Demystifying

Keeping your Social Security attorney’s office informed of any changes in your medical condition and where you are treating for your conditions is imperative to proving to the Social Security Administration that you are disabled. A large portion of the evidence used to prove your case comes from the medical records obtained from your treating sources. If your attorney’s office is unaware of a source for medical treatment, significant information documenting your disabilities may be missed. To begin with, you should provide your Social Security attorney’s office with a complete list of all physical and mental health clinics and hospitals you are currently visiting and all the ones you’ve seen over the last 12 months. Specifically the names, addresses and phone numbers for all clinics and hospitals are needed. Once this information is provided we do not need to be informed every time you have an appointment for medical treatment at one of these facilities, but inpatient hospitalizations and major changes to your condition should be reported to your case manager. You should also report new diagnoses, scheduled surgeries and any further limitations to your ability to work. It is also very important to keep your case manager informed of any new facilities you treat at once your case has begun. Informing your case manager of any new medical treating sources makes it easier to keep Social Security up to date on your current condition and ensures that the appropriate medical evidence can be obtained in supporting your disability claim. During this process you may have to visit many different clinics and hospitals as part of your medical treatment. Keeping your own detailed list of these providers will ensure that all the appropriate medical records are submitted to help document your disabilities. To learn more about how Social Security decides whether you are disabled under its rules visit: http://www.ssa.gov/disability/determination.htm

There are many types of evidence which can be considered by Social Security when determining whether a claimant is disabled. This includes statements made by the claimant, third party observations (friends and relatives who routinely observe a claimants functioning), statements by your employers, statements and records made by treating doctors, and opinions of consultative examiners.   The most effective evidence is obtained by your treating doctor. Treating source evidence generally comes in two forms: the medical records and test results from your medical appointments, and opinion evidence from the doctor regarding your limitations. According to the Eighth Circuit case law (which controls how Federal law is interprested in several states, including Minnesota), a treating physician’s opinion about the limitations caused by a disability must be given great weight in the disability determination process. A treating doctor is in the unique position to judge specific limitations as a result of his or her personal knowledge of the patient and their ongoing relationship.   Another type of evidence comes in the form of consultative examinations. Social Security routinely sends claimants to consultative examinations. These opinions are typically afforded weight less than that of a treating physician’s opinion, because the opinions generated are as the result of a one-time examination. However, if the medical evidence is scant, or if there is no medical opinion regarding a claimant’s limitations from a treating source, these consultative opinions can be relied upon heavily by Social Security in reaching their determinations. As a result, it is important to involve the treating source in the information gathering process as early and as often in the process as possible.   It may also be helpful to get information form friends and family, as well as employers when presenting a case. These statements, which typically come in the form of written statements, provide corroboration of a claimant’s testimony regarding their limitations. While these statements carry less weight than those of a doctor, they none the less must be considered by Social Security in their determinations.   Information from your previous employers can also be helpful in proving limitations. It is important to get information regarding the job responsibilities, difficulties a worker may have experienced in fulfilling these duties, as well as any special accommodations which may have been made to help the worker. This evidence, while not weighted as heavily as a treating source opinion, can be used to show difficulties in performing work activities. This also can provide support for a claimant’s testimony regarding their ability to work.   In presenting a disability claim, it is essential to gather information from a variety of sources not only to show that a medical condition exists, but also to demonstrate the effect that the condition or conditions have on a claimant’s ability to perform work activities.  

When applying for Social Security Disability Insurance (SSDI) your date last insured is a crucial aspect of whether you meet the technical aspects of this disability program. Social Security has set specific guidelines for who can qualify for disability programs and these guidelines must be met even before the question of disability is decided. The DLI is the final date in which you are eligible for SSDI benefits. Basically, it requires a disabled worker to have worked long enough and recently enough to qualify for this program. Social Security grants work credits for this program on a quarterly basis. Your quarterly benefits are based on the amount of time you work while you were paying Social Security taxes. The general rule when determining whether you meet the requirements of SSDI is that you had to have worked fulltime at least five out of the last 10 years. Social Security determines your DLI based on your work history and how many credits you have accumulated. The main reason this is important is that you have to prove to the Social Security Administration that you were disabled prior to or on your DLI. If your DLI is in the past, especially by several years by the time you first apply for SSDI, it can be more difficult to convince Social Security to find you disabled prior to your last DLI. Social Security allows workers to earn a maximum of four work credits per year. To earn a work credit you must earn $1,130 while paying Social Security taxes. To earn the maximum of four credits over a 12-month period you have to earn $4,520.  Because older workers have opportunities to earn more work credits Social Security has determined that the total number of credits needed to qualify for SSDI is higher for older workers and less for younger workers. Once you meet the technical requirements of either SSDI then Social Security will begin to determine whether you meet the medical requirements for SSDI. Below is a chart which shows how many earned work credits are needed for a worker to be eligible for SSDI. AGE                                                                                                                                              Work Credits Needed 31-42                                                                                                                                                           20 44                                                                                                                                                                 22 46                                                                                                                                                                 24 48                                                                                                                                                                 26 50                                                                                                                                                                 28 52                                                                                                                                                                 30 54                                                                                                                                                                 32 56                                                                                                                                                                 34 58                                                                                                                                                                 36 60                                                                                                                                                                 38 62 (Or Older)                                                                                                                                              40

Basically, the issue before Social Security is: is there some job which you can do on a full time basis? It doesn’t matter if you are a professional, or a laborer, white collar or blue. If you were a surgeon but now can only sit and take tickets at a toll booth on a regular basis, you may not qualify as disabled. But is that always the case? Fortunately … Nope. As you get older the rules begin to change. Social Security has developed a set of medical-vocational guidelines commonly referred to as “the girds.” The basic concept behind the grids is, the older you get the less vocational adjustment you should have to make to return to work. These rules currently begin to change when you approach age 50. They change again at 55, and again at age 60. Eventually, the rules contemplate that unless you can do pretty much the same job you had done in the past, you will be found disabled. There is a chance that these rules may be changed by Congress at some point to account for the fact that people are working longer, and that they change occupations more often now than they did in the past. For example, at some point in the future the grids may not apply until age 55. The idea being that today’s 55 is yesterdays 50. Is it a good idea to make the age limits on the grids higher? Perhaps. But for now the age at which the rules start to change is just prior to your 50th birthday.