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APPEAL PROCESS - HOW TO GET A DENIED CLAIM APPROVED

It's a fact that Social Security will deny two-thirds of all disability claims filed in Alabama.  I am still amazed that people don't know how to get a claim approved after it's been denied.  Too many just give up and suffer financially.  You don't have to. If you get a denial letter saying you are not qualified for disability benefits "under our rules," you need to know what to do.  This is NOT the final decision.  It may not be the RIGHT decision.  Here what you should do. 1.  File an appeal, also called a "Request for Hearing By An Administrative Law Judge."  You must file this in writing and within 60 days of the denial letter.  Later is too late.  Phone calls to Social Security do not count.  File in writing. 2.  Begin to collect the medical evidence from doctors, hospitals, clinics, counselors and other providers that will prove your claim.  This is a time consuming and expensive chore.  If you don't want ...

HOW DOES "BACK PAY" OCCUR?

"Back pay," also called "Past Due Benefits" is a big topic in Social Security circles.  Back pay is the lump sum that Social Security pays a disability claimant when a claim is first decided in the claimant's favor.  This is the amount the attorney or representative will be paid out of. Back pay or past due benefits occur in one of two ways: 1)  The claimant proves that he became disabled prior to filing his application for benefits.  For example, I became disabled on 6/1/15 but didn't file my application until 8/1/16.  I am entitled to collect benefits back to 6/1/15, as long as my back pay doesn't exceed 12 months. 2)  It takes Social Security a long time to decide my case.  For example, I file for disability and get denied.  I appeal and have to wait 18 months to get a hearing.  If I eventually win, I am entitled to be paid back to the date of disability in most cases. It's possible for back pay to accumulate under both of these sc...

WHO CAN PROVIDE MEDICAL EVIDENCE?

The Social Security Administration (SSA) uses medical evidence to decide if you are disabled and eligible for disability payments.  They also decide who they view as "acceptable medical sources" to provide this evidence.  Traditionally, this has included Licensed physicians Licensed or certified psychologists Licensed optometrists Licensed podiatrists Qualified speech-language pathologists On March 17, 2017, Social Security added to that list Physicians Assistants (PAs) Advance Practice Registered Nurses (APRNs) Licensed audiologists and optometrists (when circumstances are specific to their specialty practices) Yet, there are still some healthcare professionals who are not on the list of "accepted medical sources."  These include Registered Nurses Nurse Practitioners Chiropractors Licensed Clinical Social Workers (LCSW)  Licensed Professional Counselors  (LPC) What this means to you when you file a clai m If you receive some of your med...

NEW RULES OF EVIDENCE AND WHAT IT MEANS TO YOU

Social Security announced new rules of medical evidence beginning March 27, 2017 that may make it even harder to get disability benefits. Up until March 27, Social Security gave special weight to evidence from your treating physician.  The theory was that your doctor knows more about you than a doctor who only examined you one time, and certainly more than one of Social Security's doctors who has never seen you at all.  But not any more. For claims filed after March 27, 2012, your doctor's opinion is not automatically entitled to greater weight than the opinion of any other doctor.   The new rule focuses on the substance of medical opinions – not the source of the opinion. All medical opinions and prior medical findings are to be viewed equally, and will be based on “consistency and supportability” factors.  In other words, Social Security will look at all medical opinions and decide which one is more convincing. What's my fear with this new rule?  T...

WHO IS MOST LIKELY TO GET DISABILITY BENEFITS APPROVED?

When it comes to Social Security disability, all claims are not created equal.  In today's very tough world of Social Security, there are some claimants who stand out, who have a better than average chance of being approved.  Here they are: Over age 50 Long and consistent work history Compliant with regular medical treatment Statements from doctors that the illness is refractory (not responsive to treatment) Treatment with one or more of the same doctors over a long period of time A medical condition that can be objectively proven.  Has failed work attempts - tried to do other work but could not Gave up a good job to try for disability  There's a lot of pressure from Congress not to approve benefits for claimants who have less than pristine medical evidence.  Judges are simply not going to approve disability benefits these days for claimants with marginal claims.   Unfortunately, I tell someone nearly every day that they just don't have ...

THE SCOOP ON WORK CREDITS AND YOUR DISABILITY CLAIM

To get Social Security disability payments, a person must meet both the technical and medical requirements.  One of the technical requirements is that a person must have worked enough to have accumulated the required number of "quarters of coverage."  A worker may earn 1 credit for each quarter worked, provided minimum earnings were reported.  (In 2017, it requires earnings of $1700 to equal one credit.  In past years, that number was less).  Only 4 credits may be earned in one year. The minimum number of quarters of coverage depends on the claimant's age at the time disability occurs . The following chart helps to explain work credits or quarters of coverage: Age at Disability Onset The number of credits necessary for SSDI approval varies based on the age at disability onset. Between 20 and 40 work credits are usually necessary for approval, though younger workers may qualify with fewer available credits. The following table helps explain the work...

DISABILITY BENEFITS: THE BASIC QUESTIONS FOR BEGINNERS

At what age may I apply for Social Security disability (SSDI)?  Answer:  Adults may apply any time before your full retirement age.  (If you were born in 1948, for example, your full retirement age is 66).  Children may apply any t ime prior to age 18 .  There are special rules for adults who became disabled prior to age 22. 2)  What monthly benefit may I expect from SSDI?  Answer: The benefit amount will vary based on your average wages and work history.  The maximum monthly benefit in 2016 is $2,639.  The average monthly benefit is $1,166. 3) Can my spouse or dependent children also receive benefits?  Answer:  Yes, dependents may qualify for benefits based on the wage earner's disability. Dependent grandchildren may also be eligible. A spouse who is caring for a disabled wage earner's dependent children under age 16 may also qualify.  4)  Will I get Medicare insurance with my disability benefits?...