October 2011 Archives

Social Security said I am not disabled

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A friend of mine contacted me a few days ago. A long-time friend of hers was looking into filing for disability benefits. Actually, he had been considering filing for about three years, which was part of the problem (if your condition is severe enough that it makes it difficult for you to engage in and do work activity, "thinking" about applying for disability may simply amount to a very huge waste of time since, during that time of consideration you might have navigated through several layers of the system, such as the initial claim and reconsideration appeal).

He had finally gotten up the nerve to contact a local security field office and asked the person on the other end of the line "Will I qualify for disability?". This, of course, was mistake number two. The individuals who answer the phones at social security offices are SRs, or service representatives. They do not take claims but are clerical support personnel. As such, they are not qualified to answer questions like this.

Despite this fact, the service representative responded to the man's question by asking him "Can you work at all?". He told her he had been involved in programming for most of his working career. The absolute truth is that he was a cobol programmer. I don't think they even teach this language anymore and most leftover jobs for cobol have to do with very old systems in institutional settings that have not managed to creak into the 21st century...so, you can certainly see that there's a lot of forward job opportunity associated with being a cobol programmer.

After informing her of his computer background, he told her that, though his condition impaired him in such a way that he could not focus and concentrate enough to do his old job, he could still "probably flip burgers". To which the service rep replied "Then you're not disabled".

This was the the point at which my own friend, who is a friend of the cobol programmer, called me. Upon hearing the story, I told her that service reps are not qualified to answer such questions. However, there really isn't anyone at the social security office who is. That's because even the CRs, or claims representatives, who take disability and retirement claims, only take the claims. They don't actually work on them. That duty is left to disability examiners and the medical and mental consultants who provide case support to them (an M.D. physician and a Ph.D. psychologist, both of whom work in the same unit as the examiner).

Disability examiners work at a state agency that is entirely separate from the social security office. After a claim for disability is taken at a social security office, it is sent to DDS (disability determination services, or whatever serves as the equivalent agency in a particular state) agency for decision-processing, where it may stay for weeks or months while evidence is being gathered and evaluated.

More to the point, though, this particular social security employee arguably "did a bad thing". Because in their complete ignorance of how the Social Security Disability and SSI process works, they left this individual with the clear impression that, if he could work at any job and at any level of earnings, he could not be found disabled by SSA. Which is completely untrue. The system administered by SSA takes into account whether or not a person can return to their past work, but also whether or not they can do some type of other work. And that "other work" part is highly mediated by a number of considerations such as a person's age, transferable skills, and current and anticipated functional limitations which may be mental or physical in nature.

The process for making a disability determination can seem fairly complex. And in some ways it is, and in others it isn't. But one thing certainly stands out as true. There are no individuals manning the phone lines at the social security office who are qualified to answer the question "Am I disabled?". So, one point of advice to individuals who are considering filing an application for disability would be...don't ask that question, because the uninformed answer that you get back will only serve to disappoint and perhaps lead you astray.







Additional Information on:
Social Security Disability







Social Security Disability Questions



Homepage for the: Social Security Disability Resource Center




















A disability examiner (I am a former examiner) would look at the case in two ways. The first would be to see if the medical evidence supports an approval via satisyfing a listing, i.e. meeting or equaling a relevant listing for a specific condition. In this case, the examiner would check section two in the blue book (special senses and speech). Under that section of the listings (aka social security list of impairments), the examiner would look to see if your visual limitations satisfy the criteria for loss of visual acuity, loss of visual efficiency, or contraction of visual field of view.

From my experience as a disability examiner, visual cases presented a problem in that few disability examiners felt competent enough to interpret the evidence. Also, it was sometimes difficult a hunt to find a medical expert within DDS who had the proper background for dissecting this type of medical evidence.

That said, satisfying a visual impairment can be difficult. However, being determined disabled occurs in two different ways. The first is via a listing as we stated. The second is by achieving a medical vocational allowance and the following page discusses this.

How will Social Security Determine if you get Disability Benefits?







Additional Information on:
Social Security Disability







Social Security Disability Questions



Homepage for the: Social Security Disability Resource Center




















An anonymous commenter stated "I started filing ssi disability claims since i was 16 or older. I have heart trouble due to rheumatic heart disease. i have shortness of breath, headaches and i have liver problems. i could not play any sports in school, nor enlist in the military. just recently i went back to lsus medical center and was tested, so i was put on no work, i am a construction worker turned cdl truck driver with no income. do i need a lawyer or just wait for their decision."

My response: Anonymous, the answer I often give is that you wouldn't necessarily need a disability lawyer if your case is pending at the disability application or reconsideration appeal level, but that you should absolutely get social security representation if your case is scheduled for a disability hearing, or if you have simply made a request for a disability hearing and are waiting on the scheduling.

Having said this, however, many individuals will benefit from having a disability representative working on their case at one of the earlier levels for several reasons:

1. A disability representative can ensure that deadlines (such as for appeals) are met.

2. A representative can often assist the claimant with complying with any information requests that are made by the social security administration. Sometimes, this will simply be due to the fact that a claimant's disability attorney will receive copies of whatever correspondence has been sent to the claimant (from the moment that SSA is notified of the fact that the claimant is represented, they will, from that point forward, be obligated to keep both parties (the claimant and their representative) up to date with what is happening on the case.

3. Some disability representatives will be proactive in trying to get the case won as soon as possible without necessarily having to go to a hearing. When a disability case can be proven without the need for requesting a social security hearing, or waiting for a hearing date to be set after a hearing has been scheduled, it can have the effect of saving months, perhaps even as much as a year's worth of time. For a disability claimant who is unable to work, this can make the difference between surviving financially...or not.

Ultimately, when a person will "need" a disability lawyer will be a judgement call. Representation can help at earlier levels. By the same token, many individuals will do ok with waiting until their case has been denied at the reconsideration level. Without any doubt, however, if the claim requires a hearing before a social security judge, the claimant should get representation.







Additional Information on:
Social Security Disability







Social Security Disability Questions



Homepage for the: Social Security Disability Resource Center




















Are most disability claims denied by SSA?

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Someone recently posted on my other blog (inventively titled "My Disability Blog") that they had no idea that most claims are denied. When I read statements like that, sometimes for a split second I think "how could you not know that?". However, that only lasts for a fraction of a second. Because, logically, why would someone think that. After all, most individuals do not want to file for disability. And many put off doing so for years. They only finally take the step of applying for disability once it has become painfully clear to them that they have no other choice. Because of their mental or physical condition, they no longer have the ability to work and earn what SSA calls a substantial and gainful income.

So, to address the question, are most disability claims denied? Yes, the rates of approval and denial vary by state, but it has always been fairly accurate to say that, on a national basis, about seven out of 10 initial claims are denied. Why are so many claims at the disability application level denied? There are many answers to this question. And you could go on for quite a while discussing the various reasons.

However, I like to focus on the fact that most claims are denied initially, an even higher percentage are denied at the first appeal level (the request for reconsideration appeal), and then, suddenly, at the disability hearing level, the odds tilt in the claimant's favor. And there are various reasons one could entertain as to why hearings are more successful, particularly for claimants who have representation provided by a disability attorney or non-attorney disability representative. But...to some extent those reasons are rationalizations. The bald truth is that the disability system is biased and titled against claimants. Purposeful or not, it is set up in such a way that those who start the process have an unfavorable chance of winning, while those persist and file appeals see their chances for approval rise significantly.

And this is why my advice has always been this: if you have a physical condition or mental condition that impairs your ability to work, and your current earnings are below the SGA limit, apply for disability. If you get denied for disability, file an appeal. If you get denied on this first appeal, file a request for a hearing. And absolutely, by this time, make sure you have a disability lawyer or a disability representative assisting you so you can maximize your chances of winning benefits.







Additional Information on:
Social Security Disability







Social Security Disability Questions



Homepage for the: Social Security Disability Resource Center




















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