ALABAMA DISABILITY COUNSELORS

Congratulations!  You have been approved for Social Security disability benefits.  Your Notice of Decision just arrived and it's the best news you've had in a long, long time. But there's no check in the envelope.  How long will it take to get your money? The short estimate (guesstimate) is about 90 days.  Sometimes sooner, sometimes later.  There is no cut-and-dried time frame. Here's what happens after your Notice of Decision or approval letter arrives at your house: 1.  The decision maker who approved your claim sends the decision to a payment processing center, if you claim was for Social Security Disability Insurance or SSDI (also called Title 2). Processing centers are typically in Baltimore or Birmingham. The processing center will begin to check things, formulate payment amounts and get ready to send you a payment. Keep in mind payment centers get thousands of decisions each day, so processing is more waiting for your turn.  Back pay us...

You have probably heard that Social Security disability is a series of frustrations, ups and downs, and disappointments.  Sadly, most initial disability applications are denied.  If a person is feeling downtrodden already, a denial may be enough to make him or her give up and quit.  Don't let that happen to you. You have to stay the course.  The US government has designed a disability program (Social Security) that isn't easy to navigate and requires several steps to be successful.  For most folks, it simply isn't going to be quick or easy. Based on state averages in Alabama, here's what to expect on the typical case (yours might be different): APPLICATION:  You will wait 3 to 5 months and over 75 percent of these are denied by mail.  Exceptions are usually for individuals with catastrophic medical conditions that clearly and without doubt disable them.  Persons over 55 have an advantage, too.  If you get a denial, file a written appeal...

May Social Security pay a worker for a mental health related disability? Yes, if the symptoms are severe and prevent the ability to work on a full-time basis. If you look up information about mental impairments online, you will probably be directed to the Social Security "Listings."  Almost nobody can meet these listings.  And that is not the way most people get approved.  I see much harm done by folks to get online, see these listings, and think--"My case isn't nearly that bad," and they give up.   Most claimants do not meet the Listings.  Most claimants who win and get paid do not meet the Listings. Here is the common sense approach to a Social Security disability claim due to mental health problems: 1.  Are your symptoms bad enough that you can't perform the mental tasks of *work on a full-time job (8 hours a day, 5 days a week)? 2.  Do you have a diagnosed condition that has already lasted for at least 12 consecutive months, or is ...

No one I know denies that the government pressures judges to deny Social Security disability claims.  This pressure, I think, is the result of two lines of thinking in 2020: 1.  The Social Security trust fund is going broke and soon won't be able to pay all the benefits that have been awarded;  2.  It's too easy to get disability benefits and people are cheating and abusing the system. Nationwide, judges pay only about 40 percent of disability claims that come before them. That rate has been falling for the last 5 years. However, the award rate from one judge to another varies widely.  In the same office, one judge may pay 20 percent of the cases heard while a judge down the hall may pay 60 percent. Over the last three years or so, the government has been trying to level out the award rates.  They would like all judges to get in line so their award rates look pretty much alike. Stated another way, the government wants every judge to deny about 60 ...

Social Security will often pay for multiple myeloma with sufficient documentation.  The medical records submitted should provide sufficient details about the onset of the disease, the severity of symptoms, where the lesion(s) occurred and response to treatment.  Biopsy and pathology reports must be provided. In the case of stem cell transplant (bone marrow transplant), Social Security will award a period of disability starting with the date of transplant.  They will review improvement at the end of one year to determine whether payments can continue. Multiple Myeloma is considered under Listing 13.07 in the blue book. If additional or other types of cancer are involved, they should be considered under separate Listings.  

Social Security must use 5-steps in considering whether you are disabled or not.  Most cases make it to Step 4 or Step 5, where a decision is made. So, what is a Step 4 approval? Step 4 determines that a claimant who is over 50 years of age is not medically able to perform any past work (looking back at 15 years of work history).  For example, if a 55 year-old claimant worked in construction for the past 15 years, which is considered heavy exertion level, but can no longer perform heavy work, a finding of disabled is called for.   Social Security does not require persons of "advanced age" to adjust to new kinds of work.  So, the way to win at Step 4 is to  prove that you are not able to sustain any of the work you have done during the past 15 year period.  Work you did longer than 15 years ago will not count against you. Now, a quick word about Step 5.  Step 5 is where younger claimants usually wind up for a decision.  The ques...

It's extremely disappointing to be denied for disability benefits when the bills are piling up, the money is short, and you feel desperate and helpless. It's only natural to try to explain why you need disability payments.  However, there are some arguments or explanations that just go nowhere with Social Security. # 1.  I lost my drivers license; therefore, even if I had a job I'd have no way to get there.  Or, my car broke down. This sounds reasonable.  However, it is not an acceptable reason for not working in Social Security's view.  Lack of transportation is not a factor they consider in disability cases. #2.  No one will hire me. This is a common statement but irrelevant to a disability claim.  Social Security is not employment insurance ; it is disability insurance .  It only covers the inability to work, not the inability to find work. #3.  My professional license expired and I can't get it back.  For example:  ...

Can I still get SSDI benefits if I have substantial non-work related income? If you are not working, Social Security does not consider other types of income when you file an SSDI claim (also called a Title 2 claim). An individual might have income from alimony, child support, pension, retirement accounts or disability payments from the military or an insurance policy.  This type of income does not have an effect on whether you are eligible for SSDI payments. The key factor is that sources of income are not related to your own personal work.  If your spouse works, for example, it does not have any effect on your qualification for SSDI.   In fact, SSDI is not means tested at all.  A claimant does not have to prove that he or she is poor, has restricted income or financial resources.  It isn't necessary to prove that you need money. This is not true with Supplemental Security Income or SSI, also called Title 16 benefits, which are means tested. ...

Social Security receives about 1 million disability applications each year and because of very rigorous requirements only a handful receive benefits. Here are some common mistakes to avoid when you file a disability claim with Social Security. 1.  Continuing to work. The law is written so that an individual cannot work at 'substantial gainful activity' and receive SSDI benefits at the same time.  In short, if you are working and earning at least $1,260 per month you are disqualified under the law to get SSDI.  It doesn't matter why you are still working, since there are no exceptions to the law.   2.  Receiving Unemployment Benefits. In my state there is no law against receiving both SSDI benefits and unemployment benefits.  But there is a problem.  Unemployment benefits are designed for individuals who are able to work, available for work and looking for work.  It is a temporary assistance program for workers who are temporarily between...

It's not a hit song, but there must be 50 ways to win disability.  Here, I will discuss 6 of the ways. # 1.  You can win by meeting a Listing.  This is the most difficult way for most claimants because the listings are nearly impossible to meet.  But if you're unfortunate enough to have a very devastating disease, this may be possible. # 2.  You can win by proving that you can no longer do any of your past work if you are age 50 or over and meet the other requirements.  This uses the "grid rules" or medical-vocational allowances to approve your claim.  It doesn't work for claimants under age 50, however. # 3.  You may win by proving that your symptoms are so severe that you can't possibly perform even sedentary, unskilled work.  You would need a severe restriction in such basic work functions as sitting, reaching, and concentration for this. # 4.  You may win by showing mental or psychological symptoms that are severe enough to i...

Social Security makes "bad decisions" every day. Most of the time, they will routinely deny the initial disability claim.  Just a fact.  What matters is what happens next.  The denial must be appealed within 60 days.  There are basically 3 ways to file an appeal within the 60 day deadline: 1.  Go to the Social Security office.  You can file an appeal in just a few minutes at your local Social Security office.  You may want to call and make an appointment, rather than just showing up, to reduce the wait. 2.  Appeal online at socialsecurity.gov.   Click on the Disability icon, then click "Start a New Appeal."  It's a matter of filling in the online form. 3.  Appoint an attorney or representative to file the appeal for you.  You won't be charged just for filing the appeal.  However, the representative can eventually charge you a fee for working on the case if you win and recover past due benefits.  Ask the attorney...

Alabama has now joined all the other states that use a 2-step appeal process for denied disability claims. The denial rate in Alabama hovers around 75 percent.  Almost 8 out of 10 applications for disability will be denied. Claimants who eventually get paid are the persistent folks who appeal and keep appealing until the process makes a fair decision.  That's right, many times the decision is just not fair.  The early stages can be mechanical and set up to fail.  The odds get better as you go along. APPEAL STEP ONE :  Called the "Reconsideration" stage, this first appeal simply sends the denied claim back to the state agency that denied it.  It asks the state to review its decision and reconsider its action.  In all but 5 percent of cases, the state will deny the claim again.  Par for the course....totally expected. APPEAL STEP TWO :  Called the "hearing stage," this appeal takes you before an administrative law judge who will...

Back trouble is a generic term for many musculoskeletal impairments that cause pain in the back, shoulders, hips or legs.    Back and spinal issues are the single largest cause of disability in the United States.   Social Security, however, will not pay a benefit simply because of complaints of back pain, even if the doctor has recorded long term complains of pain. It's necessary to determine the cause of back pain in order to get benefits approved.  This usually requires objective tests which may include X-rays, MRIs or CT scans for imaging of the spine. These imaging studies may show degenerative disc disease.  Specifically, studies may reveal narrowing of the spinal canal, osteophyte complex (bone spurs), bulging or herniated discs or other problems. After demonstrating the cause of the pain, Social Security will try to determine how pain affects your ability to function.  How does pain limit your ability to sit, stand, stoop, reach, ...

Seizures can cause severe disruptions to the ability to work.  They can cause absence, safety issues and the inability to sustain a normal workday routine.  Therefore, they may be disabling. Here is what Social Security will want to see in an application for disability related to seizure activity: What is the diagnosis?  What type of seizures is the claimant having?  What is the cause? What happens during a seizure?  Is there more than one type of seizure occurring? What is the frequency of seizures? How long have seizures been occurring? What medical treatment has been tried? Has medical treatment reduced the frequency or severity of seizure activity? An individual with certain types of seizures may have lost their driving privilege, at least temporarily.  This, in itself, does not equal disability. The claimant should explain how seizures affects the ability to perform work related activity.  How often would he or she be absent from w...

Can a person get disability benefits because of migraine headaches? Yes, migraines may be severe enough to prevent an individual from sustaining full-time work. Full time work is defined by Social Security as 5 days per week, 8 hours per day or an equivalent schedule.  An individual must be able to maintain concentration, persistence and pace on that type of persistent schedule. So, may migraine headaches be disabling?  They may, but not necessarily.  The questions are:  How frequent are the headaches? How long do they last? How severe are they? What treatment have you tried? Generally, Social Security does not pay for migraines unless they occur several times per month, last for several hours and are severe enough to disrupt normal activities.  Social Security also wants to see treatment that includes various medications, therapies and attempts to control the headaches. If the migraines are frequent, debilitating and retractable (resistant to tr...

Obviously, at your disability hearing you must prove that you are disabled.  But you must also prove when you became disabled.  This date is called the "alleged onset date." The onset date determines the amount of your back pay award.  It also determines the date you will become eligible for Medicare insurance.   I have a client right now who is going to hearing soon.  He filed a claim in August, 2019.  If the judge finds him to have become disabled in August, his back pay will be zero ($0).  The five month waiting period will gobble it all up. However, if my client is found to have become disabled in February 2018, as he alleges, his back pay will be approximately $45,000. If his onset date is found to be August 2019, his Medicare coverage can being in January of 2021. However, if he is found to have become disabled in Feburay of 2018, he can get Medicare in July 2020. So, it's important to set the correct onset date to start the back p...

You've applied for Social Security disability and they have scheduled you for a medical examination.  Is this a good sign? About one-third of claimants are sent to a doctor for an examination.  Social Security may send you to a general practice doctor if you allege a physical disability or to a psychologist if you allege a mental impairment.  Sometimes, they will schedule an exam with both types of doctors. Will this exam help you get benefits?  Obviously, it depends on what the doctor finds and reports during his or her exam? I will say that in most cases exams by Social Security doctors do not help the claimant to get approved.  There may be several reasons why this is true: The exam will be by a doctor you've never seen before. The exam will be brief and rather superficial. The exam was ordered because there was not sufficient medical evidence from your own doctor(s).  Therefore, Social Security did not have enough evidence to approve your cl...

By Gregory Forsythe 1.  Are you working while applying for Social Security disability benefits? Social Security disability benefits are meant for persons who are not able to work.  If you are working and earning enough to support yourself, you are probably not eligible for a disability benefit.  In 2020, you are considered working at substantial gainful activity if you work and earn at least $1,260 per month.   2.  Do you have a severe medical impairment that has lasted or is expected to last at least 12 straight months? A severe impairment is one which affects at least one essential work-related function.  In simple terms, you must have a medical condition that makes you unable to work.  This condition must have lasted at least 12 straight months or be expected to last at least 12 straight months.  A short-term condition is not covered by Social Security.  Any condition expected to result in death meets the 12-month condition. 3....

Trying to place odds on winning a Social Security claim is worse than trying to put odds on winning the lotto.  Each case is different because of several factors:  claimant's age, past work experience, education, medical impairments and the judge who will hear the case. Change any one of the "components" in a case and the odds change dramatically.  But based on national averages and our experience, here is a rout idea of the averages based on millions of cases filed nationwide: APPLICATION STAGE (FIRST STAGE):  The odds of being approved at the initial application stage is between 20 and 30 percent.  Yes, 70 to 80 percent will be denied and will require appeals. RECONSIDERATION STAGE (FIRST APPEAL):  Less than 10 percent of claims are approved at Reconsideration.  However, a few do get approved here and, anyway, this step is required before you can move forward. HEARING STAGE (SECOND APPEAL):  This is actually the best chance. ...

Unfortunately, Social Security will deny about 7 out of 10 applications for disability.  However, there are appeals available and should be used.  Here is the required path for appeals. Note:  You are only allowed 60 days to file an appeal. 1.  Appeal and ask for Reconsideration.  This is the first appeal.  It asks the Disability Determination Service (DDS) to re-examine your application and reconsider their decision.  They will usually deny the claim again but this opens up further avenues of appeal. 2.  Appeal and ask for a Hearing.  At the hearing, an administrative law judge (ALJ) will hear your appeal, listen to your testimony and review all the evidence. Both the claimant and his/her attorney will appear before the judge for this hearing. The judge will give you a new decision.  This is actually the best chance of winning your benefits.   3.  If the ALJ denies your claim, appeal and ask for a review by the Ap...

The term "mental disorder" still carries a negative stigma.  However, any condition that is not physical in nature is considered a mental disorder by Social Security.  It may be a common disorder such as depression or anxiety, or it could be a more rare disorder.  But if it keeps a person from being able to work, it is a disability. The questions Social Security will want answered about mental disorders are: 1.  How severe are the symptoms? 2.  What is the frequency of symptoms? 3.  When did the severe symptoms first begin? 4.  How do the symptoms affect the ability to function? 5.  What treatment is being attempted to help the condition? Jobs are going to have both physical and mental requirements.  The physical requirements of work include the ability to stand, walk, push/pull, lift, reach, bend, etc.   The mental requirements of work include the ability to perform such function as Concentrate for up to 2-hour peri...

It's rare to file a disability claim and get approved right away.  Unfortunately, most claims are denied and must be appealed. There are common reasons for denials, some of which are: 1.  The application was filed incorrectly or incompletely.  Social Security sends you tons of forms, almost never-ending stream of questionnaires, reports and requests for information.  If each part isn't completed accurately and returned on time, a denial occurs. 2.  All of your medical information isn't received.  Social Security orders only records from the doctors or providers you tell them about.  And often, these doctors simply don't provide the records.  Therefore, a decision may be made on incomplete medical evidence. 3.  Decision makers believe you are able to do things you really can't do.  After a review of your medical records, they will assign you a "Residual Functional Capacity" or RFC for short.  This is a profile of how much you...

By Gregory Forsythe Women represent about 34 percent of new disability claims today.  The number one impairment involves musculoskeletal impairments, followed by diabetes and impairments of the endocrine system. The maximum benefit in 2020 is $3,011 per month, while the average benefit is around $1,275 per month.  Most claims also come with Medicare insurance coverage after the waiting period has been satisfied. Here are the basic requirements you must meet to get disability benefits in Alabama or Tennessee: 1.  You cannot currently be working at substantial gainful activity (SGA).  A job is substantial and gainful if you earn at least $1,260 per month before tax. 2.  You have at least one severe medical impairment that has lasted or is expected to last at least 12 straight months. This impairment prevents the ability to perform all full-time work. 3.   There is sufficient medical evidence to establish the onset, duration and severity of the imp...