Friday, September 30, 2011

Medical Records and More: What SSA Uses to Make a Decision on Your Claim

One misconception commonly held by those applying for disability benefits in San Francisco is that the only important aspect that factors into the determination process are supportive medical records. While it is true that the main requirement for qualifying for disability benefits is determined by relevant medical records, past work experience also factors heavily into Social Security’s determination process. If a claimant is found to be able to return to a past job, he or she will be denied on the basis that the disability is not severe enough to keep the claimant from working.

Social Security first determines the claimant’s residual functional capacity in order to compare it to past relevant work. There are four different levels to classify residual functional capacity:

  • Sedentary: the claimant is able to sit for six hours, stand or walk for two hours and lift a maximum of 10 pounds
  • Light: the claimant is able to sit for six hours, stand or walk for six hours and lift a maximum of 20 pounds
  • Medium: the claimant is able to sit for six hours, stand or walk for six hours and lift a maximum of 50 pounds
  • Heavy: the claimant is able to sit for six hours, stand or walk for six hours and lift a maximum of 100 pounds

If the residual functional capacity of the claimant prevents the return to previous work, the examiner will also look at the claimant’s skill level of previous work, education and age to determine if the claimant can return to work. Skill level is separated into three levels: unskilled, semi-skilled and skilled work. Education levels range between illiterate and high school graduate or more. If a claimant has below a high school education, Social Security will consider the fact that the education level of the claimant does not have direct entry into skilled work. For those with an education level of a high school graduate or above, Social Security will take into consideration that the claimant’s education level provides direct entry into skilled labor.

Similarly, age is taken into account when Social Security examines the claim. Claimants 49 and younger are classified as “ Younger Individuals,” and will find that Social Security has stricter rules when determining their disability. When a claimant reaches 50, the rules to determine their disability and ability to return to work are relaxed. Similarly restrictions are loosened again at 55 and 60. While supportive medical records play the most important role in Social Security’s determination process, past relevant work, education and age also weigh heavily in the determination process.

The best way to ensure that your claim is handled properly is to hire an attorney. Your disability attorney will stay on top of all paperwork and requests from Social Security and make sure that all your medical records have been received. For more information, visit us at www.socialsecuritylaw.com.

Tuesday, September 27, 2011

So I’ve Been Approved for Disability Benefits

Whether you’re applying for Disability Benefits or have already been approved in San Francisco, it may help to have some idea of what to expect. The following are some frequently asked questions about disability benefits that many claimants ask:

How long will I be entitled to benefits for?

There is a common misconception that once you’re approved for disability that your payments will continue for the rest of your life. While this may be true for some people, Social Security will periodically review your case to see if you are still disabled.

You will continue to receive benefits unless your medical condition improves significantly and you are no longer unable to work. All cases are reviewed from time to time based on what kind of improvement to your condition is expected when a decision is made.

If medical improvement is expected, then you case could be reviewed within 6 to 18 months of when you are approved. If improvement is possible, then your case will be reviewed every 3 years. If your condition is not expected to improve, your case will be reviewed every 5 to 7 years.

How are my benefits calculated?

The amount of money you receive for your disability benefits is based on the date you became disabled. When you apply for disability, Social Security asks you when you became disabled. Your answer to this question is your “onset date”.

Under law, you cannot become entitled to benefits until 5 months after you become disabled. Thus, Social Security will begin your payments 5 months after your “onset date”.

How do I receive my payments?

If you have a bank account, then you have the option of setting up a direct deposit for your benefits. SSA strongly encourages you to use direct deposit for your benefits.

Of course, you can still receive checks by mail if you prefer. There are some drawbacks to using checks. Because checks are delivered by the post office, they can be late by a couple of days. Also, by using direct deposit you do not have to worry about losing the check. Also, a government check must be cashed within 12 months after the date it was written otherwise it becomes void.

The most common reason why people who receive checks by mail do not get their benefits is because they do not update their address with the Social Security Administration when they move.

Do I have to pay taxes on my disability benefits?

Only about a third of social security beneficiaries pay taxes on their benefits. Those who do have to pay taxes on their benefits fall into at least one of three categories:

1) If you file a federal tax return as an “individual” and your income is more than $25,000

2) If you file a joint return and the combined income between you and your spouse is greater than $32,000

3) If you are married and file a separate return, you most likely have to pay taxes on your benefits.

Do my benefits adjust with inflation?

Social Security will increase your benefits if the cost of living increases. The increase in your benefits will be proportional to the increase in the cost of living. So, if the cost of living goes up by 3%, then your benefits will increase by 3% as well. These increases are called “cost-of-living” adjustments.

Can I try to go back to work?

Social Security encourages people to go back to work if they feel that they are cable. Once you have been approved, you are entitled to a trial work period. You can continue to receive your benefits for up to nine months while trying to work.

Disability Group, Inc. was founded on the principles of dignity and respect. We are a national law firm focused exclusively on helping people receive the Social Security Disability benefits they deserve. For more information about Social Security, or to see if you qualify for benefits, visit us at www.socialsecuritylaw.com.

Monday, September 26, 2011

How to Earn Work Credits

In order to be eligible for Social Security Disability Insurance (SSDI) benefits in San Francisco, a claimant must have earned enough work credits in the past. Work credits are earned income for each year. The general rule of thumb is that you must have earned 20 work credits in the past ten years; in other words, you must have worked five out of the past ten years in order to quality for SSDI. It is possible to earn a maximum of four work credits per year. The amount of earnings necessary to earn credits raises each year in accordance with increases with average earnings levels.

In 2011, one work credit is earned for each $1,120 of earnings made by the claimant.

Credits earned are permanent and stay on one’s earning record. However, a set amount of work credits need to have been earned in the immediate past years before a claimant becomes disabled in order to stay eligible for disability benefits. Work credits can expire! Once you stop working, you have five years to apply for disability benefits before you will become uninsured for SSDI.

Work credits also depend on an applicant’s age. For claimants who are found to be disabled prior to the age of 24, he or she must have earned six credits in the three years before being found disabled. If a claimant is found disabled between the age of 24 and 30, credits for half the time between the age of 21 and 30 are needed to be eligible for SSDI benefits. If a claimant is disabled at age 31 or older, the applicant needs at least 20 credits in the ten years immediately before being found disabled; again, this means that one must have worked at least 5 out of the 10 years immediately before the onset of their disability.

Some exceptions to the work credit rules apply. For applicants who are in the military, work credits are earned in the same manner as those who work in non-military roles; however, additional credits can also be earned under specific conditions. Similarly, mothers who have no earnings while caring for a child under the age of 3 can qualify for work credits during these years. Claimants who are employed in farm work or domestic work can also earn work credits under different rules, as can applicants who work for a church or church-controlled organization that do not pay into Social Security taxes. Benefits can also be collected by the survivors of a disabled applicant, even if the payee does not have enough work credits under their own records—the benefits will be calculated using the work credits of the deceased applicant.

Disability Group, Inc. was founded on the principles of dignity and respect. We are a national law firm focused exclusively on helping people receive the Social Security Disability benefits they deserve. For more information about Social Security, or to see if you qualify for benefits, visit us at www.socialsecuritylaw.com.

Friday, September 23, 2011

Applying for Disability Benefits with Multiple Sclerosis

If you have Multiple Sclerosis and your condition prevents you from working in San Francisco, you might consider filing for Social Security disability benefits. The Social Security Administration (SSA) lists MS as a chronic illness that can cause disability, although it may be difficult to prove. The following are some symptoms that SSA will look for when determining whether or not you are disabled:

  • Difficulty walking
  • Difficulty seeing/damaged vision
  • Concentration or memory problems
  • Extreme fatigue
  • Impaired speech
  • Difficulty performing simple tasks
  • Vertigo
  • Bladder/Bowel dysfunction
  • Muscle weakness/muscle spasms

One way to be found disabled is to meet the medical listing (listing 11.09) under the Social Security guidelines. This is determined by a doctor contracted to review the medical evidence gathered on your claim.

Another way to be found disabled is to prove that you are unable to perform any significant work activity in the national economy. Again, this needs to be supported by medical evidence and doctors’ reports. Reports that are most helpful to a disability claim include notes suggesting work limitations or any functioning limitations.

Other areas that a Social Security disability examiner or judge will look at are limitations with sitting and standing. This is important because if you need to lie down and rest after sitting for an hour or so, you would not be able to perform significant work activity required by the economy.

A doctor willing to cooperate with your disability claim can also help; many physicians will be asked to complete a short questionnaire that includes specific information that Social Security is looking for. If there is not enough evidence, then a short examination will be set up with a doctor contracted by Social Security.

Multiple Sclerosis is a disease that produces different symptoms so a good way to help your claim is to keep track of each flare-up in a journal or medical log. The best way to ensure that your claim is handled properly is to hire an attorney. Your disability attorney will stay on top of all paperwork and requests from Social Security and make sure that all your medical records have been received. For more information, visit us at www.socialsecuritylaw.com.

Thursday, September 22, 2011

What is a Consultative Exam? Will it Hurt my Case?

Many claimants who apply for disability benefits in San Francisco are scheduled for a Consultative Exam at some point throughout the decision-making process. It is normal to be unsure of what this means and why you may be scheduled for one. After you file your initial application, the Social Security Administration will forward your claim to Disability Determination Services (DDS) where it will be assigned to an adjudicator. The adjudicator is responsible for collecting all of an applicant’s relevant medical records pertaining to their disability. If the adjudicator is unable to gather enough medical records to make a decision, they will schedule a Consultative Exam (CE) for the claimant, which is an appointment with one of Social Security’s doctors.

Here are some reasons an adjudicator may find that an applicant’s medical records are insufficient:

  • Applicant’s doctor did not supply up-to-date medical information
  • Applicant’s doctor failed to respond to medical records requests
  • Records indicate a possibility of having a condition with no follow-up
  • Applicant fails to complete and return questionnaires supplied by the adjudicator
  • Applicant has not been to the hospital or seen a doctor that can supply medical evidence regarding their alleged condition

Any one of these reasons can lead to the scheduling of a Consultative Exam.

Will a Consultative Exam hurt my case?

When a Consultative Exam is scheduled, Social Security has to pay the bill, so the adjudicator would not schedule a Consultative Exam unless it is absolutely necessary. Once the exam is scheduled the adjudicator will mail out a notice informing the applicant of the exam’s date, time and location. The only reason a Consultative Exam would hurt a claim is if the applicant fails to attend. Failing to attend can almost certainly lead to a denial since the adjudicator would not have scheduled the Consultative Exam if they thought they had enough information to make a favorable decision on the claim.

One must understand that the doctor completing the Consultative Exam is only attempting to gather information regarding a specific condition. The exam is conducted to ‘fill in the blanks’ of the medical evidence provided. To avoid a Consultative Exam and save time during your claim, it is good to have copies of your medical records with you (pertaining to all of your disabilities, not just your main condition) and to inform your doctors to expect requests for records from Social Security. The best way to ensure that your claim is handled properly is to hire an attorney. Your disability attorney will stay on top of all paperwork and requests from Social Security and make sure that all your medical records have been received. For more information, visit us at www.socialsecuritylaw.com.

Friday, September 16, 2011

How the Social Security Disability Case Backlog Could Affect You

The enormous volume of claimants for Social Security Disability has created a backlog of cases. For many this can mean from the time of initial application it can take 1, 2, or even 3 years before they receive benefits! Because of the extreme backlog it is important that you do everything you can in San Francisco in order to have the most complete and accurate information possible right from your initial application.

The problem has increasingly worsened, so that in his testimony to the Subcommittee on Oversight of Government Management, the Federal Workforce and the Federal Workforce and the District of Columbia, the President of the Association of Administrative Law Judges, the Honorable D. Randall Frye stated:

“At the rate of reduction in FY 2010, without considering any increase in applications, it would still take over four years, to the first of CY 2015, to reduce the backlog to a level of under 400,000 cases, the number SSA says it needs to keep the processing pipeline filled.”

What Can I Do? A Few Suggestions For Dealing With The Backlog

Hire Representation- Claimants with a professional Representative have a statistically higher chance of receiving benefits, so if you are having a hard time filling an application, getting medical records, or with the process in general consider hiring a Representative.

Write Your Congressman- They work for you, now have them help! It is possible that your elected officials can help expedite the process and allow you to claim benefits earlier. Simply write a letter outlining your situation and what stage of the determination process you are in.

Have Complete Records- Make sure you are constantly seeing the doctor and forwarding their documentation to the Social Security Administration and your Representative. This is the most important factor in determining if you will receive benefits.

Return All SSA Paperwork- SSA is constantly sending you forms to sign and fill out throughout the application process. It is absolutely necessary that you complete these forms thoroughly and return them as soon as possible so SSA can continue working on your case. Without them, SSA may deny you or place a hold on your claim.

With disability processing times taking this long, it is essential that you ensure your claim is being processed correctly. Hiring a Social Security Disability lawyer to handle your case will guarantee that no mistakes are made and no further delays are placed on your case. To find out more, visit us at www.socialsecuritylaw.com.

Thursday, September 15, 2011

An Explanation of Medicare vs. Medicaid

Medicare is a large insurance program that is funded by the federal government. How does it work and who gets it? This is what has confused millions of Americans who cannot seem to get insurance coverage, or have a plan with limited coverage. Medicare is the health care plan for those who are over the age of 65, regardless of income.

When taxes are deducted from your payroll a portion of that does go to pay for Medicare. Medicare and Medicaid are not the same and it’s important that those who apply understand this. Medicaid is a state program that applies to people with limited income and limited resources to cover medical costs.

Medicare is medical coverage for the elderly, so the recipients must be over the age of 65. Medicare is made up of four parts which include: Part A, or what covers hospital care for those on Medicare; Part B, which is coverage for doctor’s visits as well as some medical supplies; Part C, which enables those under Part A to choose what they want coverage for, and Part D which provides coverage for prescription medications.

Medicare is a fee-for-service program. This program enables those under the plan to go to any hospital or doctor they would like within the country. Those who get Medicare can choose to receive it through a private health care plan, but these plans will have different types of coverage and costs.

Those who do receive Medicare insurance will receive their card directly from Medicare. The insurance card can be taken to doctor appointments and use it to purchase their prescription medications. This is when recipients are most grateful because medical costs are expensive and Social Security alone may not be sufficient enough to cover all expenses.

No matter what your income level, you can get Medicare. Don’t let time pass you by before you decide to learn about what is involved, and how it can help you and your loved ones get covered for your healthcare needs.

Disability Group, Inc. was founded on the principles of dignity and respect. We are a national law firm focused exclusively on helping people receive the Social Security Disability benefits they deserve. For more information about Social Security, or to see if you qualify for benefits, visit us at www.socialsecuritylaw.com.

Wednesday, September 14, 2011

Payments That Can Offset Your Potential Disability Benefits

Many people who apply for disability benefits are already receiving some sort of monthly aid. If you are wondering what will affect and possibly offset your potential disability payments and back pay, here are your answers:

Workman’s Compensation

Receiving Workman’s Compensation before or during the Social Security process will affect your eventual award amount. This is because you are being paid by a previous employer or federal agency as a result of your disability, and SSDI payments also come from a federal agency.

State Disability

Similarly, receiving State Disability at any point throughout or before the process can offset what you would be awarded. This is because you are already being paid a certain amount by a federal or state agency. Often your local Social Security office will ask for proof of exhaustion of State Disability when you first apply.

Unemployment

Receiving unemployment benefits at any point during the Social Security process will also offset your future payments and back pay because you are being paid federally. It is important to be aware that receiving unemployment while filing for disability is a contradictory statement. You are simultaneously stating that you are actively looking for work while also stating that you are too disabled to work.

Veteran’s Administration Benefits

These benefits will not offset any future disability benefits you are entitled to and those receiving VA Benefits will receive their full Social Security disability allowance.

Food Stamps and Medicaid

Receiving Food Stamps and Medicaid will not affect any part of your disability claim or potential payments. If you are not receiving either, you can apply at any point throughout the disability process if you meet the income and medical requirements for these benefits. For more information, contact your local Social Security Office.

The best way to ensure that your claim is handled properly is to hire an attorney. Your disability attorney will stay on top of all paperwork and requests from Social Security and make sure that all your medical records have been received. For more information, visit us at www.socialsecuritylaw.com.

Tuesday, September 13, 2011

Veterans and Disability Benefits: What You Must Know to Get Your Benefits in San Francisco

The Social Security Administration acknowledges the unique sacrifices made by veterans. Due to their military service, veterans can receive expedited processing of disability claims from Social Security. Benefits available through Social Security are different than those from the Department of Veteran’s Affairs and require a separate application. The expedited process is used for military service members who become disabled while on active military service on or after October 1, 2001, regardless of where the disability occurs.

In order to apply for Social Security Disability Benefits as a veteran it is important for you and your representative to compile all information and documentation related to your disability. Some standard documents required for applying for Social Security Disability Benefits include:

Original or certified copy of your birth certificate or proof of U.S. citizenship or legal residency if foreign born;

Form DD 214, if discharged from the military service;

W-2 Form or income tax return from last year;

Military or workers’ compensation to include proof of payment;

Social Security numbers of your spouse and minor children;

Checking or savings account number, if you have one;

Name, address and phone number of a contact person, in case you are unavailable; and

Medical records that you have and/or that you can easily obtain from all military and civilian sources.

With the help of your representative you should compile this information and file your initial application.

After filing your initial application it is critical that you continue to see your doctor and follow their instructions. Whether you are treated at a VA hospital or by a family physician the Social Security Administration will need continuous updates about your medical status. It is important that you and your representative stay in frequent contact with the SSA.

How does military pay affect eligibility for disability benefits?

You can still qualify for Social Security Disability Benefits even if you are receiving military pay! In order to qualify for Social Security Disability Benefits you cannot engage in any substantial work activity, military pay itself does not disqualify you. Your ability to work is what determines your eligibility for benefits so even if you are still on limited duty or undergoing some therapy or rehabilitation program you still may be eligible for benefits.

Disability Group, Inc. was founded on the principles of dignity and respect. We are a national law firm focused exclusively on helping people receive the Social Security Disability benefits they deserve. For more information about Social Security, or to see if you qualify for benefits, visit us at www.socialsecuritylaw.com.

Monday, September 12, 2011

What are some Examples of the Listings that SSA Uses to Determine Disability in San Francisco?

When determining if a person is disabled in San Francisco, Social Security has a set of listings, which is also known as “The Blue Book”. Each listing covers a variety of conditions. If a claimant’s conditions meet the requirements of a listing, the claimant will be medically eligible for disability benefits. Many people applying for disability are not aware of Social Security’s medical requirements and are often unsure if they meet a listing or not.

“The Blue Book” covers 14 physical and mental listings. The 14 listings are Musculoskeletal System, Special Senses and Speech, Respiratory System, Cardiovascular System, Digestive System, Genitourinary Impairments, Hematological Disorders, Skin Disorders, Endocrine System, Impairments that Affect Multiple Body Systems, Neurological, Mental Disorders, Malignant Neoplastic Diseases, and Immune System Disorders. Each listing has a set of requirements that must be met in order for a claimant to meet the listing. Some examples of listing requirements are as follows:

Respiratory System:

· Look for oxygen tanks; lung transplant; check FEV values in the listings chart, based on height (volume of air); limitations in pulmonary function; for asthma, look for 6 or more ER visits requiring breathing treatments in a year

Skin Disorders

· Skin disorders, burns, lesions, lasting 12 months or more; skin disorders limiting the ability to perform simple tasks (such as burns on hands); skin problems recurring despite 3 months of prescribed treatment; frequency of flare-ups

Mental Disorders

· Sobriety for at least 12 months; GAF less than 50; inability to perform simple tasks and concentrate; psychological hospitalizations, residences in in-patient facilities, suicide attempts; anti-psychotic medications

To find out more details and whether your conditions meet a listing, you can go to www.ssa.gov/disability/professionals/bluebook/AdultListings.htm. If your conditions are not severe enough to meet a listing, you will not necessarily be denied- Social Security will look into your conditions and your past work in detail and determine if you are able to return to any type of work. It is good to have a general idea of what listing your conditions fall under and make sure that Social Security is aware of all of your conditions.

With disability processing times often at well over a year, it is essential that you ensure your claim is being processed correctly. Hiring a Social Security Disability lawyer to handle your case will guarantee that no mistakes are made and no further delays are placed on your case. To find our more, visit us at www.socialsecuritylaw.com.