Monday, December 31, 2012

Self-Employment and Social Security Disability Benefits

Recently, I was asked the same question by two potential Social Security Disability Claimants: one is a small business owner who suffers from Lyme's disease and the other one, is a self-employed electrician who suffers from rheumatoid arthritis.  They both wanted to know whether they could continue to work on a part-time basis and be eligible for Social Security Disability Benefits.
The answer to their question is fairly complicated due to the fact that both of them are self-employed.  If they had been salaried employees, the answer to their question would have been relatively straight forward.  Under Social Security Disability rules a person cannot be eligible if he or she is engaging in a Substantial Gainful Activity (SGA).  For salaried employees, SGA is generally work that brings in over a certain dollar amount per month. In 2012, that amount is $1,010 for non-blind disabled applicants, and $1,690 for blind applicants. If a salaried employee makes more than that amount per month, the Social Security Administration figures that the applicant must not be disabled.  If a person makes more than the amount determined to be the SGA level, that person cannot be eligible for Social Security Disability regardless of how sick he or she may be.
However, in the case of persons who are self-employed, SGA is not determined solely on monthly income.  A small business owner might work 40 to 50 hours a week and make very little or no profit.  In order to deal with this particular issue, the Social Security Administration has an evaluation criteria which consists of three tests.
The Social Security Field Offices will consider all three tests before it can be established that the individual's work activity is not SGA. The following are just brief descriptions of each of the three tests:
1. Test One: Significant Services and Substantial Income
The individual's work activity is SGA if he or she renders services that are significant to the operation of the business, and if he or she receives from it a substantial income; or
2. Test Two: Comparability of Work Activity
The individual's work activity is SGA if, in terms of all relevant factors such as hours, skills, energy output, efficiency, duties, and responsibilities, it is comparable to that of unimpaired individuals in the same community engaged in the same or similar businesses as their means of livelihood; or
3. Test Three: Worth of Work Activity
The individual's work activity is SGA if, although not comparable to that of unimpaired individuals, it is, nevertheless, clearly worth more than the amount shown in the SGA Earnings Guidelines when considered in terms of its effect on the business, or when compared to the salary an owner would pay to an employee for such duties in that business setting.
As one can see from these requirements, those who are self-employed while applying for Social Security Disability Benefits will undergo a high level of scrutiny by the Social Security Administration.  The Field Offices will make a determination on a case by case basis depending on the level of involvement and the value of the work that the applicant performs for his or her particular business enterprise.
Given these complicated circumstances, it is advised that self-employed applicants  who wish to continue working while applying for Social Security Benefits should seek the assistance of a skilled Social Security Disability Lawyer.

Monday, December 24, 2012

Holiday Greetings!


The Holiday season is a perfect time to reflect on the the things that we have accomplished during the year and to take a moment to thank those who were there for us when we needed a helping hand.
 
Obtaining Social Security disability benefits for those who suffer from chronic conditions or physical ailments is not an easy task.  Fortunately, I am very proud to say that during 2012 I was able to count on  an outstanding network of medical and social service providers who were always there for my clients.  I would like to mention just a few of them in this post.  In the next few days, I will attempt to look back at my office records in order to find those that I have missed.  Hopefully, I will have sometime to call these great friends or to send them a note expressing my gratitude. 
 
Since the list of people that I have to thank is very long, I most instances, I am just mentioning the particular organization or group that they belong to.
  • Community Health Services (CHS)- with special thanks to Soraya Maldonado
  • Latino Community Services
  • Institute for the Hispanic Family
  • Catholic Charities
  • Charter Oak Clinic
  • The Village for Families and Children
  • Hartford Behavioral Health
  • The Malta House
  • The Institute of Living
  • The Lupus Foundation of America, Connecticut Chapter
  • Magda Quinones from St. Francis Hospital
  • Dr. Miguel Colan
  • Dr. Keshav Rao
  • Dr. Gary Belt
Finally, I would like to add that words cannot describe the emotions felt by my clients when they are able to get Social Security Disability Benefits after a prolonged struggle.  Most of them wait well over a year and endure enormous hardships before they are able to receive benefits.  As their lawyer, I know very well that each and everyone of my clients are also very grateful for the assistance provided by their medical and social service providers in the process of obtaining social security disability benefits. 

Monday, December 17, 2012

35 More Compasionate Allowances Added by the Social Security Adminstration


Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.

Compassionate Allowances (CAL) are a way of quickly identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate Allowances allow Social Security to target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly.

 
This month, the Social Security Adminstration added 35 more compassionate allowances, bringing the total number of such conditions in the expedited disability process to 200.  The new conditions include: rare diseases, cancers, traumatic brain injury (TBI) and stroke, early-onset Alzheimer's disease and related dementias, schizophrenia, cardiovascular disease and multiple organ transplants and autoimmune diseases.
 
Note: Conditions highlighted in Red are effective December 1, 2012.
 
Acute Leukemia
Adrenal Cancer - with distant metastases or inoperable, unresectable or recurrent
Adult Non-Hodgkin Lymphoma
Adult Onset Huntington Disease
Aicardi-Goutieres Syndrome
Alexander Disease (ALX) - Neonatal and Infantile
Allan-Herndon-Dudley Syndrome
Alobar Holoprosencephaly
Alpers Disease
Alpha Mannosidosis - Type II and III
Alstrom Syndrome
Alveolar Soft Part Sarcoma
Amegakaryocytic Thrombocytopenia
Amyotrophic Lateral Sclerosis (ALS)
Anaplastic Adrenal Cancer - with distant metastases or inoperable, unresectable or recurrent
Angelman Syndrome
Aortic Atresia
Aplastic Anemia
Astrocytoma - Grade III and IV
Ataxia Telangiectasia
Batten Disease
Beta Thalassemia Major
Bilateral Optic Atrophy- Infantile
Bilateral Retinoblastoma
Bladder Cancer - with distant metastases or inoperable or unresectable
Breast Cancer - with distant metastases or inoperable or unresectable
Canavan Disease (CD)
Carcinoma of Unknown Primary Site
Caudal Regression Syndrome - Types III and IV
Cerebro Oculo Facio Skeletal (COFS) Syndrome
Cerebrotendinous Xanthomatosis
Child Neuroblastoma - with distant metastases or recurrent
Child Non-Hodgkin Lymphoma - recurrent
Child T-Cell Lymphoblastic Lymphoma
Chondrosarcoma - with multimodal therapy
Chronic Myelogenous Leukemia (CML) - Blast Phase
Congenital Lymphedema
Cornelia de Lange Syndrome
Corticobasal Degeneration
Creutzfeldt-Jakob Disease (CJD) – Adult
Cri du Chat Syndrome
Degos Disease - Systemic
DeSanctis Cacchione Syndrome
Dravet Syndrome
Early-Onset Alzheimer’s Disease
Edwards Syndrome (Trisomy 18)
Eisenmenger Syndrome
Endometrial Stromal Sarcoma
Endomyocardial Fibrosis
Ependymoblastoma (Child Brain Tumor)
Erdheim Chester Disease
Esophageal Cancer
Ewing Sarcoma
Farber's Disease (FD) – Infantile
Fatal Familial Insomnia
Fibrodysplasia Ossificans Progressiva
Follicular Dendritic Cell Sarcoma - metastatic or recurrent
Friedreichs Ataxia (FRDA)
Frontotemporal Dementia (FTD), Picks Disease -Type A – Adult
Fryns Syndrome
Fucosidosis - Type 1
Fukuyama Congenital Muscular Dystrophy
Fulminant Giant Cell Myocarditis
Galactosialidosis - Early and Late Infantile Types
Gallbladder Cancer
Gaucher Disease (GD) - Type 2
Glioblastoma Multiforme (Adult Brain Tumor)
Glioma Grade III and IV
Glutaric Acidemia - Type II
Head and Neck Cancers - with distant metastasis or inoperable or unresectable
Heart Transplant Graft Failure
Heart Transplant Wait List - 1A/1B
Hemophagocytic Lymphohistiocytosis (HLH) - Familial Type
Hepatoblastoma
Hepatopulmonary Syndrome
Hepatorenal Syndrome
Histiocytosis Syndromes
Hutchinson-Gilford Progeria Syndrome
Hydranencephaly
Hypocomplementemic Urticarial Vasculitis Syndrome
Hypophosphatasia Perinatal (Lethal) and Infantile Onset Types
Hypoplastic Left Heart Syndrome
I Cell Disease
Idiopathic Pulmonary Fibrosis
Infantile Free Sialic Acid Storage Disease
Infantile Neuroaxonal Dystrophy (INAD)
Infantile Neuronal Ceroid Lipofuscinoses
Inflammatory Breast Cancer (IBC)
Jervell and Lange-Nielsen Syndrome
Junctional Epidermolysis Bullosa - Lethal Type
Juvenile Onset Huntington Disease
Kidney Cancer - inoperable or unresectable
Krabbe Disease (KD) – Infantile
Kufs Disease - Type A and B
Large Intestine Cancer - with distant metastasis or inoperable, unresectable or recurrent
Late Infantile Neuronal Ceroid Lipofuscinoses
Left Ventricular Assist Device (LVAD) Recipient
Leigh’s Disease
Leiomyosarcoma
Lesch-Nyhan Syndrome (LNS)
Lewy Body Dementia
Lissencephaly
Liver Cancer
Lowe Syndrome
Lymphomatoid Granulomatosis - Grade III
Malignant Brain Stem Gliomas – Childhood
Malignant Gastrointestinal Stromal Tumor
Malignant Germ Cell Tumor
Malignant Melanoma - with metastases
Malignant Multiple Sclerosis
Mantle Cell Lymphoma (MCL)
Maple Syrup Urine Disease
Mastocytosis - Type IV
MECP2 Duplication Syndrome
Medulloblastoma - with metastases
Menkes Disease - Classic or Infantile Onset Form
Merkel Cell Carcinoma - with metastases
Merosin Deficient Congenital Muscular Dystrophy
Metachromatic Leukodystrophy (MLD) - Late Infantile
Mitral Valve Atresia
Mixed Dementias
MPS I, formerly known as Hurler Syndrome
MPS II, formerly known as Hunter Syndrome
MPS III, formerly known as Sanfilippo Syndrome
Mucosal Malignant Melanoma
Multicentric Castleman Disease
Multiple System Atrophy
Myoclonic Epilepsy with Ragged Red Fibers Syndrome
Neonatal Adrenoleukodystrophy
Nephrogenic Systemic Fibrosis
Neurodegeneration with Brain Iron Accumulation - Types 1 and 2
NFU-1 Mitochondrial Disease
Niemann-Pick Disease (NPD) - Type A
Niemann-Pick Disease-Type C
Nonketotic Hyperglycinemia
Non-Small Cell Lung Cancer - with metastases to or beyond the hilar nodes or inoperable, unresectable or recurrent
Obliterative Bronchiolitis
Ohtahara Syndrome
Ornithine Transcarbamylase (OTC) Deficiency
Orthochromatic Leukodystrophy with Pigmented Glia
Osteogenesis Imperfecta (OI) - Type II
Osteosarcoma, formerly known as Bone Cancer - with distant metastases or inoperable or unresectable
Ovarian Cancer – with distant metastases or inoperable or unresectable
Pancreatic Cancer
Paraneoplastic Pemphigus
Patau Syndrome (Trisomy 13)
Pearson Syndrome
Pelizaeus-Merzbacher Disease-Classic Form
Pelizaeus-Merzbacher Disease-Connatal Form
Peripheral Nerve Cancer - metastatic or recurrent
Peritoneal Mesothelioma
Peritoneal Mucinous Carcinomatosis
Perry Syndrome
Phelan-McDermid Syndrome
Pleural Mesothelioma
Pompe Disease – Infantile
Primary Cardiac Amyloidosis
Primary Central Nervous System Lymphoma
Primary Effusion Lymphoma
Primary Progressive Aphasia
Progressive Multifocal Leukoencephalopathy
Progressive Supranuclear Palsy
Pulmonary Atresia
Pulmonary Kaposi Sarcoma
Retinopathy of Prematurity - Stage V
Rett (RTT) Syndrome
Rhabdomyosarcoma
Rhizomelic Chondrodysplasia Punctata
Roberts Syndrome
Salivary Tumors
Sandhoff Disease
Schindler Disease - Type 1
Severe Combined Immunodeficiency - Childhood
Single Ventricle
Sinonasal Cancer
Small Cell Cancer (of the Large Intestine, Ovary, Prostate, or Uterus)
Small Cell Lung Cancer
Small Intestine Cancer - with distant metastases or inoperable, unresectable or recurrent
Smith Lemli Opitz Syndrome
Spinal Muscular Atrophy (SMA) - Types 0 and 1
Spinal Nerve Root Cancer-metastatic or recurrent
Spinocerebellar Ataxia
Stiff Person Syndrome
Stomach Cancer - with distant metastases or inoperable, unresectable or recurrent
Subacute Sclerosing Panencephalitis
Tabes Dorsalis
Tay Sachs Disease - Infantile Type
Thanatophoric Dysplasia - Type 1
The ALS/Parkinsonism Dementia Complex
Thyroid Cancer
Transplant Coronary Artery Vasculopathy
Tricuspid Atresia
Ullrich Congenital Muscular Dystrophy
Ureter Cancer - with distant metastases or inoperable, unresectable or recurrent
Usher Syndrome - Type I
Walker Warburg Syndrome
Wolf-Hirschhorn Syndrome
Wolman Disease
Xeroderma Pigmentosum
Zellweger Syndrome

Monday, December 10, 2012

Religious Leaders go to Washington to Defend SSDI

Last week, Former Connecticut Governor John Rowland used a section of his daily radio talk show on WTIC News 1080 to criticize the Social Security Disability Program.  I didn't have a chance to listen to the show but I was told that he blasted SSDI and criticized it for allegedly being plagued with  widespread misuse of public funds.  Readers of this blog who don't reside in Connecticut might not be aware that John Rowland was a Republican Governor who, in 2004, resigned from office during a corruption investigation.  He later plead guilty in federal court and served ten months in prison, followed by four months of house arrest.  
 
While John Rowland was using disability claimants as scapegoats for the financial havoc that corrupt politicians like him have caused, a group of well respected religious leaders were in Washington defending SSDI.  On December 4th, The Jewish Council for Public Affairs and the Interfaith Disability Advocacy Coalition gathered on Capitol Hill to speak out in support of the Social Security Disability Insurance (SSDI) benefits program.  SSDI is an important lifeline for Americans unable to work due to illness or injury.  The two groups provided compelling testimony dispelling the myths about the program being widely abused and wasteful.  Their visit to Congress was a persuasive push to ensure that SSDI is not a victim of fiscal cliff negotiations.

The briefing featured presentations from two former SSDI recipients who were able to return to full-time employment after suffering tragic accidents that rendered them unable to work. The first, Donna Eshghi, a full-time nurse from Wichita, KS, contracted Hepatitis C after an unexpected needle-prick at work. A single mother, she was able to use SSDI benefits to support her family until she was able to return to work. And Deborah Krotenberg, an attorney from Atlanta, used SSDI benefits to keep herself afloat until she was able to return to work full-time after she was paralyzed in a serious car accident.

Kathy Ruffing, a Senior Fellow, Center on Budget and Policy Priorities,discussed her recent report: Social Security Disability Insurance is Vital to Workers With Severe Impairments. Additionally, Curtis Ramsey-Lucas, of the American Baptist Home Mission Societies, closed the event with an interfaith prayer.

"As a nation, we need to be committed to ensuring that when Americans become unable to work due to illness or accident, there is a safety net," said Rabbi Steve Gutow, President and CEO of JCPA. "SSDI is literally a lifeline for millions of Americans. People who collect disability insurance have paid into the system and therefore it is critical that the benefits they have earned are available in their time of need. Recent political attacks on SSDI are misguided at best. And now, as Congress and the President find ways to negotiate away from the fiscal cliff, we hope they will remember that SSDI is a critical program that must be protected."

Some key facts about SSDI:
  • According to the most recent government statistics, in October of 2012, there were 8.8 million Americans collecting SSDI.
  • There are record numbers of SSDI recipients now not because the government has made it easier to collect disability benefits, but rather because Baby Boomers are getting older and more prone to illness or injury, as well as a record number of women in the workplace. In fact, Steve Goss, the Chief Actuary of the Social Security Administration recently testified about these trends before the United States Congress.
  • By cutting funding to the Social Security Disability Insurance program, states and local communities will feel the brunt of the burden.
  • Denying or delaying benefits to disabled Americans leads to additional human suffering. They might have to file for bankruptcy or apply for welfare; some may end up in home foreclosure or be unable to get medical treatment without their SSDI benefits.
  • It’s not easy to qualify for SSDI benefits. The qualifying standards have been raised and there are many diseases which no longer solely qualify claimants for benefits, like alcoholism, diabetes, drug abuse and obesity.

Monday, December 3, 2012

Do I Automatically Get Medicare with SSDI?

...this is definitely one of the questions most often asked by my clients...  Clients also ask me a lot about whether they will get Medicaid.  I will address these questions separately below:

MEDICARE:

You will receive Medicare after you receive Social Security Disability Benefits for 24 months. When you become eligible for disability benefits, the Social Security Administration will automatically enroll you in Medicare. 

It is important to note that Social Security starts counting the 24 months from the month you were entitled to receive disability, not the month when you received your first check.  This two year period starts five months after your disability began.  (This is due to the fact that there is a five month waiting period to receive SSDI.)

However, special rules apply to:

End-stage renal disease (permanent kidney failure). People with permanent kidney failure get Medicare beginning:
  • The third month after the month a regular course of renal dialysis begins; or
  • The month of kidney transplantation.
Lou Gehrig's Disease (amyotrophic lateral sclerosis). People with amyotrophic lateral sclerosis get Medicare beginning with the month they become entitled to disability benefits.
Medicare has four parts:
  • Hospital insurance (Part A) helps pay hospital bills and some follow-up care. The taxes you paid while you were working financed this coverage, so it's premium free.
  • Medical insurance (Part B) helps pay doctors' bills and other services. There is a monthly premium you must pay for Medicare Part B and you have the option to refuse this coverage.
  • Medicare Advantage (Part C) plans generally cover many of the same benefits a Medigap policy would cover, such as extra days in the hospital after you have used the number of days Medicare covers. People with Medicare Parts A and B can choose to receive all of their health care services through one of these provider organization under Part C. There might be additional premiums required for some plans; and
  • Prescription drug coverage (Part D) helps pay for medications doctors prescribe for treatment. Anyone who has Medicare hospital insurance (Part A), medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Joining a Medicare prescription drug plan is voluntary and you pay an additional monthly premium for the coverage.
MEDICAID:

In Connecticut and Massachusetts, if you are an SSI beneficiary, you may be automatically eligible for Medicaid; an SSI application is also an application for Medicaid.  Typically, SSDI recipients get Medicare and SSI recipients get Medicaid.  SSI recepients do not have to wait a 24 month period to receive Medicaid benefits.

Monday, November 26, 2012

Connecticut Social Security Field Offices to Reduce Office Hours in 2013

 
Beginning January 2, 2013, Social Security Offices will close 30 minutes early.  On Wednesdays, Field Offices will close at noon. 

Why? According to the agency, "[w]hile agency employees will continue to work their regular hours, this shorter public window will allow them to complete face-to-face interviews and process claims work without incurring the cost of overtime. The significantly reduced funding provided by Congress under the continuing resolution for the first six months of the fiscal year makes it impossible for the agency to provide the overtime needed to handle service to the public as it has done in the past."
Note that the earlier closing times do not apply to the Offices of Disability Adjudication and Review, (the Federal Buildings where Administrative Law Judges hold hearings, also known as "ODAR"). ODARs will be maintaining their regular hours.
Some ALJ hearings are scheduled at district offices and at permanent remote hearing sites. If you have such a hearing and it is scheduled to begin after the new closing time, you should go to the location and knock on the presumably locked front door. ODAR officials tell us that security guards will be present to admit you. These officials ask that you bring the notice of hearing with you, and that your clients bring photo IDs, for the guard's inspection.
 
However, there is strong opposition to these budget cuts.  Congress should bear in mind the latest results of a public opinion poll that found that 83% of likely voters oppose cuts to the Social Security Disability Program.  A new poll commissioned by the National Organization of Social Security Claimants' Representatives ("NOSSCR"), (an organization of which I am a sustaining member), found that the vast majority of likely voters support Social Security Disability Insurance Benefits (SSDI) and believe that Congress should target other areas of government when proposing cuts.  For more information regarding this poll visit:
 
You may also want to read a great OpEd piece in support of the Social Security Disability Program that recently appeared in the Seattle Times:




Monday, November 19, 2012

Lyme Disease and Social Security Disability

Lyme Disease is the fastest growing infectious disease in the country!  I was recently shocked to hear that Lyme cases by far outnumber those of AIDS, West Nile virus, swine and avian flu combined.
 
Unfortunately, the Social Security Administration is a slow bureaucracy and it seems like it takes the agency an eternity to get the latest news.  Despite the prevalence of Lyme Disease in the U.S., the agency has failed to develop consistent guidelines or rulings to evaluate claims involving this condition.  For example, Lyme Disease has not been included in the SSA's Listing of Impairments.  Moreover, no rulings have been issued setting forth how cases involving this condition must be evaluated.  Lyme disease disability claims are currently evaluated under Listing 14.09D Inflammatory Arthritis.  Obviously, this is not a very precise listing for Lyme disease.
 
The lack of adequate guidelines makes it difficult for Social Security Claimants who suffer from Lyme Disease to win Social Security Disability Benefits.   However, persons who suffer from Chronic Lyme Disease should not be discouraged from applying for disability benefits.  Cases can still be won if the claimant is able to demonstrate that his or her condition meets the Social Security definition of disability.  As time goes by, it seems that judges and other examiners at the SSA are becoming more aware of the serious nature of Chronic Lyme Disease.  With the proper medical documentation, a competent Social Security Disability Lawyer should be able to show the serious limitations suffered by those who suffer from this disease, such as the cognitive impairments that occur when it is untreated for a long period of time. 
 
Finally, I would like to add that there is a group of advocates who work on behalf persons who suffere from Lyme Disease, who are petitioning the Social Security Administration to include Lyme Disease in the "Blue book" of Listings of Impairments.  Please visit the enclosed link and sign the petition: https://www.change.org/petitions/social-security-administration-include-lyme-disease-in-the-ssa-s-blue-book

Wednesday, November 14, 2012

Can Kids Conceived After Dad Died Get SSDI Benefits?

The Social Security Administration is refusing to grant survivor benefits to Michigan twins, who were born after in-vitro fertilization. The government says they shouldn't be recognized as heirs because they weren't alive when their father died.

A federal judge says he can't solve the Social Security dispute until the state Supreme Court decides if the kids are considered heirs under Michigan law.

This week the Michigan Supreme Court will hear arguments in this unusual case that involves a man from the Kalamazoo area who died of Lupus and twin children who were conceived through invitro fertilization.

Jeff Mattison, of Portage, Michigan who had lupus, high blood pressure and kidney failure, stopped taking certain medication at times so he could store his sperm without risk of passing on defects. On the day before his death, he injected his wife with medication for eventual harvest of her eggs for artificial insemination

In May, the U.S. Supreme Court ruled in favor of the Social Security Administration in a similar case from Florida, although that decision is not binding on the state Supreme Court. This case specifically focuses on a Michigan law.

The children, Mallory and Michael, might be eligible for $200 to $500 in monthly Social Security benefits, retroactive to their birth.


 

Monday, November 5, 2012

Sitting Limitations and Your Social Security Disability Case

 

Many Social Security Disability Claimants who suffer from conditions such as: degenerative disc disease, stenosis, osteoarthritis in the lower back or hips or, rheumatoid arthritis, have limitations as to how long they can sit through an entire work day.  These type of limitations are extremely relevant in cases where the claimant's past work involved sedentary work.  In addition, these limitations play an important role in cases where the Social Security Administration alleges that a claimant with serious physical limitations is still capable of doing a sit down job.  In my work as a Connecticut Social Security Disability Attorney, I frequently deal with cases involving postural limitations. 
To be able to do a full range of sedentary work, a person must have the capacity for prolonged sitting. Social Security Ruling 83-10 states that sitting “should generally total approximately six hours of an eight-hour workday.”  Most jobs “have ongoing work processes which demand that a worker be in a certain place or posture for at least a certain length of time to accomplish a certain task. Unskilled types of jobs are particularly structured so that a person cannot ordinarily sit or stand at will.” Social Security Ruling 83-12.
Regarding a person’s need to alternate between sitting and standing, Social Security Ruling 96-9p states:
An individual may need to alternate the required sitting of sedentary work by standing (and, possibly, walking) periodically. Where this need cannot be accommodated by scheduled breaks and a lunch period, the occupational base for a full range of unskilled sedentary work will be eroded. The extent of the erosion will depend on the facts in the case record, such as the frequency of the need to alternate sitting and standing and the length of time needed to stand. The residual functional capacity assessment must be specific as to the frequency of the individual’s need to alternate sitting and standing. It may be especially useful in these situations to consult a vocational resource in order to determine whether the individual is able to make an adjustment to other work.
 
 Consequently, if a person is unable to sit for extended periods of time, Social Security recognizes that this limitation will be very disruptive in a wide range of jobs.  In most cases involving severe postural limitations, an effective Social Security lawyer should be able to rule out a large number of jobs that the claimant can do and eventually convince the judge to rule in his favor.  Being able to persuade the judge to make a favorable ruling in these cases takes considerable skill and requires a good knowledge of Social Security rules.  Very often, sitting limitations alone will not be sufficient to be able to win a Social Security Disability case.  A skillful lawyer will also need to argue that based on the claimant's age, work experience, educational background, and other physical limitations, there are no jobs that his client can perform.
 
Feel free to give me a call or send me an email if you have any specific questions or concerns regarding sitting limitations.  (855) SSDI-HELP or ivan@ivanramoslaw.com.
 

Monday, October 29, 2012

Dead SSI Claimant is Told that He Can Work


Harley Christopher Andrews, a young man from the Orlando Metropolitan Area, died on September 2nd from an agressive form of cancer known as glioblastoma multiforme.  In addition to having to fight cancer for the last three years of his life, he also had to fight the Social Security Adminstration which denied him disability benefits. 
"He was having seizures, and his whole left side was going paralized" as a result of the brain tumor.  "He could not work", his mother Wendy told the Orlando Sentinel.
Twelve months after her son's death, she received a letter from the Social Security Administration.  The letter which was addressed to her son stated:  We're writing to let you know that we have made a disability hearing decision on your case.  Our decision: we find that your condition has improved and you are capable of working". 
This letter is just one of several "form letters" sent to Social Security claimants throught the nation.  I constantly receive angry calls and emails from claimants in Connecticut and Massachussets who are frustrated when they receive a decision from the SSA such as the one sent to the decesased claimant in Orlando. 
The tragic nature of the story of Harley Chrisopher Andrews shows how little effort the SSA makes to investigate cases and make well informed disability determinations. 
Glioblastoma brain tumors have one of the worst progmosis of any central nervous system cancers.  Prognosis is very poor with a median survival time of approximately 12-14 months and is almost invariably fatal. 
It is totally inexcusable why the Social Security Adminstration failed to award benefits to this claimant.  The tragedy endured by this young cancer victim and his family should serve as a wake up call to those who have failed to acknowlege the plight of thousands of other claimants are who routinely denied disability benefits without a valid basis.
Social Security Claimants: don't give up when you get a discouraging letter from the Social Security Adminstration such as the one received by Harley Christopher Andrews' mom.  Fight for your benefits.  Consider hiring a lawyer.  Most Social Security Disability Lawyers like me, don't charge any legal fees unless we are able to win benefits for you.     

Monday, October 22, 2012

Serving Latinos Over 50: An Essential Part of Our Mission


      I just got back from a Social Security Disability Law conference in Seattle, Washington.  During my stay in the Pacific Northwest, I had the opportunity to share my experiences as a disability attorney with other colleagues and continue to learn about the ever more complex SSI and SSDI process.  I came back thoroughly convinced of how important the Social Security Disability Programs are for our Latino Community, particularly those over 50.
        Never before in history has the U.S. contained so many older people.  Today, one out of every 9 Americans is "old"—another former youth turns 50 every 8 seconds.  January 2011 ushered in the first of approximately 77 million Baby Boomers, born from 1946 through 1964 and surging toward the gates of retirement.  Latinos, in particular, make up the fastest segment of this aging population.  An article published by the Washington State University concluded that: “Elderly Hispanics now represent the fastest-growing population currently at or near retirement.”  By 2050, Hispanics will make up 20 percent of the elderly population, up from 7 percent in 2010, according to Census data.
     As we age, our chances of becoming disabled and unable to work increase.  For example, a fifty year old person is twice more likely to become disabled than a 40 year old.  The chances become even greater in persons who have performed physical labor throughout their life --the type of work most commonly found by our forefathers when they came to this country. Given these figures, it is easy to understand why so many Latino(a)s who are between the ages of 50 and 65 need the safety net provided by the Social Security Disability programs (SSI / SSDI). 
     As I enjoyed the great apples from Yakima Valley and sipped the wonderful wines of Walla Walla County, I was reminded of the many Latino(a) workers who have thrown their backs and busted their knees working in farms in Washington State and  across the U.S.  Now, it is our moral obligation to support those who can no longer work as a result of a medical condition or injury. 


Monday, October 8, 2012

How to Get Your Doctor to Support Your Social Security Disability Case

Having a doctor on a claimant's side makes a world of difference in a Social Security Disability case.  Unfortunately, many of the persons who are considering filing for disability seem to be unaware of this important fact.  The opinion of the doctor or doctors who treat a claimant can make or break a disability claim.  For this reason, I would like to provide some helpful hints on how to enlist your doctor's help in your SSDI or SSI case and how to make the best use of his or her medical opinion regarding your physical or mental limitations.  In addition, I would like to provide some suggestions on what to do in circumstances when a doctor refuses to cooperate with the case. 
  • YOUR DOCTOR NEEDS TO KNOW YOU AS A PATIENT:   In order to make the best use of the opinion of a doctor in a Social Security case, a lawyer needs to establish that the doctor has been treating the patient long enough to be able to form a credible opinion.  Simply stated, the more the doctor knows you, the more weight Social Security is required to give to his or her opinion.  Your doctor's opinion has to be given controlling weight, unless the judge can cite specific reasons why it should be disregarded.  One of the reasons most commonly cited by judges for giving little weight to a medical opinion is that the doctor did not treat the claimant long enough to be able to form a credible opinion.  Likewise, many doctors feel uncomfortable issuing opinions or helping patients that they have just begun to treat.  For this reason, I often recommend to clients not to bring up the issue of disability with a doctor that they have just begun seeing.  I believe that doctors are often irked when a patient brings up the issue of his or her social security disability case during their first or second visit.  Therefore, whenever possible, a claimant must give his or her doctor reasonable time to form an opinion with respect to his or her limitations.
  • TALK TO YOUR DOCTOR BEFORE FILING YOUR CASE:  Before a Social Security disability claim is filed, it is a good idea to ask the treating physician whether he or she will support the claim.  Moreover, the claimant should specifically ask whether the doctor would be willing to complete a questionnaire stating his patient's limitations.  However, I think that before posing the question, the patient should engage in a dialogue with the doctor regarding problems performing specific work related tasks.  Ideally, this dialogue should take place over the course of several office visits.  I believe that a doctor is more likely to support a claim when he has had a chance to openly discuss the case with his patient beforehand.  I believe that doctors are reluctant to help patients with their disability claims when they are unexpectedly asked to support a disability claim.          
  • REMEMBER THAT YOUR CONVERSATIONS WITH YOUR DOCTOR ARE OFTEN RECORDED IN THE MEDICAL RECORD:  Many of my clients are unaware of the fact that doctors often transcribe in the medical record the content of their conversations with their patients.  In fact, doctors are known to record specific statements made by their clients that pertain to their disability claim.  Unfortunately, I have found several instances where my clients' statements have ruined their chances of getting their claim approved.  Disability claimants should be very careful with what they tell their doctors when they ask for a medical opinion.  Don't joke around with the doctor on how desperately you need the money from Social Security or how you have to look really bad in order to win disability.  Keep in mind that your comments could be misconstrued very easily and remember, it is never a good idea to suggest to a doctor to exaggerate the severity of  a condition or an illness, or to ask the doctor to be dishonest in any way.
  • GIVE YOUR DOCTOR A BRIEF QUESTIONNAIRE THAT GOES TO THE HEART OF YOUR CLAIM: Social Security Disability Lawyers often prepare questionnaires for their client's doctors.  These questionnaires ask the treating physicians to state the extent and the nature of their patients physical and mental limitations.  When preparing these questionnaires it is important to keep in mind that doctors don't have a lot of time in their hands and that they dislike having to spend time completing forms.  For this reason, I like to keep my questionnaires brief and to the point.  Moreover, the questionnaire should go right to the legal issues that are most relevant to the case.  For example, the questionnaire should specifically ask questions that could help a judge decide whether the claimant's case falls within a specific Social Security rule or guideline.  I believe that the best way to obtain a good opinion from a doctor is by giving him or her one of these questionnaires.  (In my office we call these questionnaires: "medical source statements".)  Instead of questionnaires, some doctors prefer to write a letter in support of their patient's disability claim.  I often find that these letters are not very effective because, in many instances, they fail to address the specific legal issues being decided by the adjudicators in the case.
  • OFFER TO COMPENSATE YOUR DOCTOR FOR HIS OR HER TIME:  Whenever possible, it is a good idea to offer to compensate the doctor for the time spent completing the questionnaire.  Most of the time, the amount paid is just a nominal sum.  However, I believe that doctors often appreciate the gesture and spend additional time and effort when their patient offers to remunerate them for their valuable time.
  • IF YOUR DOCTOR IS UNCOOPERATIVE, CONSIDER FINDING A NEW ONE:  Let's face it.  Some doctors don't want to help their disabled patients get benefits.  Its probably not worth your time trying to convince them to complete a medical source statement for your case.  Under those circumstances, its probably a good idea to consider changing doctors.  I know that this type of decision can be very difficult.  However, I have found that in many instances a claimant can get a new doctor that is more cooperative with their case without having to sacrifice the quality of their care.  Naturally, claimants should not wait until the last minute to get a new doctor.  The earlier they get on the right track, the better. 
  • DOCTORS WHO ARE NOT SPECIALISTS IN YOUR MEDICAL CONDITION CAN ALSO HELP YOUR CASE:  An alternative to finding a new doctor is asking one of your treating physicians who is not a specialist in your particular condition to help with your case.  I have found that primary care physicians can often issue very credible opinions which are well supported by the medical evidence in the record.  In many circumstances these opinions can be extremely helpful.   Don't be discouraged if your specialist does not help you.  The Social Security Administration knows that highly paid specialists such as neurosurgeons often refuse to complete medical source statements.  I believe that you can still win, even when your neurosurgeon refuses to complete a medical source statement.  I recently won a case in which the neurosurgeon refused to help his client.  Fortunately, prior to filing for disability, my client had seen a neurologist on several occasions for some problems related to his spinal cord condition. My client went back to the neurologist and was able to obtain a very well reasoned medical opinion.  The opinion from the neurologist, combined with a questionnaire completed by his primary care doctor, was enough to win him disability benefits.

     

Thursday, August 23, 2012

Hepatitis C and Social Security Disability

Applying for Social Security Disability Benefits due to the effects of Hepatitis C can be a frustrating process.  Hepatitis C is a viral infection affecting primarily the liver.  In many instances, the disease is asymtomatic.  However, when the condition becomes chronic, a person suffering from this disease can experience fatigue, anemia and nausea.  There is no cure for chronic hepatitis C and unfortunately, the treatment used to control it can be extremely debilitating.
 
The Social Security Administration Analyses applications for disability benefits from claimants suffering from Hepatitis C, under Section 5.05 of the Listing of Impairments.  Meeting the requirements for the listing can be very complicated.  Section 5.05 requires that a claimant prove the existence of one or more of the following conditions:
  • excess fluid in the peritoneal cavity (called ascites) or the pleural cavity (called hydrothorax)
  • spontaneous bacterial peritonitis
  • esophageal or gastrointestinal hemorrhage
  • hepatorenal syndrome
  • hepatopulmonary syndrome, or
  • hepatic encephalopathy.
If you have Hepatitis C and are thinking of applying for Social Security Disability Benefits, you should ask your doctor whether you meet any of the conditions listed in Section 5.00 of the Listing of Impairments.  You should also consider hiring a Social Security Disability Lawyer who can prepare a questionnaire for your doctor in order to fully ascertain whether you meet the listing requirements.
 
You might still be eligible for Social Security Disability Benefits, even if you do not meet the requirements in the listing.  Under those circumstances, you can argue that the condition imposes functional limitations that prevent you from working.  Proving these limitations is probably the hardest aspect of a Social Security Disability case dealing with Hepatitis C due to the fact that most of the symptoms of the disease are highly subjective. The best way to deal with this problem is by talking to your doctor and letting him or her know, as often as possible, of your symptoms.  Hopefully, you doctor will make notations on the medical record that you can use later on in the disability process.  You can also obtain statements from former co-workers and relatives attesting to your limitations.
 
Another important aspect to keep in mind is that Hepatitis C impacts your ability to perform physical work as well as your cognitive abilities.  Most claimants with Hepatitis C who are successful in obtaining disability benefits are able to show that the disease has adversely affected both of these areas of functioning.  However, if your past work experience involved mostly physical work and you are fifty or older, you might be able to win your disability case solely on your physical limitations, depending on your educational level. 

Tuesday, July 24, 2012

A Social Security Rule that Could Help Many Latino Farm Workers and Fishermen Obtain SSDI

As a Social Security Disability Lawyer, I am often asked to represent Latino workers who have spent most their life doing arduous physical work.  These workers are part of a large migration that came to this country to work in industries such as: farming, fishing and landscaping.  Due to the physical requirements of these jobs, many of these Latinos find that, after a certain age, they can no longer perform their regular occupation.   
Fortunately, there is a somewhat obscure Social Security Disability Regulation that can help these workers obtain SSDI benefits.  This regulation is commonly referred to as: the "Worn Out Worker Rule" and is contained in 20 C.F.R. 404.1562(a).  In addition, Social Security Ruling 82-63 provides an in depth explanation of this useful disability law doctrine. 
In order to meet the requirements of the Worn Out Worker Rule, a Social Security Claimant must meet the following criteria:
  1. Have a marginal educational background.  Under Social Security Rules, persons who have a formal schooling of six grade level or less are deemed to have a marginal education.  With respect to Latino workers who do not speak English, it is important to note that under Social Security Rules, persons who cannot speak English are considered to have less than a marginal education. 
  2. Must have performed 35 years or more of arduous physical labor.
  3. A severe medical condition prevents the claimant from performing his old job.
The advantage of the Worn Out Worker Rule is that a worker who meets its criteria can be found to be disabled even in cases where the worker has been released by his or her doctor to perform "medium exertional work".  This rule is extremely helpful to some of my clients who have spent most of their lives working in the nurseries and farms in Central Connecticut.  The worn out worker rule would also allow for many fisherman in New England, who would otherwise have their disability claim denied, to be awarded Social Security benefits.

Wednesday, June 20, 2012

Childhood Disability Benefits: Can a Child Receive SSDI and SSI at the Same Time?

Many parents are unaware that a child may be eligible to receive both SSDI and SSI benefits at the same time.  These children are commonly referred to as: "concurrent beneficiaries".  A “concurrent beneficiary” in Social Security parlance, is someone who receives SSDI benefits and also a reduced SSI payment.  Concurrent beneficiaries receive two separate checks each month (one for the SSDI benefit and one for the SSI), as well as both Medicare (after the 24-month Medicare Qualifying Period) and Medicaid. 
In order to understand this concept, one must be aware that a child may qualify to receive benefits under different provisions of the Social Security Act.  For example, a child may receive benefits (commonly called SSDI) because one of his parents is retired, deceased or disabled.  This type of Social Security benefit has nothing to do with whether the child in question is disabled.  A child may also be eligible to receive benefits (known by most as SSI) if he or she is found to be disabled and falls below certain economic level.  It is important for parents and childhood disability advocates to be aware that a child may be found eligible to receive concurrent payments under both of these programs.  A parent should never give up fighting for both of these benefits simply because the child has already been deemed to be eligible for one of them.  What follows is a brief summary of some common scenarios under which a child may be able to collect both benefits.
A concurrent beneficiary sometimes begins as an SSI recipient who later on is found eligible for a SSDI.  An example of this would be when a parent dies, retires, or becomes disabled, triggering eligibility for SSDI benefits for his children.  In this case, the child would get an SSDI payment that would count as unearned income for SSI.  Depending on the amount of the SSDI payment, the SSI check could be reduced or eliminated.
Another example of a concurrent beneficiary is that of a child who is receiving SSDI benefits and then, later on, subsequently meets the requirements to collect under the SSI program. A common circumstance in this type of case would be when one of the parents of child who receives SSDI, becomes unemployed, thus lowering the amount of deemed income that previously prevented him or her from receiving SSI.
In all concurrent cases, SSDI benefits take precedence since these are entitlement programs.  Once the SSDI benefit has been determined, the eligibility for SSI is made.  The SSDI payment benefit is considered unearned income for the purposes of determining both eligibility for and the amount of the SSI benefit. There is no choice when determining which benefits a beneficiary will receive since SSI is the payer of last resort in all cases.

Thursday, June 14, 2012

The SSA and the DOD Create a New Initiative to Improve Veteran's Access to Social Security Disability Benefits

The Social Security Administration and the Department of Defense (DoD) are working together to improve access to disability benefits for the nation’s Wounded Warriors, service members, veterans, and their dependents. A new nationwide project enables Social Security disability case processing sites to receive military medical records from multiple DoD facilities with a single request to a centralized DoD site. As of today, this initiative is in its first phase of nationwide expansion.
“Receiving electronic medical records for our Wounded Warriors and other military personnel will significantly shorten the time it takes to make a disability decision,” said Michael J. Astrue, Commissioner of Social Security. “This new process will improve the speed, accuracy, and efficiency of the disability program.”
Originally a pilot, the program included five states (Colorado, North Carolina, Oregon, Virginia, and Washington) and more than 60 military treatment facilities. These states are now receiving electronic medical records within 72 hours, a remarkable improvement over the previous average response time of five weeks for paper records from individual military treatment facilities.
The new DoD-Social Security collaboration consolidates requests for medical records from Social Security to a single location that has access to DoD records in a central electronic repository. This central location receives and responds to requests for medical records based on Social Security’s Electronic Records Express (www.socialsecurity.gov/ere), another successful initiative that offers electronic options for submitting health records related to disability claims.
The benefits of the new process include:
  • faster delivery of DoD medical records to Social Security,
  • a more efficient system to obtain records,
  • a reduction in the time it takes to make a medical decision on a disability claim, and
  • a reduction in the number of consultative examinations (medical exams requested by Social Security when additional tests or medical records are needed.)
This is the first step towards the long-term goal of a fully automated solution of improving medical information sharing using health information technology and the Nationwide Health Information Network Exchange.

Wednesday, June 13, 2012

Applying for Social Security Disability Benefits in Connecticut: Helpful Hints and Practical Advice

There are three ways that a person can apply for Social Security Disability Benefits:  1. in person at a local Social Security Field Office, 2. by phone or, 3. on line.  Any of these three methods is perfectly fine.  Here are some helpful hints and recommendations regarding the initial Social Security Application process, with particular emphasis on some of the issues faced by claimants who use the online system in the State of Connecticut. 

The Social Security Administration (SSA) seems to have an ongoing media campaign encouraging applicants to use the online system.  www.SSA.gov  This electronic system seems to be working relatively well for most applicants.  In addition, the SSA is constantly working on improving its online system and has been adding new features to its web page on a regular basis.  I must confess that, at times, it is hard to keep up.  One of the most common issues with respect to the online system, is that not all aspects of the Social Security process can be conducted in an electronic format.  Despite these limitations, the SSA is working at a very fast pace towards a paperless electronic system and, pretty soon, practically every aspect of the process will be conducted in an electronic format.  One example of this problem was the fact that applicants could do the entire initial application and adult disability report online but then, had to mail a separate form to the SSA giving the agency authorization to look at their medical information.  However, just today, the SSA came up with a new electronic Authorization Form to Disclose Information to the SSA (Form SSA-827).  Now applicants can provide an electronic signature to disclose their medical information, instead of using the traditional "wet ink" signature that our civilization has used for more than two millenniums. 

Another difficulty with the current online system is that it can only be used for SSDI applications.  Applicants for SSI still have to apply in person or by phone.  This causes some confusion, since most Social Security Disability Lawyers advise their clients to simultaneously apply for SSI and SSDI.  However, this apparent problem is easily solved by completing the SSDI form online and then calling the local office to do the SSI application by phone.  Another easier way of resolving this issue is by stating in the SSDI online application that the claimant also wishes to apply for SSI.  The online application specifically asks whether the applicant also wants to apply for SSI.  If the online applicant clicks on the "yes" button, someone from the SSA will contact the claimant to complete the SSI application on the phone. 

Another issue particular to Connecticut is that applicants from the Bristol area, who apply on line, receive a statement indicating their case is being handled by the Hartford Field Office instead of the Bristol Field Office.  This can be a bit confusing but, I suspect, is no big deal.  The Hartford Field Office seems to be handling cases from the Bristol area due to budget cuts.  However, even though the Hartford Field Office is in charge of the case, claimants can still go to the Bristol Field Office to submit any necessary paperwork that cannot be delivered by mail or online.  For example, this week, one of my clients from Bristol was told that she had to show proof of citizenship to the SSA in person.  Since she is disabled, driving long distances is difficult.  She thought that she had to appear in person in the Hartford filed office to show her passport.  She was a bit overwhelmed and was making arrangements to have a friend drive her to downtown Hartford.  Fortunately, I was able to talk to her before she got in the car with her friend and explained that she could present her passport to the Bristol Field Office (which happens to be very close to her house) even though the Hartford Field Office is the office which is formally in charge of her application.

Another important piece of information is that now, Social Security Field Offices close at 3:30 PM.  The early closure of the Field Offices is also due to budgetary constraints.  For your convenience here is a list of the Social Security Field Offices in Connecticut. 

Apply for Social Security Disability Benefits - Connecticut Social Security Office Phone Numbers and Addresses:

<><><><><><>
Office NameAddressCityStateZip   Telephone
Ansonia Social Security Office   307 Main StreetAnsoniaConnecticut06401    866-331-7096
Bridgeport Social Security Office   3885 Main StreetBridgeportConnecticut06606    866-331-1213
Bristol Social Security Office   225 North Main StreetBristolConnecticut06010    888-472-2403
Danbury Social Security Office   131 West StreetDanburyConnecticut06810    866-275-7821
East Hartford Social Security Office   478 Burnside AvenueEast HartfordConnecticut06108    866-706-6759
Hartford Social Security Office   960 Main StHartfordConnecticut06103    877-619-2851
Meriden Social Security Office   One West Main StMeridenConnecticut06451    877-409-8429
Middletown Social Security Office   425 Main StreetMiddletownConnecticut06457    877-692-3145
New Britain Social Security Office   233 Main Street 2nd FlNew BritainConnecticut06051    866-858-6086
New Haven Social Security Office   150 Court St 4th FlNew HavenConnecticut06510    866-331-5281
New London Social Security Office   2 Shaws CoveNew LondonConnecticut06320    866-643-3401
Norwalk Social Security Office   24 Belden AveNorwalkConnecticut06850    877-376-9854
Norwich Social Security Office   101 Water StreetNorwichConnecticut06360    888-482-3170
Stamford Social Security Office   2 Landmark SquareStamfordConnecticut06901    866-770-1881
Torrington Social Security Office   147 Litchfield StreetTorringtonConnecticut06790    860-489-1633
Waterbury Social Security Office   95 Scovill StWaterburyConnecticut06706    203-756-7476
Willimantic Social Security Office   1320 Main StreetWillimanticConnecticut06226    860-423-6386