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Judge Rebukes Social Security Official for Relying on Non-Medical Expert's Opinion
In assessing a claim for Social Security Disability Insurance benefits, an administrative law judge (ALJ) must examine an applicant's “residual functional capacity” (RFC). This is a measure of the applicant's ability to work, taking into account any mental or physical disabilities. Since the judge is not a doctor, he or she must review the opinions of physicians who have treated the claimant. The ALJ must ultimately weigh the credibility of these medical experts in making a final decision to grant or deny disability benefits.
Never Seek Medical Advice from Bureaucrats
But there are cases where judges fail to justify their decisions properly or rely on improper evidence. For example, a Chicago magistrate judge recently determined an administrative law judge improperly denied a disability applicant's claim without providing “substantial evidence.” Specifically, the magistrate said the ALJ failed to assess the claimant's RFC properly.
Chicago Appeals Court Says Disability Applicant Entitled to New Hearing
Many people are denied Social Security Disability Insurance benefits on their first application. Disability cases are initially heard by an administrative law judge (ALJ), who, despite the title, is not a judge in the conventional sense. An ALJ is actually an employee of the Social Security Administration who initially reviews claims on behalf of the Commissioner of Social Security. Typically, an ALJ examines a disability applicant's medical record, questions the applicant, and reviews expert testimony before approving or rejecting a disability claim. If the ALJ rejects a claim, the applicant may appeal to a federal court.
Judge Unimpressed With Social Security Official's “Scattershot Analysis”
In a recent case, a federal appeals court in Chicago harshly criticized an ALJ who denied a Social Security disability claim despite overwhelming evidence the applicant was “totally disabled.” The applicant was 22 years old and previously worked as a “warehouse worker, landscape laborer, and forklift driver,” according to court records. In 2010, he was “struck in the back of his head by an assailant wielding a bar stool as a weapon.” The applicant subsequently required brain surgery, during which he suffered a seizure.
Understanding Social Security Work Credits
According the Social Security Administration (SSA), more than one in four of today’s young adults will become disabled before the age of 67. It can difficult to imagine not being able to work or provide for your family, especially without the luxury of significant financial resources or savings. For many, their only option is to pursue disability benefits through the federal government. Known as Social Security Disability Insurance, or SSDI, these benefits can help replace income lost due to a qualifying condition.
Social Security Funding and Work Credits
The Social Security system is primarily funded through payroll tax contributions from workers across the country. As a type of insurance, only those who have paid into the system are eligible for primary benefits. A worker’s contribution is measured by the SSA in terms of “work credits,” which are given based upon an individual’s earnings in a given year. Each of the various SSA benefit programs, including disability, require a worker to have a minimum number of work credits in order to qualify, depending on his or her age and the specific benefit program.
Common Mistakes On SSI Disability Applications
1) Disability Onset
Most claimants try to push their onset of disability back as far as possible, thinking that they will get more money in back-benefits when they win their case. This is not accurate. The maximum allowable back-benefits for an SSI application is likely the date of filing. Making the mistake of pushing the alleged onset back too far can have significant consequences when it comes time for DDS to evaluate your claim.
2) Income
SSI and SSDI have very different financial requirements. Whereas SSDI examiners look at wages when evaluating the claims, SSI has to do with income and assets. Typically, an individual's countable resources cannot be worth more than $2000 and $3000 for a couple. Many claimants filing for SSI disability benefits become frustrated when they realize that their claims are denied for financial reasons, namely, too much income. This can be particularly frustrating when someone you live with ends up financially impacting your claim.
Secret Claimant Age Policy
I had a claimant ask me the following question recently: "Do you think the Social Security doctors would have given me a different work restriction if they did not know how old I was during the evaluation? It seems like they gave me a light enough restriction to just barely do work so that they could deny me, and not give me my benefits."
This is an excellent question. Age plays a crucial role in determining what legal standard applies to a particular claimant when evaluating whether he or she is entitled to Social Security disability benefits. Claimants under the age of 50 typically have a more difficult time obtaining benefits than those over 50. The same is true for claimants that are between the ages of 50-54 trying to get disability benefits compared to those who are over the age of 55.
The Social Security Administration makes it slightly easier to get disability benefits as the claimant goes up each listed age category. DDS doctors are fully aware of the importance of age and its legal implications when handing out work restrictions. Is it possible then, as the claimant above questioned, that some of the DDS doctors who already know the age of each claimant, give out a particular work restrictions knowing full well that he or she will be denied? Maybe yes, maybe no.
Social Security Disability Benefits and Doctor-Patient Dialogue
Social Security Disability Benefits and Doctor-Patient Dialogue
If you are applying for Social Security disability benefits, one of the most important things that you can do is seek out proper medical treatment and be on good terms with your doctor. The Social Security Administration will review medical evidence and determine whether you are capable of working. Continued treatment with your doctor will insure that there is more evidence to go off of during the process and allow for the government to get a better picture of your physical or mental limitations. To that end, understanding what your doctor is writing about you in his or her notes will not only help you become more familiar with your medical condition, but will also help you know where you stand for your disability benefits claim. The Open Notes Project is an excellent example of a concerned effort to build on those ideas.
The Open Notes Project is one example of a collaborative effort between patients and doctors to build communication and understanding in the medical field. The study involved over 100 doctors from multiple major health centers and over 19,000 patients invited to review office visit notes and comments to create open dialogue for the improvement of treatment and overall patient health and the results were quite shocking. The Open Notes Project would have patients review doctors' notes about their visits to promote understanding and better communication. Of the patients who reviewed the doctor's notes:
Seizures And Social Security Disability Benefits
"Is it easy to get Social Security disability benefits if you have frequent seizures?"
The short answer is no. There are different types of seizures, but in general, seizure disorder can be a very difficult Social Security disability benefits claim. On the one hand, having frequent seizures can be extremely debilitating. How can someone reasonably be expected to hold down a full-time job if that person is consistently blacking out! Most employers would likely not tolerate that behavior and even if they did, surely one's job performance would suffer from being routinely off task. Whether the seizures come once a week during the day or every day, the condition can be extremely limiting on one's ability to sustain gainful employment.
On the other hand, proving the intensity and frequency of seizures can be difficult. The overwhelming majority of people suffering from seizures have them outside of a hospital or doctor's office. This means that there is typically no record of the seizure taking place, at least in one's medical record. This can become particularly problematic in a Social Security disability benefits claim where they key is proving disability based on medical evidence.
Illinois Social Security Disability Blog Age 3
The title="Articles and Information by Social Security Defenders" href="http://socialsecuritydefenders.com/articles/">Illinois Social Security Disability Articles "blog" is now three years old! It is hard to believe that time went by so quickly. A lot has happened since our very first article on September 10, 2009 entitled, "At A Hearing, What Doctors Should I Use As Evidence For My Claim?" I want to thank everyone who continues to write to us, whether with comments, questions, or just a simple thank you for the information we provide. I look forward to providing you with even better and more up to date information this upcoming year.
Feel free to continue to write in, as we love hearing from you. Below are some of the common topics we receive emails about:
- Updates regarding the Social Security Administration
Effective Ambulation and Applying for Social Security Disability Benefits
Applying for Social Security Disability Benefits with Effective Ambulation
I applied for disability benefits. The Social Security Administration says that I can ambulate effectively, what does this mean? Have I lost my case?
If you are applying for Social Security disability benefits and have a physical condition that makes it difficult to walk, then the government will try to determine just how limited you really are from moving around. Some physical conditions that diminish a claimant's ability to walk are: peripheral neuropathy, osteoarthritis, rheumatoid arthritis, fibromyalgia, residuals of a stroke or heart attack, and a number of other serious debilitating medical conditions.
What will the government use to determine whether a claimant can ambulate effectively? The government will look at a number of different factors, including:
- Can you carry out activities of daily living?
SSA Technology Update
On August 25th, 2012, the Social Security Administration (SSA) gave appointed representatives with access to online business services the capability to download audio recordings from Social Security disability hearings. This is a major step towards streamlining the disability benefits appeals process.
After a claimant has been denied Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits at an administrative law hearing, he or she has 60 days to file an appeal to the Appeals Council. If the claimant chooses to file an appeal, his or her Social Security disability attorney will likely request the hearing recording from the Office of Disability Adjudication and Review (ODAR). Not unlike any other part of the disability process, obtaining the hearing recording from ODAR is often quite difficult. It involves getting the right person on the phone to speak to, receiving the physical cd in the mail, and then having a functional disk to work off of. Meanwhile, Social Security still has their filing deadline to be mindful of.