Updates from November, 2012 Toggle Comment Threads | Keyboard Shortcuts

  • Disability Group 10:00 am on November 4, 2012 Permalink | Reply  

    Adequate Funding Needed for SSA’s Programs 

    All three of Social Security’s programs- retirement, SSI, and SSDI- have seen increased numbers in caseloads, but administrative funding for the Social Security Administration (SSA) has been suspended since 2010.  Furthermore, the Budget Control Act of 2011 put a cap on discretionary spending that will reduce non-defense programs by 16% by 2021.  Between now and then, it is estimated that Social Security’s caseloads will grow by 30%, which makes it evident that SSA needs adequate funding to carry out its job functions, one of which is continuing disability reviews (CDRs).

    CDRs assess if a disability beneficiary is still eligible for benefits and aims to reduce the number of people on the rolls.  The continued and properly scheduled use of CDRs is expected to eventually reduce payments by $10 for every $1 spent in increased funding.  This measure not only ensures the integrity of the disability program, but also helps the budget.

    If fraud is suspected in a disability claim, it goes through a Cooperative Disability Investigation (CDI), which is lead by SSA’s Office of Inspector General and involves SSA, employees from the state Disability Determination Services (DDS), and local law enforcement.  The CDI requires quite a bit of resources and thus, to be effective, also calls for higher funding.  The Budget Control Act included a “cap adjustment” for program-integrity activities such as CDRs and CDIs, but in the 2012 appropriation of funds, Congress did not take advantage of the cap increases, leaving $140 million in SSA funding up for negotiation.  However, according to the Center on Budget and Policy Priorities, “President Obama has asked Congress to enact the full amount allowed for program-integrity activities in 2013.”

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  • Disability Group 10:00 am on February 2, 2011 Permalink | Reply  

    How to Prove Pain in a Social Security Disability Case 

    What is the Social Security Administration trying to do in my disability case?

    The Social Security Administration’s main goal is to decide whether you are able to work, doing either your past job or any type of job.

    Does the Social Security Administration (SSA) consider the pain I am in when deciding whether to award me disability benefits?

    In many cases, it is the person’s pain that makes them unable to work full time. Pain is subjective, meaning it cannot be measured and everyone’s tolerance for pain differs. Pain can limit what you can do, which can be measured. For example you cannot lift more than 5 pounds, sit for more than 30 minutes or walk farther than 50 yards. These are examples of “exertional limitations.”

    What happens if my pain is just there, and isn’t from doing something (walking, sitting etc.) so it cannot be measured?

    The SSA recognizes that chronic pain and non-exertional pain (pain not from doing something) exists and can limit what you can do at a job.  The SSA looks at a number of different things to decide the effect of pain on your ability to work:

    • They look at your daily activities.
    • They look at the location of your pain, how often and how long you have pain, and how intense the pain feels.
    • They look at what makes the pain appear and what makes the pain worsen.
    • They look at the medications you take and what effects the medications may have.
    • They look at what you do in order to make the pain go away or lessen (lying flat, using heat or ice, etc.).
    • They look at how your activity is limited because of your pain.

    What can I do to prove my pain affects my being able to work?

    1)     Be SPECIFIC when describing your pain.

    Don’t say,” I hurt all over and I am in constant pain.” Rather say, “I have extreme pain in my lower back. On a scale from 1 to 10 my lower back is a 5, but if I walk or stand for more than 20 minutes, the pain jumps to an 8 or 9. The pain stays that way until I take medication.”

    Don’t always say your pain is at a level of 10 because the SSA might think you are exaggerating and have a harder time believing you.

    2)      Be CONSISTENT when describing your pain.

    Your testimony at your hearing will be considered stronger if what you tell your doctor at every visit about your pain level is the same as what you have told the SSA in the application process. If there is no medical test (MRI, etc.) to prove the source of your pain, your testimony will be a very important factor in deciding whether you are found disabled. Be consistent and specific.

    Still confused about how to describe your pain?  Give us a call, and we’ll help guide you through it!

    • felicia 9:15 pm on May 10, 2011 Permalink | Reply

      I was involved in an accident 16 years ago. A car drove through a store I worked at and I got hit by debri. My right knee was injured. Over the years, I have had 4 surgeries, the last being a partial replacement. The pain now is worse than before the surgery, and I can’t sleep without Ambien. I have been out of work since this past November. My pain is constant. Usually my pain level is around a 4 or 5, but after I’ve been sitting in one place for too long (10-15min) the pain gets sharp and goes to a 7. If I walk to my mailbox and back when it is only a 5, by the time I get back to the house it’s up to a 9. I’m most comfortable when I’m stretched out on my right side with my injured leg stretched under me. That position helps, but even then when I go to bend my leg to get up, I experience a sharp pain that levels an 8 at least. With weather, usually 2 days before a front moves into the area I start hurting at higher levels. For those 2 days it is commonly around a 7 and sometimes goes up to a 9. I generally have a high tolerance for pain, but with it being my knee, I can’t function to my normal. I have worked convenience stores most of my life and in 1996 decided to go to school to become a medical assistant. My last surgery was about 6 months before I was hired at my first position as a CMA. Over the year I worked there, the pain increased until I couldn’t really do the job they expected. I can’t go up and down stairs normally, I can’t make sudden turns, and after being on my feet for a few hours, my knee would swell. As I’m sitting here typing this, my knee is feeling as if an icepick is being stuck in it. My family says I’m depressed. I feel useless most of the time because I can’t do the things I used to. Driving is getting harder. I have to use both feet for gas and brake because I can’t turn my right knee to get my foot to go to the brake. It even hurts to get out of the vehicle, because of the way I have to turn to get out. I know this is a lot of information, but I wanted someone to kind of understand why I’m checking in to this. What should I do? Everything was initially filed with Worker’s Comp. so they have all my information. I feel like giving up, because they don’t seem to care. My doctor has suggested another surgery (total knee replacement), but the WC people are having their doctors look at it because they aren’t sure another surgery would help me any.

      • felicia 9:18 pm on May 10, 2011 Permalink | Reply

        I correct… it was in 2006 not 1996 that I went to school for my CMA

    • felicia 9:26 pm on May 10, 2011 Permalink | Reply

      to correct… I started school in 2006, not 1996 for medical assistant.

      • Disability Group 9:22 am on May 13, 2011 Permalink | Reply

        Hi Felicia,

        Thank you so much for your comment and question. I am forwarding your comment to our paralegals. Stand by!

        Disability Group

    • adrian rivas 2:56 pm on July 1, 2011 Permalink | Reply

      I got lupus when I was 12 and know as a adoult I have arthritis, fibromyalgia,chronic migranes, anxiety attachs and depression. All the meds I take for these things make me tiered. I need help pruving to s.s.i that I am unaboule to hold a job.

    • Nina Luu 8:12 pm on June 3, 2012 Permalink | Reply

      I lost a kidney during a surgery after thst during the years my pain is around 5, but i can’t carry anything more then 5 pounds i tried carrying heavy stuff but i couldn’t. The pain is on the right side of my storamch sometimes if i walk more then 10 minutes 7 or 8. The surgery was caused by of bleeding in my storamch, but yhr doctors did something wrong and i lost a kidney. Since i can’t do a lot of things i have my son Victor do this. What should i do? Can you guys help me?

  • Disability Group 10:00 am on January 28, 2011 Permalink | Reply  

    SSDI Benefits for Family Members 

    Once you are approved for Social Security Disability Insurance (SSDI) benefits, certain members of your family may also be entitled to payments; auxiliary benefits may be available for your spouse, your former spouse, and your children.

    Auxiliary Benefits for Your Spouse

    Your spouse may be eligible for payments upon your award of SSDI benefits, if the spouse is (i) caring for your child, or (ii) age 62 or older.

    To receive benefits for caring for your child, the child must either be under age 16 or disabled and receiving Social Security benefits.  Benefits for a spouse caring for your child under age 16 will end once that child reaches age 16.

    Similarly, when your spouse reaches age 62, he/she will be eligible for benefits based on your earnings record.  However, the monthly amount your spouse will receive at age 62 will be less than if he/she waits until full retirement age to receive the benefit.

    If your spouse is eligible for SSDI benefits based on his/her own earnings record, your spouse will receive either that amount or the amount based on your record, whichever is higher.

    Auxiliary Benefits for Your Former Spouse

    A spouse you have divorced will be eligible for SSDI benefits based on your earnings if he/she is (i) at least 62 years old; (ii) unmarried; (iii) was married to you for at least 10 years; and (iv) is not eligible for a higher benefit amount on his/her own.

    Auxiliary Benefits for Your Children

    Your child will be eligible for SSDI benefits if the child is unmarried and (i) under age 18; or (ii) 18 or 19 and a full-time elementary or high school student; or (iii) 18 or older with a disability that began before age 22.

    For the child under age 18, the benefit will stop when he/she reaches age 18.  For the full-time student, the benefit ends upon graduation or 2 months after the child’s 19th birthday, whichever comes first.  For the disabled child, the benefit will last for the duration of the disability.  An eligible child may be biological, a step-child, adoptee, or dependent grandchild.

    As far as the amount of SSDI benefits your family members are entitled to, each may receive up to half of your benefit amount, but there is a limit on the amount SSA will pay family members in total.  The limit depends on your benefit amount and the number of family members who qualify based on your record, but the total is generally around 50 to 80 percent of your benefit amount.

  • Disability Group 10:00 am on January 24, 2011 Permalink | Reply  

    Social Security Myths EXPOSED!! Disability Group Inc Reveals The Truth About the Social Security Claims Process 

    Applying for Social Security disability benefits can be intimidating and time-consuming. Understanding how the system works can be the difference between winning or not winning your disability benefits.  Disability Group reveals common Social Security disability myths and misconceptions.

    Myth: The Social Security Administration denies everyone the first time they apply for disability.

    This is absolutely not true!  It is easy to see why people would believe this when over 70% of all first applications filed are denied.   A claim requires a lot of paperwork, and claimants are often denied when they do not provided documents that the SSA disability reviewer has requested.  A disability lawyer can be help you to prevent an unnecessary denial by staying on top of all requests from the SSA.

    Myth: The Social Security Administration will deny you a certain number of times before you are approved.

    Also not true!  Many people simply file applications over and over again, hoping to be approved.  If you continue to file and get denied at the first stage, you are denying yourself the right to an appeal and even more importantly, you are setting yourself at the back of the line again!

    Make sure that you follow the appeals process up to the highest level in a timely manner, meeting all deadlines.

    Myth: The best way to appeal a Social Security claim denial is to file a brand new application.

    No!  This is often the worst thing you can do because most initial applications are denied.  A new application will most likely be denied for the same reason as the last.  Historically, and statistically most claimants are awarded only after being heard by an administrative law judge.  A claim will never get that far in the process if you just file a new application.  Follow the appeals process and find representation.

    Myth: Certain medical conditions or mental health problems can get you automatically approved for benefits.

    No . . . . and yes.  Certain impairments are singled out.  If you meet an SSA listing it is easier to get approved, but not automatic.  All claims are evaluated according to medical evidence. See the list of the categories of impairments that meet the SSA listing here: http://www.socialsecuritylaw.com/qualify/

    Make sure to get regular medical treatment during your claim documents your condition for a better chance of obtaining benefits.  If you have irregular doctor visits and little medical evidence, your chances for approval of disability benefits is greatly reduced.

    Myth: You cannot get Social Security Disability if you have used drugs or alcohol.

    Not true. Every case is different but you have a better chance of obtaining benefits if you have maintained at least six month of sobriety.  How often and how recent you used is most important.  Simply put, Social Security will not pay benefits to someone who caused their condition or made it worse by drug or alcohol use.  If quitting would improve your condition, it is relevant and you will not win.

    If you have a history of abuse but are not currently using substances you should carefully review your medical records before filing for disability.  Doctors and mental health professionals will often indicate “suspected use” in their treatment notes.  Such indications can have a damaging effect on a disability case.

    While there are many myths about the Social Security claim process that are untrue, the process does include a fair amount of rules, regulations, and paperwork that a social security attorney is better suited to deal with.

  • Disability Group 10:00 am on January 19, 2011 Permalink | Reply
    Tags: cdr, medical review. children,   

    You got your benefits – now how do you pass a review? 

    Once you are receiving Social Security Disability benefits, the Social Security Administration will periodically review your case to make sure that you are still disabled. This review is called a Continuing Disability Review (CDR) and the law requires it.

    What can you expect from a CDR?

    When the SSA determines that you are disabled, your disability determination specialist sets a date for your case review. This schedule is called a diary. Most diaries are based on the expectation of recovery and are for three or seven years, but they can be sooner:

    • If medical improvement is “expected,” a case normally will be reviewed within six to 18 months;

    • If medical improvement is “possible,” a case normally will be reviewed no sooner than three years;

    • If medical improvement is “not expected,” a case normally will be reviewed no sooner than seven years.

    The CDR is a medical review.  SSA is trying to decide if your level of disability has improved to the point where you have medically recovered and are able to work.

    SSA will want to gather the same kind of evidence that you provided during your initial claim for Social Security Disability benefits. SSA will have you fill out forms describing your current condition and list all of the places where you have received treatment. SSA will also obtain copies of all recent medical records. If more information is needed about your condition, SSA may schedule a Consultative Exam.

    If your condition has not improved since SSA last reviewed your case, then your Social Security benefits will continue. If your condition has improved, SSA will look to see if your condition meets the current disability requirements.

    It is important that when you receive the CDR notice and forms that you fill them out and return them. If you receive the CDR mailer and throw it in the trash, SSA will send a second one. Continued failure to provide information that SSA asks for, or failure to attend an examination that it schedules, will result in termination of benefit payments. You may need help answering the questions, especially if you are not certain what is being asked and why. This is where an attorney may help.

    Continuing Disability Reviews for Children

    When a person is found to be disabled under childhood regulations, SSA will review the case when the person turns 18 to determine if the person is disabled under the adult regulations. The case is reviewed as if it were a new case. SSA is looking to see how your disability affects your ability to work as an adult. Even if your condition has not improved, your benefits will cease if your condition does not meet the current adult rules.

    Tips for a Continuing Disability Review

    SSA looks at the original status of your medical condition(s) and compares it to the current status of your medical condition(s) to decide if there has been significant medical improvement. For this reason, it is important that you continue to seek medical treatment for your condition. If you have not continued to seek medical treatment, SSA will likely order a Consultative Exam to assess your current condition. It is usually more beneficial to you if your own doctor provides that information rather than a doctor hired by SSA who really doesn’t know you or your medical condition well.

    Be honest and don’t exaggerate the symptoms caused by your current medical condition(s). The opposite is also important: don’t try to portray yourself as better than you truly are.

    SSA is required to thoroughly evaluate any new medical conditions that have arisen since you were first awarded disability benefits. For this reason, it is important to tell your disability caseworker about any new conditions or treatment you have received.

    If you receive notice that your benefits are being terminated, you are entitled to an interview with the person making the final decision on your case. If your benefits are still terminated after this interview, you can appeal the decision to an administrative law judge. You may have an attorney represent you.

    • Jera 6:19 pm on May 11, 2011 Permalink | Reply

      At last! Someone who understands! Thanks for ptosing!

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