Posted on January 19, 2016 in Denied Social Security Benefits

In assessing a claim for Social Security Disability Insurance benefits, it is essential for agency officials to see the most up-to-date information about a claimant's medical condition. A Social Security administrative law judge (ALJ) may be quick to seize on an outdated medical report as justification for denying benefits. In such cases, the applicant has every right to seek a new hearing that takes into account his or her entire medical history.

Social Security Incorrectly Relies on 10-Year-Old MRI in Denying Benefits

Here is a recent example from right here in Illinois. The applicant in this case was a 55-year-old woman who suffers from back pain, anxiety, and depression, among other ailments. The applicant first filed for Social Security Disability benefits in 2006. She received a hearing before an ALJ in 2008. The ALJ denied the claim, and in doing so largely discredited or ignored medical evidence presented by two physicians who had treated the applicant.

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 Posted on January 12, 2016 in Denied Social Security Benefits

Mental disabilities affecting a person's ability to work are often dismissed or ignored by officials overseeing the Social Security Disability insurance program. But there are many types of mental conditions, such as “deficiencies of concentration, persistence, or pace,” which may qualify a person for Social Security disability benefits. In order to determine whether your mental condition qualifies you for disability, a doctor must complete a form known as a Mental Residual Functional Capacity Assessment (MRFCA).

Part One of the MRFCA asks your doctor to rank your functioning in various categories, such as your ability to “remember locations and work-like procedures” or “carry out detailed instructions.” In each category, the doctor must describe your limitations, if any, by choosing words such as “mild” or “extreme.” Later, in Part Three of the MRFCA, the doctor must offer his or her “summary conclusions in narrative form.”

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 Posted on January 05, 2016 in Social Security Disability Medical Conditions

An important part of any Social Security Disability insurance case is establishing precisely when the applicant's disability began. Social Security regulations require agency officials to consider three factors when determining “the onset date of disabilities of a nontraumatic origin.” First and foremost, there is the onset date claimed by the applicant. Second, there is the applicant's work history. Finally, there are medical records and “all other relevant evidence.”

While medical records weigh most heavily with Social Security officials, it is often difficult to ascertain an exact onset date from such evidence alone. In those cases, Social Security may “infer” an onset date. If such an inference is not possible, Social Security must “explore other sources of documentation,” such as testimony from family members of co-workers. However, Social Security must not infer an onset date that actually conflicts with the available medical evidence.

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 Posted on December 22, 2015 in Social Security Disability Medical Conditions

When you apply for Social Security Disability insurance benefits, the official in charge of hearing your claim will solicit testimony from someone known as a “vocational expert” (VE). The VE's job is to advise Social Security if you are capable of performing any of the same jobs you held in the past, or in the alternative, if your skills can be transferred to a different vocation. In short, the VE is there to present any possible scenario, no matter how implausible, where you might return to full-time work.

In recent years many critics—including a growing number of federal judges—have questioned the value of VE testimony. One problem is vocational experts rely on a horribly outdated system for classifying and describing possible jobs. The system, known as the Dictionary of Occupational Titles (DOT), was last updated by government officials nearly 25 years ago in 1991. For example, in a recent disability appeal heard by the U.S. Seventh Circuit Court of Appeals in Chicago, the judges noted a VE claimed an applicant could work as a “counter clerk,” which the DOT defined as “processing film for subsequent photo printing.” This is not exactly an in-demand job in 2016.

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 Posted on December 16, 2015 in Denied Social Security Benefits

One excuse officials offer when denying Social Security Disability insurance benefits is the fact an applicant, in spite of a demonstrated and severe medical impairment, may continue to perform certain “daily activities,” such as cooking or household chores. Social Security may claim this proves the applicant is capable of working outside the home and therefore not genuinely disabled. But as the U.S. Seventh Circuit Court of Appeals, whose decisions govern all Social Security disability claims raised in Chicago and throughout Illinois, has said, there are “critical differences between activities of daily living and activities in a full-time job.” When performing the former, a disabled person “is not held to a minimum standard of performance, as she would be by an employer.”

But while the Seventh Circuit has made it clear Social Security cannot deny disability benefits solely because the applicant can perform “daily activities,” the agency may still consider it as a factor. A recent Seventh Circuit decision offers an illustration. In this case, a 34-year-old woman applied for Social Security disability benefits, citing “painful bladder syndrome,” bipolar disorder, and attention-deficit disorder. As a result of these impairments, the applicant complained of “severe” pain and the need to frequently use the restroom. Before a Social Security administrative law judge (ALJ), she testified “her need to urinate frequently made holding a job difficult, and that the stress of working exacerbated her symptoms.”

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 Posted on December 08, 2015 in Social Security Disability Medical Conditions

Fibromyalgia is a medical condition affecting millions of Americans, mostly women. The key symptoms of fibromyalgia, according to the Mayo Clinic, are pain, fatigue, and cognitive difficulties. In many cases, these symptoms are so severe patients are unable to work and may be entitled to Social Security Disability insurance benefits.

Social Security Fails to Consider “Onset” Date of Woman's Fibromyalgia

Social Security does have specific guidelines regarding the assessment of a fibromyalgia-based disability claim. Fibromyalgia must be diagnosed by a physician. There must be documented evidence the claimant has suffered “widespread pain” over a period of “at least three months.” Additional symptoms Social Security looks for are “fatigue, cognitive or memory problems, waking unrefreshed, depression, anxiety disorder, or irritable bowel syndrome.”

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 Posted on December 01, 2015 in Denied Social Security Benefits

Applicants for Social Security Disability insurance often present evidence of multiple ailments. For purposes of granting or rejecting a claim, Social Security need not find all of an applicant's ailments are serious enough to constitute a disability. However, if the agency determines any of a claimant's ailments are “severe,” the law requires Social Security consider the “aggregate effect of this entire constellation of ailments including those impairments that in isolation are not severe.” Unfortunately, Social Security officials often fail to follow this requirement and instead dismiss evidence of severe impairments in wrongly denying a disability claim.

SSA Failed to Consider Limits of Teenage Heart Transplant Patient

Consider a recent example from here in Illinois. The applicant is a woman who has dealt with serious health problems since childhood. She required a heart transplant at the age of 12. Afterwards, she required ongoing treatment for a number of other ailments. After her 18th birthday, the applicant filed for Social Security Disability benefits, claiming her continuing medical problems left her unable to work.

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 Posted on November 23, 2015 in Denied Social Security Benefits

Many Americans remain addicted to nicotine despite the well-documented negative health effects of cigarette smoking. Smokers often suffer from heart and lung problems as a result of their addiction. But does the fact a person continues to smoke despite health problems render them automatically ineligible for benefits under Social Security Disability Insurance? Judges in Illinois have long said “no,” even though Social Security officials like to pretend otherwise.

SSA Not Allowed to “Play Doctor”

In a recent Illinois case, a federal magistrate ordered the Social Security Administration (SSA) to reconsider the disability claim of a 51-year-old woman who has been unable to work for the past eight years due to a number of serious medical issues, including chronic obstructive lung disease. As a result, she requires an external oxygen supply at least eight hours per day.

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 Posted on November 17, 2015 in Social Security Disability Medical Conditions

In considering an application for Social Security Disability insurance benefits, government officials must not only look at a person's medical disabilities, but also his or her educational background. This is because as a person gets older, it is presumably more difficult for an impaired person to find a job. Therefore, depending on an applicant's age, limited education or literacy may contribute to a finding of disability.

Social Security regulations set forth several standards for evaluating a disability applicant's education. Social Security officials must inquire an applicant about his or her education, including how long he or she attended school, if he or she can read or write, and if he or she can perform basic arithmetic. For example, a person is deemed to have a “marginal education” if he or she has formal schooling or demonstrates learning at the sixth grade or lower level.

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 Posted on November 11, 2015 in Denied Social Security Benefits

It usually takes years before Social Security Disability Insurance applicants start receiving benefits. In many cases, claims are initially denied and must go through an extensive appeals process. After an administrative law judge (ALJ) denies a claim, the applicant must first seek an internal review with the Social Security Administration's Appeals Council. If this body still rejects the claim, the applicant can turn to the federal courts for relief. The courts do not have the power to directly award disability benefits, but they can order Social Security to reconsider your case.

When Must SSA Consider New Evidence?

A common problem in disability cases is the emergence of new information after an ALJ has conducted a hearing and rendered an initial decision. In such circumstances, the applicant may present additional evidence to the Appeals Council, which must then determine if it is “new and material” and “relates to the period on or before” the ALJ's decision. If the Appeals Council accepts the new evidence, it is added to the record, which is then reviewed in its entirety. The Appeals Council will overturn an ALJ's decision to deny disability benefits only if it is “contrary to the weight of the evidence.”

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