Posted on August 16,2011 in Social Security Disability

You went through the Social Security disability benefits process and unfortunately lost your hearing in front of an Administrative Law Judge. After you receive the letter of denial, although your medical condition is the same, you decide not to give up and start a brand new claim.

You apply for Social Security disability benefits and your new claim is now denied. You later appealed that decision by filing a Request for Reconsideration, and that was denied. You then filed a second appeal, also known as a Request for Hearing by Administrative Law Judge, hoping to eventually have your second day in court and that was denied as well. This time, your denial letter from the Social Security Administration states that your claim has been denied because of something called res judicata. As you read the letter, you see the Latin words and have no idea what they are talking about. What is res judicata and why are you unable to have your second day in court?

Res judicata is a Latin term meaning "a thing adjudged" and in the legal field is a case that has had a final judgment and is no longer subject to appeal. One of the biggest reasons for incorporating res judicata into the legal system has been to avoid unnecessary resources in the court system. And yes, the arm of res judicata has reached decisions under the Social Security Act. What this means for you is that if you have already had your day in court and lost your case and now have a new claim that meets the conditions of res judicata, the Social Security Administration can legally reject it from proceeding to court for a second hearing.

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 Posted on August 13,2011 in Social Security Disability

"The Grid, a digital frontier...I kept dreaming of a world I thought I'd never see."-Tron Legacy 2010

Kevin Flynn uttered those words in the opening scene of the movie Tron Legacy in 2010. The original digital Grid was introduced in the first Tron movie in 1982. If you have not seen either of the movies already, I would strongly encourage you to do so. Coincidentally, it was only a few years earlier that the Social Security Administration changed everything by coming up with their own version of The Grid, a different kind of standardized system used to determine whether people are entitled to Social Security disability benefits.

The Grid, also known as the Medical-Vocational Guidelines, is a system containing three charts, each for a different Residual Functional Capacity. Those three charts are vocational factors and are: 1. Age, 2. Education, and 3. Work Experience. When an individual's information is matched with The Grid, a judge will be able to come up with a conclusive finding of either "disabled" or "not disabled."

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 Posted on August 04,2011 in Social Security Disability

People always ask, "Why are you a Social Security disability lawyer?" I think what happened this morning paints a good picture of why I do what I do:

I had a disability hearing at 8:30AM this morning for a client suffering from bi-polar disorder and fibromyalgia, she is 31 years old. She has a hard time going out in public and suffers from crying spells. At 8:00AM, she called me and said, "I don't think I can come to the hearing today, I'm too nervous and I'm scared,everybody tells me I'm too young to get disability benefits, I should just give up."

I told her over and over that today is her day in court. She had waited several years to finally argue the merits of her case and why she really does deserve disability benefits, despite her youth. After some thorough convincing she came to court just in time. It was a quick visit. A few minutes later we found out that the case was approved. She turned to me and said, "I've seen tons of doctors in the last couple of years, but no one has helped change my life the way you did today. I have four children and can't provide for any of them, that will all change now."

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 Posted on July 25,2011 in Social Security Disability

Children who are too young to have worked and are believed to be disabled may qualify for Supplemental Security Income ("SSI"). As with Social Security Disability Insurance ("SSDI"), the Administration will first determine whether your son or daughter meets one of the Listing of Impairments. If a listing is met, you will be found to have adhered to the medical requirements for disability (note that a claimant would still need to meet the financial requirements). If a listing is not met, at least for SSDI, a judge will evaluate whether a claimant is able to work based on their residual functional capacity (the most that a claimant can do despite all of the limitations).

For SSI, rather than determining whether a younger child can work, a judge will look at functional equivalence. In other words, a judge will evaluate whether a claimant functionally equals a listing by looking at six domains: acquiring and using information; attending and completing tasks; interacting and relating with others; moving about and manipulating objects; caring for yourself; and lastly health and physical well-being. To functionally equal a listing, a child will need to have "marked" limitations in two domains or one "extreme" limitation. For more information on marked and extreme limitations, visit the SSA website. Thus, children who are too young to have worked can still potentially qualify for SSI benefits.

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 Posted on July 23,2011 in Social Security Disability

Yesterday afternoon, the Social Security Administration published the following press release, which I will later go on to review:

Social Security Field Offices to Begin Closing to the Public a Half Hour Early Congressional Budget Cuts Force Reduced Public Hours

Effective August 15, 2011, Social Security field offices nationwide will close to the public 30 minutes early each day. For example, a field office that is usually open to the public Monday through Friday from 9 a.m. to 4 p.m. will close daily at 3:30 p.m.

“While agency employees will continue to work their regular hours, this shorter public window will allow us to complete face-to-face service with the visiting public without incurring the cost of overtime for our employees,” said Michael J. Astrue, Commissioner of Social Security. “Congress provided our agency with nearly $1 billion less than the President requested for our budget this fiscal year, which makes it impossible for us to provide the amount of overtime needed to handle service to the public as we have in the past.”

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 Posted on July 14,2011 in Already Applied for Disability Benefits

After you apply for Social Security disability benefits, you may experience extensive periods without any correspondence with the Social Security Administration (SSA). This is no cause for panic.

The Social Security Administration does not do a great job of keeping claimants informed on the status of their claims. As long as you have a confirmation letter proving that the application has been processed, the rest is typically in the hands of SSA or your disability attorney. Over the course of months following an application for disability benefits, SSA should be gathering medical records and more information on your medical condition. If they do not have enough information after doing an initial request for records, SSA may send you for a consultative examination (a doctor appointment to determine your physical or mental limitations). They may request information periodically from you about your work history, daily activities, or medical updates. The requests can come months after you have applied and is not uncommon.

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 Posted on July 14,2011 in Social Security Disability

In order to be adjudicated as disabled before a Social Security Administrative Law Judge (ALJ), an attorney or claimants representative must follow and complete what is called the five step Social Security disability evaluation process. The evaluation process asks the individual seeking disability benefits five separate questions: (1) Are you working and are you performing substantial gainful activity; (2) Is your condition severe; (3) Does your condition meet or exceed a listed impairment; (4) Can you do previous work; and (5) What work can you do. While each of the five steps must be proven to be adjudicated as disabled, proving the fourth step can often be tricky. The process of proving whether a claimant can do previous work is determined by an individual's Residual Functional Capacity (RFC). This blog post explains what RFC is and why it is important to every disability claim before an ALJ.

The Social Security Administration (SSA) evaluates what someone's RFC is by determining the most work that a claimant can do despite any of his or her limitations. SSA determines the most work that a claimant can do by dividing "work" into four different categories: heavy, medium, light, and sedentary work. It is worth noting that there is sometimes a fifth category that is recognized for very heavy work; however, very heavy work is scarcely used and will not be discussed in this blog post. Whether a claimant wins his or her disability claim is greatly affected by which category he or she is ultimately put into. The lower an individual's RFC level, the greater the chances of meeting the fourth requirement of the five step evaluation process.

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 Posted on July 12,2011 in Social Security Disability

While I was speaking with someone over the phone today, I was asked the following question: "How reliable is the Social Security Administration when it comes to processing Social Security disability claims, I mean, do they ever lose documents?"

Like the picture worth a thousand words, I had too many words that I wanted to say and my response came out completely jumbled. To clarify, I told the individual it might be easier for me to write about it tonight with examples, here they are!

Scenario 1: Several weeks back I sent records to SSA via mail and fax, they claim to have never received the records.

Scenario 2: I sent records certified mail to a District Office and called for the status of the records, they claim it never got to their office.

Scenario 3: I walk a document into a District Office personally, several weeks later when I called for the status of said document, it is no where to be found.

-Each of these scenarios have happened to me on numerous occasions. I have learned, often the hard way, not to assume that something is received by SSA just because you sent it. Keeping copies of everything is very important. Also, it is a good idea to send important documents to SSA multiple times.

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 Posted on May 31,2011 in Social Security Disability

In order to be adjudicated as disabled before a Social Security Administrative Law Judge (ALJ), an attorney or claimants representative must follow and complete what is called the five step Social Security disability evaluation process. The evaluation process asks the individual seeking disability benefits five separate questions: (1) Are you working and are you performing substantial gainful activity; (2) Is your condition severe; (3) Does your condition meet or exceed a listed impairment; (4) Can you do previous work; and (5) What work can you do. If a claimant meets each of the five steps of the evaluation process, then an ALJ will usually find that individual to be disabled. One exception to meeting the five step evaluation process and qualifying for disability is if the finding was materially effected by a drug addiction or alcoholism.

Drug Addiction and Alcoholism (DA&A) is often referred to as the silent "6th step" of the five step Social Security evaluation process for disability benefits. The Social Security Administration's regulation 20 C.F.R. Section 404.1535 governs DA&A and states, "If we find that you are disabled and have medical evidence of your drug addiction or alcoholism, we must determine whether your drug addiction or alcoholism is a contributing factor material to the determination of disability. The key factor we will examine in determining whether drug addiction or alcoholism is a contributing factor material to the determination of disability is whether we would still find you disabled if you stopped using drugs or alcohol." If DA&A was material in the disability determination and you would not be found disabled but for the use of those substances, SSA will not find that you have met the 6th step.

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 Posted on May 08,2011 in Social Security Disability

While this blog primarily focuses on Social Security disability benefits and medical conditions and technology, every now and again the Social Security Administration ("SSA") will publish something that is relatively left field, which this blog of course has to cover. This time around, on Thursday, May 5, 2011, SSA published the most popular baby names of 2010. This year's winners were Jacob for boys and Isabella for girls. The top ten list is as follows:

Boys: 1) Jacob Girls: 1) Isabella

2) Ethan...... 2) Sophia

3) Michael.... 3) Emma

4) Jayden..... 4) Olivia

5) William.... 5) Ava

6) Alexander.. 6) Emily

7) Noah....... 7) Abigail

8) Daniel..... 8) Madison

9) Aiden...... 9) Chloe

10) Anthony... 10) Mia

For more information, feel free to check out the article on the SSA website.

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