WHAT IS A 'PARTIALLY FAVORABLE' SOCIAL SECURITY DECISION?

You attended a hearing on your Social Security disability claim.  A few weeks later, you receive a Notice of Decision in the mail that says you have received a Partially Favorable decision.  Does this mean that you are only partially disabled, not fully disabled?

ANSWER:  No.  Social Security does not make awards for partial disability.  You are either disabled or not disabled.  There is no such category as "partially disabled" within Social Security law.

A "partially favorable" decision means that the administrative law judge has found you to be disabled.  However, he or she has changed some material fact in your application.  Most often, this change involves the established onset date--the date you were found to have become disabled.  For example, in your application you may have alleged that you became disabled on June 1, 2012.  After reviewing the facts of the case, the judge may have decided that you did not become disabled until September 1, 2012.  Therefore, he will amended the onset date to September 1, a material change in the application. 

This change will affect the amount of your back pay.  In short, you will not be paid for the months June - August, 2012, a loss of 3 months of  benefits.The amount of your monthly benefit will not be affected.  You are still considered disabled, but for not as long a period as you originally claimed.  Since you lost part of your period of disability, thus part of your back pay, the decision is partially favorable.  In other words, it is not as favorable to you as it would have been if the judge had found that you became disabled in June instead of September.

I often encounter well meaning public officials who believe that a "partially favorable" decision means that the claimant is only "partially disabled."  This is not the case because, as I have said, Social Security never makes any award for a "partial disability."  You are either disabled or you are not disabled - nothing in between.  The date on which you became disabled is an example of why a decision might be "partially favorable.:"

The confusion is complicated by the fact that some agencies, such as the Veterans Administration, do make partial disability awards.  A VA claim decision may find that a veteran is 50 percent disabled, or 80 percent disabled, for example.  However, Social Security will never make such an award.  With Social Security, it is all or none.

SOCIAL SECURITY DISABILITY: WHAT YOU WISH YOU HAD KNOWN

You Must File a Timely Application.  You must apply for Social Security disability benefits within 5 years after you stop working.  Your insured status will expire, making a new claim impossible.  If there are gaps in your work history, you may have even less time to file a new claim.  Don't wait too long to file after you stop working.

You Must Have Enough Quarters of Work.  You become an insured person under the Social Security Act by working and paying FICA taxes.  Most adults need 20 quarters of work to be covered.  These 20 quarters generally must have been accumulated within the most recent 10 year period prior to filing a claim.  Very young individuals might need less than 20 quarters of work.

Your Disabling Condition Must Last At Least 12 Months.  Short term disability lasting less than 12 consecutive months is not covered by Social Security.  You must have an impairment that has lasted, or can be reasonably expected to last at least 12 months.

You Cannot Be Working When You Apply.  You may not be working at "substantial gainful activity" during the period you wish to receive disability benefits.  In 2015, Social Security classifies substantial gainful activity as earnings/wages of at least $1,090 per month.

You Must Have Medical Treatment.  Under Social Security regulations, a disabling impairment must be medically determinable.  Medical records must be available to support the impairment.  Medical treatment should be consistent and recent.

You Cannot Depend on a Social Security Doctor's Examination.  Social Security may send you to a doctor with whom they contract to perform an examination.  This exam will be brief and superficial.  In our experience, these exams fail to help the claimant 99% of the time.  Social Security will use this exam to deny your claim.

You Need Support From Your Own Doctor.  According to Social Security regulations, much weight will be given to opinions of your own treating doctor(s).  Your doctor should provide support and this includes more than just routine medical records. Try to get your doctor to provide you with a Medical Source Statement that lists your functional limitations, such as restrictions in sitting, standing, lifting, bending, kneeling, etc.  Mental restrictions, such as concentration and memory, should also be documented.

You May Need To Be Examined By a Specialist.  20 CFR 404.1527 provides that extra consideration may be given to a doctor who is a specialist practicing in his/her field of medicine.  For instance, if you have a bad back you may need an orthopedic specialist.  For arthritis or fibromyalgia, you would need to consult a rheumatologist.

You Must File An Appeal Within 60 Days If You Are Denied.  Only about 30 percent of applications are approved by Social Security at the initial level.  The other 70 percent must be appealed.  The 60 day deadline is absolute.  If you do not appeal within the 60 days your claim dies and there is no appeal.  Do not wait on medical evidence or anything else.  File your appeal immediately, then work on whatever needs to be done to shore up the case.

Most Appeals Are Handled By a Professional Disability Advocate or Attorney.  Social Security appeals comprise a highly specialized field and require knowledge, skill and experience.  Contact a professional advocate, such as the Forsythe Firm, to help you with the appeal.  We offer free claims evaluation and never charge a fee unless you win.  We will also help insure that you receive maximum benefits, including back payments.

VETERANS MAY GET EXPEDITED DISABILITY PAYMENTS

Veterans may get expedited claim processing for Social Security disability benefits.

To get expedited processing, veterans must self identify and have a 100 percent permanent disability rating from the Veterans Administration.

By "self identify," we mean that the veteran must inform Social Security of their 100 percent VA disability rating at the time the application is filed.  We recommend sending a copy of both your DD-214 form and your VA awards letter that shows the percentage of disability award.

Does a 100% VA disability award guarantee approval of Social Security benefits?  No.  While a VA award does not automatically qualify for Social Security disability benefits, it does qualify for a much faster processing time--that is, a much quicker answer.  And, since the VA disability evaluation is similar to the Social Security evaluation process, the VA award can work in your favor.

If a vet receives Social Security disability benefits, will it reduce the VA benefits?  No.  Veterans paid into the Social Security trust fund during their military careers and may be entitled to Social Security benefits in addition to VA benefits.

What about veterans with a less than 100% VA award?  May they still be eligible for Social Security disability benefits?  Yes, of course.  

What if a veteran is not able to perform military duties but is still on active duty and is receiving full military pay?  He or she may still be eligible for Social Security disability benefits.  The key issue is whether or not the individual is able to perform the job, not whether he or she is receiving military pay.  Thus, a veteran should apply immediately for Social Security disability and not wait for a discharge from military duty, which would waste unnecessary time and lose benefits.

The Forsythe Firm is honored to review disability cases for veterans and help them decide the best course of action to receive Social Security disability benefits.  Consultations are absolutely without cost or obligation.  We only charge a fee if we represent you, win your case, and also recover past due or retroactive benefits (in a lump sum).  Please contact Charles Forsythe in Huntsville at (256) 799-0297.

Our office is located at the intersection of Old Madison Pike and Governors West directly in front of the Bridge Street Town Centre, near Arsenal Gate 2.


 

WILL SOCIAL SECURITY OBTAIN MY MEDICAL RECORDS?

If you have an initial application for disability benefits pending (have not been denied yet), Social Security will attempt to get your medical records.  Once you are denied and file an appeal, it is up to you or your representative to obtain medical records.

While Social Security attempts to obtain records during the initial application process, we find that they do not always get all the records.  It is a good idea for the claimant's representative to check and be sure all the records that were requested have been received.  Sometimes, it is necessary for the representative to contact medical providers to obtain records that otherwise would be missed.

The old adage among Social Security disability attorneys and advocates is very much true:  "If it isn't in the medical records, it did not happen."

A fundamental principle of Social Security disability is that an impairment must be demonstrated (proved) by objective medical evidence.  Claiming that you have severe symptoms will not be enough to win benefits.  The medical evidence must support the claim or you will not be successful.


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SEE A MEDICAL SPECIALIST

When you are trying to get Social Security disability benefits, it is to your advantage to be treated by a doctor who is a specialist in your area of impairment.  For instance, if you are disabled by heart disease, you want to be treated by a cardiologist, if possible.  If you have joint or back problems, you want to be seen by an orthopedic specialist.  For depression or mental impairments, you need to see a psychiatrist or clinical psychologist.

Everything about Social Security disability decisions are regulated.  According to 20 CFR 404.1527, the opinions of doctors who treat you are usually given more weight if they are specialists, treating an illness or injury within their area of specialty.  Thus, a cardiologist is given more weight for a diagnosis or opinion about chest pain than an ear nose and throat (ENT) doctor would be accorded.

Specialized treatment is not always available because of no insurance and limited ability to pay doctor's bills.  Many claimants have to see doctors at community clinics for this reason. 

Also, keep in mind that not all practitioners are "acceptable medical sources" with Social Security decision makers.  Nurse practitioners, chiropractors and counselors are examples of medical professionals who are not "acceptable medical sources" when it comes to providing evidence about disability matters.  Social Security will not generally accept a diagnosis about an impairment from these practitioners unless it is also supported by an "acceptable medical source," such as an medical doctor (MD), doctor of osteopath (DO), etc.

VALUE OF A MEDICAL SOURCE STATEMENT

Applicants for Social Security disability benefits should always try to obtain a Medical Source Statement from their treating doctor.  This is a form on which your doctor gives an opinion about your ability to perform certain work related functions, such as sitting, standing, walking, lifting, bending, concentrating, etc.  Here are some of the benefits of getting your doctor to provide this form:

1. It establishes your residual function capacity, which is what Social Security disability decisions are based on.  Your doctor is in the perfect position to decide what your maximum functional abilities are.
2. It helps to establish the severity of your medical conditions.  Without pinning down how severe your impairments are, it is unlikely you can win benefits.
3. It helps establish the date on which you first became disabled, called "the established onset date."  You can usually get benefits back to this date if you were not gainfully employed after that date.

There are basically two types of Medical Source Statement forms:  HA-1151-BK for physical impairments and HA-1152-BK for mental impairments.  Try to ensure that you are using the newest version of each form.

Remember, federal regulations require Social Security to give more weight to the opinion of your treating doctor than to a consulting doctor who examines you once.  So more weight is given to your doctor than to a doctor you hire for a one-time evaluation.  Your doctor's opinion also gets more weight than the consulting doctor Social Security sent you to.  (20 Code of Federal Regulations 404.1527(c)(2).

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WHY MORE PEOPLE CHOOSE THE FORSYTHE FIRM

• The Forsythe Firm will help prepare your application and supporting forms for you.

• The Forsythe Firm never charges a fee unless you win and get back pay.

• The Forsythe Firm is a locally owned and operated professional firm.

• The Forsythe Firm has a good track record of winning disability claims.

• The Forsythe Firm is conveniently located across from the Bridge Street Mall.

• The Forsythe Firm will appeal any unfavorable decision and go with you to hearings.

• The Forsythe Firm receives approved fees by direct payment from Social Security*

• The Forsythe Firm practices only in the area of Social Security disability.

• *The Forsythe Firm charges you no upfront fees, deposits or expenses.

To make an appointment for a free consultation, case evaluation, or just to get questions answered about a disability claim, please contact us without cost or obligation.

CALL HUNTSVILLE (256) 799-0297       IN ATHENS CALL (256) 431-1599

CHOOSING YOUR ALLEGED ONSET DATE

The allged onset date (AOD) could be defined several ways, including:

1. the date you claim you first became unable to work, or
2. the date you believe you first became eligible for Social Security benefits.

The term alleged onset date never occurs in the Social Security disability application.  The application simply asks, "On what date did you become unable to work?"

Many people choose the day following their last day of work to be their AOD--but this is not necessarily the case.  The AOD may be before or after the last day of work.  At a hearing, the administrative law judge will carefully examine the alleged onset date to see if it can be supported by medical evidence.

The judge may want to move your alleged onset date forward to a more recent date.  This would often reduce the amount of back pay you would be entitled to receive.  The date that the judge determines to be the date you first became unable to work becomes your established onset date. 

Congress has mandated a five-month waiting period.  Social Security must deduct five full months of benefits from the established onset date.  For example, if your established onset date is March 15, you will become eligible to be paid for the month of September (April - August would serve to fulfill the five-month waiting period).

The waiting period prevents payment to persons with very short term disabilities and it also saves the government money on long term claims by deducting the first five months of payments.

WIDOW OR SURVIVOR BENEFITS

Many times a person hasn't worked long enough, or hasn't worked recently enough to be eligible for Title II disability benefits under his or her own work record.  Another venue to check would be widow's benefits. Reduced retirement benefits may be available to widows at age 60.  Disability benefits may be available at age 50.

Basic requirements for widow's disability benefits are:

• You were married to the worker for at least 10 years.
• Your disability began before or within 7 years of the worker's death.
• You are at least 50 years of age.
• You meet the same definition of disability as would be required of a worker.

Survivor's benefits may be available at any age if you take care of the deceased worker's child who is under the age of 16 OR the child is disabled and receives a benefit under the deceased worker's record.

Remarriage after age 50 does not affect disability benefits.  Remarriage after age 60 will not affect retirement benefits.

You must go to a Social Security office to apply for Widow's or survivor's benefits.  You cannot apply for these benefits online.  Taking a completed Disability Report with you will shorten the time required for the application process.  The Disability Report can be downloaded from www.socialsecurity.gov.  

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MAKE THE "WORK HISTORY REPORT" YOUR FRIEND

When you apply for Social Security disability, you will be asked to complete several lengthy forms.  One of them is the Work History Report which tells about your past jobs.

This is a long, complicated form that many applicants rush through, half-way complete or give little effort.  A poorly prepared work history report can get your claim for disability benefits denied.  Here's why.

Decision makers must decide whether you can perform any of your past relevant work.  First, they must know what your past jobs were.  More importantly, they must know the exact duties of each job.  A decision maker will classify each one of your past jobs in terms of its skill level and exertion level.

• Skill levels:  skilled, semi-skilled or unskilled

• Exertion levels:  sedentary, light, medium, heavy or very heavy

If the Social Security decision maker finds that you are physically and mentally able to perform even one of your past relevant jobs, the regulations require a decision of not disabled, which equals no benefits.

You should be extremely careful to describe each job on the Work History Report in terms of how much standing, walking, lifting, reaching, kneeling, stooping, etc. you performed.  Try to give an accurate estimate based on your recollection of a typical day's work.

Finally, keep in mind that the question about "What is the heaviest weight you lifted?" means the heaviest weight you ever lifted on that job, even if you only lifted it very occasionally, such as once every month.  For example, if you worked as a cashier which was mostly light work - but once a week you had to help unload a truck which involved lifting cases of inventory that weighed 40 pounds--you really had a medium exertion job, not light.  That could be the turning point in your claim.

Describe the duties of each of your past jobs in great detail, especially the standing, walking and lifting. I cannot over emphasize how important this could be.

 

HOW AN ADVOCATE MAY HELP YOU WIN SOCIAL SECURITY DISABILITY CLAIMS

An advocate is a trained person that you appoint to represent you before the US Social Security Administration.  The advocate will be the only person besides yourself at the hearing who is totally dedicated to getting your disability benefits approved.

Here is how a professional advocate or representative can help you:

Screen your application to be sure it is complete, accurate and compelling.  We find that many disability applications are denied on some technical point or simply because of an error in the application forms.

Develop a legal theory of your case that can be approved.  Winning a Social Security disability case is technical and must have the weight of legal persuasion behind it.  A winning legal theory simply means that somebody points out chapter and verse of the rules, regulations or laws that support your claim.  This may involve Listings, Medical-Vocational Guidelines, Social Security Rulings, federal court decision or any number of complicated rules and regulations.

Represent you at your hearing.  Hearings are presided over by US administrative law judges, professionals trained in federal administrative law.  You may also face a medical expert (doctor) and/or a vocational expert.  Be sure you have your own expert sitting at your left elbow during this hearing. This will only happen if you appoint a representative to go to the hearing with you.

Recover maximum retroactive or "back pay" benefits.  Social Security must pay you from the established onset date of your disabling impairment, subject to certain rules and regulations. Your representative will work to be sure you recover as much money as you are entitled to get.  One simple change in your "established onset" can mean the difference between no back pay and getting tens of thousands of dollars in back pay settlement.  Let your advocate take the steps required to recover all your back pay.

Remember, there can be no fee for your representative's service unless you win your case and also recover past due benefits (back pay).  Consultations are free.

 

GET SOCIAL SECURITY BENEFITS AT AGE 50?

If you are age 50 or over, you may qualify for Social Security benefits for any physical or mental condition which prevents you from full-time work.

Yes, younger individuals may also qualify.  However, Social Security uses Medical-Vocational Guidelines which relax the requirements somewhat for persons age 50 and over.

In addition to your age, other factors include your past work experience and education.  But being age 50 or more is the greatest single advantage a claimant has in being approved for Social Security benefits.

The Forsythe Firm will provide you with a free case evaluation and local consultation.  If we represent you, you will never pay a fee until you get benefits with back payments.  If you do not win benefits you will never pay us a fee for any service we perform.

Contact us at (256) 799-0297.  We're located across from Bridge Street.

FOCUS ON WHY YOU ARE DISABLED, NOT WHY YOU CAN'T GET A JOB.

The Social Security Act provides benefits for workers who are disabled.  It does not provide benefits to workers who cannot find a job.  There is huge distinction.

The following are EMPLOYMENT PROBLEMS,not covered by the Social Security Act; therefore, no benefits are payble for any of these situations:

• Nobody will hire me.
• There are no jobs open in my neighborhood.
• My job skills are ancient and no longer in demand.
• The economy has tanked.
• The work I used to do is now performed by machines (automation).
• The type of jobs I could once get have moved to Mexico or Asia.
•  Employers only see me as a liability.

I repeat that the above type of reasoning relates to unemployment and has nothing to do with disability or Social Security.  

I must have a strategy to win Social Security disability and my strategy must focus on Why I am Disabled, not Why I Can't Get a Job. 

Why I am disabled must, therefore, focus on what I can and cannot do in terms of work related activities.  How long can I sit?  How long can I stand/walk?  How many pounds can I lift?  For how long can I stay focused?  Is my memory in any way impaired?  Do I have limitations in stooping, bending or reaching?  Am I able to understand, remember and carry out instructions?  Can I work up to 2 hours without a break?  Can I persistently work 8 hours a day, 5 days a week without being absent more than 1 day per month?  What medical evidence proves that I have some of those limitations?  Can I get a Medical Source Statement (MSS) from my doctor which supports those limitations?

Without a strategy that deals with Why I Am Disabled, the system will let me down, every time.  Social Security is like any other court in the land, in that, you must prove certain facts using allowable evidence, according to the governing regulations.  It takes a strategy to do that.  And these days it takes a pretty solid strategy.

Find out more about Social Security disability.

GET A MEDICAL SOURCE STATEMENT FROM YOUR DOCTOR

Your doctor cannot approve you or sign you up for Social Security disability.  However, your doctor can and should play an important role in providing evidence for full and fair evaluation of your disability claim.

You should ask your doctor to provide a Medical Source Statement for you, such as form HA-1151 for physical impairments or HA-1152 for mental impairments.  Why is this form so important to a successful Social Security disability claim.

It's important because it goes to the heart of what Social Security needs to approve your claim.  That is, your limitations in the ability to perform work related activity.  Your medical records alone do not show these limitations.  In short, a Medical Source Statement gives your doctor's opinion as to how much you can lift and carry, how long you can sit, walk and stand; and may evaluate your ability to concentrate or react appropriately to other people.

Let's say Sara goes to her doctor with a complaint of chronic back pain.  The doctor examines her and prescribes a muscle relaxer and a light duty pain pill with instructions to return in 30 days if the pain is not a lot better.  Here is what the doctor's medical record will probably say:

Ms. Jones is a pleasant 51 year-old female who presents today for some pain in her lower back, which she has experienced for about 3 months.  She is a well nourished lady in no apparent distress.  Respiration is clear.  Reflexes in all lower extremities (LE) are normal.  I am going to prescribe some Flexeril and Naproxen to try.  She will return in 4 weeks if not improved.

The above notation is virtually useless in a Social Security disability claim.  It presents no severity of symptoms, no limits for lifting, standing, walking, sitting, bending, etc.  In short, it gives Social Security no reason to believe that the patient cannot work every day in just about any capacity.  It says that she has some back pain.  That's all.  And that is not nearly enough.

Ask your doctor to provide you with a Medical Source Statement that gives the specifics of your functional limitations.  Not all doctors will do so, but this form can make the difference between an award an a denial of your claim.   

Social Security will NOT ask your doctor for this statement; they will only ask for medical records, which as explained are woefully inadequate to get you approved.  It is up to the claimant or her representative to obtain this form from the doctor.

AVOID FATAL MISTAKES IN YOUR SOCIAL SECURITY DISABILITY CLAIM

Only about one-fourth of applications for Social Security disability benefits are approved without a hearing.  Below are some of the serious mistakes that claimants make.  If you are filing for Social Security disability, know these mistakes and avoid them for the best chance of winning benefits:

1.  Believing that the Social Security doctor will find that you are disabled.  This is very unlikely.  The doctor Social Security sends you to will spend no more than 15 -20 minutes with you and will perform a very limited examination.  He has no incentive to find you disabled, since he is paid by Social Security.  You may have better luck with your own doctor.

2.  Don't fail to ask your own doctor to complete a Medical Source Statement.  This is a form which explains what specific limitations you have in performing work related functions, such as sitting, standing, walking, lifting, bending, concentrating, etc.  This is in addition to routine medical records and does not require a special examination.

3.  Filing for disability while you are still working.  You cannot file for disability while you are working at "substantial gainful activity" or SGA.  In 2015, this amounts to work that pays you at least $1,090 per month.  In 2014, the SGA limit was $1,070 per month.  Work that pays less than the SGA amount may not disqualify you.

4.  You have to prove that your disability will last at least 12 consecutive months (or that it has already lasted that long).  There is no short term disability with Social Security.  12 months is the minimum duration for a qualifying disability.

5. Failing to get medical treatment.  All disability awards must be based on "medically determinable impairments."  You will need your doctor to examine you, diagnose your problems and determine how severe your symptoms are.  Medical doctors and clinical psychologists are "accepted medical sources" with Social Security.  Chiropractors, counselors and nurse practitioners are not.

6.  Failure to get psychological problems diagnosed and treated.  Social Security must consider psychiatric or emotional problems as well as physical problems - but they must be diagnosed by a psychiatrist or clinical psychologist, or at least by your family doctor.

7.  You must apply while you have Social Security coverage.  Not everyone has Social Security disability coverage.  You become covered by working and paying a special tax called FICA tax, which is required to be withheld on every worker.  However, you must earn enough quarters of work to be covered.  Also, when you stop working, you eventually lose your disability coverage with Social Security.  This usually happens after 4 years of no work.  If there are gaps in your work, your coverage may expire in less than 4 years.  The date you stop being covered is called your "date last insured" or DLI.

8.  You have to appeal unfavorable decisions within 60 days.  Being denied is not the exception, it's the rule.  Be prepared to file a request for hearing within 60 days after you receive a denial letter from Social Security.  This 60 day rule is very strict.  If you wait too long you cannot appeal the claim and must start all over.

9.  Avoid trying to represent yourself (pro se representation).  Social Security law is a highly technical and specialized field.  The US disability program is governed by thousands of pages of rules and regulations.  If you don't meet the rules or follow the correct procedures you can be denied and this may cost you thousands--even hundreds of thousands of dollars over the years.  Consider getting a specialist to represent you and arrange a "contingency fee" situation where the representative gets paid only if you win. 

10.  Failure to prepare the vocational (work) aspects of your claim.  There are two important parts of a Social Security disability claim:  the medical aspect is the best known part.  However, there is an equally important vocational aspect to the claim.  Past work will be classified and a vocational expert will be asked to determine whether there are any jobs in the US economy that you could still perform, in spite of your physical and/or mental limitations.  Failure to adequately prepare the vocational aspect of your claim will result in a denial, just like failure to prepare the medical part of the claim will get you denied.

11.  Failing to get a Medical Source Statement from your doctor.  This is not the same thing as routine medical records, which Social Security will obtain for you.  Social Security will NOT ask for a medical source statement.  Common forms used for this purpose are forms HA-1151 for physical impairments or HA-1152 for mental impairments.  It is up to the claimant or his representative to get this form completed by the doctor.  It can make the difference between approval or denial of your claim.

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RECONSIDERATION vs. REQUEST FOR HEARING

When Social Security denies a disability claim, there are appeals that can be made to get a another chance.  In 40 states, the next step is called "Reconsideration."  That's really a waste of time but it is required in those 40 states (Alabama is not one of them).

"Reconsideration" simply means that a different disability examiner will review your claim to be sure the one who denied your claim didn't make a mistake.  Guess what?  In about 97 percent of cases, nothing changes at "reconsideration."  After you are denied again at reconsideration, you may now move on to a request for hearing by an administrative law judge.

10 states, of which Alabama is one, does not require the "reconsideration" step and allows you to move directly from denial to a request for hearing.  This saves time, since the "reconsideration" step usually takes 3 to 4 months.

Reconsideration does not:

• allow you to meet with someone face to face to discuss your claim
• take your case before an administrative law judge
• send you for more medical examinations (usually)
•  allow your attorney or representative to appear on your behalf

On the other hand, a hearing does allow you to personally appear before an administrative law judge with your representative.  You are allowed to present your case and any additional medical evidence you may have.  

What are the odds of getting something changed - Reconsideration vs. Hearing?

• At reconsideration, there is only about a 3 percent chance of getting a better decision.
• At a hearing, about one half of denials are reversed and benefits are awarded (national average).  
• Claimants who are represented have a drastically better chance of awards at hearings. 

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DANGER OF REPRESENTING YOURSELF AT A SOCIAL SECURITY DISABILITY HEARING

"Do you want to be the only inexperienced person in the room?  If you walk into a Social Security disability hearing unrepresented, you will be."

Social Security disability hearings are handled by administrative law judges.  They have a law degree and  usually practiced law for years before becoming a judge. Their job is to conduct the hearing according to all the laws, rules and regulations.

The vocational witness will have a master's or doctor's degree and years of experience as a vocational rehabilitation counselor.  She has probably attended thousands of Social Security disability hearings.

If there is a medical expert (ME), he/she will have a Doctor of Medicine (MD) degree, or equivalent.

Into this frightening crowd of professional persons sits the claimant, with no training in Social Security disability rules, regulations or procedures.  The claimant doesn't usually have a clue about what procedures will be followed, what his burden of proof is or what kind of evidence is accepted.

The claimant cannot be expected to know the myriad of technical terms and their meanings: SGA, PRW, RFC, AOD....  What are the demands of sedentary work as opposed to light work?  How do non-exertional limitations play into all this?  How many days per month may I be absent for medical treatment and still hold a full-time job? 


"Is it unfair, and totally illogical, to expect the claimant to handle his Social Security disability hearing successfully alone."

 

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