Social Security Administration

What Is Ahead For Government Workers Facing Social Security Cuts?

city hall building, social securityMore than 2 million former government workers face significant cuts in their Social Security because they had a government job that included a pension. The decreased payouts are the result of the Government Pension Offset (GPO) and the Windfall Elimination Provision (WEP), two statutes that prevent retirees from receiving payments from both social security and public sector pensions.  […]

70% of Initial Social Security Disability Claims are Denied: What Now?

attorney for social securityEvery year, millions of Americans apply for Social Security Disability Insurance (SSDI) benefits. Unfortunately, the Social Security Administration (SSA) denies 70 percent of initial claims.

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Should Social Security Be Considered an Entitlement Program?

Social Security Franklin D. Roosevelt signed the Social Security Act into law in 1935. The intent of this Act was to provide protection to average citizens and their families from falling into poverty during their old age. When there is talk about cutting the federal budget, the subject of cutting Social Security benefits is often brought up. This is because of concerns over the program’s long-term viability. Since 2010, Social Security has paid out more money than it has coming in. In fact, 45 percent of the government’s payouts can be attributed to Social Security, Medicare and Medicaid payments. […]

What is Residual Functional Capacity and How Does It Affect your SSD Case?

Social SecurityAnyone that is applying for social security disability payments is going to be evaluated by a claims examiner at the DDS (Disability Determination Services). The evaluation performed by the claims examiner will include a residual functional capacity (RFC) assessment that is performed by a medical or psychological consultant at the DDS. This RFC assessment helps the claims examiner figure out whether or not to approve or deny the claim.

A Breakdown of the RFC Assessment

The DDS physician will rate the residual functional capacity of the person filing the claim based on that individual’s medical evidence. There are two types of RFC assessments – physical and mental.

  • Physical – A physical RFC assessment is based on the physical ability that an individual has to perform normal day-to-day activities. For example, the ability to walk, crouch or stand for certain periods of time. Some of the other factors that will be considered include how well the individual can manipulate, grasp and reach over head as well as how much the individual can lift.
  • Mental – A mental RFC assessment will be performed by either a psychologist or a psychiatrist. Mental symptoms, such as illogical thinking and poor memory, are taken into consideration, as are the individual’s ability to focus and concentrate, their ability to interact in a social setting and their ability to engage in simple, routine and repetitive tasks.

Submitting an RFC Assessment by a Treating Doctor

The DDS will use medical records to determine whether the application is approved or declined. However, the claim stands a better chance if it is submitted with an RFC assessment provided by their personal doctor.The Social Security Administration gives greater weight to a treating doctor’s assessment because the physician examines the patient and more accurate, metrics-based determination of disability.

An RFC completed by a treating doctor is always preferable, no matter how favorable the medical evidence is to the applicant. Medical information can often be interpreted in different ways, which means that having an RFC completed out by a personal doctor will provide a more clear conclusion as to the disability of the applicant.

Residual functional capacity assessments play an important part in determining whether a social security disability claim is approved. Social security claims are difficult to win without the necessary evidence. A physician-prepared residual functional assessment will greatly strengthen any social security disability claim.

What is ‘substantial gainful activity’?

Male Garden Worker Using Digital TabletEvaluating vocational activity during SSD claims

People seeking Social Security Disability benefits must prove they cannot perform “substantial gainful activity” because of their impairments. Additionally, claimants cannot engage in SGA while seeking benefits. To many SSD applicants, this may sound like a subjective requirement. However, as a Chicago disability attorney could attest, the Social Security Administration employs strict standards to determine whether work constitutes SGA.

Defining SGA

Every year, the SSA uses average national wages to identify an amount of earnings that represents SGA. In 2015, blind individuals who earn over $1,820 per month are engaging in SGA. For all other individuals, the SGA earnings limit is $1,090. These limits apply only to income from employment.

The SSA may find that a person is performing substantial work even if the person’s earnings fall below the relevant limit. For example, self-employed individuals are evaluated under distinct standards, which account for job duties and hours. A claims examiner may consider the following questions when assessing whether a self-employed individual is performing SGA:

  • Does the person provide significant services and earn substantial income? The services of sole proprietors and people who put substantial time into the business are considered significant.
  • Does the person perform roughly the same level of work as a non-disabled person in a similar business? The SSA may take job duties, hours and special skills into account.
  • Does the value of the individual’s work exceed $1,090 per month? The SSA may consider the wages a hired employee would make while working in the applicant’s position.

Regardless of whether an applicant is self-employed, the SSA may count volunteer work as SGA. As a Chicago disability attorney understands, unpaid positions with significant hours and demands may qualify as SGA. The SSA may also find that an individual would receive earnings above the SGA level if he or she were paid for volunteering.

Special exceptions

In a few cases, a person may earn wages above the SGA threshold and still receive benefits. The SSA allows working individuals to subtract impairment-related work expenses from their counted income. For example, individuals who need to take special transportation to work may deduct the associated costs. Additionally, Social Security Disability Insurance beneficiaries are permitted to have earnings exceeding the SGA limits during trial work periods.

A trial work period is triggered when a beneficiary’s earnings exceed a set threshold. In 2015, this threshold is $750, as any Chicago disability attorney knows. For self-employed individuals, working over 80 hours in one month sets off a trial work period. Up to nine non-consecutive months can be included in a trial work period. During these months, beneficiaries can engage in work that is considered SGA without losing their benefits.

Qualifying for SSD benefits after a disabling car accident injury

Car accident CrashIllinois Social Security attorneys can assist victims

Serious car accidents affect many Chicago residents each year. According to The Chicago Tribune, in 2013, an average of 783 crashes occurred daily in Illinois. About two-thirds of these accidents were speed- or alcohol-related. Crashes involving these factors often have devastating consequences, as most Illinois Social Security attorneys are aware. Sadly, this accident rate may remain similarly high in 2015 due to falling gasoline prices.

When car accident victims suffer injuries that prevent them from working, they may qualify for Social Security Disability benefits. However, this isn’t a certainty, even for people with severe injuries. Accident victims still must meet the Social Security Administration’s stringent criteria.

Disability requirements

The SSA uses a very specific definition of “disability” when awarding SSD benefits. A condition is only disabling if it is expected to prevent a person from working for at least 12 months. Many car crash injuries may heal within this period. The SSA also requires a five-month waiting period before a person can receive benefits for a disabling condition. Therefore, accident victims often must wait to receive any benefits they are eligible for.

Many people assume they will qualify as disabled if they physically cannot perform their current jobs. However, as any Illinois Social Security attorneys could explain, the SSA also considers a person’s ability to perform other work. If a car accident injury allows for light or sedentary work, it is not considered disabling.

Evaluating disablement

The SSA automatically classifies various conditions as disabling if they meet specified criteria. These disabling medical conditions and associated requirements are listed in Disability Evaluation Under Social Security, or the “Blue Book.” A number of common car accident injuries appear in the book, including the following:

  • Musculoskeletal injuries — these include spine injuries, amputations and fractures.
  • Brain injuries — several adverse side effects of brain injury, including stroke and epilepsy, are also considered disabling.
  • Burns and other soft tissue injuries — these injuries must severely limit a person’s ability to walk or perform fine motor tasks.
  • Anxiety, depression and other mental disorders — mental illnesses that develop after a traumatic accident or serious injury may be found disabling.

For each of these injuries, the Blue Book specifies the signs and symptoms applicants must document, along with required forms of evidence.

Car accident victims may also receive SSD benefits through medical-vocational allowances. The SSA evaluates the sum total of a victim’s impairments, rather than one injury, when awarding an allowance. As most Illinois Social Security attorneys would agree, an accident victim who suffered numerous moderate injuries might qualify for an allowance. Even if none of the injuries are independently disabling, the cumulative effects of the injuries may merit SSD benefits.

Can I still qualify for SSD benefits if I have never held a job?

A beautiful broken hearted multiracial girlSocial Security Disability provides financial assistance to people who cannot work due to disabling medical conditions. As any Illinois Social Security lawyer knows, SSD benefits are not awarded based on financial need. Besides meeting medical criteria, beneficiaries must have adequate earnings to qualify as “insured.” Given this requirement, SSD benefits are not directly available to people who have never worked. However, these individuals may be eligible for other disability benefits.

Benefits for dependents

The dependents of SSD beneficiaries may qualify to receive their own benefits. A dependent’s health and financial need do not affect the person’s eligibility for benefits. Dependent benefits may be available to spouses, ex-spouses, widows and widowers of beneficiaries, depending on each dependent’s age. Someone who cares for the minor or disabled child of an SSD beneficiary may also collect benefits, regardless of age.

Spouses and ex-spouses of beneficiaries can collect dependent benefits after the age of 62. However, ex-spouses may only receive benefits if the marriage lasted more than 10 years. Furthermore, ex-spouses must not remarry or qualify to collect a higher benefit based on another person’s work history.

Surviving spouses and ex-spouses of deceased beneficiaries may collect survivors benefits starting at age 60. Survivors benefits are only available to ex-spouses if the marriage to the beneficiary lasted over 10 years. Surviving spouses and ex-spouses who qualify as disabled may begin collecting benefits at age 50. The Social Security Administration considers a person disabled if the following criteria are met:

  • The disabling medical condition is expected to last over a year or prove fatal.
  • The person can no longer perform any work that he or she performed in the recent past.
  • The person is unable to pursue new work due to the disabling condition.

As any Illinois Social Security lawyer understands, people who meet these criteria may also qualify for other Social Security benefits.

SSI disability benefits

The SSA awards Supplemental Security Income disability benefits based on financial need. The SSA uses the same medical criteria to determine whether individuals are eligible for SSD and SSI benefits. However, SSI beneficiaries do not have to meet earnings requirements to qualify for benefits.

SSI disability benefits are only available to people with low income and assets. In 2015, an SSI beneficiary’s countable monthly income cannot exceed $733, and a beneficiary’s assets cannot exceed $2,000. However, the SSA does not count every asset or all income toward these limits. This can make determining benefit eligibility challenging.

Disabled individuals may benefit from discussing the availability of these forms of assistance with an Illinois Social Security lawyer. An attorney may be able to offer advice on an individual’s eligibility for both categories of benefits.

What qualifies as a musculoskeletal system disorder?

pDistraughtManOnSteps_9366984_mClaiming SSD for joint, bone and muscle conditions

Musculoskeletal system disorders are conditions that affect the bones, joints and muscles. People who suffer from these disorders in Illinois may experience anything from mild pain and stiffness to significant physical limitations. These disorders can be highly debilitating, as any Chicago Social Security attorney understands. Fortunately, victims may qualify for Social Security Disability benefits.

The Social Security Administration recognizes the disabling nature of many musculoskeletal system disorders. The first chapter in the SSA’s “Blue Book” of disabling impairments is devoted entirely to these disorders. Additionally, many musculoskeletal disorders that are not explicitly included in the Blue Book may still qualify as disabling.

Recognized disorders

Numerous categories of musculoskeletal system disorders are listed in the Blue Book. These include the following injuries, diseases and disorders:

  • Amputations
  • Spinal disorders
  • Joint dysfunction
  • Soft tissue injury due to burns
  • Fractures of the legs, feet or upper extremities

Additionally, the Blue Book recognizes the possibility of disablement resulting indirectly from musculoskeletal system disorders. For instance, reconstructive surgery of a weight-bearing joint that causes a limited ability to walk is listed in the book.

People who suffer from listed musculoskeletal disorders may qualify for SSD benefits by meeting requirements described in the appropriate listing. For example, a joint disorder must limit a person’s ability to walk or perform fine motor tasks. Additionally, the disorder must be medically documented, and it must cause pain, stiffness and limited motion. If these criteria are met, a joint disorder is automatically considered disabling.

Other musculoskeletal system disorders that don’t appear in the Blue Book may also qualify as disabling. The victims of these disorders may receive medical-vocational allowances if they cannot perform gainful work. As any Chicago Social Security attorney knows, the SSA may use various factors to determine whether a person can work gainfully. These include the person’s physical limitations, age, job skills and relevant knowledge.

Documenting musculoskeletal disorders

People claiming SSD benefits for musculoskeletal system disorders must provide a diagnosis from an acceptable medical source. Licensed physicians and podiatrists both qualify as acceptable sources. SSD applicants also should furnish objective evidence of the disorder, such as medical imaging or tests. Applicants may supplement this evidence with descriptions of the physical limitations the disorder causes.

For people seeking SSD benefits, establishing the expected duration of musculoskeletal system disorders is critical. As any Chicago Social Security attorney knows, a condition must be terminal or expected to last over 12 months to qualify for benefits. Some musculoskeletal disorders, such as fractures and spine injuries, may heal or improve within this time period. However, medical treatment records and statements from doctors can help applicants prove a disorder is anticipated to last longer.

 

Can I apply for Social Security Disability if I have cancer?

pDistraughtManOnSteps_9366984_mClaiming benefits with an Illinois SSD attorney

The American Cancer Society estimates that over 1.6 million new cancer cases will be diagnosed in 2015. As any Illinois SSD attorney knows, people diagnosed with the disease may face numerous adverse symptoms and health complications. Fortunately, Social Security Disability benefits may be available to cancer victims. The Social Security Administration automatically considers some cancers disabling. Other cases may qualify for benefits based on the functional limitations the victim experiences.

Automatic disability determination

A diagnosis of certain cancers is enough to meet the SSA’s medical criteria. For example, inflammatory breast cancer and cancer of the pancreas are automatically considered disabling. However, most cancers must have specific characteristics, such as inoperability or metastasis, to qualify as disabling. For evidence, the SSA typically requires a diagnosis supported with clinical findings, symptoms and statements from medical professionals.

The SSA outlines the medical criteria different types of cancer must meet in the “Blue Book” of impairments. The SSA also identifies cancers that merit expedited claim processing in the list of Compassionate Allowances conditions. Every condition on this list is generally severe enough to warrant benefits. Thus, the SSA requires minimal objective evidence in claims involving these conditions.

In addition to meeting medical criteria, applicants seeking SSD benefits for cancer must meet financial requirements. Applicants cannot perform work with monthly income over $1,090. Applicants also must qualify as insured based on past earnings. People who fail to meet these criteria cannot receive benefits, regardless of how disabling their conditions are.

Medical-vocational allowances

If cancer is not considered disabling under the Blue Book, a victim may still qualify for benefits. As any Illinois SSD attorney understands, the SSA may award medical-vocational allowances if cancer prevents victims from working gainfully. To determine whether cancer precludes gainful employment, the SSA considers the following factors:

  • Age — the SSA recognizes that older claimants may have trouble learning new skills or changing work.
  • Education — the SSA acknowledges that claimants with lower educational levels may have fewer job opportunities.
  • Work-related skills — the SSA uses work experience and skills to evaluate the work a claimant can perform.
  • Residual functional capacity — the SSA also considers the functional limitations the cancer causes.

The effects of chemotherapy or other treatments are additionally factored into RFC. The SSA may consider immediate symptoms and potential long-term effects, such as cognitive impairment.

For people seeking medical-vocational allowances, proper documentation of functional limitations is essential, as any Illinois SSD attorney can attest. Applicants can ask a physician to complete an RFC assessment form. Applicants can also request statements from non-medical sources, such as co-workers or friends. These sources can complement objective evidence by providing insights into the symptoms and limitations the applicant experiences.

 

Create a record of how your disability affects your life through a journal

Notebook and pen Black and whiteDocumentation of symptoms, treatments and daily effects

Many Social Security Disability claims are not approved solely on the strength of medical records. Instead, claim decisions often depend on the unique symptoms and limitations a condition causes. As any Illinois Social Security Disability attorney can attest, applicants usually must personally document and describe these effects. A journal can be invaluable in helping applicants accurately remember and explain the effects of their disabling conditions.

Preserving key information

Applicants can use journaling to record various daily impacts of their medical conditions. Through a journal, applicants can track symptoms and functional limitations they face at work or elsewhere. To create a thorough record, applicants can also record their medical treatments and any associated gains or side effects.

Applicants should be careful to record their symptoms and limitations in specific, descriptive language. Applicants should note the location, frequency and severity of symptoms, along with any precipitating factors. Similarly, applicants should describe exactly how or why the disabling medical condition affects their ability to perform daily activities.

Applicants can also use journaling to track the course and effectiveness of the treatments they receive. Social Security may deny a claim if the disabling condition could be managed through treatment without adverse side effects. Thus, applicants should focus on documenting the limitations of the available treatments.

Benefits during claims

As any Illinois Social Security Disability attorney knows, the nature and severity of some conditions are not externally apparent. Journaling can strengthen claims involving conditions that are complex or difficult to establish with objective evidence alone. Such conditions include emotional illnesses or pain disorders, such as depression, anxiety, fibromyalgia and chronic pain.

Keeping a journal can also offer benefits for people with more readily apparent conditions. The following factors make journaling advisable for most applicants:

  • The SSD claim process is rarely quick. Applicants who must appeal denials often do so months after filing their claims. After this delay, remembering symptoms and functional limitations can be challenging.
  • Vagueness or inconsistency can make a claim appear less credible. Unfortunately, describing symptoms such as pain in a precise manner can be difficult. Journaling helps applicants practice articulating their symptoms and daily struggles.
  • SSD applicants must support their claims with documentation from medical sources and even personal sources. A journal can help these people understand an applicant’s condition and its impacts.

Additionally, a journal may help illustrate the progression of the disabling condition. Small changes that occur gradually may be easier to detect through journal entries.

As any Illinois Social Security Disability attorney can confirm, journaling does not have to be a difficult or time-consuming task. Short but detailed daily notes can strengthen an applicant’s claim and even significantly affect the final outcome.