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Will it Take a Decade to Decide My Disability Case?
Applying for Social Security Disability insurance benefits is not a simple process. It is certainly not a quick process either. Many claims languish for several years and require multiple hearings before an applicant starts to receive benefits.
Appeals Court Refuses to End Case After Nine Years
Sadly, even in extreme cases, applicants are forced to go through multiple rounds of court hearings just to receive fair treatment. A recent decision by the U.S. Seventh Circuit Court of Appeals in Chicago illustrates just how laborious the process can be. This particular Social Security claim has been pending for nearly a decade, and it has yet to be resolved.
The applicant in this case has not worked since 2003. Two years earlier, he suffered a serious back injury that eventually required surgery. The surgery failed to relieve the applicant’s chronic pain, however, and even today he still requires regular pain medication treatments that are only partially effective. The applicant is also unable to afford certain medically recommended treatments because they are not covered by his insurance.
What Illinois Disability Recipients Need to Know About Medicare
October 15 is the beginning of the annual “open enrollment” period for the federal Medicare program. This is the time during which Medicare-eligible individuals can make changes to their health insurance coverage, such as adding or dropping benefits. For 2016, open enrollment lasts until December 7.
Can I Receive Medicare While on Disability?
Although Medicare is generally associated with individuals age 65 or older, anyone approved for Social Security Disability Insurance benefits can also receive coverage under the program. Under federal law, anyone under the age of 65 is automatically enrolled in certain parts of Medicare after they have received disability benefits for at least 24 months (two years). The government will automatically send an eligible disability recipient a Medicare insurance card approximately three months before this two-year benchmark.
Will Medical Evidence of Heart Failure Prove I Am Disabled?
Heart failure is one of the leading causes of death in the United States. According to the Centers for Disease Control and Prevention, approximately 5.7 million American adults currently suffer from some degree of heart failure. About 50 percent of these people will die within five years of diagnosis.
The term “heart failure” itself is somewhat misleading. It does not mean a person’s heart has stopped working, or even that there is irreversible damage to the heart tissue itself. Medical professionals use a classification scale developed by the New York Heart Association (NYHA) to assess degrees of heart failure. The NYHA scale helps determine what limits a person’s heart failure may have on his or her daily activities—including the ability to work. Even at lower classification levels, heart failure may render a person unable to work and qualify him or her for Social Security Disability insurance benefits.
Does Social Security Understand How to Assess Mental Illness in Disability Cases?
Social Security officials are not doctors. Yet when assessing claims for disability benefits, they often pretend they know more about medical impairments than even the applicant’s treating physician. Such presumptions are inconsistent with the law and courts frequently chide Social Security for “playing doctor.”
Social Security Confuses “Negative” Symptoms of Schizophrenia With “No” Symptoms
Just recently, the U.S. Seventh Circuit Court of Appeals in Chicago ordered Social Security to reconsider the disability claim of a man suffering from schizophrenia because the agency’s administrative law judge (ALJ) “misunderstood” the medical evidence in the case.
The applicant is a 46-year-old former mailroom worker. He was diagnosed with schizophrenia more than 20 years ago. While the applicant was able to manage the condition with medication for many years, his health began to deteriorate five years ago when his doctor switched him to a generic version of the same drug.
Can Depression and Anxiety Disorders Qualify Me for Disability Benefits?
Anxiety and depression are serious mental health disorders. In some cases they may produce symptoms so severe as to qualify a person for Social Security Disability insurance benefits. However, Social Security officials are often quick to dismiss medical evidence of mental health problems, and in some cases illegally substitute their own non-expert opinions for the views of medical professionals.
Magistrate Finds “Red Flags” in Social Security’s Rejection of Applicant With Mental Disorders
Here is a recent example from here in Illinois. A 50-year-old man applied for disability benefits. He previously worked as a custodian and manual laborer.
As part of the disability review process, a state agency doctor examined the applicant and diagnosed him with “depressive disorder and generalized anxiety disorder.” This was more than a case of the applicant feeling sad or anxious. The agency doctor noted the applicant “had difficulty maintaining a consistent level of attention and concentration during the examination.” There was also evidence of “impaired memory.” A second agency doctor charged with reviewing the applicant’s medical history agreed his “depression and anxiety amounted to severe impairments.”
Can Social Security Ignore My Pain?
Social Security Disability cases often turn on agency officials’ subjective views of the applicant’s “credibility.” This is a particular issue when the applicant’s inability to work is due to chronic pain. Put bluntly, Social Security administrative law judges (ALJs) have a history of disregarding complaints of pain as faking or exaggeration on the part of the applicant.
Social Security Chided Again for Equating Life Activities With Employment
The law, however, at least as it is supposed to be applied in Illinois, is that Social Security cannot simply ignore an applicant’s testimony regarding their pain. Nor can Social Security point to evidence the applicant is capable of performing daily “life activities” as conclusive proof that he or she can hold down a physically demanding full-time job.
Does Age Matter When It Comes to Applying for Disability Benefits?
How old you are when you apply for Social Security Disability insurance benefits can have a significant impact on your case. If you are age 50 or older, Social Security regulations require the agency to consider how your advancing age “will seriously affect your ability to adjust to other work.” This is critical because part of assessing a disability claim is determining what types of alternative work, if any, the applicant may be able to perform despite his or her medical impairments.
Judge Orders Social Security to Consider Applicant’s Case for a Third Time
In some cases Social Security officials may attempt to mischaracterize an applicant’s true ability to work in order to justify denying benefits. Here is a recent example from here in Illinois. The applicant in this case was 50 at the time she applied for disability benefits. She previously worked for the United States Postal Service for more than 20 years, the last five as a postmaster.
Can Social Security Revoke Disability Benefits?
Social Security Disability insurance benefits are not necessarily permanent. Social Security may review and revoke disability benefits if it later determines that an individual is capable of working. This does not necessarily mean the individual no longer suffers from a disability, only that Social Security now has reason to believe that he or she can hold down a meaningful job in some capacity.
Court Upholds Decision to End Benefits for Illinois Man With Learning Disability
In one recent case, the Chicago-based U.S. Seventh Circuit Court of Appeals upheld Social Security’s decision to terminate the disability benefits the plaintiff—a man in his late 40s who suffers from a severe learning disability. Social Security initially determined the plaintiff was disabled and unable to work in 1993. But in 2004, the agency reviewed the man’s case and determined “his disability had ended.”
Will Social Security Deny My Disability Claim Because I Take Care of My Children?
One of the factors that Social Security looks at in reviewing a claim for disability benefits is how an applicant’s medical impairments affect his or her ability to perform “activities of daily living.” In other words, Social Security wants to know whether the applicant’s disability is severe enough to restrict his or her ability to perform basic tasks such as driving and other “daily living” activities. The presumption is that a person who is able to perform activities of daily living without significant restriction, therefore, should also be able to hold down a full-time job.
Judge Blasts Social Security for Using Child’s Medical Care to Deny Mother’s Disability Claim
The reality, however, is that Social Security often overstates the importance of daily living activities. In many cases, their findings regarding such activities are merely a pretext for declaring the disability applicant’s claim lacks credibility. Social Security is routinely criticized by federal courts for this practice.
Can I Be Denied Disability Benefits for Non-Medical Reasons?
Social Security Disability Insurance provides benefits for individuals who are no longer able to work due to a documented physical or mental impairment. Indeed, most Social Security cases revolve around establishing that a disability exists and then demonstrating how it affects the applicant’s ability to work. But, in addition to insufficient medical proof of a disability, Social Security may also reject your claim for a number of non-medical reasons.
Is Your Earned Income Too High?
Social Security will assess how much money you made from “substantial gainful activity” (SGA) when assessing your disability application. The SGA is a threshold amount of earnings above which you are considered “able to engage in competitive employment.” This amount changes annually based on inflation. In 2022, the SGA threshold is $1,350 per month or $2,260 for people who are blind.