Author name: patrick@greemantoomey.com

Many disability claimants who receive a written decision from an Administrative Law Judge are surprised to find a paragraph in the decision discussing whether the claimant is “credible.” This part of the decision often seems like a personal attack. This article explains what this “credibility analysis” is, and what judges have to consider in each case. A symptom is something the claimant experiences personally. Pain, anxiety, sadness, tiredness, and even things like rashes or vomiting are all symptoms: they are the outward signs of the sickness the claimant believes makes them disabled. No symptom can prove a claimant is disabled, no matter how genuine the individual’s complaints are, unless there are medical signs and laboratory findings demonstrating “medically determinable physical or mental impairments that could reasonably be expected to produce the symptoms.” 20 C.F.R. §§ 404.1529 and 416.929; Social Security Ruling (SSR) 96-7p. After the SSA decides that medical evidence proves a “medically determinable impairment,” the judge examines the intensity, persistence, and pace of symptoms to determine how the symptoms might limit the claimant’s ability to work. The judge must consider “all the available evidence.” 20 C.F.R. §§ 404.1529(c) and 416.929(c); Social Security Ruling (SSR) 96-7p. There are seven specific credibility factors the judge should consider: (i) Daily activities; (ii) The location, duration, frequency, and intensity of pain or other symptoms; (iii) Precipitating and aggravating factors; (iv) The type, dosage, effectiveness, and side effects of any medication taken; (v) Treatment other than medication for relief of pain or other symptoms; (vi) Any other measures used to relieve pain or other symptoms (e.g., standing for 15 to 20 minutes every hour, sleeping on a board, etc.); and (vii) Other factors. 20 C.F.R. §§ 404.1529(c) and 416.929(c); Social Security Ruling (SSR) 96-7p. The judge will consider all the observations and opinions of doctors, teachers, counselors, nurses, and other sources about the claimant’s attitude, behavior, symptoms, test results, and remarks. The judge also considers the claimant’s testimony at their hearing, and all the written responses the claimant submitted on SSA forms throughout the application process. The credibility analysis is not intended as a personal attack. The purpose is to examine symptoms as they are recorded by third parties and remembered by the claimant, and to determine how the intensity, persistence, and pace of symptoms might limit the claimant’s capacity for work. This analysis is required by SSA regulations, and is part of every decision.  

If you are receiving Supplemental Security Income (SSI) payments and have any additional income the Social Security Administration (SSA) may deduct the value or partial value of that income from each of your monthly checks. SSA makes these deductions because SSI payments are based upon the recipient’s financial need. As of January 2012, the maximum monthly benefits for SSI is $698. Any necessary deductions will be subtracted from that amount. SSA classifies income as any of the following, click here for direct link to SSA’s website: · Earned Income is considered to be wages from working or self-employment net-income. · Unearned Income is all income that is not earned by working. For example pensions, State disability payments, unemployment benefits, and cash from friends and relatives all are considered unearned income. · In–Kind Income is food or shelter given to you for free or less than its fair market value. · Deemed Income is the part of the income of your spouse or parent(s) that you live with that is deducted from your benefits. If you are receiving any type of the above stated income SSA will make a deduction. Depending on what type of income you are receiving the calculation of the deductions will be different. For all types of income SSA exempts the first $20. For earned income, SSA will exempt the first $20. Then exempt an additional $65. Any earned income over $65 will then be divided into half and deducted from your monthly benefit amount. For example, if you are receiving SSI and make $200 per month in earned income, the deduction will be made like this: $200 – 20 = $180 – 65 = $115.00/2 = $57.50 Meaning $57.50 would be deducted from the maximum SSI payment of $698.00 month. For unearned income, SSA will still exempt the first $20 but any amount above that will have a dollar for dollar deduction. For example, if you have unearned income valued at $200 per month, the calculation of your deduction will look like this: $200 – 20 = $180 Meaning that $180 would be deducted for the maximum SSI payment of $698.00 per month, resulting in a monthly benefit amount of $510. The value of any in-kind income is deducted in the same fashion as unearned income. For deemed income a portion of the value of your spouse’s or parent(s)’ income may be deducted. SSA does recognize several exemptions which do not offset the monthly benefit amount. For example, the value of food stamps or assistance based on need from a state/local government. For more examples of these exemptions and SSA’s rules on SSI payments please click here.  

The rules for Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are clearly related to an applicant’s ability to work. An adult applicant must prove they are unable to work at a substantial gainful level, but what about SSI for children? Obviously the ability to work cannot be considered in determining the disability of child. To medically qualify for SSI a child must have a physical or mental condition that seriously limits his or her activities and the condition must last for a 12-month consecutive period. Children do not have to be a specific age to qualify for SSI; children from birth to 18 may qualify for SSI, and those young adults age 18-22 who can no longer qualify for children’s SSI benefits, may qualify for benefits from a parent’s Social Security earnings. For more clarification visit: http://www.socialsecurity.gov/disability/disability_starter_kits_child_factsheet.htm#disability. Once qualifying requirements are satisfied then income requirements must be met for a child to potentially be eligible for SSI. Social Security will consider all household income, the number of parents present in the household, and the number of non-disabled children in the household when determining SSI eligibility for a child. Below is a chart that specifies monthly household income limitations for child SSI eligibility. Those who are earning over the limitation will not have a child who is eligible for SSI.   Non-Disabled Children          One Parent Income    Two Parent Income               0                                              $2,917                         $3,617 1                                              $3,267                         $3,967 2                                              $3,617                         $4,317 3                                              $3,967                         $4,667 4                                              $4,317                         $5,017 5                                              $4,667                         $5,367 6                                              $5,017                         $5,717   The above income limits do not apply when:   The parent(s) receive(s) both earned income (for example, wages or net earnings from self-employment) and unearned income (for example, Social Security benefits, pensions, unemployment compensation, interest income, and State disability). The parent(s) receive(s) a public income maintenance payment such as Temporary Assistance for Needy Families (TANF), or a needs–based pension from the Department of Veterans Affairs. The parent pays court-ordered support payments. The child has income of his or her own. Any ineligible child has income of his or her own, marries, or leaves the home. There is more than one disabled child applying for or receiving SSI benefits. Your State supplements the Federal benefit.  

A few days ago we talked about the effects of having your claim transferred to the National Hearing Center (link). In that post, we mentioned video teleconference (VTC) hearings, but it’s worth discussing them in a bit more depth because they can occur in places other than the National Hearing Center. A typical Social Security disability hearing takes place in a hearing room at one of the Offices of Disability Adjudication and Review (ODAR). Each state has at least one ODAR, and this is typically where the administrative law judges and support staff are located. At a typical hearing, the ALJ and the claimant meet face-to-face, and discuss the claimant’s conditions, work experience, and other important information. A VTC hearing has the same format as a regular hearing, but this time the claimant and the judge are not in the same room. Instead, the judge is typically at the ODAR and the claimant and his or her representative (if he or she has one) appear at a different location. The other location is often a local Social Security office, although it can also be a federal courthouse, a public library, or even a hotel conference room. In a VTC hearing, the judge and claimant are able to see one another by live video. While you can decline a VTC hearing and have one in person instead, VTC hearings are often more convenient for claimants because the VTC location may be much closer to where you live. Regardless of the location, the actual content and process of the hearing is the same as when everyone is in the same room. However, technical issues sometimes can arise, and some of the hearing sites can be difficult to find. Having a Social Security disability attorney like those from Greeman Toomey can help walk you through the process and represent your interests at your hearing.

The Ticket to Work is a free and voluntary program from Social Security that is available in all 50 states to assist disabled individuals find, enter, and maintain employment.  An individual becomes eligible to participate in the Ticket to Work program when he or she starts receiving SSDI or SSI benefits based on disability. There is no penalty for not using the program, but there are several benefits for those who choose to enroll.  First, a Ticket allows a disabled individual to obtain services from a state vocational rehabilitation (VR) agency or another approved provider of their choice – these approved providers are called “Employment Networks”.  An EN is an entity that contracts with Social Security to provide or coordinate the delivery of necessary services to disability beneficiaries. The EN can be a single individual, a partnership/alliance (public and/or private) or a consortium of organizations collaborating to combine resources to serve Ticket-holders. Second, the program allows a disabled individual to continue receiving benefits and maintain Medicaid/Medicare coverage during the transition back into the workforce.  Third, the program allows individuals to select part-time or work-from-home alternatives.  Fourth, Social Security will not perform a medical review of a disability claim so long as the claimant is making “timely progress” with the use of a Ticket to Work. For more information on Ticket to Work, including a list of approved Employment Networks, call 1-866-YOURTICKET (1-866-968-7842).  For a list of approved ENs, please visit https://yourtickettowork.com/web/ttw/en-directory.