SSDI

Demystifying, General Info, Legal News, SSA, SSDI

What is Date Last Insured?

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

Demystifying, General Info, Legal News, SSA, SSDI

The Availability of Medical Consultants to Advise on Disability Cases

Social Security has a variety of consultants, both medical and vocational, who are routinely called upon as experts in Social Security disability cases. It would seem to follow that since these individuals are seen as experts by Social Security, they would prove valuable informational sources for claimants as well. Right? Wrong. On July 9, 2010 the Social Security Region VII Office of General Counsel issued an opinion on this issue and determined that if a medical or vocational expert is utilized by Social Security, or by the State at the initial and reconsideration level, it would be a conflict of interest for them to consult with attorneys or claimants regarding a disability claim — even if the expert has no contact or personal involvement in an individual’s claim. In other works, even if an expert has nothing to do with your claim, they are estopped from giving information to you or your attorney. This is true even if the expert does not work on claims in your area, or even your state. It seems counterintuitive that, in a process which is supposed to be fact finding in nature, Social Security would ban one of the people they have deemed to be an expert from providing information which would lead to the most just decision. This opinion is clearly at odds with Social Security stated opinion that the administrative process is intended to be non-adversarial in nature.  

Demystifying, General Info, Legal News, SSA, SSDI

Can the Government Stop my Benefits?

Once you are found disabled, typically, your benefits will continue until some condition occurs which causes them to stop. A number of conditions can make this occur, including: returning to work, an improvement in your disabling condition, reaching retirement age, confinement in prison or jail, and/or an increase in assets. If you return to work on a regular basis (at what Social Security deems a, “substantial gainful level,” your benefits can be stopped. Social Security defines substantial gainful activity as earning more than $1,010 a month. However, there are more factors to be considered. Social Security will also take into consideration the type of work you are doing, whether you need special accommodations in performing this work, or if you are working in a sheltered work environment (where more assistance is needed). Social Security has designed a set of criteria which allows workers to attempt to return to work without jeopardizing benefits. This is referred to as a trial work period. If you return to work making over $720 a month, Social Security will consider this a trial work period and this period can last for up to nine months without losing your disability benefits. If the work period proves unsuccessful (you have to again stop working), your benefits will continue. Once you reach retirement age, you will start receiving benefits under the Social Security Retirement program. You cannot receive disability and retirement benefits at the same time. If Social Security determines that you condition has improved to the point where you no longer meet the eligibility requirements for disability, your benefits can be stopped. Your allowance is periodically reviewed by Social Security over the course of several years. For this reason it is important to continue seeing your doctors and maintaining the records to show continuing disability. If you are serving time in prison, your disability benefits will be withheld for the time period you are incarcerated. In some specific cases, the type of crime may cause your benefits to be stopped altogether. Finally, if you are receiving SSI rather than SSDI, your benefits can also be stopped if you exceed the income or asset limit. SSI is a need based disability program and if you have assets over $2000, or personal income of more than $698, you benefits may stop. Income can include spouse’s incomes, free food or shelter, or parental income on behalf of a minor.  

Demystifying, SSA, SSDI

Weight of Different Types of Evidence

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.  

Legal News, SSA, SSDI

Classifying the Physical Demands of Occupations: Part I – Strength

This is the first installment in the blog series titled “Classifying the Physical Demands of Occupations.” When evaluating a claim for Social Security disability benefits and/or Supplemental Security Income the Social Security Administration (SSA) must classify the physical demands of your past relevant work and potentially the physical demands of other jobs that exist in the national economy. To do this the SSA relies on the Dictionary of Occupational Titles (DOT) and its companion publication, the Selected Characteristics of Occupations (SCO). The physical demands of occupations are evaluated in relationship to twenty different factors. One factor that is used is “Strength”. The SCO describes five different “Strength” categories that are differentiated by exertional requirements: sedentary, light, medium, heavy and very heavy. Sedentary work generally requires exerting up to 10 pounds of force on an occasional basis or a negligible amount of force (less than 10 pounds) on a frequent basis. Light work generally requires exerting up to 20 pounds of force on an occasional basis, 10 pounds of on a frequent basis, or a negligible amount of force constantly. Jobs may also be classified as light if they require: standing or walking to a significant degree; sitting most of the time while pushing or pulling arm or leg controls; or working at a constant production rate pace. Medium work generally requires exerting up to 20 to 50 pounds of force occasionally, 10 to 25 pounds of force frequently, or up to 10 pounds constantly. Heavy work generally requires exerting up to 50 to 100 pounds of force occasionally, 25 to 50 pounds frequently, or 10 to 20 pounds constantly. Very Heavy work generally requires exerting in excess of 100 pounds of force occasionally, 25 to 50 pounds frequently, or more than 20 pounds constantly. It is important to understand that these five categories listed above are the sub-categories that fall under the “Strength” factor which is only one of the 20 factors that the SSA consider when evaluating the physical demands of occupations.

Legal News, SSA, SSDI

Doctor accuses patients of gaming disability system. Disability attorney disagrees

In a recent article titled “Patients are gaming thedisability system — at high cost to themselves and society” Dr. Marnin E. Fischbach explains how he believes many of his health patients are abusing the SSA Disability program. His article states that many of his patients have gotten approved for benefits and since have had their conditions improve but still remain on SSA disability. Jennifer Modell, an attorney specializing in disability, writes a rebuttal. Her article explains that SSA does conduct disability reviews to determine if recipients still qualify for disability. For more information on Continuing Disability Reviews please click here.

General Info, SSA, SSDI

I’ve been found disabled by SSA, do I receive medical insurance?

If SSA finds that you are disabled you will qualify for medical insurance, but when you’re eligible and what type of insurance you receive varies by disability benefit program. You may be eligible for either Medicare or Medicaid. Medicare is a federally run insurance health insurance program. It will help cover your hospital and medical bills. When you become eligible for Medicare a premium will be deducted from your monthly benefits. Medicaid is a state administered need based assistance program. If you are approved for Disability Insurance Benefits (DIB) you will be eligible for Medicare 30 months from the date you are found disabled. This sounds like a long time to wait for Medicare coverage to start, but if your disability onset date is in the past you may have already put a large dent in the waiting period. You may qualify you Medicare coverage faster if you have been diagnosed with permanent kidney failure, amyotrophic lateral sclerosis (Lou Gehrig’s disease), or a terminal illness. If you are approved for Disabled Adult Child benefits or Disabled Widows Benefits you will also qualify for Medicare. If you are approved for Supplemental Security Income (SSI) you will most likely be eligible for Medicaid. Medicaid is a state administered program that like SSA is based upon financial need. If you have been approved for SSI check with your local Medicaid office to see if you qualify. For more information regarding Medicare eligibility click here.  

Demystifying, SSA, SSDI

What is date last insured?

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

Legal News, SSA, SSDI

Chronic Traumatic Encephelopathy: When your job asks the worst of your body, can Social Security still be there?

Both the Huffington Post and the Deseret News have recently discussed the greater occurrence of Chronic Traumatic Encephelopathy (CTE) amongst military veterans due to bomb blasting and football players due to the tackles received on the field.  Both cases generally appear as Traumatic Brain Injury (TBI), but later degenerates more fully into CTE. Let’s be clear, TBI can be deadly, and can also give the claimant headaches, nausea, vomiting, ears ringing, difficulty balancing, fatigue, ringing in ears and blurred vision, just to name a few symptoms.  All of these symptoms, if severe enough, can interfere with a claimant’s inability to work.  CTE can be even worse, showing disorientation, overt dementia, staggard gait, confusion, impeded speech, tremors and deafness.  These symptoms, if severe enough, can make it near impossible for a claimant to maintain the pace and persistence of competitive employment. Many claimants with conditions like TBI and CTE, who’s conditions are a result of the work activity they knowingly entered into, wonder if Social Security is even an option, due to an “I brought this on myself” mentality.  This concern is unfounded.  Even if a claimant’s injury is the result of being in a risky environment that the claimant knowingly put him or herself in, Social Security can still be there for the claimant.  The real issue is whether the claimant has a severe mental or physical impairment that prevents him/her from being able to work consistently 8 hours per day, 5 days per week.  For many people with the degenerative condition that is Chronic Traumatic Encephelopathy, the answer will be a clear yes. Social Security claimants generally don’t run into trouble on the sole basis of assuming the risk that caused the condition unless the condition is directly linked to the abuse of drugs or alcohol.  If that is the case, then the claimant would have to show sobriety (often times of 12 months or longer), before being able to prove their claim.  CTE is generally not linked to the abuse of drugs or alcohol and exists separate and apart from that use. Furthermore, the debilitating effects of CTE, in many cases, may result in faster treatment from Social Security.  As one article discussed, the debilitating mental effects of CTE has resulted in suicidal tendencies.  If the claimant’s condition has shown to cause recent suicidal ideation, then Social Security should assign a Critical Case designation and expedite the claim.  While this doesn’t cut much time off the claimant’s processing on the initial application and request for reconsideration, due to the time it takes to request and review medical records, it can result in a substantially shorter wait time for a hearing.  The policy behind this expedite is that it allows the claimant quicker means to get the level of medical treatment that being on Social Security provides, and possible save the claimant’s life. For the Huffington Post article, click Here. For the Deseret News article, click Here.

General Info, SSA, SSDI

The Greeman Toomey Blog

The Greeman Toomey Blog is updated nearly every day with insights, updates and explanations of the issues surrounding the practice of Social Security Disability law.  The group of content writers for the GT Blog is comprised of 10 SSDI attorneys and a couple experienced paralegals who deal directly with their subject matter daily.  If you have any suggestions or questions you would like the bloggers to address, please contact us through the form on this website. You can receive blog updates via our Twitter feed (@greemantoomey) or by liking us on Facebookor just check back here. Thanks for reading the GT Blog!

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