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We usually think of Social Security Disability Insurance (SSDI) as a federal program.  But, as currently practiced, it is a joint program involving both the state and federal governments. Each of the 50 states has an office to process and make initial decisions on disability claims, whether SSDI or SSI.  These offices are generally called "the state agency," and will have official names like "The Disability Determination Service."  In Alabama, this agency is located in Birmingham. While your case is at the "state" or "agency" level, your medical records will be ordered and interpreted.  Someone will go over your past work record to analyze your past jobs for the most recent 15-year period.  Then, the state agency will make a determination whether or not you meet the rules for a disability benefit. This "application stage" usually takes 4 to 5 months. If you are approved, you will receive a letter stating that you qualify for disability ...

Most disability cases will wind up before a judge, just as a matter of routine.  It's not an exception, it's the rule.  In our practice, only about 1 case in 15 gets approved without a hearing, and I think that is about average with everyone these days. So, what will a judge look at, and what will it take to convince the judge that you qualify for a benefit (payment)? 1.  What Will the Judge Look At? A judge will look first at the technical issues of the case, to be that it fits the legal requirements of a Social Security disability claim. Does the claimant have insured status and when does it expire? Does the claimant have a severe condition that has lasted at least 12 consecutive months, is expected to last at least 12 straight months OR is expected to end in death? Is the alleged onset date (AOD) within the insured period for SSDI? 2.  Does the Claimant Meet Social Security's Definition of "Disabled"? There are many different definitions of "disability....

You may have heard it said that the 3 most important factors in a disability claim are age, age and age.  Why is being 50 or older so important? Because the rules change at age 50, that's why. Starting at age 50, the medical-vocational guidelines (grid rules) often make it easier to be approved.  Besides age, the rules will also consider:  education, past relevant work, transferable skills, and residual functional capacity. If the combined factors (listed above) line up, the grid rules may direct a finding that you are disabled and eligible for benefits. But the grid rules are moving targets.  If just ONE factor is against you, it may not work. So, you need age, education, past relevant work, transferable skills and residual functional capacity going for you. Who Determines Residual Functional Capacity (RFC)? Social Security determines your Residual Functional Capacity (RFC).  However, you may be able to influence this with information from your doctor. If you d...

Social Security uses the same rules but uses administrative changes to deny claims.  It gets harder and harder to get approved in Alabama. In the era of Cronovirus, you can't even walk into a Social Security office to apply for benefits.  You can still apply over the phone or online, however. Because of COVID-19 you cannot have a regular hearing if you are denied. The only hearing available to you is over the phone. The question is:  Can you still get Social Security disability in Alabama in 2020? The answer is:  Yes. If you have courage, persistence and dedication--you can still get benefits. Courage:  You must believe in your claim and take the necessary actions to get it approved, no matter how inconvenient it is. Persistence:  You must keep at it relentlessly, even after multiple denials.  Most claims are won on the third attempt .  Denied at application, denied at Reconsideration, approved at the hearing. Dedication:  Sometimes it takes ...

It's perfectly alright to represent yourself before Social Security.....if....you are well prepared and know what you are getting into. Here Are 6 Questions To Answer Before Appointing Yourself Representative On Your Own Case : 6.  What is Your Alleged Onset Date (AOD) ? Getting this wrong will cost you thousands of dollars in back pay and will delay the start of your Medicare coverage. It will also cost you money for every child or dependent eligible for benefits under your claim.  Also, is your alleged onset date legally feasible and defensible? 5.  What Was the Exertion Levels of All the Jobs You Held During the Last 15 Years?   At Step 4 of the hearing, you must prove that you cannot perform any of the full-time jobs you performed during the past 15 year period.  To do this, you need to understand their exertion levels according to the Dictionary of Occupational Titles (DOT).  Exertion levels are:  Sedentary, Light, Medium, Heavy, and Very Heavy....

Social Security has a very strict , narrow definition of "disability."  You are not disabled in their eyes because you think you are, or even because your doctor says you are.  Generally, your condition(s) must be so severe that you are not able to perform even the most basic of work-like activity for 8 hours per day.  This means you are not able to hold even a sedentary (sit down) minimum wage job. In addition to being severe, your condition(s) must last a minimum of 12 straight months OR be expected to last that long OR be expected to end in death. Looking at applications we've seen denied in the last year, here are the basic causes of denial in most cases: 1.  There Isn't Enough Hard Medical Evidence to Prove Disability. Statements that you make about your own medical condition or symptoms are called "allegations."  They are not considered evidence or proof.   Another term for these allegations is "subjective evidence."  Social Security believ...

Sometimes, claimants in the Social Security disability process will encounter action by the Appeals Council (AC). This is a group of judges headquartered in Falls Church, Virginia.  They review decisions made by Administrative Law Judges. The Appeals Council represents the third tier appeal of a disability claim. APPLICATION DENIED:  GOES TO RECONSIDERATION RECONSIDERATION DENIED:  GOES TO ADMINISTRATIVE LAW JUDGE (ALJ) ALJ DENIES:  GOES TO APPEALS COUNCIL APPEALS COUNCIL DENIES:  MAY GO TO FEDERAL DISTRICT COURT The Appeals Council may review a decision of a lower body on appeal by the claimant, or on its own motion .  This means the Council may decide on its own to review a decision, favorable or unfavorable, anytime it wants to--whether or not the claimant has requested it to do so. The most common action by the AC is a remand, returning the case to the judge who made the decision, pointing out problems of law and asking for a new hearing.  When thi...

Here are 3 Social Security mistakes that can cost you thousands of dollars, and they may continue to cost you money as long as you live. 1.  Filing for Early Retirement Instead of Filing for Disability. Perhaps you are forced to stop working because of medical conditions.  You are 62, so you can take early retirement with Social Security.  The problem is, at age 62 your retirement benefit will be reduced by about 30 percent and this reduction will follow you for as long as you live.  It does not increase when you reach full retirement age because it is "locked in" at the reduced amount.  A better alternative would be to file for Social Security disability which will give you a much higher benefit, now and later.  Of course, the disability benefit is harder to get because it isn't automatic.  So, why not apply for the early retirement if you need the money now and also apply for disability.  Yes, you can apply for both . Your early retirement ...

When you file for Social Security disability benefits, the application asks you when you first became unable to work.  Technically, they are asking when you first became unable to work at "substantial gainful activity" or SGA.  That means basically a full-time job OR earning at least $1,260 per month in gross wages (before tax). This date that you put on your application becomes the "Alleged Onset Date" or AOD.  It is vitally important because it controls when your disability pay starts and the total amount of your back pay. The onset date also controls when you become eligible for Medicare. The AOD also controls when your children or dependents begin to receive monthly payments! Putting the wrong date can cost you thousands and thousands of dollars. You want to take the claim back as far as you can.  However, you must not have been working at SGA level on the date of your alleged onset.  Generally, you cannot have worked at SGA level after the alleged onset dat...

When's the right time to apply for Social Security Disability, or SSDI? The general answer is:  "As soon as you stop working and are convinced that you will not become able to work again within the next 12 months." Some things to keep in mind: 1.  You can't apply for SSDI while you're still working.  If you have wages, salary, or self employment income of at least $1,260 per month (gross), you are barred from filing an application.  There are no exceptions. 2.  There is no such thing as working while you are "unable to work."  The federal law does not permit you to claim disability while working at substantial gainful activity , no matter what age you are or what your medical impairments are. 3.  Social Security requires that you be unable to work due to a medical impairment which has lasted for 12 straight months, is e xpected to last 12 straight months, OR to end in death.  There's no benefit for a short term disability (where you're ...

Social Security adopted the grid rules to streamline disability benefits for individuals who are at least 50 years old.  After 50, and especially starting at 55, the grids combine medical-vocational factors like age, education, past relevant work, transferable skills, and residual functional capacity to quickly determine if a claimant qualifies for disability benefits. These guidelines should often make hearings unnecessary and approve claimants of advanced age who can no longer perform their past work due to a medical impairment. However, Social Security too often ignores their own rules. We see the "state agencies," referring to the Disability Determination Service (DDS) of the state, deny claims that should have been paid.  When this happens, a hearing is inevitable and benefits are delayed for months, sometimes years, while we fight the government in court. It's my experience that sometimes the state examiner just ignored the grid rules.  But it is more likely that a ...

When you apply for Social Security disability, the Disability Determination Service (DDS) will mail you some additional forms to complete and return. One of those forms will be a Work History Report .  This report will ask for a history of your past work over the last 15 years.  Frankly, this form is one of the most complicated and confusing that you will encounter. There is an entire page devoted to each one  of your past jobs.  You will be asked to describe what you did in the job.  You will be asked to estimate how much you lifted frequently and as a maximum.  You will estimate how much you sat, stood, walked, reached, handled, crouched, stooped, crawled, handled, etc.  These functions are to be estimated by the number of hours you performed each function. Why in the world does Social Security need this level of detail?  Why can't you just ignore this form, or skip over the details?  Here's why: Social Security is trying to determine if yo...

Disability benefits will continue as long as (a) you remain disabled and (b) you have not reached your full retirement age. Do disability benefits end at full retirement age?  Yes, they do technically.  But don't be alarmed.  The disability benefit ends and your retirement benefit begins.  There is usually no change in the amount of benefit. No missed payment and no delay. There are 2 Social Security trust funds:  one for disability and one for retirement.  When you reach full retirement age the payments stop coming out of the disability trust fund and start being paid from the retirement trust fund. You won't even notice the difference.  The payment simply converts automatically from disability to retirement.  You won't need to do anything -- no paperwork, no forms.

While any severe condition may qualify for disability benefits, there is a list of conditions, along with symptoms, called the Listings.  If all of these conditions are met, there is usually a favorable case. Let me caution you that only a fraction of disability claimants will meet all of the conditions in the Listing.  Most claimants will take a more general approach to getting benefits approved:  Proving their combined non-listing level impairments make them unable to perform either their past relevant work OR any other work. You begin with filing a complicated Social Security disability application, either online or at your Social Security office.  You provide names, addresses and phone numbers of all your medical providers, so Social Security can obtain the records.  You will also give your detailed work history. About 7 out of 10 claimants will be denied initially.  You will ask for "Reconsideration."  This is your first appeal.  It is a pape...

Social Security Disability Insurance (SSDI) is a a federal program with very explicit, very strict rules you must meet to qualify for a benefit.  The 2 most important factors to get qualified are: Being able to prove your case with acceptable evidence, both medical and vocational. Being able to prove disability on the basis of the rules, regulations, and requirements outlined by the Social Security Administration in the 20 Code of Federal Regulations and the Social Security Act. Proof requires a lot more than "telling your story."  Every claimant feels that they are disabled and should get Social Security benefits.  Yet, Social Security will agree in only about 25 percent of cases.  The other 75 percent will have to wade through difficult appeals and hearings. The most important proof is medical proof.  Medical proof consists of 2 kinds of evidence: (1) Objective medical findings obtained from examinations, laboratory studies, X-rays, MRI or CT scans or other st...

If Social Security applied the Medical-Vocational guidelines properly, more people should be awarded disability benefits.  We are seeing that Social Security often does not apply the "grid rules" correctly and deny claims that should have been paid. The Medical-Vocational guidelines (or "grid rules") combine educational level, past relevant work, age and residual functional capacity to determine that a claimant is disabled.   For example, a 55 year-old individual with a high school education, who has performed unskilled work at the medium exertion level or higher, and who is now restricted to light work--would meet the grid rule for approval.   That claim should be approved at Step 4 of the evaluation process:  unable to perform any past relevant work and there are no skills transferable to light or sedentary level. However, we often see Social Security ignoring the rules and finding that the claimant "could perform other work which exists in the national e...

In almost every disability hearing for an adult Social Security will call a vocational witness (VE) to testify.  The VE has two jobs: 1.  He or she will classify the claimant's Past Relevant Work or PRW.  Each full-time job performed during the past 15 years will be classified as to its     EXERTION LEVEL Sedentary Light Medium Heavy Very Heavy     and SKILL LEVEL Skilled Semi-Skilled Unskilled 2.     The Vocational Expert will answer the judge's hypothetical questions about how various functional limitations restrict the claimant's ability to perform work. In most cases, in order to win the case, the conclusion must be reached that the claimant cannot perform any of his past relevant work or any other work which exists in significant numbers in the United States economy.     The testimony of the vocational witness is often problematic.  The VE's testimony, in fact, may form the basis for the judge to deny the c...

There is a large portion of Americans who are self-reliant, hard working and diligent.  They don't ask for much help from anyone but will freely offer a neighbor help if they need it.  The folks are certainly not someone who would ever want any handouts or welfare.  The nation was built on such people. But I want to tell you why you should never, ever feel ashamed in filing a Social Security disability claim if you are truly disabled. It's not a handout.  It's not welfare.  It doesn't run up the national debt. Social Security disability is an insurance program that you paid into for decades.   It's a US government backed insurance policy.  And every worker who draws a paycheck pays into it.  On your paycheck stub, you will see withholding tax for FICA (Federal Insurance Contribution Act).  That's the Social Security and Medicare premium you pay every week or every month on payday. Some FACTS about Social Security disability: ...