Holiday Wish List Favorable Decision

I know the number one thing on many of your minds this holiday season is getting back a favorable SSDI, SSI, or VA decision. I hope this wish comes true for as many of you as possible. For those of you who have not received a favorable decision you might want to go through the following check list to see if you are doing all you can to win.
Did you get all your relevant medical records in?
Does SSA have RFC forms from your doctors showing your limitations from your medical conditions?
Do you have a lawyer?
Have you researched what you have to prove to win your Social Security Disability claim.
Have you learned about what happens at a Social Security Disability hearing if you are at that stage.
I wish you all a Happy Holiday Season!

Social Securirty Disability and Back Impairments

One of the most common medical conditions listed in a SSDI or SSI claim is some sort of back impairment. The more common conditions of the back and neck are herniated discs, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, and vertebral fracture. How a claim for benefits is won for these conditions depends on many factors. I will try and simplify the way the majority of these cases are won. In general if you are over 50 years old and your prior work is considered light or heavier you will probably only have to show your back condition limits you to sedentary work to be found disabled. If you are younger than 50 years old or prior work was sedentary the case usually requires that you be found capable of less than sedentary work and there would not be a significant number of jobs you could perform. There are some exceptions to this see my web page GRID Rules to understand the whole picture. So if you are under 50 or over 50 but your prior work was sedentary how do you show you can't even do a significant number of sedentary jobs with a back impairment. There are several ways you can do this I will discuss a couple here. Your inability to sit for long periods of time is important but what is more important is why you can't sit for long. It is because of pain. Your documentation and testimony of pain is important because it can show an inability to concentrate in a work setting. The medication you take particularly narcotic pain medication can further decrease your ability to concentrate. It is also very common for those who suffer from a long history of back pain to develop depression. The symptoms of depression can have serious impacts on ones ability to do sedentary work. To see how depression can affect a disability claim see my page on depression and SSDI. If your back impairment is in your cervical spine it can often lead to pain and loss of sensation in your arms and hands and often times leads to headaches. All these limitations also interfere with ones ability to do sedentary work. For more details on back impairments and Social Security disability.

Proposed New Regulations Will Curtail Claimant's Rights

There has been proposed regulation changes that will in my opinion make it even more difficult to get a fair decision in a Social Security Disability claim. SSA is proposing new rules allegedly to speed up processing times but will ultimately lead to an unfair process to the claimant and in my opinion more denials. One of these changes would restrict the submission of evidence at the hearing stage. Evidence would have to be submitted 5 days prior to the hearing date. There are exceptions to this rule but it appears as if the discretion is left up to the ALJ. I know from experience in dealing with SSDI cases for many years that it is not always possible to get all the medical evidence in 5 days before the hearing. Lawyers and claimants are often pleading with doctors who treat the claimants to get the records in a reasonable time. There is a provision to address this but it sounds like the discretion is left to the ALJ. This would be fine if I did not know from experience that some ALJs will take this new procedure to deny almost all medical records submitted after the 5 days prior to hearing. Evidence submitted after the hearing would be even more restricted. I will cover this topic again when the final rulings are released.

Drugs, Alcohol and Social Security Disability

One area of Social Security Disability law which is hard to find on the Internet is how drugs and alcohol addiction are evaluated by SSA in a disability case. Many of you may have heard that you can not get SSDI or SSI for drug and alcohol addiction. This is true but just because you have an addiction does not mean you can't get disability based on other medical conditions. The drug or alcohol addiction can not be material to the finding of disability. SSA is supposed to first determine if you are disabled based on all your medical conditions including the drug addiction. If SSA finds you are disabled based on all your conditions they are then supposed to decide if you were not using drugs or alcohol would you still be disabled under their rules. Proving disability in these cases can be easier if you have a long period of sobriety and during that time period you are shown to still be disabled. It is a little trickier when you don't have a long period of sobriety. In these situations it can be helpful to have statements from your doctors that show what your limitations would be even if you were not using drugs or alcohol. You can even get disability for conditions that were probably cause by your addiction if they are disabling even if you stopped using. An example of this is you can get disability for severe cirrhosis of the liver caused by alcoholism if it is disabling absent alcohol abuse.

Social Security Disability and non-exertional limitations

In this post I will address the importance of what is called non-exertional limitations and more specifically about concentration. They are exactly what the sound like they are limitations on your ability to work that do not involve physical exertion. These limitations are most important in cases involving people under 50 years old, cases that involve mental disabilities, and cases were someone over 50 years old had past work that was sedentary in nature. How much one can lift and do other physical activities is important but when trying to show you can't even do a sedentary job non-exertional limitations are key. A sedentary job usually requires one to be able to sit at a desk and do the work. If you have limitations in memory, concentration, dealing with supervisors or co-workers you can see how this would prevent even this type of work. Many case are denied because SSA says you can do sedentary work. One example of an important non-exertional limitation that is often overlooked particularly in cases that involve back conditions is an inability to concentrate due to pain or side effects from pain medication. One question ALJ's like to ask claimants at a hearing is why they feel they can't do a sit down job. The most common answer in these cases is because "I can't sit that long". What is often not mentioned is why you can't sit that long. It is because of pain. If you get increased pain after sitting would this not interfere with your ability to concentrate on the task at hand. As stated earlier narcotic pain medication also is known to decrease ones ability to concentrate. Ones ability to sit for periods of time is important but many ALJs and vocational experts will find jobs you can do that have an option for sitting or standing as you need to. So don't forget to mention how your pain and medication make it difficult for you to be able to concentrate. To get more helpful tips on how to win SSDI.

How to Win Social Security Disability Benefits

The most important question I am sure most of you want to know is how do you win an SSDI or SSI claim for disability benefits. In this post I give some very general tips on what you can do to help your claim succeed. There is no trick to win your claim. However, if you want to give your self the best chance to win you should make sure to do the following things. Read as much as you can about Social Security Disability. Most importantly you need to know how Social Security will determine if you are disabled. Ounce you understand SSA's five step process for determining disability you can start to figure out how it applies to your particular case. There are several key ingredients to a successful claim. First, and often times overlooked is that you must have a "good" case. This means you have a medical condition or several medical conditions that interfere with your ability to do things that would impact your ability to work. Second, you must have all relevant medical records submitted to SSA. Third, you need RFC forms or reports from your treating doctors that show how your medical conditions affect your ability to do things. Fourth, you should be under the care of the appropriate doctors and taking your medication as prescribed. Fifth, you should have a "theory" of your case. This means you know how the law applies to your case and can articulate why you are disabled under SSA rules. If you do not fully understand what you have to prove in your particular case or you think your case may be difficult to prove you should contact a lawyer. You should not rely on Social Security to make your case for you and don't assume they got all your medical records. Make use of a good Social Security Disability resource such as my website and the SSA website. There are many more tips on how to win your claim for Social Security Disability available on my website. Lastly, these claims can take a long time and can be extremely frustrating but never take it out on the employees at SSA it will not help your case and may actually hurt it. I wish you luck in your pursuit of SSDI and SSI benefits and if you have any questions feel free to contact me.

Fibromyalgia and a Social Security Disability Claim

Fibromyalgia claims have a few unique challenges. First of all, the diagnosis of fibromyalgia by its definition includes the counting out of all other possible cause for the symptoms. There is no objective piece of evidence you can point to to prove you have the condition (like an x-ray or MRI). This makes your rheumatologist opinion and diagnosis extremely important. Your testimony at a hearing is also important because an ALJ opinion of your credibility will have a big impact on how he or she decides. Another difficulty with these cases is that one of the most disabling features of the disease is fatigue. It can be very difficult to show evidence of fatigue and how it limits you. I also often see date of onset problems and date of last insured problems because it often takes many doctors and years before a diagnosis is made. There also appears to be a general bias against fibromyalgia by SSA doctors and SSA employees. Lastly, this medical condition is often diagnosed in younger people which makes a claim for disability often times more difficult. This is one of the medical conditions were I almost always recommend someone trying to get Social Security Disability or SSI to find a lawyer who has handled these types of cases. A disability claim for Fibromyalgia is difficult but winnable but it sometimes requires allot of patients and proper development of your file. Read more on Fibromyalgia and a disability claim.

Here Come the Lawyers.

My observations at the NOVA conference is that there will soon be many more attorneys handling Veterans disability claims. I would guess that there was about twice as many lawyers at the conference than at the last one. Most of them were lawyers who handle Social Security Disability cases in their practice. I believe this is good news for veterans because it will be much easier for vets to be able to find lawyers for their disability claims. Social Security Disability lawyers should be able to make a fairly smooth transition into this field because there is allot of similarities in how you develop a case and they will be familiar with the medical terminology. SSDI attorneys are also used to dealing with a government agency. I have to mention how impressed I have been with the speakers at the conference. Many of the attorneys who spoke at the conference have been doing VA claims for years and they were more than willing to share their insight and knowledge with the lawyers hoping to enter into this field.

MS and Social Security Disability

Multiple Sclerosis is a difficult to diagnose disease and can be a difficult Social Security Disability case. One thing that makes MS cases hard is that many times a person out of work because of MS symptoms goes undiagnosed for years and when they finally get a diagnosis of multiple sclerosis they may be past the date of last insured (last day they are insured for benefits). Another problem with these claims is that the most limiting symptom for many people who suffer from this condition is fatigue. So when an individual goes to functional capacity exam they may perform pretty well but what is not seen is that the individual can do nothing for several days after the exam. It is a good idea if you suffer in this way to tell your doctor so it is in your medical records. I have more on MS and Social Security Disability on my website.

Speach by Commissioner of the Social Security Administration

Michael J. Astrue, Commissioner of the Social Security Administration spoke to the National Organization of Social Security Claimant's Representatives today. My impression is that he appears to have a good grip on the problems confronting him and the desire to make the changes necessary at SSA to try and fix them. He spoke of the baby boomer generation and the affect it is going to have on the Social Security system. He mentioned the obvious increase in the amount of people who will be on Social Security as a problem. What I did not consider and thought was quite interesting is that there is another problem from the baby boomers reaching retirement age. Many SSA employees are older as a result of the many hiring freezes that have occurred over the years. So many experienced SSA employees will be retiring as well. He mentioned that SSA will drop below 60,000 employees which is the lowest rate since the 70s. This tells me that more claims plus less SSA employees equals more delays in processing of claims. He also mentioned that 150 new ALJs will begin working in June. I will be reporting more on what The Commissioner had to say at my Social Security Disability website.

How does SSA view medical evidence.

A Social Security Disability file contains allot of medical evidence. So how does SSA determine what evidence should be given the most weight? The Social Security Administration is supposed to look at many factors when determining what weight they should give a particular piece of medical or opinion evidence. Notice I say supposed to because I have found SSA employees and ALJs don't always view it as they are supposed to. Generally, treating doctors are supposed to be given more weight than non-treating doctors. In other words your doctor's opinion is supposed to be given more weight than the SSA consultative doctors. Your doctors opinion must however still be consistent with the medical records in the file. Specialties are also considered by SSA. For example a diagnosis of depression by a psychiatrist is more "valuable" than a diagnosis of depression by a family doctor. What does this mean to you. You must make sure you have your treating doctors medical records and opinion of your limitations in the file. If you are seeing a specialist for your condition getting those records and opinion of your limitations from that specialist is a very important. One last note chiropractors are not given much weight so if you have a back condition an orthopedics opinion is much better. I have left out allot here but this is to give you a general idea of how SSA looks at evidence.

Make sure to check out my Ultimate Disability Guide.

Many of you who read my blog may already know about my website the Ultimate Disability Guide. If you want to learn about Social Security Disability I believe it is the best source on the web. I have tried to make everything as easy to understand as possible. I cover many topics including how to apply, how SSA determines if you are disabled, how to win your ssdi claim, what happens at a hearing and many more topics as well. If you are looking to learn about Social Security Disability visit the site. I update the site frequently so if you have not been there in a while make sure to check back often. Take advantage of this free resource the more you know the better chance you have to win your claim. Even if you have a lawyer you should try and learn all you can it can only help. I will write again soon.

I will be going to two conventions this month.

I will be attending a conferences this month on Social Security Disability and Veterans Disability. So make sure to keep checking back because I will report on any new developments in these areas of law. At the Social Security Disability conference I will be looking forward to finding out how the SSA program for Internet access to the SSA file is going and when it can be expected to be launched in full. At the veterans disability conference I am particularly interested in how the new law allowing lawyers to represent veterans is going and if there is any momentum for repealing this law that some groups are trying to do. i will also report back anything I think might be of interest to you and your claim for disability.

How important is testimony at a SSDI hearing?

Your testimony at a Social Security Disability hearing is extremely important. This does not mean you should study the possible questions you will be asked and memorize answers you think will help you. You should have an idea of the types of questions that will be asked but you do not want your testimony to come across as scripted. The perfect answer to a question for your case that is thought to be scripted can hurt you allot more than a bad honest answer. I have seen good medical record cases lose because of testimony and not so strong medical record cases win because of testimony given. The sure way to hurt your case is to clearly exaggerate your symptoms. The best way to help your case is to come across as believable and honest. The best way to come across as credible is to tell the truth about your condition and why it keeps you from being able to work. It is not just words spoken you are being evaluated the entire time you are in the hearing and sometimes in the waiting room. One example I often see is that claimants may exaggerate or not understand how long they can sit. A claimant may say "I can only sit 5 minutes" and then proceed to sit through the hearing for an hour. I understand that many times people sit in pain because they think they can't get up during the hearing but you can. Another example is if there is no record of you being prescribed a cane and back brace and you show up with a cane and back brace exposed over your clothes chances are the ALJ will think you are putting on a show. If you have a cane or brace that is not prescribed by a doctor but you need it and got it on your own, don't say it was prescribed by a doctor. Be honest and say I got it on my own because it helps. For more on testimony at a hearing go to my web page Social Security Disability hearing.

Access to Social Security Disability e-file anytime for lawyers

I have heard through the grapevine that SSA will soon be making available claimants files online through a secure network. This could be the most significant change the Social Security Administration has made in years. i say this because what it means is that a lawyer will have access to SSA's file on a claimant right from the beginning. By having this access a representative can make sure a file is fully developed as early as possible leading to faster decisions on claims. It will also save money for the clients because it will eliminate the lawyer from getting medical records that are already in the file. The way it is now it is extremely difficult for a lawyer to see what SSA has until the case is close to a hearing. This gives the attorney less time to get medical records and review files. If this new system is implemented a lawyer will be able to evaluate a case much earlier, get the medical records that are needed and if the case is strong enough write a pre-hearing brief and request a favorable decision right away so that the claimant does not have to wait the long time it takes to get a hearing. This would be a win for all parties involved. It should lead to faster decisions, better prepared files and ultimately less backlog for SSA. I will find out more at the next NOSSCR conference and report what I hear.

Why are denial rates so high at application and reonsideration?

Denial rates are significantly higher for Social Security Disability and SSI claims at application and reconsideration than they are at the hearing stage. In this post I will give my opinion as to why this is the case. Many people who apply often do so with out help of a lawyer and with out learning what they have to prove to win. Many people simply give the information to SSA and let SSA get the medical records and develop the case. There appears to be the attitude that I will see what happens and if I am denied I will get help with my claim. This leads to an underdeveloped file that is not ready for a decision and frequently results in a denial. At reconsideration which SSA is slowly getting rid of it is usually the same information being looked at by a different SSA employee. This is why reconsideration has such a high denial rate. If the information in the file was not enough the first go around chances are it won't be for the next SSA employee either. The denial rate decreases at the hearing level for several reasons. A greater percentage of the cases are represented by a lawyer or representative and the file has had more time to be developed properly. You also have the advantage of seeing an ALJ in person which adds a human element to the case and allows for testimony to point out things that the record by itself simply can not do. Many people come to me at hearing most of those files are extremely underdeveloped files. So if you do decide to do it alone make sure to become as knowledgeable as you can so that you know what you need and can get the information to win early.

Two New Pages Added to Ultimate Social Security Disability Guide

I have recently completed two new pages for my informational website on Social Security Disability called The Ultimate Disability Guide. The first new page deals with ssdi and ssi denial rates. The information provided should at least give you some idea of the rate at which SSA denies and approves claims. The chart shows the allowance and denial rates for ssdi and ssi at application and reconsideration.

The second page is about the backlogs at SSA and the average processing times for each Office of Disability Adjudication and Review or ODAR. This basically covers the time period between filling your request for hearing until a decision is made. So if you are one of the many people wondering how long does it take to get a decision at the hearing stage or as Social Security likes to say how long does it take for the claim to get processed. The above page link is for you but try not to get to discouraged by what you see.

New page on SSDI and SSI hearing wait times.

I have just finished my new page which gives the average processing times for social security disability cases at the hearing stage for every ODAR in the country. Go to the link above to see how long it takes for a case to be processed in your area. I hope this information is helpful in preparing you for the long delays at the hearing level.

SSA Backlog Highest It Has Ever Been

In July of 2007 there was a total of 749,224 cases pending. This is the largest amount of cases ever. The average processing time is a whooping 528 days. SSA hopes to hire about 1,000 new employees to deal with the increase. This will probably do little to help the situation. In the mean time those applying for Social Security Disability benefits look to deal with longer and longer wait times. The Social Security Administration is working on other initiatives to decrease the processing time which I have mentioned in other post and I will continue to update as more information becomes available. This information was obtained from the NOSSCR Social Security Forum.

How long does it take to get SSDI or SSI decision?

I have not posted in a while but I have been working on gathering statistics on how long cases are taking at each stage of the process. I know this is very important to allot of you and I am working hard to get accurate numbers. I will be posting the results over the next couple of weeks. I will try and cover wait times at the various ODAR offices or hearing offices and the local district offices. Check back often to get this valuable information.