Demystifying

If you work, Social Security may deduct your Impairment Related Work Expenses (IRWE) from the amount of earnings they use to figure your SSI benefit.  This means that Social Security will not reduce your SSI benefit as much because they will not count all of your earnings. IRWE may include out-of-pocket expenses for: (1) medical items  – such as medicine, medical supplies, medical devices, service animals, bandages, and syringes; (2) medical services  – such as counseling, doctors visits, and some attendant care services; and (3) transportation and modifications to your home, car, or van to allow you to work.  Normally, public transportation is not an IRWE. The expense must not be reimbursed by any other source (such as Medicare, Medicaid, or a private insurance carrier) and must be related to your disabling impairment(s) and needed in order for you to work.  Generally, it does not matter if you also need the item or service for daily living.  For example, the cost of a wheelchair usually can be deducted from the earnings Social Security might count even though the wheelchair is used for both daily living and work. Generally, you must be working in the month you pay for an IRWE. However in certain situations, Social Security can deduct IRWE amounts for expenses you pay before you start or after you stop work. Here’s a link to a table listing examples of deductible and non-deductible IRWE:    http://www.ssa.gov/redbook/eng/ssdi-and-ssi-employments-supports.htm#3

Here’s a recent Washington Post article about the projected depletion of the Social Security disability trust fund by 2016.  According to the article, the aging baby boomer population and the country’s economic troubles have placed increased strain on the program over last several years – applications have risen more than 30 percent since 2007.   If the program runs through its reserve incoming payroll-tax revenue will only cover 79 percent of the benefits.  And, since the program is barred from running a deficit, benefits would then be cut to match revenue.   According to the article, this fast-approaching depletion has yet to inspire a concerted effort by lawmakers to find a solution.  

We discussed Global Assessment of Functioning (GAF) scores and how they may be helpful in your Social Security disability claim. But why are GAF scores in particular helpful? GAF scores serve two purposes. First, they summarize your mental health status. Mental health conditions can vary wildly from person to person; two people with identical diagnoses may have significant differences in severity. A GAF score succinctly describes the severity of your mental health conditions at the time of evaluation in a manner that can be easily understood. Second, GAF scores provide a snapshot of your condition in time. Your psychiatrist, psychologist or other mental health provider will often give you a GAF score each time you have an appointment. If this is done over several visits or more, your mental health can be examined to see if it is increasing or decreasing in severity due to things like medication changes, outside circumstances, or other forces. This can be helpful to your claim by showing Social Security that your mental health problems are severe, and have persisted despite attempts at treatment. As it is with many other aspects of the Social Security process, explaining the significance of GAF scores to Social Security can be complex and difficult. Having the assistance of an experienced advocate like the attorneys at Greeman Toomey can help develop the record and, consequently, your claim. Contact us at 1-877-332-3252 or at www.greemantoomey.com today.

When someone first applies for Social Security Disability Insurance (SSDI) a question on the application will ask if the applicant has ever worked for the railroad. Considering most of the questions on the application, this may seem like a strange one, but it is an important question. The Railroad Retirement Act provides benefits to retired and disabled workers of the railroad, and their dependents, based on their length of employment in the railroad industry. The benefits paid are similar in structure to how SSDI works, but there are considerable differences, including payment amounts, eligibility age and taxation amounts. One main difference is the monthly benefit amount paid. According to 2010 fiscal year numbers, the average monthly payment by the Railroad Retirement Board (RRB) was $2,185 per month compared to $1,170 per month for Social Security. Spouse’s benefits averaged $815 per month for railroad workers and $560 under Social Security. Another major difference from Social Security is the age in which railroad workers are eligible for benefits. Railroad workers are eligible for FULL benefits at age 60 with 30 or more years of service. Social Security recipients are able to start receiving benefits at age 62, but pay a penalty by receiving payments prior to their full retirement age no matter how many years they worked. Social Security recipients who decide to collect early payments receive about 80 percent of what their full retirement amount would be and will never reach that full retirement amount no matter what age they become. In addition to receiving railroad retirement benefits, railroad workers are also eligible for Social Security benefits for their children if the railroad worker is disabled or retired. The Railroad Retirement Act only provides payments to children of deceased railroad workers. It may sound like the railroad benefit system is better than Social Security because payments tend to be more and the age of full eligibility is less than that for Social Security recipients, but railroad workers are paying more in taxes for their benefits. Social Security recipients pay the Tier I payroll tax rate of 5.65 percent. Railroad workers pay the same rate, but also have to pay the Tier II payroll tax rate of 3.9 percent for earnings up to $79,200 for a combined payroll tax rate of 9.55 percent. For more information about how railroad retirement benefits compare to Social Security benefits visit http://www.rrb.gov/opa/qa/pub_1103.asp.  

Residual Functional Capacity (RFC) forms can be among the most supportive documents a treating physician can complete. This form shows the treating physician’s opinion of an individual highlighting the various limitations due to medical conditions. Many people often assume that if a physician is supportive that in itself means that you are disabled. However, this is not correct. It is very important for a claimant to obtain a written statement from the physician elaborating on the limitations regarding functional capabilities. Social Security wants to know exactly what conditions prevent a person from working and this document is the best way to show those limitations.  The RFC should also explain why a person is limited in other areas as well. There are two different types of RFCs, physical and mental health. The physical RFC is used to determine different types of physical limitations. The RFC has various boxes to check that show limitations. After a series of questions and boxes for the physician to mark, the form asks questions about medical or clinical findings that support a physician’s conclusion.  For example:  Are lifting and carrying affected by the claimant’s impairment?  Occasionally (very little up to 1/3 of 8 hour work day) less than 10 lbs, 10 lbs, 20 lbs, 25 lbs, 50 lbs, 100 lbs or more.  Frequently (1/3 to 2/3 of 8 hour work day) less than 10 lbs, 10 lbs, 20 lbs, 25 lbs, 50 lbs, 100 lbs or more.  Your doctor will check off which lifting limitation applies to you. The mental RFC is used to determine how a psychiatric condition limits the ability to work.  This form is very similar to the physical RFC except the questions are different and geared towards mental health limitations.  Generally, there are a series of questions for the physician to answer about the claimant’s ability to carry out very short and simple instructions and other mental health capabilities in a work place setting.

On April 30, 2012 the Social Security Administration (SSA) issued a press release titled: “Social Security and Department of Defense Implement New Process to Improve Efficiency for Wounded Warriors Applying for Disability Benefits.” The press release focuses on the SSA’s new project that allows medical records for veterans to be accessed electronically. The electronic processing of record requests has reduced the wait time for the delivery of records from the Department of Defense (DoD) allowing medical decisions on the SSA disability claims to be issued faster. This project has also helped to reduce costs for both the SSA and DoD. Since the introduction of the program, the medical records requests are processed within 72 hours from a centralized DoD location. Before the program began these original requests took an average of five weeks because each individualized military treatment center would be required to mail paper records to the SSA. According to the press release, this project has also led to a reduction in the number of consultative examinations required for veterans. This program, which was initially introduced in only five states, has now begun expansion nationwide. To read more about this initiative view the full press release.

Many social security claimants don’t fully realize that, when they file their initial application to prove they are disabled and receive Social Security, they can file under two programs with two distinct technical requirements. One program, Disability Insurance Benefits (DIB), is based on how much a claimant has paid into the system, through Social Security taxes, over the past 10 years. The other program, Supplemental Security Income (SSI), is based on how few assets, and how little income, the claimant’s household has. However, after being found to meet the technical requirements of one or both programs, a claimant still has to be found medically disabled under the Social Security Administration’s policies and procedures. To apply for both programs, a claimant will have to complete an Adult Disability Report, either online, by hand, or by interview with a representative at the Social Security Administration. In order to apply for DIB, a claimant can go online to SSA.gov, and complete the online application, or the claimant can complete the application by interview with the SSA. However, the SSI portion of the application can only be completed through an interview with the SSA, either in person or by telephone. This fact is especially important if a claimant has completed the Adult Disability Report and the Online Benefits Application, but then has found out he/she does not have the wage credits to qualify for DIB. The claimant will then absolutely have to complete the SSI interview with the Social Security Administration in order to continue with the application. Applying for both programs from the beginning of the initial application is an ideal action for many claimants. Sometimes claimants think they have paid enough into the system, or that their conditions became disabling while they were still insured under the Social Security Disability system, but find out after applying that this is not the case. Applying for Supplemental Security Income in this case may rescue these claims, if the claimant has the requisite few assets. On the other side of the coin, a claimant might think they have the necessary few assets and little income, but receive a technical denial for SSI after the interview, due to just being over the line. This is an instance where also turning in a Benefits Application to Social Security may be a good idea, as the claimant may still have paid enough into the system to be insured at the time their condition became disabling. Due to the mutually exclusive technical requirements for both Supplemental Security Income and Disability Insurance Benefits, it is reassuring to know that if a claimant applies for both programs, and then gets technically denied from one (either by having too many assets, or by not paying enough into the system), that claimant will not automatically be denied from the other. The only technical denial that carries across both claims is when a claimant is, at the time of the application, making more that $1,010 per month in gross income (before taxes are taken out).

A huge sigh of relief usually follows the notification that a claimant’s Social Security disability hearing is scheduled. Finally, it gives a claimant a chance to have their “day in court” to prove they deserve either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. Sometimes that relief is soon replaced with trepidation about the hearing process when informed that a Vocational Expert (VE) will testify at the hearing. The first question many people have is “what is a vocational expert?” The question that soon follows is “what are they going to testify about?” The Administrative Law Judge (ALJ) will appoint an independent VE in all cases where non-exertion limitations are claimed. Non-exertion limitations are all limitations that are NOT exertion limitations such as the ability to sit, stand, walk, lift, push and pull. To learn more about how Social Security classifies exertion limitations and non-exertion limitations visit http://ssblog.bsgfdlaw.com/what-are-non-exertional-limitations/.   Vocational Experts are appointed to appear either in person or by phone in over 90 percent of ALJ hearings. These VEs are supposed to be independent sources of information without any stake in the outcome of a disability hearing. The VE will be asked to give his or her opinion about what jobs a claimant can perform and what sort of limitations a claimant may be faced within performing the duties of those jobs. An ALJ will ask the VE if a claimant can perform his or her past jobs, and if not, whether the claimant can do other work. If the VE believes a claimant can do other work more detail will be provided on what types of jobs the claimant can perform and the VE will give an overview of the current job market for those jobs in the claimant’s community. Fortunately, the claimant or the claimant’s representative, who can include an attorney, is permitted to question the VE to try and exclude any jobs the VE indicated were viable options based on the claimant’s disabilities. The VE’s testimony, along with medical evidence, can be a deciding factor in the outcome of a disability hearing. For more information about VE testimony and how it may impact a Social Security disability hearing visit http://www.disabilitysecrets.com/vocational-expert-said-no-jobs-available.html.