Recently in Social Security Disability Benefits Category


November 12, 2011

A claim for Social Security Disability benefits is a claim for benefits because the applicant is unable to work. The claimant is literally telling the Social Security Administration [SSA] that because of medical impairments [mental or physical] the person cannot work any job that exists in the United States and expects to be unable to work for at least 12 continuous months. As a result, any excess level of earned income that a claimant receives after their AOD, may lead a Social Security case examiner or adjudicator to determine that they are not disabled. In short, it is highly unlikely that an applicant is unable work under normal conditions and continues to acquire a large sum of income.

The types of "income" that may show Social Security that you have the ability to work include wages from temporary or part time jobs, and self employment income [see our blog entry regarding unemployment benefits as another type of income affecting disability claims]. For further details please visit the official website of the Social Security Administration in regards to the relationship between work activity and benefits.
Working even part time or temporarily can be used as proof that you have the ability to continue to work and/or that you have the ability work fulltime. Contrary to what a lot of people believe it is not staying under a certain maximum income that solely determines their eligibility. The question for Social Security is always the claimant's ability to work. If a claimant is able to work, that person should work. Working is emotionally and usually financially better than drawing disability pay. Social Security is not designed to discouraged claimants from working but rather intended to pay only those persons who are unable to work.


November 3, 2011

A Social Security Disability claim is an application for assistance because the applicant has lost the ability to work. The applicant is implicitly telling the Social Security Adminstration that due to medical conditions (physical or mental) "I am unable to work ANY job that exists within the United States, and I expect my conditions
to limit me for at least 12 continuous months." (Note: the applicant cannot perform the duties of any job, not just your previous occupation) The former statement is a bold declaration; therefore, any relative action taken after an applicant's alleged onset disability date or AOD, may potentially affect the outcome of their claim. For example, let's take a look at how an applicant's collection of unemployment benefits after their AOD can damage their claim.

Unemployment benefits can negatively affect your claim for disability benefits because receipt of these benefits usually require the applicant to declare that he or she is ready, willing and able to work. If you are telling one agency that you are able to work to get unemployment benefits, you are filing a contradictory claim for Social Security disability benefits because you are alleging that you are unable to work because of a disability. Social Security can use the receipt of unemployment benefits as one of the factors they consider in analyzing your claim for disability benefits.

Furthermore, the Employment Commission or unemployment agency could later find that you must repay any unemployment benefits that you received if your Social Security claim is awarded within the same time period you received unemployment benefits. Therefore, it is highly important that an applicant's AOD, does not contradict itself in regards to unemployment (ability to work) and disability insurance benefits (inability to work).

Why Do I Have to See a Social Security Doctor to Get Social Security Benefits, part 2

October 13, 2011

As Discussed in Part 1 of this blog, the Social Security Administration often schedules medical examinations for disabled individuals who have applied for Supplemental Security Income [SSI] and Social Security Disability Income [SSDI] benefits.

The medical exams, referred to as "consultative examinations" by Social Security, are paid for by the Social Security Administration but are supposed to be unbiased. While there are few cases where an individual might be advised to refuse to attend an examination, typically Social Security will flat out deny your claim if you fail to attend the consultative examination without a good cause.

If you attend the examination, there are several things that you should expect or at least anticipate:

  1. Be mindful you are being observed. The Doctor and doctor's staff may be watching you from the second that you get out of your car until the second you get back in it to go home. I have personally read numerous reports where the doctor makes a note that a claimant got of their car and walked to the office door without any problem but then began holding his or her back or limping the second that they walked into the door of the docotr's office. The doctor's report might note that a claimant was seen laughing on the phone but then became shy or tearful when entering the doctor's office.

  2. Be honest. "Malingering" is the medical term for person who is believed to be exaggerating his or her symptoms. While some of us believe that the term is being misused or overused, the key is not to give the doctor any reason to write down you could be malingering.

  3. Tell the doctor everything. Social Security is supposed to provide the doctor with a copy of all relevant records and documents, but most of the time, the doctors have not reviewed anything. Therefore, you must tell the doctor everything. Remember this: doctors will write down almost anything you tell them but they cannot write anything if you don't tell them it. Example if you walk in and the doctor asks how you are doing and you reply "I'm doing fine," the doctor will write down "the patient is doing fine" even though you are in pain or having other symptoms because you did not say this.

False Income Tax Returns and Your Social Security Disability Claim

June 30, 2011

As a federal agency, the Social Security Administration [SSA] receives reports of income that claimants for Social Security Disability benefits file with the IRS. This information helps the SSA to calculate eligibility or ineligibility for certain SSA benefits and the amounts that are paid. In obtaining this information, the SSA also receives disclosures of unemployment benefits, other governmental benefits, as well as reported earnings from employment and self-employment.

In these times of economic hardship, some people have been lured into filing tax returns that report self employment earnings that have actually not been earned or earned at lesser amounts than is reported on the tax return. Such returns are fraudulent. The recent government stimulus packages and possibilities for tax rebates and refunds have made these fraudulent tax returns a greater temptation as people seek to get some financial relief. Unfortunately, filing a false tax return has implications that exceed the benefits of the rebate or refund that was received and can have a detrimental effect on the receipt of Social Security benefits..

First, a false tax return is a crime that could subject the filer to penalties, fines, interest, and even criminal action being taken against them. The false return may not be discovered for years, compounding the amount of fines and other assessments over time. A small refund could subject the filer of the false return to double and triple the liability when the IRS seeks refund of the improperly earned rebate or refund.

Second, the false information is reported to SSA that then assumes that the reported earnings are correct. The effect is that a claimant for SSA disability benefits will be found to have worked and earned income during a time that the same claimant is alleging that he or she is unable to work. Although the claimant may have a real disability, the false return can result in denial of a SSA disability claim because the claimant will appear to be working and not reporting it to SSA. The effect is evidence that the person does not meet the requirements of "inability to work" that is necessary for SSA disability benefits. Even worse, it can raise serious credibility problems about the truthfulness of other statements the person is making.

Actions we take in desperation are always potential risks. Involving federal agencies in desperate actions is even more risky and inadvisable. If you have filed a tax return to seek a refund or rebate you may not have earned, it would be in your interest to seek the advice of an experienced social security disability attorney or tax professional.

Why do I have to go see a Social Security doctor to get disability benefits? (Part 1)

April 18, 2011

641572_taking_a_bite.jpgAfter an individual files an application for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), the Social Security Administration typically sets an appointment for a medical examination to be done by a doctor paid by the Social Security Administration. These appointments are set by state agencies called either Disability Determination Services (DDS) or Disability Adjudication Services (DAS), depending on the state in which you reside (i.e. the state agency in Georgia is DAS). The appointments themselves are referred to as consultative examinations. Many people question the reason for the examination and the need to go to see a Social Security doctor.

For a claim for Social Security Disability or Supplemental Security Income benefits to be successful, the claimant has the burden to prove that he/she is disabled and, in general, is unable to perform substantial gainful activity (work). The Social Security Administration has a duty to develop a claim for benefits by obtaining medical records and other evidence. While it seems that the Administration often falls short in their duty to develop the evidence, the Administration does routinely set up medical evaluations in order to assist in their determination of disability.

When a disability medical exam has been scheduled, it is usually important that the individual attend the exam and do their best during the exam. If an individual fails to go to a scheduled medical exam, Social Security will typically deny the claim for disability benefits. However, there are certain situations where an individual may not need to go to a disability medical exam.

As noted earlier, the person claiming that he/she is disabled has to prove it. Therefore, if the disabled individual receives regular medical treatment and the records of their treating doctors support a finding of disability, there is no need to waist the taxpayers' money for an unnecessary medical exam. Further, there are some instances where the state agency will schedule an appointment with a doctor who does not specialize in the alleged disability or with a doctor known to be biased against the disabled individuals.

We will continue this discussion in Part 2 in order to provide insight into the medical examinations themselves and what can be done to help your claim for disability benefits.

It is important to get advice specific to your disabilities, situation and evidence before you go to a disability medical exam.

The Social Security Disability Claim Evaluation Process

April 12, 2011

Once a claimant files for Social Security Disability Benefits, the disability evaluation process begins. Social Security will use the information that the applicant provides on the application forms to attempt to gather medical evidence of the disability from doctors, hospitals and schools. Social Security may also send the claimant to doctors chosen by Social Security for examinations and/or tests that are called consultative examinations if Social Security has insufficient information to evaluate whether the claimant is disabled.

Once evidence is received by Social Security it is evaluated by examiners at the local state agency which is called the Disability Determination Services [DDS] or Disability Adjudication Services [DAS]. Social Security is looking for more than just a diagnosis by a doctor that a claimant has a medical condition. For adult claims, they are looking for whether the claimant has physical or mental problems that prevent the person from working any job. For children, they are looking for whether the child has physical, mental or growth problems that seriously limit the child from doing things other children in the child's age group is able to do.

In fact, Social Security will deny more claims that it will grant at this initial level. Most of the time Social Security will send a letter called a Notice of Determination or Notice of Disapproved Claim finding that the adult applicant is not disabled because he or she is able to do the work they used to do or able to do some other less stressful or less demanding work. In a child's claim, Social Security often denies the claim finding that the child has no severe or marked limitations on functioning as other children of the same age function.

The key is to not give up if you feel that you are unable to work or that your child is not functioning normally. If you receive an initial denial notice, you must appeal within 60 days of the date on the notice. In most states, including Georgia, Florida, North and South Carolina and Tennessee, the first level of appeal is called "Request for Reconsideration". Once such an appeal is filed with the local Social Security office, the claim will be reconsidered along with any new information that the claimant provides on the appeal forms. In most cases, the Social Security Administration will then again deny the claim, sending a Notice of Reconsideration or Reconsideration Denial Notice. The claimant will then have another 60 days to file a "Request for a Hearing" - the second level of appeal - that will give the claimant an opportunity to be heard by an Administrative Law Judge and the best chance for a favorable decision.

Use of Department of Veterans' Affairs Disability Decisions by the Social Security Administration

April 11, 2011

904093_army.jpgWhen deciding a claim for Social Security Disability Benefits (SSDI) or Supplemental Security Income (SSI) the Social Security Administration is required to take into account a disability decision made by the Department of Veterans' Affairs (VA). Similarly, the VA is required to take into evidence a favorable decision with regard to Social Security benefits. The VA's regulations, however, are not as claimant friendly as the Social Security Administration's.

According to the Social Security Administration's own rules and regulations, a decision by any governmental agency about whether an individual is disabled or blind must be considered evidence. See 20 C.F.R. §404.1512(b)(5); see also Social Security Ruling 06-03p. While such evidence is not binding on the Social Security Administration, various Circuit Courts have helped determine the weight that should be given to favorable/unfavorable disability decisions. See 20 C.F.R. §404.1504. With regard to a veteran's disability rating from the VA, the Circuit Courts that have jurisdiction over 20 states and over Guam and Northern Mariana Islands have said that the Social Security Administration must give them evidentiary weight.

For veterans living in Georgia, Alabama, or Florida, the 11th Circuit Court held that a VA decision rating a veteran's disability is entitled to "great weight". See Brady v. Heckler, 724 F.2d 914, 921 (11th Cir. 1984).

Continue reading "Use of Department of Veterans' Affairs Disability Decisions by the Social Security Administration" »

How Does Workers' Compensation Affect Social Security Disability Benefits?

April 4, 2011

Often times our clients have a workers' compensation case as well as a Social Security disability case. A question that comes up is whether the client can receive a monthly check for Social Security disability as well as a weekly check from workers' compensation. The short answer is: it depends. If you are receiving a weekly workers' compensation check under Georgia law, the amount of that weekly check will not be reduced by any Social Security income benefits you might be getting.

However, the amount of the monthly Social Security disability check may be partially reduced or even completely cut out while you are receiving Georgia workers' compensation weekly checks.

Any reduction in Social Security income benefits is determined by calculating the amount of your average earnings (ACE) before you got disabled. Generally speaking, the total combined amount of your monthly workers' compensation and Social Security disability income benefits cannot exceed 80% of what you were earning on the job when you got hurt. Otherwise, you may very well end up having the amount of your monthly Social Security disability income check reduced or cut out altogether.

One way to keep your Social Security check from being reduced or eliminated by the Georgia workers' compensation checks you are getting is to reach a settlement in your workers' compensation case with your employer and its insurance company. There needs to be special language in your workers' compensation settlement document which takes the total amount of your workers' compensation settlement and breaks it down into a weekly amount based on how long the actuarial tables say you will live given your current age. With this, the Social Security Administration treats you as though you are still getting a weekly workers' comp check even though workers' comp ends after your settlement.

However, the "make believe" workers' comp check that the Social Security Administration says you are getting will be significantly less than the actual workers' comp check you were receiving before the settlement. This will typically cause your monthly Social Security disability income check to go back up after the workers' comp settlement goes through.

Continue reading "How Does Workers' Compensation Affect Social Security Disability Benefits?" »

Receiving both Social Security Disability and Veterans' Disability benefits

March 31, 2011

A misunderstanding exists that veterans cannot receive both Social Security disability and Veterans' disability benefits at the same time. This is not true. A veteran can receive both Social Security disability and service connected Veterans' disability benefits at the same time.

The misunderstanding occurs because both the Social Security Administration and the Department of Veterans' Affairs have two types of disability benefits. Both government agencies have one disability benefit program that analyzes a veteran's income and resources when determining eligibility and another disability benefit program that does not.

Through the Social Security Administration a veteran can be awarded Social Security Disability (also called SSDI, Disability, Disability Insurance benefits or Title 2 benefits) and/or Supplemental Security Income (also called SSI or Title 16 benefits).

Continue reading "Receiving both Social Security Disability and Veterans' Disability benefits" »

Types of Social Security Disability Benefits

March 29, 2011

Most of us are aware that Social Security may be available to pay us disability benefits if we become unable to work or function because of a medical problem or problems. However, most people are unaware that SSA actually has many types of Social Security disability benefits. The type of benefits that a person may qualify for depends on many factors such as the type of disability, the disabled person's past work history, or the relationship of the disabled person to the person who did work.

The following is a summary of some of the types of disability benefits available and basic qualifications for the benefits:

1. Disability Income or Insurance Benefits, also called SSDI or DIB, may be payable to a person who has worked at least 5 years out of the last 10 years and now is unable to do any work because of severe medical conditions [impairments] that have or will leave the person unable to work for at least 12 continuous months.

2. Supplemental Security Income, also called SSI, may be payable to a disabled adult person who is unable to work because of severe medical conditions [impairments] who do not qualify for SSDI because they have no past work, not enough past work, or past work that is too long ago. This benefit is affected by income of others in the household.

3. Supplemental Security Income- disabled child, also called SSI- DC, may be payable to a child who meets the disability requirements for children who are under the age of 18 at the time of application. These benefits are subject to reduction based on the income of parents in the same household.

Continue reading "Types of Social Security Disability Benefits" »