Monday, January 28, 2013

Congestive Heart Failure and SSDI Benefits

If you suffer from congestive heart failure, you may be eligible for Social Security Disability benefits.  Congestive heart failure, occurs when the heart is unable to provide sufficient pump action to distribute blood flow to meet the needs of the body.  Heart failure can cause a number of symptoms including shortness of breath, leg swelling, and exercise intolerance. The condition is diagnosed with echocardiography and blood tests.

The Social Security Administration generally calls congestive heart failure “chronic heart failure.”  In adult disability claims, Social Security uses the  five-step sequential evaluation in deciding whether the claimant is entitled to benefits.  Under the first two steps, the SSA will determine whether the claimant is working, and whether his or her impairment is considered “severe.”

Once the first two steps are decided in the claimant's favor, there are two basic ways that a person can qualify for Social Security benefits due to  congestive heart failure: 1. the individual can meet the requirements of a listing set out in Social Security's list of qualifying impairments or, 2.  show that he or she is unable to work.

Social Security uses the Listings of Impairments manual as their guide to determine whether a claimant meets or does not meet the Social Security Administration's requirements for total disability. The listing for congestive heart failure is found in Section 4.02. Section 4.02 states that in order to meet the lisitng of impairments, the claimant must suffer from one of the following
  • Systolic failure. This occurs when the heart has weakened pumping strength and can be shown by one of the following:

  • the heart’s ejection fraction (the percentage of blood pumped out of the heart with each heartbeat) is 30% or less during a period of stability (not during an episode of acute heart failure), or

  • the heart’s left ventricular end diastolic dimensions are larger than 6.0 cm.

OR

  • Diastolic failure. This occurs when the heart is unable to fill properly, and must be shown by all of the following:

  • thickness of left ventricular wall and interventricular septum 2.5 cm or larger on imaging

  • an enlarged left atrium 4.5 cm or larger, and

  • normal or elevated ejection fraction during a period of stability (not during an episode of acute heart failure).
In addition, the claimant must also have one of the following symptoms.
  • Inability to perform an exercise tolerance test (ETT) at a workload equivalent to 5 METs or less due to certain difficulties.

  • If an exercise tolerance test would be too risky, persistent symptoms of heart failure that very seriously limit activities of daily living (ADLs) are required, or

  • At least three episodes of heart failure and fluid retention within the past 12 months, requiring emergency room treatment or hospitalization for at least 12 hours.
If a claimant's condition is severe but not at the same or equal level of severity as a medical condition on the list, then the Social Security Administration must go to step 4 and 5 of the disability process and determine if  the condition interferes with the person's ability to do the work that he or she did previously (during the last 15 years). 
 
If the claimant cannot do the work performed in the past 15 years, the Social Security Administration will see if he or she is able to adjust to other work.  The Social Security Administration will consider the persons' medical conditions as well as his or her age, education, past work experience and any transferable skills that the claimant may have. If the claimant cannot adjust to other work, the claim will be approved. If the claimant can adjust to other work, the claim will be denied.

Monday, January 21, 2013

Applying for Social Security Disability with Multiple Sclerosis (MS)

 
Every competent Social Security Disability lawyers knows that applying for Social Security Benefits with Multiple Sclerosis (MS) can be a complex task due to the episodic nature of this condition.  It is well known that, in many cases involving MS, there are periods of time when the condition makes a person very sick and periods when there are little to no symptoms.  However, with the right strategy and suficient medical evidence, claimants have a good chance of being awarded Social Security Disability Benefits. 

Multiple Sclerosis is an autoimune condition that affects the central nervous system, the brain, the spine and the optic nerve.  MS affects the myelin (a the fatty substance that surrounds and protects the nerve fibers in the central nervous system), as well as the nerve fibers themselves. The damaged myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fiber is damaged or destroyed, nerve impulses traveling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms that can occur.  Symptoms include: fatigue, numbness, walking (gait) balance, & coordination problems, bladder dysfunction, bowel dysfunction, vision problems, dizziness and vertigo, pain, cognitive dysfunction, emotional changes, depression and spasticity.
There are two basic ways that a person can qualify for Social Security benefits due to Multiple Sclerosis. An individual can meet the requirements of a listing set out in Social Security's list of qualifying impairments or show that he or she is unable to work.
Social Security uses the Listings of Impairments manual as their guide to determine whether a claimant meets or not the Social Security Administration's requirements for total disability.  The listing for Multiple Sclerosis is found in Section 11.09.  Section 11.09 states that in order to meet the lisitng of impairments, the claimant must suffer from one of the following:

  1. Disorganization of motor function; 

  2. Visual or mental impairment; or

  3. Significant, reproducible fatigue of motor function with substantial muscle weakness on repetitive activity, demonstrated on physical examination, resulting from neurological dysfunction in areas of the central nervous system known to be pathologically involved by the multiple sclerosis process.
Please note that the lisiting provides a very specific definition of each one of these symptoms.  For a more detailed definition click on the link: http://www.ssa.gov/disability/professionals/bluebook/11.00-Neurological-Adult.htm#11_09   Claimants must prove that they suffer from symptoms of the level of severity specified in the listing in order to be found to meet from one of these three characteristics. 
If a claimant's condition is severe but not at the same or equal level of severity as a medical condition on the list, then the Social Security Administration must go to step 4 and 5 of the disability process and determine if the condition interferes with the person's ability to do the work that he or she did previously (during the last 15 years).
If the claimant cannot do the work performed in the past 15 years, the Social Security Administration will see if he or she is able to adjust to other work. The Social Security Administration will consider the persons' medical conditions as well as his or her age, education, past work experience and any transferable skills that the claimant  may have. If the claimant cannot adjust to other work, the claim will be approved. If the claimant can adjust to other work, the claim will be denied.
To support our friends in the Connecticut chapter of the National Multiple Sclerosis Society visit: http://www.nationalmssociety.org/chapters/ctn/index.aspx
For our firends in the Massachusetts Chapter visit: http://www.nationalmssociety.org/chapters/MAM/index.aspx

 

Monday, January 14, 2013

Arthritis Patients Applying for Social Security Disability


According to the Center for Disease Control, Arthritis is one of the most common causes of disability in the United States. 
 
Before addressing how a person with Arthritis can qualify for Social Security Disability Benefits, it is necessary to explain the nature of this condition.  Arthritis is a disorder affecting the joints and is characterized by inflammation and joint pain. It is most prevalent in the thumbs, fingers, feet, hips, knees, neck, back, and shoulders.  The joints are integral for many body movements, and arthritis can limit range of motion and prevent necessary movements. Arthritis is typically seen in older individuals but can affect children as well.  There are three main types of arthritis: osteoarthritis, rheumatoid arthritis and psoriatic arthritis. About twice as many women are affected by arthritis than men.

Osteoarthritis (OA):  also known as degenerative arthritis or degenerative joint disease, is a group of mechanical abnormalities involving degradation of joints, including articular cartilage and subchondral bone. Symptoms may include joint pain, tenderness, stiffness, locking, and sometimes an effusion. A variety of causes—hereditary, developmental, metabolic, and mechanical—may initiate processes leading to loss of cartilage. When bone surfaces become less well protected by cartilage, bone may be exposed and damaged. As a result of decreased movement secondary to pain, regional muscles may atrophy, and ligaments may become more lax.

Rheumatoid Arthritis (RA):  An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. In addition to causing joint problems, rheumatoid arthritis can also affect your whole body with fevers and fatigue.  Rheumatoid arthritis is much more common in women than in men and generally occurs between the ages of 40 and 60. Treatment focuses on controlling symptoms and preventing joint damage.  Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.  RA can lead to the formation of tissue that can harden and form a bony ankylosis which is a fusion of the joint that prevents any movement of the joint.  Rheumatoid arthritis can be diagnosed by a blood test that reveals a rheumatoid factor (antibodies) in the blood. X-rays are also used to determine if there is swelling of the effected joints.

Psoriatic arthritis: is a form of arthritis that affects some people who have psoriasis — a condition that features red patches of skin topped with silvery scales. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin lesions appear.  Joint pain, stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.
 
There are two basic ways that a person can qualify for Social Security benefits due to arthritis.   An individual can meet the requirements of a listing set out in Social Security's list of qualifying impairments or show that he or she is unable to work. 
 
The list of impairments is essentially a "Blue Book" used by the Social Security Administration to determine whether an individual meets the Social Security definition of disability. If a person’s condition “meets or equals” the listing, then that person is automatically deemed to be disabled. The listing for rhematoid arthritis and psoriatic arthritis is contained in Section 14.09 of the listing.  The listing refers to these conditions as "inflamatory arthritis".  In other to meet Section 14.09 of the listing, a claimant must prove that he or she has one of the following conditions:
 

  • RA or psoriatic arthritis present in a joint in the legs, causing significant difficulties in walking.
  • RA or psoriatic arthritis that affects joints in both arms, preventing a claimant from performing many types of tasks with the arms (involving both large muscle movements and small manipulations).
  • An inflammation or permanent deformity in one or more major joints, along with moderate involvement of at least two more organs or body systems, causing at least two symptoms out of these four: severe fatigue, fever, malaise, and/or involuntary weight loss.
  • Ankylosing spondylitis or another spondyloarthropathy, with fixation of your spine of at least 45 degrees.
  • Ankylosing spondylitis or another spondyloarthropathy with fixation of your spine of at least 30 degrees, along with moderate involvement of at east two or more body systems, or
  • Repeated flare-ups of RA or psoriatic arthritis with at least two of symptoms (such as fever, extreme fatigue, malaise, or weight loss) that cause limitations in activities of daily living, social functioning, or ability to complete tasks.

  • In cases of osteoarthritis, a claimant can also seek to prove that his or her condition meets Section 1.02 of the Listing, which is the Section that deals with "Major Disfunctions of the Joints".  In order to meet this Section of the listing a Claimant must have:

  • Major dysfunction of a joint;

  • Characterized by gross anatomical deformity (e.g., subluxation, contracture, bony or fibrous ankylosis, instability); and
  • Chronic joint pain and stiffness; with

  • Signs of limitation of motion or other abnormal motion of the affected joint(s); and

  • Findings on appropriate medically acceptable imaging of joint space narrowing, bony destruction, or ankylosis of the affected joint(s).

  • If your condition is severe but not at the same or equal level of severity as a medical condition on the list on Section 14.09 or Section 1.02, then the Social Security Administration must determine if it interferes with your ability to do the work you did previously (during the last 15 years).
    If you cannot do the work you did in the past 15 years, the Social Security Administration will see if you are able to adjust to other work. The Social Security Administration will consider your medical conditions and your age, education, past work experience and any transferable skills you may have. If you cannot adjust to other work, your claim will be approved. If you can adjust to other work, your claim will be denied.

    Monday, January 7, 2013

    Military Service and Social Security Disability


    Earnings for active duty military service or active duty training have been covered under Social Security since 1957.  Social Security has covered inactive duty service in the armed forces reserves (such as weekend drills) since 1988.
    If you served in the military before 1957, you did not pay Social Security taxes, but we gave you special credit for some of your service.
    You can get both Social Security benefits and military retirement. Generally, there is no reduction of Social Security benefits because of your military retirement benefits. You’ll get your full Social Security benefit based on your earnings.
     
    Social Security and Medicare taxes
    While you are in military service, you pay Social Security taxes just as civilian employees do. In 2012, the tax rate is 5.65 percent, up to a maximum of $110,100. If you earn more, you continue to pay the Medicare portion of the tax (1.45 percent) on the rest of your earnings.

     
    How your work qualifies you for Social Security
    To qualify for benefits, you must have worked and paid Social Security taxes for a certain length of time. In 2012, you will receive four credits if you earn at least $4,520. The amount needed to get credit for your work goes up each year. The number of credits you need to qualify for Social Security benefits depends on your age and the type of benefit for which you are eligible. No one needs more than 10 years of work.

    Extra earnings
    Your Social Security benefit depends on your earnings, averaged over your working lifetime. Generally, the higher your earnings, the higher your Social Security benefit. Under certain circumstances, special earnings can be credited to your military pay record for Social Security purposes. The extra earnings are for periods of active duty or active duty for training. These extra earnings may help you qualify for Social Security or increase the amount of your Social Security benefit.
    If you became disabled while on active military service on or after October 1, 2001 you can receive expedited processing of your Social Security disability claim.
    When you apply for Social Security benefits, you will be asked for proof of your military service (DD Form 214) or information about your reserve or National Guard service.