Demystifying

There are several ways to check the status of a pending disability claim. You can always check the status of your Disability Insurance Benefit (DIB) or Supplemental Security Income (SSI) claim by calling the Social Security Administration (SSA) directly. The phone number for the SSA’s national line is 1-800-772-1213. The SSA has representatives available at this number from 7 am to 7 pm Monday through Friday. It may be in your best interest however, to call your local SSA office, as they will most likely be able to give you more specific information regarding the status of your claim. To find the contact information for your local office use the Social Security Office Locator on the SSA’s website.  The phone number for your local office can also be found on correspondence issued from that office. The SSA has recently begun offering claimants the opportunity to check the status of their Initial Applications or Requests for Reconsideration online. This is available on the Application Status Information page on the SSA’s website. If your Initial Application or Request for Reconsideration is currently under medical review, in addition to the methods listed above, you can check the status of your claim with the Disability Determination Services agency that handles the processing of medical determinations for your state. The phone number for the specific office reviewing your claim will be listed on correspondence from the Disability Determination Services agency. Some correspondence will also provide you with the name and direct number of your disability examiner. If your claim is pending for a hearing you can contact the SSA’s national line, your local office, or the hearing office handling your claim. The SSA hearing offices are called the Office of Disability Adjudication and Review (ODAR). To locate your ODAR office you can use the Hearing Office Locator featured on the SSA‘s website.

Our office has designated intake receptionists available to take prospective client’s calls seven days per week. If interested in becoming a new client of Greeman Toomey PLLC please feel free to give our office a call and ask to do what is called a “new client intake.” During the intake interview you will be asked a series of questions. The interview normally takes approximately fifteen minutes. The intake receptionist will then show your information to one of the attorneys at our office to determine if we would be able to assist you with your claim. When calling it may be helpful to have in front of you the following information: a copy of any recent correspondence from the Social Security Administration (SSA), a list of diagnoses/conditions, names of any supportive doctors and a current list of medications. We will also be asking questions regarding past employment and current source of income. If Greeman Toomey is able to assist with your claim we will be providing you with a packet of information about our firm, the process of applying for SSA disability and forms that need to be signed and returned. Our office cannot represent without receiving those forms back. Depending on where you live an attorney may be able to come to your home or you are always welcome to come into the office. If you are not in the area, we will mail the packet with a prepaid return envelope for your convenience.

Lots of people speculate about the link between the economic downturn and the recent spike in Social Security disability applications. A few insightful academics and journalists are examining this issue in more depth, and are looking into the role employers play in the recent surge of Social Security applications. David Autor and Mark Duggan published a paper examining why SSDI awards are rising as the health of Americans improves, stating that SSDI “appears in practice to function like a nonemployability insurance program for a subset of beneficiaries.” (The Growth in the Social Security Disability Rolls: A Fiscal Crisis Unfolding, NBER Working Paper No. 12436, August 2006. Available online at http://www.nber.org/papers/w12436). But why are so many disabled individuals currently considered unemployable? If more individuals with long-term medical problems were able to remain in the labor force, it would lessen the current strain on the SSDI system and, as discussed previously on this blog, help many SSDI applicants hold down the jobs they so desperately want. One idea is from Richard Burkhauser, a policy professor at CornellUniversity, and Mary Daly, the associate research director at the Federal Reserve Bank of San Francisco. They published a paper in the Spring 2012 issue of the Journal of Policy Analysis and Management that proposes raising taxes on businesses with a larger share of former employees on SSDI. This would provide an incentive for these companies to offer employees better accommodations and rehabilitation programs. A recent Bloomberg news article paraphrases Burkhauser and Daly’s article, and concludes that employers might be responsible for some of the Social Security Administration’s inefficiencies by failing to accommodate the long-term disabled. Another way that employers might be contributing to the rise in SSDI applications is by what Neal Grunstra, the president of Mindbank Consulting Group, calls “looking for a unicorn.” The Wall Street Journal recently wrote about employers developing absurdly specific job requirements and refusing to hire anyone who would require training or reasonable accommodations. Peter Cappelli, a professor at the Wharton School of the University of Pennsylvania, spoke to the Wall Street Journal about the long-term trend of employers getting pickier and pickier throughout the economic downturn. Professor Cappelli’s new book explores this issue in much greater depth. This trend, if true, places job-seekers requiring medical accommodations at a huge disadvantage. Choosing to buck this trend is yet another way employers could do their share to help SSDI applicants get back to work. This would lessen the current burden on the Social Security Administration, and shorten the wait for individuals who are truly disabled under the current definitions of the Social Security Act.

As noted in a recent Associated Press article, returning veterans from the Iraq and Afghanistan wars are among the medically and mentally troubled veterans ever seen. The statistics are staggering: nearly 45 percent of Iraq and Afghan veterans have applied for service-related disability benefits through the Veterans Administration. Many wounded warriors are unaware that they may dually qualify for both VA benefits and Social Security Disability Benefits if the injuries they sustained as a part of their service render them unable to work for a period of 12 months of more. In addition, the Social Security Administration provides special expedited processing for military applicants who was on active duty at the time they became disabled, so long as the disability began on or after October 1, 2001. Greeman Toomey works with many current and former members of the military, both as a routine part of our practice and as volunteer attorneys through the free legal clinic sponsored by the Minnesota Assistance Council for Veterans. If you are a military veteran with a service connected disability that prevents you from working, we want to hear your story. Call us for a free initial consultation at 1-877-332-3252.

Being denied for Disability Insurance Benefits or Supplemental Security Income is not an unusual experience, as this blog has discussed before. As mentioned in the earlier post, you can appeal the denial and it is something we do here at Greeman Toomey on a daily basis. The Social Security Administration’s rules give you sixty (60) days to appeal a denial and meeting that deadline can mean the difference between eventually receiving benefits and being denied benefits for a very long time. Appealing the SSA’s denial not only keeps your claim for benefits moving forward, it is an official way for you to state that you disagree with the SSA’s determination. If you do not appeal the denial within 60 days then you are not challenging the SSA’s determination, implicitly stating that you agree with it – even if you actually don’t! You do have the option of re-filing for benefits if you do not appeal in time, but there are consequences for not challenging the prior denial. Determinations made by the SSA have a doctrine called “administrative res judicata” applied to them. This doctrine means that the SSA and its Administrative Law Judges will not usually reopen something that was already decided in the past and was not challenged within 60 days. For example, if the SSA determines that John Doe’s back injury does not prevent him from working as of June 1, 2010 and Mr. Doe never appeals, then Mr. Doe cannot claim that he was unable to work as of January 1, 2009 on a new claim – he can only claim that he was unable to work on June 2, 2010 or later because the SSA has not made a determination about his condition after June 1, 2010. This limit in how far back in time you can allege a disability can reduce the amount of back pay available to you when re-filing a claim, but it can have a more significant affect on your ability to file for benefits. Claims for DIB require you to show that your conditions prevented you from working on or before your Date Last Insured. Using the same example, Mr. Doe would generally ineligible to re-file for DIB if his DLI was on March 31, 2010 because the June 1, 2010 determination was not appealed and now cannot be challenged because of the administrative res judicata doctrine, leaving Mr. Doe limited to only an SSI claim when re-filing. Tracking and meeting these deadlines are part of the service firms like Greeman Toomey provide to clients. It is our job to explain how missing these deadlines can affect our client’s claims, to prevent our clients from missing the deadlines, and to help our new clients mitigate any problems created by determinations that weren’t appealed in the past.

On this blog we’ve covered the 5 step sequential evaluation process , which is the method Social Security uses to determine if a claimant is disabled. We’ve also discussed how a person can be successfully found disabled by equaling a Listing. However, the most direct way to be found disabled is to meet a Listing of Impairments. The Listings (there is both an adult Listing and a child Listing) are just what they sound like: a list of medical conditions that, in Social Security’s judgment, are so severe that merely meeting the criteria is enough to find a claimant disabled. To “meet” a Listing means that Social Security does not even get into what a claimant’s physical and/or mental limitations are; a person with a condition contained in the Listing who is not currently working is presumed to be unable to work on a full-time basis. There are a variety of sections in the Listing of Impairments, covering a wide range of both physical and mental health conditions. Some listings are very straightforward, requiring only a test or examination (see, e.g., section 3.02 (requiring an FEV1 level below a certain threshold depending on the claimant’s height)) or a certain number of events (see, e.g., section 11.02A (requiring seizures with loss of consciousness more frequently than once per month despite at least three months of prescribed treatment)). Other sections of the Listing are more opinion-based, such as an opinion by a medical professional about the severity of the condition’s impact (see, e.g., section 12.04B (requiring marked difficulties or restrictions in activities of daily living, social functioning, or concentration, persistence or pace)). Whether your condition is opinion-based or based on your medical evidence alone, having a Social Security disability attorney like those at Greeman Toomey PLLC can assist you in analyzing your situation and presenting your strongest case to Social Security.

Receiving a letter in the mail stating that Social Security is going to review your medical condition after you’ve been awarded benefits can by scary.  Our office receives many phone calls each week from individuals in receipt of such letters asking why their case is being reviewed and how the review process works. Social Security is required by law to review the medical condition of all people receiving disability benefits from time to time to make sure they are still disabled.  As a general rule, if your health has not improved, or if your disability still keeps you from working, you will continue to receive benefits. To assist in making the determination, Social Security will gather new information about your medical condition.  This means they will ask your doctors, hospitals, and other medical sources for your medical records. Social Security will also ask them how your medical condition limits your activities, what your medical tests show, and what medical treatments you have received.  If more information is need, Social Security will pay for and ask you to go to a special examination. After gathering new information, Social Security looks at what your medical condition was when your case was last reviewed and any new health problems you may have.  At this point, a decision is made about whether your medical condition has improved.  If it has, a decision is made about whether your medical condition has improved enough to allow you to work.  Social Security will also consider whether your overall medical condition affects the kind of work you can do. If Social Security decides you can work, your benefits will stop.  Your disability benefits also will stop if: Social Security decides a mistake was made in an earlier decision to give you or continue your disability benefits. You are not following the treatment your doctor ordered (without a good reason), and you probably could work if you followed the treatment. You gave Social Security false or misleading information regarding an earlier decision. You are not cooperating with Social Security, and you do not have a good reason for not cooperating. You are working and your average monthly earnings show that you are doing substantial gainful work. If Social Security decides your disability benefits will stop, and you disagree, you can appeal the decision. That means you can ask Social Security to look at your case again. When you get a letter telling you about the decision, the letter will tell you how to appeal.

  The Social Security Administration’s evaluation does not mainly focus on a claimant’s diagnosis. Instead, it focuses on the functional limitations claimant has because of their diagnoses. It is important to demonstrate how the condition affects and limits the claimant. Asperger’s Syndrome is listed under the Social Security Disability Listing of Autism. Asperger’s Syndrome is a social interaction syndrome, so it is in a slightly different category than Autism. Asperger’s Syndrome prevents an individual from understanding basic social functions such as expressions, gestures, and or how someone conveys a feeling by the language of their body movements. Many children and adults with Asperger’s Syndrome require modifications to their daily lives to allow them to succeed in school and in a work environment. It is reasonable to assume that many people with Asperger’s Syndrome require at least some support or special conditions in the workplace. Many people with Asperger’s may be limited by the need for repetitive behaviors (such as hand twisting or flapping) and restricted interests. Behaviors such as these may prevent a person with Asperger’s from successful employment, and may result in the claimant feeling alienated by employers and co-workers. This alienation often causes further isolation and in turn increases the possibility for depression and anxiety. People with Asperger’s Syndrome are often covered by the Individuals with Disabilities Act to receive accommodations in both work and in school, although the requirements of this Act are separate from the Social Security disability analysis. Asperger’s Syndrome is characterized by three clusters of symptoms or general kinds of difficulties that can directly impact employment: Difficulty processing sensory input (sensory integration). Difficulties understanding social intercourse (theory of mind). Differences in “executive function” (organizational skills) and cognition/information-processing skills, such as difficulty appreciating the “big picture” (“central coherence”). For more information on Asperger’s Syndrome and Autism in the Social Security disability process, see the listing for childhood impairments and the listing for adults.

Among the questions asked to Greeman Toomey attorneys and staff, the most frequent one is “how am I supposed to survive until my hearing?” Unfortunately the average wait time for a hearing before an Administrative Law Judge is 12-15 months from the date of your appeal. If a claimant receives unfavorable decisions at the Initial and Reconsideration phase of the Social Security disability claim, which the majority of applicants do, the next step is to request a hearing before an ALJ. When faced with the reality of waiting 12-15 months for a hearing, Social Security Disability Insurance (SSDI) and Supplemental Security (SSI) claimants ask “How am I supposed to survive until my hearing?” Those who are claiming to be unable to work, or work at a full-time level, can easily run into financial stress without the ability to bring home a paycheck. Unless someone has a spouse or relative that can pay the bills, pay the rent and put food on the table while you are waiting 12-15 months for a hearing, the next question is “where do I turn for financial help?” Unfortunately there is no simple answer to that question. Housing and financial assistance is limited, but here are a few suggestions that might ease the financial burden when waiting for a Social Security disability hearing.  Contact your county to see what services you may be eligible for. If you are unable to treat for your conditions because you don’t have health insurance you may be qualify for medical assistance so you can see doctors and get help paying for prescriptions. You might qualify for food assistance. Reach out to local charities. One good resource for this is the United Way, which can connect people to more than 40,000 different resources by simply calling 211 or visiting https://www.unitedwaytwincities.org/get_help/. Most communities also have local food shelves that will provide food assistance to those who need it. Many people applying for Social Security disability are unable to work at all, but others may be able to work on a limited basis. Under most circumstances, Social Security allows people to work and earn up to $1,010 (GROSS INCOME BEFORE TAXES) per month and still meet the technical requirements for disability. This might provide enough income to make ends meet. If all else fails and you are already waiting for a hearing to be scheduled there is the option of asking Social Security to expedite your case. This means you are asking Social Security to move you ahead of other people who may also be facing financial distress. To be considered, Social Security will look at your ability to provide food, medicine and shelter for yourself.