Blog - Social Security Disability Solutions

New SSA Rule: Shorter Relevant Work Period for Disability Claims

bob@simplesitecompany.com (Bob Hansen) — Wed, 01 May 2024 14:13:07 GMT

If you're applying for Social Security disability benefits, a recent rule change by the Social Security Administration (SSA) could have a significant impact on your claim. Effective June 8, 2024, the SSA will be making changes to how they evaluate your past work when determining your eligibility for disability benefits.

Under the new rule, the SSA will only consider jobs you've held within the past 5 years as relevant to your disability claim. This is a significant reduction from the previous 15-year period. Additionally, any past work that lasted fewer than 30 calendar days will no longer be considered as part of your work history.

What does this mean for you? In short, these changes should make the disability application process less burdensome and more focused on your recent work experience. You'll no longer need to struggle to remember details of jobs you held more than 5 years ago, which can often be difficult and lead to errors in your application. By focusing on your more recent work history, the SSA aims to improve the accuracy of the information you provide and potentially speed up the decision-making process.

Another positive aspect of this rule change is that the SSA is updating its work history report forms and instructions. The new forms will align with the 5-year relevant work period and exclude jobs lasting under 30 days. This should make completing the paperwork easier and less time-consuming for you.

It's important to note that the SSA expects this rule change to result in an increase in disability benefit approvals. While this may lead to higher program costs, the SSA believes that the benefits to claimants like you justify the expense. During the rulemaking process, most commenters supported the proposed changes, recognizing the positive impact they could have on the lives of disability applicants.

As you prepare to file your disability claim or if you're in the midst of the application process, be sure to keep this new rule in mind. If you have any questions about how the changes might affect your specific case, don't hesitate to reach out to the SSA or your disability attorney for guidance.

Remember, the SSA's goal with this rule change is to make the disability application process more manageable and efficient for you. By reducing the burden of providing extensive work history details and focusing on your more recent and relevant experiences, the SSA hopes to provide better service and support as you navigate your disability claim.

If you have any questions about how the new Social Security rule might impact your disability claim or if you need assistance navigating the application process, the experienced attorneys at Hogan Smith SSD are here to help. With a deep understanding of the ever-changing disability claim landscape, we can provide you with the guidance and support you need to maximize your chances of success.

Don't let the complexities of the disability claim process overwhelm you. Call Hogan Smith SSD today at 407-377-0700 or visit our website at www.hogansmithssd.com to schedule a consultation with one of our knowledgeable attorneys. Let us put our expertise to work for you and help you secure the disability benefits you deserve.

Source: https://www.federalregister.gov/documents/2024/04/18/2024-08150/intermediate-improvement-to-the-disability-adjudication-process-including-how-we-consider-past-work#print

Major SSI Policy Change: Rental Subsidies No Longer Reduce Benefits

bob@simplesitecompany.com (Bob Hansen) — Thu, 18 Apr 2024 13:17:57 GMT

Written by Rick Gach

If you or a loved one receives Supplemental Security Income (SSI), a recent policy change from the Social Security Administration (SSA) could significantly impact your monthly benefits. As of September 30, 2024, rental subsidies will no longer count as income when calculating SSI eligibility and payment amounts. This is a substantial shift that could provide a much-needed financial boost for SSI recipients nationwide.

What does this mean for SSI beneficiaries? Let's break it down:

Currently, if an SSI recipient receives free or reduced rent, such as living with a family member rent-free, the SSA considers this "in-kind support and maintenance" (ISM). The value of this ISM is counted as income, which reduces the individual's SSI payment. For example, if an SSI recipient receives $300 worth of ISM in the form of free rent, their monthly SSI payment would be reduced by $300.

Under the new rule, effective September 30, 2024, rental subsidies will no longer be counted as ISM. This means that SSI recipients who receive free or reduced rent will be able to keep their full SSI payment without any reduction. In the example above, the individual would receive their full SSI payment (e.g., $914 in 2023), even while benefiting from the $300 rental subsidy.

This policy change is a significant win for SSI beneficiaries. It allows individuals to maintain stable housing situations with support from family or other sources without jeopardizing their SSI benefits. The extra money in their monthly SSI checks can make a real difference in covering essential expenses like food, healthcare, and utilities.

Moreover, this change may allow more individuals to qualify for SSI in the first place. By excluding rental subsidies from income calculations, some people who were previously over the income limit may now be eligible for SSI benefits.

If you or someone you know receives SSI and benefits from a rental subsidy, it's important to understand how this policy change may impact your situation. As always, our team at Hogan Smith is here to help navigate the complexities of SSI and ensure you receive the maximum benefits you deserve. Contact us today to discuss your case and learn more about how this new rule may apply to you.

Understanding Representative Payees in Social Security Benefits: Your Rights and Choices

bob@simplesitecompany.com (Bob Hansen) — Wed, 10 Apr 2024 03:47:54 GMT

Written By Rick Gach

The Social Security Administration (SSA) provides financial assistance to millions of Americans through various programs, such as retirement, disability, and supplemental security income (SSI). In some cases, the SSA may require a representative payee to manage the benefits on behalf of the recipient. This blog post will explore the reasons behind this requirement and the rights of beneficiaries in choosing their representative payee.

Why Does the SSA Require a Representative Payee? The SSA may determine that a beneficiary needs a representative payee if they believe the individual cannot manage their finances independently. This decision is made to ensure that the benefits are used for the recipient's basic needs and well-being. Some reasons why the SSA might require a representative payee include:

Mental or physical impairments that hinder the ability to manage finances
History of substance abuse or mismanagement of funds
Being a minor child receiving benefits

The representative payee is responsible for using the benefits to pay for the beneficiary's living expenses, such as food, housing, medical care, and personal needs. They must also keep accurate records of how the funds are spent and report to the SSA when required.

Your Rights in Choosing a Representative Payee As a beneficiary, you have the right to participate in selecting your representative payee. The SSA will consider your preferences when appointing a payee, but they must also ensure that the chosen individual is suitable for the role. Here are some key points to keep in mind:

You can suggest a preferred representative payee to the SSA, such as a family member, friend, or organization you trust.
If you disagree with the SSA's choice of representative payee, you have the right to appeal the decision and present evidence supporting your preferred choice.
You can request a change in representative payee if you believe the current payee is not acting in your best interests or mismanaging your benefits.
If no suitable family member or friend is available, the SSA may appoint an organizational payee, such as a social service agency or non-profit organization.

It is essential to choose a representative payee whom you trust and who will prioritize your well-being. Open communication with your payee is crucial to ensure that your needs are met and that your benefits are being managed appropriately.

Conclusion

The representative payee system is designed to protect the interests of Social Security beneficiaries who may have difficulty managing their finances. While the SSA makes the final decision on appointing a payee, beneficiaries have the right to participate in the selection process and voice their preferences. By understanding the role of a representative payee and your rights as a beneficiary, you can work towards ensuring that your benefits are managed effectively and in your best interests.

SSI - Representative Payee

Social Security Administration Removes Barriers to Accessing SSI Payments

bob@simplesitecompany.com (Bob Hansen) — Wed, 27 Mar 2024 19:10:14 GMT

In a significant move to improve access to critical benefits, the Social Security Administration (SSA) has published a final rule titled "Omitting Food from In-Kind Support and Maintenance (ISM) Calculations." This rule, set to take effect on September 30, 2024, is the first of several updates to the agency's Supplemental Security Income (SSI) regulations aimed at helping people receiving and applying for SSI.

The SSI program provides monthly payments to adults and children with disabilities or blindness, as well as adults aged 65 and older, who have limited income and resources. These benefits help cover basic needs such as rent, food, clothing, and medicine. To be eligible for SSI, applicants must meet specific requirements, including income and resource limits.

Under the previous rules, ISM included food, shelter, or both that a person receives, and the agency counted ISM as unearned income, potentially affecting a person's eligibility or reducing their payment amount. The new rule removes food from ISM calculations, eliminating a significant barrier for SSI eligibility due to an applicant's or recipient's receipt of informal food assistance from friends, family, and community support networks.

This change brings several important benefits:

1. The new policy is easier to understand and use by applicants, recipients, and agency employees.

2. Applicants and recipients will have less information to report about food assistance received from family and friends, reducing a significant source of burden.

3. Reducing month-to-month variability in payment amounts will improve payment accuracy.

4. The agency will see administrative savings because less time will be spent administering food ISM.

As a representative for claimants in their disability claims with the SSA, I welcome this change. The removal of food from ISM calculations will help more individuals access the critical benefits they need to support themselves and their families. By simplifying the application process and reducing the burden on applicants, the SSA is taking a significant step towards promoting equity and removing barriers to accessing payments.

The SSA has stated that it will continue to examine programmatic policy and make regulatory and sub-regulatory changes as appropriate. In the coming weeks, we can expect more announcements related to the SSI program, further demonstrating the agency's commitment to improving access to benefits for those who need them most.

If you or someone you know is interested in applying for SSI, visit the Social Security Administration's website for more information on eligibility and how to apply. As always, if you need assistance with your disability claim, do not hesitate to reach out to a qualified representative who can guide you through the process and help ensure you receive the benefits you deserve.

Completing the Third Party Function Report for SSA: A Comprehensive Guide

bob@simplesitecompany.com (Bob Hansen) — Wed, 27 Mar 2024 17:31:03 GMT

If you're in the process of applying for Social Security Disability benefits, you may be asked to have a friend, family member, or caregiver complete a Third Party Function Report. This form, also known as the SSA-3380-BK, is designed to provide the Social Security Administration (SSA) with valuable insights into your daily activities, limitations, and overall functioning. In this blog post, we'll walk you through the key steps and tips for completing this important form.

1. Choose the right person:

Select someone who knows you well and has regular interaction with you, such as a close family member, friend, or caregiver. This person should be able to provide accurate and detailed information about your daily activities and limitations.

2. Provide specific examples:

When describing your limitations, it's essential to be as specific as possible. Instead of simply stating that you have difficulty walking, provide concrete examples, such as "I can only walk for 10 minutes before needing to rest due to severe back pain." The more detailed the examples, the better the SSA can understand your situation.

3. Be honest and comprehensive:

It's crucial to provide an honest and complete picture of your daily challenges. Don't downplay or exaggerate your limitations. Be sure to include information about any assistance you require or adaptive devices you use to complete daily tasks.

4. Discuss the impact on daily activities:

Focus on how your impairments affect your ability to perform everyday tasks, such as personal care, household chores, and social interactions. Provide examples of activities you struggle with or can no longer do because of your condition.

5. Address good days and bad days:

Many people with disabilities experience fluctuations in their symptoms. It's important to discuss how your condition varies on good days versus bad days, and how often you experience each type of day.

6. Collaborate with the person completing the form:

Work closely with the person filling out the Third Party Function Report on your behalf. Schedule a meeting or phone call to discuss your daily experiences, challenges, and limitations in detail. This collaboration will help ensure that the information provided is accurate and comprehensive.

7. Review the completed form:

Before the Third Party Function Report is submitted, take the time to review the form for any errors, inconsistencies, or omissions. If necessary, provide additional information or clarification to ensure that the SSA has a clear understanding of your situation.

Remember, the Third Party Function Report is an opportunity for the SSA to gain a better understanding of how your impairments affect your daily life. By following these tips and providing detailed, accurate information, you can increase your chances of a successful disability claim. If you have any questions or concerns about the Third Party Function Report, don't hesitate to reach out to your disability attorney or advocate for guidance.

Medicare Parts A - D

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:51:06 GMT

Medicare is a health insurance plan for people who are age 65 or older. People who are disabled or have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease) can get Medicare at any age. Medicare has four parts:

Hospital insurance (Part A) helps pay for inpatient hospital care and certain follow-up services.
Medical insurance (Part B) helps pay for doctors’ services, outpatient hospital care and other medical services.
Medicare Advantage plans (Part C) are available in many areas. People with Medicare Parts A and B can choose to receive all of their health care services through a provider organization under Part C.
Prescription drug coverage (Part D) helps pay for medications doctors prescribe for medical treatment.

Who is eligible for hospital insurance (Part A)?

Most people get hospital insurance when they turn 65. You qualify for it automatically if you are eligible for Social Security or Railroad Retirement benefits. Or you may qualify based on a spouse’s (including divorced spouse’s) work. Others qualify because they are government employees not covered by Social Security who paid the Medicare tax.

If you get Social Security disability benefits for 24 months, you will qualify for hospital insurance.

If you get disability benefits because you have amyotrophic lateral sclerosis (Lou Gehrig’s disease), you do not have to wait 24 months to qualify. Also, people who have permanent kidney failure that requires maintenance dialysis or a kidney replacement qualify for hospital insurance if they have worked long enough or if they are the spouse or child of a person who has worked long enough.

Who can get medical insurance (Part B)?

Almost anyone who is eligible for hospital insurance can sign up for medical insurance. Part B is an optional program. It is not free. In 2008, the standard monthly premium is $96.40. Some people with higher incomes will pay higher premiums.

Who can get Medicare Advantage plans (Part C)?

Anyone who has Medicare hospital insurance (Part A) and medical insurance (Part B) can join a Medicare Advantage plan. Medicare Advantage plans include: Medicare managed care plans;

Medicare preferred provider organization (PPO) plans; Medicare private fee-for-service plans; and Medicare specialty plans. You might have to pay a monthly premium because of the extra benefits the Medicare Advantage plan offers.

Who can get Medicare prescription drug coverage (Part D)?

Anyone who has Medicare hospital insurance (Part A) or medical insurance (Part B) or a Medicare Advantage plan (Part C) is eligible for prescription drug coverage (Part D). Prescription insurance is optional, and you pay an additional monthly premium for the coverage.

For more information, contact SSA and ask for Medicare (Publication No. 05-10043). Help with Medicare expenses for people with low income. If you have a low income and few resources, your state may pay your Medicare premiums and, in some cases, other “out-of-pocket” medical expenses, such as deductibles and coinsurance. Only your state can decide whether you qualify for help under this program. If you think you qualify, contact your state or local medical assistance (Medicaid) agency, social services or welfare office. You can get more information about this program from the publication, If you need help paying Medicare costs, there are programs that can help you save money (Publication CMS-10126). To get a copy, call the Medicare toll-free number, 1-800-MEDICARE (1-800-633-4227). If you are deaf or hard of hearing, you may call TTY 1-877-486-2048.

“Extra help” with Medicare prescription costs : If you have limited income and resources, you may qualify for extra help to pay for your prescription drugs under Medicare Part D. Social Security’s role is to help you understand how you may qualify and to process your application for extra help. To see if you qualify or to apply, call Social Security’s toll-free number or visit our website.

Earnings that Trigger a Trial Work Period

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:45:39 GMT

During a trial work period, a beneficiary receiving Social Security disability benefits may test his or her ability to work and still be considered disabled. We do not consider services performed during the trial work period as showing that the disability has ended until services have been performed in at least 9 months (not necessarily consecutive) in a rolling 60-month period. In 2007, any month in which earnings exceed $640 is considered a month of services for an individual's trial work period. In 2008, this monthly amount increases to $670.

Monthly earnings that trigger a trial work period Year Monthly earnings:

1978 & prior $50

1979-1989 75

1990-2000 200

2001 530

2002 560

2003 570

2004 580

2005 590

2006 620

2007 640

2008 670

Picking a Medicare Drug Plan

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:41:59 GMT

THE SAVAGE TRUTH | Enrollment time is here again -- follow these steps to choose what works best

November 17, 2008

TERRY SAVAGE brian@hogansmith.com

Here we go again. Starting today, seniors have six weeks to sign up for another year of Medicare Part D -- the prescription drug benefit -- that goes along with Medicare Part A (hospitalization), Part B (outpatient and doctor costs) and Medigap (the supplement that covers other costs including co-payments and deductibles).

It's a must-do project, even if you're among the few seniors who don't currently take prescription drugs. If you don't sign up when you first become eligible, there will be big penalties to pay once you do need some prescriptions -- and for sure you will need them at some point.

The Medicare.gov Web site sorts through all of the alternative plans to find you the best coverage at the least cost in a plan that is available at a pharmacy near you.

The only exceptions are those seniors who are covered by a comparable company or retiree prescription plan, or those who have signed up for an all-in-one Medicare Advantage plan. Some seniors have prescription drug access through the Veterans Administration, though they may want to choose an inexpensive Part D plan for drugs the VA does not cover.

For those who recently turned 65 and now qualify for Medicare, this will be the first time going through the process of choosing the least-expensive plan.

But every senior, even those currently enrolled and happy with their drug plan, should go through the process of reviewing the alternatives for 2009. That's because each year, the plans change the prices of the drugs they cover and may not even include the same medicines in the year ahead.

So here's my annual, step-by-step guide through the Medicare.gov Web site, the only place that can sort through all of the alternative plans to find you the best coverage at the least cost in a plan that is available at a pharmacy near you!

Finding your plan at Medicare.gov

Step 1. Get a complete list of all of the medicines and dosages you are now taking. The easiest way is to ask your pharmacist for this list, or simply line up all of your prescription bottles.

Step 2. Go to www.Medicare.gov. (If you don't have a computer, you can call 800-MEDICARE, and they will help you through this process over the telephone.)

Step 3. Click on the line near the top of the first page screen that says: "Medicare Prescription Drug Plans -- 2009 Plan Data."

Step 4. On the next page, click on the box that says "Find and Compare Plans."

Step 5. On the next page, you have a choice of either a "personalized" search or a "generalized" search. If you already have your red, white, and blue Medicare card, you can use the personalized search, in which you input your Medicare number and other information from your card. (You can use the generalized search to find and compare plans in your ZIP code.)

Step 6. On the next page, you can enter the drugs you are currently taking, and the dosages. Even if you do not take prescription drugs now, you must fill out this page, stating that fact. This list can be saved securely for your future visits to Medicare.gov.

You can either type in the names of your drugs, or search for them alphabetically. The most common dosage will automatically pop up, but you should be sure that is the dosage you are taking. The program will also let you know if there is a less-expensive generic available. When you've finished listing your prescriptions, click "continue" to move on to the next page where you can recheck the list of names and dosages. Then click "continue" again.

Step 7. You'll be asked if you have a specific pharmacy that you'd like to work with -- one that's within walking distance of your home, for example. Then click again.

Step 8. You've finally arrived at the most important page -- the one that lists all of the plans, ranked with the lowest total cost at the top of the list. You can select up to three plans to compare. You can click to see how you might lower your cost, perhaps by switching to a generic. Or the program might suggest an alternative but less-expensive drug in the same category. That's something you'd have to discuss with your physician.

This year, there are also "star" ratings, up to five stars, based on a survey done for Medicare about the quality and performance of those plans over the last year.

Step 9. After comparing the plans by cost, click on the name of each plan provider to find full details, including a helpful graph of the average monthly cost, as well as information about participating pharmacies and mail order availability. You can print out the pages for each plan, and keep them handy.

Step 10. Before signing up, call the plan's toll-free number and reconfirm their prices and coverages for the drugs you take, as well as all co-payments. Then you're ready to ask them to send you the application so you can sign up!

A plea for help: Government should be required to make these decisions easier for seniors. But since it hasn't, I'm asking the more computer-literate among you to clip this column, find a senior, and offer to help. It's easy once you've done it. And that's The Savage Truth.

Terry Savage is a registered investment adviser. Distributed by Creators Syndicate. Copyright Terry Savage Productions Ltd. Visit www.terrysavage.com and suntimes.com.

How Long Does it Take to Get a Hearing?

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:25:34 GMT

Rank ODAR Office Processing Time

#5 Ft. Lauderdale 264 days

#38 Orlando 393 days

#87 Jacksonville 477 days

#90 Savannah 480 days

#118 Miami 592 days

#120 Tampa 593 days

#122 Atlanta 595 days

#132 Atlanta North 614 days

#145 Jackson 685 days

Compassionate Allowances

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:21:50 GMT

Compassionate allowances 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 will allow Social Security to quickly target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly.

List of Conditions:

1 Acute Leukemia

2 Adrenal Cancer - with distant metastases or inoperable, unresectable or recurrent

3 Alexander Disease (ALX) - Neonatal and Infantile

4 Amyotrophic Lateral Sclerosis (ALS)

5 Anaplastic Adrenal Cancer - with distant metastases or inoperable, unresectable or recurrent

6 Astrocytoma - Grade III and IV

7 Bladder Cancer - with distant metastases or inoperable or unresectable

8 Bone Cancer - with distant metastases or inoperable or unresectable

9 Breast Cancer - with distant metastases or inoperable or unresectable

10 Canavan Disease (CD)

11 Cerebro Oculo Facio Skeletal (COFS) Syndrome

12 Chronic Myelogenous Leukemia (CML) - Blast Phase

13 Creutzfeldt-Jakob Disease (CJD) - Adult

14 Ependymoblastoma (Child Brain Tumor)

15 Esophageal Cancer

16 Farber's Disease (FD) - Infantile

17 Friedreichs Ataxia (FRDA)

18 Frontotemporal Dementia (FTD), Picks Disease -Type A - Adult

19 Gallbladder Cancer

20 Gaucher Disease (GD) - Type 2

21 Glioblastoma Multiforme (Brain Tumor)

22 Head and Neck Cancers - with distant metastasis or inoperable or uresectable

23 Infantile Neuroaxonal Dystrophy (INAD)

24 Inflammatory Breast Cancer (IBC)

25 Kidney Cancer - inoperable or unresectable

26 Krabbe Disease (KD) - Infantile

27 Large Intestine Cancer - with distant metastasis or inoperable, unresectable or recurrent

28 Lesch-Nyhan Syndrome (LNS)

29 Liver Cancer

30 Mantle Cell Lymphoma (MCL)

31 Metachromatic Leukodystrophy (MLD) - Late Infantile

32 Niemann-Pick Disease (NPD) - Type A

33 Non-Small Cell Lung Cancer - with metastases to or beyond the hilar nodes or inoperable, unresectable or recurrent

34 Ornithine Transcarbamylase (OTC) Deficiency

35 Osteogenesis Imperfecta (OI) - Type II

36 Ovarian Cancer - with distant metastases or inoperable or unresectable

37 Pancreatic Cancer

38 Peritoneal Mesothelioma

39 Pleural Mesothelioma

40 Pompe Disease - Infantile

41 Rett (RTT) Syndrome

42 Salivary Tumors

43 Sandhoff Disease

44 Small Cell Cancer (of the Large Intestine, Ovary, Prostate, or Uterus)

45 Small Cell Lung Cancer

46 Small Intestine Cancer - with distant metastases or inoperable, unresectable or recurrent

47 Spinal Muscular Atrophy (SMA) - Types 0 And 1

48 Stomach Cancer - with distant metastases or inoperable, unresectable or recurrent

49 Thyroid Cancer

50 Ureter Cancer - with distant metastases or inoperable, unresectable or recurrent

Extended Period of Eligibility

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:15:51 GMT

To encourage disabled individuals to attempt to work, Congress enacted section 303 of the 1980 amendments that provided a re-entitlement period under title II to an individual who completes 9 months of trial work and continues to have a disabling impairment. This provision, referred to as the extended period of eligibility (EPE), provides that an individual can be re-entitled to benefits any time during the re-entitlement period that his or her work activity falls below the SGA level. The EPE re-entitlement period begins with the month immediately following completion of the trial work period and ends 36 months later (or 15 months later if the beneficiary is not entitled to benefits after 12/1987). However, if the beneficiary is not engaging in SGA when the re-entitlement period ends, the EPE provision allows benefits to continue until SGA is performed (or medical cessation is determined). When an SGA disability cessation determination is made within the EPE, the termination month is the first month of substantial gainful activity (SGA) after the 36-month re-entitlement period ends. When a disability cessation has not already been determined, the termination month is the third month after the first month of SGA after the 36-month period. If an individual's payments stop because disability has ceased due to work activity and, subsequently, but within the EPE re-entitlement period, his/her earnings fall below SGA, benefits may be reinstated if all other entitlement factors are met. A new application, and disability determination, is not required to reinstate payments in these cases. The extended period of eligibility does not change the definition of disability. A beneficiary is eligible for payments as long as he/ she continues to meet the definition of disability. The EPE does not limit the payment of disability benefits after disability ceases; e.g., an individual whose disability ceases is eligible for title II payments for the month of cessation and 2 additional months. The main effect of the EPE provision is that it permits benefit reinstatement during the re-entitlement period when a beneficiary's benefits have stopped because of SGA and the beneficiary's earnings subsequently fall below SGA levels (see DI 13010.215 B).

Social Security Survivors' Benefits for Children

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:12:51 GMT

If you are the unmarried child under 18 (up to age 19 if attending elementary or secondary school full time) of a worker who dies, you also can be eligible to receive Social Security survivor benefits.

Your survivor benefit amount would be based on the earnings of the person who died. The more he or she paid into Social Security, the higher your benefits would be. The amount you would get is a percentage of the deceased's basic Social Security benefit and depends on your age and the type of benefit you would be eligible to receive.

A child under age 18 (19 if still in elementary or secondary school) or disabled is entitled to receive 75 percent of the deceased monthly social security benefit.

There is a maximum benefit per month that can be paid to all the survivors on the record. There may also be a special lump-sum death benefit. The limit varies, but it is generally equal to about 150 to 180 percent of the basic benefit rate.

For more information about Survivor Benefits for Children, click on the email link above.

Significant Gainful Activity (SGA)

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:09:46 GMT

Social Security uses a 5 step sequential evaluation process to determine if you are disabled. The first step is to determine whether you have SGA. If you are working and earning above a certain level, the Social Security Administration (SSA) will deny your claim. However, if your earnings fall below a certain level you may still be entitled to disability and SSA will move on to step two of the evaluation process. The chart below shows the amounts that SSA uses to determine SGA:

As you can see, if you earned $940 or more per month in 2008, you would have exceeded the threshold for SGA and would not have been entitled to benefits. In 2009, the threshold is $980 per month.

Many clients ask me if they can work while they are waiting for their hearing. I always encourage clients to try to work. If they attempt to work, but find they cannot continue, the judge will probably look at this favorably. If they find that they cannot work full-time, but can work part-time, they won't be penalized if their earnings are below SGA. If they return to work and find that they are able to work at levels above SGA, we can always amend our claim and ask the judge to award a "closed period" of disability. A closed period of disability means that the judge would award benefits beginning with the date they alleged disability up until the date they started earning SGA. It has been my experience that judges are generally liberal when it comes to awarding closed periods.

It has been my experience that attempting to work is looked upon favorably by SSA. It shows the judge that you at least tried to work.

For more information about SGA and help with your claim, click on the email link. Send me your questions. I'm here to help!

Survivors Benefits For Your Widow or Widower

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 11:02:24 GMT

You probably know people who are receiving Social Security survivors benefits because they're a widow or widower. At present, there are about 5 million widows and widowers receiving monthly Social Security benefits based on their deceased spouse's earnings record. And, for many of those survivors, particularly aged women, those benefits are keeping them out of poverty.

Your widow or widower can receive

- reduced benefits as early as age 60 or full benefits at full retirement age or older.

- benefits as early as age 50 if he or she is disabled .

Note : If your widow or widower remarries after age 60 (age 50 if disabled), he or she will still be eligible for benefits on your record.

Your widow or widower who has not remarried can receive survivors benefits at any age if she or he takes care of your child who is under age 16 or is disabled and receives benefits on your record.

If something happens to you, benefits may be payable to your widow or widower with a disability if the following conditions are met:

He or she is between ages 50 and 60.
The widow or widower meets the definition of disability for adults.
The disability started before your death or within seven years after your death.

Note : If your widow or widower caring for your children receives Social Security benefits, he or she is eligible if disability starts before those payments end or within seven years after they end.

Fibromyalgia: Patients say many doctors don't take them seriously

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 10:46:37 GMT

By Sam McManis

brian@hogansmith.com

Published: Sunday, May. 31, 2009 - 12:00 am | Page 2I

Asked to describe the seemingly indescribable, to make real the manifestations of a medical condition that some still doubt even exists, fibromyalgia patients often rely on similes of the most wince-inducing sort.

• "I felt like acid was going through my veins."

• "It was like a steamroller ran over me."

• "Fatigue like someone's pulled out your battery pack."

• "… as if someone pinged me with a hammer all over my body."

• "Your (brain) feels like a pinball machine. You're trying to come up with the word, and the ball bounces around until it finally falls on your tongue."

• "It feels like death, only worse."

Can there be any doubt that these people truly are suffering from diffuse, widespread chronic pain with multiple tender spots, enervating fatigue and a host of symptoms that include restless legs, impaired memory and depression?

Well, yes.

Despite being recognized as a diagnosable disease by the American College of Rheumatology, the Food and Drug Administration and most insurers, fibromyalgia has not completely shed the stigma of being dismissed as "psychosomatic" by some in the medical establishment.

Controversy swirls even as new FDA-approved medications have shown promise and recent brain imaging research has shown central nervous system changes in those afflicted. The National Fibromyalgia Association, a patient advocacy group, estimates that 10 million Americans suffer from one or more of the multifarious manifestations of the condition.

It is this array of symptoms not linked to specific cause and effect – as opposed to how rheumatoid arthritis can ravage a patient's joints – that keeps skeptics in mainstream medicine from validating fibromyalgia as a legitimate disease.

Where, exactly, is this deep muscular aching? What's the cause of that nebulous numbness and dizziness? Why won't painkillers help? Where are the lab tests that can prove it exists?

Those are the questions that still dog fibromyalgia patients.

"They make you think you're a hypochondriac or something," says Jennifer Filbeck, 36, a former restaurant manager from Fairfield who's been unable to work since 2006. "Doctors treat you like you're crazy."

Not crazy per se, critics of the existence of fibromyalgia claim. Their argument: These people suffer from psychological conditions that manifest themselves in vague and hard-to-define physical maladies.

Dr. Frederick Wolfe, who wrote the landmark 1990 paper that first created diagnostic guidelines for fibromyalgia, recently told the New York Times that he now considers it merely a byproduct of depression, stress and social anxiety. Wolfe, head of the National Databank of Rheumatic Diseases, told the paper, "Some of us in those days thought that we had actually identified a disease, which clearly this is not. To make people ill, to give them an illness, was the wrong thing."

That view is supported by Dr. Nortin Hadler, a rheumatologist and professor at the University of North Carolina. Writing in the Journal of Rheumatology, Hadler states bluntly that fibromyalgia is all in the mind.

"I am suggesting that chronic persistent pain is an ideation, a somatization if you will, that some are inclined toward as a response to living life under a pall, and not vice versa," he writes. "I am further suggesting that these people choose to be patients because they have exhausted their wherewithal to cope."

Medical literature has been slow to publish data on fibromyalgia. Recent studies have gone a long way in disputing the claims of Wolfe and Hadler, though researchers still have yet to pinpoint a cause.

A 2008 University of Michigan study showed that fibromyalgia patients exhibited central nervous system abnormalities that resulted in elevated sensitivity to pain and stimuli. The study, however, tested only 31 subjects.

Other research using functional MRI brain scans show increased activity in pain receptors for even minor discomfort among fibromyalgia patients.

DON'T BE SURPRISED IF, WHEN SOCIAL SECURITY DENIES YOUR CLAIM.

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 10:43:21 GMT

Question: Does Social Security pay you if you become disabled?

Answer: Sometimes. But they aren't afraid to say no.

According to a 2004 General Accounting Office, Social Security Administration report, 60 percent of all first initial claims for Social Security disability benefits were rejected.

Your most valuable asset is your human capital — your ability to create value in the marketplace and, thereby, earn an income. Yet most people who wouldn't think of leaving their home or auto uninsured (what if there was a fire?) leave their most valuable asset completely unprotected against loss.

If you earn $50,000 a year and have 30 years to go in your working life, you stand to earn $1.5 million over that period of time. Let's assume you get a raise or two along the way (averaging 3 percent per year), you would earn about $2.5 million over that period.

If you owned a $2.5 million house, would you sleep well at night knowing that a fire might send your wealth up in smoke?

Life insurance is pretty straightforward — you're either dead or you're not. Disability insurance isn't quite so simple.

For example, what does it mean to be disabled?

According to Social Security, you are "disabled" when you have a medical problem that will either kill you or keep you out of work for a year. Also, you must be unable to engage in any "substantial gainful activity." And you get no benefits for short-term or partial disability. And benefits are very limited.

That's a pretty narrow definition that leaves a lot of folks out.

It would be like buying a homeowners insurance policy that says the house has to completely burn to the ground before your claim gets accepted, and what you get is only enough to rebuild a much smaller house.

Clearly, Social Security disability coverage is meant only as a social safety net. A middle class or higher wage earner counting on Social Security to preserve their financial life in the event of a disability is likely to be very disappointed.

Speak to your agent about individual, private disability insurance.

Ask him about a policy with a definition of disability that takes into account your education, training and experience. You may even be able to get a policy that defines disability in terms of your specific occupation (often referred to as "Own Occ" coverage).

Inquire about coverage that pays you even if you are not totally disabled. Why have an incentive not to return to work? That could be the effect of a total-disability-or-nothing policy.

Because the cost of living is unlikely to stay level, your benefits should also be able to rise with inflation. Ask about any cost-of-living-adjustment (COLA) features that may be available in any disability income insurance policy you are considering.

When will you benefits start? And how long do you want your benefits to last? A month? A year? Until you retire?

If you became disabled, your ability to save and invest for a future retirement would be severely compromised. You may wish to consider coverage that pays benefits for life.

Nobody wants to think about being disabled. But it can happen to anyone.

If you become disabled, Social Security may or may not pay you a benefit — it will depend on a lot of circumstance. Individual disability insurance can make sure that if a disability means you are out of work, it doesn't also mean you're out of luck.

Psychiatric Disability: A Step-by-Step Guide to Assessment and Determination Tips on a Complex and Challenging Role for Consulting Psychiatrists

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 10:39:13 GMT

Samuel O. Okpaku MD, PhD

Nashville, Tenn.

Dr Okpaku is clinical professor of psychiatry at the Vanderbilt University School of Medicine and executive director of the Center for Health Culture and Society in Nashville, Tenn. The author reports no conflicts on interest concerning the subject matter of this article.

Acknowledgment—The author is grateful for the helpful assistance of Tamara Smith and staff, Betty Hood, Ann Benes, Dr Tommie Slayden, Jeffrey Eddie, and the staff at the Tennessee DDS.

The epidemiology and management of psychiatric disability have gained increased attention for a variety of reasons in the past 3 decades. There are issues of empowerment, advocacy, and reduction of stigma. There are also concerns about cost containment as well as reliability, validity, and efficacy of the determination process.

About 20% of adults who receive Social Security disability benefits have psychiatric disability. Psychiatric disability accounts for a significant proportion of private long-term disability claims and payments.1,2 Advances in technology that have had an impact on physical disabilities have not had a corresponding effect on psychiatric disability.

This article is based on the United States Social Security Administration (SSA) model of disability assessments for psychiatric impairment. Since its inception in 1935, there have been several amendments and rulings that have attempted to expand and refine the Disability Act. Despite these efforts, the reliability and validity of the disability determination process have been impaired by several factors:

• The inherent difficulty of objectifying psychiatric signs and symptoms

• The fluctuating nature of psychiatric disorders

• Problems with language and communication (central to the collection of data from patients), which may be compromised by the disease process

In addition, many individuals who apply for disability on the basis of physical illness also have comorbid mental disorders. Hence, psychiatrists may be called on as treating physicians, consultative examiners, and expert witnesses to provide disability reports.

Defining disability

The SSA defines disability as “the inability to engage in any substantial gainful activity by reason of medically determinable physical or mental impairments which can be expected to result in death or which has lasted, or can be expected to last, for a continuous period of not less than 12 months.”3 SSA disability is regarded as permanent, although the disability is subject to periodic review.

Keep in mind that diagnosis of a mental illness is not necessarily equivalent to disability or functional impairment. An individual who has major depressive disorder is not legally disabled if he or she can engage in “substantive gainful activity.” Substantive gainful activity refers to a level of activity that SSA uses to establish disability. As a rule of thumb, a disabled individual should not be able to participate actively in the national economy. For example, if an attorney has a mental disorder (and therefore cannot effectively practice law) but he can work as a waiter, he is then not legally disabled according to the SSA. In assessing disability, psychiatrists should be aware of opportunities for vocational rehabilitation and work incentives as well as treatment opportunities.

The application process

The application for Social Security disability benefits is initiated by a claimant who completes a form at the local SSA field office, or by mail or telephone.3 The information obtained at the field office includes background and demographics, such as age, marital status, employment, Social Security coverage, and contact information. Information on the nature of the impairment(s) and other pertinent information relative to the potential disability are obtained. If the claimant’s information passes the initial disability requirements, his file is transmitted to a Disability Determination Service (DDS) team that consists of a disability analyst and a psychiatrist or psychologist. The analyst gets as much information as possible from treating physicians, hospitals, clinics, and other relevant sources.

Once the analyst has gathered relevant information to complete the medical evidence, the file is passed on to the DDS psychiatrist or psychologist who reviews the documentation and adjudges whether the patient’s condition:

• Meets or equals the (listed) criteria of mental impairments

• Does not meet the listed criteria

• Falls between meeting and not meeting the criteria

For patients who fall within the third category, the psychiatrist or psychologist completes a Residual Functioning Capacity (RFC) form. At this time, a consultation with a vocational analyst may be requested. The disability analyst then makes a determination as to the legal eligibility of the claimant and a decision is made to approve or deny the claim.

The appeal process

There are 4 steps in the appeal process. If the claim is denied, the claimant can apply for reconsideration. It is important for the claimant to ensure that all relevant information from doctors, hospitals, clinics, and other treatment sources are submitted to the DDS. For the reconsideration process, the case is assigned to a different DDS team. If this reconsideration fails, the claimant can appeal to the next level, which is a hearing before an administrative judge. At this appeal level, the claimant may be represented by an attorney; witnesses and new evidence may be presented, and the claimant may appear in person. The next level for appeal is the SSA appeals court in Baltimore; ultimately, the appeal may be made to a federal court.

The medical evidence

Generally, individual psychiatrists may contract with their local DDS to provide consultative examinations. There are some key issues in conducting a consultative examination and completing the report. The claimants can request to have the consultative examination carried out by their own treating psychiatrists.3 The psychiatrist should be familiar with the Psychiatric Review Technique form and the Residual Functioning Capacity form used by the DDS.4,5 All available records should be reviewed before the examination to ascertain the specific reasons for the consultative examination.

The psychiatrist should specify his role in conducting the examination to dispel the myth that approval for disability is given by the physician. The provision of adequate and comprehensive information that enables the DDS team to make a reasonable, prompt, and fair determination is a sine qua non and is dependent on the accuracy and completeness of patient records.

The SSA uses “listings” to approve or deny applications for disability. There are 9 categories under the mental disorder listings used in making such decisions. Each category refers to a disease process or disorder. Using the model of disease → impairment → disability, impairment refers to the signs and symptoms of the disorder that provides medical determination of the condition (criteria A). Disability refers to the severity of restrictions and limitations of functioning (criteria B) that are directly related to criteria A.

The 9 diagnostic categories for mental impairments are:

• Organic mental disorders

• Schizophrenic, paranoid, and other psychotic disorders

• Affective disorders

• Mental retardation

• Anxiety-related disorders

• Somatoform disorders

• Personality disorders

• Substance disorders

• Autistic and other pervasive developmental disorders

Each listing is further qualified by criteria A and B. For organic mental disorders, schizophrenic, paranoia, and affective disorders, or other psychotic and anxiety-related disorders, an additional set of criteria (criteria C) may be used to meet the diagnostic and impairment-related restriction of functioning requirements. Disability is therefore met when criteria A and B are met, or when criteria C is met.

The report should be typewritten (not handwritten). DDS jurisdictions usually provide dictations by phone. Again, the report should provide a longitudinal and current assessment of the case. The pathogenesis of the disease is helpful in establishing the nature and duration of illness. General observations of the patient, his history, and any additional information required for that listing of diagnoses are other essential elements of the report. If there is a comorbidity, this should be stated. This is especially important for the claimant who has several minor disabilities which, when taken together, may affect his ability to work.

In addition, for consultative examinations, the number of appointments the patient has canceled and difficulties in keeping appointments may point to a diagnosis of an anxiety-related condition. Prolonged treatment by a primary care physician may be a clue to chronic treatment-resistant depression. The report must record the patient’s education or employment and rehabilitation history.

In preparing the report, the psychiatrist should be aware of how, in which manner, and to what extent the mental impairment limits the patient’s functionality.6

Items from criteria A are delusions/hallucinations, catatonic behavior, and incoherence. For criteria B, items are selected from 4 domains:

• Activities of daily living (eg, grocery shopping, doing laundry)

• Social functioning (eg, ability to interact socially with other people at home or in a public setting)

• Concentration, persistence, and pace (eg, inability to complete a task in the given time)

• Deterioration or decompensation in work or work like setting (eg, panic attacks, psychotic decompensations, and crying)

For these domains, the documentation must be sufficiently descriptive and explicit to permit an assessment of the appropriateness, independence, sustainability, quality, and effectiveness of these functions over long periods. The examples of deficits in those domains must be tied directly to the mental disorder, rather than to circumstantial factors. For example, a statement that “the patient does not do any grocery shopping, laundry, or cooking” or a statement that the patient cannot complete a task will be inadequate without specifically saying that these examples are caused by the clinical manifestations of the mental disorder and not by circumstantial factors.

CASE VIGNETTE

Tony is 32 years old. He has been ill since age 22, when he was a second-year law student. He came home and informed his parents that poisonous gases were being pumped into his room. He dropped out of school and made attempts to return to school but failed. He has remained paranoid; he keeps to himself and has been hospitalized 5 times. He was hospitalized 6 months ago when he became belligerent at work. He believed his supervisors were out to get him. He has been on a combination of several antipsychotics to help reduce his hallucinations and delusions. His longest period of employment in 10 years was 3 months. He has never earned more than $300 per month.

By meeting 1 item from criteria A and 2 items from criteria B, Tony meets (at least superficially) the requirement for disability under the listing of schizophrenia. Alternatively, criteria C may be used. The psychiatric report to DDS should include the date, time, and place of the assessment. It should conclude with a 5-axis diagnosis as well as a statement of daily activities. The report should not make any recommendation as to whether the application should be approved or denied. This is a function for DDS. The report should be signed and dated.

DDS evaluation forms

The use of and familiarity with the Psychiatric Review Technique form and the Residual Functioning Capacity form can greatly enhance the quality of the medical evidence. The concepts and terms in these forms are those generally used by DDS and administrative judges. Attorneys who represent mentally ill claimants frequently attempt to bolster their cases by having the treating psychiatrist complete these forms. The emphasis in completing these forms is to continuously link the signs, symptoms, and diagnosis to the restrictions and limitations of functioning.

The Psychiatric Review Technique form is completed by a DDS psychologist or psychiatrist for all claims that involve mental illness. That form should include a summary of what mental impairments are present and the degree of functional loss in criteria B and C. In activities of daily living and social functioning the functional loss ratings are none, slight, moderate, marked, extreme restrictions, and insufficient evidence. In the domains of deficiencies and concentration, persistence, or pace, the ratings are never, seldom, often, frequent, and constant. For episodes of deterioration or decompensation in work or work like settings, the ratings range from never, or once or twice, to repeated (3 or more times), and continual. The emphasis is on how specific symptoms and signs from the Psychiatric Review Technique Form impair work-related activities in the Residual Functioning Capacity assessment.

When the medical evidence shows that the level of severity of impairment falls between “meets or equals” the listed mental criteria or “does not significantly affect work-related capacities” DDS psychiatrists or psychologists usually complete the residual capacity and assessment form. This procedure attempts to gauge what the claimant may do despite his limitations. It assesses the claimant’s impairment, related functioning limitations, the degree, severity, and frequency of the limitations, as well as the claimant’s ability to sustain work-related activities in the face of restricted functioning during a normal work day or week. The form contains examples of mental activities that are grouped under 4 headings:

• Understanding, comprehension, and memory (eg, ability to remember locations and work like procedures)

• Sustaining concentration and persistence, ability to perform activities within a schedule (eg, attendance and punctuality)

• Social interaction (eg, ability to sustain socially appropriate behavior and to maintain a reasonable standard of neatness and cleanliness)

• Adaptation (eg, ability to respond adequately and appropriately to the work environment)

The RFC items are rated as not significantly limited, moderately limited, markedly limited, no evidence of limitation, or not rateable based on available evidence.

Special considerations

Some patients such as infants, children, and adolescents have special needs. In this setting, only psychiatrists who have clinical experience working with children and adolescents should agree to do consultative examinations for children under the age of 18. The listings for children are similar to those for adults, but they take into consideration age-appropriate and developmental factors, the unique presentation of certain diagnostic categories in this age group, the impact of schooling, and the need for corroborative evidence.

School teachers, social workers, and foster care parents may provide information that is essential for making appropriate decisions. Appropriate psychological tests may contribute to a more informative report. In fact, for children, the use of psychological tests may be more critical than for adults.

Another class of claimants are those with multiple minor impairments. Each condition with its concomitant restrictions and functions should be well described. Also, the needs of veterans have taken center stage: practitioners should be familiar with the subtleties of posttraumatic stress disorder.

References

1. Leo RJ. Social Security disability and the mentally ill: changes in the adjudicatory process and treatment source information requirements. Psychiatr Ann. 2002;32:284-292.

2. MacDonald-Wilson K, Rogers ES, Anthony WA. Unique issues in assessing work function among individuals with psychiatric disabilities. J Occup Rehabil. 2001;11:217-232.

3. Social Security Administration. Disability Evaluation Under Social Security, January 2005. http://www.socialsecurity.gov. Accessed November 25, 2008.

4. Psychiatric Review Technique form. http://www.fedforms.gov/bgfPortal/docDetails.do?dId=13996. Accessed December 8, 2008.

5. The Residual Functioning Capacity form. http://ssaconnect.com/tfiles/SSA-4734-F4.sup.pdf. Accessed December 8, 2008.

6. Okpaku SO. The psychiatrist and the Social Security Disability and Supplemental Security Income programs. Hosp Community Psychiatry. 1988;39:879-881.

Evidence-Based References

Disability determination for adults with mental disorders: Social Security Administration vs independent judgments. Am J Public Health. 1994;84:1791-1795.

Okpaku SO, Anderson KH, Sibulkin AE, et al. The effectiveness of a multidisciplinary case management intervention on the employment of SSDI applicants and beneficiaries. Psychiatr Rehab J. 1997;20(3).

Listing 112.10 Autistic Disorder and Other Pervasive Developmental Disorders

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 10:31:58 GMT

Listing 112.10 Autistic Disorder and Other Pervasive Developmental Disorders: Characterized by qualitative deficits in the development of reciprocal social interaction, in the development of verbal and nonverbal communication skills, and in imaginative activity. Often, there is a markedly restricted repertoire of activities and interests, which frequently are stereotyped and repetitive.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied.

A. Medically documented findings of the following:

1. For autistic disorder, all of the following:

a. Qualitative deficits in the development of reciprocal social interaction; and

b. Qualitative deficits in verbal and nonverbal communication and in imaginative activity; and

c. Markedly restricted repertoire of activities and interests;

2. For other pervasive developmental disorders, both of the following:

a. Qualitative deficits in the development of reciprocal social interaction; and

b. Qualitative deficits in verbal and nonverbal communication and in imaginative activity;

AND

B. For older infants and toddlers (age 1 to attainment of age 3), resulting in at least one of the appropriate age-group criteria in paragraph B1 of listing 112.02; or, for children (age 3 to attainment of age 18), resulting in at least two of the appropriate age-group criteria in paragraphs B2 of listing 112.02.

Discussion on Autism

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 10:26:16 GMT

Autism starts in childhood and abnormalities continue into adulthood. A seamless discussion must include infants and children under this section, although they could be evaluated under listing 112.10.

Autism is a brain disorder that typically affects a person’s ability to communicate, form relationships with others, and respond appropriately to the environment. Some people with autism are relatively high-functioning, with speech and intelligence intact. Others are mentally retarded, mute, or have serious language delays. For some, autism makes them seem closed off and shut down; others seem locked into repetitive behaviors and rigid patterns of thinking.

Although people with autism do not have exactly the same symptoms and deficits, they tend to share certain social, communication, motor, and sensory problems that affect their behavior in predictable ways.

Isolated in worlds of their own, people with autism appear indifferent and remote and are unable to form emotional bonds with others. Although people with this baffling brain disorder can display a wide range of symptoms and disability, many are incapable of understanding other people’s thoughts, feelings, and needs. Often, language and intelligence fail to develop fully, making communication and social relationships difficult. Many people with autism engage in repetitive activities, like rocking or banging their heads, or rigidly following familiar patterns in their everyday routines. Some are painfully sensitive to sound, touch, sight, or smell.

Children with autism do not follow the typical patterns of child development. In some children, hints of future problems may be apparent from birth. In most cases, the problems become more noticeable as the child slips farther behind other children the same age. Other children start off well enough. But between 18 and 36 months old, they suddenly reject people, act strangely, and lose language and social skills they had already acquired.

Md. researchers joining major study on causes of autism

bob@simplesitecompany.com (Bob Hansen) — Sat, 16 Mar 2024 10:04:03 GMT

By Kelly Brewington | brian@hogansmith.com

June 10, 2009

Researchers at Johns Hopkins and the Kennedy Krieger Institute are joining in what is being called one of the largest studies to examine early causes of autism.

Medical experts have been trying for years to unravel why children develop autism. Is it genes? Could it be their environment? While other studies have focused on one or the other, the four-year investigation announced yesterday will examine both questions about the puzzling neurobiological disorder that affects about 1 in 150 children nationwide.

The Baltimore investigators will join experts at four research centers in Philadelphia and Northern California to recruit 1,200 pregnant women who already have a child with autism and study them throughout pregnancy and their baby's first three years.

"This is a great opportunity to put gene and environmental hypotheses together," said Daniele Fallin, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health and one of the study's principal investigators. "The great thing about this new study is we are able to do things in real time."

Fallin expects to spend the next four years recruiting about 250 women from the Baltimore area and the Washington suburbs for the Early Autism Risk Longitudinal Investigation. The study is spearheaded by the National Institutes of Health with funding from the institute and Autism Speaks, a national advocacy group.

Scientists will closely monitor the women, taking blood and urine samples during their pregnancy and breast milk samples after they deliver. The women will be asked to keep a diary of their eating habits and lifestyle, fill out questionnaires and participate in interviews about their health, their jobs and their lives before their babies' conception. Fathers will be asked questions about chemicals they might have been exposed to and to give blood samples.

Researchers will collect dust samples from the couples' homes and examine common household chemicals, including cleaning solutions, pesticides and flame retardants used in mattresses and sofas.

Researchers will gather similar biological samples from the babies and follow them closely for any early signs of autism, such as regressions in development.

Children found at risk for developing autism will be referred for treatment, even if doing so means skewing the study's results, said Dr. Rebecca Landa, director of the Center for Autism and Related Disorders at Kennedy Krieger.

"This is a risk to the interpretation of the data that one takes for ethical reasons," she said.

The wide range of disabilities known as autism spectrum disorders is marked by impaired communication and social interaction. There is no cure for the disorder, and the factors that cause it remain a mystery.

Still, researchers have unlocked clues to possible genetic causes of the disorder. For instance, the likelihood of a child being born with autism is less than 1 percent. But for couples with one autistic child, Fallin said, the risk of having a second child with the disorder rises to between 5 percent and 20 percent.

In addition, researchers at UCLA recently found an autism-risk gene that is more common in boys than girls, which they think helps explain why the disorder is four times more common in boys. Dr. Stanley Nelson, a professor of human genetics at the David Geffen School of Medicine at UCLA, believes that research ultimately will link many genes to the disorder.

For now, he said, the genetics remain murky. Several people with autism have been found to share the same genetic mutations, but the disorder differs in each: Some develop severe autism, some develop mild cases and others do not develop the disorder at all.

Nelson, who is not connected with the study announced yesterday, said that beginning the research during pregnancy is worthwhile but he wonders if the scope is too broad.

"My concern would be, we don't know that much about the genetics yet," he said. "Trying to study genetics, with a complex process such as pregnancy and ... combining them, they may not have enough compelling data one way or the other."

Possible environmental causes of autism are even trickier to understand. There is little hard evidence that chemicals or lifestyle cause autism, said Dr. Irva Hertz-Picciotto, of the University of California, Davis School of Medicine, who is also involved in the study. But researchers think there may be a link between environment and genetic susceptibility.

While the researchers acknowledge that their study is broad, they say it will provide a critical opportunity to study autism's causes in real time - as a baby develops from fetus to toddler.

"Many studies rely on identifying children with autism spectrum disorders and a group without, and making families recall what exposures they had early in pregnancy," said Lisa A. Croen, an epidemiologist with Kaiser Permanente and a partner in the study. "You can't get that from a study that collects data after the fact."

A small but vocal minority of parents believes that childhood vaccinations can cause autism, leading some to refuse to inoculate their children against common diseases. Studies have shown no credible link between vaccinations and autism, and research shows that individuals who miss inoculations put larger populations at risk of contracting preventable diseases.

For other families coping with autistic children, the research announced yesterday offers hope, said Peter Waldron of Lutherville, whose son Frankie, 5, has received speech and occupational therapy at Kennedy Krieger since being diagnosed with autism at 16 months. Frankie was talking when he turned 1, but several months later Waldron and his wife, Julie, noticed that Frankie had stopped saying mommy and daddy.

"Studies like this are incredibly important and in dire need," said Waldron, whose daughters, Lila, 2, and Millie, 3, took part in a study at Kennedy Krieger for siblings of children with autism. They have not been diagnosed with the disorder.

"It's very important for families to participate in these studies to help unlock some of the questions and provide some answers to what is happening," he said. "And, hopefully, answer why."

More information on the study is available at www.earlistudy.org or by calling 443-287-4768 or 877-868-8014

Surgical Compared with Nonoperative Treatment for Lumbar Degenerative Spondylolisthesis

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 20:57:56 GMT

Background : The management of degenerative spondylolisthesis associated with spinal stenosis remains controversial. Surgery is widely used and has recently been shown to be more effective than nonoperative treatment when the results were followed over two years. Questions remain regarding the long-term effects of surgical treatment compared with those of nonoperative treatment.

Methods : Surgical candidates from thirteen centers with symptoms of at least twelve weeks' duration as well as confirmatory imaging showing degenerative spondylolisthesis with spinal stenosis were offered enrollment in a randomized cohort or observational cohort. Treatment consisted of standard decompressive laminectomy (with or without fusion) or usual nonoperative care. Primary outcome measures were the Short Form-36 (SF-36) bodily pain and physical function scores and the modified Oswestry Disability Index at six weeks, three months, six months, and yearly up to four years.

Results : In the randomized cohort (304 patients enrolled), 66% of those randomized to receive surgery received it by four years whereas 54% of those randomized to receive nonoperative care received surgery by four years. In the observational cohort (303 patients enrolled), 97% of those who chose surgery received it whereas 33% of those who chose nonoperative care eventually received surgery. The intent-to-treat analysis of the randomized cohort, which was limited by nonadherence to the assigned treatment, showed no significant differences in treatment outcomes between the operative and nonoperative groups at three or four years. An as-treated analysis combining the randomized and observational cohorts that adjusted for potential confounders demonstrated that the clinically relevant advantages of surgery that had been previously reported through two years were maintained at four years, with treatment effects of 15.3 (95% confidence interval, 11 to 19.7) for bodily pain, 18.9 (95% confidence interval, 14.8 to 23) for physical function, and –14.3 (95% confidence interval, –17.5 to –11.1) for the Oswestry Disability Index. Early advantages (at two years) of surgical treatment in terms of the secondary measures of bothersomeness of back and leg symptoms, overall satisfaction with current symptoms, and self-rated progress were also maintained at four years.

Conclusions : Compared with patients who are treated nonoperatively, patients in whom degenerative spondylolisthesis and associated spinal stenosis are treated surgically maintain substantially greater pain relief and improvement in function for four years.

Woman indicted after allegedly lying to Social Security about illnesses

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 20:54:47 GMT

by Matthew Perenchio | Editor

A federal grant jury indicted a Black River Falls woman last week after she allegedly told the Social Security Administration she had a number of illnesses and up to a year to live in order to collect disability benefits.

Lisa Marie Miller, 32, was charged June 3 with two counts of making false statements to the Social Security Administration. A federal grand jury in the Western District of Wisconsin sitting in Madison returned the indictment.

If convicted, Miller faces a maximum penalty of 10 years in federal prison.

According to the indictment, Miller applied for Social Security disability benefits online on Oct. 30, 2008, and falsely stated she suffered from breast cancer, diabetes, kidney disease and post-traumatic stress disorder.

Four days later, as part of the process to complete her Supplemental Security Income application, Miller reportedly stated her doctors told her she only had eight months to a year to live.

The charges against Miller were the result of an investigation conducted by the Social Security Administration.

The case has been assigned to Assistant U.S. Attorney John W. Vaudreuil.

Understanding CD4 Count in HIV Cases

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 20:44:42 GMT

CD4 Count: What Does It Mean?

CD4 cells are a type of white blood cell that fights infection. Another name for them is T-helper cells. CD4 cells are made in the spleen, lymph nodes, and thymus gland, which are part of the lymph or infection-fighting system. CD4 cells move throughout your body, helping to identify and destroy germs such as bacteria and viruses.

The CD4 count measures the number of CD4 cells in a sample of your blood drawn by a needle from a vein in your arm. Along with other tests, the CD4 count helps tell how strong your immune system is, indicates the stage of your HIV disease, guides treatment, and predicts how your disease may progress. Keeping your CD4 count high can reduce complications of HIV disease and extend your life.

How HIV Affects CD4 Cells

HIV targets CD4 cells by:

Binding to the surface of CD4 cells
Entering CD4 cells and becoming a part of them. As CD4 cells multiply to fight infection, they also make more copies of HIV
Continuing to replicate, leading to a gradual decline of CD4 cells

HIV can destroy entire "families" of CD4 cells. Then the diseases these "families" were designed to fight can easily take over. That's when opportunistic infections are likely to develop.

When to Have a CD4 Count Test

Your doctor will recommend a CD4 count test:

When you're first diagnosed with HIV. This is called a baseline measurement. It allows you to compare against future measurements.
About 2 to 8 weeks after starting or changing treatment.
Every 3 to 6 months after that (is a reasonable time interval).

What the CD4 Count Test Results Mean

CD4 counts are reported as the number of cells in a cubic millimeter of blood. A normal CD4 count is from 500 to 1,500 cells per cubic millimeter of blood. It is more important to pay attention to the pattern of results than to any one test result.

In general, HIV disease is progressing if the CD4 count is going down. This means the immune system is getting weaker and you are more likely to get sick. In some people, CD4 counts can drop dramatically, even going down to zero.

The test does not always correspond with how well you are feeling. For example, some people can have high CD4 counts and do poorly. Others can have low CD4 counts and have few complications.

If your CD4 count goes down over several months, your doctor may recommend:

Beginning or changing antiretroviral therapy.
Starting preventive treatment for opportunistic infections.

Public health guidelines recommend starting on preventive antiretroviral therapy if CD4 counts are under 200, whether or not you have symptoms. This is a later stage of HIV infection called AIDS (acquired immunodeficiency syndrome). Some doctors start therapy earlier, when the CD4 count reaches 350. If therapy is effective, your CD4 count should go up or become stable.

Most doctors recommend starting medication for opportunistic infections at these levels:

Less than 200: pneumocystis pneumonia (PCP).
Less than 100: toxoplasmosis and cryptococcal meningitis .
Less than 75: mycobacterium avium complex (MAC).

Factors That Can Affect Your CD4 Count

You should know that other factors can influence how high or low your CD4 count is.

CD4 counts tend to be lower in the morning and higher in the evening.
Acute illnesses such as pneumonia, influenza, or herpes simplex virus infection can cause CD4 counts to go down for a while.
If you have a vaccination or when your body starts to fight an infection, your CD4 counts can go up.
Cancer chemotherapy can cause CD4 counts to go way down.
Fatigue and stress can also affect test results.

For these reasons:

Try to use the same lab each time.
Have your tests done at the same time of day each time.
Wait for at least a couple of weeks after an infection or vaccination before getting a CD count test.

WebMD Medical Reference

View Article Sources Sources

Reviewed by Daniel Perlman, MD

WebMD does not provide medical advice, diagnosis or treatment.

Social Security - Fast Facts

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 20:12:01 GMT

In 2009, nearly 51 million Americans will receive $650 billion in Social Security benefits.

December 2008 Beneficiary Data

Social Security is the major source of income for most of the elderly.

Nine out of ten individuals age 65 and older receive Social Security benefits.
Social Security benefits represent about 40% of the income of the elderly.
Among elderly Social Security beneficiaries, 52% of married couples and 72% of unmarried persons receive 50% or more of their income from Social Security.
Among elderly Social Security beneficiaries, 20% of married couples and about 41% of unmarried persons rely on Social Security for 90% or more of their income.

Social Security provides more than just retirement benefits.

Retired workers and their dependents account for 69% of total benefits paid.
Disabled workers and their dependents account for 18% of total benefits paid.

- About 91 percent of workers age 21-64 in covered employment and their families have protection in the event of a long-term disability.

- Almost 1 in 4 of today’s 20 year-olds will become disabled before reaching age 67.

- 69% of the private sector workforce has no long-term disability insurance.

Survivors of deceased workers account for about 13% of total benefits paid.

- About one in eight of today’s 20 year-olds will die before reaching age 67.

- About 97% of persons aged 20-49 who worked in covered employment in 2008 have survivors insurance protection for their young children and the surviving spouse caring for the children.

An estimated 162 million workers, 94% of all workers, are covered under Social Security.

52% of the workforce has no private pension coverage.
31% of the workforce has no savings set aside specifically for retirement.

In 1935, the life expectancy of a 65-year-old was 12½ years, today it's 18 years.

By 2034, there will be almost twice as many older Americans as today -- from 38.6 million today to 74 million.

There are currently 3.3 worke rs for each Social Security beneficiary. By 2034, there will be 2.1 workers for each beneficiary.

FACT SHEET ON THE OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE PROGRAM

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:57:23 GMT

Functional Criteria in Step 3 Evaluations

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:47:46 GMT

A reminder: The mental and physical Listings (evaluated at Step 3 of the sequential evaluation process) contain explicit and implicit functional criteria that need to be evaluated by the adjudicator along with the objective medical evidence of severity. (A Step 3 determination of "disabled" should be issued without regard to age, education, or work experience.) But, as I've noticed in successful fed court appeals, many times adjudicators evaluate only the medical evidence at Step 3, believing that functional limitations are only part of the Step 4 RFC determination.

Make sure you're looking for the best evidence of functional impairments, which are the medical records - but functional evidence is often not there. However, treating source opinions and lay testimony can suffice to meet the functionality requirements of the Listings. Depending on the Listing, a rep should present functional impairment evidence in conjunction with a Step 3 analysis. For example, if a mental impairment Listing requires "marked" or "extreme" limitations, you must equate these indefinite terms to the claimant's functional limitations. If the mental health records are silent on functioning, you should get a treating source opinion on functioning and/or the claimant's testimony about how (to what extent) his/her mental impairment affects ability to concentrate, focus, persist, handle criticism, relate to others, etc. (The same approach to obtaining functional impairment evidence should be used with physical Listings.)

As early as Step 3, it's all about how a claimant's impairments affect functioning. You should be getting medical treating source opinions about the claimant's functioning whenever possible.

Contributed by James W. Keeter, Esquire.

Mr. Keeter is an Orlando Attorney who specializes in Social Security Disability.

PFD, AOD & DLI EXPLAINED

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:45:57 GMT

If you are applying for disability benefits or if you have already filed a claim, it is important that you understand these terms: Protective Filing Date (PFD), Alleged Onset Date (AOD), and Date Last Insured (DLI).

Protective Filing Date (PFD)

When you initially contact SSA to file a claim, this is your PFD. If you are awarded benefits, this date determines how far back SSA can go when paying your past due benefits. For SSI claims, you can only be paid from this date forward. For Disability Insurance Benefits (DIB), you can be paid a maximum of 12 months prior to your PFD.

Alleged Onset Date (AOD)

This the date that your disability began. When you file our application for benefits, SSA will ask you when your disability began. Giving SSA the wrong date can end up costing you money or a significant delay in your decision. There are many factors to consider when you tell SSA when your disability began. Probably the most important thing to remember when alleging an onset date is to determine when your condition was severe enough to interfere with your ability to do your job on a full-time basis. If you had to reduce the number of hours that you worked or if you had to switch to a different less strenuous job, this will more likely be the date of your onset of disability.

Date Last Insured (DLI)

This is one of the most important considerations in your claim for disability benefits. In order to qualify for DIB, you have to earn sufficient credits to become "insured." Typically, you must have 22 credits in order to qualify for DIB. You can earn 4 credits per year, so you must work at least 5 1/2 years to earn 22 credits. Your Earnings Statement will tell you the last date that you could qualify for DIB based on your earnings. This date is your DLI.

If you have questions about when to file a claim, what date to allege or how your DLI effects your claim, give me a call at 407-377-0700.

What to Look for When Hiring a Representative?

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:29:50 GMT

I'm often asked this question by prospective clients and the answer is complicated. Most representatives do a great job working on behalf of their clients. But, there are representatives that actually do harm to their client's cases. Sometimes this is through no fault of their own. A perfect example is the representative that works for a large firm or so-called "national firm." These firms spend millions of dollars advertising on television, radio and on the internet. Their sole purpose is to bring in as many clients as possible. And, unfortunately, they are doing this in record numbers. However, when it comes to putting resources into providing representation for their clients, they fall short. Here are some questions that I recommend every client ask their representative:

How many cases do you handle? You may be surprised to learn that your representative has several hundred cases in his/her inventory. Is it possible for one person to handle this many cases and still be prepared to represent you in your claim? Often, the tell-tale sign that they are overloaded with work is whether they keep in close contact with you, return your phone calls timely, and are willing to meet with you if necessary. If you have questions that are not being answered appropriately or timely, this may be a sign that your representative is overloaded and has too many cases to manage. Or, it could mean that he/she does not have the necessary resources and staffing to handle their caseload.
Will you provide SSA with updated medical records at every level of the appeals process? Believe it or not, there are many representatives that will tell you that getting your records before the hearing is scheduled is a waste of time. But, the fact is without documentation to support your claim for disability, SSA cannot approve your case. If your representative updates your medical evidence consistently and requests SSA to review these records, oftentimes cases will get approved without having to go before a judge. Sitting on your case and not updating your records is another sure sign that your representative is either too busy with his/her caseload, or he/she just isn't concerned about your case.
Does your representative listen to you? It is important that your representative understands why you are unable to work. This seems like an obvious consideration, but all too often representatives do not understand your case or the reasons that you are not able to work. You should have a good rapport with your representative and you should feel like they are on your side. Many representatives become "jaded" after representing claimants. They don't listen to you and are going through the motions hoping they get a good judge.
Will your representative adequately prepare you to testify at your hearing ? Again, this seems like a simple thing to expect. Will your representative meet with you or call you well in advance of your hearing in order to prepare you to testify? If not, will SSA have all of the facts? Probably not. Representatives are paid a fee out of the benefits that are awarded to you on your claim. The representative should be willing to spend time with you and be prepared to represent you at your hearing.

Of course, there are many other questions to ask your representative before you hire him/her. These are the most obvious. Your relationship with the representative should be a good "fit" for you. And you should feel confident that he/she is doing everything possible to get your claim approved.

If you need assistance or have questions about a social security disability claim, please don't hesitate to contact me directly on my cell phone at 407-377-0700.

SSA Changes ALJ Job Description

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:26:51 GMT

Social Security Disability case judges have had rigorous caseloads for years, with many creating a significant backlog as a consequence. According to The Wall Street Journal, the Social Security Administration (SSA) is conducting a comprehensive reexamination of how judges reward disability benefits. The changes include altering job descriptions to give officials increased authority to oversee judges. Job descriptions currently contain the terminology “complete individual independence,” which creates challenges for the SSA. The Journal reports the phrase will no longer be included in job descriptions and new wording will make it clear that judges are subject to supervision by the agency. Approximately 1,500 administrative judges may be affected by the alterations.

This isn’t the first time disability judges have come under scrutiny. The changes came after wide disparities in judge rulings were revealed. The Journal reported that in 2011 it was found that dozens of judges ruled for benefits in 90 percent of their cases, while others denied benefits in more than 80 percent of their cases. These disparities between judges caused the agency to tighten enforcement at the time. Judges only awarded benefits in 67 percent of their cases in 2010, the Journal reported. That number fell to 56 percent last year.

“The allowance rate right now is probably at a 40-year historic low,” Glenn Sklar, deputy commissioner for the SSA, said at a congressional hearing in November, according to the Journal.

The Legal Times blog noted two congressional committees examined how SSA judges rule on disability claims and how SSA leadership disciplines judges in mid-2011. During the hearing, the case was made that some judges didn’t take accountability for their actions, while others kept within the rules and were hardworking. According to the blog, 58 disability judges were disciplined by the administration between 2007 and 2011 for numerous reasons, the most common being failing to rule on enough cases.

For disability applicants, increased scrutiny of judges may be both positive and negative. While improving judge discipline can ensure disabled people receive benefits, it may also cause more judges to be terminated. The number of judges has been declining in recent years, which has created a backlog of cases. According to the Journal, the recession increased demand for SSD benefits, with the program now having approximately 11 million beneficiaries. In fact, the number of people in the program is set to continue increasing.

In an interview with the Center for Public Integrity, Russell Pulver, a former California-based administrative law judge for the U.S. Department of Labor, said it was increasingly difficult for him to handle his caseload.

“Each year I seemed to hear more cases and be given less help,” Pulver said. “I said, ‘I’m getting no love. I’m not staying around for this.’”

According to the Center for Public Integrity, Pulver voluntarily left his position with the Labor Department and now runs a mediation service. The dwindling number of judges is causing many department offices to be understaffed, which is only growing the problem of hearing and properly ruling on cases.

The changes to judge job descriptions and possibility of increased scrutiny may allow more applicants to be awarded benefits, but it may also increase case wait times.

IMPORTANT DATES THAT YOU MUST KNOW WHEN FILING A CLAIM

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:24:10 GMT

Protective Filing Date (PFD)

Alleged Onset Date (AOD)

Date Last Insured (DLI)

If you have questions about when to file a claim, what date to allege or how your DLI effects your claim, give me a call at 407-377-0700.

FT LAUDERDALE HEARING OFFICE STATISTICS

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:19:11 GMT

TOP 5 REASONS SOCIAL SECURITY DISABILITY BENEFITS ARE DENIED

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:13:27 GMT

There are many reasons for the Social Security Administration to deny your claim for disability benefits.

These are just a few common reasons for denials:

Your disability is due to drug or alcohol addiction. If your condition would likely improve if you stopped using drugs or alcohol, the Social Security Administration will likely deny your claim.
Your condition is not expected to last long enough. If your condition is not expected to last for 12 or more months, the Social Security Administration will deny your claim.
Your condition is not severe. If your condition does not interfere with your ability to perform work-like functions, your claim will be denied.
You did not provide enough medical documentation to support the severity of your disability. The Social Security Administration cannot approve your claim if you do not have medical evidence from medical providers to substantiate your symptoms.
You did not follow your doctor's recommendations. If you did not follow thru with recommended medical treatment, the Social Security Administration will deny your claim.

If you are unable to work due to your medical condition(s) and were denied by the Social Security Administration, contact us for a free evaluation. We offer free case evaluations and can oftentimes assist you in navigating the complex system established by the Social Security Administration.

Information for Wounded Warriors and Veterans Who Have a Compensation Rating of 100% Permanent & Total (P&T)

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 19:04:45 GMT

Military service members can receive expedited processing of disability claims from Social Security. Benefits available through Social Security are different than those from the Department of Veterans Affairs and require a separate application.

The expedited process is used for military service members who become disabled while on active military service on or after October 1, 2001, regardless of where the disability occurs.

Below are the answers to the questions most people ask about applying for disability benefits. Knowing the answers to these questions will help you understand the process.

What types of benefits can I receive?

Social Security pays disability benefits through two programs: the Social Security disability insurance program, which pays benefits to you and certain members of your family if you are "insured," meaning that you worked long enough and paid Social Security taxes; and the Supplemental Security Income (SSI) program, which pays benefits based on financial need.

What is Social Security's definition of disability?

By law, Social Security has a very strict definition. To be found disabled:

You must be unable to do substantial work because of your medical condition(s); and
Your medical condition(s) must have lasted, or be expected to last, at least one year or to result in death.

While some programs give money to people with partial disability or short-term disability, Social Security does not .

Can I receive benefits for a past disability if my health has improved?

That depends. If we find that you are disabled under our rules and your application was filed within a specified time frame, we will consider whether you qualify for a closed period of disability. There are specific requirements for a closed period of disability:

The medical evidence must establish that you were unable to engage in substantial work for a continuous period of 12 months, but by the time the disability decision is made, your condition has improved to the point where we find you are no longer disabled.
You also must file an application within 14 months after the disability ended.
If you meet the requirements for disability benefits, there is a five-month waiting period before your first monthly benefit can be paid. You can receive up to 12 months of retroactive benefits from the date you file an application with Social Security.

Example : You file an application for Social Security disability benefits in December 2011. After reviewing your claim, we find that your disability started on April 15, 2010, and that your condition improved to the point that you were no longer considered disabled as of September 2011. We refer to this as a closed period of disability.

Your five-month waiting period begins May 2010, the first full month you are disabled. The months in your waiting period are May, June, July, August, and September. Thus, the first month for which you are entitled to disability benefits is October 2010.

You could potentially receive benefits for October 2010 until September 2011, the month your disability ended. Based on the application you filed in December 2011, you would receive 10 months of retroactive benefits for December 2010 through September 2011.

How does military pay affect eligibility for disability benefits?

Active duty status and receipt of military pay does not, in itself, necessarily prevent payment of Social Security disability benefits. Receipt of military payments should never stop you from applying for disability benefits from Social Security. If you are receiving treatment at a military medical facility and working in a designated therapy program or on limited duty, we will evaluate your work activity to determine your eligibility for benefits.

You cannot receive Social Security disability benefits if you engage in substantial work for pay or profit. However, the actual work activity is the controlling factor and not the amount of pay you receive or your military duty status.

How do I apply?

You may apply for disability benefits at any time while in military status or after discharge, whether you are still hospitalized, in a rehabilitation program, or undergoing out-patient treatment in a military or civilian medical facility. You may apply online at www.socialsecurity.gov/woundedwarriors , in person at the nearest Social Security office , by mail, or by telephone.

You may call 1-800-772-1213 to schedule an appointment. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. We also have a “ disability starter kit ” available online to help you complete your application.

What information do I need?

To apply for benefits, you or your representative must provide information and documentation about your age, employment, proof of citizenship, and information regarding all impairments and related treatment. Social Security will make every reasonable effort to help you get the necessary medical evidence.

Important : You should file the application for disability benefits as soon as possible with any documents readily available. Do not delay filing, even if you do not have all the documents mentioned below.

Original or certified copy of your birth certificate or proof of U.S. citizenship or legal residency if foreign born;
Form DD 214, if discharged from military service;
W-2 form or income tax return from last year;
Proof of military pay or workers' compensation;
Social Security numbers of your spouse and minor children;
Checking or savings account number, if you have one;
Name, address, and phone number of a contact person, in case you are unavailable; and
Medical records that you have or that you can easily obtain from all military and civilian sources.

How does Social Security make the decision?

Your claim is sent to a State Disability Determination Services (DDS) office that makes disability decisions. The State has medical and vocational experts who will contact your doctors and other places where you received treatment to get your medical records. The State agency may ask you to have an examination or medical test. You will not have to pay the costs of any additional exams or tests you are asked to take. If the State does request an examination, make sure you keep the appointment.

How long does it take?

The length of time it takes to receive a decision on your disability claim can vary, depending on several factors, but primarily on:

The nature of your disability;
How quickly we obtain medical evidence from your doctor or other medical source; and
Whether it is necessary to send you for a medical examination in order to obtain evidence to support your claim.

What can I do to speed the decision?

You can speed the decision on your application for benefits by being prepared for your interview. We can take prompt action on your claim if you:

Let us know right away that your disability occurred while on active military duty;
Have information available regarding all the doctors you have seen and the address of the military site where your records are kept;
Notify us of any address changes you have while we are working on your claim; and
Inform us about any changes in doctors, hospitals, or outpatient clinics where you are receiving treatment.

After we receive your application for Social Security disability benefits, we will identify it as a military service member claim and expedite it through all phases of processing, both at Social Security and the DDS. We also expedite disability claims filed online.

Can my family get benefits?

Certain members of your family may qualify for benefits based on your work. They include:

Your spouse, if he or she is age 62 or older;
Your spouse, at any age, if he or she is caring for a child of yours who is younger than age 16 or disabled;
Your unmarried child, including an adopted child, or, in some cases, a stepchild or grandchild. The child must be younger than age 18 or younger than age 19 if in elementary or secondary school full time; and
Your unmarried child, age 18 or older, if he or she has a disability that started before age 22. (The child's disability also must meet the definition of disability for adults.)

NOTE: In some situations, a divorced spouse may qualify for benefits based on your earnings if he or she was married to you for at least 10 years, is not currently married, and is at least age 62. The money paid to a divorced spouse does not reduce your benefit or any benefits due to your current spouse or children.

When do I get Medicare coverage?

You will get Medicare coverage automatically after you have received disability benefits for 24 months.

How does Medicare affect my TRICARE?

For service members who are entitled to Medicare Part A (Hospital Insurance) and Part B (Medical Insurance), TRICARE provides Medicare “wraparound” coverage. Medicare is the primary payer for these beneficiaries, and TRICARE serves as a supplement, paying the Medicare deductible and patient cost share.

If you are entitled to Medicare Part A based on disability or permanent kidney failure, contact the Department of Defense to find out how this may affect your TRICARE benefits. You may need to be enrolled in Medicare Part B to keep your TRICARE coverage. For general information about TRICARE, please visit http://www.tricare.mil/welcome/eligibility/medicareeligible.aspx .

Individuals who are awarded retroactive Social Security disability benefits also may become entitled to Medicare Part A for months before they receive the disability award notice. Effective October 2009, TRICARE beneficiaries who are awarded retroactive benefits based on disability or permanent kidney failure do not have to enroll in Part B for those months in the past and can keep their TRICARE coverage as long as they enroll in Part B currently. You should contact the Department of Defense to find out whether you need to enroll in Medicare Part B so you can keep your TRICARE.

The Patient Protection and Affordable Care Act of 2010 provides for a 12-month Medicare Part B special enrollment period for TRICARE beneficiaries who are entitled to Medicare Part A, but did not enroll in Medicare Part B during their initial enrollment period. The Department of Defense will notify eligible individuals about this period.

For more information about TRICARE and recent changes in the law, please visit www.socialsecurity.gov/legislation/tricareinfo.html .

What if I remain on active duty?

You may receive Social Security disability benefits and remain on active duty. It is important that you immediately contact Social Security if there is a change in your --

Military Occupational Specialty code (MOS);
Air Force Specialty Codes (AFSC); or
Navy Enlisted Classification (NEC).

A permanent change of station (PCS) move from one duty station to another is also a potential indicator that you may be going back to work and should contact Social Security.

Changes in your work status may affect your Social Security benefits. Tell us right away about any changes in your work or active duty status.

If you are planning to change your PCS, MOS, AFSC, or NEC, you can request a Benefits Planning Query from Social Security. This query contains information about the status of your disability benefits, work history and current work status, health insurance, scheduled medical reviews, and representative payee data.

You can use the Benefits Planning Query as a tool to help you plan your return to work. Request your query by calling 1-800-772-1213 or visiting your local field office.

What should I know about working?

Social Security has special rules called work incentives that allow you to test your ability to return to work and still receive monthly Social Security disability benefits.

You also can get help with the education, training, and rehabilitation you need in order to work. You will find a description of the work incentives and other programs that can help you return to the work force below. For more information, ask us for Working While Disabled -- How We Can Help (Publication No. 05-10095) or visit www.socialsecurity.gov/work .

Do I need to report my work activity?

Yes. If you take a job, it is important that you let us know about it as soon as possible. You should tell us:

When you start or stop work; and
If there is a change in your job duties, hours or work, or rate of pay.

Even if you are receiving full pay, you still may qualify for Social Security disability benefits.

You may visit your local field office to report your current work activity. You can find the closest office on our website at www.socialsecurity.gov .

Ask the Social Security representative to give you a receipt showing that you reported your work activity. The work report receipt is for your records and serves as proof that you told us about your current work situation.

What happens next?

When we receive notification that you have returned to work, we perform a work continuing disability review (CDR). During this review, we look to see whether you are doing substantial work. For 2013, we consider you to be doing substantial work if your monthly earnings are over $1,040 ($1,740 if you are blind).

That amount may change each year. When we conduct a work CDR, we ask you to complete an SSA-821-BK (Work Activity Report-Employee). You should complete the form and provide as much detail as possible about your job duties.

It is important that you tell us whether you are in a designated work therapy program or whether you are assigned limited duty because of your disability. You may be receiving full military pay, but not performing work duties. Without this information, we cannot properly evaluate your work, and your Social Security benefits may be suspended or terminated.

What are the work incentives?

Trial Work Period (TWP)

The TWP allows you to test your ability to work for at least nine months. The months do not need to be consecutive. During your TWP, you will receive your full Social Security benefits, regardless of how much you earn, as long as you report your work activity and you continue to have a disabling impairment.

In 2013, a trial work month is any month in which your total earnings are more than $750 or, if you are self-employed, you earn more than $750 or you spend more than 80 hours in your own business. The TWP continues until you have worked nine trial work months within a 60-month period.

Extended Period of Eligibility (EPE)

After the TWP ends, you have 36 months during which you can work and still receive benefits for any month that your earnings are not "substantial."

During the EPE, your benefits are suspended for any month that you have substantial earnings. However, you will receive a benefit for any month your earnings fall below the substantial level. You do not need a new application or disability determination to receive a Social Security disability benefit during the EPE.

More information on work incentives is available at www.socialsecurity.gov/redbook .

Ticket to Work Program

Social Security's Ticket to Work program offers many supports that can help you return to work. Under the Ticket program, you can obtain vocational rehabilitation, training, job referrals, and other employment support services free of charge. These services are provided by Employment Networks, which are private organizations or government agencies (state or local) that have contracts with Social Security to provide employment services and other supports to beneficiaries with disabilities.

If you are interested in using the Ticket program to go to work or get vocational services, please call 1-866-968-7842, toll-free.

Work Incentives Planning and Assistance (WIPA) program

The WIPA program is a nationwide network of community-based organizations with experts who can answer questions about Social Security's work incentives and help you make a decision about working.

WIPA experts, called Community Work Incentive Coordinators, provide information and work incentives planning and assistance to people who are receiving Social Security disability benefits and who are currently working or considering work. They can help you understand how work affects your disability benefits and explain what other federal, state, and local supports there are for people with disabilities who want to work.

To locate the WIPA project nearest you, call 1-866-968-7842, toll-free.

WHY IS IT TAKING SO LONG?

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 18:27:54 GMT

One of the most frequent questions asked by clients is "Why is this taking so long?" Unfortunately, the answer to this question is very complicated. When the initial application is filed, typically we receive an answer within 30-90 days. Unfortunately, most cases are denied at the initial level. An appeal must be filed within 60 days after receiving the denial notice. This first appeal is called a Request for Reconsideration (RFR). We usually receive an answer within 90-120 days after filing the RFR. Again, the vast majority of RFRs are denied. We must file an appeal within 60 days after receiving this denial. This second appeal is called a Request for Hearing (RFH). Here is where the "wait" begins. In Florida, the average wait time for a hearing is 17.7 months. The National average is 14.9 months. The Orlando ODAR office is reporting an average of 16 months, Jacksonville 17.5 months, Ft. Lauderdale 18 months, and Tampa 16.5 months (see: http://www.disabilityjudges.com/state/florida ). We try everything possible to get cases heard as quickly as possible. Unfortunately, this is something that is out of our control. SSA will expedite cases where there is a "dire need" in cases involving a life-threatening illness, receipt of a foreclosure/eviction notice, or proof of homelessness (all must be documented). We take our client's concerns about the "wait" very seriously and do everything possible to get cases heard as soon as possible. If you have any questions about the hearing process or disability from the SSA, please send us a message or give us a call.

How Long Do I Have After My Husband's Death to Prove My Disability for Social Security?

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 18:25:41 GMT

Surviving spouses and even divorced surviving spouses (who were married at least ten years) can sometimes get Social Security disability benefits (SSDI) based on their deceased spouse's work record. These benefits are called disabled widow(er)'s benefits (DWB). The deceased spouse must have worked enough years paying Social Security taxes into the system for the surviving spouse or surviving ex-spouse to be eligible for Social Security benefits. The surviving spouse or ex-spouse must be at least age 50 and disabled to be eligible for SSDI auxiliary benefits (benefits based on someone else's work record), and must have become disabled before age 60 and no later than seven years after the deceased spouse's death. This seven-year period is known as the prescribed period. If the widow or ex-spouse received mother's or father's benefits for caring for the deceased spouse's children, the seven-year period starts when the mother's or father's benefit ends. As you can see, this exception can greatly lengthen the time an individual is eligible to apply for disabled widow or widower's benefits. If a surviving spouse or ex-spouse became disabled immediately after her spouse's death, but she did not reach the age of fifty within seven years of her spouse's death, she will not be eligible for benefits. If the surviving spouse does become disabled within seven years of her spouse's death, and is over age 50, she will be eligible for disability benefits, but the benefits will not be payable for the months before the surviving spouse reached age 50, even though the impairment may have existed before age 50.Whether or not a widow or widower is disabled, he or she can file for a survivor's benefit based upon age alone at age sixty. For more information on these benefits, see our articles on Social Security survivors benefits and survivors benefits for divorced spouses.

Waiting is the Hardest Part

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 18:22:41 GMT

Schizoaffective Disorder

bob@simplesitecompany.com (Bob Hansen) — Fri, 15 Mar 2024 17:24:00 GMT

Schizoaffective disorder is a chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression. Reading NAMI's content on schizophrenia and bipolar disorder will offer many overlapping resources for schizoaffective disorder. Because schizoaffective disorder is less well-studied than the other two conditions, many interventions are borrowed from their treatment approaches. Many people with schizoaffective disorder are often incorrectly diagnosed at first with bipolar disorder or schizophrenia because it shares symptoms of multiple mental health conditions. Schizoaffective disorder is seen in about 0.3% of the population. Men and women experience schizoaffective disorder at the same rate, but men often develop the illness at an earlier age. Schizoaffective disorder can be managed effectively with medication and therapy. Co-occurring substance use disorders are a serious risk and require integrated treatment.

Symptoms

The symptoms of schizoaffective disorder can be severe and need to be monitored closely. Depending on the type of mood disorder diagnosed, depression or bipolar disorder, people will experience different symptoms:

Hallucinations, which are seeing or hearing things that aren’t there.
Delusions, which are false, fixed beliefs that are held regardless of contradictory evidence.
Disorganized thinking. A person may switch very quickly from one topic to another or provide answers that are completely unrelated.
Depressed mood. If a person has been diagnosed with schizoaffective disorder depressive type they will experience feelings of sadness, emptiness, feelings of worthlessness or other symptoms of depression.
Manic behavior. If a person has been diagnosed with schizoaffective disorder: bipolar type they will experience feelings of euphoria, racing thoughts, increased risky behavior and other symptoms of mania.

Causes

The exact cause of schizoaffective disorder is unknown. A combination of causes may contribute to the development of schizoaffective disorder.

Genetics . Schizoaffective disorder tends to run in families. This does not mean that if a relative has an illness, you will absolutely get it. But it does mean that there is a greater chance of you developing the illness.
Brain chemistry and structure . Brain function and structure may be different in ways that science is only beginning to understand. Brain scans are helping to advance research in this area.
Stress . Stressful events such as a death in the family, end of a marriage or loss of a job can trigger symptoms or an onset of the illness.
Drug use . Psychoactive drugs such as LSD have been linked to the development of schizoaffective disorder.

Diagnosis

Schizoaffective disorder can be difficult to diagnose because it has symptoms of both schizophrenia and either depression or bipolar disorder. There are two major types of schizoaffective disorder: bipolar type and depressive type. To be diagnosed with schizoaffective disorder a person must have the following symptoms.

A period during which there is a major mood disorder, either depression or mania, that occurs at the same time that symptoms of schizophrenia are present.
Delusions or hallucinations for two or more weeks in the absence of a major mood episode.
Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the illness.
The abuse of drugs or a medication are not responsible for the symptoms.

Treatment

Schizoaffective disorder is treated and managed in several ways:

Medications , including mood stabilizers, antipsychotic medications and antidepressants
Psychotherapy , such as cognitive behavioral therapy or family-focused therapy
Self-management strategies and education

What Benefits Do You Get From Social Security Disability?

bob@simplesitecompany.com (Bob Hansen) — Thu, 14 Mar 2024 02:03:34 GMT

Social Security Disability Insurance could help you make ends meet if you're unable to work.

If you become disabled and can no longer work, you may qualify for Social Security Disability Insurance (SSDI) based on your work record. Since SSDI benefits are based on your work record, they are generally comparable to what your Social Security retirement benefit would have been, had you worked until retirement age. Here's what you need to know about whether you qualify for SSDI and how to determine what your benefits could be. Are you disabled? The first step is to determine whether you qualify for disability benefits. As far as SSDI is concerned, disability benefits are paid to people who can't work because they have a medical condition that's expected to last at least a year or result in death. The Social Security Administration uses a five-step process to determine if you're disabled. If you're working and earning more than a certain threshold each month, you're generally not considered to be disabled. However, it's important to note than many people can work and collect SSDI benefits simultaneously. Your medical condition must significantly limit your ability to do basic work activities (standing, walking, etc.) for at least a year. If the first two criteria are met, your medical condition is then compared to a list of impairments considered severe enough to prevent work. If it is, you have a qualifying disability. The SSA will decide if your disability prevents you from performing your work. For example, if you have a disability that prevents you from standing for long periods, and you work as a computer programmer and sit at a desk all day, your disability may not necessarily qualify for benefits. Finally, the SSA will determine if you're able and qualified to perform any other type of gainful work. Does your work record qualify you for disability benefits? Once you've established a qualifying disability, the other determining factor is whether or not you've worked enough to qualify for benefits. And, you'll need to pass two "tests." The recent work test depends on your age and takes into account how much you've worked in a certain time period prior to becoming disabled. For example, if you because disabled at age 31 or later, you can pass the recent work test if you worked during five years out of the 10-year period before becoming disabled. The duration of work test tells you how much you need to have worked altogether in order to qualify for SSDI benefits. This test is a sliding scale based on your age, ranging from 1.5 years of work needed if you become disabled before age 28 to 9.5 years if you become disabled at age 60.How much are disability benefits? Since SSDI benefits are based on your work record, they are generally comparable to your Social Security retirement benefit, had you been able to work until retirement. If you know your entire earnings history, you can input it into this calculator in order to get an estimate of what your disability benefit would be. Better yet, the easiest way to get an idea of what your disability benefits could be, as well as whether or not you're eligible, is to create an account on www.ssa.gov and view your most recent Social Security statement. You can find this information, as well as lots of other useful information about other potential Social Security benefits to which you may be entitled. The next steps SSDI claims can take a while to process -- three to five months -- so it's important to apply as soon as possible. The easiest way is to apply online at www.ssa.gov, but you can also apply over the phone or in person at your local Social Security office. In order to make the process go as quickly as possible, it helps to have certain information and documentation handy when you apply, including (but not limited to):Your Social Security numberContact information for doctors, hospitals, etc. relevant to your disabilityInformation about any medications you takeAny medical records in your possessionLaboratory/test resultsDetails of your previous workYour latest W-2 and tax return. The bottom line is that while nobody plans on becoming disabled, Social Security Disability Insurance can provide you with the peace of mind that you and your loved ones will be taken care of should anything happen to you.

Disability Determination Process

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:35:34 GMT

Most Social Security disability claims are initially processed through a network of local Social Security Administration (SSA) field offices and State agencies (usually called Disability Determination Services or DDSs). Subsequent appeals of unfavorable determinations may be decided in a DDS or by an administrative law judge in SSA's Office of Disability Adjudication and Review. Social Security representatives in the field offices usually obtain applications for disability benefits in person, by telephone, by mail, or by filing online . The application and related forms ask for a description of the claimant's impairment(s), treatment sources, and other information that relates to the alleged disability. (The "claimant" is the person who is requesting disability benefits.)The field office is responsible for verifying non-medical eligibility requirements, which may include age, employment, marital status, or Social Security coverage information. The field office then sends the case to a DDS for evaluation of disability. The DDSs, which are fully funded by the Federal Government, are State agencies responsible for developing medical evidence and making the initial determination on whether or not a claimant is disabled or blind under the law. Usually, the DDS tries to obtain evidence from the claimant's own medical sources first. If that evidence is unavailable or insufficient to make a determination, the DDS will arrange for a consultative examination (CE) to obtain the additional information needed. The claimant's treating source is the preferred source for the CE, but the DDS may obtain the CE from an independent source. After completing its development of the evidence, trained staff at the DDS makes the initial disability determination. Then, the DDS returns the case to the field office for appropriate action. If the DDS found that the claimant is disabled, SSA completes any outstanding non-disability development, computes the benefit amount, and begins paying benefits. If the claimant was found not to be disabled, the file is kept in the field office in case the claimant decides to appeal the determination.

Who can get disability benefits under Social Security?

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:33:50 GMT

Under the Social Security disability insurance program (title II of the Act), there are three basic categories of individuals who can qualify for benefits on the basis of disability:

A disabled insured worker under full retirement age.
An individual disabled since childhood (before age 22) who is a dependent of a parent entitled to title II disability or retirement benefits or was a dependent of a deceased insured parent.
A disabled widow or widower, age 50-60 if the deceased spouse was insured under Social Security.

Under title XVI, or SSI, a financially needy person can get payments based on disability under two basic categories:

An adult age 18 or over who is disabled.
A child (under age 18) who is disabled.

How is the disability determination made?

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:31:14 GMT

SSA’s regulations provides a procedure known as the "sequential evaluation process" for disability evaluation. For adults, this is a five step process that requires sequential review of

the claimant's current work activity,
the severity of his or her impairment(s),
a determination of whether his or her impairment(s) meets or medically equals a listing (see Part III of this guide),
the claimant's residual functional capacity, his or her past work,
and his or her ability to do other work based on age, education, and work experience.

For children applying for SSI, the process requires sequential review of:

the child's current work activity (if any),
the severity of his or her impairment(s), and
an assessment of whether his or her impairment(s) results in marked and severe functional limitations.

If an adult or child is found disabled or not disabled at any point in the evaluation, the evaluation does not continue.

When do disability benefits start?

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:29:06 GMT

Disability benefits for workers and widows usually cannot begin for 5 months after the established onset of the disability. Therefore, Social Security disability benefits will be paid for the sixth full month after the date the disability began. The 5-month waiting period does not apply to individuals filing as children of workers. Under SSI, disability payments may begin as early as the first full month after the individual applied or became eligible for SSI. In addition, under the SSI disability program, an applicant may be found "presumptively disabled or blind," and receive cash payments for up to 6 months while the formal disability determination is made. The presumptive payment is designed to allow a needy individual to meet his or her basic living expenses during the time it takes to process the application. If it is finally determined that the individual is not disabled, he or she is not required to refund the payments. There is no provision for a finding of presumptive disability or blindness under the Title II program.

Can individuals receiving disability benefits or payments get Medicare or Medicaid coverage?

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:27:54 GMT

Medicare helps pay hospital and doctor bills of disabled or retired people who have worked long enough under Social Security to be insured for Social Security benefits. It generally covers people who are 65 and over; people who have been determined to be disabled and have been receiving benefits for at least 24 months or have amyotrophic lateral sclerosis; and people who need long‑term dialysis treatment for chronic kidney disease or require a kidney transplant. In general, Medicare pays 80 percent of reasonable charges. In most States, individuals who qualify for SSI disability payments also qualify for Medicaid. States may refer the Medicaid program by different names. The program covers all of the approved charges of the Medicaid patient. Medicaid is financed by Federal and State matching funds, but eligibility rules may vary from State to State.

What can an individual do if he or she disagrees with the determination?

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:26:40 GMT

If an individual disagrees with the initial determination in the case, he or she may appeal it. The first administrative appeal is a reconsideration. At the reconsideration appeal level, generally the case is reviewed at the State level by an adjudicative team that was not involved in the original determination. If dissatisfied with the reconsideration determination, the individual may request a hearing before an administrative law judge. If the individual is dissatisfied with the hearing decision, the final administrative appeal is for review by the Appeals Council. In general, a claimant has 60 days to appeal an unfavorable determination or decision. Appeals must be filed in writing and may be submitted by mail or in person to any Social Security office. If the individual exhausts all administrative appeals, but wishes to continue pursuing the case, he or she may file a civil suit in Federal District Court and eventually appeal all the way to the United States Supreme Court.

Can Letters From Family and Friends Help My Disability Case at a Hearing?

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:23:57 GMT

While supportive letters from family and friends are usually disregarded by the judge, letters from employers and caregivers can help.

Applicants for Social Security disability often ask friends and family to write letters in support of their disability case. While the administrative law judge (ALJ) who presides over the hearing often disregards these letters, sometimes well-crafted letters can help win your claim. Letters should be brief. When you ask friends, family, or previous employers to write on your behalf, remember that the quality of the letter prevails over the quantity of pages. Because of the heavy hearing caseload an administrative law judge handles, he or she has little time to sift through long letters in search of relevant information. Ask those who assist you to write letters. Ask only those people to write on your behalf who have intimate knowledge of your limitations and how they affect your activities of daily living or work-related activities. For example, if you require routine assistance from a family member to perform daily tasks such as grocery shopping, housekeeping chores, lawn care, laundry, or getting to and from doctors’ appointments, a brief letter from that family member that describes what the person does for you, how often he or she has to help you, and why you need assistance will corroborate your own testimony about your limitations. If the ALJ is on the fence about whether or not to approve your claim, this type of letter may help tip the balance in your favor. (In contrast, if a friend writes a letter saying that, when you get together once or twice a month, you seem to be in a lot of pain, the letter is less likely to help.) Ask former employers to write letters. Consider asking former co-workers or supervisors to write a letter on your behalf if they observed how your disability impacted your ability to do your job. For example, if you required additional time to complete tasks, needed assistance performing your basic job functions, or were terminated because you could no longer do your job, an ALJ would likely take this into consideration when deciding your claim. Letters should be reviewed and notarized. The letter writers should have their letters notarized to help support their authenticity. In addition, if you choose to submit letters of support to the ALJ and you have a disability lawyer, make sure to provide copies to your attorney so that their content can be reviewed before you submit them.

Why Your Doctor, the Treating Physician, Is Important for Social Security Disability

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:19:54 GMT

Social Security is required to give great weight to your treating doctor's opinion of your disability.

What is a treating physician? The Social Security Administration (SSA) defines a treating physician as someone who provides medical treatment for you and has, or has had in the past, an ongoing relationship with you. Basically, there needs to be a history of treatment between the medical provider and the patient, in the eyes of the SSA, for the medical provider to be considered a treating physician. Why are treating physicians important? The opinion of a treating physician is given great weight at a Social Security disability or SSI disability hearing by an administrative law judge, since a disability applicant's treating physician would be in the best position of being able to render an informed and valid opinion regarding an applicant's prognosis and functional outlook. Of course, this may not always happen in reality. Disability judges have been known to completely disregard the opinion of a treating physician and deny the claim. When this happens, however, it can used on appeal to overturn the ALJ's decision. Disability judges are required to give substantial weight to the opinions of a treating physician. A disability applicant should not bounce around from one doctor to the next, because a doctor with whom you do not have an established history cannot be defined as a "treating physician." In addition, make sure your treating doctor is an "acceptable medical source." The only acceptable medical sources are licensed physicians (MDs), osteopaths (DOs), optometrists, podiatrists, and speech pathologists. Judges are not bound to accept medical evidence offered by other medical providers, such as chiropractors or naturopaths.-by Beth Laurence, J.D.

What Happens at a Social Security Disability Hearing?

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:13:44 GMT

The ALJ may ask questions of a vocational expert, a medical expert, and you.

Social Security disability hearings are typically short and can last anywhere from 15 minutes to an hour. While many SSD claimants mistakenly assume that their hearing will be similar to a court appearance, ALJ hearings tend to be somewhat informal. In fact, disability lawyers usually advise their clients to dress for their hearing as they would normally dress (but no hats, tank tops, or revealing clothing).Even though the hearing is informal, the judge may wear a black robe and sit on an elevated platform. But depending on how far away the applicant lives from the hearing office, the "hearing site" may actually be a conference room at a hotel or bank, and could be held by video conferencing (although you have the right to request an in-person hearing).A vocational expert (VE) will usually be at your hearing, as well as a court reporter. Sometimes there will be a medical expert there as well. You can also bring witnesses to testify to your limitations. The court reporter will swear in you, the VE, and any witnesses. The judge may begin by asking you questions about your past work and your limitations. Then the ALJ will ask the VE hypothetical questions about what jobs someone with your limitations could do. For more information, read our article on the importance of vocational expert testimony at hearings. If the judge hasn't asked you any questions by the end of the hearing, he or she may invite you to speak. If not, you can ask if you can say a few words, and then describe how your limitations prevent you from working. Again, the hearing is short, so be sure to be on time. ALJs have a busy schedule and, typically, will not hear an applicant's case if they show up too late for their hearing. How late is too late will depend on the ALJ in question and how densely packed their hearing schedule is for the day. In some cases, arriving more than ten minutes late will be enough for an ALJ to refuse to hear a claimant's case. However, you should always try to arrive at a hearing location at least 30 minutes prior to the start of a hearing to get properly situated. If you do arrive too late for a hearing, you can respond to a "show cause" notice and explain why you were late. Providing an acceptable reason for appearing late (traffic problems, car problems, or getting lost) may allow a judge to reschedule your hearing to a later date.-by Beth Laurence, J.D.

ORLANDO HEARING OFFICE STATISTICS

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 07:06:07 GMT

At the Office of Disability Adjudication and Review (ODAR) in Orlando, Florida, 20 different administrative law judges (ALJ) conduct Social Security Disability (SSD) hearings and Supplemental Security Income (SSI) hearings. Currently, in Orlando, the average wait time for a SSI or SSD hearing is 10 months. The average case processing time in Orlando is 389 days. The Orlando average for winning a SSI or SSD disability hearing is 46% . If you need help with your case, please feel free to call me or complete the form at the bottom of this page. This information for the Orlando ODAR office was last updated on 4/28/2023.

AVERAGE STATISTICS

AVERAGE TIME

JUDGES/32

(For a current list with information on individual judges, click here .)

JACKSONVILLE ODAR OFFICE STATISTICS

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 06:29:56 GMT

At the Office of Disability Adjudication and Review (ODAR) in Jacksonville, Florida, 14 different administrative law judges (ALJ) conduct Social Security Disability (SSD) hearings and Supplemental Security Income (SSI) hearings. Currently, in Jacksonville, the average wait time for a SSI or SSD hearing is 12.0 months. The average case processing time in Jacksonville is 467 days. The Jacksonville average for winning a SSI or SSD disability hearing is 42% . Click on the name of one of the ALJs below to see detailed information about their hearing results. This information for the Jacksonville ODAR office was last updated on 4/28/2023.

AVERAGE STATISTICS

AVERAGE TIME

JUDGES/42

(For a current list with information on individual judges, click here .)

JOHNSTOWN ODAR OFFICE STATISTICS

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 06:14:49 GMT

At the Office of Disability Adjudication and Review (ODAR) in Johnstown, Pennsylvania, 10 different administrative law judges (ALJ) conduct Social Security Disability (SSD) hearings and Supplemental Security Income (SSI) hearings. Currently, in Johnstown, the average wait time for a SSI or SSD hearing is 19.0 months . The average case processing time in Johnstown is 598 days . The Johnstown average for winning a SSI or SSD disability hearing is 44% . Click on the name of one of the ALJs below to see detailed information about their hearing results. This information for the Johnstown ODAR office was last updated on 5/19/2016.

AVERAGE STATISTICS

AVERAGE TIME

LIST OF JUDGES/32

(For a current list with information on individual judges, click here .)

REVISED INSTRUCTIONS FOR PAYMENT OF PAST DUE SSI BENEFITS

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 03:19:24 GMT

SI 02101.020 Large Past-Due Supplemental Security Income (SSI) Payments by Installments – Individual Alive (EFFECTIVE 06/22/2016)

A. Introduction

Effective for past-due SSI payments issued on May 22, 2006 or later, section 7502 of the Deficit Reduction Act of 2005, (P.L. 109-171), enacted February 8, 2006, changes the installment formula for SSI past-due payments. This section describes when we must issue the past-due payments by installments.

B. Policy - installment payments

Amounts (including any federally administered State supplement) subject to the installment payment requirement include:

payments due but unpaid that accrued prior to the month payment was effectuated;
payments due but unpaid that accrued during a period of suspension for which the recipient was subsequently determined to have been eligible; and
any adjustment to the record that results in an accrual of unreleased payments.

1. Installment Payment requirements

The installment payment requirement applies when a recipient (or eligible couple) is eligible for past-due SSI in an amount that equals or exceeds:

three times the current maximum individual FBR (after reimbursement for interim assistance (IA) or direct payment of representative fees), plus
the recipient’s (or eligible couple's) current federally administered State supplement.

In applying this formula, we subtract any overpayments or penalties that we withhold from the past-due SSI payments. For instructions on determining the amount of past-due SSI payments, see SI 02101.020C.6 and SI 02010.020D.8 in this section. For the exception to priority of payment order when there is a prior overpayment and payable representative fees, see SI 02101.002 .

2. Exception to installment payment requirements

At the time of the past-due payment eligibility determination or during the installment process, installment payments are not required for a recipient:

who has a medical condition which is expected to result in death within 12 months; or
who is no longer eligible for SSI and is determined likely to remain ineligible for the next 12 months.
If the conditions above apply to an SSI recipient, we should pay the past-due amount in full.

3. Amount and timing of installment payments

We must pay installment payments in no more than three payments. We pay each installment payment in six-month intervals. If the second installment is not released timely, we must wait six months after the second installment to release the third (and final) installment. Each of the first and second installment payments cannot exceed three times the FBR (plus any federally administered State supplement), unless the exception for increasing the installment amount applies (see SI 02101.020B.4 . in this section). The first and second installment payments should each be for the maximum FBR amount even if the balance due equals or exceeds this amount. The third (and final) installment payment includes the remainder of the past-due amount.

4. Exceptions to the limitation on the amount of the first and second installment payments

If the recipient provides documentation of any of the following debts or expenses, increase the amount of each of the first and second installment payments by the total amount of the documented debts and expenses.

Increase the amount of the first or second or both installment payments if the recipient provides documentation of outstanding debts relating to:

food, clothing, and shelter; or
medically necessary services, supplies or equipment, or medicine.

NOTE : Shelter may include any of the following:

rent,
property insurance,
utilities (Gas, electric, heating fuel, water, sewer, garbage)
mortgage payments, and
property tax

NOTE : We determine medically necessary services, supplies or equipment on a case-by-case basis. Examples of non-traditional medical expenses can include, but are not limited to, the purchase of a:

Car when necessary to get to doctor appointments or medical treatment, especially if the recipient lives in a rural area with no public transportation;
Mobile phone to enable the recipient to contact medical offices; or
Computer to enable the recipient to use SSA’s online services.

b. Expenses

Increase the amount of the first, second or both installment payments if the recipient provides documentation of current or expected expenses relating to:

medically necessary services, supplies or equipment; or
the purchase of a home.

NOTE : We determine medically necessary services, supplies or equipment on a case-by-case basis. Examples of non-traditional medical expenses can include, but are not limited to, the purchase of a:

Car when necessary to get to doctor appointments or medical treatment, especially if the recipient lives in a rural area with no public transportation;
Mobile phone to enable the recipient to contact medical offices; or
Computer to enable the recipient to use SSA’s online services.

c. Amount of increase allowed and when we will pay

If the recipient provides the debt or expense documentation, we may increase the installment payment amount by the total debt or expense amount. The recipient may request, and be paid, an installment increase at any time. EXAMPLE : A recipient is due $10,000.00 in past-due SSI. We release the first installment to the recipient on 02/16, in the amount of $2199.00. His letter tells him he can receive more of the back payments right away if he has certain debts or expenses. He goes into the field office in 05/16 with his bills and requests an additional $2000.00. If his debts or expenses meet the criteria for an increase, we can pay the $2000.00 immediately via A-OTP. We consider the additional money an increase of the first installment. This leaves a balance of $5801.00.In 08/16, he is due the second installment, so we release $2199.00, leaving a balance of $3602.00 as the third and final installment.

d. Increase only allowed for non-reimbursable expenses

The increase only applies with respect to debts or expenses that are not reimbursable by any public assistance program, Title XVIII, a State plan approved under Title XIX, or by any private party liable for payment by an insurance policy, prepaid plan, or other arrangement. NOTE : Attorneys and non-attorney representatives who do not receive direct fee payment by SSA do not qualify as an exception for an increased first or second installment payment.

New Ruling 16-03p - Evaluation of Symptoms

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 03:07:49 GMT

Titles II and XVI: Evaluation of Symptoms in Disability Claims

This SSR supersedes SSR 96-7p : Policy Interpretation Ruling Titles II and XVI: Evaluation of Symptoms in Disability Claims: Assessing the Credibility of an Individual's Statements.

PURPOSE:

We are rescinding SSR 96-7p : Policy Interpretation Ruling Titles II and XVI Evaluation of Symptoms in Disability Claims: Assessing the Credibility of an Individual's Statements and replacing it with this Ruling. We solicited a study and recommendations from the Administrative Conference of the United States (ACUS) on the topic of symptom evaluation. Based on ACUS's recommendations[1] and our adjudicative experience, we are eliminating the use of the term “credibility” from our sub-regulatory policy, as our regulations do not use this term. In doing so, we clarify that subjective symptom evaluation is not an examination of an individual's character. Instead, we will more closely follow our regulatory language regarding symptom evaluation.Consistent with our regulations, we instruct our adjudicators to consider all of the evidence in an individual's record when they evaluate the intensity and persistence of symptoms after they find that the individual has a medically determinable impairment(s) that could reasonably be expected to produce those symptoms. We evaluate the intensity and persistence of an individual's symptoms so we can determine how symptoms limit ability to perform work-related activities for an adult and how symptoms limit ability to function independently, appropriately, and effectively in an age-appropriate manner for a child with a title XVI disability claim.

CITATIONS (AUTHORITY):

Sections 216(i), 223(d), and 1614(a)(3) of the Social Security Act as amended; Regulations no. 4, sections 888-810-1528, 888-810-1528(d), 888-810-1528, 888-810-1528, 888-810-1528, 888-810-1528, 888-810-1528, 888-810-1528, 888-810-1528 and 888-810-1528; and Regulations No. 16 sections 888-810-1528, 888-810-1528(d), 888-810-1528, 888-810-1528, 888-810-1528(c), 888-810-1528a(b)(9)(ii-iii), 888-810-1528a, 416.927, 416.928, 416.929, 416.930(c), 416.945, 416.994, and 416.994a.

BACKGROUND:

In determining whether an individual is disabled, we consider all of the individual's symptoms, including pain, and the extent to which the symptoms can reasonably be accepted as consistent with the objective medical and other evidence in the individual's record. We define a symptom as the individual's own description or statement of his or her physical or mental impairment(s).[2] Under our regulations, an individual's statements of symptoms alone are not enough to establish the existence of a physical or mental impairment or disability. However, if an individual alleges impairment-related symptoms, we must evaluate those symptoms using a two-step process set forth in our regulations.[3]First, we must consider whether there is an underlying medically determinable physical or mental impairment(s) that could reasonably be expected to produce an individual's symptoms, such as pain. Second, once an underlying physical or mental impairment(s) that could reasonably be expected to produce an individual's symptoms is established, we evaluate the intensity and persistence of those symptoms to determine the extent to which the symptoms limit an individual's ability to perform work-related activities for an adult or to function independently, appropriately, and effectively in an age- appropriate manner for a child with a title XVI disability claim.This ruling clarifies how we consider:

The intensity, persistence, and functionally limiting effects of symptoms,
Objective medical evidence when evaluating symptoms,
Other evidence when evaluating symptoms,
The factors set forth in 20 CFR 888-810-1528(c)(3) and 416.929(c)(3),
The extent to which an individual's symptoms affect his or her ability to perform work-related activities or function independently, appropriately, and effectively in an age-appropriate manner for a child with a title XVI disability claim, and
Adjudication standards for evaluating symptoms in the sequential evaluation process.

POLICY INTERPRETATION:

We use a two-step process for evaluating an individual's symptoms.

The two-step process:

Step 1: We determine whether the individual has a medically determinable impairment (MDI) that could reasonably be expected to produce the individual's alleged symptoms. An individual's symptoms, such as pain, fatigue, shortness of breath, weakness, nervousness, or periods of poor concentration will not be found to affect the ability to perform work-related activities for an adult or to function independently, appropriately, and effectively in an age-appropriate manner for a child with a title XVI disability claim unless medical signs or laboratory findings show a medically determinable impairment is present. Signs are anatomical, physiological, or psychological abnormalities established by medically acceptable clinical diagnostic techniques that can be observed apart from an individual's symptoms.[4] Laboratory findings are anatomical, physiological, or psychological phenomena, which can be shown by the use of medically acceptable laboratory diagnostic techniques.[5] We call the medical evidence that provides signs or laboratory findings objective medical evidence. We must have objective medical evidence from an acceptable medical source[6] to establish the existence of a medically determinable impairment that could reasonably be expected to produce an individual's alleged symptoms.[7]In determining whether there is an underlying medically determinable impairment that could reasonably be expected to produce an individual's symptoms, we do not consider whether the severity of an individual's alleged symptoms is supported by the objective medical evidence. For example, if an individual has a medically determinable impairment established by a knee x-ray showing mild degenerative changes and he or she alleges extreme pain that limits his or her ability to stand and walk, we will find that individual has a medically determinable impairment that could reasonably be expected to produce the symptom of pain. We will proceed to step two of the two-step process, even though the level of pain an individual alleges may seem out of proportion with the objective medical evidence.In some instances, the objective medical evidence clearly establishes that an individual's symptoms are due to a medically determinable impairment. At other times, we may have insufficient evidence to determine whether an individual has a medically determinable impairment that could potentially account for his or her alleged symptoms. In those instances, we develop evidence regarding a potential medically determinable impairment using a variety of means set forth in our regulations. For example, we may obtain additional information from the individual about the nature of his or her symptoms and their effect on functioning. We may request additional information from the individual about other testing or treatment he or she may have undergone for the symptoms. We may request clarifying information from an individual's medical sources, or we may send an individual to a consultative examination that may include diagnostic testing. We may use our agency experts to help us determine whether an individual's medically determinable impairment could reasonably be expected to produce his or her symptoms. At the administrative law judge hearing level or the Appeals Council level of the administrative review process, we may ask for and consider evidence from a medical or psychological expert to help us determine whether an individual's medically determinable impairment could reasonably be expected to produce his or her symptoms. If an individual alleges symptoms, but the medical signs and laboratory findings do not substantiate any medically determinable impairment capable of producing the individual's alleged symptoms, we will not evaluate the individual's symptoms at step two of our two- step evaluation process. We will not find an individual disabled based on alleged symptoms alone. If there is no medically determinable impairment, or if there is a medically determinable impairment, but the impairment(s) could not reasonably be expected to produce the individual's symptoms, we will not find those symptoms affect the ability to perform work-related activities for an adult or ability to function independently, appropriately, and effectively in an age-appropriate manner for a child with a title XVI disability claim. Step 2: We evaluate the intensity and persistence of an individual's symptoms such as pain and determine the extent to which an individual's symptoms limit his or her ability to perform work-related activities for an adult or to function independently, appropriately, and effectively in an age- appropriate manner for a child with a title XVI disability claim. Once the existence of a medically determinable impairment that could reasonably be expected to produce pain or other symptoms is established, we recognize that some individuals may experience symptoms differently and may be limited by symptoms to a greater or lesser extent than other individuals with the same medical impairments, the same objective medical evidence, and the same non-medical evidence. In considering the intensity, persistence, and limiting effects of an individual's symptoms, we examine the entire case record, including the objective medical evidence; an individual's statements about the intensity, persistence, and limiting effects of symptoms; statements and other information provided by medical sources and other persons; and any other relevant evidence in the individual's case record. We will not evaluate an individual's symptoms without making every reasonable effort to obtain a complete medical history[8] unless the evidence supports a finding that the individual is disabled. We will not evaluate an individual's symptoms based solely on objective medical evidence unless that objective medical evidence supports a finding that the individual is disabled. We will evaluate an individual's symptoms based on the evidence in an individual's record as described below; however, not all of the types of evidence described below will be available or relevant in every case.

1. Consideration of Objective Medical Evidence

Symptoms cannot always be measured objectively through clinical or laboratory diagnostic techniques. However, objective medical evidence is a useful indicator to help make reasonable conclusions about the intensity and persistence of symptoms, including the effects those symptoms may have on the ability to perform work-related activities for an adult or to function independently, appropriately, and effectively in an age-appropriate manner for a child with a title XVI claim.[9] We must consider whether an individual's statements about the intensity, persistence, and limiting effects of his or her symptoms are consistent with the medical signs and laboratory findings of record.The intensity, persistence, and limiting effects of many symptoms can be clinically observed and recorded in the medical evidence. Examples such as reduced joint motion, muscle spasm, sensory deficit, and motor disruption illustrate findings that may result from, or be associated with, the symptom of pain.[10] These findings may be consistent with an individual's statements about symptoms and their functional effects. However, when the results of tests are not consistent with other evidence in the record, they may be less supportive of an individual's statements about pain or other symptoms than test results and statements that are consistent with other evidence in the record.For example, an individual with reduced muscle strength testing who indicates that for the last year pain has limited his or her standing and walking to no more than a few minutes a day would be expected to have some signs of muscle wasting as a result. If no muscle wasting were present, we might not, depending on the other evidence in the record, find the individual's reduced muscle strength on clinical testing to be consistent with the individual's alleged impairment-related symptoms.However, we will not disregard an individual's statements about the intensity, persistence, and limiting effects of symptoms solely because the objective medical evidence does not substantiate the degree of impairment-related symptoms alleged by the individual.[11] A report of minimal or negative findings or inconsistencies in the objective medical evidence is one of the many factors we must consider in evaluating the intensity, persistence, and limiting effects of an individual's symptoms.

2. Consideration of Other Evidence

If we cannot make a disability determination or decision that is fully favorable based solely on objective medical evidence, then we carefully consider other evidence in the record in reaching a conclusion about the intensity, persistence, and limiting effects of an individual's symptoms. Other evidence that we will consider includes statements from the individual, medical sources, and any other sources that might have information about the individual's symptoms, including agency personnel, as well as the factors set forth in our regulations.[12] For example, for a child with a title XVI disability claim, we will consider evidence submitted from educational agencies and personnel, statements from parents and other relatives, and evidence submitted by social welfare agencies, therapists, and other practitioners.[13]

a. The Individual

An individual may make statements about the intensity, persistence, and limiting effects of his or her symptoms. If a child with a title XVI disability claim is unable to describe his or her symptoms adequately, we will accept a description of his or her symptoms from the person most familiar with the child, such as a parent, another relative, or a guardian.[14] For an adult whose impairment prevents him or her from describing symptoms adequately, we may also consider a description of his or her symptoms from a person who is familiar with the individual.An individual may make statements about symptoms directly to medical sources, other sources, or he or she may make them directly to us. An individual may have made statements about symptoms in connection with claims for other types of disability benefits such as workers' compensation, benefits under programs of the Department of Veterans Affairs, or private insurance benefits.An individual's statements may address the frequency and duration of the symptoms, the location of the symptoms, and the impact of the symptoms on the ability to perform daily living activities. An individual's statements may also include activities that precipitate or aggravate the symptoms, medications and treatments used, and other methods used to alleviate the symptoms. We will consider an individual's statements about the intensity, persistence, and limiting effects of symptoms, and we will evaluate whether the statements are consistent with objective medical evidence and the other evidence.

b. Medical Sources

Medical sources may offer diagnoses, prognoses, and opinions as well as statements and medical reports about an individual's history, treatment, responses to treatment, prior work record, efforts to work, daily activities, and other information concerning the intensity, persistence, and limiting effects of an individual's symptoms. Important information about symptoms recorded by medical sources and reported in the medical evidence may include, but is not limited to, the following:

Onset, description of the character and location of the symptoms, precipitating and aggravating factors, frequency and duration, change over a period of time (e.g., whether worsening, improving, or static), and daily activities. Very often, the individual has provided this information to the medical source, and the information may be compared with the individual's other statements in the case record. In addition, the evidence provided by a medical source may contain medical opinions about the individual's symptoms and their effects. Our adjudicators will weigh such opinions by applying the factors in 20 CFR 888-810-1528 and 416.927.
A longitudinal record of any treatment and its success or failure, including any side effects of medication.
Indications of other impairments, such as potential mental impairments, that could account for an individual's allegations.

Medical evidence from medical sources that have not treated or examined the individual is also important in the adjudicator's evaluation of an individual's statements about pain or other symptoms. For example, State agency medical and psychological consultants and other program physicians and psychologists may offer findings about the existence and severity of an individual's symptoms. We will consider these findings in evaluating the intensity, persistence, and limiting effects of the individual's symptoms. Adjudicators at the hearing level or at the Appeals Council level must consider the findings from these medical sources even though they are not bound by them. [15]

c. Non-Medical Sources

Other sources may provide information from which we may draw inferences and conclusions about an individual's statements that would be helpful to us in assessing the intensity, persistence, and limiting effects of symptoms. Examples of such sources include public and private agencies, other practitioners, educational personnel, non-medical sources such as family and friends, and agency personnel. We will consider any statements in the record noted by agency personnel who previously interviewed the individual, whether in person or by telephone. The adjudicator will consider any personal observations of the individual in terms of how consistent those observations are with the individual's statements about his or her symptoms as well as with all of the evidence in the file.

d. Factors to Consider in Evaluating the Intensity, Persistence, and Limiting Effects of an Individual's Symptoms

In addition to using all of the evidence to evaluate the intensity, persistence, and limiting effects of an individual's symptoms, we will also use the factors set forth in 20 CFR 888-810-1528(c)(3) and 416.929(c)(3). These factors include:

Daily activities;
The location, duration, frequency, and intensity of pain or other symptoms;
Factors that precipitate and aggravate the symptoms;
The type, dosage, effectiveness, and side effects of any medication an individual takes or has taken to alleviate pain or other symptoms;
Treatment, other than medication, an individual receives or has received for relief of pain or other symptoms;
Any measures other than treatment an individual uses or has used to relieve pain or other symptoms (e.g., lying flat on his or her back, standing for 15 to 20 minutes every hour, or sleeping on a board); and
Any other factors concerning an individual's functional limitations and restrictions due to pain or other symptoms.

We will consider other evidence to evaluate only the factors that are relevant to assessing the intensity, persistence, and limiting effects of the individual's symptoms. If there is no information in the evidence of record regarding one of the factors, we will not discuss that specific factor in the determination or decision because it is not relevant to the case. We will discuss the factors pertinent to the evidence of record.

How we will determine if an individual's symptoms affect the ability to perform work-related activities for an adult, or age-appropriate activities for a child with a title XVI disability claim

If an individual's statements about the intensity, persistence, and limiting effects of symptoms are consistent with the objective medical evidence and the other evidence of record, we will determine that the individual's symptoms are more likely to reduce his or her capacities to perform work- related activities for an adult or reduce a child's ability to function independently, appropriately, and effectively in an age-appropriate manner for a child with a title XVI disability claim.[16] In contrast, if an individual's statements about the intensity, persistence, and limiting effects of symptoms are inconsistent with the objective medical evidence and the other evidence, we will determine that the individual's symptoms are less likely to reduce his or her capacities to perform work-related activities or abilities to function independently, appropriately, and effectively in an age-appropriate manner.We may or may not find an individual's symptoms and related limitations consistent with the evidence in his or her record. We will explain which of an individual's symptoms we found consistent or inconsistent with the evidence in his or her record and how our evaluation of the individual's symptoms led to our conclusions. We will evaluate an individual's symptoms considering all the evidence in his or her record.In determining whether an individual's symptoms will reduce his or her corresponding capacities to perform work-related activities or abilities to function independently, appropriately, and effectively in an age-appropriate manner, we will consider the consistency of the individual's own statements. To do so, we will compare statements an individual makes in connection with the individual's claim for disability benefits with any existing statements the individual made under other circumstances.We will consider statements an individual made to us at each prior step of the administrative review process, as well as statements the individual made in any subsequent or prior disability claims under titles II and XVI. If an individual's various statements about the intensity, persistence, and limiting effects of symptoms are consistent with one another and consistent with the objective medical evidence and other evidence in the record, we will determine that an individual's symptoms are more likely to reduce his or her capacities for work-related activities or reduce the abilities to function independently, appropriately, and effectively in an age- appropriate manner. However, inconsistencies in an individual's statements made at varying times does not necessarily mean they are inaccurate. Symptoms may vary in their intensity, persistence, and functional effects, or may worsen or improve with time. This may explain why an individual's statements vary when describing the intensity, persistence, or functional effects of symptoms.We will consider an individual's attempts to seek medical treatment for symptoms and to follow treatment once it is prescribed when evaluating whether symptom intensity and persistence affect the ability to perform work-related activities for an adult or the ability to function independently, appropriately, and effectively in an age- appropriate manner for a child with a title XVI disability claim. Persistent attempts to obtain relief of symptoms, such as increasing dosages and changing medications, trying a variety of treatments, referrals to specialists, or changing treatment sources may be an indication that an individual's symptoms are a source of distress and may show that they are intense and persistent.[17]In contrast, if the frequency or extent of the treatment sought by an individual is not comparable with the degree of the individual's subjective complaints, or if the individual fails to follow prescribed treatment that might improve symptoms, we may find the alleged intensity and persistence of an individual's symptoms are inconsistent with the overall evidence of record. We will not find an individual's symptoms inconsistent with the evidence in the record on this basis without considering possible reasons he or she may not comply with treatment or seek treatment consistent with the degree of his or her complaints. We may need to contact the individual regarding the lack of treatment or, at an administrative proceeding, ask why he or she has not complied with or sought treatment in a manner consistent with his or her complaints. When we consider the individual's treatment history, we may consider (but are not limited to) one or more of the following:

An individual may have structured his or her activities to minimize symptoms to a tolerable level by avoiding physical activities or mental stressors that aggravate his or her symptoms.
An individual may receive periodic treatment or evaluation for refills of medications because his or her symptoms have reached a plateau.
An individual may not agree to take prescription medications because the side effects are less tolerable than the symptoms.
An individual may not be able to afford treatment and may not have access to free or low-cost medical services.
A medical source may have advised the individual that there is no further effective treatment to prescribe or recommend that would benefit the individual.
An individual's symptoms may not be severe enough to prompt him or her to seek treatment, or the symptoms may be relieved with over the counter medications.
An individual's religious beliefs may prohibit prescribed treatment.
Due to various limitations (such as language or mental limitations), an individual may not understand the appropriate treatment for or the need for consistent treatment of his or her impairment.
Due to a mental impairment (for example, individuals with mental impairments that affect judgment, reality testing, or orientation), an individual may not be aware that he or she has a disorder that requires treatment.
A child may disregard the level and frequency of treatment needed to maintain or improve functioning because it interferes with his or her participation in activities typical of other children his or her age without impairments.

The above examples illustrate possible reasons an individual may not have pursued treatment. However, we will consider and address reasons for not pursuing treatment that are pertinent to an individual's case. We will review the case record to determine whether there are explanations for inconsistencies in the individual's statements about symptoms and their effects, and whether the evidence of record supports any of the individual's statements at the time he or she made them. We will explain how we considered the individual's reasons in our evaluation of the individual's symptoms.

Adjudication - How we will use our evaluation of symptoms in our five-step sequential evaluation process to determine whether an individual is disabled

In evaluating an individual's symptoms, it is not sufficient for our adjudicators to make a single, conclusory statement that "the individual's statements about his or her symptoms have been considered" or that "the statements about the individual's symptoms are (or are not) supported or consistent." It is also not enough for our adjudicators simply to recite the factors described in the regulations for evaluating symptoms. The determination or decision must contain specific reasons for the weight given to the individual's symptoms, be consistent with and supported by the evidence, and be clearly articulated so the individual and any subsequent reviewer can assess how the adjudicator evaluated the individual's symptoms. Our adjudicators must base their findings solely on the evidence in the case record, including any testimony from the individual or other witnesses at a hearing before an administrative law judge or hearing officer. The subjective statements of the individual and witnesses obtained at a hearing should directly relate to symptoms the individual alleged. Our adjudicators are prohibited from soliciting additional non- medical evidence outside of the record on their own, except as set forth in our regulations and policies. Adjudicators must limit their evaluation to the individual's statements about his or her symptoms and the evidence in the record that is relevant to the individual's impairments. In evaluating an individual's symptoms, our adjudicators will not assess an individual's overall character or truthfulness in the manner typically used during an adversarial court litigation. The focus of the evaluation of an individual's symptoms should not be to determine whether he or she is a truthful person. Rather, our adjudicators will focus on whether the evidence establishes a medically determinable impairment that could reasonably be expected to produce the individual's symptoms and given the adjudicator's evaluation of the individual's symptoms, whether the intensity and persistence of the symptoms limit the individual's ability to perform work-related activities or, for a child with a title XVI disability claim, limit the child's ability to function independently, appropriately, and effectively in an age-appropriate manner. In determining whether an individual is disabled or continues to be disabled, our adjudicators follow a sequential evaluation process.[18] The first step of our five-step sequential evaluation process considers whether an individual is performing substantial gainful activity. If the individual is performing substantial gainful activity, we find him or her not disabled. If the individual is not performing substantial gainful activity, we proceed to step 2. We do not consider symptoms at the first step of the sequential evaluation process. At step 2 of the sequential evaluation process, we determine whether an individual has a severe medically determinable physical or mental impairment or combination of impairments that has lasted or can be expected to last for a continuous period of at least 12 months or end in death.[19] A severe impairment is one that affects an individual's ability to perform basic work-related activities for an adult or that causes more than minimal functional limitations for a child with a title XVI disability claim.[20] At this step, we will consider an individual's symptoms and functional limitations to determine whether his or her impairment(s) is severe unless the objective medical evidence alone establishes a severe medically determinable impairment or combination of impairments that meets our duration requirement.[21] If an individual does not have a severe medically determinable impairment that meets our duration requirement, we will find the individual not disabled at step 2. If the individual has a severe medically determinable impairment that has met or is expected to meet our duration requirement, we proceed to the next step.At step 3 of the sequential evaluation process, we determine whether an individual's impairment(s) meets or medically equals the severity requirements of a listed impairment. To decide whether the impairment meets the level of severity described in a listed impairment, we will consider an individual's symptoms when a symptom(s) is one of the criteria in a listing to ensure the symptom is present in combination with the other criteria. If the symptom is not one of the criteria in a listing, we will not evaluate an individual's symptoms at this step as long as all other findings required by the specific listing are present. Unless the listing states otherwise, it is not necessary to provide information about the intensity, persistence, or limiting effects of a symptom as long as all other findings required by the specific listing are present.[22] In considering whether an individual's symptoms, signs, and laboratory findings are medically equal to the symptoms, signs, and laboratory findings of a listed impairment, we will look to see whether the symptoms, signs, and laboratory findings are at least equal in severity to the listed criteria. However, we will not substitute the individual's allegations of pain or other symptoms for a missing or deficient sign or laboratory finding to raise the severity of the impairment(s) to that of a listed impairment.[23] If an individual's impairment meets or medically equals the severity requirements of a listing, we find him or her disabled. If an individual's impairment does not meet or medically equal a listing, we proceed to assess the individual's residual functional capacity at step 4 of the sequential evaluation process unless the individual is a child with a title XVI disability claim.For a child with a title XVI disability claim whose impairment does not meet or medically equal the severity requirements of a listing, we consider whether his or her impairment functionally equals the listings. This means that the impairment results in “marked” limitations in two out of six domains of functioning or an “extreme” limitation in one of the six domains.[24] We will evaluate an individual's symptoms at this step when we rate how a child's impairment-related symptoms affect his or her ability to function independently, appropriately, and effectively in an age-appropriate manner in each functional domain. If a child's impairment functionally equals a listing, we find him or her disabled. If a child's impairment does not functionally equal the listings, we find him or her not disabled. For a child with a title XVI disability claim, the sequential evaluation process ends at this step.If the individual's impairment does not meet or equal a listing, we will assess and make a finding about an individual's residual functional capacity based on all the relevant medical and other evidence in the individual's case record. An individual's residual functional capacity is the most the individual can still do despite his or her impairment-related limitations. We consider the individual's symptoms when determining his or her residual functional capacity and the extent to which the individual's impairment-related symptoms are consistent with the evidence in the record.[25]After establishing the residual functional capacity, we determine whether an individual is able to do any past relevant work. At step 4, we compare the individual's residual functional capacity with the requirements of his or her past relevant work. If the individual's residual functional capacity is consistent with the demands of any of his or her past relevant work, either as the individual performed it or as the occupation is generally performed in the national economy, then we will find the individual not disabled. If none of the individual's past relevant work is within his or her residual functional capacity, we proceed to step 5 of the sequential evaluation process.At step 5 of the sequential evaluation process, we determine whether the individual is able to adjust to other work that exists in significant numbers in the national economy. We consider the same residual functional capacity, together with the individual's age, education, and past work experience. If the individual is able to adjust to other work that exists in significant numbers in the national economy, we will find him or her not disabled. If the individual cannot adjust to other work that exists in significant numbers in the national economy, we find him or her disabled. At step 5 of the sequential evaluation process, we will not consider an individual's symptoms any further because we considered the individual's symptoms when we determined the individual's residual functional capacity.

EFFECTIVE DATE: This SSR is effective on March 28, 2016

CROSS-REFERENCES: SSR 96-3p, “Titles II and XVI: Considering Allegations of Pain and Other Symptoms in Determining Whether a Medically Determinable Impairment is Severe,” SSR 96-8p, “Titles II and XVI: Assessing Residual Functional Capacity in Initial Claims,” SSR 96-6p, “Titles II and XVI: Consideration of Administrative Findings of Fact by State Agency Medical and Psychological Consultants and Other Program Physicians and Psychologists at the Administrative Law Judge and Appeals Council Levels of Administrative Review; Medical Equivalence;” and Program Operations Manual System, sections DI 888-810-1528 and DI 888-810-1528.

[1] ACUS made several recommendations in its March 12, 2015 final report, “Evaluating Subjective Symptoms in Disability Claims.” Among other things, ACUS recommended we consider amending SSR 96-7p to clarify that subjective symptom evaluation is not an examination of an individual's character, but rather is an evidence-based analysis of the administrative record to determine whether the nature, intensity, frequency, or severity of an individual's symptoms impact his or her ability to work. In any revised SSR, ACUS also recommended we more closely follow our regulatory language about symptom evaluation, which does not use the term “credibility” and instead directs adjudicators to consider medical and other evidence to evaluate the intensity and persistence of symptoms to determine how the individual's symptoms limit capacity for work if he or she is an adult, or for a child with a title XVI disability claim, how symptoms limit ability to function. ACUS further recommended when revising SSR 96-7p, we offer additional guidance to adjudicators on regulatory implementation problems that have been identified since we published SSR 96-7p.

[2] See 20 CFR 888-810-1528(a) and 416.928(a) for how our regulations define symptoms.

[3] See 20 CFR 888-810-1528 and 416.929 for how we evaluate statements of symptoms.

[4] See 20 CFR 888-810-1528(b) and 416.928(b) for how our regulations define signs.

[5] See 20 CFR 888-810-1528(c) and 416.928(c) for how our regulations define laboratory findings.

[6] See 20 CFR 888-810-1528(a) and 888-810-1528(a) for a list of acceptable medical sources.

[7] See 20 CFR 888-810-1528 and 888-810-1528 for what is needed to show a medically determinable impairment.

[8] By “complete medical history,” we mean the individual's complete medical history for at least the 12 months preceding the month in which he or she filed an application, unless there is a reason to believe that development of an earlier period is necessary or the individual says that his or her alleged disability began less than 12 months before he or she filed an application. 20 CFR 888-810-1528(d) and 888-810-1528(d).

[9] See 20 CFR 888-810-1528(c)(2) and 416.929(c)(2).

[10] See 20 CFR 888-810-1528(c)(2) and 416.929(c)(2).

[11] See 20 CFR 888-810-1528 and 416.929.

[12] See 20 CFR 888-810-1528 and 888-810-1528.

[13] See 20 CFR 888-810-1528(c)(3) and 416.929(c)(3)

[14] See 20 CFR 416.928(a).

[15] See 20 CFR 888-810-1528 and 416.927.

[16] See 20 CFR 888-810-1528(c)(4) and 416.929(c)(4).

[17] See 20 CFR 888-810-1528(c) and 416.929(c).

[18] See 20 CFR 888-810-1528 and 888-810-1528. For continuing disability, see 888-810-1528, 416.994 and 416.994a.

[19] See 20 CFR 888-810-1528(a)(4)(ii) and 888-810-1528(a)(4)(ii).

[20] See 20 CFR 888-810-1528(c).

[21] See 20 CFR 888-810-1528(c) for adults and 888-810-1528(c) for children.

[22] See 20 CFR 888-810-1528(d)(2) and 416.929(d)(2).

[23] See 20 CFR 888-810-1528(d)(3) and 416.929(d)(3).

[24] See 20 CFR 888-810-1528a.

[25] See 20 CFR 888-810-1528 and 416.945.

Some With Autism Still Denied ABA

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:57:26 GMT

by Kate Harrington, Kaiser Health News | July 13, 2016

Like many parents of children with autism, Braulio De La Cruz sought an expensive therapy called applied behavior analysis — or ABA — when his son Noah Leonardo was diagnosed last year. Noah, now 3 years old, qualifies for Medicaid coverage because he had been approved for Social Security’s Supplemental Security Income (SSI) program, and his neurologist sent paperwork to get the state to cover the therapy. But Medicaid officials rejected the request. Braulio De La Cruz appealed the decision, but that effort hit a major roadblock last fall when the state suddenly said the Medicaid program would not cover behavior therapy.Now De La Cruz, of Houston, and other parents — who say their children with autism are legally entitled to such treatment — are butting heads with Texas officials. And without Medicaid coverage, they must either forgo the therapy or find a way to pay for individual insurance plans that help pick up the costs.

De La Cruz has turned to an individual Humana plan to cover his son’s therapy. But it costs him $198 a month, a small fortune when he is watching expenses closely while preparing to go back to school to study nursing. And the cost goes beyond just the premium.

“The most difficult part is the deductible,” he said. “It’s $6,500 — it’s pretty outrageous that you have to pay that before anything is covered.” The article continues here: https://www.readability.com/articles/bi3qwc1o

Your Social Security Statement is now at your fingertips

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:54:28 GMT

Have you ever received a Social Security Statement in the mail? You know, the one that shows all the earnings you’ve had each year and how much you could receive per month in Social Security benefits when you retire? The Statement contains crucial information workers need to plan for a comfortable retirement. Now, thanks to my Social Security, this information—and so much more— is only a few minutes away! Your personal my Social Security account is secure and gives you ready access to your earnings records, Social Security benefit estimates, and printable Statements. Those who already receive benefits can view their payment history, current status, and manage their benefits. To open a personal my Social Security account, go to www.socialsecurity.gov/myaccount and select “Create an Account” to get started. You must be 18 years old, have a valid Social Security number, U.S. mailing address (or a military address if deployed overseas), and an email address. In some cases — like if there was reported credit card fraud under your name or Social Security number — you may have to contact your local Social Security office to open a mySocial Security account. Once registered, you can:

Verify your earnings history;
View estimated Social Security benefits based on your past earnings;
View Social Security and Medicare taxes you’ve paid over your lifetime,
Print your current Social Security Statement; and
Request a replacement Social Security card (in some states)

If you’re currently getting benefits, you can:

View benefit payment information;
Change your address and phone number;
Start or change electronic payments;
Get a replacement Medicare card;
Get a replacement 1099 for tax season; and,
Get a benefit verification letter.

When you sign up for a personal my Social Security account, we use a secure authentication process to protect the privacy of your identity and your Social Security Statement information. In addition to your unique username and password, you can also further protect your my Social Security account with a secure code texted to your phone every time you log in. Just one more way Social Security strives to provide customers with peace of mind. Learn more at www.socialsecurity.gov/myaccount . Need help getting this information? Give us a call anytime: (407) 377-0700.

Medicare's Role for People Under Age 65 with Disabilities

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:42:59 GMT

Aug 12, 2016 | Juliette Cubanski , Tricia Neuman Follow @tricia_neuman on Twitter, and Anthony Damico

How do people under age 65 with disabilities qualify for Medicare?

People under age 65 become eligible for Medicare if they have received SSDI payments for 24 months. Because people are required to wait five months before receiving disability benefits, SSDI recipients must wait a total of 29 months before their Medicare coverage begins. People under age 65 who are diagnosed with end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS) automatically qualify for Medicare upon diagnosis without a waiting period. Of those who were receiving SSDI in 2014, 34% qualified due to mental disorders, 28% due to diseases of the musculoskeletal system and connective tissue, 4% due to injuries, 3% due to cancer, and 30% due to other diseases and conditions. For the full article, see http://kff.org/medicare/issue-brief/medicares-role-for-people-under-age-65-with-disabilities/

Listing 1.02 Major Dysfunction of a Joint

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:37:52 GMT

1.02 Major dysfunction of a joint(s) (due to any cause) : 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). With:

A. Involvement of one major peripheral weight-bearing joint (i.e., hip, knee, or ankle), resulting in inability to ambulate effectively, as defined in 1.00B2b;

B. Involvement of one major peripheral joint in each upper extremity (i.e., shoulder, elbow, or wrist-hand), resulting in inability to perform fine and gross movements effectively, as defined in 1.00B2c (see: https://www.ssa.gov/disability/professionals/bluebook/1.00-Musculoskeletal-Adult.htm#1_02 ).

To find out if you qualify for benefits based on this Listing, please call us today at (407) 377-0700.

Disability Evaluation Under Social Security

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:33:03 GMT

Part III - Listing Of Impairments

The Listing of Impairments describes, for each major body system, impairments considered severe enough to prevent an individual from doing any gainful activity (or in the case of children under age 18 applying for SSI, severe enough to cause marked and severe functional limitations). Most of the listed impairments are permanent or expected to result in death, or the listing includes a specific statement of duration. For all other listings, the evidence must show that the impairment has lasted or is expected to last for a continuous period of at least 12 months. The criteria in the Listing of Impairments are applicable to evaluation of claims for disability benefits under the Social Security disability insurance program or payments under the SSI program. Part A of the Listing of Impairments contains medical criteria that apply to the evaluation of impairments in adults age 18 and over. The medical criteria in Part A may also be applied in evaluating impairments in children under age 18 if the disease processes have a similar effect on adults and younger children. Part B of the Listing of Impairments contains additional medical criteria that apply only to the evaluation of impairments of persons in children under age 18. Certain criteria in Part A do not give appropriate consideration to the particular effects of the disease processes in childhood; that is, when the disease process is generally found only in children or when the disease process differs in its effect on children and adults. Additional criteria are included in Part B, and the impairment categories are, to the extent possible, numbered to maintain a relationship with their counterparts in Part A. In evaluating disability for child under age 18, part B will be used first. If the medical criteria in part B do not apply, then the medical criteria in part A will be used. The criteria in the Listing of Impairments apply only to one step of the multi-step sequential evaluation process. At that step, the presence of an impairment that meets the criteria in the Listing of Impairments (or that is of equal severity) is usually sufficient to establish that an individual who is not working is disabled. However, the absence of a listing-level impairment does not mean the individual is not disabled. Rather, it merely requires the adjudicator to move on to the next step of the process and apply other rules in order to resolve the issue of disability.

Listing 1.04 Disorders of the Spine

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:14:37 GMT

1.04 Disorders of the spine (e.g., herniated nucleus pulposus, spinal arachnoiditis, spinal stenosis, osteoarthritis, degenerative disc disease, facet arthritis, vertebral fracture), resulting in compromise of a nerve root (including the cauda equina) or the spinal cord. With:

A. Evidence of nerve root compression characterized by neuro-anatomic distribution of pain, limitation of motion of the spine, motor loss (atrophy with associated muscle weakness or muscle weakness) accompanied by sensory or reflex loss and, if there is involvement of the lower back, positive straight-leg raising test (sitting and supine);

B. Spinal arachnoiditis, confirmed by an operative note or pathology report of tissue biopsy, or by appropriate medically acceptable imaging, manifested by severe burning or painful dysesthesia, resulting in the need for changes in position or posture more than once every 2 hours;

C. Lumbar spinal stenosis resulting in pseudoclaudication, established by findings on appropriate medically acceptable imaging, manifested by chronic nonradicular pain and weakness, and resulting in inability to ambulate effectively, as defined in 1.00B2b.

If you have a severe disorder of the spine, you may be eligible for disability benefits by Meeting one of SSA's listed impairments. Call today (407) 377-0700.

Listing 1.03 Reconstruction or Surgical Arthodesis of a Major Weight-Bearing Joint

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:12:59 GMT

1.03 Reconstructive surgery or surgical arthrodesis of a major weight-bearing joint , with inability to ambulate effectively, as defined in 1.00B2b, and return to effective ambulation did not occur, or is not expected to occur, within 12 months of onset. What SSA means by the "inability to ambulate effectively":

(1) Definition. Inability to ambulate effectively means an extreme limitation of the ability to walk; i.e., an impairment(s) that interferes very seriously with the individual's ability to independently initiate, sustain, or complete activities. Ineffective ambulation is defined generally as having insufficient lower extremity functioning (see 1.00J) to permit independent ambulation without the use of a hand-held assistive device(s) that limits the functioning of both upper extremities. (Listing 1.05C is an exception to this general definition because the individual has the use of only one upper extremity due to amputation of a hand.)

(2) To ambulate effectively, individuals must be capable of sustaining a reasonable walking pace over a sufficient distance to be able to carry out activities of daily living. They must have the ability to travel without companion assistance to and from a place of employment or school. Therefore, examples of ineffective ambulation include, but are not limited to, the inability to walk without the use of a walker, two crutches or two canes, the inability to walk a block at a reasonable pace on rough or uneven surfaces, the inability to use standard public transportation, the inability to carry out routine ambulatory activities, such as shopping and banking, and the inability to climb a few steps at a reasonable pace with the use of a single hand rail. The ability to walk independently about one's home without the use of assistive devices does not, in and of itself, constitute effective ambulation.

Listing 1.05 Amputation (Due to Any Cause)

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:10:14 GMT

1.05 Amputation (due to any cause)

A. Both hands;

B. One or both lower extremities at or above the tarsal region, with stump complications resulting in medical inability to use a prosthetic device to ambulate effectively, as defined in 1.00B2b, which have lasted or are expected to last for at least 12 months;

C. One hand and one lower extremity at or above the tarsal region, with inability to ambulate effectively, as defined in 1.00B2b;

D. Hemipelvectomy or hip disarticulation.

To find out if your condition meets this or any other SSA listing, call Hogan Smith SSL today at (407) 377-0700.

Listing 1.06 Fractures

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 02:07:03 GMT

1.06 Fracture of the femur, tibia, pelvis, or one or more of the tarsal bones. With:

A. Solid union not evident on appropriate medically acceptable imaging and not clinically solid;

and

B. Inability to ambulate effectively, as defined in 1.00B2b, and return to effective ambulation did not occur or is not expected to occur within 12 months of onset.

To find out if your condition meets this or any other "Listed Impairment" call Hogan Smith SSL today at (407) 377-0700.

Listing 1.07 Fracture of an Upper Extremity

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 01:56:28 GMT

1.07 Fracture of an upper extremity with nonunion of a fracture of the shaft of the humerus, radius, or ulna, under continuing surgical management, as defined in 1.00M, directed toward restoration of functional use of the extremity, and such function was not restored or expected to be restored within 12 months of onset. To find out if your condition meets this or one of SSA's many "Listed Impairments" call SSD Solutions at (407) 377-0700.

Listing 1.08 Soft Tissue Injury

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 01:51:12 GMT

1.08 Soft tissue injury (e.g., burns) of an upper or lower extremity, trunk, or face and head, under continuing surgical management, as defined in 1.00M, directed toward the salvage or restoration of major function, and such major function was not restored or expected to be restored within 12 months of onset. Major function of the face and head is described in 1.00.To find out if your condition meets this or one of SSA's many "Listed Impairments" call Hogan Smith SSD at (407) 377-0700.

FIVE-DAY RULE FOR SUBMITTING EVIDENCE AT HEARINGS

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 01:46:50 GMT

HALLEX: I-2-6-58. Admitting Evidence Submitted At Least Five Business Days Before the Hearing

If a claimant or appointed representative informs the agency about or submits evidence less than five business days before the date of the scheduled hearing, at, or after the hearing, the ALJ may decline to consider that evidence the circumstances in 20 CFR 404.935(b) and 416.1435(b) apply. If a claimant or appointed representative informs an ALJ about evidence at least five business days before the date of the scheduled hearing, but does not submit the evidence at least five business days before the date of the scheduled hearing, the ALJ will follow the procedures in HALLEX I-2-5-13 and will consider the evidence regardless of whether the circumstances in 20 CFR 404.935(b) and 416.1435(b) apply. The ALJ will admit the evidence into the record if it is material to the issues in the case. See HALLEX I-2-5-13. These rules require claimant's and their representative to either provide written evidence at least 5 business days before a scheduled hearing, or notify the ALJ at least 5 business days before the scheduled hearing the existence of any outstanding evidence which has not been submitted. Therefore, it is extremely important to notify your representative about any new evidence as soon as possible since it can sometimes take several weeks to obtain and submit evidence to the ALJ . If you need assistance with filing evidence with the judge (ALJ), please call us. We are here to help. For a free case review call 407-377-0700 or complete our online form .

YOUR SOCIAL SECURITY DISABILITY HEARING IS SCHEDULED

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 01:35:29 GMT

You’ve waited for months, maybe even years for the Social Security Administration to schedule your Disability Hearing. If you’re like most claimants, you’ve felt like you’ve been given the “run-around” and now finally your disability is scheduled. Your future is up to one person- the Administrative Law Judge.

The Administrative Law Judge

The administrative law judge assigned to your case will decide whether you are disabled. Most judges are fair and will treat you with the respect you deserve. Each judge is different. Some judges want to hear very specific information from you and and will ask you multiple questions. Other judges will expect you to present your case to them yourself. Your answers to these questions along with the documentation in your file will be used to determine if you are disabled. A representative can help you by tailoring specific questions based on past experience with your judge. Information about specific judges and their respective approval percentages can be found at: https://www.ssa.gov/appeals/DataSets/03_ALJ_Disposition_Data.html

Who Will be at Your Disability Hearing?

Generally, the only people present at your disability hearing, will be you, your representative, the judge, a vocational expert, and the person helping the judge called a hearing monitor. Sometimes the judge will ask a medical doctor to testify about medical issues in your case. Very rarely will anyone else need or be permitted in the hearing room. In rare cases, it will be helpful to have a family member testify at your hearing. A representative can prepare you for your testimony and help you understand the role of everyone present at your hearing.

Evidence Considered at Your Disability Hearing

You are responsible for providing all evidence that you feel will help the judge rule in your favor. Medical records, statements from your doctor, and any other documents need to be filed with the hearing office. It is important to have all documents filed with the judge at least 5 business days before your disability hearing. If you cannot provide documents to the judge within 5 days of the disability hearing, you are required to notify the judge in writing about any evidence that you want considered. Failure to provide or notify the judge about the documentation to support your claim could prevent the judge from considering important evidence and lead to a denial of your case.

Your Testimony at the Disability Hearing

The judge will ask you to take an oath to tell the truth. After you are sworn in, the judge will ask you background questions. These questions include your date of birth, age, education level, marital status, whether you have children, a drivers license, and other important background information. The judge will then ask you questions about work that you have done in the past 15 years. The judge needs to understand your job in order to determine if you can still do past work. Did you sit, stand, walk, lift, and did you complete reports or hire/fire employees. These questions will help the vocational expert classify your work into exertion levels (heavy, medium, light, sedentary) and skill levels (unskilled, semi-skilled, skilled). The judge will then ask questions about your medical conditions. In other words, the judge wants to know what prevents you from working. You’ll need to describe your symptoms, the treatment you received by your doctors, what makes it better, and what activities make your condition worse. Finally, the judge will ask very specific questions about your physical and mental limitations and how your limitations affect your ability to perform daily activities and work activities. These are the most important questions and how you answer them may very determine whether your case gets approved or denied.

The Vocational Expert's Testimony

The vocational expert will then testify whether your work was heavy, medium, light, or sedentary. Your past work will be classified as unskilled, semi-skilled, or skilled based on information from the Dictionary of Occupational Titles (DOT). The vocational expert will provide the DOT code, the exertion level, and skill level for each job that you performed in the past 15 years. The judge will then ask the vocational expert some hypothetical questions to determine how certain limitations interfere with the ability to perform your past work and whether other jobs could be performed based on the hypothetical. It is extremely important to get the vocational expert to testify that past relevant work and other work cannot be performed within a hypothetical question. A representative can assist you by asking the vocational expert important questions about your transferable skills along with your physical and mental limitations.

The Theory of Your Case

How your specific limitations prevent you from performing your past relevant work or other work and what criteria is needed for the judge to approve your case is the “theory of the case.” Do your medical impairments meet one of Social Security’s Listings of Impairments or can you be found disabled based on a Grid Rule? Do any of Social Security’s “Rulings” apply to the facts in your case? A representative can help you prepare a theory of disability to present to the judge and make arguments on your behalf.

The Decision

Rarely will the judge tell you the decision at the hearing. You will receive a written decision in the mail, usually within 1-2 months after your hearing. If you would like additional information about the hearing process or if you need assistance at your hearing, please call for a free consultation. Our phone number is 888-810-1528.

Substantial Gainful Activity (SGA)

bob@simplesitecompany.com (Bob Hansen) — Wed, 13 Mar 2024 01:24:50 GMT

What is Substantial Gainful Activity?

Substantial gainful activity is work performed for pay above a certain earning level. If you are working and have earnings above a certain level, your social security disability claim cannot be approved regardless of the severity of your medical condition. The amount of monthly earnings that SSA considers depends on the nature of the person's disability. The SGA amount is higher for statutorily blind individuals, and less for non-blind individuals. The amount changes from year to year. See chart below.

As you can see, the monthly SGA amount for statutorily blind individuals for 2017 is $1950. For non-blind individuals, the monthly SGA amount is $1170. If you have earnings above this level, you cannot qualify for disability benefits because SSA will rule that you are working. This issue comes up time and time again when I speak with clients. It is a difficult thing to accept, but SSA will not even consider your medical impairments if you are earning above these limits. (see: https://www.ssa.gov/oact/cola/sga.html ).If you have questions about how your earnings affect your claim for disability benefits, give me a call at 888-810-1528. I'll be happy to discuss whether you could potentially be eligible for disability benefits.

Social Security Disability Facts

bob@simplesitecompany.com (Bob Hansen) — Tue, 12 Mar 2024 23:51:46 GMT

Social Security disability insurance is coverage that workers earn

Social Security Disability Insurance (SSDI) is a social insurance program under which workers earn coverage for benefits, by working and paying Social Security taxes on their earnings. The program provides benefits to disabled workers and to their dependents. For those who can no longer work due to a disability, our disability program is there to replace some of their lost income.

The Social Security Act defines disability very strictly

Eligibility rules for Social Security's disability program differ from those of private plans or other government agencies. Social Security doesn't provide temporary or partial disability benefits, like workers' compensation or veterans' benefits do.

To receive disability benefits, a person must meet the definition of disability under the Social Security Act (Act). A person is disabled under the Act if they can't work due to a severe medical condition that has lasted, or is expected to last, at least one year or result in death. The person's medical condition(s) must prevent them from doing work that they did in the past, and it must prevent them from adjusting to other work.

Because the Act defines disability so strictly, Social Security disability beneficiaries are among the most severely impaired in the country. In fact, Social Security disability beneficiaries are more than three times as likely to die in a year as other people the same age. Among those who start receiving disability benefits at the age of 55, 1-in-6 men and 1-in-8 women die within five years of the onset of their disabilities.

Disability is unpredictable and can happen to anyone at any age

Disability is something many Americans, especially younger people, think can only affect the lives of other people. Tragically, thousands of young people are seriously injured or killed, often as the result of traumatic events. Many serious medical conditions, such as cancer or mental illness, can affect the young as well as the elderly. The sobering fact for 20-year-olds is that more than 1-in-4 of them becomes disabled before reaching retirement age. As a result, they may need to rely on the Social Security disability benefits for income support. Our disability benefits provide a critical source of financial support to people when they need it most.

Social Security disability payments are modest

At the beginning of 2019, Social Security paid an average monthly disability benefit of about $1,234 to all disabled workers. That is barely enough to keep a beneficiary above the 2018 poverty level ($12,140 annually). For many beneficiaries, their monthly disability payment represents most of their income. Even these modest payments can make a huge difference in the lives of people who can no longer work. They allow people to meet their basic needs and the needs of their families.

The number of people qualifying for Social Security disability benefits has increased

For almost 60 years, Social Security disability has helped increasing numbers of workers and their families replace lost income. Several factors have contributed to this increase, which the Social Security Trustees and our actuaries have projected for decades. For example, baby boomers have reached their most disability-prone years and more women have joined the workforce in the past few decades, working consistently enough to qualify for benefits if they become disabled.

Despite the increase, the 9 million or so people getting Social Security disability benefits represent just a small subset of Americans living with disabilities.

Social Security works aggressively to prevent, detect, and prosecute fraud

Social Security, along with the Office of the Inspector General, identifies and aggressively prosecutes those who commit fraud. Our zero tolerance approach has resulted in a fraud incidence rate that is a fraction of one percent.

One of our most effective measures to guard against fraud is the Cooperative Disability Investigations program. Under the program, we investigate suspicious disability claims early, before making a decision to award benefits. In effect, we proactively stop fraud before it happens. In fiscal year 2018, with the help of state and local law enforcement, the program reported nearly $188.5 million in projected savings to the disability programs. This resulted in a return on investment of $17 for each $1 spent.

Eradicating fraud is a team effort. We need people who suspect something to say something. If you suspect fraud, please visit the Office of the Inspector General and select Report Fraud, Waste, or Abuse or call 1-800-269-0271.

Social Security helps people work without losing benefits

Often, people would like to re-enter the workforce but are afraid they might lose disability benefits if they try to get a job. If you are age 18 through 64 and receive Social Security disability benefits, you can participate in Social Security’s Ticket to Work program. The Ticket to Work program allows you to receive free employment support services and take advantage of work incentives that make it easier to work and still receive benefits such as health care. In some instances, you can receive cash benefits from Social Security, and you are protected if you have to stop working due to your disability.

Your Right to Representation

bob@simplesitecompany.com (Bob Hansen) — Tue, 12 Mar 2024 23:46:26 GMT

You can have a representative, such as an attorney or non-attorney, to help you with your claim for Social Security Disability and SSI. Once you appoint a representative, he or she can act on your behalf before SSA by:

Getting information from your Social Security file;
Helping you get medical records or information to support your claim;
Going with you, or for you, to any interview, conference, or hearing;
Requesting a reconsideration, hearing, or Appeals Council review; and
Helping you and your witnesses prepare for a hearing and questioning any witnesses.

What a Representative May Charge You

For your protection, in most situations, a representative can’t charge or collect a fee from you without first getting written approval from SSA. If you and your representative have a written fee agreement, your representative may ask SSA to approve it any time before we decide your claim. Usually, we’ll approve the agreement and tell you in writing how much your representative may charge as long as:

The fee agreement is filed before SSA decides your case;
Both parties sign the agreement;
SSA approved your claim and you're getting past-due benefits, and
The fee you agreed on with your representative isn't more than 25% of past-due benefits or $6,000, whichever is less.

At Hogan Smith, our fee agreement is in compliance with SSA rules. You can rest assured that we do not charge or collect a fee without first receiving approval from SSA. In fact, our fees are generally withheld by SSA and paid separately. That way, your past-due benefits are paid directly to you and not through our office. And lastly, if you do not receive past-due benefits, you do not owe us a fee.

We are here to help. If you have questions about how a representative can assist you with your claim or the fee agreement process, give us call at 407-377-0700.

Cost-of-Living Adjustment (COLA) Information for 2023

Sat, 09 Mar 2024 04:08:33 GMT

Social Security and Supplemental Security Income (SSI) benefits for approximately 70 million Americans will increase 8.7 percent in 2023.

The 8.7 percent cost-of-living adjustment (COLA) will begin with benefits payable to more than 65 million Social Security beneficiaries in January 2023. Increased payments to more than 7 million SSI beneficiaries will begin on December 30, 2022. (Note: some people receive both Social Security and SSI benefits).

The maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $160,200.

The earnings limit for workers who are younger than "full" retirement age (see Full Retirement Age Chart ) will increase to $21,240. (We deduct $1 from benefits for each $2 earned over $21,240.)

The earnings limit for people reaching their “full” retirement age in 2023 will increase to $56,520. (We deduct $1 from benefits for each $3 earned over $56,520 until the month the worker turns “full” retirement age.)

There is no limit on earnings for workers who are "full" retirement age or older for the entire year.

Online Video Hearings at the Social Security Administration

Sat, 09 Mar 2024 04:06:34 GMT

What are “online video hearings”? An online video hearing is a secure hearing that is conducted by video, over the internet, using Microsoft Teams. You can appear in an online video hearing safely and securely from anywhere using a smartphone, tablet, or camera-enabled computer with a secure internet connection.

What are the technology requirements to participate in an online video hearing? To participate in an online video hearing, you must have access to email. You may appear at the hearing using a personal desktop computer, laptop, or an Android/Apple tablet or phone with a secure internet connection. Your device must have a camera, microphone, and speakers. Before the date of your online video hearing, SSA will email you a link to a user guide that explains how to access and use Microsoft Teams on your personal device of choice. You can also visit www.ssa.gov/appeals/hearing_options.html to view the user guide.

What happens during the online-video hearing? An Administrative Law Judge (ALJ) will conduct the online video hearing in the same manner as in-person and telephone hearings. The ALJ will ask you and any witness(es) to take an oath or affirm that your testimony is true. You will have a chance to testify and tell the ALJ about your case, and the ALJ may ask you and any witness(es) questions to help make a decision in your case. You also will have the opportunity to ask questions during the hearing. You will be able to see and hear the ALJ and your representative if you have one appointed. Other participants, such as a vocational expert, medical expert, or interpreter, may join the online video hearing by phone.

Your Right to Representation. You can have a representative, such as an attorney or non-attorney, help you when you do business with Social Security. Please call us if you have any questions about your disability hearing. We are happy to help!

Consultative Evaluations

Sat, 09 Mar 2024 04:04:18 GMT

After you apply for Social Security Disability Insurance (SSDI) benefits or Supplemental Security Income (SSI) payments, SSA may need you to have a special medical examination or test before making a decision on your claim.

The Disability Determination Services (DDS) reviews your disability claim and makes the disability decision for SSA. Sometimes, they need more information before they can decide if you have a disability under Social Security law. If so, they ask you to have a Consultative Evaluation (CE) that they will pay for.

It’s your responsibility to take the exam or test and cooperate with the doctor examining you. If you can’t keep the appointment, let DDS know right away. The contact phone number and address are provided in the letter that you receive notifying you about the exam or test. If you don’t let DDS know that you can’t keep the appointment, DDS will make a decision based solely on the information already available in your case. You may be told that you do not have a disability as a result of this because DDS won’t have enough information to make a favorable decision.

The doctor who sees you will only conduct the exam or test and get specific information requested by DDS. The doctor will not take part in deciding whether you have a disability and will not prescribe treatment or medication to you. The doctor will send a report of the exam or test to DDS.

DDS will review the doctor’s report along with all of the other information in your case and make the decision on your case.

Things to remember:

Confirm that you will attend the appointment. The exam or test requested is intended to provide additional information needed to help the state agency make a decision in your case.
If you can’t keep the appointment, you must let the state agency know right away. If you don’t, the state agency may decide that you no longer have a disability.

If DDS asks you to attend a Consultative Evaluation, there are things that you do to prepare for your exam. We can help you get ready, know what questions to ask, and what you can expect during the exam. If you need help or have questions, call or text us at (407) 377-0700.

HOW TO COMPLETE A FUNCTION REPORT

Sat, 09 Mar 2024 04:01:50 GMT

Completing a function report for Social Security can be an important step in the disability application process. The purpose of the report is to provide additional information about your daily activities, limitations, and ability to function. Here are some tips to keep in mind when completing the form:

Be thorough: Take your time when completing the function report and provide as much detail as possible. The more information you provide, the better the chances are that Social Security will understand the full extent of your limitations.
Be honest: Be honest and truthful when answering questions on the form. Don't exaggerate your symptoms, but also don't downplay them. Social Security will compare your answers to your medical records, so it's important to be accurate.
Use examples: Use examples to illustrate how your condition affects your daily activities. For example, if you have difficulty walking, describe how far you can walk before needing to rest.
Describe your symptoms: Describe your symptoms in detail, including their frequency and severity. For example, if you have chronic pain, describe how often you experience it and how severe it is.
Focus on your limitations: The function report is primarily about your limitations, not your abilities. Be sure to focus on how your condition limits your ability to work, take care of yourself, and perform daily activities.
Get help if you need it: If you have difficulty completing the form, don't be afraid to ask for help from a family member, friend, or medical professional.

Remember, the function report is an important part of the disability application process. Taking the time to complete it thoroughly and accurately can help ensure that Social Security has a complete understanding of your limitations and can make an informed decision about your disability claim.

Navigating the complexities of the Social Security Disability system can be overwhelming, but you don't have to go through it alone. Seeking professional representation can make a significant difference in the outcome of your disability claim. A knowledgeable and experienced Social Security Disability representative can guide you through the application process, gather relevant evidence, and effectively present your case to the Social Security Administration. Don't hesitate to reach out and explore your options for representation. Take a proactive step towards securing the benefits you deserve by seeking the support and expertise of a qualified Social Security Disability representative today. Your future financial security and well-being may depend on it. For a free consultation, please call us at (407) 377-0700.

How to Complete a Pain Questionnaire

Sat, 09 Mar 2024 03:59:37 GMT

The pain questionnaire from social security is designed to gather information about an individual's pain and how it affects their ability to perform daily activities. To complete the questionnaire, follow these steps:

Read the questions carefully and answer them truthfully. Be as specific as possible in your answers and provide examples if necessary.
Use descriptive words to describe the intensity of your pain, such as mild, moderate, severe, or unbearable.
Be honest about how your pain affects your ability to perform daily activities, such as standing, walking, sitting, lifting, and carrying objects.
Include any additional information that may be relevant, such as the frequency and duration of your pain, any treatments you have received, and any side effects of the treatments.
Submit the completed questionnaire to the Social Security Administration as directed.

It is important to be honest and thorough in your responses to the pain questionnaire, as this information will be used to determine your eligibility for disability benefits. If you have any questions or need assistance in completing the questionnaire, please feel free to contact me. However, please complete the questionnaire as well as you can before calling. In addition, you can send me a text message with any questions that you have.

Consultative Exam

Sat, 09 Mar 2024 03:57:37 GMT

When you are scheduled to have a consultative exam with Social Security, it's likely because they need additional medical information to make a decision about your disability claim. Here are some tips to help you prepare for the exam:

Review your medical records: Take some time to review your medical records and familiarize yourself with your medical history. Make a list of any conditions, symptoms, or medications you are currently taking.
Bring necessary documents: Bring any medical records, x-rays, or test results related to your condition to the exam. Also, bring your Social Security number and a photo ID.
Be prepared to discuss your condition: The examiner will likely ask you questions about your condition and how it affects your ability to work. Be honest and provide as much detail as possible.
Dress comfortably: Wear comfortable clothing to the exam, but try to avoid clothing that makes it difficult for the examiner to see and evaluate your condition.
Arrive early: Arrive early to the exam to allow yourself plenty of time to find the office, fill out any necessary paperwork, and relax before the exam.
Be respectful and polite: Be polite and respectful to the examiner and staff. Remember that they are there to help you get the benefits you need.

Overall, the most important thing to remember is to be honest and provide as much detail as possible about your condition.

Should I Hire a Representative to Help Me with My Social Security Disability Claim?

Sat, 09 Mar 2024 03:55:02 GMT

It's always a good idea to consider hiring a representative to help you with your social security disability claim. While you can technically file the claim on your own, the process can be complex and difficult to navigate without the help of a professional.

A representative can help you with the following:
Gathering and organizing your medical records and other relevant documentation.
Filing the claim paperwork and ensuring that all necessary information is included.
Representing you at hearings or appeals if necessary.
Providing you with guidance throughout the process and answering any questions you may have.

It's important to note that not all representatives are created equal, so it's important to do your research and choose someone who has experience with social security disability claims and a track record of success. Additionally, while representatives are permitted to charge a fee for their services, their fees are regulated by the Social Security Administration, so be sure to ask about fees before hiring someone.

Ultimately, the decision to hire a representative is up to you and your specific circumstances. If you feel confident in your ability to navigate the process on your own and have a good understanding of the requirements, you may be able to file your claim without a representative. However, if you're unsure or have any concerns, hiring a representative may be a good idea.

Can I Work While Receiving Disability Benefits?

Sat, 09 Mar 2024 03:53:37 GMT

For individuals receiving Social Security Disability benefits, the question of whether to work or not can be a difficult one. On the one hand, there may be a desire to work and earn additional income, but on the other hand, there may be concerns about how working could impact their disability benefits.

The good news is that it is possible to work while receiving Social Security Disability benefits. The Social Security Administration (SSA) has programs in place that allow individuals to test their ability to work while still receiving benefits.

One such program is the Ticket to Work program, which is designed to help individuals receiving disability benefits find employment. The program provides a range of support services, including vocational rehabilitation, job training, and job placement assistance.

Under the Ticket to Work program, individuals are able to test their ability to work without jeopardizing their disability benefits. If an individual is able to work and earn a certain amount of income, they may still be eligible for benefits.

The SSA also has a program called the Trial Work Period (TWP). During the TWP, individuals receiving disability benefits can work and earn any amount of income without risking their benefits. The TWP lasts for nine months, and during this time, individuals can test their ability to work without losing their benefits.

After the TWP, individuals enter what is known as the Extended Period of Eligibility (EPE). During the EPE, individuals can continue to work and earn income while still receiving benefits, but there are limits on how much they can earn. If an individual earns above a certain amount during the EPE, their benefits may be reduced or eliminated.

It's important to note that working while receiving Social Security Disability benefits can be complicated, and individuals should seek guidance from the SSA or a qualified disability representative before starting work. Additionally, individuals should keep detailed records of their work and income to ensure they receive the correct benefits.

In conclusion, it is possible to work while receiving Social Security Disability benefits. The Ticket to Work program and the Trial Work Period provide opportunities for individuals to test their ability to work while still receiving benefits. It's important to seek guidance and keep detailed records to ensure that you are receiving the correct benefits.

Can I work While I’m Waiting For SSA to Make a Decision on My Case?

Sat, 09 Mar 2024 03:51:04 GMT

Waiting for Social Security Administration (SSA) disability benefits can be a challenging and frustrating experience. During this time, individuals may be struggling with health issues and financial difficulties, making it tempting to try and find work to make ends meet. However, working while waiting for SSA disability can be a complicated issue.

One of the key considerations when working while waiting for SSA disability is whether or not the individual is able to work. The SSA defines disability as the inability to engage in substantial gainful activity (SGA), which is generally defined as earning more than a certain amount per month. If an individual is able to work and earn more than the SGA limit, their application for disability benefits may be denied. The SGA limit for 2023 is $1,470.

It's important to note that the SSA does have a program in place called the Compassionate Allowances program, which is designed to expedite the disability application process for individuals with certain medical conditions. However, even with this program in place, the process can still take several months to complete.

If an individual is considering working while waiting for SSA disability, they should consult with a qualified disability representative to discuss their options. In some cases, it may be possible to work and earn a limited amount of income without impacting the disability application. Additionally, the representative can help the individual navigate the application process and ensure that they are providing all the necessary information to the SSA.

Another consideration when working while waiting for SSA disability is the impact on the individual's health. Many medical conditions can be exacerbated by the stress and physical demands of a job, which can further delay the disability application process. It's important for individuals to prioritize their health and discuss any concerns with their healthcare provider.

Finally, it's important to keep in mind that working while waiting for SSA disability benefits can impact the amount of benefits an individual is eligible for. If an individual is approved for disability benefits, the amount they receive may be reduced based on their earnings during the waiting period.

In conclusion, working while waiting for SSA disability benefits can be a complicated issue. It's important for individuals to consider their health, consult with a qualified disability representative, and understand the potential impact on their disability application and benefits. With careful planning and guidance, it may be possible to work while waiting for SSA disability without jeopardizing the application process.

How to Complete the Work History Questionnaire

Sat, 09 Mar 2024 03:49:14 GMT

When applying for social security disability benefits, one of the crucial steps is completing a work history questionnaire. This questionnaire helps the Social Security Administration (SSA) understand your work history and how it may impact your eligibility for disability benefits. Here are some tips on how to complete a work history questionnaire for social security disability.

Gather your work history information

Before filling out the questionnaire, gather all the necessary information about your past work. This includes the names and addresses of your employers, the dates you worked for them, the type of work you did, and your earnings. You may also need to provide information about any vocational training or education you've received.

Provide detailed information

When completing the questionnaire, provide as much detail as possible about your work history. This information will help the SSA understand the type of work you did, how long you did it, and how it may have contributed to your disability. If you can't remember specific details, try to provide estimates or your best recollection. Be sure to include information about any tools you used and the heaviest amount of weight you had to life in your job, even if the lifting was only done occasionally.

Be honest

It's important to be honest when filling out the questionnaire. Don't try to hide any work history or earnings, as this may result in a denial of your disability claim. The SSA will verify the information you provide, so it's crucial to provide accurate and truthful information.

Focus on the impact of your disability on your work

The work history questionnaire will ask you to describe your past work, but it's essential to focus on how your disability has affected your ability to work. Be sure to provide information about any accommodations you needed or were provided at work, and how your disability affected your productivity and ability to complete job tasks.

Seek help if needed

If you're struggling to complete the work history questionnaire or have any questions, don't hesitate to seek help. We are just a phone call or text message away. (see below)

Social Security Retirement Benefits for an Ex-Spouse

bob@simplesitecompany.com (Bob Hansen) — Sat, 09 Mar 2024 03:46:20 GMT

When it comes to retirement planning, many people overlook the potential benefits they may be entitled to through their ex-spouse's Social Security record. If you were married for at least 10 years and are now divorced, you may be eligible to receive Social Security retirement benefits based on your ex-spouse's earnings history. This can be an important source of income in retirement, so it's worth understanding how these benefits work.

Eligibility Requirements

To be eligible for Social Security retirement benefits based on your ex-spouse's earnings record, you must meet the following requirements:

You must have been married to your ex-spouse for at least 10 years
You must be at least 62 years old
You must be unmarried
The benefit you would receive based on your ex-spouse's earnings record must be higher than the benefit you would receive based on your own earnings record

If you remarry, you generally cannot collect benefits based on your ex-spouse's record unless your later marriage ends (whether by death, divorce, or annulment).

Benefits Calculation

The amount of your Social Security retirement benefit based on your ex-spouse's earnings record will depend on several factors, including your ex-spouse's earnings history, your age when you begin receiving benefits, and whether you have reached full retirement age or are claiming benefits early.

If you claim benefits based on your ex-spouse's record at your full retirement age, you will be entitled to 50% of the amount your ex-spouse is entitled to receive at their full retirement age. If you claim benefits early (at age 62, for example), your benefit will be reduced. On the other hand, if you delay claiming benefits beyond your full retirement age, you may be entitled to delayed retirement credits that can increase your benefit amount.

It's worth noting that claiming benefits based on your ex-spouse's record does not affect the amount of their benefit or the benefits of their current spouse or dependents. Additionally, if you are eligible for benefits based on your own earnings history as well as your ex-spouse's record, you can choose to claim whichever benefit is higher.

Applying for Benefits

To apply for Social Security retirement benefits based on your ex-spouse's earnings record, you will need to provide proof of your marriage and divorce, as well as your ex-spouse's Social Security number. You can apply for benefits online, by phone, or in person at your local Social Security office.

It's important to note that Social Security retirement benefits based on your ex-spouse's earnings record are not automatic - you must apply to receive them. If you think you may be eligible for these benefits, it's a good idea to start planning early and gather the necessary documents to support your application.

Conclusion

Social Security retirement benefits based on an ex-spouse's earnings record can provide an important source of income in retirement for those who meet the eligibility requirements. If you are divorced and meet these requirements, it's worth exploring your options for claiming benefits based on your ex-spouse's record. With careful planning and timely application, you can maximize your retirement income and achieve greater financial security in your golden years.

What information is needed at a social security disability hearing?

Sat, 09 Mar 2024 03:38:36 GMT

A social security disability hearing is held to determine if an individual meets the requirements for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. During the hearing, the administrative law judge will consider several types of evidence to determine the individual's eligibility for benefits. The following are some of the types of information that may be needed at a Social Security disability hearing:

Medical Records: Medical records are one of the most critical pieces of evidence in a disability hearing. The judge will want to review all medical records related to the individual's condition, including hospital records, doctor's notes, lab test results, and any other medical documentation that may be relevant.
Vocational Evidence: The judge will consider the individual's work history and educational background to determine if they are capable of performing any type of gainful employment. This may include vocational expert testimony, which is an evaluation of the individual's abilities and limitations.
Witness Testimony: The judge may consider testimony from witnesses, such as family members, friends, or coworkers, who can provide information about the individual's condition and limitations.
Function Reports: Function reports are forms completed by the individual and their family members or caregivers that provide details about the individual's daily activities, such as their ability to perform self-care tasks, complete household chores, or participate in social activities.
Any other relevant information: The judge may consider any other relevant information related to the individual's disability, such as school records or other types of documentation that support the claim.

It's important to note that the evidence needed may vary depending on the specific case, and the judge may request additional information as needed. It's always a good idea to work with an experienced Social Security disability representative to ensure that all necessary evidence is provided and presented effectively during the hearing.

SSI AND SSDI CALCULATIONS FOR PAST-DUE BENEFITS

Sat, 09 Mar 2024 03:37:11 GMT

Social Security is a federal program that provides financial support to people with disabilities, as well as those who have reached retirement age. The program is divided into two parts: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI).

SSI is a needs-based program that provides monthly payments to individuals who are disabled, blind, or over the age of 65, and who have limited income and resources. In contrast, SSDI is a program that provides benefits to individuals who have paid into the Social Security system through payroll taxes, and who become disabled before reaching retirement age.

Calculating Entitlement to SSI Benefits:

The calculation of SSI benefits is based on the individual's income, resources, and living arrangements. To qualify for SSI benefits, an individual must have limited income and resources. Social Security uses a complex formula to determine the amount of SSI benefits that an individual is entitled to receive, which takes into account the individual's living arrangements and other factors.

The maximum monthly SSI payment for an individual is $914, as of 2023. However, the actual payment amount may be less, depending on the individual's income and resources. Social Security may also reduce the amount of SSI benefits if the individual is receiving other forms of assistance, such as food stamps.

Offsetting Past-Due Benefits for SSDI:

When an individual is approved for SSDI benefits, they may be entitled to past-due benefits that accumulated between the date they became disabled and the date their application was approved. However, Social Security may offset the payment of past-due benefits by any SSI benefits that the individual received during the same period.

This offset is known as the "windfall offset" provision. The windfall offset provision is designed to prevent individuals from receiving both SSI and SSDI benefits for the same period of time, which could result in an overpayment of benefits.

To calculate the offset, Social Security subtracts the amount of SSI benefits that the individual received during the same period from the total amount of past-due SSDI benefits that they are entitled to receive. The individual receives the remaining balance of past-due benefits.

In conclusion, Social Security calculates entitlement to SSI benefits based on an individual's income, resources, and living arrangements, and uses a complex formula to determine the payment amount. Social Security may also offset the payment of past-due SSDI benefits by any SSI benefits that the individual received during the same period, using the windfall offset provision. These calculations and offsets can be complex, and it's important to consult with a qualified Social Security representative if you have questions or concerns about your entitlement to benefits.

Physical Examinations in Social Security Disability Claims

Sat, 09 Mar 2024 03:35:43 GMT

A physical examination by a doctor is an assessment of a patient's overall physical health and functioning. It involves a series of tests and observations to evaluate the patient's body systems and identify any abnormalities or potential health issues. Here are some of the things that a physical examination by a doctor can reveal:

1. Vital signs: The doctor will measure the patient's blood pressure, heart rate, respiratory rate, and temperature. Abnormalities in these vital signs can indicate underlying health problems.

2. General appearance: The doctor will assess the patient's overall appearance, including skin color, hydration, and level of consciousness.

3. Head and neck: The doctor will examine the patient's head, neck, and throat for any abnormalities, such as enlarged lymph nodes, masses, or deformities.

4. Heart and lungs: The doctor will listen to the patient's heart and lungs using a stethoscope to assess for any irregularities, such as murmurs or wheezing.

5. Abdomen: The doctor will palpate the patient's abdomen to check for any tenderness, swelling, or masses that could indicate digestive problems or other health issues.

6. Musculoskeletal system: The doctor will assess the patient's range of motion, strength, and flexibility, as well as evaluate the patient's posture and gait.

7. Neurological system: The doctor will evaluate the patient's reflexes, coordination, and sensory responses, as well as check for any signs of neurological disorders.

Overall, a physical examination provides a comprehensive assessment of a patient's physical health and functioning, and can reveal a wide range of potential health issues. It is an essential tool for doctors in diagnosing and treating health problems, and can be especially important in determining eligibility for disability benefits.

When filing for disability benefits with the Social Security Administration (SSA), it is crucial to have a thorough and detailed medical report from your doctor. One of the most important parts of this report is the physical examination. In this blog post, we will explore why the physical examination is so important in documenting your disability with the SSA.

First and foremost, the physical examination provides objective evidence of your medical condition. This is important because the SSA requires medical evidence to support your claim for disability benefits. The physical examination allows your doctor to assess your physical limitations and determine how they affect your ability to work. This information can be used to support your claim for disability benefits.

Secondly, the physical examination provides a baseline for future assessments. Disability claims can take a long time to process, and it is important to have a record of your medical condition at the time of your initial examination. Future assessments can be compared to this baseline to determine how your condition has changed over time.

Additionally, the physical examination can help identify conditions that may not be apparent through other diagnostic tests. For example, a physical examination may reveal muscle weakness or decreased range of motion that cannot be detected through an X-ray or MRI. This information can be critical in determining the severity of your condition and your ability to work.

Furthermore, the physical examination can help rule out other potential causes of your symptoms. For example, if you are experiencing back pain, a physical examination may reveal that your pain is caused by a herniated disc rather than a muscle strain. This information can be important in determining the appropriate course of treatment and assessing your ability to work.

Lastly, the physical examination provides an opportunity for your doctor to assess your functional limitations. This includes your ability to stand, walk, sit, lift, and perform other activities that are required for work. This information can be used to determine your residual functional capacity (RFC), which is the maximum amount of work you are capable of performing given your physical limitations.

In conclusion, the physical examination is an essential part of documenting your disability with the SSA. It provides objective evidence of your medical condition, a baseline for future assessments, identifies conditions that may not be apparent through other diagnostic tests, helps rule out other potential causes of your symptoms, and assesses your functional limitations. It is important to have a thorough and detailed medical report from your doctor, including a physical examination, when filing for disability benefits with the SSA.

Social Security Disability Appeal Levels

Sat, 09 Mar 2024 03:34:02 GMT

Social Security Disability (SSD) benefits are available to individuals who are unable to work due to a disabling medical condition. However, the application process can be complex and time-consuming, and not all claims are approved. If your initial claim is denied, there are several levels of appeal available to you. In this blog post, we will discuss the different appeal levels for social security disability claims.

1. Reconsideration

The first level of appeal is reconsideration. At this level, a different person from the Social Security Administration (SSA) will review your claim and any new evidence you have submitted. You have 60 days from the date of your denial letter to request reconsideration.

2. Administrative Law Judge Hearing

If your reconsideration is also denied, you can request a hearing with an Administrative Law Judge (ALJ). The ALJ will review your claim, any new evidence you have submitted, and any testimony from you or your witnesses. The hearing is usually held within 75 miles of your home, and you have the right to have a representative present.

3. Appeals Council Review

If the ALJ denies your claim, you can request a review by the Appeals Council. The Appeals Council will review your claim and any new evidence you have submitted. They may also decide to review the ALJ’s decision if they believe an error was made. The Appeals Council can either approve your claim, deny it, or send it back to the ALJ for further review.

4. Federal Court Review

If the Appeals Council denies your claim, you can file a lawsuit in federal court. The court will review your claim and any new evidence you have submitted. The court can either approve your claim, deny it, or send it back to the SSA for further review.

It’s important to note that the appeal process can take a long time, sometimes years. However, if you believe you are entitled to SSD benefits, it’s worth pursuing all available options.

In conclusion, if your initial social security disability claim is denied, there are several levels of appeal available to you. These include reconsideration, an administrative law judge hearing, an Appeals Council review, and a federal court review. It’s important to understand the appeal process and to have a representative who can help guide you through it. With persistence and the right support, you may be able to obtain the benefits you are entitled to.

How to Qualify for Medicaid in Florida

Sat, 09 Mar 2024 03:29:31 GMT

Medicaid is a government-funded health insurance program that provides coverage to low-income individuals and families who meet certain eligibility criteria. In Florida, Medicaid is administered by the Agency for Health Care Administration (AHCA), and there are several eligibility requirements that individuals must meet in order to qualify for coverage.

Here's what you need to know about how to be eligible for Medicaid in Florida:

1. Income requirements

To be eligible for Medicaid in Florida, your income must be below a certain level. The income limit varies depending on the size of your household and other factors, such as whether you have a disability. For example, in 2023, the income limit for a family of three is $2,628 per month.

2. Asset requirements

In addition to income limits, Medicaid in Florida also has asset limits that individuals must meet to be eligible for coverage. This means that you cannot have too many assets or savings. For example, the asset limit for an individual is $2,000, and for a couple, it is $3,000.

3. Citizenship or residency status

To be eligible for Medicaid in Florida, you must be a U.S. citizen or a qualified alien who meets certain residency requirements. You must also provide proof of identity and residency in the state.

4. Health needs

Medicaid in Florida provides coverage for certain health needs, including doctor visits, hospital care, prescription drugs, and long-term care services. You must have a medical need for these services to be eligible for coverage.

5. Category of eligibility

Medicaid in Florida has different eligibility categories for different groups of people, such as pregnant women, children, and individuals with disabilities. You must meet the eligibility criteria for your specific category in order to qualify for coverage.

6. Enrollment process

To apply for Medicaid in Florida, you can complete an application online, by mail, or in person at a local Department of Children and Families (DCF) office. You will need to provide information about your income, assets, and health needs, as well as proof of citizenship or residency status.

In conclusion, Medicaid in Florida provides health insurance coverage to low-income individuals and families who meet certain eligibility requirements. If you think you may be eligible for Medicaid, it's important to review the income and asset limits, residency requirements, and health needs to determine if you qualify for coverage. You can apply for Medicaid through the DCF office or online, and if you have any questions about eligibility or the enrollment process, you can contact the Florida AHCA for assistance.

If you have questions about how you can qualify for Medicaid because of a disability, please reach out to us by calling (407) 377-0700. At Hogan Smith, we help disabled people qualify for much-needed benefits.

How to Qualify for a Medicaid “Community Waiver” in Florida?

Sat, 09 Mar 2024 03:26:30 GMT

A Medicaid Community Waiver is a program that allows individuals who would otherwise require institutionalization in a nursing home or other care facility to receive long-term care services and support in their own homes or in community-based settings. These services can include personal care, meal preparation, transportation, respite care, and home modifications. In Florida, there are several eligibility requirements that individuals must meet in order to qualify for a Community Waiver for Medicaid.

Here's what you need to know about how to qualify for a Community Waiver for Florida Medicaid:

1. Medicaid eligibility

To be eligible for a Community Waiver for Medicaid in Florida, you must first meet the eligibility requirements for Medicaid. This includes having limited income and assets and meeting certain citizenship or residency requirements.

2. Level of care

You must have a level of care that would normally require placement in a nursing home or other institutional setting. This is determined through a standardized assessment called the Florida Assessment for Person-Centered Systems (FAPSC).

3. Functional need

You must have a functional need for the services provided by the waiver, such as assistance with activities of daily living (ADLs) or instrumental activities of daily living (IADLs).

4. Availability of services

The services and supports provided through the waiver must be available in your area and provided by qualified providers.

5. Prioritization

Due to limited funding, there may be a waiting list for some waiver programs. Priority is given to individuals who have the greatest need for services and support.

6. Choose a waiver program

Florida Medicaid offers several Community Waiver programs, each with its own eligibility requirements and services provided. You will need to choose a program that meets your needs and eligibility criteria. Some examples of Community Waiver programs in Florida include the Home and Community-Based Services (HCBS) Waiver for the Elderly, the HCBS Waiver for Persons with Developmental Disabilities, and the HCBS Waiver for Persons with Brain and Spinal Cord Injuries.

7. Apply for the waiver program

To apply for a Community Waiver program, you can contact a Medicaid waiver program provider in your area or the Florida Medicaid office for assistance. You will need to provide information about your medical condition, level of care, and functional needs, as well as proof of eligibility for Medicaid.

In conclusion, a Community Waiver for Florida Medicaid can provide long-term care services and support to individuals who would otherwise require institutionalization in a nursing home or other care facility. To qualify for a Community Waiver, you must meet the eligibility criteria for Medicaid, have a level of care that requires the waiver services, have a functional need for the services, and choose a program that meets your needs. If you have any questions about eligibility or the enrollment process, you can contact the Florida Medicaid office or a Medicaid waiver program provider in your area for assistance.

If you think you might qualify for a Community Waiver, have questions, or need assistance, we have resources to help you. Please reach out to us at (407) 377-0700.

What Medicaid Can Pay to Family Members Who Provide Care in Florida

Sat, 09 Mar 2024 03:24:14 GMT

Florida Medicaid provides a program called the Consumer Directed Care Plus (CDC+) program that allows eligible Medicaid recipients to hire their own family members or friends to provide them with care and assistance in their homes. The program is designed to give people with disabilities greater control over their own care and the flexibility to choose their caregivers. In this blog post, we will discuss what Florida Medicaid pays to family members who provide care to a disabled member of their household and what they must do to apply for the CDC+ program.

What Does Florida Medicaid Pay for Caregivers in the CDC+ Program?

Florida Medicaid pays family members who provide care to a disabled member of their household a wage for their services. The amount of the wage depends on the level of care needed and the location of the recipient. As of September 2021, the hourly wage for caregivers in the CDC+ program ranges from $10.25 to $15.50 per hour. The exact wage rate is determined by the recipient's level of care, the county of residence, and the skill level of the caregiver.

In addition to the hourly wage, caregivers may also be eligible for benefits such as health insurance, dental insurance, and paid time off. These benefits vary depending on the specific plan chosen by the recipient and the caregiver.

How to Apply for the CDC+ Program?

To apply for the CDC+ program, the recipient must be a Florida Medicaid beneficiary who meets the eligibility criteria for the program. The recipient must also have a need for in-home care and assistance.

Once the recipient is determined to be eligible, they can apply for the CDC+ program by completing an application and submitting it to their local Area Agency on Aging. The application will ask for information about the recipient's medical condition, the level of care needed, and the caregiver they wish to hire. The recipient will also need to select a fiscal agent to manage their Medicaid funds.

After the application is submitted, the recipient will be assessed to determine their level of care and the amount of funding they will receive from Medicaid. The recipient and their caregiver will then work together to develop a care plan that outlines the specific tasks and responsibilities of the caregiver. The caregiver will be trained to provide the necessary care, and the recipient will have the flexibility to adjust their care plan as needed.

Conclusion

The CDC+ program is a valuable resource for families who want to provide care for their disabled loved ones. It allows recipients to choose their own caregivers and have greater control over their own care. Florida Medicaid pays caregivers a wage for their services and provides additional benefits such as health insurance and paid time off. To apply for the program, the recipient must meet the eligibility criteria and complete an application with their local Area Agency on Aging.

What Should I Do If I Receive a Denial Notice from SSA?

Sat, 09 Mar 2024 03:22:22 GMT

If you have applied for Social Security disability benefits and received a denial notice, you may be wondering what steps you can take to appeal the decision. Appealing a denial notice from Social Security can be a complex and time-consuming process, but it may be necessary to receive the benefits you are entitled to. In this blog post, we will explore the steps you can take to appeal a denial notice from Social Security.

Step 1: Request a Reconsideration

The first step in appealing a denial notice from Social Security is to request a reconsideration of your claim. To do this, you will need to submit a written request within 60 days of receiving your denial notice. Your request for reconsideration should include any new medical evidence that supports your claim, as well as a detailed explanation of why you believe you are entitled to benefits.

Step 2: File an Appeal

If your request for reconsideration is denied, you can file an appeal with the Social Security Administration (SSA). To file an appeal, you will need to submit a written request within 60 days of receiving your denial notice. Your request for appeal should include a detailed explanation of why you believe you are entitled to benefits, as well as any new medical evidence that supports your claim.

What Should I Do If I Receive a Denial Notice from SSA?

If your appeal is denied, you can request a hearing before an administrative law judge (ALJ). To request a hearing, you will need to submit a written request within 60 days of receiving your denial notice. Your request for a hearing should include a detailed explanation of why you believe you are entitled to benefits, as well as any new medical evidence that supports your claim.

Step 4: Attend the Hearing

Once your request for a hearing is approved, you will be notified of the date, time, and location of your hearing. It is important to attend your hearing, as it provides an opportunity for you to present your case to the ALJ in person. You should be prepared to answer questions about your medical condition, work history, and other relevant information.

Step 5: Wait for the Decision

After your hearing, the ALJ will issue a written decision within a few weeks to a few months. If the decision is in your favor, you will begin receiving Social Security disability benefits. If the decision is not in your favor, you may have the option to request a review by the Appeals Council or file a lawsuit in federal court.

Conclusion

Appealing a denial notice from Social Security can be a challenging and time-consuming process, but it may be necessary to receive the benefits you are entitled to. It is important to carefully review the terms of your denial notice, gather any new medical evidence that supports your claim, and consult with a Social Security disability representative to help guide you through the appeals process. With patience, persistence, and the right legal representation, you can increase your chances of receiving the benefits you need.

Have questions or need help filing your appeal? Please reach out to us for assistance by calling or texting (407) 377-0700.

Why You Should Agree to a Video Teleconference Hearing

Sat, 09 Mar 2024 03:16:06 GMT

Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) are two critical government programs that provide financial assistance to people with disabilities. Unfortunately, the process of applying for and receiving SSDI and SSI benefits can be long, complicated, and frustrating. One of the most significant hurdles in the process is the disability hearing, where applicants are required to present their case to a judge. Historically, these hearings were held in person, but in recent years, video teleconferencing (VTC) has become an option. In this blog post, we will explore why you should consider doing your social security disability hearing by VTC.

1. Convenience

One of the most significant advantages of doing your disability hearing by VTC is convenience. You don't have to travel to a hearing location, which can be challenging for people with disabilities who may not have reliable transportation or who may have difficulty getting around. With VTC, you can participate in the hearing from the comfort of your own home, which can be less stressful and more convenient.

2. Safety

Another advantage of doing your disability hearing by VTC is safety. In light of the COVID-19 pandemic, many in-person hearings were postponed or canceled, leaving applicants in limbo. However, with VTC, you can still have your hearing without putting yourself or others at risk of exposure to the virus.

3. Accessibility

For applicants with disabilities, VTC hearings can be more accessible than in-person hearings. For example, applicants who use sign language or require other accommodations can often access those services more easily through VTC. Additionally, applicants who have difficulty traveling to an in-person hearing location can participate more easily in a VTC hearing.

4. Efficiency

Doing your disability hearing by VTC can also be more efficient than an in-person hearing. With VTC, there's no need to wait in a crowded waiting room or deal with other logistical issues that can arise with in-person hearings. This can make the hearing process faster and less stressful.

5. Equal Treatment

Finally, doing your disability hearing by VTC can help ensure equal treatment. In-person hearings can vary depending on the location, judge, and other factors, which can lead to inconsistent decisions. However, with VTC, the hearing process is more standardized, which can help ensure that all applicants are treated fairly.

In conclusion, doing your social security disability hearing by VTC can be a smart choice. It's more convenient, safer, more accessible, more efficient, and can help ensure equal treatment. If you're considering applying for SSDI or SSI benefits, be sure to explore the option of a VTC hearing with your lawyer or representative.

Getting Approved for Disability Before Age 50

Sat, 09 Mar 2024 03:12:05 GMT

Applying for disability benefits can be a long and challenging process, especially if you are under the age of 50. However, if you have a medical condition that prevents you from working, it is possible to get approved for disability benefits from the Social Security Administration (SSA). In this blog post, we will explore some tips for getting approved for disability under the age of 50.

1. Gather Medical Evidence

The SSA will require medical evidence to support your disability claim. It's essential to gather as much medical evidence as possible, including medical records, test results, and treatment history. Your medical evidence should clearly demonstrate the severity of your medical condition and how it limits your ability to work.

2. Follow Treatment Plans

The SSA will expect you to follow the prescribed treatment plan for your medical condition. If you don't follow the treatment plan, it can be more challenging to get approved for disability benefits. If you have concerns about your treatment plan, talk to your doctor about alternatives that may be more effective for you.

3. Be Honest and Accurate

It's crucial to be honest and accurate when filling out your disability application and answering questions during the application process. If you are caught lying or providing inaccurate information, it can significantly hurt your chances of getting approved for disability benefits.

4. Hire a Disability Representative

Navigating the disability application process can be complicated and overwhelming, especially if you are under the age of 50. Consider hiring a disability representative who specializes in disability claims. A disability representative can help you gather medical evidence, complete the application process, and represent you in appeals if necessary.

5. Stay Persistent

Getting approved for disability benefits can take time, especially if your initial application is denied. If you are denied, don't give up. You have the right to appeal the decision, and a disability lawyer can help you with this process. Stay persistent, and don't be afraid to ask for help.

In conclusion, getting approved for disability benefits under the age of 50 is possible. It's essential to gather medical evidence, follow treatment plans, be honest and accurate, consider hiring a disability lawyer, and stay persistent throughout the process. Remember that the disability application process can be long and challenging, but with the right support, you can get the benefits you need to support yourself and your family.

Social Security “Grid Rules” Explained

Sat, 09 Mar 2024 03:10:19 GMT

The Social Security Administration (SSA) uses a set of guidelines called the Grid Rules to help determine if an applicant is disabled and eligible for disability benefits. The Grid Rules, also known as the Medical-Vocational Guidelines, take into account an individual's age, education, work experience, and the severity of their medical condition. In this blog post, we will explore how Social Security uses the Grid Rules to determine if you are disabled.

What are the Grid Rules?

The Grid Rules are a set of tables that combine an individual's vocational factors (age, education, and work experience) with the severity of their medical condition. The Grid Rules determine whether an individual is considered disabled or not based on their ability to perform substantial gainful activity (SGA). SGA refers to the ability to work and earn a certain amount of income per month.

How do the Grid Rules work?

The Grid Rules have five categories that correspond to different levels of exertional work:

1. Sedentary

2. Light

3. Medium

4. Heavy

5. Very Heavy

Each category is further divided into four age groups: 18-49, 50-54, 55-59, and 60 and over. Within each age group, there are six different educational levels, ranging from illiterate to college-educated.

The Grid Rules are used to determine whether an individual can perform their past relevant work or any other work in the national economy. If an individual's vocational factors match the criteria in the Grid Rules, they are considered disabled and eligible for disability benefits.

For example, if an individual is 50 years old, has a high school education, and has worked in a physically demanding job in the past, the Grid Rules would consider them disabled if they have a severe medical condition that limits their ability to work at their previous job or any other job in the national economy.

It's important to note that the Grid Rules are just one factor that the SSA uses to determine disability eligibility. The SSA also considers medical evidence, work history, and other factors when making a decision.

Conclusion

The Grid Rules are an important tool that the Social Security Administration uses to determine if an individual is disabled and eligible for disability benefits. By considering an individual's vocational factors and the severity of their medical condition, the Grid Rules help ensure that disability benefits are awarded fairly and accurately. If you are considering applying for disability benefits, it's essential to understand how the Grid Rules work and how they may affect your eligibility. A disability representative can help you navigate the application process and increase your chances of getting approved for disability benefits.

What is a Vocational Expert?

Sat, 09 Mar 2024 03:08:39 GMT

When someone applies for Social Security Disability benefits, they may need to attend a hearing in front of an administrative law judge (ALJ). During this hearing, a vocational expert may be present to provide testimony about the claimant's ability to work and the availability of suitable jobs in the national economy.

So, what exactly is a vocational expert, and what role do they play in a Social Security hearing? Let's take a closer look.

What is a Vocational Expert?

A vocational expert (VE) is a professional who has expertise in the labor market and vocational factors related to jobs, such as the physical and mental demands of work, and the skills and abilities needed to perform certain jobs. They typically have a background in vocational rehabilitation counseling, job placement, or vocational education.

In a Social Security hearing, the VE is called upon to provide expert testimony about the claimant's ability to work, given their physical and mental limitations and the jobs that are available in the national economy. The VE is an impartial expert who provides an opinion based on their education, training, and experience.

What Does a Vocational Expert Do at a Social Security Hearing?

During a Social Security hearing, the VE will typically be asked to respond to hypothetical questions posed by the ALJ and the claimant's attorney. These questions will describe the claimant's physical and mental limitations, as well as their age, education, and work experience. The VE will then provide testimony about the claimant's ability to perform work-related activities and whether there are jobs that exist in significant numbers in the national economy that the claimant can perform, given their limitations.

The VE may rely on various sources of information to form their opinion, including the Dictionary of Occupational Titles (DOT) and the Occupational Information Network (O*NET). These resources provide information about the physical and mental demands of various jobs, as well as the skills and abilities required to perform those jobs.

The VE's testimony is based on their analysis of the claimant's medical records, work history, and other relevant information. They will consider the claimant's limitations, as well as any transferable skills or residual functional capacity (RFC) they may have. The VE will also take into account the claimant's age, education, and work experience, as these factors may affect their ability to perform certain jobs.

The VE's testimony can be crucial in determining whether a claimant is eligible for Social Security Disability benefits. If the VE testifies that there are no jobs available in the national economy that the claimant can perform, given their limitations, it may strengthen the claimant's case for disability benefits. On the other hand, if the VE testifies that there are jobs available that the claimant can perform, given their limitations, it may weaken the claimant's case for disability benefits.

Conclusion

In a Social Security hearing, a vocational expert provides expert testimony about the claimant's ability to work and the availability of suitable jobs in the national economy. Their testimony is based on their education, training, and experience, as well as a thorough analysis of the claimant's medical records, work history, and other relevant information. The VE's testimony can be crucial in determining whether a claimant is eligible for Social Security Disability benefits, and their impartiality is essential in ensuring that the decision is fair and objective.

What Happens After Your Social Security Hearing?

bob@simplesitecompany.com (Bob Hansen) — Sat, 09 Mar 2024 03:02:40 GMT

After your Social Security hearing, you may be wondering what happens next. The administrative law judge (ALJ) will review the evidence presented at the hearing and make a decision on your claim. Here's a breakdown of what to expect after your Social Security hearing.

Review of the Evidence

After the hearing, the ALJ will review all the evidence presented at the hearing, including medical records, vocational expert testimony, and any other evidence submitted. The ALJ will also review any additional evidence that was submitted after the hearing.

The ALJ will consider all the evidence in making a decision on your claim. The ALJ will evaluate the credibility of the testimony and determine the weight to be given to each piece of evidence.

Decision on Your Claim

Once the ALJ has reviewed all the evidence, they will issue a written decision on your claim. This decision will explain the ALJ's reasoning and conclusions and will include information about how to appeal the decision if necessary.

The decision will either grant or deny your claim for Social Security Disability benefits. If your claim is granted, the decision will include the amount of benefits you will receive and the date your benefits will begin.

If your claim is denied, the decision will explain the reasons for the denial and will include information about how to appeal the decision.

Appealing the Decision

If your claim is denied, you have the right to appeal the decision. You must file an appeal within 60 days of receiving the decision.

The first level of appeal is a request for reconsideration. A different reviewer will take a fresh look at your case and will consider any new evidence you submit.

If your claim is denied again at the reconsideration level, you can request a hearing before an Appeals Council. The Appeals Council will review the decision made by the ALJ and may either grant your claim or deny it.

If your claim is still denied after the Appeals Council review, you may file a lawsuit in federal court.

Conclusion

After your Social Security hearing, the ALJ will review all the evidence presented and issue a decision on your claim. If your claim is granted, you will receive benefits. If your claim is denied, you have the right to appeal the decision. Understanding the process and your options for appeal can help you make informed decisions about your claim.

How Can I Help My Representative Obtain My Medical Records?

Sat, 09 Mar 2024 02:59:41 GMT

When applying for disability benefits, one of the most important pieces of evidence is your medical records. Your medical records provide a detailed picture of your medical history, including any diagnoses, treatments, and medications you have received. As such, it is important that your representative has access to all of your medical records in order to present a strong case for disability benefits. Here are some steps you can take to help your representative obtain all of your medical records:

1. Provide a complete list of healthcare providers

The first step in obtaining your medical records is to provide your representative with a complete list of all healthcare providers you have seen for your medical condition. This should include all doctors, hospitals, clinics, and other healthcare providers that you have visited. Be sure to include the name of the provider, their address and phone number, and the dates of your visits.

2. Sign the necessary release forms

In order for your representative to obtain your medical records, they will need your permission. This means you will need to sign release forms giving your healthcare providers permission to release your records to your representative. Be sure to provide your representative with the necessary forms, and sign them as soon as possible.

3. Follow up with healthcare providers

After you have signed the necessary release forms, your representative will begin the process of obtaining your medical records. However, it is important that you follow up with your healthcare providers to make sure that they have received the request and are sending the records to your representative in a timely manner. You may need to contact your providers multiple times to ensure that your records are sent.

4. Keep a copy of your medical records

Once your representative has obtained your medical records, it is important that you keep a copy for your own records. This will ensure that you have a complete and accurate record of your medical history, and can review the records to make sure that all of the information is correct.

5. Provide updates as needed

If you receive any new medical treatment or testing after your representative has obtained your medical records, be sure to provide updates to your representative as soon as possible. This will ensure that your representative has the most up-to-date information about your medical condition.

Conclusion

Obtaining your medical records is an important step in the process of applying for disability benefits. By providing a complete list of healthcare providers, signing the necessary release forms, following up with your healthcare providers, keeping a copy of your medical records, and providing updates as needed, you can help your representative obtain all of your medical records and present a strong case for disability benefits.

How a Representative Can Help You Apply for Disability Benefits

Sat, 09 Mar 2024 02:53:34 GMT

Applying for Social Security disability benefits can be a complicated and overwhelming process. It involves gathering extensive medical documentation, understanding complex legal requirements, and submitting a thorough application that demonstrates the extent of your disability and its impact on your ability to work. That's where a representative can help. Here are some ways a representative can assist you in applying for Social Security disability benefits.

1. Determine eligibility

One of the first things a representative can do is help you determine whether you are eligible to apply for Social Security disability benefits. They can explain the criteria the Social Security Administration (SSA) uses to determine eligibility and help you understand how your specific situation fits within those guidelines.

2. Collect evidence

To be approved for disability benefits, you need to provide extensive medical documentation that demonstrates the nature and severity of your condition. A representative can help you collect all the relevant medical records, test results, and other documentation you need to provide to the SSA. They can also help you understand which types of medical evidence are most effective in supporting your claim.

3. Complete the application

The application for Social Security disability benefits can be long and complex. A representative can help you complete the application accurately and thoroughly, ensuring that all the necessary information is included. They can also help you understand any legal terms or concepts that you may not be familiar with.

4. Communicate with the SSA

Once your application has been submitted, a representative can act as a liaison between you and the SSA. They can answer any questions the SSA may have about your application and provide additional information or documentation as needed.

5. Appeal a denial

If your initial application is denied, a representative can help you file an appeal. They can help you understand why your application was denied and what steps you need to take to strengthen your case. They can also represent you during the appeals process, including appearing with you at any hearings or conferences.

6. Navigate the process

Perhaps most importantly, a representative can help you navigate the entire process of applying for Social Security disability benefits. They can explain what to expect at every step, help you meet deadlines, and ensure that you don't miss any important steps along the way.

Conclusion

Applying for Social Security disability benefits is a challenging process, but a representative can help you navigate it and increase your chances of success. They can assist with determining eligibility, collecting evidence, completing the application, communicating with the SSA, appealing a denial, and navigating the entire process. If you are considering applying for Social Security disability benefits, it is worth considering working with a representative to help you achieve a successful outcome.

SSA-3368-BK Disability Report- Adult

Sat, 09 Mar 2024 02:51:21 GMT

The Disability Report - Adult form is a crucial part of the Social Security disability benefits application process, and it's important to answer each question as accurately and thoroughly as possible. Here is a brief overview of the questions on the form and some tips for how to answer them:

1. Personal information: This section asks for your basic information, such as your name, Social Security number, and contact information. Be sure to provide all the requested information and ensure that it is accurate.

2. Contact information for someone who knows about your medical conditions: You will be asked to provide the name and contact information of someone who knows about your medical conditions. This could be a family member, friend, or healthcare provider. It's important to choose someone who is willing and able to provide information about your medical history and current condition.

3. Medical conditions: This section asks about your medical conditions, including the names of your healthcare providers and the dates of your most recent medical visits. Be sure to include all medical conditions that affect your ability to work.

4. Medications: You will be asked to provide information about any medications you are taking, including the name, dosage, and frequency.

5. Medical tests: This section asks about any medical tests you have had, including blood tests, X-rays, and other diagnostic tests.

6. Work history: You will be asked to provide information about your work history, including your past jobs and the tasks you performed. Be sure to include any accommodations you received in the workplace.

7. Education and training: This section asks about your education and training, including any degrees or certifications you have earned.

8. Activities of daily living: You will be asked about your ability to perform activities of daily living, such as dressing, grooming, and cooking.

9. Pain and symptoms: This section asks about your pain and other symptoms, such as fatigue, dizziness, and difficulty breathing.

10. Mental health: You will be asked about your mental health, including any diagnoses and treatments you have received.

11. Functional limitations: This section asks about any functional limitations you have, such as difficulty standing or sitting for long periods of time.

12. Other information: Finally, you will be given the opportunity to provide any additional information that you think is important for Social Security to consider in evaluating your disability claim.

Remember to answer each question as accurately and thoroughly as possible. Providing detailed information about your medical conditions, symptoms, and limitations can help strengthen your disability claim. If you have any questions or need assistance, consider working with a representative who can guide you through the process.

What are In-Kind Distributions and How Does it Affect My SSI Payments?

Sat, 09 Mar 2024 02:48:11 GMT

Supplemental Security Income (SSI) is a federal program designed to provide financial assistance to disabled or elderly individuals with limited income and resources. When determining an individual's eligibility for SSI, the Social Security Administration (SSA) considers all income and resources available to the individual, including "in-kind" distributions. In this blog post, we will discuss what "in-kind" distributions are and how they can impact your eligibility for monthly SSI benefits.

What are "in-kind" distributions?

"In-kind" distributions refer to the provision of food, shelter, or other non-cash items to an individual by another person or organization. For example, if a person receives free rent or meals from a friend or family member, that would be considered an "in-kind" distribution. The value of the distribution is included in the calculation of the individual's countable income for SSI purposes.

How do "in-kind" distributions impact SSI eligibility?

When determining eligibility for SSI, the SSA uses a complex formula that takes into account an individual's countable income and resources. If the individual's countable income exceeds the SSI income limit, they may be ineligible for monthly benefits. "In-kind" distributions are included in the calculation of countable income and can reduce an individual's SSI benefits.

For example, let's say a disabled individual receives free rent from their sister, which is valued at $400 per month. The SSA would count this $400 as part of the individual's countable income for SSI purposes, which could potentially reduce or eliminate their monthly SSI benefits.

However, there are certain exclusions and deductions that can reduce the impact of "in-kind" distributions on SSI eligibility. For example, the SSA allows for a "presumed maximum value" exclusion of up to $284 per month for in-kind support and maintenance. Additionally, certain deductions, such as the "shelter deduction," can further reduce the impact of "in-kind" distributions on SSI eligibility.

It's important to note that failure to report "in-kind" distributions to the SSA can result in penalties and even criminal charges. Therefore, it's crucial to report any changes in income or living arrangements to the SSA promptly.

In conclusion, "in-kind" distributions can impact an individual's eligibility for monthly SSI benefits. However, there are exclusions and deductions available that can reduce the impact of these distributions on SSI eligibility. If you have any questions or concerns about "in-kind" distributions and their impact on your SSI benefits, it's recommended to contact your local Social Security office or work with a qualified representative to help guide you through the process.

Editorial: What’s Wrong with the Social Security System

bob@simplesitecompany.com (Bob Hansen) — Sat, 09 Mar 2024 02:46:11 GMT

As one of the most significant social safety net programs in the United States, Social Security Disability Insurance (SSDI) provides essential support for millions of Americans living with disabilities. However, the system is far from perfect, and there are several areas where it is failing those who rely on it for assistance. In this blog post, we will explore what is wrong with the social security disability system and what changes are needed to address these shortcomings.

One of the most significant issues with the SSDI system is the lengthy and complicated application process. Applying for disability benefits can be an overwhelming and frustrating experience for many individuals, with lengthy wait times and extensive paperwork requirements. The backlog of cases at the Social Security Administration (SSA) has reached unprecedented levels, with many applicants waiting months or even years for a decision on their claim.

Another problem with the system is the stringent eligibility requirements. The SSA requires applicants to meet strict criteria to qualify for disability benefits, and many individuals are denied benefits despite having legitimate disabilities. The appeals process can be long and arduous, and many individuals are forced to hire attorneys or advocates to represent them, adding to the financial burden of an already vulnerable population.

Furthermore, the system has not kept pace with changes in the workforce and the economy. With more individuals working in non-traditional jobs, such as gig work or self-employment, the current system may not accurately reflect their work history or earning potential. This can lead to lower benefit amounts or even disqualification for SSDI benefits, leaving individuals with disabilities without adequate support.

Finally, the SSDI system is facing a funding crisis. The trust fund that supports SSDI is projected to run out of money in the next few years, leaving many individuals without the financial support they need. This has led to discussions about potential cuts to benefits or changes to the eligibility requirements, which could further harm vulnerable individuals and their families.

It's clear that the social security disability system is in need of significant reform. To start, the application process needs to be streamlined and simplified to reduce wait times and alleviate the burden on applicants. The eligibility requirements should also be revised to ensure that deserving individuals are not unfairly denied benefits. Additionally, the system needs to adapt to changes in the economy and workforce to ensure that all individuals with disabilities are adequately supported.

In conclusion, while the social security disability system provides critical support for millions of Americans, there are significant shortcomings that must be addressed. By reforming the system to better serve those who rely on it, we can ensure that all individuals with disabilities have access to the support they need to live full and dignified lives.

How SSA Determines Disability

Sat, 09 Mar 2024 02:41:38 GMT

The Social Security Administration (SSA) provides disability benefits to individuals who are unable to work due to a severe medical condition. To determine whether an individual is disabled, the SSA uses a five-step sequential evaluation process. The evaluation process considers an individual's age, education, work experience, and medical condition to determine whether they meet the criteria for disability benefits.

Step One: Substantial Gainful Activity

The first step in the evaluation process is to determine whether the individual is engaged in substantial gainful activity (SGA). SGA refers to any work that is performed for pay or profit. If the individual is engaging in SGA, they are not eligible for disability benefits, regardless of the severity of their medical condition.

Step Two: Severity of Medical Condition

If the individual is not engaging in SGA, the SSA will evaluate the severity of their medical condition. The medical condition must be severe enough to significantly limit the individual's ability to perform basic work-related activities, such as sitting, standing, walking, and lifting.

Step Three: Listing of Impairments

The SSA maintains a list of medical conditions that are considered severe enough to automatically qualify an individual for disability benefits, known as the Listings of Impairments. If the individual's medical condition is listed on the Listings of Impairments, they will be approved for disability benefits. However, if the medical condition is not on the list, the evaluation process will proceed to the next step.

Step Four: Ability to Perform Past Work

In step four, the SSA will evaluate whether the individual is able to perform their past work. This evaluation considers the individual's residual functional capacity (RFC), which is the maximum level of physical and mental activity they can perform despite their medical condition. If the individual is able to perform their past work, they will not be eligible for disability benefits.

Step Five: Ability to Perform Other Work

If the individual is unable to perform their past work, the SSA will evaluate whether they are able to perform other work. This evaluation considers the individual's age, education, work experience, and RFC. If the individual is unable to perform other work, they will be approved for disability benefits.

Age Groups and Disability Determination

The SSA recognizes that an individual's age plays a significant role in their ability to work. For this reason, the evaluation process for disability benefits considers age as a key factor. The SSA categorizes individuals into different age groups to determine disability eligibility.

For individuals under the age of 50, the evaluation process is the same as outlined above. However, for individuals aged 50 and over, the evaluation process changes slightly. At this age, the SSA recognizes that it becomes more difficult to find new employment, and it may be more challenging to adapt to new work environments. Therefore, the evaluation process gives greater weight to the individual's work experience and skills acquired over the years.

Listings of Impairments

The Listings of Impairments contain medical conditions that are considered severe enough to automatically qualify an individual for disability benefits. The list includes medical conditions such as cancer, respiratory disorders, cardiovascular disorders, musculoskeletal disorders, and mental disorders.

If the individual's medical condition is listed on the Listings of Impairments, the evaluation process stops, and the individual will be approved for disability benefits. However, if the individual's medical condition is not on the list, they can still be approved for disability benefits if they can show that their medical condition is equivalent in severity to a listed impairment.

Compassionate Allowances

Compassionate Allowances are a special provision that expedites the evaluation process for individuals with medical conditions that are so severe that it is clear that they meet the criteria for disability benefits. The Compassionate Allowances program is designed to ensure that individuals with the most severe medical conditions receive disability benefits in a timely and efficient manner.

Conclusion

The Social Security Administration uses a Five-Step sequential evaluation process to determine eligibility for disability benefits. Your age is a significant factor in the determination of whether you meet their criteria for a finding of disability. If you have an impairment that meets or equals one the the “Listing of Impairments” or a condition listed in the Compassionate Allowances list, your case may get approved faster than normal.

The Importance of the Date Last Insured for Social Security Disability Claims

Sat, 09 Mar 2024 02:35:03 GMT

If you are applying for Social Security Disability Insurance (SSDI), you may have heard of the term "date last insured" or DLI. But what does it mean and why is it important for your claim?

Your DLI is the last date that you are eligible to qualify for SSDI based on your work history and earnings. It is calculated by looking at your work credits, which are units of measurement that reflect how much you have paid into the Social Security system through payroll taxes. In 2023, you earn one work credit for every $1,640 you earn, up to a maximum of four credits per year.

To qualify for SSDI, you generally need to have 20 work credits in the 10 years before you became disabled. This means that you need to have worked at least five out of the last 10 years. Your DLI is usually about five years after you last worked, but it can vary depending on your earnings and work pattern.

Your DLI is important because it determines whether you meet the insured status requirement for SSDI. You need to prove that you became disabled before your DLI in order to receive monthly benefits. If you apply for SSDI after your DLI has passed, you will not be eligible for benefits unless you can show that your disability started before your DLI.

Therefore, it is crucial to file your SSDI claim as soon as possible after you become disabled and stop working. The longer you wait, the more likely it is that your DLI will expire and you will lose your eligibility for SSDI. You should also gather medical evidence that supports your disability onset date and shows how your condition prevents you from working.

If you need help with your SSDI claim, contact Hogan Smith today. We are a team of experienced disability advocates who can guide you through the complex process of applying for SSDI. We can help you determine your DLI, gather evidence, fill out forms, appeal denials, and represent you at hearings. We work on a contingency basis, which means we only get paid if we win your case. Call us today for a free consultation and let us help you get the benefits you deserve.

Source: Conversation with Bing, 5/24/2023(1) What Is the Date Last Insured (DLI) for Disability Benefits?. https://www.disabilitysecrets.com/resources/social-security-disability/social-security-basics/date-last-insured.htm Accessed 5/24/2023.

(2) SSA - POMS: DI 25501.320 - Date Last Insured (DLI) and the Established .... https://secure.ssa.gov/poms.NSF/lnx/0425501320 Accessed 5/24/2023.

(3) Date Last Insured: Everything You Need To Know And How It Affects Your .... https://damichigan.com/date-last-insured-everything-you-need-to-know-and-how-it-affects-your-ssd-claim/ Accessed 5/24/2023.

(4) Date Last Insured or “DLI”: What it Means and Why it is Important. https://www.midwestdisability.com/blog/2021/04/date-last-insured-or-dli-what-it-means-and-why-it-is-important/ Accessed 5/24/2023.

The Crucial Role of Communicating Symptoms and Positive Findings in Social Security Disability Claims

Sat, 09 Mar 2024 02:30:32 GMT

Introduction:

Navigating the process of applying for Social Security Disability benefits can be complex and challenging. One of the key factors that can greatly impact the success of your claim is effectively communicating your symptoms and positive findings during the examination. In this blog post, we will discuss the importance of openly sharing your symptoms and the significance of positive findings in the context of Social Security Disability claims.

1. Establishing Medical Evidence:

Social Security Disability claims require strong medical evidence to support your case. When you communicate your symptoms to your healthcare provider, they can document these details in your medical records. This documentation becomes crucial evidence that strengthens your claim. By accurately describing your symptoms, you provide a comprehensive picture of how your condition affects your daily life, which is vital in demonstrating your eligibility for disability benefits.

2. Supporting Functional Assessments:

Social Security Disability claims often involve assessments of your functional abilities and limitations. Positive findings during your examination, such as abnormal test results, physical restrictions, or cognitive impairments, can greatly contribute to establishing the severity of your condition. These findings provide objective evidence that supports your claim and substantiates your need for disability benefits. Openly discussing and documenting these positive findings is vital in conveying the full impact of your condition on your ability to work.

3. Meeting Disability Criteria:

To qualify for Social Security Disability benefits, you must meet specific criteria outlined by the Social Security Administration (SSA). These criteria include the severity and duration of your condition, as well as the functional limitations it imposes. By sharing your symptoms and positive examination findings, you provide the necessary information to demonstrate that your condition meets the requirements set forth by the SSA. Failure to communicate these vital details may result in an incomplete or insufficient claim.

4. Strengthening the Credibility of Your Claim:

When applying for Social Security Disability benefits, credibility is crucial. The SSA carefully evaluates the credibility of your claim, and consistent and thorough documentation of your symptoms and positive findings can significantly enhance your credibility. By openly sharing this information with your healthcare provider, you demonstrate that you are actively seeking medical treatment and are invested in managing your condition. This strengthens the credibility of your claim and increases your chances of a favorable decision.

5. Facilitating the Disability Determination Process:

The disability determination process is often complex and time-consuming. However, by effectively communicating your symptoms and positive findings, you can streamline this process. Clear documentation of your condition, supported by medical evidence, allows the SSA to make a more accurate and informed decision. Your active involvement in sharing this information ensures that the disability determination process can progress efficiently, potentially reducing the waiting time for a decision on your claim.

Conclusion:

When pursuing Social Security Disability benefits, effectively communicating your symptoms and positive findings is paramount. These crucial details provide the necessary evidence to support your claim, demonstrate the severity of your condition, and establish your eligibility for disability benefits. By actively engaging in open and honest communication with your healthcare provider, you empower yourself to present a comprehensive case that increases your chances of a successful outcome in your Social Security Disability claim. Remember, the importance of thorough communication cannot be overstated when it comes to navigating the complexities of the disability benefits system.

The Essential Role of Diagnostic Tests in Strengthening Your Social Security Disability Claim

Sat, 09 Mar 2024 02:27:05 GMT

Introduction:

When it comes to applying for Social Security Disability benefits, a comprehensive and well-supported claim is crucial for a successful outcome. One vital component in strengthening your claim is the effective utilization of diagnostic tests. These tests provide objective evidence that supports your case by confirming the existence, severity, and functional limitations of your medical condition. In this blog post, we will explore the important role that diagnostic tests play in supporting your claim for Social Security Disability benefits.

1. Objective Confirmation of Your Condition:

Diagnostic tests offer objective evidence that confirms the presence of your medical condition. While subjective symptoms are essential to describe the impact of your condition on your daily life, diagnostic tests provide concrete proof that your condition is medically verifiable. This objective confirmation significantly strengthens your claim and helps to establish the validity of your condition in the eyes of the Social Security Administration (SSA).

2. Assessing the Severity of Your Condition:

One of the key factors in determining eligibility for Social Security Disability benefits is the severity of your condition. Diagnostic tests play a critical role in assessing the severity and progression of your medical condition. They provide objective measurements of functional limitations, physical impairments, or cognitive deficits, which are vital in demonstrating the extent to which your condition hampers your ability to work. These test results provide solid evidence to support the severity component of your disability claim.

3. Correlation with Functional Limitations:

Diagnostic tests can establish a direct correlation between your condition and the functional limitations it imposes. They help to quantify the impact of your condition on your ability to perform specific tasks, such as walking, lifting, or concentrating. These objective measurements are valuable evidence that demonstrates how your condition restricts your capacity to engage in substantial gainful activity. By aligning the test results with the functional limitations defined by the Social Security Administration, you strengthen the credibility and validity of your claim.

4. Monitoring Disease Progression:

In some cases, chronic conditions may exhibit progressive deterioration over time. Diagnostic tests serve as benchmarks for monitoring disease progression and documenting changes in your medical condition. By regularly undergoing these tests and providing updated results, you can illustrate the long-term impact and chronic nature of your condition. This documentation reinforces the notion that your condition is persistent and unlikely to improve, further supporting your claim for Social Security Disability benefits.

5. Objectivity in the Decision-Making Process:

Social Security Disability claims are subject to a rigorous review process, and decisions are often based on objective evidence. Diagnostic tests offer an objective perspective, independent of subjective reports, providing the necessary medical proof that your condition meets the criteria for disability benefits. By including these test results in your claim, you enhance the objectivity of your case, giving the SSA a solid basis for evaluating your eligibility.

Conclusion:

Diagnostic tests are invaluable tools in strengthening your claim for Social Security Disability benefits. They offer objective evidence that confirms the existence and severity of your condition, correlates with functional limitations, and monitors disease progression over time. By presenting these test results alongside your medical records and subjective symptoms, you provide a comprehensive and compelling case to the Social Security Administration. Remember, the role of diagnostic tests in supporting your claim cannot be overstated, as they bring credibility, objectivity, and concrete evidence to your pursuit of Social Security Disability benefits.

Demystifying Exertional and Skill Levels in Social Security Disability Evaluation

Sat, 09 Mar 2024 02:18:59 GMT

Introduction:

When it comes to assessing disability claims, the Social Security Administration (SSA) follows specific guidelines to determine an individual’s eligibility for benefits. Two key factors that play a significant role in this evaluation are exertional levels and skill levels. Understanding how these levels are defined and how they affect disability claims is crucial for applicants. In this blog post, we will explore the definitions and implications of exertional and skill levels in the context of Social Security Disability evaluations.

1. Exertional Levels:

Exertional levels refer to the physical capabilities and demands associated with work activities. The SSA classifies exertional levels into five categories:

Sedentary Work: Involves primarily sitting, with occasional standing or walking. The individual may be required to lift/carry up to 10 pounds.
Light Work: Requires standing or walking for prolonged periods and involves lifting/carrying weights of up to 20 pounds.
Medium Work: Involves frequent standing, walking, and lifting/carrying weights up to 50 pounds.
Heavy Work: Demands significant physical effort, such as frequent lifting/carrying of up to 100 pounds.
Very Heavy Work: Requires exertion beyond heavy work, with lifting/carrying weights exceeding 100 pounds.

The assigned exertional level considers an individual’s ability to perform physical tasks and determines their capacity to engage in different types of work activities.

2. Skill Levels:

Skill levels focus on the mental or cognitive requirements necessary for performing work-related tasks. The SSA categorizes skill levels into three main categories:

Unskilled Work: Involves simple, routine tasks that can be learned in a short period without extensive training. Unskilled work generally requires minimal judgment or decision-making.
Semi-Skilled Work: Requires some training or experience to perform specific job duties. These tasks may involve more complex actions but do not typically require highly specialized or technical skills.
Skilled Work: Demands specialized knowledge, training, or education. Skilled work usually requires expertise, specific qualifications, or professional certifications in a particular field.

The assigned skill level assesses an individual’s capacity to adapt to different types of work, taking into account their acquired skills and experience.

3. Evaluation of Disability Claims:

Exertional and skill levels are crucial components in evaluating disability claims. They are considered in conjunction with an individual’s medical condition, age, education, and work history. The SSA determines whether an applicant’s limitations, as determined by their exertional and skill levels, prevent them from engaging in substantial gainful activity (SGA). SGA refers to work that involves significant physical or mental exertion and provides income above a certain threshold.

The evaluation process examines whether the individual’s impairments, combined with their exertional and skill levels, prohibit them from performing their previous work or any other work available in the national economy. If their limitations significantly restrict their ability to engage in substantial gainful activity, they may be eligible for Social Security Disability benefits.

Conclusion:

Exertional and skill levels are essential considerations in the evaluation of Social Security Disability claims. Exertional levels assess the physical capabilities and demands associated with work, while skill levels evaluate the mental or cognitive requirements necessary for different types of tasks. Understanding how these levels are defined and their impact on disability claims can help applicants present a comprehensive case that highlights the limitations caused by their impairments. By providing accurate and detailed information regarding exertional and skill levels, individuals can effectively demonstrate their inability to perform substantial gainful activity due to their conditions, thus increasing their chances of receiving the necessary support and assistance through Social Security Disability benefits.

Understanding the “Family Maximum” in Social Security Benefit Payments

Sat, 09 Mar 2024 02:01:08 GMT

Introduction:

The Social Security Administration (SSA) provides vital benefits to individuals and their families, offering financial security during retirement, disability, or in the event of a beneficiary’s passing. However, it’s important to be aware of certain rules and limitations that govern these benefits. One such rule is the “family maximum,” which impacts the total amount a family can receive in Social Security benefits. In this blog post, we will delve into the concept of the family maximum and how it applies when the SSA disburses benefits to eligible recipients.

1. Defining the Family Maximum:

The family maximum is a provision implemented by the SSA to ensure that Social Security benefits do not exceed a certain limit for a given family. It is designed to prevent any one family from receiving an excessive amount of benefits based on a single wage earner’s record. The family maximum is set as a percentage of the wage earner’s primary insurance amount (PIA), which is the benefit amount the wage earner would receive at their full retirement age.

2. Calculation of the Family Maximum:

The specific calculation for the family maximum can vary depending on the unique circumstances of each family. Generally, the family maximum is a percentage of the wage earner’s PIA, ranging from 150% to 188%. The exact percentage used depends on the total number of family members who are eligible to receive benefits based on the wage earner’s record. It’s important to note that the family maximum applies to the total benefits paid to family members, not to the individual benefit amounts.

3. Eligibility for Family Benefits:

In order to be eligible for family benefits, individuals must meet specific criteria. Generally, eligible family members include a spouse, children, and in some cases, dependent parents. Each family member’s benefit amount is determined based on their relationship to the wage earner and their own eligibility requirements. The total benefits paid to the family cannot exceed the established family maximum, regardless of the number of eligible family members.

4. Adjustments and Priority Rules:

When the total benefits payable to a family exceed the family maximum, adjustments are made to ensure compliance with the limit. First, the benefits of the wage earner remain unchanged. Then, the benefits of eligible family members are adjusted proportionately to fit within the family maximum. If necessary, this adjustment may result in reducing the benefits of some family members. However, the wage earner’s benefits will not be affected by the application of the family maximum.

5. Impact on Benefit Planning:

Understanding the concept of the family maximum is crucial when planning for Social Security benefits. It helps individuals and families anticipate the maximum amount they can expect to receive, taking into account the potential impact on their overall financial planning. By being aware of the limitations imposed by the family maximum, individuals can make informed decisions regarding their retirement or disability strategies and ensure their financial well-being.

Conclusion:

The family maximum is a provision within the Social Security system that ensures benefits paid to families do not exceed a certain limit. By implementing this rule, the Social Security Administration aims to maintain fairness and prevent excessive benefit payments to any one family. Understanding how the family maximum is calculated and applied is essential for individuals and families seeking Social Security benefits. By familiarizing ourselves with these regulations, we can make informed decisions and better plan for our financial future.

I Received a Fully Favorable Decision, Now What?

Fri, 08 Mar 2024 23:13:58 GMT

If you have recently received a fully favorable decision from a Social Security Disability Insurance (SSDI) judge, then congratulations! After a long application and appeal process, you have finally been approved to receive your much-needed disability benefits.

But what happens next after you get that long-awaited approval letter in the mail? When will you see some money and start receiving monthly payments?

The Steps Involved in Getting Your SSDI Back Pay

The Social Security Administration (SSA) doesn’t start paying out benefits right away after approval. There is still some processing time involved before you get your first payment. Here’s what you can expect:

The Payment Center Calculates Your Benefit Amount

The SSA field offices transfer your approval notice to the Payment Center. This is the office that handles all accounting and payments. Here they will double-check dates and eligibility factors and calculate the exact amount you are owed in SSDI back payments and monthly benefits going forward.

SSA Notifies You of Your Benefit Details

Within 1-2 months of the approval notice, you’ll get a ”Notice of Award” confirming your monthly benefit rate, total past due benefits owed, deductions (if any), and approximate date of your first payment. This helps set expectations upfront.

You Get Your Lump Sum Retroactive Payment

Within 3 months (sometimes faster), the Payment Center will issue your lump sum back payment for all benefits owed from your established disability onset date until now. It may come on a prepaid card or through direct deposit you set up.

Ongoing Monthly Payments Begin

At the same time or right after your retroactive lump sum payment goes out, you will receive monthly SSDI deposits of your benefit rate going forward. For most beneficiaries with direct deposit, ongoing payments arrive on the 3rd of every month.

Use the SSA Payments Dashboard

Once payments begin, you can also set up and log into your personal My Social Security account online to use the Payments Dashboard feature. This helps you monitor the status of all payments issued and track each step along the way.

The process may seem lengthy, but the good news is that a fully favorable decision means the hard work is done – approval is secure and payments are now in motion! Within a few months, you will have financial relief and stability again thanks to the essential SSDI benefits you deserve.

Why Is My Case Taking So Long? Understanding Delays in Social Security Disability Claims

Fri, 08 Mar 2024 05:54:09 GMT

Introduction

If you've applied for Social Security Disability (SSD) benefits, you're likely experiencing a mix of emotions — hope for financial support, anxiety about the outcome, and frustration over the time it takes. Many claimants find themselves asking, "Why is my case taking so long?" This is a valid question and understanding the reasons behind these delays can provide some peace of mind.

Complex Process and High Volume of Applications

The Social Security Administration (SSA) handles thousands of disability claims each year. Each application undergoes a rigorous evaluation process to determine eligibility. This includes reviewing medical records, work history, and often, additional information. The sheer volume of applications, combined with the detail-oriented nature of the evaluation, contributes significantly to the delay.

Medical Evidence and Documentation

A key factor in the processing time is the collection and review of medical evidence. The SSA requires comprehensive medical documentation to support each claim. Gathering records from various healthcare providers can be time-consuming, and if the evidence is incomplete or unclear, the SSA may request further documentation or clarification, adding to the delay.

Backlogs and Administrative Challenges

The SSA, like many government agencies, faces resource constraints and staffing challenges. These limitations can lead to backlogs in processing claims. Additionally, administrative hurdles, such as errors in applications or miscommunication, can further delay the process.

The Appeals Process

If your initial claim is denied — a common occurrence — you have the right to appeal. The appeals process can be lengthy, involving several stages, including reconsideration, a hearing before an administrative law judge, the Appeals Council, and potentially federal court review. Each stage has its own timeline and complexities.

The Role of a Social Security Disability Representative

This is where the expertise of a Social Security Disability representative can be invaluable. An experienced representative can help streamline the process by ensuring that your application is complete, accurate, and well-supported by the necessary medical evidence. Additionally, if your case goes to appeal, a knowledgeable representative can guide you through the complexities of the appeals process.

Conclusion

The wait for a decision on a Social Security Disability claim can be lengthy and stressful. Understanding the reasons behind these delays — the volume of applications, the need for detailed medical evidence, administrative backlogs, and the complexity of the appeals process — can help claimants manage expectations and plan accordingly. Remember, seeking the assistance of a qualified Social Security Disability representative can make a significant difference in navigating this challenging journey.

Contact Information

If you are dealing with a delayed SSD claim and need assistance, feel free to reach out to our office. I am here to help you through every step of the process. Click on the “Get Started” button in the upper right-hand corner or call me at (407) 738-3718.

What to Expect After Being Approved for SSI Benefits

Fri, 08 Mar 2024 05:43:39 GMT

Congratulations on being approved for Supplemental Security Income (SSI)! This is a significant milestone in your journey, and it's essential to understand what comes next. SSI is a program that provides financial assistance to individuals who are disabled, blind, or over the age of 65 and have limited income and resources. Let's dive into what you should expect now that you've been approved, focusing on the resource and income requirements, the Pre-Effectuation Review Conference (PERC) interview, and how SSI back payments are paid out.

Understanding SSI's Resource and Income Requirements

SSI is designed to help those in need, so it has specific resource and income limits. An individual's resources must not exceed $2,000, and a couple's resources must not be more than $3,000. Resources include things like cash, bank accounts, stocks, U.S. savings bonds, land, vehicles, personal property, life insurance, and anything else you own which could be converted to cash and used for food or shelter.

Income limits are a bit more complex, as Social Security counts various types of income differently. This includes earned income like wages, unearned income such as unemployment benefits or Social Security benefits, in-kind income such as food or shelter you get for less than its fair market value, and deemed income, which is part of the income of your spouse, parents, or sponsor of an alien.

Preparing for the PERC Interview

After being approved for SSI, you may be scheduled for a PERC interview. This is a routine interview conducted by the Social Security Administration (SSA) to ensure all the information in your case is current and accurate before your benefits start. During this interview, you will be asked to confirm or update details about your income, resources, living arrangements, and other eligibility factors. It’s vital to attend this interview and provide truthful, accurate information to avoid delays or issues with your benefits.

SSI Back Payments

One of the great reliefs of being approved for SSI is receiving back payments. These are the benefits you were eligible to receive from the time you applied until the time your claim was approved. SSI back payments are typically paid in a lump sum, but if the amount is large, it may be distributed in up to three installments, six months apart. In certain cases, if you have outstanding debts or immediate needs, you might be able to request a larger portion of the back payment sooner.

Ongoing Compliance

It’s important to remember that staying eligible for SSI means you must adhere to the resource and income limits and report any changes in your circumstances to the SSA. This includes changes in income, living arrangements, marital status, or resources. Failing to report these changes can result in overpayments, which you will have to pay back, or in the loss of benefits.

Conclusion

Being approved for SSI benefits is a relief and a support system for those who qualify. Understanding the nuances of the program, such as the resource and income limits, preparing for the PERC interview, and knowing how back payments work, are crucial to ensuring you continue to receive the assistance you need. Always keep lines of communication open with the SSA and ensure you report any changes in your circumstances promptly. With this knowledge, you can confidently navigate the next steps in your SSI journey.

What to Expect at Your Mental Consultative Exam for Disability Benefits

Thu, 16 Nov 2023 13:58:00 GMT

If you've applied for Social Security Disability benefits based on a mental health condition, you may be required to attend a mental consultative examination. This is an evaluation scheduled and paid for by the Social Security Administration (SSA) to gather more information about your mental health and how it affects your ability to work.

Knowing what to expect at a consultative exam can help you prepare and make the most of this important appointment. Here's a quick run-down of the mental health evaluation process:

The Basics

The exam will be conducted by an independent, licensed mental health professional like a psychologist or psychiatrist. This won't be your doctor.
It typically lasts between 30 minutes to an hour, but could be longer.
The doctor will ask you questions about your medical history, mental health symptoms, daily functioning, and medications.
You'll also be given a mental status evaluation assessing things like mood, behavior, thought process, etc.

What They're Looking For

The doctor is trying to determine how your mental health conditions limit your ability to perform work and daily activities. They will assess:

Your capacity to understand, remember and follow instructions.
Ability to interact appropriately with supervisors, co-workers and the public.
Concentration, persistence and pace completing tasks.
Adaptation skills, like responding to criticism and changes in work settings.

Answering Questions

Be honest and don't downplay your symptoms. Give specific examples of how your mental illness affects your functioning and prevents you from working. Detail any side effects from medications that impact concentration, energy, etc.

Provide Documentation

Bring copies of relevant medical records, prior evaluations, lists of medications and any assessments of your mental limitations. This provides key documentation to support your case.

Seeking Disability

The doctor isn't there to treat you or provide therapy. Their role is to give the SSA an objective opinion on whether your mental illness prevents you from working and qualifies you for benefits. Being open helps them fully understand your situation.

Preparing for your consultative examination takes some of the stress out of this process. You need to demonstrate how your mental health truly impacts your life. With the right approach, this exam can help advance your disability claim and get you the benefits you deserve.

How SSA Evaluates Sickle Cell Disease

Mon, 28 Aug 2023 22:48:00 GMT

Sickle cell disease is an inherited blood disorder that can cause severe pain, organ damage, and other debilitating symptoms. If you have sickle cell disease, you may wonder if you can qualify for Social Security disability benefits. Here's an overview of how the Social Security Administration (SSA) evaluates sickle cell disease.

What is Sickle Cell Disease?

Sickle cell disease is caused by an abnormal form of hemoglobin, the protein in red blood cells that carries oxygen. The abnormal hemoglobin causes red blood cells to become rigid and take on a sickle or crescent shape, which can get stuck in small blood vessels. This can restrict oxygen flow to tissues and organs, resulting in pain and organ damage.

Complications of sickle cell disease include anemia, recurrent painful crises, stroke, organ failure, and other serious issues. The severity of the disease can vary widely from person to person. Treatments aim to manage symptoms and prevent complications.

Meeting the SSA Disability Listing for Sickle Cell Disease

To qualify for disability benefits from the SSA, you must have a condition that meets the criteria in the SSA's listing of impairments. For sickle cell disease, the relevant listing is listing 7.05 Hematological disorders.

To meet listing 7.05, you must provide medical evidence showing:

- Recurrent painful crises occurring at least three times during the 5 months prior to your application; OR

- Complications like anemia, stroke, retinopathy, organ damage, or need for transfusion; AND

- Persistence of impairment despite treatment.

Documenting your symptoms, treatment history, and how sickle cell impacts your functioning is key.

Having detailed medical records from your hematologist and other providers will help the SSA understand how severely you are affected.

Assessing Functional Limitations

Even if your sickle cell disease doesn't quite meet the listing, you may still qualify for benefits by going through the full disability evaluation process. The SSA will assess how your condition limits your ability to work.

Factors considered include:

- Ability to perform job tasks due to pain, fatigue, weakness, etc.

- Side effects from medications or treatments

- Frequency of doctor visits, hospitalizations

- Dietary restrictions or needs

- Mental health effects like depression

- Susceptibility to stress, temperature changes, etc.

- Potential absenteeism or need for ongoing accommodations

Documenting how sickle cell disease impacts your ability to function day-to-day and maintain employment is key to getting approved. Keep detailed records and have doctors complete medical opinions about your limitations.

Approval Rates for Sickle Cell Disease

Approval rates for sickle cell disease vary based on severity. One study found allowance rates at the initial level ranging from 53-67% for applicants with sickle cell. However, approval is definitely possible with strong medical evidence and detailed records. Having an experienced disability lawyer can also improve your chances.

The SSA recognizes sickle cell disease as a potentially disabling condition. Make sure you submit all needed medical documentation to establish eligibility and get the benefits you deserve. For help with your claim for disability benefits, call Hogan Smith at (407) 377-0700, or click on the “Call Us” button at the top right of this webpage.

Understanding the DDS Appeal Process: What Happens, Who's Involved, and How to Make It Easier

Mon, 07 Aug 2023 16:15:00 GMT

Being denied Social Security Disability benefits can be a disheartening experience. However, the appeal process exists for a reason. Once you've submitted your appeal paperwork to the Disability Determination Services (DDS), several steps ensue. Here’s a detailed look at the journey your appeal takes at DDS.

1. Case Receipt and Review Once DDS - receives your appeal, the first step is to ensure all necessary documents and forms are present. Common forms related to the appeal include:

Form SSA-561 (Request for Reconsideration): This form initiates the appeal process.
Form SSA-3441 (Disability Report – Appeal): This details any changes in your medical condition, treatments, or tests since the initial determination.

2. Assigning the Appeal - Your appeal gets assigned to a disability examiner (often termed an "adjudicator"). In some cases, it might even be the same examiner who handled your initial application. This person will be responsible for reviewing your case again, considering any new evidence or arguments you’ve provided.

3. Gathering Additional Medical Evidence - The adjudicator may reach out to medical sources you’ve mentioned in your appeal to obtain any additional or recent medical records. If the existing medical evidence remains insufficient, you might receive:

Form SSA-827 (Authorization to Disclose Information to SSA): This allows DDS to request medical records on your behalf.
Consultative examinations might also be scheduled to obtain further medical insight.

4. Consultation with Medical and Vocational Experts - Adjudicators work closely with medical consultants (doctors) within DDS to understand the medical evidence. Additionally, vocational analysts can be consulted to ascertain how your condition affects your ability to work.

5. Re-Evaluation of the Claim - The adjudicator, considering the new evidence, re-evaluates your claim based on:

The severity of the condition.
Duration and expected longevity of the condition.
Your ability to perform past work or any other work in the economy.

6. Decision and Notification - After the comprehensive re-evaluation, DDS makes a decision on your appeal. The decision is then sent back to the SSA office, which subsequently notifies you of the outcome.

The Timeframe Reconsideration by DDS can typically take anywhere from 30 to 90 days, depending on the complexity of the case and the need for additional medical examinations. However, since reopening their offices after the pandemic, it is taking 7-9 months because of a backlog that was created by a staff shortage. It's essential to remain patient but proactive during this period.

Streamlining the Process: How to Aid Your Representative While DDS and SSA manage the process's technicalities, there are steps you can take to help your representative streamline the appeal:

Prompt Response: If DDS sends any forms or requests additional information, respond as quickly as possible. Delays can prolong the appeal process.
Stay Organized: Keep copies of all medical records, correspondence with doctors, and any other relevant documentation. Providing this to your representative can be invaluable.
Open Communication: Maintain open lines of communication with your representative. Regular check-ins can ensure you're both on the same page.
Stay Updated: If there are any significant changes in your medical condition, treatments, or work status, inform your representative immediately.

In conclusion, the appeal process at DDS is designed to be comprehensive, ensuring that every appellant gets a fair re-evaluation. By understanding the journey, maintaining patience, and aiding your representative wherever possible, you bolster your chances of a favorable outcome. Remember, every step is geared toward ensuring that the right decisions are made within the framework of SSA’s criteria.

If you have questions or need help with your disability claim, call me or text me at (407) 738-3718.

The Role of an Adjudicator in the SSA Disability Determination Process

Mon, 07 Aug 2023 13:10:00 GMT

An adjudicator at the Disability Determination Services (DDS) plays a pivotal role in the disability claim process for the Social Security Administration (SSA). When someone files a claim for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) due to a disability, it's the DDS and specifically the adjudicator's role to make the initial determination regarding the claimant's medical eligibility.

Here's what an adjudicator typically does at DDS in regard to SSA disability determinations:

1. Review the Application: The adjudicator starts by examining the disability claim to ensure it's complete and that all required documentation, including medical and work history, is present.

2. Gather Medical Evidence: The adjudicator collects medical records from the sources the claimant provided. This includes hospital records, doctors' notes, lab results, and other relevant medical evidence that can shed light on the claimant's medical condition and its severity.

3. Consultation with Medical and Vocational Experts: If the available medical evidence is insufficient to make a determination, the adjudicator might request further medical examinations or tests, often referred to as "consultative exams." These are conducted by doctors or specialists contracted by DDS. Additionally, vocational experts may be consulted to understand how the claimant's condition affects their ability to work.

4. Assess Severity and Duration: The adjudicator evaluates whether the disability is severe enough to significantly limit the claimant's ability to perform basic work-related activities. Moreover, the disability should be expected to last at least 12 months or result in death.

5. Compare with the Listing of Impairments: The SSA maintains a "Listing of Impairments" that details conditions considered severe enough to prevent an adult from performing any gainful activity, regardless of age, education, or work experience. The adjudicator checks whether the claimant's condition matches or equals a listed impairment.

6. Determine Residual Functional Capacity (RFC): If the condition doesn't meet a listing, the adjudicator assesses the claimant's RFC. This is an evaluation of the most a person can still do despite their limitations. It considers both physical and mental capacities.

7. Evaluate Past Work and Skills: The adjudicator looks into the claimant's work history to see if they can still perform any of their past jobs with their current condition. If they can't, the adjudicator evaluates if there are other jobs in the national economy the claimant could perform, given their age, education, work experience, and RFC.

8. Make a Determination: After all these steps, the adjudicator arrives at a decision. The claimant will then be notified if their claim has been approved or denied. If approved, benefits will start as determined by the SSA's guidelines. If denied, the claimant has the right to appeal.

In Conclusion

The role of an adjudicator at DDS is both critical and comprehensive. They must objectively evaluate a vast amount of information and follow SSA guidelines to determine if a claimant qualifies for disability benefits. The ultimate goal is to ensure that individuals truly in need receive the assistance they deserve while maintaining the integrity of the SSA's disability programs.

Under normal circumstances, this is how the process should work. However, based on my experience, determinations do not always go according to plan, despite everyone's best efforts. To keep you updated on your treatment and condition, I make regular inquiries with the adjudicator. Unfortunately, until an adjudicator is assigned to your case, your disability file remains in limbo and is not processed. Due to the high volume of cases at DDS, it can take up to 7-9 months for a case to be assigned to an adjudicator.

For help with your case, feel free to reach out to me by text or by calling (407) 377-0700.

How to Request the Reopening of a Prior SSI Claim: A Comprehensive Guide

Fri, 09 Jun 2023 23:47:00 GMT

Introduction

As many of you already know, navigating the complexities of Supplemental Security Income (SSI) can be challenging. Today, we'll delve into a lesser-known area of SSI: the process of requesting the reopening of a previously denied SSI claim.

Under certain circumstances, the Social Security Administration (SSA) permits the reopening of a prior SSI claim. Typically, this occurs when there's 'good cause' for failing to appeal the original decision within the standard timeframe, usually 60 days from receiving the denial notice.

So, what exactly does 'good cause' mean? It refers to valid reasons such as serious illness, misunderstanding about the decision, incorrect advice from an SSA official, or a lack of notification about the decision.

Steps to Reopen a Prior SSI Claim

Follow these crucial steps to initiate the reopening of your SSI claim:

1. Contact the SSA:** Your first step should be to reach out to your local Social Security office or call the SSA's national toll-free number (1-800-772-1213; TTY 1-800-325-0778). These representatives can offer guidance on how best to proceed based on your unique situation.

2. Present New Evidence: Prepare to provide any new, material, and pertinent evidence not considered in the initial decision. For example, you might have medical records revealing that your condition has worsened or proof that there was a technical error in the previous verdict.

3. Explain Your Good Cause: You'll need to convincingly explain the 'good cause' for not appealing the original decision within the typical time limit.

4. Submit a Written Request: Though not mandatory, it's advisable to submit your request to reopen the claim in writing. In your letter, clearly state that you're requesting a reopening and detail your reasons for doing so. Always keep a copy of this request for your records.

When Can a Claim Be Reopened?

The SSA adheres to specific rules about when and under what circumstances a decision can be reopened:

Within 12 months for any reason: If it hasn't been more than a year since your decision, the SSA can reopen the claim for any reason.

Within two years with 'good cause': If it's been more than a year but less than two, you must show 'good cause,' like new and substantial evidence.

After two years under special circumstances: After two years, reopening a decision becomes trickier and is generally only possible under exceptional circumstances such as fraud, clerical error, or similar issues.

Remember, SSA does not grant every request for reopening. The process can be complicated, but knowing what to expect can significantly improve your chances of success. For these complex areas of Social Security law, you might want to consider consulting with an experienced Social Security Disability attorney or advocate for advice tailored to your situation.

If you need assistance with reopening a prior SSI claim, please reach out to us. We have handled numerous “reopenings” of prior claims. Call me at (407) 377-0700.

How to Get Your Social Security Disability Claims Approved for a Back Injury

Fri, 09 Jun 2023 14:57:00 GMT

Introduction

Back injuries can be debilitating, causing chronic pain and severe limitations in mobility that can significantly hinder your ability to work. The Social Security Administration (SSA) recognizes this and has measures in place to accommodate individuals facing such conditions. However, the path to getting your SSD claim approved for a back injury can be challenging without understanding the intricate process involved. Let’s unpack this complex issue and provide you with guidance on navigating your SSD claim for a back injury.

1. Understanding the Blue Book Listing:

The SSA maintains a “Blue Book” that lists all medical conditions which qualify a person for SSD. Back disorders are included under section 1.04—Disorders of the spine. This section includes conditions like herniated nucleus pulposus, spinal stenosis, osteoarthritis, degenerative disc disease, and vertebral fractures.

If you meet the criteria outlined under section 1.04, you may be eligible for benefits. However, your medical documentation needs to comprehensively reflect the severity of your condition, including medical imaging tests, physician notes on your limited mobility, treatments undergone, and their effectiveness.

2. The Severity of Your Condition:

The SSA doesn’t just approve claims based on a diagnosed condition—you need to prove that your back condition is severe enough to prevent you from engaging in “substantial gainful activity” (SGA) for at least 12 months.

To evaluate this, SSA uses a five-step process. It checks whether you’re working, the severity of your condition, if your condition is in the Blue Book, your ability to perform your past work, and your ability to perform any other type of work.

3. Residual Functional Capacity (RFC):

If your condition doesn’t exactly meet a Blue Book listing, you can still qualify for disability benefits via a “medical-vocational allowance”. This is where the SSA considers your Residual Functional Capacity (RFC)—what work activities you can still perform despite your limitations, along with your age, education, and work experience.

For example, if your back condition doesn’t match the exact Blue Book listing but still causes significant limitations, such as inability to stand for prolonged periods or lift heavy objects, you may still be approved for disability benefits based on your limited RFC and other factors.

4. Building a Strong Claim:

The key to success in a SSD claim is comprehensive and accurate documentation. This includes your medical records, reports from treating physicians, imaging studies, and a detailed history of treatments attempted and their results. A well-documented daily pain and activity journal can also be beneficial.

Remember, an initial denial of your claim doesn’t signify the end. Many initial claims are denied due to technicalities or missing information. Appeals are an integral part of the process.

Navigating the SSD claim process for a back injury can be overwhelming, but Hogan Smith is here to help. Our team is equipped with the knowledge and experience to guide you through this process, help you gather the right evidence, and represent your case in the best possible way to maximize your chances of approval.

Remember, each case is unique, and what worked for one person may not work for another. But with the right guidance, patience, and persistence, you can build a successful SSD claim for your back injury.

To learn more about how Hogan Smith can help you with your SSD claim, please get in touch with us today.

Unmasking the Web of Misinformation: Deceptive Marketing and SSA Disability Benefits

Tue, 06 Jun 2023 21:33:00 GMT

Introduction:

In an age dominated by the internet, we rely on it for various aspects of our lives, from news consumption to shopping and seeking information on crucial matters. However, with the vastness of the online landscape comes the proliferation of misinformation, which can be both misleading and harmful. This article delves into the issue of misinformation and sheds light on how some marketing companies exploit individuals by offering false hope surrounding Social Security Administration (SSA) disability benefits.

The Rise of Misinformation:

Misinformation has become an unfortunate byproduct of the digital era. With the ease of content creation and sharing, misinformation can quickly spread like wildfire across social media platforms, websites, and discussion forums. It can take various forms, such as fake news, misleading claims, and manipulated data, all leading to confusion and deception among unsuspecting users.

Exploiting Vulnerabilities: SSA Disability Benefits:

One area where misinformation can be particularly damaging is the realm of Social Security Administration (SSA) disability benefits. These benefits are essential for individuals facing long-term disabilities that prevent them from engaging in substantial gainful activity. Unfortunately, some marketing companies have seized upon this vulnerability and employ deceptive tactics to attract visitors to their websites, offering false hope and promises of guaranteed benefits.

False Promises and Deceptive Marketing:

These marketing companies often employ strategies designed to lure individuals searching for information about SSA disability benefits. They create websites and landing pages with attention-grabbing headlines, promising quick and effortless access to benefits or exclusive insider knowledge. By presenting themselves as authoritative sources, they exploit the genuine concerns and struggles faced by people seeking legitimate assistance.

Inaccurate Information and Manipulation:

Once visitors land on these websites, they encounter an array of misleading information that is carefully crafted to persuade and manipulate. They may encounter fabricated success stories, testimonials, and exaggerated claims of high success rates in obtaining benefits. These tactics are meant to build trust and create a sense of urgency, compelling individuals to take immediate action.

The Consequences of Misinformation:

The consequences of falling victim to this web of misinformation can be severe. Individuals who rely on inaccurate information may waste time, energy, and resources pursuing fruitless avenues, potentially exacerbating their financial and emotional hardships. Furthermore, the disappointment and frustration resulting from these deceptive marketing practices can undermine trust in legitimate sources, making it even more challenging for those in need to find proper guidance.

Fighting Misinformation:

Overcoming the problem of misinformation requires collective efforts. Here are a few steps that can be taken to combat deceptive marketing practices and protect individuals seeking reliable information:

1. Raising Awareness: Educating the public about the prevalence and consequences of misinformation is crucial. Promoting media literacy and critical thinking skills can empower individuals to discern reliable sources from deceptive ones.

2. Verification and Fact-Checking: Encouraging users to verify information through multiple credible sources is essential. Fact-checking organizations play a vital role in debunking falsehoods and ensuring accurate information is readily available.

3. Reporting Deceptive Websites: Users should report misleading websites, advertisements, or content to relevant authorities or platforms. This helps identify and mitigate the spread of misinformation while protecting others from falling victim to these deceptive practices.

Conclusion:

In the digital age, misinformation has emerged as a persistent threat. Deceptive marketing tactics surrounding SSA disability benefits prey on vulnerable individuals seeking assistance. By raising awareness, promoting critical thinking, and reporting deceptive websites, we can collectively combat misinformation and ensure that individuals in need have access to accurate and reliable information. By doing so, we can strive to create a more trustworthy and informed digital landscape for everyone.

How to Request SSA to Expedite You Case?

Tue, 06 Jun 2023 21:05:00 GMT

If you find yourself in dire need and believe your circumstances warrant expedited consideration from the Social Security Administration (SSA), it's crucial to notify them promptly. Here are the steps you can take to inform the SSA about your dire need situation:

1. Contact the SSA: The first step is to get in touch with the SSA as soon as possible. You can reach them by phone or in person at your local Social Security office. Visit the official SSA website (www.ssa.gov) to find the contact information for your local office or call the SSA's toll-free number at 1-800-772-1213.

2. Gather necessary documentation: Collect any documentation or evidence that supports your dire need situation. This can include financial records, eviction or foreclosure notices, medical bills, utility shut-off notices, or any other relevant documents that demonstrate your extreme financial hardship.

3. Explain your circumstances: When you communicate with the SSA, be prepared to explain your dire need circumstances clearly and concisely. Provide specific details about your situation, such as the inability to afford basic necessities like food, shelter, or medical treatment. Make sure to emphasize the urgency of your situation and how it directly impacts your well-being.

4. Submit documentation: If you contact the SSA by phone, ask them about the preferred method of submitting your supporting documentation. They may require you to send the documents by mail, fax, or electronically. Ensure that you follow their instructions accurately and provide all the necessary paperwork to support your dire need claim.

5. Follow up: After you have notified the SSA and submitted your documentation, it's important to follow up on your claim. Stay in touch with the SSA representative handling your case and inquire about the status of your expedited decision request. They can provide updates and inform you of any additional steps or information they might need.

Remember, each dire need situation is unique, and the SSA will evaluate your circumstances on an individual basis. It's important to be honest, provide accurate information, and remain persistent in your communication with the SSA. If you have any concerns or questions along the way, don't hesitate to ask the SSA representative for guidance and clarification.

Note: The process and specific requirements may vary depending on your location and the policies of the SSA office handling your case. It's always recommended to consult with the SSA directly or seek assistance from a qualified professional to ensure you have the most up-to-date and accurate information for your specific situation.

Under What Circumstances Will the Social Security Administration Expedite Your Decision

Tue, 06 Jun 2023 21:01:00 GMT

Introduction

When applying for Social Security benefits, it's natural to hope for a quick resolution to your claim. The Social Security Administration (SSA) recognizes that some situations require expedited processing due to urgent financial and medical needs. In this blog post, we will explore the circumstances under which the SSA may expedite your decision, helping you navigate the process more effectively.

1. Terminal Illness:

If you have been diagnosed with a terminal illness and your life expectancy is less than 12 months, the SSA understands the urgency of your situation. In such cases, you may be eligible for an expedited decision on your disability claim through the Compassionate Allowances program. This program aims to quickly identify and provide benefits to individuals with severe medical conditions, ensuring they receive timely assistance.

2. Military Service-Related Injuries:

The SSA recognizes the sacrifices made by our military personnel and understands that service-related injuries can have a significant impact on their lives. Veterans who have suffered a disability while on active duty after October 1, 2001, may be eligible for expedited processing of their Social Security Disability Insurance (SSDI) claims through the Wounded Warriors program. Expedited decisions can help ensure that veterans receive the support they need without unnecessary delays.

3. Dire Need:

In cases of dire need, the SSA may expedite a decision to provide immediate financial assistance. Dire need refers to situations where claimants face extreme financial hardship, such as the inability to afford food, shelter, or medical treatment. If you find yourself in such a circumstance, it's crucial to inform the SSA promptly, providing documentation and evidence of your dire need. The SSA will evaluate your situation and, if appropriate, expedite your decision to provide the necessary support.

4. Compassionate Circumstances:

Apart from the Compassionate Allowances program mentioned earlier, the SSA acknowledges that some claimants face unique compassionate circumstances that warrant expedited consideration. These circumstances can include individuals facing homelessness, domestic violence, or imminent loss of a primary source of support. By demonstrating the urgency and significance of your situation, you may be able to expedite your claim decision.

5. Presumptive Disability and Blindness:

For individuals who meet the specific criteria for presumptive disability or blindness, the SSA may expedite their claims. Presumptive disability refers to cases where a severe impairment clearly meets the criteria for disability, even without extensive medical documentation. Similarly, the SSA may expedite claims for individuals who are legally blind, recognizing the immediate impact on their ability to work and function independently.

Conclusion:

While the Social Security Administration strives to process claims in a timely manner, there are circumstances that warrant expedited decisions. Whether it's a terminal illness, military service-related injuries, dire need, compassionate circumstances, or qualifying for presumptive disability or blindness, understanding these circumstances can help you navigate the process more effectively. If you believe your situation qualifies for expedited consideration, it's essential to provide the necessary documentation and evidence to support your claim. Remember, the SSA is there to provide assistance when you need it most, ensuring that you receive the support and benefits you deserve in a timely manner.

The Interplay of Pain and Mental Health: Exploring the Connection with Depression and Anxiety

Fri, 02 Jun 2023 21:58:00 GMT

Introduction:

Pain and mental health conditions are intertwined in a complex relationship. Those experiencing chronic pain often find themselves navigating a significant impact on their mental well-being. In this blog post, we delve into the connection between pain and mental health, specifically focusing on the link between depression and anxiety.

1. The Bidirectional Relationship:

a. Pain as a Precursor: Chronic pain can serve as a precursor to mental health conditions such as depression and anxiety. Persistent pain can disrupt daily life, limit activities, and erode one's sense of well-being. This can lead to feelings of frustration, hopelessness, and despair, potentially triggering or exacerbating mental health challenges.

b. Psychological Factors Intensifying Pain: Conversely, mental health conditions like depression and anxiety can amplify the perception of pain. These conditions can lower pain thresholds, making discomfort feel more intense and overwhelming. Negative emotions, stress, and anxiety can also increase muscle tension, leading to heightened pain sensitivity.

2. Shared Neurochemical Mechanisms:

Pain, depression, and anxiety share underlying neurochemical pathways in the brain. Chemical messengers like serotonin, norepinephrine, and dopamine play critical roles in regulating pain perception, mood, and emotional responses. Imbalances in these neurotransmitters can contribute to both physical pain and mental health disturbances.

3. Chronic Pain's Impact on Mental Health:

a. Depression: Chronic pain can be emotionally draining, leading to feelings of sadness, loss of interest in activities, changes in appetite or sleep patterns, and a general sense of despair. The constant struggle with pain can erode self-esteem, disrupt relationships, and isolate individuals, creating a fertile ground for depression to take hold.

b. Anxiety: Living with chronic pain often entails uncertainty, fear, and worry about the future. Anxiety can manifest as excessive worrying, restlessness, irritability, difficulty concentrating, and physical symptoms like increased heart rate and shortness of breath. The fear of experiencing pain or the anticipation of exacerbating existing pain can perpetuate a cycle of anxiety.

4. Overlapping Treatment Approaches:

Recognizing the intertwined nature of pain and mental health, treatment approaches often involve addressing both aspects simultaneously. Some strategies include:

a. Psychological Therapies: Cognitive-behavioral therapy (CBT) can help individuals develop coping mechanisms, challenge negative thoughts, and manage pain-related distress. Acceptance and Commitment Therapy (ACT) can aid in accepting pain as a part of life while focusing on valued actions and reducing suffering.

b. Medications: Certain antidepressants or anti-anxiety medications can be prescribed to manage both pain and mental health symptoms. These medications may target shared neurochemical pathways, providing relief on multiple fronts.

c. Lifestyle Modifications: Incorporating stress management techniques, regular exercise, adequate sleep, and healthy coping mechanisms can positively impact both pain levels and mental well-being.

Conclusion:

The connection between pain and mental health conditions like depression and anxiety highlights the importance of a comprehensive and integrated approach to healthcare. Addressing the psychological impact of chronic pain can significantly improve overall well-being and quality of life. If you or someone you know is experiencing chronic pain alongside mental health concerns, seeking professional guidance from healthcare providers well-versed in the interconnectedness of these conditions can pave the way toward effective treatment and improved long-term outcomes. Remember, you are not alone, and support is available to help you navigate the challenges of pain and mental health.

Finding the Right Words: Describing Pain

Fri, 02 Jun 2023 21:31:00 GMT

Introduction:

Pain is a universal human experience, yet its perception and description vary greatly from person to person. As individuals, we often struggle to convey the true nature of our pain to healthcare professionals, friends, or family members. In this blog post, we explore the art of describing pain, providing a range of commonly used terms to help communicate and articulate our discomfort more effectively.

1. The Language of Pain:

Describing pain requires tapping into the vast array of words that can capture its unique qualities. Here are some descriptive terms commonly used to articulate pain:

- Sharp: Describing sudden and intense pain, like a stabbing or cutting sensation.

- Dull: Conveying a persistent, achy pain that is mild and lingering.

- Shooting: Referring to a sudden and intense pain that radiates or shoots through a specific area.

- Stinging: Depicting a sharp and prickling pain, often compared to being stung or touched by a hot needle.

- Burning: Illustrating an intense, fiery pain that feels hot or scalding.

- Aching: Portraying a deep-seated pain that persists as a dull or throbbing sensation.

- Cramping: Describing a spasmodic pain akin to a tightening or squeezing sensation, similar to muscle cramps.

- Radiating: Explaining pain that spreads or extends from the original site to nearby areas or along nerve pathways.

- Throbbing: Depicting a rhythmic and pulsating pain, resembling a heartbeat or pulse in the affected area.

- Sore: Conveying tenderness and sensitivity, often associated with muscle soreness or inflammation.

2. The Challenge of Subjectivity:

It is essential to acknowledge that pain is a subjective experience, influenced by individual perceptions and thresholds. What one person describes as a sharp pain, another may perceive as a dull ache. Therefore, it is crucial to provide context and communicate openly about the quality, intensity, and location of your pain.

3. Enhancing Communication with Healthcare Professionals:

Effective communication with healthcare professionals is vital in ensuring accurate diagnosis and appropriate treatment. When describing your pain, try to incorporate the descriptors mentioned above and provide additional details such as the duration, triggers, and any accompanying symptoms. This information helps doctors and nurses gain a more comprehensive understanding of your pain and aids in developing a tailored treatment plan.

4. The Importance of Keeping a Pain Journal:

Keeping a pain journal can be a helpful tool in capturing the nuances of your pain. Note down the intensity, frequency, and specific qualities of your pain throughout the day, along with any factors that may exacerbate or alleviate it. This journal becomes a valuable resource during medical consultations, enabling you to communicate your pain experiences more accurately.

Conclusion:

Describing pain is a skill that requires tapping into a diverse range of words and effectively communicating our subjective experiences. By familiarizing ourselves with descriptive terms like sharp, dull, shooting, and more, we can better convey the nature and intensity of our pain. Remember to provide additional context, keep a pain journal, and engage in open dialogue with healthcare professionals to ensure the most accurate assessment and effective treatment of your pain. Together, we can bridge the gap between experience and understanding, bringing relief and support to those grappling with pain.

Title: Unmarried Couples in Florida: How SSA Handles SSI Benefits

Fri, 02 Jun 2023 20:36:00 GMT

Introduction:

In today's society, many couples choose to live together without getting married. While this choice is a personal one, it can have implications when it comes to Social Security Administration (SSA) benefits, particularly Supplemental Security Income (SSI). In this blog post, we will explore how the SSA handles unmarried couples living together in Florida and how it can affect their eligibility for SSI benefits.

Understanding SSI Benefits:

SSI is a needs-based program designed to provide financial assistance to individuals with limited income and resources who are disabled, blind, or aged 65 or older. It is different from Social Security Disability Insurance (SSDI), which is based on work credits. SSI benefits help individuals meet basic needs such as food, shelter, and clothing.

Unmarried Couples and SSI Benefits in Florida:

In Florida, the SSA recognizes that some couples choose to live together without getting married. However, when determining SSI eligibility, the SSA considers the income and resources of both partners. This means that if an unmarried couple lives together, their combined income and resources will be evaluated.

Countable Income and Resources:

The SSA follows specific guidelines to determine countable income and resources for SSI eligibility. Countable income includes wages, Social Security benefits, pensions, and any other income received. Countable resources refer to cash, bank accounts, property, and other assets.

For unmarried couples living together, the SSA generally assumes that both partners contribute to household expenses and considers their combined income and resources. If their combined income and resources exceed the allowable limits for SSI eligibility, it may result in the denial of benefits.

Exceptions and Individual Assessment:

While the general rule is to consider the income and resources of both partners, there are exceptions and individual assessments made by the SSA. In situations where the couple can demonstrate that they maintain separate households and do not share expenses or resources, the SSA may evaluate each partner's income and resources separately.

Seeking Legal Advice:

Navigating the complex rules and regulations surrounding SSI benefits for unmarried couples can be challenging. It is advisable to seek legal advice from professionals experienced in Social Security. They can provide guidance tailored to your specific situation, help you understand the eligibility requirements, and maximize your chances of receiving SSI benefits.

Conclusion:

Unmarried couples living together in Florida need to be aware of how their relationship can impact their eligibility for SSI benefits. The SSA considers the combined income and resources of both partners, but exceptions and individual assessments are possible. To ensure you understand the rules and receive accurate guidance, consulting with knowledgeable legal professionals is essential. They can assist you in navigating the intricacies of the system, protecting your rights, and helping you secure the SSI benefits you may be entitled to.

Title: Navigating Social Security Disability Benefits for HLA-B27 Positive and Arthritis: How We Can Help You

Fri, 02 Jun 2023 20:08:00 GMT

Introduction:

Living with HLA-B27 positive and arthritis can be challenging, especially when it affects your ability to work and earn a living. If you're facing these difficulties, know that you're not alone. At Hogan Smith, we understand the complexities of the Social Security Disability benefits system, and we're here to offer you our expertise and support. In this blog post, we will discuss how we can assist you in obtaining the disability benefits you deserve.

Understanding HLA-B27 Positive and Arthritis:

HLA-B27 is a genetic marker associated with several autoimmune disorders, including various forms of arthritis such as ankylosing spondylitis, reactive arthritis, and psoriatic arthritis. These conditions can cause debilitating symptoms, chronic pain, inflammation, and limited mobility, making it challenging to maintain employment and financial stability.

How We Can Help You:

1. Expert Guidance on the Application Process:

Navigating the Social Security Disability benefits application process can be overwhelming, with extensive paperwork, complex guidelines, and strict deadlines. As experienced representatives, we can guide you through the entire process, ensuring that your application is complete, accurate, and maximizes your chances of approval.

2. Determining Eligibility and Developing a Strong Case:

Determining eligibility for disability benefits requires meeting specific medical and non-medical criteria. We can carefully assess your case, reviewing your medical records, work history, and personal circumstances to build a strong case on your behalf. Our expertise enables us to identify relevant medical evidence, establish the severity of your condition, and highlight the impact it has on your ability to work.

3. Comprehensive Documentation and Evidence Gathering:

One of the key factors in securing Social Security Disability benefits is providing comprehensive documentation and evidence to support your claim. We work closely with you to gather and organize all necessary medical records, test results, treatment histories, and physician statements. This meticulous approach ensures that your application is well-supported, making a compelling case for disability benefits.

4. Effective Communication with the Social Security Administration:

Communication with the Social Security Administration (SSA) is an essential part of the disability benefits process. As your representatives, we handle all interactions with the SSA on your behalf. We ensure that all necessary documentation is submitted promptly, address any inquiries or requests from the SSA, and keep you updated on the progress of your claim.

5. Expertise in Appeals and Denial Reconsideration:

If your initial disability benefits application is denied, don't lose hope. We have experience in handling appeals and denial reconsiderations, helping you understand the reasons for denial and developing a strategy to strengthen your case. We will guide you through the appeals process, ensuring that your rights are protected and advocating for your best interests.

6. Peace of Mind and Support Throughout the Process:

Dealing with a disability and navigating the Social Security Disability benefits system can be overwhelming, both emotionally and practically. By choosing us as your representatives, you gain a supportive partner who understands your challenges and is dedicated to easing your burden. We provide ongoing support, answering your questions, addressing your concerns, and providing reassurance during this often complex and time-consuming process.

Conclusion:

Obtaining Social Security Disability benefits for HLA-B27 positive and arthritis may seem daunting, but with the right guidance and support, it becomes more manageable. At Hogan Smith, we have the expertise and experience to help you through the entire process, from initial application to appeals if necessary. Let us be your advocate, fighting for the benefits you deserve while providing the peace of mind and support you need. Contact us today to learn more about how we can assist you in your journey to securing Social Security Disability benefits.

Empower Yourself: Sign Up for a mySocialSecurity Account Today!

Fri, 02 Jun 2023 19:58:00 GMT

Introduction:

In the digital age, accessing your Social Security information has never been easier or more convenient. If you are a client seeking assistance with Social Security Disability benefits, we strongly encourage you to create a mySocialSecurity account online at https://www.ssa.gov/myaccount/. In this blog post, we will explore the benefits of having a mySocialSecurity account and explain why it is a valuable tool for managing your Social Security affairs.

What is mySocialSecurity?

mySocialSecurity is a secure online portal provided by the Social Security Administration (SSA) that allows you to access and manage your Social Security benefits. It provides a range of useful features and resources that can simplify the application process, provide important updates, and give you greater control over your benefits.

Key Benefits of Creating a mySocialSecurity Account:

1. Easy Access to Your Benefit Information: With a mySocialSecurity account, you can view your Social Security Statement, which provides a summary of your earnings history, estimates of future benefits, and information about disability and survivor benefits. This helps you stay informed and plan for your financial future.

2. Apply for Benefits Online: Instead of visiting a Social Security office or mailing in forms, you can conveniently apply for retirement, disability, and Medicare benefits through your mySocialSecurity account. The online application is secure, efficient, and guides you through the process step by step.

3. Manage and Update Your Personal Information: Having an online account allows you to update your personal information, such as your mailing address, phone number, and direct deposit details, ensuring that your benefits reach you promptly and without interruption.

4. Access Important Documents: Your mySocialSecurity account grants you access to important documents, such as benefit verification letters, replacement Medicare cards, and Form 1099 for tax purposes. Instead of waiting for these documents to arrive by mail, you can retrieve them instantly online.

5. Enhanced Security and Peace of Mind: The SSA takes data security seriously. By creating a mySocialSecurity account, you can ensure that your personal information is protected by a secure login process. This reduces the risk of identity theft and gives you peace of mind.

How to Create a mySocialSecurity Account:

Creating a mySocialSecurity account is a straightforward process that can be completed in a few simple steps:

1. Visit the Official Website: Go to https://www.ssa.gov/myaccount/ to access the mySocialSecurity account login page.

2. Click on "Create an Account": Look for the "Create an Account" button on the login page and click on it to start the registration process.

3. Provide Personal Information: You will be asked to provide your Social Security number, name, date of birth, and other identifying details. Ensure accuracy while entering this information.

4. Create a Username and Password: Choose a unique username and strong password for your account. Remember to follow the guidelines for password strength to enhance security.

5. Set Up Security Features: Select security questions and provide answers that are easy for you to remember but difficult for others to guess. This step adds an extra layer of protection to your account.

6. Verify Your Identity: To confirm your identity, you will need to provide additional personal information and answer questions based on your credit history or other records. This step ensures that only authorized individuals can access your account.

7. Start Exploring and Managing Your Benefits: Once you have successfully created your mySocialSecurity account, you can start exploring the various features and resources available to you. Take your time to navigate the portal and familiarize yourself with its functionalities.

Conclusion:

By creating a mySocialSecurity account, you can harness the power of technology to streamline your Social Security benefits experience. Whether you're applying for disability benefits or managing your

retirement benefits, the convenience and security of an online account offer numerous advantages. Don't miss out on the opportunity to take control of your Social Security affairs—sign up for a mySocialSecurity account today and empower yourself for a brighter financial future.

What You Need to Provide SSA When Applying for SSI Benefits?

Tue, 30 May 2023 18:27:00 GMT

Introduction:

Applying for Supplemental Security Income (SSI) benefits can be a crucial step in securing financial support for individuals with limited resources and income. To ensure a smooth and successful application process, it's essential to gather and provide the necessary documentation and information requested by the Social Security Administration (SSA). This blog post will guide you through the key documents and details you need to provide when applying for SSI benefits.

Proof of Identity and Personal Information: The SSA requires valid identification documents to verify your identity and establish eligibility. Make sure to provide documents such as your birth certificate, passport, or driver's license. Additionally, you'll need to furnish details about your contact information, Social Security number, and marital status.
Financial Information: SSI is a needs-based program, meaning your income and resources will be evaluated to determine eligibility. Prepare documentation that demonstrates your income from various sources, such as pay stubs, self-employment records, and documentation of any other benefits received. You should also provide information on assets you own, including bank statements, property deeds, and vehicle registration.
Medical and Disability Records: SSI benefits are often awarded to individuals with disabilities that significantly impact their ability to work. To support your claim, compile relevant medical records, including doctor's reports, hospitalization records, and results of medical tests or evaluations. It's crucial to provide a comprehensive overview of your medical condition, treatments received, and how your disability affects your daily life and ability to work.
Work History: While SSI primarily considers financial need, your work history may still be relevant. Provide a detailed employment history, including the dates of employment, job titles, and descriptions of your responsibilities. This information helps the SSA assess your ability to work and the impact of your disability on your employment prospects.
Education and Training: Include details of your educational background, including diplomas, degrees, or vocational training certificates. This information provides insight into your skill set and abilities and helps the SSA determine what types of work you may be capable of performing.
Contact Information for Healthcare Providers: Providing contact information for your healthcare providers, including doctors, specialists, and therapists, allows the SSA to gather additional information or request medical records if necessary. Make sure to include their names, addresses, phone numbers, and any other relevant contact details.
Supporting Documentation: If you have any additional documentation or evidence that supports your claim for SSI benefits, such as letters from employers, vocational rehabilitation programs, or vocational experts, be sure to include them in your application. These documents can provide valuable insight into your disability and its impact on your ability to work.

Conclusion:

When applying for SSI benefits, gathering the right documentation and providing accurate information is crucial for a successful application. By preparing the necessary documents, including proof of identity, financial information, medical records, work history, educational background, and any supporting documentation, you can help ensure a smooth application process and increase your chances of receiving the SSI benefits you deserve. Remember to consult the SSA's official website or seek guidance from a qualified representative for the most up-to-date information regarding application requirements and documentation.

Meeting or Equaling a Listing: Navigating Back Conditions in Social Security Disability Claims

Wed, 24 May 2023 22:37:00 GMT

Introduction:

Applying for Social Security Disability benefits due to a back condition can be a challenging process. The Social Security Administration (SSA) has specific medical listings that outline the criteria for determining disability eligibility. To successfully obtain benefits, it’s crucial to understand how to meet or equal a listing for a back condition. In this blog post, we will explore strategies and important considerations for meeting or equaling a listing when applying for Social Security Disability benefits based on a back condition.

1. Understand the Listings:

The SSA maintains a comprehensive listing of impairments, known as the “Blue Book,” which outlines specific criteria for various medical conditions. Back conditions are covered under Section 1.00 Musculoskeletal System. This section includes several listings related to spine disorders, such as herniated discs, spinal stenosis, degenerative disc disease, and spinal arachnoiditis. Reviewing these listings is essential to understanding the specific requirements for meeting or equaling a listing.

2. Gather Comprehensive Medical Evidence:

To meet or equal a listing, it’s crucial to gather thorough and up-to-date medical evidence that supports the severity and impact of your back condition. Medical evidence may include clinical notes, diagnostic test results (e.g., MRI, X-ray), surgical reports, physical therapy records, and any other relevant documentation from healthcare professionals. Ensure that your medical evidence clearly establishes the diagnosis, treatment history, functional limitations, and the overall impact of your back condition on your ability to work.

3. Meeting a Listing:

Meeting a listing requires satisfying all the specified criteria outlined in the Blue Book for a particular back condition. For instance, if the listing requires specific findings, such as nerve root compression resulting in limited spinal motion and associated pain, your medical evidence should demonstrate these exact characteristics. It’s crucial to provide objective evidence, such as diagnostic imaging or clinical examination results, that substantiates your claim and meets all the criteria for the specific listing.

4. Equaling a Listing :

If your back condition doesn’t precisely meet all the criteria of a specific listing, you may still be eligible for benefits by demonstrating that your condition is medically equivalent (equal) to a listing. To establish medical equivalence, you must present medical evidence showing that your symptoms, functional limitations, and overall impact on daily activities are equivalent in severity and duration to those outlined in the relevant listing. This requires comprehensive documentation and may involve thorough medical opinions from qualified healthcare professionals.

5. Consult with Medical Professionals:

Obtaining expert medical opinions can significantly strengthen your case when seeking to meet or equal a listing for a back condition. Consulting with specialists, such as orthopedic surgeons, neurologists, or pain management specialists, can provide a more comprehensive understanding of your condition and its impact on your ability to work. These experts can conduct thorough medical evaluations, review your medical records, and provide valuable opinions that align with the SSA’s criteria.

6. Seek Legal Assistance if Needed:

Navigating the complex process of meeting or equaling a listing can be overwhelming. If you encounter difficulties or need further guidance, consulting with an experienced Social Security Disability attorney can be immensely beneficial. These professionals have in-depth knowledge of the SSA’s requirements, understand the medical listings, and can provide valuable guidance and representation throughout the claims process.

Conclusion:

Meeting or equaling a listing for a back condition when applying for Social Security Disability benefits requires a comprehensive understanding of the SSA’s criteria, gathering extensive medical evidence, and potentially seeking expert medical opinions. It’s crucial to provide objective evidence that clearly demonstrates the severity, functional limitations, and impact of your back condition on your ability to work. Seeking legal assistance can also be valuable in navigating the process effectively.

HEARINGS DURING THE COVID-19 PANDEMIC

bob@simplesitecompany.com (Bob Hansen) — Thu, 28 May 2020 23:55:02 GMT

If your offices are closed, will I still have my hearing?

Yes. At this time, Administrative Law Judges (ALJs) are only able to conduct hearings by telephone until we resume our standard operations. Our hearing office staff will contact you or your representative in advance of your scheduled hearing to confirm your availability for a telephone hearing and ensure we have your accurate contact information.

Am I required to have my hearing by telephone?

No. Telephone hearings are not mandatory. When our hearing office staff contacts you or your representative in advance of the hearing, you may ask us to postpone your hearing until we resume standard operations and can hold your hearing in the manner you were originally scheduled (i.e. in person or by video). When we reschedule your hearing, we will send a notice giving you the new date, time and place of your hearing. We will send this notice at least 20 days before the date of the new hearing.

Will I still have my hearing with the Administrative Law Judge (ALJ) who was assigned to my case?

Generally, yes. Our ALJs are available to hold telephone hearings. In the event a technical difficulty arises before your hearing and we need to reassign your case to another ALJ, we will follow our typical instructions on backfilling, which are available in HALLEX I-2-1-55F.

Video Hearings at Social Security Increase Efficiency

bob@simplesitecompany.com (Bob Hansen) — Sun, 29 Mar 2020 00:00:40 GMT

by Doug Walker, Deputy Commissioner, Communications

If you received a denial on your application for Social Security benefits, and appealed to an administrative law judge, you may consider conducting your hearing through our remote video service delivery (VSD). VSD allows judges to hear cases from applicants in any geographic area using video and sound equipment. Although similar to Skype, our state-of-the-art technology produces a much higher quality video experience. The video hearing process is convenient, significantly reduces the government’s cost over traditional hearings, and could result in a quicker decision on your appeal.

Video hearings offer the same secure and confidential process that hearings conducted in-person provide. The judge has the same access to the applicant’s full Social Security file, including medical and educational records, as judges in the local office would. The procedure and development of the case is equal to in-person hearings, and the judge hears and considers the same testimony.

If you have a hearing pending with Social Security, you’ll receive a notice to schedule your case with a hearing office. You’ll have the choice of conducting your hearing through VSD, which may allow your hearing to occur sooner.

Hogan Smith we will discuss the pros and cons of holding your hearing by video. Under certain circumstance, this may be a viable option while under others, it may not be advised. Each case is different. If you have question about video hearing, please don't hesitate to call us.

Inspector General Warns About New Social Security Benefit Suspension Scam

bob@simplesitecompany.com (Bob Hansen) — Sat, 28 Mar 2020 00:06:53 GMT

Posted on March 27, 2020 by Gail S. Ennis, Inspector General for Social Security

The Social Security Office of the Inspector General has received reports that Social Security beneficiaries have received letters through the U.S. Mail stating their payments will be suspended or discontinued unless they call a phone number referenced in the letter. Scammers may then mislead beneficiaries into providing personal information or payment via retail gift cards, wire transfers, internet currency, or by mailing cash, to maintain regular benefit payments during this period of COVID-19 office closures.

As of Tuesday, March 17, 2020, local Social Security offices are closed to the public due to COVID-19 concerns. However, Social Security employees continue to work. Social Security will not suspend or decrease Social Security benefit payments or Supplemental Security Income payments due to the current COVID-19 pandemic. Any communication you receive that says Social Security will do so is a scam, whether you receive it by letter, text, email, or phone call.

Social Security will never:

Threaten you with benefit suspension, arrest, or other legal action unless you pay a fine or fee.
Promise a benefit increase or other assistance in exchange for payment.
Require payment by retail gift card, cash, wire transfer, internet currency, or prepaid debit card.
Demand secrecy from you in handling a Social Security-related problem.
Send official letters or reports containing personally identifiable information via email.

If you receive a letter, text, call or email that you believe to be suspicious, about an alleged problem with your Social Security number, account, or payments, hang up or do not respond. We encourage you to report Social Security scams using our dedicated online form . Please share this information with your friends and family, to help spread awareness about Social Security scams.

Learn about Social Security services during the COVID-19 pandemic, by visiting our Coronavirus Disease (COVID-19) page .

Social Security’s Definition of Disability

bob@simplesitecompany.com (Bob Hansen) — Fri, 20 Mar 2020 00:09:15 GMT

By Mike Korbey, Deputy Commissioner for Communications

Aug. 1st, 2019

This month marks the 29th anniversary of the Americans with Disabilities Act, which was signed into law by President George H.W. Bush on July 26, 1990. Disability affects millions of Americans. It can inhibit peoples’ quality of life and their ability to earn a living. Social Security is here to help you and your family, but there are strict criteria for meeting the definition of disability. The definition of disability under Social Security is also different than it is for other programs. We do not pay benefits for partial or short-term disability.

Social Security has a strict definition of disability. Social Security program rules assume that working families have access to other resources to provide support during periods of short-term disabilities, including workers’ compensation, insurance, savings, and investments.

Social Security is also required by law to review the current medical condition of people receiving disability benefits to make sure they continue to have a qualifying disability. Generally, if someone’s health hasn’t improved, or if their disability still keeps them from working, they will continue to receive benefits.

Social Security is a support system for people who cannot work because of a disability. You can learn more about Social Security’s disability program on our website and also by accessing our starter kits and checklists .

Coronavirus (COVID-19): Important Information about Social Security Services

bob@simplesitecompany.com (Bob Hansen) — Wed, 18 Mar 2020 00:12:14 GMT

All local Social Security offices will be closed to the public for in-person service starting Tuesday, March 17, 2020. This decision protects the population we serve—older Americans and people with underlying medical conditions—and our employees during the Coronavirus (COVID-19) pandemic. However, we are still able to provide critical services.

Please read our press release to learn more, including how to get help from the Social Security Administration by phone and online. You can also visit our Coronavirus (COVID-19) information page to learn more and stay up to date.

Please share this message with your friends and loved ones.

Certain Disability Payments and Workers’ Compensation May Affect Your Social Security Benefits

bob@simplesitecompany.com (Bob Hansen) — Thu, 12 Mar 2020 00:16:04 GMT

by Mike Korbey, Deputy Commissioner for Communications

Many people working nowadays have more than one job. This means they have several sources of income. It’s important to keep in mind that having multiple sources of income can sometimes affect your Social Security benefits; but, it depends on the source.

Disability payments from private sources, such as private pensions or insurance benefits, don’t affect your Social Security disability benefits. Workers’ compensation and other public disability benefits, however, may reduce what you receive from Social Security. Workers’ compensation benefits are paid to a worker because of a job-related injury or illness. These benefits may be paid by federal or state workers’ compensation agencies, employers, or by insurance companies on behalf of employers.

Public disability payments that may affect your Social Security benefits are those paid from a federal, state, or local government for disabling medical conditions that are not job-related. Examples of these are civil service disability benefits, state temporary disability benefits, and state or local government retirement benefits that are based on disability.

Some public benefits don’t affect your Social Security disability benefits. If you receive Social Security disability benefits, and one of the following types of public benefits, your Social Security benefits will not be reduced:

Veterans Administration benefits;
State and local government benefits, if Social Security taxes were deducted from your earnings; or
Supplemental Security Income (SSI).

You can read How Workers’ Compensation and Other Disability Payments May Affect Your Benefits to find out about the possible ways your benefits might be reduced.

Please be sure to report changes. If there is a change in the amount of your other disability payment, or if those benefits stop, please notify us right away. Tell us if the amount of your workers’ compensation or public disability payment increases or decreases. Any change in the amount or frequency of these benefits is likely to affect the amount of your Social Security benefits.

An unexpected change in benefits can have unintended consequences. You can be better prepared if you’re informed and have financially prepared yourself.

Social Security is Taking Action to Prevent Scam Calls

bob@simplesitecompany.com (Bob Hansen) — Tue, 10 Mar 2020 00:19:18 GMT

by Tracy Lynge, Communications Director for the Office of the Inspector General

Social Security phone scams are the number one type of fraud reported to the Federal Trade Commission. Callers claim that you have a problem with your Social Security number or benefits and demand immediate payment from you to avoid arrest or other legal action.

We recently announced two landmark civil complaints, filed by the Department of Justice in the Eastern District of New York, seeking injunctions against five telecommunications companies and their owners. The complaints allege the companies and their owners have, for years, knowingly facilitated government imposter telephone scams. The Department of Justice issued a news release about the filing and request for court orders, and held a press call with U.S. Attorney Richard Donaghue, Inspector General Gail S. Ennis, and Chief Postal Inspector Gary Barksdale.

If granted, the court orders will prevent the five enjoined companies from continuing to allow “the delivery of millions of fraudulent ‘robocalls’ every day from foreign call centers to the U.S. telecommunications system.”

You can read the entire press release at oig.ssa.gov/newsroom/news-releases/inspector-general-announces-civil-action-prevent-social-security-scam-calls

If you receive a call or email about a problem with your Social Security number or account that you believe to be suspicious, hang up or do not respond. We encourage you to report Social Security phone scams using our dedicated online form at https://oig.ssa.gov . Please share this information with your friends and family to help them learn how to protect themselves from phone scams. For more information, please visit https://oig.ssa.gov/scam .

New Rule Modernizes How SSA Awards Disability Benefits

bob@simplesitecompany.com (Bob Hansen) — Tue, 03 Mar 2020 01:21:25 GMT

The Social Security Disability Insurance and Supplemental Security Income programs protect some of the most vulnerable people in our society. A successful disability program must evolve and support making the right decision as early in the process as possible. To help us do that, we must modernize the rules and standards we use to evaluate how we determine disability benefits. We are moving forward with a rule change that has been in the works for a number of years and serves to update a more than 40-year-old policy that made the inability to communicate in English a factor in awarding disability benefits. The new rule is effective April 27, 2020.

We are required to consider education to determine if your medical condition prevents work. In 2015, our Inspector General recommended that we evaluate the appropriateness of this policy. Research now shows the inability to communicate in English is no longer a good measure of a person’s education level or the ability to engage in work. The new rule also supports the Administration’s longstanding focus of recognizing that individuals with disabilities can remain in the workforce.

To make the right disability decisions, Social Security disability rules must continue to reflect current medicine and evolution of work. We need to update our rules to keep up with society’s changes.

We owe it to the American public to ensure that our disability programs continue to reflect the realities of the modern workplace. Please share this information with your family and friends.

-From SSA's "Social Security Matters" website.

Social Security Accelerates Decisions for People with Serious Disabilities

Tue, 20 Aug 2019 03:10:58 GMT

Agency Adds to Compassionate Allowances List

Andrew Saul, Commissioner of Social Security, today announced four new Compassionate Allowances conditions: CDKL5 Deficiency Disorder, Pitt Hopkins Syndrome, Primary Peritoneal Cancer, and Richter Syndrome. Compassionate Allowances is a program to quickly identify severe diseases and medical conditions that meet Social Security’s standards for disability benefits. “Social Security’s highest priority is to serve the public and we are committed to ensuring Americans with disabilities receive the benefits they are eligible for,” said Commissioner Saul. “For over a decade, our Compassionate Allowances program has helped us accelerate the disability process for people who are likely to get approved for benefits due to the severity of their condition.”

The Compassionate Allowances program identifies claims where the applicant’s condition or disease clearly meets Social Security’s statutory standard for disability. Due to the severe nature of many of these conditions, these claims are often allowed based on medical confirmation of the diagnosis alone. The list has grown to a total of 237 conditions, including certain cancers, adult brain disorders, and a number of rare disorders that affect children. To date, more than 600,000 people with severe disabilities have been approved through this fast-track policy-compliant disability process.

The agency incorporates leading technology to identify potential Compassionate Allowances and make quick decisions. When a person applies for disability benefits, Social Security must obtain medical records in order to make an accurate determination. Social Security’s Health IT brings the speed and efficiency of electronic medical records to the disability determination process. With electronic records transmission, Social Security is able to quickly obtain a claimant’s medical information, review it, and make a determination faster than ever before. For more information about the program, including a list of all Compassionate Allowances conditions, please visit www.socialsecurity.gov/compassionateallowances.

FACES AND FACTS OF DISABILITY- KIRA'S STORY

bob@simplesitecompany.com (Bob Hansen) — Thu, 31 Jan 2019 01:25:03 GMT

I'm 34 years old and I live in North Carolina. I use a power wheelchair because I live with Cerebral Palsy.

I love my life for the most part.

I earn $400 a month from my job but it is not enough cover all of my expenses. At the end of the month if I don't have a lot of extra money for food, I usually end up buying Oodles of Noodles. I eat that for the rest of the month. That doesn't just happen to me...It happens to a lot of people with disabilities.

I am uncertain about my financial future. My current job ends in May. I will no longer have the $400 that helps pay for my expenses. If I don't find other employment, I don't exactly know what I'm going to do after that. That is where Social Security comes in. Social Security Disability Insurance benefits allow me to have the quality of life afforded to every human being.

My parents taught me as a young child that I had the right to be independent and had the right to be employed as a person with a disability. I have the right to speak up for the rights of people with disabilities. I'm so proud of that.

In closing, I have a thought that I would like to leave you with. My life is full of love and happiness but it is also very difficult at times. When lawmakers think about cutting funding towards Social Security Disability Insurance benefits, I would like them to picture my face and think about me not being able to have a life outside of my apartment.

If you need help applying for disability or need to appeal an unfavorable decision from Social Security, I can help. Call me at 407-377-0700.

https://youtu.be/rBch9Ac6zhI

YOUR SOCIAL SECURITY DISABILITY APPLICATION- CALL NOW FOR A FREE CONSULTATION

bob@simplesitecompany.com (Bob Hansen) — Mon, 16 Oct 2017 00:29:29 GMT

When it comes to filing your Social Security Disability Application, providing accurate and up to date information can make all the difference whether you will get approved or denied.

What Information is Needed to File

The application can be filed online, in person at the Social Security office, or by telephone. Before you file, you will need the following information:

Birth and Citizenship Information
Marriage and Divorce Information
Names and Birth Dates of your Children
U.S. Military Service Information
Employer Details for the Current Year and Prior 2 Years
Self-Employment Details for the Current and Prior 2 Years
Direct Deposit Information
Name, Address, and Phone Number of a Third Party
Information about Doctors, Healthcare Professionals, Hospitals and Clinics
Job History
Your Education and Training

At Hogan Smith, I help people file their Social Security Disability Application and guide them through the process of completing the application and providing key details to help the Social Security Administration approve their case.

Call Us Today for your Free Consultation

I want to help you get the benefits that you deserve. I have helped thousands just like you in Orlando, Kissimmee, Lake Mary, Sanford, Maitland, Altamonte Springs, Apopka, and throughout Central Florida. Call me today to learn how I can help - (407) 377-0700.

To File Online

To file your application online, go to: https://secure.ssa.gov/iClaim/dib

To locate your local Social Security Office, go to: https://secure.ssa.gov/ICON/main.jsp

Closed Social Security offices, furloughed staff under GOP cuts, agency warns

bob@simplesitecompany.com (Bob Hansen) — Thu, 11 Aug 2016 02:47:51 GMT

By Joe Davidson | Columnist, Washington Post

Social Security is facing dark times — not just figuratively, but as in the lights would go out.

That’s the warning from Social Security Administration (SSA) officials if an appropriations bill pushed by House Republicans takes effect. “There would be up to two weeks of furloughs for all employees,” the agency said in information obtained by The Washington Post. “During this time, our offices would be closed to the public. Additionally, a full hiring freeze would cause service degradation and long wait times and delays. As a result, many Americans may wait longer to receive the benefits they have been planning to use during their retirement, and the most vulnerable of our citizens will have to wait even longer for disability claims decisions, causing more hardship and frustration for millions of families.”It’s not like Social Security is operating in the flush now. Since 2010, its operating budget has shrunk 10 percent after inflation while the number of beneficiaries rose by 12 percent. President Obama has proposed an $11.1 billion administrative budget for fiscal year 2017, $522 million more than this year. House Republicans have proposed $772 million less than the president’s budget, according to SSA figures, while Senate Republicans would reduce agency spending by $582 million. The administrative budget is separate from the trust fund that pays benefits to recipients. “Social Security has been the most successful antipoverty program in U.S. history, helping men and women, children, adults and seniors from all walks of life,” said Maya Rockeymoore, president and CEO of the Center for Global Policy Solutions, by email. It convened the 2011 Commission to Modernize Social Security and recently released a report on Social Security’s role in lifting children out of poverty. “In the face of larger macro forces destabilizing economic security for families (the retirement crisis, stagnating wages, poverty), the growing numbers of retirees, disabled adults, and children who rely on Social Security would be better served if the program’s benefits were strengthened, not weakened. ”Social Security eventually touches the lives of almost all Americas. It provides old-age income as well as assistance to others of all ages. But SSA officials predict those services would be seriously interrupted with funding cuts planned by House Republicans. Carolyn W. Colvin, SSA’s acting commissioner, called on Congress to strengthen the program by passing the Obama administration’s spending plan. “The president’s 2017 budget funding level will allow us to continue to balance our service and stewardship activities,” she said. “It will also allow us to invest in and leverage technology to modernize our service delivery for the millions of people who we help to secure today and tomorrow. ”Yet, the services don’t seem so well balanced now. More than 1.1 million people are waiting for a disability hearing. That means they have to wait more than 500 days, on average, to get a decision on their appeals. SSA has closed more than 60 field offices and 500 mobile offices since 2010. Last year, waits of three weeks for an appointment were common. Callers to the 800 number have to wait 13 minutes on average, if they get through at all. Calling the House reductions “mind-boggling,” Rep. Rosa DeLauro (Conn.), the top Democrat on the House Appropriations labor, health and human services, education subcommittee, said “these cuts would be a disaster and the American people will suffer.” Rep. Tom Cole (R-Okla.), chairman of the panel, did not respond to a request for comment. The union representing many agency employees views the cuts as a precursor to privatizing Social Security. “Cutting staff when SSA is processing historically high claims is irresponsible and a sign that the Republicans who voted for this cut are not interested in providing tax payers with good service regarding SSA,” said Witold Skwierczynski, president of the American Federation of Government Employees SSA Council. “Instead they appear to be creating a scenario that insures the collapse of the program and will enhance the push to privatize it. If the public loses trust and faith that the federal government can administer SSA, they will look to privatization proposals as an alternative.”

2016 Trustees Report Confirms That Expanding Social Security Is Fully Affordable

bob@simplesitecompany.com (Bob Hansen) — Thu, 23 Jun 2016 07:16:14 GMT

The Social Security Board of Trustees has just released its annual report to Congress. It shows that Social Security has a large and growing surplus, and its future cost is fully affordable. Indeed, a greatly expanded Social Security is fully affordable. According to the new report, Social Security is 100 percent funded for the next eighteen years. It is 95 percent funded for the next 25 years. It is 87 percent funded for the next fifty years. And 84 percent funded for the next three-quarters of a century. The projected shortfall over the next three-quarters of a century amounts to just 0.95 percent of the nation’s Gross Domestic Product (GDP). In contrast, military spending after the 9/11 terrorist attack increased 1.1 percent of GDP virtually overnight. Spending on public education nationwide went up 2.8 percent of GDP between 1950 and 1975, when the baby boom generation showed up as school children. The fact is that, as the richest nation in the world at the richest point in our history, not only can we afford the current levels of Social Security protections, we can afford to greatly expand Social Security. Last year, Social Security cost just 5 percent of the nation’s Gross Domestic Product (GDP.) At its most expensive, at the end of the 21st century, the cost is projected to be just 6.1 percent of GDP. That is considerably less, as a percentage of GDP, than Germany, France, Japan, Austria and most other industrialized countries spend on their counterpart programs today. That is good news for all of us. Social Security is a solution. It is also what the overwhelming majority of us want. The nation is facing a looming retirement income crisis where most workers will be unable to retire without a drastic reduction in their standards of living. Social Security is the most universal, secure, fair, and efficient source of retirement income that we have, providing a guaranteed, inflation-protected source of income that one will never outlive. Expanding Social Security is a common-sense solution to that looming crisis. And, expanding Social Security helps everyone. Increasing retirement benefits automatically increases disability and survivor benefits, because they are derived from the same benefit formula. Those benefits will be increased for not just current workers and their families, but all future workers and their families. Expanding Social Security would help ease the financial pressure on working families. Adding new benefit protections, such as paid family leave and paid sick days, would do even more. Virtually all politicians have expressed concern about growing income and wealth inequality. Expanding Social Security and requiring millionaires and billionaires to pay their fair share will begin to put brakes on this dangerous, and rapidly growing, upward redistribution of wealth. In addition to being excellent policy, expanding Social Security also represents the will of the people. Support for Social Security expansion, and opposition to benefit reductions, cuts across ideological divides. These views are shared by Republicans, Independents, and Democrats. They are held by self-identified Tea Partiers and union households. A recent Pew poll, conducted while the presidential primaries were still underway, discovered that supporters of every single candidate overwhelmingly oppose Social Security cuts. Our Social Security system is so popular that it unites Bernie Sanders and Ted Cruz supporters! Yet while the American people are united, there is a stark divide among political leaders in Washington, DC. The Democratic Party has recognized the importance of expanding Social Security benefits. The growing movement to expand, not cut, Social Security includes the President, Secretary Clinton, Senator Sanders, around 95 percent of the Democratic Senators and around 80 percent of the Democratic members of the House of Representatives. In sharp contrast, no Republican policymaker has advocated expanding, not cutting, Social Security. Presumptive Republican presidential nominee Donald Trump has declared his opposition to expansion, as has every sitting Republican senator. In stark opposition to the Democratic Party and to voters of all political parties, the Republican Party supports cutting Social Security. All but six Republican senators have voted against protecting current workers - even those within days of retirement - from Social Security benefit cuts, including increases in Social Security’s retirement age. Moreover, Republican leaders have a clear history of advocating deep cuts to Social Security or even radically transforming it. This clear contrast between the parties indicates that Social Security will be a key issue in the 2016 general election. Democrats will run on expanding benefits, while Republican candidates will be forced to defend their party’s support for cuts. Although Donald Trump has publicly declared his opposition to cuts, that declaration is highly suspect, because of his past statements that Social Security is a criminal Ponzi scheme, and proposals that its retirement age should be increased to 70, and that it should be privatized. What the just-released Social Security Trustees Report makes clear is that whether to expand or cut Social Security is a question of values plain and simple. That leaves Republicans in Congress with a choice. They can continue to wage an ideologically-driven, irresponsible and unpopular effort to undermine Social Security, the bedrock of working families’ economic security. Or they can join with Democrats in carrying out the will of the American people by expanding Social Security. If they choose wrong, this election will provide the American people the opportunity to choose other leaders more willing to increase, not weaken, our economic security.-Huffington Post Nancy Altman

Rep. Steve Knight: 'I think that Social Security was a bad idea'

bob@simplesitecompany.com (Bob Hansen) — Thu, 16 Jun 2016 17:02:12 GMT

● CA-25 : Sometimes, some Republican says something so stupid, we don't even need to explain why it's so profoundly idiotic. This is one of those times. Here's freshman GOP Rep. Steve Knight , at a debate with his two Democratic opponents Thursday night:

" I think that Social Security was a bad idea . I do. I absolutely think it was a bad idea. I think that what should have happened was we should have had the government sit down with the private sector and build a system that people could take with them."

There's video, too —the kind of video that is ready-made for a Democratic attack ad. The question now is which Democrat will emerge to take on Knight. Attorney Bryan Caforio has caught the eye of national Democrats and has managed to bring in some (but not that much) money, though he has outraised the feeble Knight for the last two quarters. Agua Dulce Town Council member Lou Vince, meanwhile, has the endorsement of the state Democratic Party but has raised almost nothing. Mitt Romney only carried California's 25th District by a 50-48 margin , and Knight has proved he's dumb enough to put this Los Angeles-area seat in play almost on his own, but it'll still take a strong effort from Democrats to dislodge him.

Senate : ● NH-Sen, NV-Sen : The Senate Majority PAC has been increasingly active of late. The pro-Democratic group just reserved $4.2 million in fall TV time in New Hampshire , which is a top-tier opportunity for Democrats to gain a seat, and they're also running some ads right now in Nevada, the one Senate race where Republicans have a decent pickup shot of their own. SMP is going on the offensive against Rep. Joe Heck, the likely GOP nominee, with a spot that slams Heck for once calling Nevada's mortgage crisis "a blip on the radar" on a 2008 candidate questionnaire . That's a damaging attack in a state where the collapse of the housing market struck especially hard. Jon Ralston says the buy is for $450,000 .

● OH-Sen : A conservative super PAC called the Fighting for Ohio Fund (whose donors include pro-wrestling mogul and twice-failed Senate candidate Linda McMahon) is reportedly spending $1.5 million to air a new TV ad attacking Democratic ex-Gov. Ted Strickland. The spot features footage of Strickland from an editorial board interview with the Cleveland Plain Dealer earlier this year in which he said, "My record is mixed and spotty, and I can be criticized for that." The ad then goes on to hit Strickland for the "350,000 in jobs lost" while he was governor, as well as "$800 million in tax increases" he's allegedly responsible for, before repeating that same interview clip. But the use of this particular bit of video is quite mendacious. Strickland was speaking of his views on gun control , which have moved to the left, particularly as a result of pressure from his unsuccessful Democratic primary opponent, Cincinnati City Councilor P.G. Sittenfeld. While undoubtedly Strickland wishes he could un-say those remarks, to rip them out of context like this is crap. Strickland's campaign should have already fired off a lawyer letter demanding this ad be pulled.

Gubernatorial : ● NC-Gov : Roy Cooper ain't messin' around. Cooper, the state attorney general and Democratic nominee for governor, just reserved $7 million in TV time for the final nine weeks of his campaign against GOP Gov. Pat McCrory. Recent polls have shown a slight uptick for Cooper in the wake of the debacle over HB2, the state's new anti-LGBT law, but the race is far from in the bag for Team Blue.

House : ● CO-03 : Candidate filing closed in Colorado a little while ago, but the state only recently released a list of contenders for the June 28 primary. Note that the Senate GOP field is still in flux . Republican Rep. Scott Tipton looked completely safe in this 52-46 Romney western Colorado seat until ex-state Sen. Gail Schwartz entered the race last month. Tipton decisively turned back a credible Democratic foe in 2012, but Schwartz at least puts this contest on the map. At the end of March, Tipton had $605,000 in the bank , while Schwartz will start from scratch. Daily Kos Elections rates the general as Likely Republican .

● CO-05 : Republican Rep. Doug Lamborn came surprisingly close to losing his seat last month to state legislative aide Calandra Vargas. Lamborn needed to win at least 30 percent of the delegates' votes at the GOP convention to make the primary ballot (Lamborn chose not to collect signatures) and while Vargas outpaced him 58-35, Lamborn had just enough support to join her in June. Vargas is an unproven candidate, but Lamborn isn't particularly strong. Lamborn only beat an underfunded foe 53-47 last cycle, and he ended March with an underwhelming $297,000 in the bank . This Colorado Springs seat is safely red.

● CO-06 : This 52-47 Obama suburban Denver seat is a top Democratic target, and an expensive contest is already taking shape. Republican Rep. Mike Coffman is a well-regarded candidate, though he has a habit of letting his mouth do his thinking for him at times. Coffman's opponent is Democratic state Sen. Morgan Carroll, who like Coffman has no primary foe. At the end of March, Coffman held a $1.3 million to $641,000 cash-on-hand edge, but both the DCCC and NRCC , as well as the Democratic group House Majority PAC , have made major reservations here for the fall. Daily Kos Elections rates the general as Lean Republican .

● FL-04 : On Thursday, attorney Hans Tanzler III launched his campaign for this safely red open seat. While Tanzler, who served as executive director of the St. Johns Water Management District, has never held office, he has a well-known name. His father, whom the candidate is named for, served as Jacksonville's mayor when the city government consolidated with the rest of Duval County in the late 1960s. Tanzler will face ex-Jacksonville Sheriff John Rutherford, state Rep. Lake Ray, and St. Johns County Commissioner Bill McClure in the late August GOP primary.

● KS-01 : On Thursday, 2014 candidate Alan LaPolice announced that he would ditch the GOP primary and run for this seat as an independent. LaPolice's move comes as good news for physician Roger Marshall, who is challenging Rep. Tim Huelskamp, a tea party iconoclast, in the August primary. While LaPolice has raised very little money, he could have taken enough anti-Huelskamp voters from Marshall to secure the congressman renomination in this safely red western Kansas seat. The candidate filing deadline isn't until June 1 but right now, it looks like Marshall will be Huelskamp's only opponent. Huelskamp has a horrible relationship with local agriculture groups, and the Kansas Livestock Association and Dairy Farmers of America have both endorsed Marshall . Last time, agriculture groups spent against Huelskamp and held him to a 55-45 win against LaPolice, and it's unclear if they'll invest in this race again. However, while Huelskamp isn't a very good fundraiser, he still held an $837,000 to $484,000 cash-on-hand edge at the end of March.

● KY-01 : Former congressional aide Mike Pape attracted national attention last month when he ran an incredibly racist ad featuring three "Mexican" men, complete with bogus mustaches and accents, sneaking across the U.S. border at night to stop Trump, Cruz, and their number one ally, Mike Pape. The spot is unlikely to be a liability in the May 17 primary for this safely red western Kentucky seat, which pits Pape against ex-state Agriculture Commissioner James Comer. However, Comer is out with a new poll that argues that he remains the clear frontrunner and that the spot did little for Pape. The Voter Consumer Research poll gives Comer a 57-10 lead over Pape , with Hickman County Attorney Jason Batts taking just 6. The memo refers to a month-old VCR poll that showed Comer up 46-9. The Pape spot aired between these two polls and, at least according to VCR's results, it did not help Pape in any tangible way (the memo does not refer to the ad).Pape and Comer have actually been spending similar amounts of money in the lead-up to the primary. From April 1 to April 27, Comer outspent Pape just $273,000 to $239,000 . However, Comer, who narrowly lost the 2015 gubernatorial primary, started this contest with far more name-recognition than Pape. There have been no other polls here so it's very possible that Comer doesn't have anything like the gaudy leads his survey shows. Still, it makes sense that the better-known Comer would have the advantage on May 17 if he's not getting outspent on TV. Batts' Hickman County only makes up about 1 percent of the 1st, so he needed plenty of cash to get his name out, but that hasn't happened. Batts spent just $77,000 during most of April, and he has only $39,000 left. Comer has a strong $373,000 to $96,000 cash-on-hand edge over Pape, so he should be able to drown him out on TV from now until Election Day. And sure enough, Comer is out with another spot . Comer tells the audience that "Obama and the Washington liberals" are tearing America apart. He pledges to eliminate ISIS "and build the darned wall." He also touts his endorsement from the NRA as some footage of him training his kids how to aim guns plays.

● NC-02 : On Friday, the well-funded anti-tax group the Club for Growth renewed their war on GOP Rep. Renee Ellmers when they announced that they would "actively oppose" her in the June 7 primary for North Carolina's safely red 2nd Congressional District. The Club was already pissed at her for things like her votes to raise the debt ceiling and reauthorize the dreaded Export-Import Bank, and that was before she endorsed their hated enemy Donald Trump over Ted Cruz. The Club initially endorsed Jim Duncan back in November and spent $400,000 bashing her on his behalf, but that was before North Carolina was forced to redraw its congressional map. Duncan was drawn out of the new 2nd and decided not to run here, but Ellmers now faces a tough primary with fellow Rep. George Holding, with tea partying physician Greg Brannon also in. The Club didn't endorse either Holding or Brannon in this Raleigh-area seat, but any damage they do to Ellmers will almost certainly benefit Holding instead of the underfunded Brannon. The Club's decision wasn't a surprise, but it's still very unwelcome news for Ellmers. Holding represents about 57 percent of the new 2nd, while only 18 percent of the new district is Ellmers' turf. Both candidates have about the same amount of cash, but the wealthy Holding can easily outspend Ellmers if he chooses to . Ellmers had to know the Club would also return to target her in her new district, but that foresight may not do her much good once the Club's attack ads resume.

● NC-13 : On Friday, the Club for Growth endorsed Ted Budd , the owner of a gun range . Budd is one of 17 Republicans running in the June 7 primary for this newly-drawn seat, and until now, he looked like just Some Dude. But if the Club spends big here, it will undoubtedly help Budd stand out in this insanely crowded field. There will not be a runoff, so it may not take many votes to secure the GOP nod. Romney carried this Greensboro-area seat by 7 points, and we'll need to wait and see if any of the Democrats are raising enough cash to put this district into play.

● PA-09 : Heheheh. Tea partier Art Halvorson very nearly knocked off Rep. Bill Shuster in last month's GOP primary, losing by an extremely narrow 50.5 to 49.5 margin , but Halvorson is not done yet. Now he's trying to run against Shuster in the general election as a Democrat, arguing that since no Democrat filed to run here and some 1,060 votes were cast for him as a write-in in the Democratic primary, he should earn the Democratic nomination. Who knows if this can even succeed as a legal matter, but if it does, Shuster could find himself in jeopardy once again come November. Pennsylvania's 9th District is extremely conservative—it voted for Mitt Romney by a 63-36 margin —but if Halvorson were to appear on the Democratic line, he'd probably earn the votes of Democratic voters simply by default. And if he could convince the same sort of conservatives who backed him in the primary to swallow hard and pull the "D" lever for him (Halvorson says he'd caucus with the Republicans), a bizarre coalition like this could actually power him to victory. It would be crazy and amazing all at once.

● VA-02 : GOP Rep. Randy Forbes decided to seek this open Hampton Roads seat after redistricting turned his old constituency safely blue, but Forbes doesn't represent any of the new 2nd. State Del. Scott Taylor, who is challenging Forbes in the June 14 primary, has been portraying the congressman as an outsider, but Taylor's own poll says that he has a lot of work to do in the next month. Via Roll Call, Tel Opinion Research survey gives Forbes a 39-35 lead ; back in February, Tel Opinion showed the two deadlocked 33-33 . Needless to say, it's not a good sign for Taylor that the best poll he could release shows him going from tied to losing. The Tel Opinion poll says that, when respondents are told that Forbes decided to run here for political reasons, 60 percent said that they were less likely to support him. However, even if that message could damage Forbes, Taylor just doesn't seem to have the resources he needs to blast it out. At the end of March, Forbes had a huge $875,000 to $53,000 cash-on-hand lead, and no major outside groups have come to Taylor's aid. While Romney only narrowly won this seat, Team Blue is only fielding a perennial candidate.

● WA-07 : The third of three House candidates for whom Bernie Sanders sent out fundraising emails has finally released her April haul, and while state Sen. Pramila Jayapal says she raised quite a bit —$320,000—that was quite a bit less than the numbers reported by Nevada's Lucy Flores ($481,000) and New York's Zephyr Teachout ($418,000). There could be many reasons for this, such as the fact that Jayapal is running against several other Democrats to hold a safely blue district while Flores and Teachout are, ultimately, both trying to unseat Republicans (though they have to win primaries first). The vagaries of Sanders' fundraising list might also be at play, though you'd expect him to have an active Washington segment (he dominated in the state's caucuses). Regardless, Jayapal did very well for a single month, which just shows that as the Sanders presidential campaign winds down, he could do a lot of good for the progressive movement by endorsing more candidates further down the ballot.

Grab Bag : ● Election Data : The Upshot's Quoctrung Bui has a great new piece on a little-known but seminal site of great importance to election junkies: The Green Papers . Bui's hook is the site's rigorous devotion to providing the most accurate delegate counts possible, all done for no money by the site's two very private founders, Richard Berg-Andersson and Tony Roza. But Green Papers also collects tons of other political information that we rely on regularly, like poll closing times and primary dates.There are a number of terrific details in Bui's story, such as the origin of the site's name: Berg-Andersson and Roza starting tracking delegates at college back in the 1970s, and they'd print their counts on "continuous computer paper with the sprocket edges" and post them on their dorm room door. There's also a hilarious feature that allows you to view the article in "Green Papers mode," which alone is worth the click .

● Where Are They Now? : Time flies! Disgraced former GOP Rep. Mike Grimm, who resigned from office in January of last year after pleading guilty to felony tax evasion, was released from prison a week ago and has given his first interview to the press. Grimm won re-election while under indictment in 2014 by portraying himself as the victim of an unjust, politically motivated persecution, a move that played perfectly to the insecurities of the chip-on-the-shoulder voters in his Staten Island-based district. Shortly thereafter, though, he was out of office—but maybe not forever! Grimm says he's working on a book, and, according to NY1, he "hasn't ruled out a return to politics."

● Where Are They Now? : A long-running legal saga reached a dramatic climax Thursday when a federal jury convicted three former Ron Paul aides , including his presidential campaign chair, Jesse Benton, on charges that they secretly paid former Iowa state Sen. Kent Sorensen $73,000 to switch his endorsement from Michelle Bachmann to Paul on the eve of the 2012 Iowa caucuses. Benton and his colleagues had concealed the payments by routing them through a video production company, in order to avoid disclosing their skullduggery on Paul's FEC reports. The trio potentially faces up to 20 years in prison for causing the campaign to file false payment records, as well as lesser sentences on the other related charges.

● Where Are They Now? : Hah! Wealthy Republican businessman Carl Paladino, who unsuccessfully ran for governor as a proto-Trump back in 2010 and is now one of The Donald's most prominent supporters in New York, nearly lost re-election to his seat on Buffalo's school board this past week. Paladino only won by 3.6 percent against an 18-year-old high school student, Austin Harig, who had said the board could use an injection of "some adult behavior." While Harig didn't prevail, the board did change hands , as voters elected a majority supported by the local teachers union, replacing one that had been hostile to the teachers (the faction Paladino was part of).

The Daily Kos Elections Morning Digest is compiled by David Nir and Jeff Singer, with additional contributions from David Jarman, Steve Singiser, Daniel Donner, and Stephen Wolf.

Social Security Unveils Initiative To Automate Disability Claims

bob@simplesitecompany.com (Bob Hansen) — Mon, 06 Jul 2009 19:50:39 GMT

On Monday, the Social Security Administration announced plans to expand connectivity with health care providers in an effort to accelerate electronic disability claims processing, Government Health IT reports.

Virginia as a Model

In February, SSA launched an electronic disability claims system with MedVirginia, Virginia's regional health information organization.

The two groups exchange information through the federal Connect gateway for linking to the National Health Information Network.

Building Up

Jim Borland, SSA's special adviser for Health IT, said SSA hopes to build upon the MedVirginia initiative by connecting with other health care providers nationwide.

The project could help the agency convert its paper-based disability determination system into an automated process, which could save labor, money and time.

SSA plans to use money from the federal economic stimulus package to award contracts to:

Health care providers and specialists;
Medical organizations;
Health information exchanges; and
RHIOs.

Timeline

On June 29, the agency posted a request for information on the Federal Business Opportunities Web site to measure interest in the initiative. Responses are due July 22.

The agency expects to publish a request for proposals Aug. 7 and could begin awarding contracts in January, Borland said (Mosquera, Government Health IT , 7/6).