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Tips For Your Next Consultative Examination
You have applied for Social Security disability benefits, whether SSDI or SSI, and the government decides to set up an appointment for you to see one of their doctors. Is this a good thing? Below are some tips and basic information you should be aware of when you attend the exam:
1) The exam is not to figure out a way to improve your health. The doctor is not there to prescribe medication to you. It is supposed to be a non-biased exam to determine your medical condition and resulting functional limitations.
2) Make sure to bring with you all medications, braces, and ambulatory devices.
3) When the doctor asks you what problems you have, make sure to mention everything that is causing you pain, whether physical or mental. The doctor may not have read your file and will need you to tell him or her everything about your condition(s).
4) You must attend the examination even if you do not feel like it. Failure to attend the examination could result in a denial of Social Security disability benefits.
Best February Social Security Disability Blogs
For February's "Best Social Security Disability Blogs" of the month, we listed our top 4 blogs by Social Security disability lawyers nationwide:
Hearing Office Status Report Now Available Online -Maine lawyer Gordon Gates on Social Security Disability Lawyer Blog
Autonomic Neuropathy And Disability Benefits -Illinois disability lawyer Aaron Rifkind on Illinois Social Security Disability Blog
Will Filing For Unemployment Hurt Your Social Security Disability Case? -Georgia disability lawyer Jonathan Ginsberg on his Social Security Disability Blog
My Doctor Said I'm Disabled, Why Was I Denied Disability Benefits?
Social Security regulations provide that treating physicians' opinions are generally given more weight than other medical sources. A treating physician would typically have spent more time with you and gotten to know your condition much better than any other medical professional. However, there are a number of circumstances where a treating physician's opinion will not be given more weight in a Social Security disability claim, whether for SSDI or SSI benefits. The following are several factors Social Security will evaluate when reviewing a treating doctor's opinion:
1) How often have you been treated by your doctor?
Have you seen your doctor only three times in two years or do you see him or her every month?
2) Is your doctor a specialist treating you for a particular condition?
A specialist focuses his or her practice to a particular area of practice such as a cardiologist with the heart or a dermatologist with skin disorders. If you are seeing a specialist for a particular condition that professional's opinion will typically be given more weight.
Social Security Advisory Board, Part II
The Social Security Advisory Board (SSAB) in February published an extensive document discussing the Social Security disability system entitled, "Aspects of Disability Decision Making: Data and Materials." In that document, the SSAB produced a number of different statistical charts and graph composites of the data they collected. One such graph discussed the percentage of the United States population receiving Social Security Disability Insurance by gender and age group in 2010.
While the percentages comparing men and women are about the same, what should be noted is the trend that the SSAB was able to come up with. The fact of the matter is that more people are getting on disability benefits over 50 than anyone else in the population. Whereas individuals under the age of 30 receiving disability benefits account for less than 2% of the population, people between the ages of 50-60 on disability account for 6-14% of the people in the United States. While the data does not clearly demonstrate why this is the case, this trend is most likely due to the government making it easier for people that are older to get disability benefits and because the likelihood of getting ill increases as you get older.
Social Security Advisory Board, Part I
The Social Security Advisory Board (SSAB) in February published an extensive document discussing the Social Security disability system entitled, "Aspects of Disability Decision Making: Data and Materials." In that document, the SSAB produced a number of different statistical charts and graph composites of the data they collected. One such graph discussed the combined Social Security Disability Insurance and Supplemental Security Income allowance rates at each adjudicative level from 1986-2010.
A common trend throughout the years is that if you appeal a denial of Social Security disability benefits to the hearing level, your chances of getting approved increase significantly. Whereas the approval rates at the initial application level throughout the years typically varied between 30-40%, the approval rates at the hearing level are approximately 20% higher. It should also be noted that if your application is denied, statistically you will have to appeal again to the hearing level to have a chance. The approval rates at the reconsideration level are an abysmal 10-20%.
ODAR Processing Times January 2012
The Social Security Administration (SSA) publishes the average Social Security disability benefits claim processing times of all of the hearing offices across the nation. In the last couple of years, SSA has made a major push to "speed up" the processing of disability claims. Processing time means from the time a request for hearing is completed to the final disposition of the hearing request.
While the average processing times have decreased in the past year, Illinois hearing centers are still some of the slowest offices in the country. If you have applied for Social Security disability benefits, whether Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), and you live in Illinois below is an approximation of what you can expect depending on the office working on your claim:
Chicago: 356 days
Evanston: 362 days
Oak Brook: 377 days
Orland Park: 363 days
For a frame of reference, the hearing office with the fastest average processing time in the country is the Shreveport office at less than half of these offices, 172 days.
How Much Does It Cost To Obtain My Medical Records?
Essential to any Social Security disability benefits claim is medical records. Medical records are the primary source of evidence used to prove whether a claimant is in fact disabled and unable to work. One major dilemma that claimants routinely have is the inability to obtain their medical records. An individual can have thousands of medical records and the costs can amount to hundreds of dollars that they simply do not have. This is completely understandable, as most claimants have stopped working and have little to no income. Not only can the costs involved with gathering medical records be staggering, but this is particularly difficult for people who are struggling to put food on the table and pay for the day to day medications needed to survive and cope with debilitating medical conditions.
Our Social Security disability law firm represents claimants in a number of different states. In particular, Indiana, Illinois, and Nevada have set state limits on the cost of gathering one's medical records for Social Security disability benefits claims. Below are the limits:
Drug Abuse And Alcoholism
Yes, drug abuse and alcoholism can have a significant impact on your Social Security disability benefits claim. In fact, drug abuse and alcoholism can potentially disqualify a claimant from receiving benefits, regardless of the severity of the medical condition. In other words, a judge can make his or her decision before you even get to arguing your case and why you are disabled. We strongly recommend claimants to stay away from drugs and if it is still a problem when applying for disability benefits, to seek out professional counseling and/or treatment.
In the rare circumstances that drug abuse or alcoholism does not disqualify a claimant outright, it can nonetheless significantly damage the credibility of the claimant. Drug abuse and alcoholism begs the question:
-If you were not on drugs, would your condition improve to the point that maybe you could work at a job full-time?
-If you really are unable to afford medical treatment, how can you possibly afford drugs?
Risks of Appealing a Partially Favorable Decision
Few Social Security disability applications are approved of at the initial level. When a claimant is denied disability benefits, he or she can appeal the decision, disagreeing with the government's determination. After several denials, a claimant may find him or herself in front of an administrative law judge. The judge will ultimately rule whether the claimant is medically disabled.
One outcome of a judge's ruling is that you are issued a "partially favorable decision." In other words, the judge agrees with you that you are or were disabled, but does not completely agree with your initial argument for disability. Typically, a partially favorable decision will result in the approval of Social Security disability benefits with a different onset of disability from the alleged date. This means the judge did not award the claimant the full back benefit award.
Many claimants immediately file an appeal of the judge's partially favorable decision with the hope of obtaining the full back benefit award. Appealing the judge's favorable decision is a risky move. The Appeals Council has the authority to rule contrary to the judge's opinion and find that the claimant is not at all disabled. This is a major risk a claimant takes when filing an appeal of a partially favorable decision.
What Disability Cases Get Approved?
In a previous blog post, I had mentioned that the Social Security Administration (SSA) denies the majority of Social Security disability benefits claims, whether SSDI or SSI. What was not mentioned was what types of claims are approved.
In 2009, SSA approved 846,290 disability applications. Approximately 37% of those applications either met or equaled one of the government's Listing of Impairments. In other words, the claimant had a particular medical condition so severe that it warranted disability benefits without even getting to their educational background, work history, or what jobs he or she could still perform. Meeting or equaling a listing is the ideal way to win a Social Security disability case.
For the other 63% of disability benefits applications in 2009 that were approved, the claimant would have had to prove that the combination of his or her impairments prevents holding down a full-time job. In other words, any number of severe medical conditions combine to prevent someone from working. In court, functional capacity arguments often boil down to whether there are jobs out there that an individual with like limitations can still perform in the economy. These arguments are inherently more challenging to win than simply proving that a listing is met.