Social Security Claim

June 03,2019
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How to Obtain Disability Benefits If You Can’t Work

There are two types of disability benefits available to those who are impaired through the Social Security Administration (SSA). Your New York Social Security disability lawyers have explained the difference between Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) below.


Supplemental Security Income

SSI should be your first attempt when applying for disability benefits. In order to qualify, you must have an impairment that will last for at least twelve months or will result in death. This impairment must prevent you from working.

Work Requirements

There are duration requirements for how long you must have worked prior to applying for SSDI benefits. You must also have worked a certain amount of years over the span of your life. Your New York Social Security disability lawyers can further explain the precise requirements based on your particular situation.

Social Security Disability Income

SSDI benefits require that the applicant have a financial need in order to receive them. Unlike SSI benefits, there is no minimum past work requirement to qualify. In fact, you may still be able to work while receiving SSDI.

Income Requirements

Your New York Social Security disability attorney will discuss with you whether or not your current financial situation will allow you to qualify for SSDI benefits. Generally, you will need to provide SSA with all pertinent financial information before being approved.


Claim Rejections

First time applicants are often faced with their claims being rejected. Your New York Social Security disability lawyers will reassure you that many claims are later accepted on appeal. Thus, it is important not to give up after the initial application.

Moving Forward with Your Claim

If you suffer from an impairment that prevents you from working full time, it is important to speak with your New York Social Security disability lawyers about your options for benefits. The attorneys at Hermann Law Group, PLLC can help. Call their office today at 1-877-773-3030 for your Free Case Evaluation.

Applying For Social Security Disability Benefits

Social Security disability benefits are available to qualifying individuals who “are unable to engage in substantial gainful activity due to a physical or mental impairment, or a combination of impairments, that is expected to result in death or that has lasted or is expected to last for more than 12 months.”   In order for you to find out whether or not you meet the above definition of disability and are entitled to receive benefits, you will need to fill out and submit an application.

Application Methods

The Social Security disability attorney accepts applications by phone, over the Internet or through application in person at a local office. A disability attorney in NJ can explain that claimants who wish to apply for benefits at a local Social Security office or over the phone must contact the Social Security Administration to set up an appointment time. A representative from the call center for the toll-free number can schedule the appointment, give the claimant directions to the Social Security Administration office and instruct the claimant about the information that he or she needs to bring to the appointment. If the applicant is applying over the phone, a disability attorney in NJ can explain that an approximate time and date will be provided to the claimant when he or she should expect the call. Once the phone interview is completed, the claimant will receive the application to sign. If applying over the Internet, the claimant must go to the Social Security Administration’s website. SSI applications cannot be completed over the Internet.

Applying For SSD Benefits  can be a confusing and time consuming task. Although you can file on your own by requesting the forms from your local Social Security office or filing online, at Hermann Law Group we will work with you to complete the initial application forms, and we will file the claim for you. There is no additional fee for this service, and we prefer to be involved in a claim from the very beginning, so that we can make sure that all of the necessary, relevant information is included before your claim is filed

Our many years of experience have showed us that when a claimant files his or her own application, often crucial information is left out of the claim. Sometimes, relevant medical problems are never entered into the application. In addition, the claimant is often unaware if his or her treating sources have not responded to the Social Security Administration’s requests for records, leaving the claim incomplete.

Hermann Law Group is one of the only firms in the New York Metropolitan area that files claims electronically. Whether you file yourself, with a Social Security representative, by phone, or at a local Social Security office, when a claim is filed manually, it is held in the Social Security office until an agency representative is able to convert it into an electronic file. By filing your claim electronically for you, we ensure that your claim will be developed and decided more quickly. In rare circumstances where manual filing can lead to an expedited determination, we file manually for you, and request an expedited determination of your claim.

You can apply for social security disability benefits in person, by mail, over the telephone, or on the internet.  The telephone numbers and the addresses of local social security administration field offices are available in the telephone directory or on the social security administration’s official web site, https://www.ssa.gov .  Regardless of which of the available application methods you choose, the process will start with an application form that will need to be filled out as completely and accurately as possible.

An in person interview can take place at a local social security field office.  You will need to call ahead and arrange an appointment to meet with an agent who will assist you with the application process.  The application asks for your personal information such as name, address, marital status and social security number.  Be prepared to provide names and addresses of your doctors, and dates of treatment.  You will need an original copy of your birth certificate and other paperwork.   When you call for your appointment, you should ask the representative what additional documents you need to have with you.

A telephone interview will require that you be able to provide the same information that is needed for the in person meeting.  The representative who talks to you on the phone will fill out the form as you answer the questions and will tell you what paperwork you will need to provide in order to complete the application.  You may mail the paperwork or drop it off at the local social security field office.

If you apply by mail, or over the internet, you will have time to gather the requested information as you go through the application.  The online application may be paused to allow time for you to locate answers to the questions.  Just as with the in person or the telephone interviews, any additional paperwork requested by the SSA may be mailed or dropped off at the local field office.

Advice for Answering Tricky Questions on the Application Form

Most of the questions on the application form ask that you provide information that is important and easily obtainable.  However, there are some questions that require more serious consideration before providing an answer.  For instance, question number 10 on the basic application form asks you to provide “the date that you became unable to work because of your illness, injuries, or conditions.”  The correct answer may or may not be the last day that you worked.  If your condition is the result of an accident or a work injury, then the onset date may be the date that the injury or event occurred.   If your condition is one that got worse over time and you became less and less able to do the tasks necessary for your job, the onset date may be sometime before your last day of employment.  The date determined to be the date of the onset of the condition will affect the amount of your retroactive benefits.   An incorrect decision on the date of onset can cost you many months of benefits.

Your response to question 24 will also have a serious impact on the success of your application.  This item asks you to list “the illnesses, injuries, or conditions that limit your ability to work” and to provide a brief description.  The information that you provide here is critical to an accurate and full evaluation of your ability to earn a living.  You need to include a complete list all physical and mental conditions that affect your ability to perform the tasks needed to do your job.  Keep in mind that your disability may be the result of a combination of physical and or mental conditions.

A description of your condition should include more than the medical name.  For example, an answer that lists your condition as Crohn’s disease does not fully describe your situation.  You will need to be specific as to what this disease has done to you and how this disease limits your ability to work.  If Crohn’s disease causes constant abdominal pain or diarrhea and you are spending most of your day in the bathroom, include that information in your description.  If you have had multiple surgeries to remove portions of your perforated colon, describe the effect of these surgeries on both your physical and mental abilities.  Tell them why you can’t work!  Your “brief description” is your opportunity to provide a first impression of how serious your condition really is.  Don’t exaggerate but be thorough and list all of your conditions.  If you need more room than what is provided on the form, include more information in the remarks section found on page 5 of the paper form.

Eligibility

In order to be eligible for New York Social Security Disability Benefits or New Jersey Social Security Disability Benefits, your disability must prevent you from engaging in “substantial gainful activity,” and be expected to last 12 months or more. This means more than just showing that you cannot do your regular work. Social Security takes your age, education and past relevant work (performed in the last 15 years) into consideration when deciding if your conditions prevent substantial gainful activity.

A qualifying disability can be from any source or from any combination of problems, physical or mental. Many people make the mistake of not telling Social Security about all of their medical problems, especially those that had not stopped them from working. At Hermann Law Group, we will make sure that all of your medical conditions are fully documented, increasing your likelihood of a successful application and the best possible outcome for your claim.

When to File

File as soon as possible.

Although your disability must be expected to last for at least 12 months, you need not wait for 12 months before applying. In fact, we urge our clients to apply as soon as possible, if they meet the eligibility requirements. Because it usually takes four to six months from the date of application to receive an initial decision, and because Social Security will only pay you going back a year from when you apply no matter how long you have been disabled, it is wise to apply sooner rather than later.

General Tips

Claimants often want to know how to win a Social Security disability claim. A Social Security disability lawyer can explain that the best advice that he or she can give about how to win a Social Security disability claim is to provide the Social Security Administration claim with all of the information that the representatives need. Also, always be honest and refrain from minimizing your impairments or exaggerating them. When you receive certain forms from the Social Security Administration such as the Disability Report, be sure that you provide thorough details so that representatives have a clear understanding of how the medical condition affects his or her daily activities.

Should You Get a Lawyer?

Do you need an attorney to begin the application process?  The quick answer to that question is no.  The application process is designed to make it possible for you to undertake the process on your own.  Representatives of the social security administration will attempt to answer your questions and help you fill out the forms, but the truth is– they are not your representatives.  An attorney experienced in handling social security disability claims will understand the importance of your answers to the questions on the application form.  Having an attorney at the first stage of the process will increase your chances of success and may shorten your application process by many months.

How to Apply for Social Security Disability in NY?

You may decide that the best answer to that question is to start with a call to the Hermann Law Group to set up an appointment to meet with an attorney who is experienced at handling Social Security disability claims.  There is no charge for your initial consultation and you will not be obligated to have the attorney represent you.  You really do not need to face this very important challenge on your own.  Call us at 877-773-3030.

 

File Your Social Security Disability Claim

Have you been curious about the application process for Social Security benefits? There are three unique ways to apply for these benefits, and you can learn about them in the following video.


Social Security Disability Attorney at Hermann Law Group explains the process of filing your social security disability claim in New York. Watch the video for more information and contact us for a free consultation.

 

Watch the video created by the Hermann Law Group. This video clip will provide you information pertinent to when you should file your disability claim. Contact our attorney office for more information.

Our Social Security Hackensack NJ Attorney Lists Filing Basics

If you are disabled, or have a condition that prevents you from being able to have gainful employment, then you may want to talk to a Social Security Hackensack NJ attorney. Those who qualify can receive disability benefit payments from the Social Security Administration (SSA) for not being physically or mentally able to work. It is important that you understand how disability benefits from the SSA work when you are seeking to receive them. The following information from your Social Security Hudson NY attorney will discuss what the requirements are to receive disability and how to file an appeal if you are denied. If you have any further questions, contact your Social Security Hackensack NJ attorney for assistance.

The Basics of Social Security Disability Benefits

There are two types of benefits that you could apply for with the SSA: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). SSI is typically given to those applicants who are considered to be low-income, who are blind, or children. Those applications who are granted SSI benefits are those who have paid into the system through their years of working. SSI is funded by the deductions that have been taken from paychecks over the years. In order for the SSA to consider you as disabled, you must suffer from a physical or mental condition that leaves you from being able to earn a monthly income through gainful employment. Your condition must also have lasted over the past 12 months, or is predicted by your medical professional to last 12 months or more. There is a book used by the SSA, commonly called the “blue book”, that serves as a guideline for medical conditions that will be approved for disability benefits. Your medical condition must either meet or equal a listing in the blue book in order for your claim to be approved.

Appealing After Being Denied for Benefits

If you have been denied by the SSA for disability benefits, you still have the opportunity to appeal your case and let it be heard again. There will be four steps to having your appeal looked at again. Your case will go through the following:

  • A reconsideration by another representative of the SSA
  • A hearing that takes place with an Administrative Law Judge (ALJ)
  • Having your claim reviewed by the SSA Appeals Council
  • Filing a claim with the Federal Court system

There will be a small portion of disability claims that are approved after going through a reconsideration. However, for the majority of disability cases going through the appeals process, they will need to go through a hearing with the ALJ before it is approved. An important fact to keep in mind about filing for an appeal is that you only have a limited amount of time to do so. When you receive your denial of benefits in the mail, there will be an amount of time given for you to file your appeal with the SSA. If you find that your case is going to a hearing, you may want to consider hiring an experienced disability attorney to help on your case. An attorney will be able to help you prepare for the hearing, which can help your case be a success.

Social Security Disability Application Tips From Our New York Disability Attorney

You might wonder why you should use the services of a New York disability attorney when applying for Social Security disability benefits. After all, the Social Security Administration approves applications based on your medical condition and your inability to work, and you’re obviously not able to work so your application should be approved without question, right? Unfortunately, that usually is not how the process goes. Your condition is apparent to you, of course, but it must be proven to the Social Security Administration. Denial of an application is common. Multiple denials, even, are far too common.

An experienced New York disability lawyer not only can more easily navigate through the complexities and intricacies of the process and the paperwork to be completed and then submitted by the set deadlines, but can also help guide you to a better understanding of your case and provide welcome support through all the stages of the disability benefits application process. More importantly, a disability attorney can improve your chances of winning and receiving the benefits that you deserve.

To improve your chances of a successful application approved by the Social Security Administration, follow the tips below, which emphasize the importance of timely submissions, constant communication, accurate information, extensive documentation and legal representation.

Don’t Delay: Apply Today

Social Security Disability Attorney New York Since the Social Security disability application process can stretch out for months or even years, do not wait to apply. Submit your application as soon as possible. There is no need to wait until your finances are strained, since financial considerations are not a factor in the Social Security Administration’s decision about your eligibility to claim disability benefits.

Once your application is approved, you may be able to get benefits that predate your approval date. The date of your Social Security disability application is an indicator of when benefits should have been paid on that date and possibly earlier.

Identify Every Medical Condition

Be thorough when listing your medical conditions on the application. Do not omit the mention of any medical problem you are experiencing, no matter how minor the symptom might seem. In reviewing claims for benefits, the Social Security Administration evaluates your overall condition, level of functioning and ability to work. One or two issues on their own might not disable you, but the combination of multiple afflictions could be disabling.

Even if your medical condition is not on a list, you may still be considered disabled if you are impaired. However, it can be helpful if your condition is on the list of impairments. If you meet multiple requirements on an impairment listing, you may be approved automatically. If you don’t meet a listing, then the SSA will continue on to other considerations of disability.

Keep Visiting the Doctor Regularly

Although you may have seen many doctors in order to get a diagnosis, you will have to continue medical treatment throughout your disability. Your disability claim will be evaluated based on your medical records, which are cumulative. You should continue to see a doctor as often as they recommend. If you need to miss an appointment, you should reschedule at the earliest date possible.

The Social Security Administration will review all of your treating sources, which is what they call doctors and other medical care providers. They will review all records. You want to have good medical records that are completed with a plethora of information. The more visits you have with a doctor, the more that doctor should know about your disability. Thus, the SSA will likely be concerned with their ongoing treatment recommendations.

Take Prescribed Medications

The Social Security Administration will see which prescription medications doctors have prescribed to you in your records. You may be asked if you are following doctor recommendations and taking those prescriptions. Failing to take prescriptions may be considered failure to follow doctor’s orders. If you do not abide by treatment recommendations, your Social Security Disability application may not be approved. The Administrative Law Judge (ALJ) will likely not be concerned with excuses and explanations, even if you felt you had no way to obtain medications. You are expected to follow a treatment plan.

Don’t Throw Any Relevant Documentation Away

Social Security Disability Application Tips, New York AttorneyThe Social Security Administration reviews your entire medical record. The more objective evidence that you can produce to prove the existence and extent of your medical condition, the stronger your claim will be in the eyes of the reviewers. Keep all related documentation, which could include doctors’ notes in your chart, receipts from travel to appointments, receipts for purchases of prescriptions, discharge summaries from hospital stays, records of emergency room visits, results of blood work and diagnostic tests, referrals to specialists and more. Organize all of the documentation and keep it handy for review by your New York disability lawyer or for submission to the Social Security Administration in support of your application or subsequent appeals.

If Denied, Reply at Once and Try Again

The Social Security Administration frequently denies applications for disability benefits. Prepare for the possibility of denial, and plan to appeal. If denied, appeal at once. You are allowed only 60 days to file any appeal, so it is important that you don’t delay. If you miss the deadline to appeal, then you will be forced to begin again with a new application.

Communicate, Communicate, Communicate

Communication, both written and verbal, is crucial for the success of your disability claim.

  • You should communicate with yourself in the form of a daily journal, recording how you feel, your pain levels, your response to treatment and your limitations in your day-to-day life.
  • Of critical importance is communication with your health care providers, both about your intent to file a disability claim and about the details of your follow-up care. Your doctor needs to respond in a timely manner to any requests from the Social Security Administration for information about your condition. If possible, have your physician write a letter of support for your application, detailing your limitations and the impact your medical conditions have on your ability to work. Be sure you are clear about the recommended treatment prescribed by your doctor, and follow all directions for medication, follow-up appointments, etc.
  • Communicate with the Social Security Administration about the status of your case, and regularly check your mail for correspondence requesting additional information or specifying important deadlines. Keep the administration informed of your current address at all times.
  • Check in regularly with your attorney for updates on your case or to share additional information about your care or condition.

Be Cordial With Anyone Working Your Case

The Social Security Administration has many over worked people on staff, and you should always treat them with politeness. Even if you feel your case has been mishandled, you should remain calm and discuss your case with people. Do not lose your temper with people at the SSA or the ALJ during a hearing. You never know how much influence a person has over your case.

Always Tell the Truth

Do not exaggerate your symptoms or stretch the truth about their impact on your ability to perform daily tasks. Resist the temptation to make your condition appear more debilitating than it might be. Do not provide the answers you think might help win your case. Instead, be honest at all times. Be truthful in your recounting of the symptoms that you experience. Do not lie about the tasks that you are and are not able to do because of your medical condition. Be candid about your condition at every step of the process, from the initial application to any appeals to any testimony you might be called upon to provide before an administrative law judge. If you are caught in a lie, then you almost certainly will lose your case.

Remain Persistent

The application process for obtaining Social Security disability benefits can be lengthy. This is especially true if your initial or subsequent applications and appeals are denied. Do not give up, though. Continue to file appeals if possible. Have patience, and be persistent despite the frustrations you might encounter along the way.

Social Security Disability Claim Timeframe

If you are applying for Social Security New Rochelle NY disability benefits, you’re probably wondering how long the process will take. Unfortunately, the Social Security Administration, or SSA, does not have time limits in place under most circumstances, so the answer varies significantly depending on a variety of factors. As anxious as you may be for your case to be approved, this is typically a situation where you just have to be patient. Certain factors influence the amount of time it takes for a case to be approved, however. By understanding these factors, you can at least get a feel for how long it will take, whether it’s around a month or as long as two years.

Factors

A few factors that influence how long it takes for an SSI disability case to be processed include:

  • Claims Examiner’s Caseload – The busier an SSA claims examiner is, the longer the process is likely to take. Some examiners deal with around 100 cases at a time, which is fairly easy to manage. Yours is likelier to be handled quickly in this situation. However, other examiners juggle as many as 300 cases at once. In that case, your claim could linger for some time.
  • Health Care Providers’ Efficiency – For your case to be processed, you must provide medical records to back up your disability claims. Oftentimes, obtaining these records is a long, involved process. Examiners typically request them immediately. The problem is that doctors and hospitals often drag their feet. Luckily, the SSA is now working with many major HMOs to allow such records to be transmitted electronically, which would significantly reduce the amount of time that’s typically needed to process these cases.
  • The Seriousness of the Impairment – Certain impairments are so severe that they almost automatically make a claimant eligible for SSI disability benefits. These include AIDS, advanced cancer, ALS, double amputation and blindness.

Tips for Expediting an SSI Disability Claim

To help expedite your Social Security New Rochelle NY case, try the following:

  • Provide complete, thorough information in your application. Clearly outline all of the sources of your medical treatment, including doctors’ names, clinic addresses and dates. One thing that holds claims processing up is missing or incomplete information on an application. If the person processing your case has to contact you repeatedly, everything gets pushed back further.
  • Include your medical records with your application. In other words, don’t wait for the disability examiner to request them. Go out and get the records yourself. This isn’t always easy. Some doctors are reluctant to accommodate patients in this way. Many hospitals charge exorbitant fees to have medical record copies made. However, many states have laws that forbid health care providers from charging for medical records if they are needed to process a disability claim, so be sure to check the laws in your area. You may not have to pay a dime for your records. By including your records with your application, you may be able to shave several months off the processing time. It involves a little more legwork from you, but it could also mean being approved for SSI disability a lot sooner.
  • Look into the SSA’s fast-track programs. The agency will expedite disability claims that involve a serious illness listed on the compassionate allowance list. They also expedite cases involving terminal illness and cases involving an illness that qualifies the claimant for presumptive disability benefits.

Here is a brief video provided by the Hermann Law Group explaining if you can potentially expedite your disability claim to receive compensation. Watch the video to find more details.

Social Security’s Five-Step Sequential Evaluation Process

When it comes to filing for disability, the Social Security Administration has a five-step process for evaluating claims for eligibility. The SSA uses multiple criteria, including medical and vocational, that can be quite confusing. An experienced disability lawyer goes over the process below.

Step 1 of the Sequential Evaluation Process

#1. “Are you working?”  If you are working and that work is considered to be “substantial gainful activity” by SSA, then that is the end of the inquiry.  You are not eligible to receive Social Security or SSI disability benefits.  Full-time work will generally be considered to be substantial gainful activity.  But, some part-time work could also be considered to be substantial gainful activity.  SSA will look at how much you are earning.  For 2016 the maximum amount of gross monthly income you can earn before those earnings are considered to be substantial gainful activity is $1,130.00 with some exceptions.

The first step in the evaluation process is to determine whether or not the claimant is engaged in what is termed by SSA as “substantial gainful activity.” The finding as to what constitutes substantial gainful activity is not always clear-cut. It involves exercising judgment as well as applying a set dollar amount to whatever earnings the claimant may have. Generally, claimants whose earnings exceed the dollar limit of substantial gainful activity are denied benefits. You should have a disability lawyer represent you even at this early stage of filing for disability.

Activities that the SSA does not consider substantial gainful activity include:

  • self-care
  • household tasks
  • unpaid training
  • hobbies
  • therapies
  • school attendance

However, while the SSA field office may not consider these to be substantial gainful activity in this step, the Disability Determination Service may use this as evidence the claimant can do substantial gainful activity and is therefore not disabled.

If you are found to be engaged in substantial gainful activity at this step, you will be denied benefits without the SSA having to consider any medical criteria.

Step 2 of the Sequential Evaluation Process

#2. “Do you suffer from a severe, physical or mental, medically determinable impairment or combination of impairments that have lasted or are expected to last at least 12 months?” An impairment is severe if it significantly limits a person’s ability to perform work-related activities.  Most of the time the Social Security Administration finds there is a severe impairment or combination of impairments.

Step 2 is a determination whether:

  • medical evidence demonstrates the existence of an impairment, or
  • a combination of physical or mental impairments severe enough to keep you from engaging in any substantial gainful activity.

When the medical evidence establishes only a slight abnormality or a combination of slight abnormalities which have no more than a slight effect on your ability to work, the SSA will determine that you are not disabled.

Even if it is found at Step 2 that you have a severe impairment, your claim can still be denied if the impairments do not meet the duration test. The duration test is a finding that the impairment is not expected to result in death, and neither lasted 12 months or is expected to last for a continuous period of 12 months.

Step 3 of the Sequential Evaluation Process

#3. “Do you meet the Listings of Impairments?”  Federal regulations known as “the Listing of Impairments” divide the body into different systems, such as the senses, musculoskeletal, cardiopulmonary, etc.  Under each system are specific medical conditions. For each of them, the regulations spell out medical findings that qualify a person for disability benefits.  It is very difficult to meet the exact criteria in the Listings because the criteria describe very extreme and severe levels of impairment.  If you don’t meet all of the criteria for your most significant impairment, you can argue that you have a combination of impairments that are the equivalent of meeting the Listing.  In other words, you might be missing a particular medical finding or your medical tests show a problem slightly less severe than what is required, and you have another condition or conditions that similarly do not quite meeting the Listings.  If you look at your impairments together, they are the equivalent of meeting a Listing.  SSA has made this more difficult to do, as now the federal regulations call upon the evaluator to use a medical expert to evaluate equivalency arguments.  When a case is at the hearing level, many of the ODARs (Office of Disability Adjudication and Review) do not want to go to the expense of hiring a medical expert and they do not have any already employed by them.

If you are found to meet or equal a Listing, however, you win.  Of course, there are still questions that your local Social Security Office will have to go over with you to make sure that you meet all of the non-medical requirements of either Social Security or SSI disability.  But, if you are not found to meet the Listings, don’t despair.  Most cases are not decided at this Step of the Sequential Evaluation Process.

If you are found to have a severe impairment and such impairment or combination of impairments is expected to last at least 12 months, the process moves to Step 3.

Step 3 is the point where Disability Determination Service (DDS) uses a systematic collection of medical criteria known as the Listings of Impairments. The Listings have 10 categories containing about 110 different mental and physical ailments with detailed diagnoses.

Many of the conditions contained in the Listings require particular tests. If your condition meets the Listings, your application will be approved with no further evaluation.

When filing for disability, you may be wondering, “How do I know if my condition meets the Listings?” The short answer is – you won’t know until the medical evidence is evaluated by an experienced disability advocate in cooperation with a medical doctor or psychiatrist. The Listings are intended to be specific. If your impairments meet the medical conclusions contained there, your medical evidence must show it nearly word for word.

If all the above was not confusing enough, it is possible to have a claim approved if the disorder is considered to medically equivalent to a listed impairment.

If, however, your condition does not meet or equal a Listing, the claim will move to Step 4.

Step 4 of the Sequential Evaluation Process

#4. “Can you perform any of your past relevant work?”  Your past relevant work is defined as any work that you did at a level considered to be substantial gainful activity, during the last 15 years prior to the onset of your disability.  If the work was not performed for at least 30 days or was part of a sheltered workshop, it will not be considered as past relevant work.  In analyzing this, SSA will first look at how you have described this work in various documents, such as a Work History Report, which you will be required to complete.  They will consider how much you had to sit, stand, walk, lift, climb, crawl, stoop, bend, handle large and small objects, and more.  They will consider if you were a supervisor and had to complete various reports, or whether you were more of an unskilled worker, such as a laborer.

At the Initial and Reconsideration levels, the State agencies that SSA contracts with do not usually have vocational experts on staff to delve deeper into just what your past relevant work entailed.  However, at the hearing level, the administrative law judge will often retain the services of a vocational expert to explain to the physical demands and skill level that would be required to perform your past relevant work.  The vocational expert will also tell the judge if through your past relevant work, you have gained skills that could be transferred to less demanding work.

If SSA determines that you are still able to perform any of your past relevant work, despite having a severe impairment or impairments, then you will be found not to be disabled and your claim will be denied.

If it is determined that you can’t perform any of your past relevant work, then you move to Step 5.

Step 4 considers whether you have the residual functional capacity (RFC) that allows you to perform your past relevant work. Residual functional capacity is used to determine whether you can do basic work-related activities associated with jobs previously held in the 15 years before the date you believe you became disabled. If you are deemed to be able to do your past relevant work, your claim will be denied.

If the DDS finds that you cannot do your past relevant work, the process moves to Step 5.

Step 5 of the Sequential Evaluation Process

#5. “Is there other work, existing in significant numbers in the national economy, that you could still perform?”  At this level, the evaluator looks at your age, highest level of education, the skill level of your past relevant work, and whether you have transferable skills.  The evaluator also looks at something called your residual functional capacity or RFC.  Your RFC is an estimate of what level of activity you can still perform, despite having severe impairments.  There are physical and mental RFC’s, but the main thing considered here, at least initially, is your physical RFC. So, for example, if you are 55 years old, have a 10th grade education, a history of heavy, unskilled work, and you are now able to lift only 10 lbs. and walk only 2 hours out of an 8 hour day, SSA will find that you are disabled at Step 5.  If everything were the same, except you are only 35 years old, you would be found not to be disabled.  You would be expected to find less demanding work.  This is but one example.

In Step 5, the SSA answers the question whether or not your can perform other work in the national economy. The concept of residual functional capacity returns in Step 5. This time Residual Functional Capacity is evaluated with vocational factors. “Vocational” in the sense used here means areas that relate to an occupation, education, skills, training, etc.

The SSA uses the residual functional capacity along with vocational factors – age, work experience and education to determine if you can do other work than those jobs previously held despite your severe impairments.

It does not matter if there are no local places hiring for those jobs. However, those jobs must exist in significant numbers in the national economy.

Evaluating the Claimant’s Credibility

One of the most critical tasks that an administrative law judge has in Social Security disability cases is determining whether a particular claimant is credible. There are several pieces of evidence that the judge may look at in making this assessment.

Potential Evidence

Your SSI lawyer Westchester can explain that the judge may look at evidence associated with your claims of pain or other symptoms and how they affect your ability to function. Such evidence may consist of medical examination results and lab test results. Additionally, he or she may look at more subjective evidence, such as medical opinions provided by psychologists, physicians, and other healthcare representatives who have a history with you. Additionally, he or she may review statements that you, friends, family members, and other acquaintances of yours have prepared that detail such aspects of your life as your medical history, your treatment history, your employment record, your attempts to work, your daily activities, and other information related to your impairments. Lastly, your SSD attorney Westchester can explain that the administrative law judge may take into consideration his or her own observations of your conduct during the hearing, as well as that of his or her staff and other representatives from the Social Security Administration.

Consistency in Statements

An SSD attorney Westchester can explain that one of the best ways that you can increase your level of credibility with the judge is to be consistent in your statements. Your testimony should be consistent with other statements you have provided as part of your case and with other aspects of your case record.

Factors that Affect Credibility

The administrative law judge may consider several factors. For example, he or she evaluates how closely your statements are to results in your medical records. Additionally, the administrative law judge will assess how consistent your statements are with previous things that you have stated in your record. In particular, the administrative law judge will compare the statements that you have made to treating doctors and other healthcare providers with the statements that you make at the hearing. If you applied for other benefits, such as private insurance disability benefits, veterans’ benefits, or workers’ compensation benefits, the judge will evaluate the statements that you made in these applications, if they are part of your case record.

Explaining Differences

In some instances, there may be a perfectly valid reason as to why statements you make are not consistent, even though they are credible. For example, your symptoms may change over time. Be sure to explain such differences.

“I’m Disabled and Unable to Work Because…”

The way in which a Social Security Disability claimant finishes that sentence is at the heart of every claim for Disability Insurance Benefits. In order to be found eligible for Social Security benefits, there are certain medical as well as non-medical requirements which must be satisfied. The medical requirements could be summed up by how the above sentence is completed.

All too often, potential clients will give me reasons for their inability to work which do not address these medical requirements and, if not for the guidance of an experienced Social Security practitioner, could very well doom a claim. One common example is, “no one will hire me with my medical condition.” Another is, “I can’t travel to and from work.” While these two explanations may be factually accurate, they do not specify a medical reason for not being able to work. Not only do these fail to specifically answer the question being asked by the Social Security Administration, but they can actually irreparably damage your claim.

The Social Security Administration must determine if a claimant has a medical condition (or conditions) that prevent him or her from being able to work on a full-time basis for a period of at least twelve (12) months. To put it simply, they do not care if no one will hire you, or whether you can travel to and from a place of employment. They assume for purposes of their analysis that the hypothetical job is available to you and that the commute is not an issue. Once there, can you do the job? If you cannot for medical reasons, then benefits are potentially payable.

The potential harm done by answering the question by failing to state a medical reason is that it can imply your ability to work when you cannot. Therefore, it is imperative that a brief medical explanation be offered in support of a claim for disability benefits.

Applying for Disability When You Are Self Employed

If you are self employed and have developed a condition that restricts your ability to work, our Hudson Valley disability lawyers want you to know that you may be eligible for Social Security disability benefits.  You may also be able to continue your business on a limited basis.  The Social Security Administration determines that you are disabled if you are unable to engage in substantial gainful activity because of a physical or mental condition.  If you are able to do some work but your earnings or the value of your services to your business do not exceed the average monthly earnings threshold used by the Social Security Administration to measure substantial gainful activity, then you may be disabled.

If you were working for someone else and drawing a paycheck, the Social Security Administration would look at your monthly earnings as a base to determine whether or not your efforts amount to substantial gainful activity or SGA.  For self employed individuals, the Social Security Administration (SSA) applies the following three special tests to determine whether or not you are engaged in SGA:

TEST 1.  Significant Services and Income.  Are you rendering significant services to the business and is your average monthly earnings in excess of the minimum SGA threshold in effect at the time.  For 2016, the amount is $1,130.00 a month.  If the answer to both of these questions is yes, then you are not eligible for disability.  If the answer to either of these questions is no then SSA will go to the next test.

If you are the sole owner of your business and have no employees, any work that you do is automatically considered significant by the Social Security Administration.  If you are a co-owner of the business or if you have employees, your efforts will be considered significant if they amount to more than half of the time needed to manage the business or  if you manage the company for at least 46 hours per month.

TEST 2.  Comparable Work.  Is the work that you are performing comparable to the work of persons without disability in your community engaged in the same or a similar business?   If yes then you are engaged in SGA and do not qualify regardless of your earnings.

This test looks at the work that you are able to do.  It is not a test of the quality of the work or the value of the work to the business.  If you are a plumber and are performing the same duties with the same level of skill and efficiency as other plumbers in the community and are able to work comparable hours as other plumbers, then the SSA may determine that you are not disabled.  If your work is not comparable to other plumbers then the SSA will go on to the next test.

TEST 3Worth of Work.  Is the work that you perform worth more than the threshold SGA earnings in terms of its value to the business or would you need to pay someone else more than the threshold monthly earnings to do the work that you are doing.  If the answer to either of these questions is yes, then you do not qualify for benefits.  If the answer to both questions is no, they you are not engaged in substantial gainful activity and may qualify for benefits.

This test looks at the value of the work that you actually perform.  It is not based on the value of the work that you performed for the business before your injury.  If it takes you twice as long to do a job, then that job may have considerably less value to the business than it would have if performed by someone who is healthy.

The second part of this test requires a determination of how much you would have to pay someone to do the work that you are doing, at the same pace and with the same quality.  This is not based on what it would cost you to hire someone with the skill and efficiency that you had before your injury.  The issue is how much it cost you to hire someone to do the same work that you are currently doing.

Self employed workers pay into the Social Security fund and are entitled to the same disability benefits as workers who draw a paycheck.  The application process is complicated and may take longer than you would hope but if you are not able to work you should qualify for benefits.  Don’t be discouraged!

Tips for Success

  1. Talk to an attorney. You do have a right to benefits if you become disabled but you have the burden of proving that you are disabled.
  2. Well meaning efforts to go into the office may be viewed as evidence that you are not disabled. Showing up when you are not able to actually do the work may not be a good idea.
  3. Follow your doctor’s recovery and treatment recommendations. If your doctor says stay home, stay home!
  4. Consider hiring someone do some of the work rather than pushing yourself to do more than you should. The fact that the doctor says that you have an impairment or condition that may qualify you for disability does not mean that the SSA will consider you disabled if you put your health at greater risk and prove that you are able to work.
  5. Hire an experienced attorney! I am repeating this tip because these cases have special requirements.  Applying for disability when you are self employed can be complicated.  Success depends upon proper presentation of the facts.  The Hudson Valley disability lawyers at the Hermann Law Group have years of successfully representing clients in these types of cases and will help you get the benefits that you are entitled to.

Social Security Hackensack NJ Lawyers Discuss Fraud When Applying for Disability

If you plan on filing for Social Security disability benefits, you may want to schedule a consultation with an attorney that specializes in Social Security Hackensack NJ. While filing for Social Security Hackensack NJ, there are certain things you will want to make sure you avoid doing. One of those things is committing fraud when you file. Committing fraud is a very serious offense. If you are found knowingly committing fraud when applying for Social Security benefits, then you will likely be facing criminal charges. The following information regarding Social Security Hackensack NJ discusses how to avoid committing fraud when you file for disability benefits.

What Is a Material Fact?

The Social Security Administration (SSA) needs something to rely on to back-up your disability claim. This is what a material fact is for. If you intentionally lie about a material fact, ask or have anyone have to lie for you about a material fact, or intentionally misrepresent a material fact, then you have committed an act of fraud. The following are examples of the fraud discussed above:

  • If you (the claimant) filed for SSI benefits (benefits for those with low income and low assets) yet you purposely do not mention a camper that you own that you are renting to a family member. If you had claimed this asset, then you would not have been eligible for SSI benefits.
  • If the claimant states that they have an 8th grade education, when it reality they actually obtained a GED. The claimant purposely lied because they knew that having a much lower education level would increase their chances to receive benefits.
  • A claimant filed a disability claim based on their diagnosis of anxiety and depression. However, the claimant had intentionally made false statements to their medical professionals about how their anxiety and depression impacts their daily life. Due to the statements made by the claimant, the medical professionals have written their report to reflect the claimant’s statements.

Wages to Determine Eligibility

One piece of the puzzle that the SSA uses to determine your eligibility for SSI or SSDI disability benefits is your earnings. Lying about what your income is or asking others to lie about your income for you is considered to be fraudulent behavior. The following are examples of how you could commit fraud when it comes to reporting your income to the SSA:

  • When filing for disability benefits, the claimant reported that the last time they were able to work was May of 2011. However, the claimant lied. The last time that they were able to work was May of 2013, just before filing for disability. The claimant lied on their SSA disability benefits application in order to receive a larger amount of money in back pay.
  • The claimant was self-employed and hurt themselves while on the job. However, the claimant did not qualify for disability benefits because they had not paid any taxes to Social Security over the years. The claimant also did not qualify for benefits due to their income being too high. Instead of reporting their actual income on the application, the claimant instead did not report their earnings in order to qualify for benefits.

Right to a Payment

If the SSA discovers that you have committed fraud by lying, hiding, or failing to report any pertinent information then it could impact your rights to receive disability payments for you or on someone else’s behalf. The following are examples of how fraudulent behavior could have an impact on your disability payments:

  • An adult child was responsible for receiving their mother’s disability benefits. The adult child fails to notify the SSA that their mother has passed away and continuing receiving her benefits.
  • The claimant had been receiving both their spouse’s railroad pension as well as benefits from the SSA. When the spouse passed away, it was never reported so the claimant could continue to receive the dual benefits.
  • The claimant had originally filed for disability benefits as a single woman. Throughout the time that the claimant has been receiving her benefits, she got married. Her spouse is a full-time worker whose income would leave her ineligible to continue receiving the same disability benefits. Knowing that this would happen, the claimant knowingly did not report her marriage to the SSA in order to continue receiving benefits.
  • A parent had been receiving benefits for their minor child. The child moves out of the home, but the parent does not report it to continue receiving benefits.

Representative Payee

A representative payee is someone who is designated to receive payments on someone else’s behalf. A representative payee is responsible for taking the money received to help pay for items that the claimant needs. However, instead of spending the money on the claimant, the representative payee spends the money on their personal debt or on things for themselves or their family, then they have committed fraud.

Submitting a Social Security Number

If you knowingly use a fake Social Security number in order to establish a Social Security record, then you are committing fraud. The following are examples of fraud:

  • The claimant knew that they were not eligible based on their criminal history, but submitted a fake SS number in order to be approved.
  • The claimant is not a citizen of the United States so instead uses a fake SS number to establish residency and receive disability benefits.

Consult with a Social Security Hackensack NJ Lawyer

If you are concerned about submitting your information to the Social Security Administration when applying for disability benefits, then you may want an experienced Social Security Hackensack NJ lawyer to review it first. For a skilled and experienced professional, contact Hermann Law Group, PLLC at (914) 286-3030. Hermann Law Group, PLLC knows the attorneys who specialize in Social Security Hackensack NJ and will help you with your disability claim. Call today for your consultation!