SSD claims based on mental disability due to conditions such as depression, however, the medical record is only part of the documentation necessary. While results of psychological testing and the impression of a medical professional are important, information from non-medical sources are also critical to a successful claim. For example, information from the claimant himself, family members, friends, and coworkers can substantially supplement the record and verify the findings of the medical record. Equally important is to present this evidence from various sources over as long a period of time as possible. Such longitudinal evidence will better establish the severity and extent of your functional impairment. Much of this information needs to be properly and effectively presented in the initial application. Many of my clients have come to me after being rejected for an SSD claim despite actually meeting a medical listing for depression solely because they did not include all the appropriate evidence in their applications. As I mentioned before, including all the appropriate evidence from the beginning can mean the difference between receiving SSD benefits and dealing with a frustrating rejection from the SSA. If you are not sure what to include in your application, seek the assistance of a knowledgeable, experienced attorney in your area.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

How long do I have to wait for a hearing before an Administrative Law Judge?

One of the most often asked questions I receive in my practice is: “How long do I have to wait until I get my hearing date with the ALJ?”  The answer I have for my clients isn’t one they usually like: “it may be a long time.”  In truth, the amount of time you have to wait for a hearing depends on the hearing office handling your Social Security Disability claim.  This links provides information regarding the average wait time per each hearing office. http://www.ssa.gov/appeals/DataSets/01_NetStat_Report.html   It is important to note that these time frames apply to the amount of time from the filing of a Request for Hearing until you go before an ALJ.  This timeframe does not include the time in which it takes the Social Security Administration to decide your initial claim and your request for reconsideration.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

What happens if my medical condition does not meet a medical listing?

A few weeks ago, I posted a blog article about the medical listings for back impairments. As I mentioned in the post, a medical listing is a collection of medical criteria that need to be met and documented in order for the Social Security Administration (SSA) to deem you disabled from a medical standpoint and grant you Social Security Disability (SSD) benefits (either Social Security Disability Insurance Benefits or Supplemental Security Income benefits). But what if your medical condition does not meet all of the criteria necessary for a medical listing but still prevents you from performing your existing job or finding new employment? Don’t worry, all is not lost. In this post I will explain how you can still qualify for SSDI benefits even if your condition does not qualify for a medical listing.

Meeting a medical listing is not the only way to prove that you are disabled per SSA regulations. Many people applying and obtaining SSD benefits do not meet a medical listing. As I discussed in a previous article, if your condition does not meet a medical listing, you can still prove that you are disabled by demonstrating that you are both unable to work at your previous job(s) or at any other jobs on a full time sustained basis.

If you do not meet a medical listing, the SSA will assess your Residual Functional Capacity (RFC). Simply put, an RFC is a determination of what you can still do despite your medical condition. In basic terms, the SSA will determine if you are still capable of performing heavy, medium, light, or sedentary work. This determination will be based on a medical opinion about your physical restrictions. At this point, your treating physician’s opinion is crucial because you want to present the most compelling evidence possible demonstrating your ability (or inability) to perform certain work functions. As such, documentation by your physician can be the difference between getting approved or denied SSD benefits.

As I mentioned, the RFC will determine the extent of physical and mental exertion that you can still take on in the context of your medical condition and/or disability. However, a given RFC may prevent you from doing one type of job but not another. For example, an RFC that restricts you to sedentary work may qualify you for SSD if you were a trained lumberjack but may not qualify you for benefits if you were a data entry clerk. As such, once the SSA determines your RFC, they will then look at your past relevant work. Employing the expertise of vocational experts, the SSA will then determine if your RFC will allow you to continue performing your usual job activities. If the SSA determines that your RFC does not preclude you from performing this past relevant work, then your application for SSDI benefits will be denied.

Conversely, if you are not capable of performing your past relevant work with this RFC, the SSA will move on to the next step of determining whether, given your age, education, and past work experience you would be capable of performing other work. For example, if you are a lumber jack but your RFC limits you to sedentary work, the SSA will determine if you can perform a sedentary job like that of a data entry clerk. This determination, as I previously mentioned, is made based on how old you are, what level of schooling or training you completed, your education background, and your past work. If the evaluation then determines that this combination of factors prevents you from performing another type of job, you will be granted SSD benefits.

This is a very general description of the process for determining whether you are disabled despite not having met a medical listing. As you can imagine, in reality, the decision making process is more complex and labor intensive. Multiple factors contribute to the determination of whether you are able to return to past relevant work and/or to perform a new type of job. Nonetheless, the main take home message remains the same: if your medical condition prevents you from being able to perform your job, you still may be able to qualify for SSD benefits despite not meeting a medical listing.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

What is the process for determining whether you qualify for Social Security Disability (SSDI or SSI) benefits?

Many people applying for Social Security Disability benefits are confused about the process the Social Security Administration (SSA) goes through in order to determine whether someone is eligible for Social Security Disability (SSD) benefits. The Social Security Administration has actually laid out specific steps that they follow to determine if someone is disabled and therefore qualifies for SSD benefits. In this post, I provide a simplified description of the sequence of steps the SSA takes to evaluate whether you are disabled per Social Security’s regulations. 

       1.    Did you earn more than a specific amount of money since your alleged onset date of disability (the date that you claimed you became disabled)?

In this first step, the SSA will obtain a report of your earnings to determine if you have earned money since the day you claimed you became disabled. If you have earned money since the day you claim you became disabled, the SSA will look to see if the average monthly amount you earned is more than the SGA or the Substantial Gainful Activity amount for that year. This is the maximum monthly amount of money you can earn while still being eligible for SSD benefits during that period of time. This amount changes from year to year. For 2012, for example, the SGA amount is $1010 per month if you are not blind and $1690 per month if you are blind. As I mentioned, the SGA amount differs each year and you can determine the SGA amount for each year by going to the SSA.GOV website (http://www.ssa.gov/oact/cola/sga.html).

In general, if your average monthly earnings exceed the SGA amount for that particular year, then the SSA will determine that you are not eligible for SSD benefits. There are certain exceptions that apply to this rule and if you have been denied on this basis, you should contact an attorney experienced in handling Social Security Disability claims. If you have not earned more than the SGA amount, then SSA will move your claim to Step 2.

       2.    Is the claimant’s condition “severe”?

· The second step is to determine if your condition is “severe.” SSA defines a condition as “severe” if it has more than a minimal effect on your ability to do basic work activities. This is a very low threshold to meet as most impairments will have some effect on a person’s ability to perform basic work-related activities, even if the condition does not completely prevent work activities. If your condition is considered “severe”, then the SSA will progress your claim to Step 3.

      3.    Does your condition meet a medical listing?

The third step in the process is to determine if your medical condition meets a medical listing. In order to meet a medical listing, specific criteria must be met which deem the condition (in and of itself) severe enough to automatically warrant SSD benefits. The SSA maintains a list of such medical conditions for each major body system, all of which can be found on the SSA website. If your condition meets a medical listing then you are considered disabled for purposes of SSD benefits. In some cases, people applying for SSD may not see their condition(s) specifically acknowledged by the SSA as a potential medical listing. In such a situation, the SSA will determine if your condition is equivalent in severity to a related medical condition that is actually on the list.

Even if their condition is listed, however, most people applying for SSD do not have a condition(s) severe enough to automatically qualify for benefits via a medical listing. If your condition does not meet a medical listing all is not lost. If your condition does not meet or equal a medical listing, the SSA will move to Step 4.

      4.    Can you perform past relevant work?

If your condition does not meet or equal a medical listing, the SSA will then determine whether you are capable of performing “past relevant work.” “Past relevant work” is work performed within the previous 15 year period, assuming that it lasted long enough to be learned and was substantial gainful activity (SGA). If the answer is no (you cannot return to any past relevant work) the SSA will proceed to Step 5.

      5.    Can you perform other work?

If it is determined that you cannot perform your past relevant work, the SSA will try to determine whether there is any other work you could reasonably do based on your age, education, and transferability of job skills. This decision will also be based on your residual functional capacity. This term refers to what tasks and skills an individual can still perform despite the functional limitations and restrictions caused by the physical and/or mental impairments stemming from a documented medical condition. The types of jobs that SSA can determine you are capable of performing diminishes with older age, less education and less previous work experience. That means that the older you are, the less education you have and the less previous work experience you have, the more difficult it is for the SSA to determine that there is other work that you can do. If you are unable to perform any past relevant work or any other work (based on your age, education and work experience), then you should be approved for Social Security Disability benefits.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

My back condition prevents me from working: Can I get SSD benefits?

Studies have shown that 8 out of 10 Americans will experience back pain at some point in their lives. For most people, such pain can be treated with a massage, a trip to the chiropractor, physical therapy, or anti-inflammatory medicine. For some, however, back pain could be a sign of serious conditions, which can eventually lead to significant disability. In fact, some people are so disabled by back problems that they are no longer able to work. These people often face financial hardships and apply for Social Security Disability (SSD) benefits only to be rejected because their conditions do not meet the specific medical criteria necessary to receive SSD benefits. In this post, I will review some of the specific back conditions eligible for SSD benefits.

Medical Listing
Claimants can be found eligible for SSD benefits if they can demonstrate that their medical condition meets all the requirements of a medical listing. This listing is a very detailed comprehensive description of the exact criteria that must be met to qualify a specific condition for SSD consideration. All of this information can be quickly and easily found on the SSA.GOV website. The problem, however, is that the criteria provided is heavily laden with medical terminology, making it nearly impossible for lay people to understand. It took me many days with a medical dictionary and discussions with physician friends and colleagues to get a clear understanding of this very technical terminology. I will try to explain the criteria for a medical listing for a back condition without resorting to all of this medical language to the extent that is possible.
It is important to note that a person can be found eligible for SSD benefits even if their condition does not meet a medical listing.  I will discuss this further in another post.  This post will focus on getting SSD benefits for a back condition based on meeting a medical listing.

Back Conditions Specifically Recognized by the SSA
In describing the medical listing for back problems on its website, the SSA lists several specific conditions that it recognizes. These are important to understand:

1. Herniated Nucleus Palposus: This is what in lay language is called a slipped disk. The spine is composed of interlocking bones (vertebrae) spaced apart by softer cushions called discs. These discs are made of a hard outer surface called the annulus fibrosis which surrounds a soft central component called the nucleus palposus. Occasionally, the outer covering gets worn down allowing the nucleus palposus to bulge out from the spine. Sometimes the nucleus palposus can bulge out so far as to “herniate” or fall onto the nerves of the spinal cord which travel right behind it. This pressure on the nerves can cause back pain, sciatica (pain travelling down one or both legs) as well as weakness or numbness of the legs. Depending on the location along the spinal cord, the damage to nerves can cause problems with walking, urinating, or having bowel movements.

2. Spinal Stenosis: The nerves of the spinal cord travel within a canal formed by the vertebrae of the spine. Sometimes this canal is too narrow (stenosis), placing pressure on the nerves. This narrowness could be something that you are born with or can be due to a variety of problems ranging from trauma to bone spurs. Regardless of the cause, the pressure on the nerves damages them, leading to symptoms similar to those of a herniated nucleus palposus.

3. Facet Arthritis: As I previously mentioned, the spinal cord travels in a canal created by the bones of the spine. At each level of the spinal cord, the two bones surrounding the cord to form the canal are kept together by small joints called facet joints. These joints allow for movement of the spine. As a result, they can face some significant wear and tear leading to arthritis. When the arthritis is mild or moderate, it can cause back pain and stiffness. When it is severe, facet arthritis can create swelling of the area, which puts pressure on the nerves and causes nerve damage and the associated symptoms I previously mentioned.

4. Degenerative Disc Disease: As I mentioned previously, the vertebrae of the spine are cushioned by discs that sit between them. These discs provide padding so the bones don’t rub against each other during movement. With time and use, these disks wear down, allowing the vertebrae to rub against each other. This rubbing can cause severe pain particularly with sitting, twisting, or bending.

5. Osteoarthritis: Osteoarthritis, and specifically Spinal Arthritis, is the generic term for the Facet Arthritis described above.

6. Vertebral Fracture: Like an arm or leg, the bones of the spinal column can also break due to trauma. Such breaks or fractures can cause significant pain. Occasionally the fracture can also cause damage to the nerves of the spinal cord with the associated symptoms I previously mentioned.

7. Spinal Arachnoiditis: No, this has nothing to do with spiders. The Arachnoid Mater is a covering of the brain and the spinal cord. Sometimes this covering can get inflamed due to chemicals, infections, trauma, chronic compression, or surgery. This inflammation, called Arachnoiditis, can subsequently lead to the formation of scar tissue, which can make the nerves of the spinal cord stick together and get damaged. Symptoms caused by this condition include pain and tingling of the legs, trouble controlling the legs, pain with sitting, and, depending on the location of the injury, trouble with urination or bowel movements.

Criteria For Eligibility for SSD by meeting a medical listing
Simply being diagnosed with one of the above conditions is not enough to meet a medical listing for SSD. In order to meet a medical listing, claimants with one of these spinal conditions must also demonstrate that the condition led to impairment of a nerve or the spinal cord in ONE of the following scenarios
1. Compression of a spinal nerve (through slipped disk, facet arthritis, vertebral fracture, degenerative disk disease etc.) as demonstrated by ALL of the following:

a. Neuroanatomic distribution of pain: every nerve of the spinal cord is responsible for making specific muscles move and for making specific areas of the body “feel.” As a result, doctors can often determine which spinal nerve is injured based on which muscles are not working and which parts of the body are numb. In order to meet a medical listing, the SSA requires that the area of pain and weakness described by the claimant should correspond to the expected neuroanatomic distribution of a damaged nerve or nerves as seen on an imaging test(MRI, etc.).

b. Limitation of motion of the spine: pain or stiffness of the back which significantly limits a claimant from bending or twisting .

c. Motor Loss: As I mentioned before, each nerve of the spinal cord is responsible for specific muscles. When the nerve is damaged, doctors often see a decrease in size (atrophy) and weakness of the muscles corresponding to that nerve. To meet a medical listing, a claimant should demonstrate weakness and atrophy of the muscles corresponding to damaged spinal nerve as seen on imaging tests.

d. Sensory Loss: Each nerve of the spinal cord also provides sensation, which is the ability to feel something. With nerve damage, this ability to feel the corresponding parts of the body is also decreased. Again, the area of decreased sensation documented for a claimant needs to match an appropriate nerve seen to be damaged on an imaging test.

e. Loss of reflexes: The health of certain nerves of the spinal cord is also determined by a test of reflexes. This is the test performed by doctors when they hit your knee with a hammer and look for your leg to jump. Some areas of damage to the spinal cord can cause these reflexes to either be more or less noticeable. As always, such changes in reflexes need to correspond to the appropriate damaged spinal nerve as evidenced through imaging.

f. Positive straight leg raising test: This criteria applies only for those claimants with lower back problems. This test is performed with the claimant lying down and sitting up. The doctor lifts each leg with the knee straight. If pain shooting down the raised leg occurs during this procedure, the test is considered positive , signaling a significant back problem.

                                                                     OR

2. Spinal Arachnoiditis: As I describe above, this condition is an inflammation of the covering of the spinal cord. In order to meet a medical listing for SSD, spinal arachnoiditis needs to be clearly documented in the claimant’s medical record through at least ONE of the following:

a. Operative Report: Documentation of the condition in an operative report in which a surgeon performing back surgery on the claimant clearly states that evidence of spinal arachnioiditis was seen once the spinal cord was visualized during the surgery

b. Pathology Report: Verification on a pathology report that spinal arachnoiditis was found during a biopsy of the spinal cord.

c. Imaging: The presence of spinal arachnoiditis needs to be demonstrated on a medically appropriate imaging test like and MRI.

In addition to the documentation of the presence of the condition in the medical record, the claimant must also demonstrate that spinal arachnoiditis causes:

a. Dyesthesia: This is an abnormal sensation that feels like burning under the skin which subsequently causes the claimant to need a

b. Repeated Change of Posture or Position: The burning sensation caused by spinal arachnoiditis can often cause people with the condition to constantly change their position so as to avoid it. For the purpose of a medical listing, the claimant needs to demonstrate that he needs to change position at least every 2 hours due to this burning sensation caused by the condition.

                                                                          OR


3. Lumbar Spinal Stenosis: As I mentioned previously, spinal stenosis is a condition which causes compression of the nerves of the spinal cord due to the fact that the bony canal in which the spinal cord travels is too narrow. To meet a medical listing, claimants with spinal stenosis need to demonstrate the following:

a. Verification of the condition with appropriate medical imaging

b. Pseudoclaudication: This is a constellation of symptoms caused by spinal stenosis which includes weakness as well as chronic pain that does NOT follow the distribution of a single particular nerve or group of nerves but, rather, is diffuse. In order to meet a medical listing, a claimant must demonstrate that the pseudoclaudication from the spinal stenosis subsequently causes an

c. Inability to ambulate: The SSA has a specific definition for this: Inability to ambulate effectively means an extreme limitation of the ability to walk; i.e., an impairment(s) that interferes very seriously with the individual's ability to independently initiate, sustain, or complete activities. Ineffective ambulation is defined generally as having insufficient lower extremity functioning to permit independent ambulation without the use of a hand-held assistive device(s) that limits the functioning of both upper extremities. Basically, the SSA is saying that to meet the medical listing for spinal stenosis, a claimant must demonstrate that the condition prevents him or her from walking without the aid of a walker. The SSA then goes on to elaborate:  Therefore, examples of ineffective ambulation include, but are not limited to, the inability to walk without the use of a walker, two crutches or two canes, the inability to walk a block at a reasonable pace on rough or uneven surfaces, the inability to use standard public transportation, the inability to carry out routine ambulatory activities, such as shopping and banking, and the inability to climb a few steps at a reasonable pace with the use of a single hand rail. The ability to walk independently about one's home without the use of assistive devices does not, in and of itself, constitute effective ambulation.  Hence, the claimant must demonstrate that the spinal stenosis completely prevents him or her from getting around independently.

A Few Words On Documentation

As you can see, the criteria for a medical listing for back disorders are quite extensive and detailed. In my practice however, I have noticed that most people get denied a medical listing for back problems not because they do not meet the criteria but, rather, because their medical records are not adequate. All of the specific details I mentioned in the above criteria for medical listing need to be present in the medical records. For example, it is not enough to present documentation of a doctor’s visit in which the doctor states that the claimant complains of back pain. Rather, a detailed physical exam must be included which demonstrates the appropriate objective findings I previously mentioned like numbness, weakness, atrophy, positive leg raises, etc. In addition, particularly for back disorders, reports of appropriate imaging tests (like MRI) in the claimant’s medical record are crucial. It is so disappointing to see someone disabled from a back disorder be denied SSD benefits or need to go through an extensive appeals or reapplication process because of a lack of medical records. Understanding the criteria for a medical listing and appropriately presenting this criteria through extensive and appropriate medical records can be the difference between winning and losing an SSD claim for a back disorder.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

The ALJ denied my claim for Social Security Disability benefits. Now what should I do?

A common question I get from my clients is what to do if their claim is denied by an Administrative Law Judge (ALJ). This is a major decision point in the process for obtaining Social Security Disability benefits. The decision carries significant ramifications so it is important to consider the advantages and disadvantages before moving forward. In this post, I will discuss the options for someone whose claim for Social Security Disability benefits has been denied by an ALJ.

If the ALJ denied your claim for Social Security Disability benefits, you have one of two options:

1) You can decide to disregard your first claim and start fresh.

OR

2) You can also decide to appeal.

Because this decision really does have significant consequences going forward, I do strongly recommend consulting with an experienced Social Security Disability attorney. Choosing one path versus another may mean giving up some rights. While each Social Security Disability claim has its unique issues, here are some basic things to consider in deciding which path to pursue:

Appealing the ALJ’s Decision. If you have received an unfavorable decision from the ALJ, you can appeal this decision to the Appeals Council. In submitting an appeal to the Appeals Council, your attorney should submit legal briefing discussing why the ALJ made mistakes in his decision regarding your eligibility for disability benefits. The advantage to this route is that you keep your alleged onset date (the date you told the Social Security Administration you could no longer work) and protective filing date (the date you filed your application for Social Security Disability benefits). This is important because it means that your back pay would be based on those dates rather than a new date in a new claim. This can be a substantial sum of money. In addition, your Medicare and Medicaid eligibility would be based on the alleged onset dates and protective filing dates rather than a new date in a new claim.

The disadvantage of this path is that the appeals process is a long process. The Appeals Council can take from 12-14 months to decide your case. During this time you are not receiving any benefits. In addition, if they agree with the ALJ, you would have waited a long time and still not been able to receive any Social Security Disability benefits. For many people, waiting this long for benefits can be very difficult, if not impossible.

It is important to note that if you have received an unfavorable decision from the Appeals Council, you will be able to file an appeal in Federal Court. With your Federal Court appeal you will be able to also file a new claim with the Social Security Administration for Social Security Disability benefits. However, this will take still more time without receiving any benefits.

Starting a New Claim. If you have received an unfavorable decision from the ALJ, you can also start a new claim with the Social Security Administration. Starting a new claim can be beneficial because it allows many claimants another opportunity to demonstrate that they are eligible for Social Security Disability benefits. In addition, in pursuing a new claim, you have a new opportunity to prove your disability with a new examiner in the initial stages of your Social Security Disability claim and, hopefully, a new ALJ at the hearing stage. These new people evaluating your case may see your case in a different light and grant you benefits. If granted, these benefits may come much sooner than if you choose to wait out the appeals process.

The disadvantage of submitting a new claim, however, is that you will have a new alleged onset date and protective filing date for your case and, as a result, give up a lot of potential back pay.

There are also certain circumstances in which filing a new case is not an option. One example is when a claimant is filing for SSDI benefits and their Date Last Insured (the date by which they must prove they became disabled) has already expired. In this situation, the only option would be to appeal the decision.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

What are the steps for applying for Social Security Disability benefits?

Social Security Disability benefits can provide critical financial assistance for people that are disabled and no longer able to earn a living. Applying for these benefits, however, can be a complicated, confusing and frustrating process. Most people who apply for Social Security Disability benefits will get denied initially. As a result, people applying for Social Security Disability benefits often go through a long process before getting the benefits they need and deserve. Understanding the process and not getting discouraged by an initial rejection can mean the difference between eventually receiving Social Security Disability benefits and remaining empty handed.

In this post, I review the steps of the process that may be required to get Social Security Disability benefits. While benefits may be granted at any one of these steps, it is crucial to remember that most people will go through several steps before they win their claim for benefits.

Initial Claim

The first step to obtaining Social Security Disability benefits is the initial application. To begin the process, you must file an application. There are several ways to file an application including (1) going to a local Social Security Administration (SSA) office), (2) speaking with SSA over the phone, (3) asking an attorney to assist you with the paperwork and arrange an appointment for you.

During your initial application process, SSA will request information from you including, your social security number, date of birth, your alleged onset of disability, contact information for your treating physicians, information about your employment for the past 15 years, income and asset information, and information about your activities of daily living. Once you have completed the initial application, you may also be sent additional questionnaires pertaining to your work experience or particular impairment. The Social Security Administration may also require that you attend an appointment with a consultative examiner. The purpose of this appointment is for the examiner to determine whether the disability for which you are requesting benefits meets the appropriate guidelines of the Social Security Administration.

Some individuals are approved at this level of the claims process. Most are not. The beginning of the application process is very important for every claimant because it is crucial at this point to accurately describe your condition, your past work experience and your current level of functioning. Once you have responded to these questionnaires it is often very difficult to change your answers. Often times, applicants are denied benefits at this stage because they complete the required paperwork incorrectly or do not provide enough detail.

Reconsideration

Most people applying for Social Security Disability benefits are denied at the initial claim stage. If you are denied, you should immediately file a Request for Reconsideration. This is the next step in the process for obtaining Social Security Disability benefits. With the Request for Reconsideration, you will also be required to complete a Disability Report - Appeal. In this paperwork, you will be asked about any additional or worsening impairments or the contact information for any additional physicians they may be seeing at the time. As with the initial claim, completing the paperwork accurately is critical to move the process forward.

Unfortunately, at this stage, the Social Security Administration usually reaffirms its original decision and denies the applicant Social Security Disability benefits.

Hearing

After being denied at the Reconsideration stage, you must file a Request for Hearing. This is a request to have your claim heard before an Administrative Law Judge. During this hearing, an Administrative Law Judge (and not the Social Security Administration) will decide whether you should be awarded Social Security Disability benefits. The hearing is informal but your testimony will be taken under oath. At the hearing, the Administrative Law Judge will often have a vocational expert and/or a medical expert to testify. The vocational expert will testify as to what your past work entailed and assist the judge in determining whether based on your condition you would be able to work. The medical expert will testify and provide an opinion as to your medical condition. During the hearing, you will be asked to testify regarding your age, education, past work experience, and functional limitations.

At this point it is very helpful for claimants to have an attorney present. An attorney should work to ensure that all the evidence is properly entered into the record, you understand the types of questions that you will need to respond to, and the proper questions and answers are asked of the experts at the hearing. Having an attorney greatly increases your chances of winning at the hearing level and also helps preserve the record in case you are required to appeal the Administrative Law Judge’s decision.

Appeal to the Appeals Council

If you are not granted benefits after a hearing before an Administrative Law Judge, there are still several steps of appeal available. The first level of appeal is to the Appeals Council. At this stage, the Appeals Council will request formal legal arguments explaining why your claim for Social Security Disability benefits is justified and why the Administrative Law Judge was wrong to deny benefits in the first place. As you can imagine, at this stage of the process, a legal background is vital to successfully argue for benefits. After reviewing the legal arguments submitted, the Appeals Council can then do one of three things:

1) Agree with the Administrative Law Judge’s decision

2) Send the case back to the Administrative Law Judge to evaluate it once again

3) Disagree with the Administrative Law Judge and grant Social Security Disability benefits to the applicant

Federal Court

If the Appeals Council decides to agree with the Administrative Law Judge’s decision (and, yet again, deny benefits), you can further appeal your claim to the Federal Court. At this stage, an attorney is crucial because the judge will request legal briefing on the matters you are appealing. Without an attorney, a claimant has little chance of success at the federal court level. Like the Appeals Council, the Federal Court can rule in one of three ways:

1) Agree with the Administrative Law Judge’s decision

2) Send the case back to the Administrative Law Judge for further consideration

3) Grant Social Security Disability benefits to the claimant.

Take Home Message

Applying for Social Security Disability benefits is often a long and complicated process. While most applicants will initially be rejected, many steps are available to appeal the initial decision and still receive benefits. The further in the process you go, the more complicated the steps become and the more necessary it is to have some legal knowledge and experience. It is crucial to make the most of every step of the process through an effective and persuasive application and argument for benefits.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

Great news for those suffering with Fibromyalgia: The Social Security Administration now officially recognizes Fibromyalgia as a medical condition

Fibromyalgia can be a devastating condition causing pain throughout the body as well as severe fatigue.  Fibromyalgia can be incapacitating, preventing a good quality of life and the ability to work.  Even though fibromyalgia has long been recognized as a debilitating condition, it has been historically difficult for people with fibromyalgia to prove that they have a medical condition that qualifies them for Social Security Disability benefits.

Fortunately, there is now some great news for people suffering from fibromyalgia.  The Social Security Administration has finally adopted guidelines under which they will consider fibromyalgia cases.  According to these rules, the Social Security Administration will consider your fibromyalgia a disabling condition if your medical records demonstrate the following:

• A history of widespread pain that lasts for at least three months.  The pain may fluctuate in intensity and may not always be present.
• Evidence that other disorders that could cause the symptoms or signs were excluded; and
• One of the following:
• At least 11 tender points on physical examination OR
• Repeated manifestations of six or more fibromyalgia symptoms including:
• fatigue
• cognitive or memory problems (often called "fibro fog")
• waking unrefreshed
• depression
• anxiety disorder
• irritable bowel syndrome
• muscle pain
• muscle weakness
• headache
• pain or cramps in the abdomen
• Raynaud's phenomenon
• hives or welts
• blurred vision
• fever
• heartburn
• oral ulcers
• loss of taste
• change in taste
• seizures
• dry eyes
• shortness of breath
• loss of appetite
• rash
• sun sensitivity
• hearing difficulties
• easy bruising
• hair loss
• frequent urination or bladder spasms

Once you can demonstrate that your condition meets the criteria for fibromyalgia, the Social Security Administration will determine whether your condition is severe enough to keep you from working on a full time sustained basis.  These new guidelines can help people suffering from fibromyalgia present a more clear cut case for disability benefits.

If you are suffering from fibromyalgia and are no longer able to work, you can now apply for Social Security Disability benefits with the understanding that you condition will be recognized.  To increase your chances of getting Social Security Disability benefits, you should begin or continue treating with a physician.  If possible, you should consider seeing a rheumatologist (a physician who specializes in conditions such as fibromyalgia).

Although this new ruling is great news for people suffering from fibromyalgia, proving a fibromyalgia case in front of the Social Security Administration can still be tricky.  You should consult with an experienced Social Security Disability attorney in your area to ensure the best possible result for your case.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

Can my child receive Social Security Disability benefits?

If you have a child suffering from a mental or physical disability, you may be wondering if you can obtain Social Security Disability benefits for him or her.  The answer is YES you can.  Many children suffer from disabilities that qualify them for Social Security Disability benefits.  A child younger than 18 can receive Supplemental Security Income (SSI) benefits if (1) he or she meets Social Security's definition of disability for children and (2) his or her income and resources fall within the eligibility limits.

What medical conditions would meet Social Security's definition of disability for a child?
There are various medical conditions -- both physical and mental conditions -- that would meet Social Security's definition of disability.  Some of these conditions include: autism, growth impairments, conditions related to the muskuloskeletal system, vision and hearing problems and asthma.  In general the Social Security Administration (SSA) is looking to see if a child has a physical or mental condition (or combination of conditions) that results in severe limitations to their ability to function at home, school and in the community.  In addition, the condition must have been disabling, or expected to be disabling, for at least 12 months.

For most cases, the SSA will follow the normal procedures in determining whether your child qualifies for Social Security Disability benefits.  However, for some medical conditions SSA will make SSI payments right away for up to 6 months while it determines whether your child is disabled.  The conditions that may qualify include: HIV infection, total blindness, total deafness, cerebral palsy, down syndrome, muscular dystrophy, severe intellectual disorder, and birth weight below 2 pounds and 10 ounces.  If SSA then decides that your child is not eligible for SSI benefits, you will not be required to pay this money back.

How does SSA determine the income and resources for a child?
When deciding if a child can receive SSI benefits, SSA will consider the child's income and resources as well as the income and resources of family members living in the child's household.

What happens when my child turns 18?
When a child turns 18, SSA will reevaluate whether the child is still eligible for SSI benefits under the medical and non-medical rules that apply to adults.  Your child will continue to receive SSI benefits if his or her medical and financial conditions qualify him or her for benefits under the rules that apply to adults.  A major difference is that SSA does not count income and resources of family members when assessing whether an adult meets the financial requirements for SSI benefits.  This means that many children who could not qualify for SSI benefits because their parents' income and resources were too high would be able to qualify at the age of 18.

If you have any questions regarding whether you child qualifies for SSI benefits, you should contact an attorney that is experienced in handing Social Security Disability benefits.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

There may be more applications for Social Security Disability because more Americans have disabilities.

Lately there has been a lot of discussion regarding the dramatic increase in Social Security Disability applications.  People have put forth numerous reasons attempting to explain the increase.  Commentators have cited the economic conditions, people unable to find jobs, and an aging population.  These are probably all valid reasons but perhaps one additional reason is that more Americans have a disability.  According to the Census data, in 2010 there were 56.7 million people with a disability.  That is an increase of 2.2 million people since 2005.  http://www.disabilityscoop.com/2012/07/26/census-more-disabilities/16111/

Veterans Applying for Social Security Disability benefits: 4 Commonly Asked Questions

There are many veterans or military service personnel who have become disabled and qualify for Social Security Disability benefits along with the benefits provided by the Veteran's Administration.  Here are answers to 4 questions that are commonly asked by veterans or military service personnel regarding Social Security Disability benefits:

• Can I receive Social Security Disability benefits and veterans disability benefits?

This depends on the type of benefits you are applying for.  You can receive Social Security Disability Insurance (SSDI) benefits and VA compensation benefits (service-connected disability benefits) at the same time.  However, to calculate Supplemental Security Income (SSI) benefits, the Social Security Administration will include the VA pension benefits you receive when determining the amount of SSI benefits you can collect.

• If I already receive veteran's disability benefits, am I automatically qualified for Social Security Disability benefits? 

No.  Both programs are completely separate and have different eligibility requirements.  As a result, being eligible for disability on one program does not automatically qualify you for another program.

• Does military pay affect my eligibility for Social Security Disability benefits?

The answer to this question depends on whether you are engaging in substantial work activity.  You are not eligible for Social Security Disability benefits if you are engaged in substantial gainful activity, which means that you are getting paid over a certain amount for work activity.  However, if you are receiving military pay while you are on limited duty or receiving medical treatment this would generally not constitute work activity and, therefore, you would be eligible for Social Security Disability benefits.

• When can I apply for SSDI or SSI benefits?

Military service personnel can apply for SSDI and SSI benefits while in military status or after discharge.  There are several ways to apply including online and at a Social Security office.  You can also apply by finding an experienced attorney who handles Social Security Disability claims.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

Can I receive Social Security Disability benefits based on my mental condition?

The short answer is "YES."  Individuals can apply for Social Security Disability benefits based on a mental condition.  The Social Security Administration will consider most mental conditions including, but certainly not limited to, anxiety, depression, bipolar, schizophrenia, and personality disorders.  That being said, the decision as to whether you are eligible for Social Security Disability benefits does not come down to the diagnosis of a mental condition.  Instead, the Social Security Administration will determine whether your mental condition meets a medical listing (per Social Security's rules and regulations) or prevents you from sustaining employment on a regular basis -- 8 hours a day 5 days a week.

To determine whether your mental impairment meets a medical listing or affects your ability to sustain a full-time job, the state disability agency (that is contracted with the Social Security Administration to make initial determinations regarding your disability) will send you, and often times third parties, questionnaires to complete regarding your daily activities.  It is very important that you complete these questionnaires as accurately and comprehensively as possible so that you provide an accurate description of your daily activities.  For this reason, it is often very beneficial to consult with an experienced Social Security Disability attorney as early as possible in the application process. 

Along with completing questionnaires, the state disability agency will request and review medical records and often times arrange for you to attend a consultative examination with a mental health professional.  These consultative examinations are short and often times provide inadequate descriptions of your mental impairments.  However, the Social Security Administration will use these consultative examinations to deny benefits.  For this reason, it is crucial for any individual applying for Social Security Disability benefits on the basis of a mental condition to document their condition by establishing a complete medical record with their own treating physicians.  Moreover, when treating with a mental health professional for a significant amount of time, you can usually obtain statements from your physician documenting the limitations you face as a result of your mental health condition.  Such medical records and statements will go a long way in helping you prove your claim for Social Security Disability benefits.

If you or someone you know is seeking Social Security Disability benefits for a mental health condition, it is important to consult with an experienced Social Security Disability attorney early on in the process.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

Why should I care about my Date Last Insured (DLI)?

You may have heard the terminology Date Last Insured or DLI thrown around if you have spoken to a representative at the Social Security Administration (SSA) or to a Social Security Disability attorney.  What is a DLI and why should you even worry about it?

An issue regarding your Date Last Insured (DLI) is only relevant if you are filing a claim for Social Security Disability Insurance (SSDI) benefits.  That means if you do not qualify for SSDI because you havent worked long enough to qualify for this federal insurance program, you dont need to worry about your DLI.  However, if you are applying for SSDI, your DLI may be very relevant. 

The Date Last Insured or DLI is the last day you qualify for Social Security Disability benefits under the SSDI program.  In order to qualify for SSDI, you must prove that your disability began before your DLI.  This generally means that you must have some sort of evidence demonstrating that your disability began prior to your DLI.  If you are found disabled on or before your DLI, then you will receive SSDI.  If you are found disabled after your DLI, then you will not qualify for SSDI benefits. 

It is important to remember that you do NOT have to apply for SSDI benefits before your DLI .  This means you can file for SSDI benefits after your DLI as long as you are able to prove that your disability began prior to your DLI.

Here is an example.  Ana files a claim for SSDI benefits on June 1, 2010.  Her Date Last Insured is December 31, 2009.  At the hearing, the Administrative Law Judge (ALJ) finds that Ana is disabled as of January 1, 2009.  In this scenario, Ana would qualify for SSDI benefits.  However, if the ALJ found that Ana was disabled as of January 1, 2010, she would not qualify for SSDI benefits.

It is important to remember that a DLI is only relevant in claims for SSDI.  This means that if there is an issue with your DLI that makes you ineligible for SSDI benefits, you may still qualify for SSI benefits. 

If you have any questions regarding your DLI, you should consult with an attorney experienced in handing Social Security Disability cases.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

Injured military personnel can get Social Security Disability benefits faster

A new nationwide project has been established that allows the Social Security Administration to receive military records from the Department of Defense faster.  This program will reduce the time it takes for the Social Security Administration to make disability decisions for "Wounded Warriors," service members, veterans, and dependents.  This is great news for veterans and military personnel who have been injured and desperately need disability benefits to support themselves and their families.  For more information, see http://www.socialsecurity.gov/pressoffice/pr/ssa-dod-hit.pr.html

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

What's the difference between Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI)?

There are two federal programs that individuals can apply for when they become disabled and are unable to work.  Figuring out the difference between these two programs can often be confusing.  Here are some basic similarities.  Both of these programs -- Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) -- are funded by the federal government to provide financial support for individuals who are disabled for 12 or more months.  In both programs you are required to prove that you are not able to work as a result of a physical or mental condition.  For both programs, you must also show that your condition is expected to last for at least 12 months or result in death. 

So what is the difference between SSDI and SSI?  The major difference between SSDI and SSI is the non-medical proof you must show to qualify. 

SSDI is a federal insurance program of the government that is funded by your payroll taxes.  That means if you are working and paying taxes, you are paying into this federal insurance program.  Your eligibility for SSDI is based on whether you have worked for enough time and paid enough into the system.  Generally, if you have worked for 5 of the past 10 years as of the date of onset of disability, you will qualify for SSDI.  Younger claimants need to work for less time to become insured by SSDI.  Your benefit amount is based on your earnings.  By and large, the more you earned, the more benefits you will receive if you qualify for SSDI.

SSI is a needs-based program of the government administered by the Social Security Administration (SSA).  To qualify, SSA will evaluate your financial situation, and not your previous work.  SSA will assess your financial situation by examining your assets and determining how much SSI benefit you are eligible for based on any income you receive.

In certain circumstances you can receive benefits under both SSDI and SSI.  This generally occurs when you apply for and qualify for both programs and your SSDI benefits are under the SSI benefit amount you would be eligible for.  As a result, it is generally a good idea for claimants to apply for both SSDI and SSI at the initial stage of the application process to ensure receipt of the maximum benefits.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.

Do I qualify for Social Security Disability benefits?

Many hard working individuals who become injured or ill wonder if they will be able to keep working as a result of this injury or illness.  If you are in this position, you may be considering whether you should apply for Social Security Disability benefits.  Before you begin the application process, you should first consider whether your condition would qualify you for Social Security Disability benefits.     

Many people believe that simply being unable to work at their current job means that they are disabled per Social Security's rules and regulations.  This is, in fact, not true.  Indeed, being unable to work at your current job and being found "disabled" by the Social Security Administration are two very different things.  At the same time, you do not have to be completely bedridden to be found disabled.  The basic rule is that your condition must either meet a medical listing (as defined by Social Security's rules) or you must demonstrate that based on your age, education, and work experience, your condition would prevent you from working at a full time job -- 8 hours a day, 5 days a week.

Proving that you are unable to work gets easier as you get older.   If a Social Security claimant is over age 45 the process for obtaining disability benefits becomes easier.  At age 50, more people with a significant medical condition will qualify for disability benefits; most people with a significant medical condition will qualify at age 55; and even more people with a significant medical condition will qualify at age 60.  However, even younger claimants (persons under 45) can still qualify for benefits if they have a disability which prevents them from being able to sustain a job full-time (or 8 hours a day, 5 days a week).

If you are truly unable to work, you should apply for Social Security Disability benefits.  There are several stages to the application process and you can win benefits at any of those stages.  Many people are not successful at the initial stages of their claim - either at the initial claim or at the request for reconsideration.  In fact, most people will end up at a  hearing during which they will appear before an Administrative Law Judge to make their case for Social Security Disability benefits.  At this point, many claimants will be granted benefits but if you are not, there are several more stages of appeal.

For help with a Social Security claim at any stage, you should consult with a qualified and experienced Social Security Disability attorney.  Consulting with a Social Security Disability attorney early on in the process can often help you make a stronger case for benefits in the future.

This is NOT legal advice.  This blog provides general information about Social Security Disability cases.  To discuss your particular circumstances and claim, please contact a lawyer in your area.