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  Disability Group 12:41 pm on February 21, 2012 Permalink | Reply
  Tags: Disability, process ( 2 ), Social Security Administration ( 2 ), ssa ( 6 )   

  The 5 Step Disability Determination Process 

  By: Disability Group

  The Social Security Administration follows a five step process to decide if an applicant is disabled or not at all levels of the process (Initial, reconsideration, hearing).  This means that, to decide the claim, SSA will ask five questions, in order. If at any time during the process it is determined that a claimant is or is not disabled, the evaluation stops and they do not advance to the next question. Only at questions 3 and 5 can you win your claim.  The five questions are as follows;

  1.      Are you working?

  • If you are not working, SSA moves onto question 2.
  • If the answer to this question is yes, than you will lose your claim at this stage and SSA will not go on to question 2.
  • If the answer to this question is yes, but only part-time work you may advance to the next question of SSA determine your part-time work does not meet industry standards.

  2.      Do you have a severe impairment, expected to last at least 12 months or result in death?

  • If the answer to this question is no the process stops and the claim is denied at this stage.
  • If your impairment is considered severe then SSA moves onto question 3.
  • A severe impairment is one that significantly affects capacity to do work-related activities.

  3.      Does your impairment or combination of impairments meet or equal the listings that SSA maintains?

  • If the answer to this question is yes and your conditions meets a listing set forth in “The Blue Book” than you will win your case at this stage. They will not go onto question four. It is extremely difficult to win your case at this stage.
  • If your condition does not meet a listing SSA will move onto question 4.
  • SSA defines some conditions as severe and has listed these conditions in what they call “The Blue Book”.

  4.      Are you able to return to your past relevant work?

  • At this stage, if SSA determines you are able to return to a previous job then you lose at this point.
  • If at this stage SSA determines you are not able to return to any past work, they will move onto question 5.
  • Past relevant work is work that was performed in the previous 15 years.
  • At this stage SSA will have the claimant fill out questionnaires to determine if the activities performed on a regular basis can be applied to a job.

  5.      Considering your age, education, and work experience, is there any other jobs that exist in significant numbers in the national economy that you are able to do?

  • If SSA succeeds in finding a job in the national economy that the claimant could perform your claim is denied at this stage.
  • If no such job exists then you are found disabled and you win your case.
  • At this stage it is the Social Security Administration’s responsibility to prove that a job exists in significant numbers that the claimant can perform effectively. 

  This five question structure is the basic structure used at every stage of the claims and appeals process in a disability benefits case. It is extremely important to file an appeal within 60 days of receiving a denial letter. If the claimant fails to file within the time frame given (60 days) the applicant must start over from the beginning (initial level). For this reason some claimants choose to hire representation At Disability Group, Inc. our trained legal staff will guide your through the stages and take care of your claim from start to finish including filing any necessary appeals and representing you at the hearing level if necessary.  Call us today for a free legal consultation.

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  Disability Group 8:02 am on February 15, 2012 Permalink | Reply
  Tags: Auxiliary Benefits, Disability Insurance Benefits, social security disability ( 4 ), ssa ( 6 )   

  Auxiliary Benefits 

  By: Disability Group

  If you have been awarded Disability Insurance Benefits (DIB) from the Social Security Administration (SSA), your children also may be able to qualify for benefits under your own Social Security number.  Your child needs to be dependent on the parent who is receiving monthly benefits in order to qualify.  The benefit paid to the child is determined by the earning record of the parent and how much he or she has paid into Social Security; typically the amount is one half of the monthly benefit paid to the disabled parent.  Social Security calls these monthly payments paid to the dependent child of a disabled worker “auxiliary benefits.” 

  A child is dependant under Social Security’s rules if:

  • The child is the legitimate child of the worker and has not been legally adopted by someone else during his or her life.
  • The child is younger than 18.

  And:

  • A child born out of wedlock but is able to inherit property from the disabled worker.
  • A child born from a voidable marriage or an invalid ceremonial marriage.
  • An adopted child that has been legally adopted before the worker was found disabled.

  Natural born children are not the only dependents eligible for auxiliary benefits.  In some cases, grandchildren and stepchildren can also qualify for these benefits under Social Security’s rules.  In all cases, proof has to be shown that the child is dependent on the disabled worker. 

  • For stepchildren, proof has to be shown that the child is at least half dependant on the step-parent.   
  • For grandchildren, the child has to have begun living with the grandparent before the age 18 and lived with the grandparent for at least one year before the grandparent became entitled to benefits. The child has to have been receiving at least one-half support from the grandparent.

  Once the child has reached the age 18, auxiliary benefits will stop.  Similarly, if the disabled worker returns to work, all payments will stop—including the benefits for the dependent children.  It is also important to note that Supplemental Security Income (SSI) does not provide auxiliary benefits to the children of the disabled.

   

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  Disability Group 9:49 am on February 13, 2012 Permalink | Reply
  Tags: disabled child, my child, Social Security disability benefits, SSI   

  Help! My Child was Denied SSI Benefits because I Work! 

  By: Disability Group

  Disabled children under the age of 18 can qualify for Supplemental Security Income (SSI) if they meet the Social Security’s definition of disability for a child. Your child’s income and resources may affect their eligibility for the program. Social Security does take into account the household income when approving child cases because they recognize that families with lower income have a more difficult time making ends meet.

  My child has no income, why does Social Security use my working income?

  First, Social Security will consider your child’s income and resources. If the child’s parents have income and resources, Social Security considers them available to the child through their parents. If the parent works and has resources the child is at an advantage, as opposed to a non-working parent with limited resources. Social Security’s process of deciding how much of the parents income and resources qualify is called “Deeming”.

  When does “Deeming” apply?

  Deeming applies when the child’s parents have resources and the child meets the following criteria:

  • Is less than 18 years of age
  • Lives at home with either birth parents or adoptive parents
  • The child lives away at school and visits their parents throughout the year and is still under their parent’s control.

  I don’t have any income, is my spouse’s income deemed if they are my child’s step parent?

  Step parent’s income and resources are deemed as long as either the birth parent or adoptive parent lives in the home. 

  What does not get “deemed”?

  Items not deemed are income from: Temporary Assistance for Needy Families, Department of Veterans Affairs’ pensions, county assistance, foster care benefits, and income that is used to pay court –ordered child support.

  Examples of resources that are not deemed are if the parent owns only one property, if the parent only owns one car which is the sole means of transportation, and money in pension funds.

  Although there are many items that are deemable, only a portion of the parent’s income or assets are deemable toward the child. The compete value of the assets, income or resources are not deemed.

   When does “deeming” stop?

  Deeming stops on your child’s eighteenth birthday. If your child did not qualify for SSI because of deeming they may be able to receive SSI when they turn eighteen.

  What will my child’s monthly payment be?

  The amount is different in every state. The cost of living is a major factor in determining the actual amount each child gets. If you have questions about the specific amount, contact your local Social Security Office.

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  Disability Group 12:53 pm on February 10, 2012 Permalink | Reply
  Tags: Alleged Onset Date, disabled, Social Security Administration ( 2 ), ssa ( 6 )   

  Alleged Onset Dates 

  By: Disability Group

  The Basics:

  Your alleged onset date is the date you are telling the Social Security Administration (SSA) you first became disabled.  Your onset date is important as this is used by your attorney to determine how far back medical records need to be obtained and by SSA to determine when you became eligible to receive disability benefits.

  Your alleged onset date will usually be one of the following:

  • The date you stopped working;
  • The date you were diagnosed with a certain condition;
  • The date you turned either 50 or 55;
  • The date after an unfavorable decision;
  • The date a doctor said you were unable to work; or
  • The date you applied for disability benefits (usually for Supplemental Security Income [“SSI”] benefits).

  For most cases, the date in which you stopped working is chosen as the date you first became disabled strictly for technical reasons. As you cannot work and collect social security disability benefits, choosing the date you stopped working typically maximizes the amount you can collect under Social Security Regulations.  Although you may have been diagnosed with a condition and continued to work, under Social Security Regulations, you are not eligible to receive benefits until you’ve stopped working.

  Similarly for technical reasons, if you have a prior unfavorable decision before an administrative law judge on a past application for social security disability benefits, your onset date cannot be earlier than the date after you received this decision.

  For SSI benefits, as you are unable to collect benefits prior to the date of your application, the date in which you applied is typically chosen as your onset date as this again maximizes the benefits you are able to receive under Social Security Regulations.

  Amendments:

  In most cases, the date you state on your application will remain your onset date for the entire life of your application.  In some instances, however, following a review by an attorney at our office or an attorney with the Office of Disability Adjudication (“ODAR”) and Review, an amendment may be necessary. 

  These amendments are done in order to better argue your case.  In the case of an attorney with ODAR making the requested amendment, this may be done in order to get your case granted as soon as possible. 

  Typically, amendments to an onset date are needed if a claimant continues to work after date of their alleged onset or if a particular doctor states the claimant has been disabled since a certain date.  Another common occurrence is the amendment of a disability onset to an individual’s 50^th or 55^th birthday.  This occurs as Social Security Regulations are drafted so that they apply differently to those who are 50-55, 55-60 and 60 or above than to individuals who are under 49.

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  Disability Group 9:34 am on February 7, 2012 Permalink | Reply
  Tags: Social Security Applications, social security disability ( 4 ), ssa ( 6 ), SSI benefits   

  Why am I not receiving SSI benefits? 

  By: Disability Group

  Some SSI applicants may not receive payments in spite of their qualifying disability.  The following are the top reasons why applicants may not receive benefits in spite of their eligibility.

  You do not give Social Security Administration (SSA) permission to contact your financial institutions.

  Because SSI is a need-based program, SSA must be able to determine your eligibility by reviewing your financial information.  Upon application, you must give SSA permission to review records from banks, credit cards, loan companies, trust companies, savings associations, and any other source that would reveal your current financial status.  This may include giving SSA access to financial information belonging to others, i.e. your spouse or others living in your household. 

  You leave the United States.

  You lose your eligibility for SSI benefits for any month during which you are outside of the United States for the entire month.  If you are outside of the United States for 30 or more days, you are not considered to be back in the United States until you are back for 30 days. You may be eligible for SSI benefits in the month in which the 30 days end if you continue to meet all other eligibility requirements.

  You do not apply for other benefits.

  If you do not apply for certain other benefits which you are entitled, you may be denied SSI benefits or have your payments suspended.  These other benefits include annuities, pensions, retirement benefits, or disability benefits.  Specifically, you must apply for veterans’ compensation and pensions, workers’ compensation payments, Social Security insurance benefits, and unemployment insurance benefits.

  You are disabled and drug addiction or alcoholism is a contributing factor material to the determination of disability.

  Drug addiction and alcoholism are major impediments to your initial award of benefits.  Most judges are very careful to evaluate whether the severity of your disability is a result of your addiction.  If you receive SSI benefits and the judge finds that drug addiction or alcoholism is a contributing factor material to the determination of your disability, you must seek appropriate treatment for your addiction.  You will lose eligibility for SSI benefits if SSA determines that you have failed to comply with the treatment requirements. If your benefits are suspended because you failed to comply with treatment requirements, you will not be eligible to receive benefits until you have demonstrated compliance with treatment for a period of time.

  The Social Security process is complex and has many rules.  Applicants should seek legal advice from a Social Security Attorney before they proceed with an application.

   

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  Disability Group 10:32 am on February 3, 2012 Permalink | Reply
  Tags: lawyers ( 2 ), social security ( 2 ), social security disability ( 4 ), social security lawyers ( 2 ), ssa ( 6 )   

  Medical Evidence “Acceptable Medical Sources” and “Other Sources” 

  By: Disability Group

  The Social Security Administration has established regulations pertaining to what types of medical providers can give opinions and provide evidence regarding an individual’s conditions and functional limitations.  Normally, evidence from chiropractors, nurses, and physical therapists will not be given considerable weight because these professions are not considered “acceptable medical sources” by Social Security.

  Under Social Security regulations, acceptable medical sources include:

  • licensed physicians,
  • licensed or certified psychologists,
  • licensed optometrists,
  • licensed podiatrists
  • qualified speech-language pathologists.

  However, Social Security allows evidence from “other sources” to be considered when evaluating the strength of an individual’s claim. These “other sources” may include: audiologists, chiropractors, licensed clinical social workers, naturopaths, nurse practitioners, physician assistants, therapists.  Furthermore, non-medical sources such as educational personnel, employers and family caregivers may also be considered. 

  It must be noted however, that although evidence from other medical sources may be considered by Social Security, “information from these sources cannot establish the existence of a medically determinable impairment.   Instead, there must be evidence from an acceptable medical source for this purpose.”  The natural consequence of this means that an acceptable medical source is still needed to establish the diagnosis or condition.  Fortunately, once the condition has been established by an acceptable medical source, other medical sources may provide evidence regarding the functional limitations and the severity of the condition.

  It is worth noting that Social Security will consider the same factors in evaluating medical opinions from acceptable medical sources and opinion evidence from other sources.  The factors considered include but are not limited to: how long the source has seen the claimant, the frequency of treatment, the consistency of the opinion with the other evidence and the degree to which the source presents relevant evidence to support an opinion.  

  Evidence from an acceptable medical source is usually the best way to establish the existence and severity of a condition. However, once the condition has been established by this source, evidence from the aforementioned other sources may be a persuasive way to convince Social Security of your disability and functional limitations.

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  Disability Group 2:26 pm on February 2, 2012 Permalink | Reply  

  Activities of Daily Living (“ADLs”): What They Are and How They Affect Your Claim 

  By: Disability Group 

  If you have not already, you will likely have to fill out a Disability Report for the Social Security Administration describing, among other things, what you do on a day-to-day basis.  Should your case require you to attend a hearing before an administrative law judge, he or she may also ask questions about how you spend your day. This information is referred to as your activities of daily living (“ADLs”).

  What are activities of daily living?

  ADLs comprise of the activities that you perform on an average day. The judge will be particularly interested what household chores, if any, you are able to perform such as vacuuming, gardening, washing dishes, preparing meals and doing laundry as well as leisure activities such as reading or watching television.  It is important to mention if anyone assists you with your ADLs, including doing them for you entirely. 

  How do they affect your claim?

  A claimant’s ability to perform ADLs is just one of the factors a judge may consider in determining disability.  The judge is not interested in your personal life.  Instead these questions are used to determine what you’re able to do at home as this will reflect what you may be able to do should you try to return to work.

  In many instances, these questions are also used to test your credibility.  As such, it is important to be honest and not exaggerate what you are or are not able to do.  The judge will be looking for inconsistent statements. For example, a claimant who testifies that he experiences great pain when standing for longer than five minutes, but is able to weed his backyard will not appear credible in the eyes of the administrative law judge.

  What is the administrative law judge looking for?

  The judge will be looking for honest and detailed statements in regards to what you do on an average day. Being detailed is important.  Although you may be able to load a dishwasher, this is much different than washing a load of dishes by hand. Similarly, stating that you prepare meals is much different than stating you microwave most of your meals, but are able to cook some meals with a pot as long as you can sit down every few minutes.

  If you require extra assistance in performing even basic activities of daily living such as showering or putting on clothes, be sure to let your attorney know as this is information that the judge should definitely hear.

  General statements of doing nothing will not help your case and will cause you to lose credibility in the eyes of the judge.  Again, the details matter. Spending all day in bed because you are in pain is not the same as “doing nothing.”

  Be sure to speak with your attorney before the hearing if you have any questions of what will be asked of you at the hearing.

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  Disability Group 1:38 pm on January 31, 2012 Permalink | Reply  

  Can I apply for Supplemental Security Income if my spouse has earnings? 

  By: Disability Group

  Supplemental Security Income (SSI) is a federal program that is designed to give financial aid to people with disabilities.  The program is different than Social Security Disability Insurance (SSDI) in several ways.  The biggest difference is in eligibility: in order to receive SSDI, you must have worked and paid into Social Security for a certain amount of time.  However, you do not have to have any work history to receive SSI.  In order to receive SSI, you must have “limited” income and resources, as defined by the Social Security Administration.

  What income counts?

  Income that is included in the Social Security Administration’s calculation includes money you earn from work.  It also includes money you receive from other sources, such as Social Security benefits, workers compensation, unemployment benefits, Department of Veteran’s Affairs, friends and relatives.  Finally, income also includes “in-kind” income, which is any food or shelter that you receive free or at less than its fair market value.

   What are your resources?

  Resources are the things that you own.  They include your cash, your bank accounts, stocks, and bonds, your land, your vehicles (except the first one), your personal property, your life insurance, and anything else that could be converted into cash and used for food or shelter. 

  Please note that certain resources do not count for SSI. 

  The resources that don’t count include;

  a)      the home you live in

  b)       household goods

  c)       burial spaces  

  d)      one vehicle, regardless of its value.

   Because this list is complicated, please refer to the SSA website for more details.

  Do my spouse’s income and resources count as my income and resources for SSI?

  Yes.  In order to be eligible for SSI in 2012, if you are not married, you may only have an income of $698/month.  However, if you are married, you and your spouse cannot make more than $1,048/month in total.  Those figures go up each year.  For more information on the current limits, click here. 

  Generally, if you are not married, you cannot have more than $2,000 in resources.  If you are married, though, then you cannot have more than $3,000 in combined resources.

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  Disability Group 2:44 pm on January 30, 2012 Permalink | Reply  

  Benefits for Children 

  By: Disability Group

  Are children entitled to disability benefits?

  Pursuant to the Social Security Code, while disabled, children are eligible for SSI benefits based on their disabilities.  Non-disabled children may also be eligible for auxiliary benefits based on the insured status of a disabled parent.

  These benefits extend to biological children, adopted children, and stepchildren.  In addition, dependent grandchildren and step-grandchildren may be eligible for Title II (SSDI) disability benefits by way of their disabled grandparent’s earning records.

  To qualify, the child must be either:

  1. Under age 18, or
  2. Under age 19, and enrolled in primary or high school full time

  However, the disability benefits will end either once the child turns 18, finishes school, or in any other way stops attending school full time.  If the child is still in high school on his/her 18^th birthday, benefits will end either the day the child graduates, or 2 months after turning 19. Benefits will also end if the child is paid by an employer to go to school, joins the workforce, or gets married.

  How much is a non-disabled child entitled to receive under Title II?

  A child is eligible to receive up to one-half of a living parent’s full retirement or disability benefit. On the other hand, if the parent is deceased, the child may receive up to 75 percent of the deceased parent’s benefit.

  Can a disabled child collect disability despite a lack of work history?

  If the disability began prior to age 22, disabled adult children may also collect DIB benefits despite lack of work history. While the disabled adult child may be eligible for SSI, Title II may allow for additional benefits based on an eligible parent’s earning record. In this case, the amount the disabled adult child receives may be greater under Title II than under Title XVI.  This is because SSI payments are reduced by resources and unearned income received by a recipient.

  
   
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  Disability Group 2:17 pm on January 27, 2012 Permalink | Reply  

  What is Past Relevant Work? 

   By: Disability Group

  At Step 4 of the 5-step sequential disability evaluation process that SSA uses to determine if a claimant is disabled, the claimant has the burden of proving that he or she is incapable of doing any “past relevant work.”

  To qualify as past relevant work:

  1. The job must have been performed within:
     1. 15 years prior to adjudication; or
     2. if insured status has lapsed, 15 years prior to the date last insured
  2. The job must have been “substantial gainful activity,” meaning:
     1. the job must have involved doing significant mental or physical activities; and
     2. it must have done at the SGA level.
  3. The job must have lasted long enough for the claimant to develop the ability needed for average performance.

  It is important to know that a job qualifies as past relevant work even if the job was done only part-time, as long as it was substantial gainful activity.  Therefore, you as the claimant must identify the easiest full or part-time past relevant job and then figure out why you cannot still do the past work.  If you had an easy job in the past 15 years that you can still do, you will be found not disabled, unless you can put together an argument that your impairments meet or medically equal one of the impairments in the Listing of Impairments.

  Determining whether you can do past relevant work is determined by comparing your current residual functional capacity with the physical and mental demands of past relevant work.

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