Social Security Disability News

Wednesday, February 10, 2016

Will Social Security Review My Claim To Determine If I Am Still Disabled?

Yes. Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”) beneficiaries are subject to periodic reviews by the Social Security Administration (“SSA”).

On average, SSA will review a claimant’s benefits every 3 to 5 years. However, SSA is allowed to review a claim at any time that they see fit. Thus, if SSA expects that a condition may improve or cease over a period of time, they may flag the case for a quicker review. In fact, it is not at all unusual for an Administrative Law Judge (“ALJ”) to add the condition to a decision that the case be reviewed within a 1 year period.

Additionally, SSI recipients tend to be reviewed more often than SSDI beneficiaries. This is because SSI is a “needs-based” program in which a claimant is responsible for reporting any changes in income or household earnings. Thus, claimants are charged with regularly reporting relevant changes in their economic status to SSA when they are receiving SSI benefits.

All claimants, regardless of whether they are receiving SSDI or SSI benefits, should presume they will have their eligibility regularly reviewed by SSA. In order to prevent your benefits from being terminated, stay in consistent treatment with the appropriate medical and mental health providers who customarily treat your conditions. Additionally, make sure you familiarize yourself with SSA’s rules about working while collecting benefits. Finally, make sure you report any changes in your household income levels to SSA if you are a SSI recipient.

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

Thursday, January 7, 2016

3 Important Changes for 2016 that Could Affect Your Social Security Disability and/or Supplemental Security Income benefits

Every year the Social Security Administration (“SSA”) makes several changes to the monetary thresholds associated with Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”) benefits. It is important to know about these changes, so you are in compliance with SSA’s requirements.

1. SSA has increased the threshold value for full-time work.

In order to be found disabled under SSA’s definition of disability, you must be able to prove that you are unable to earn a certain monetary value due to the limitations from your disability. This value is referred to as Substantial Gainful Activity (“SGA”). If you are able to work at SGA levels, SSA will not consider you to be disabled. For 2016, that monthly rate is $1,130.00 for a non-blind individual and $1,820.00 for a blind individual. Thus, if you are able to earn such monthly earnings, in spite of any impairment that you have, then you are not disabled under SSA’s definition of disability.

2. SSA has increased the amount that a person can earn during a Trial Work Period.

SSA allows SSDI recipients to test their ability to work in a program called a Trial Work Period (“TWP”). During a TWP, a SSDI recipient is able to work for a 9 month period without being at risk for losing his/her benefits. These months do not have to be consecutive. Specifically, SSA looks to see whether an individual can earn at certain levels over a rolling 60 month period. If a person exceeds certain monetary levels for 9 months (even if not consecutive) over a 5 year period, then the TWP has been exhausted. SSA will then look to see if a person has exceeded SGA values (see above) to determine whether or not, the person is still under a disability. For 2016, SSA will consider any month in which a SSDI recipient earns more than $810.00 to be a month in which goods and services have been performed at a TWP level.

3. SSA has increased the value of a quarter of coverage.

In order to receive SSDI benefits, you must be insured for benefits. This means you must have paid into the Social Security system through the Federal Insurance Contributions Act (“FICA”). An individual must have worked a sufficient amount of quarters to be entitled to these benefits. Every year a person can earn up to 4 quarters. For 2016, one quarter of coverage is $1,260.00. This means you must earn at least $5,040.00 for 2016 in order to obtain all 4 quarters for the year.

For more information, please see: https://www.ssa.gov/news/press/factsheets/colafacts2016.html

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

Friday, December 18, 2015

Tips for Claimants as 2015 Wraps Up

The holidays are upon us. As 2015 draws to a close and 2016 gets ready to commence, we wanted to make a few suggestions to Social Security Disability Insurance (“SSDI”) and Supplemental Security Income (“SSI”) applicants who have cases pending with the Social Security Administration.

1. Make sure you have a health insurance plan in place that covers your needs.

As we enter a new calendar year, health insurance plans routinely change. You should review your policy to make sure that your health insurance plan still covers your medications, treatments and allows you to see your preferred specialists. Any time you are having a procedure, call your insurance company to make sure that your treatment is covered at the facility it is scheduled to be performed at. Sometimes the doctor performing the procedure may take your insurance, but the facility where the procedure is being performed at doesn’t accept your health insurance. You should be able to verify this information online or by calling the customer service number on the back of your insurance card.

2. Request a copy of your medical records for the last calendar year.

It is important to make sure that your medical providers are documenting what you tell them at your appointments. An excellent way to figure this out is by requesting and reviewing your medical records at the end of every calendar year. If important information is absent from your medical records, than discuss this with your provider, so he/she can start maintaining an accurate record of your health history.

3. Schedule important checkups.

It may sound like common sense, but going through the recommended routine medical evaluations every year can save your life. Besides having a general checkup with your family practitioner, make sure you schedule any recommended annual evaluations – whether it be a skin cancer check, a pap smear, a mammogram, a prostate examination, or a colonoscopy. Just like your car requires an oil change every year, performing the recommended basic health care maintenance is a crucial necessity.

Saturday, November 28, 2015

Questions To Expect at Your Social Security Disability Hearing

Many individuals who attend a Social Security Disability Insurance and/or a Supplemental Security Income hearing are nervous about appearing before an Administrative Law Judge. For many people, this is the first legal proceeding that they have ever attended and it can be very intimidating. To help you prepare for your upcoming hearing, we have made a list of questions that are commonly asked at your hearing.

1. What is you date of birth?

2. How old are you?

3. How far did you go in school?

4. When was the last date that you attended school?

5. Are you in school now?

6. Did you ever attend a trade school or have some other type of vocational training?

7. When did you last work?

8. What was your last job title?

9. What were your tasks and duties at this job?

10. How much weight did you lift at this job?

11. Was it a sitting or standing job?

12. What other work have you performed in the last 15 years?

13. What is preventing you from being able to work?

14. What are your symptoms?

15. What is your level of pain on a pain scale? Zero being no pain and ten being pain severe enough to force you go to the emergency room.

16. What types of treatment have you tried?

17. Have you had any surgeries?

18. Have you had any hospitalizations?

19. Are you able to concentrate while watching a television program?

20. Are you able to read and understand a page in a book?

21. How long can you sit?

22. How long can you stand at one time?

23. How long can you walk at one time in terms of minutes or city blocks?

24. How much weight can you lift at one time in terms of pounds?

25. Do you require an assistive device to help you walk or stand? Which device?

26. Where do you live?

27. Who do you live with?

28. Who does the chores in your household?

29. Who does the cleaning?

30. Who does the cooking?

31. Who does the grocery shopping?

32. Do you have any children? Who cares for them?

33. Have you traveled at all since you applied for disability? Where?

34. Why can’t you perform a sit-down job?

35. Why can’t you perform a job that allows you to sit and stand at will?

36. Have you ever abused alcohol or drugs?

37. How have you been supporting yourself since you stopped working?

While the Administrative Law Judge or your attorney may ask you additional questions based on your specific disability, the above questions are representative of many of the general types of questions that you will hear at your hearing. Be open and honest when answering these questions. Listen carefully to what the Administrative Law Judge or your attorney is asking you, so you stay on track when responding. Always answer questions succinctly.

Got a question about SSDI or SSI that you need us to answer? Please check out our website at www.westcoastdisability.com . We try to provide you with helpful information on our website that will allow you to successfully navigate the Social Security Disability process. Also, feel free to email me your questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 103.

Monday, November 16, 2015

Tips For Appearing In Front of An Administrative Law Judge

Most claimants have to attend a hearing in front of an Administrative Law Judge (“ALJ”) when pursuing Social Security Disability Insurance (“SSDI”) and/or Supplemental Security Income (“SSI”) benefits. This is because the majority of claimants are denied by the Social Security Administration (“SSA”) at the lower administrative levels of the Social Security Disability system. This necessitates an appeal, which is followed by a scheduled hearing. Here are some important tips to help you prepare for your hearing in front of an Administrative Law Judge.

1. Get to Your Hearing Early – It is important to arrive for your hearing at least 30 minutes before the scheduled time. Traffic in Southern California is unpredictable and chaotic. While it may normally only take you 30 minutes to get to your hearing site, even a slight traffic accident could back you up for hours. Thus, prepare for the worst case traffic scenario and leave your home with plenty of time to spare. Most ALJs will only wait a minute or two past your scheduled hearing time for you to appear. If you are not present, you run the risk of the ALJ dismissing your case.

2. Bring A Photo I.D. – SSDI/SSI benefits are administered through the Federal government. Thus, regardless of whether your hearing site is in a Federal building or not, the Office of Disability Adjudication and Review (SSA’s hearing location) is considered a Federal facility. Thus, a current photo identification card, such as a driver’s license, is required.

3. Dress Appropriately – You are appearing in front of Federal Administrative Law Judge. Show this Judge that you are taking the process seriously by dressing appropriately. This does not mean you need to wear a suit to the hearing. Conservative, business casual attire is appropriate. Do not wear shorts, jeans, tank tops, or t-shirts. Keep any makeup and hairstyling to a minimal.

4. Listen to the Questions the Judge Asks You – The ALJ will have specific questions he/she wants to ask you. Answer those questions succinctly. Do not go on tangents talking about erroneous information. You are given limited time to present your case. Usually, the Judge has anywhere from 5 to 10 hearings a day. Thus, you need to be brief and focus on the questions being asked of you. Straying off of topic will annoy the ALJ.

5. Be Honest With the Judge – Answer all questions truthfully. The ALJ is charged with assessing your credibility. If you exaggerate your condition or mislead the Judge, he/she may state that you were not truthful in the hearing decision.

6. Look at Judge When Answering Questions – You are at the hearing to tell an ALJ why you are unable to work. The Judge is the decision maker. Therefore, you should speak directly to the Judge when answering his/her questions. Speak directly to the Judge even if your attorney is asking you a question. Remember your attorney should already know why you are applying for disability. The hearing is your chance to tell your story to a Judge.

7. Be Polite to The Judge – Some ALJs can be aggressive. While unfortunate, you must remain professional and polite throughout the whole hearing. Should your claim be denied and you have to appeal the matter, transcripts and recordings will be available. You want the Appeals Council, the reviewing bureau that hears the appeal of ALJ denials, to see that you have conducted yourself appropriately during the hearing, even if the ALJ was out-of-line at times. It is also important to remain polite to all experts at the hearing.

These simple tips may seem basic, but preparing yourself for your hearing can make all the difference when it comes to the decision.

Tuesday, October 20, 2015

The Social Security Disability Backlog Grows

If you noticed that it is taking a long time to have your Social Security Disability claim heard by an Administrative Law Judge, you are not alone. It seems that there are one million cases waiting to be heard currently by the Social Security Administration (“SSA”). The Washington Post noted that this backlog is so long that it exceeds the population of 6 different states.

The average time to get a hearing before an Administrative Law Judge is at 450 days, though www.disabilityjudges.com estimated that the national average is closer to 461 days. Keep in mind that these time frames relate only to the hearing level stages at the Office of Disability Adjudication and Review. These estimates do not take into account the waiting periods at the initial application or reconsideration levels, which are the first two stages of the Social Security Disability and Supplemental Security Income claims process. It can take the Social Security Administration anywhere from 4 to 9 months to make a decision at each one of these two initial stages. Thus, it can take anywhere from close to 2 to 3 years from your initial filing date until you appear before an Administrative Law Judge currently.

The four main reasons for this dramatic backlog include an increase in the number of hearing requests, fewer overall judges, less-productive judges, and less attorneys and personnel to assist at the hearing offices.

The Social Security Administration replaced the two officials in charge of the hearing offices with new leadership. This changing-of-the guard is in the process of developing new ways to decrease the backlog. Hiring new judges, training attorneys and claim examiners employed by the hearing offices to screen the cases for possible early decisions, scheduling more video hearings, and eliminating duplicate evidence from the file to streamline the process, are all part of the plan.

Backlogs at SSA will always exist, but SSA is hoping to decrease the hearing waiting times to 270 days by 2020. For more information on the backlog, please see: https://www.washingtonpost.com/blogs/federal-eye/wp/2015/10/19/the-biggest-government-backlog-is-getting-worse-watchdog-says-but-social-security-has-a-plan/.

Thursday, September 17, 2015

Social Security Experts

The Social Security Administration (“SSA”) often utilizes expert witnesses when assessing a claimant’s disability. SSA may send a claimant to a physical or mental health doctor for an evaluation. SSA may also call a medical expert or a vocational expert to testify at a hearing.

The experts who appear at the hearing have never examined the claimant. These experts simply review the exhibit files and give their opinions based on the written evidence and reports. SSA pays for these experts to testify.

Claimants often inquire about the objectivity of these expert witnesses, given that their appearances are being paid for by the government. As one of my clients put it, “Why would a doctor bite the hand that feeds him?” It is a good question and there is no perfect answer.

Some expert witnesses do make a significant income off of their testimony for SSA, but that alone does not necessarily mean they will compromise their ethics and testify in a biased manner. Thankfully, your attorney is given the opportunity to cross-examine these witnesses. Thus, if the testimony is inaccurate and does not align with the medical evidence and clinical findings, we are able to poke holes in the expert’s theories.

Additionally, SSA is supposed to give controlling weight to the opinion of your treating physician over that of the expert witness. This is because the government recognizes that your own doctor is better-suited to assess your capabilities, rather than a doctor who does not have a longitudinal history with you. Thus, there are strategies that we use to combat expert witnesses who do not testify objectively.