Social Security Administration

Seeking SSD benefits for emotional illnesses

AngerChallenges of establishing emotional or mood disorders

Many people in Illinois suffer from emotional illnesses, such as depression and anxiety. According to the Anxiety and Depression Association of America, anxiety affects 18 percent of Americans, while depression affects 6.7 percent. These illnesses can be physically and emotionally debilitating, and some may even qualify for Social Security Disability benefits. However, proving this is the case can be difficult, as many Social Security lawyers in Chicago know.

The causes of emotional illnesses are sometimes unclear, since both neurological and environmental factors can contribute. Symptoms are often self-reported, which can make establishing credibility difficult. Still, there are a few ways that victims may qualify for benefits, depending on the nature of their conditions.

“Blue Book” conditions

The Social Security Administration’s “Blue Book” contains a list of conditions that are considered disabling if they satisfy set requirements. Various disabling emotional illnesses appear in the book, including depression, bipolar disorder, anxiety, stress and certain phobias.

For most emotional illnesses, the Blue Book details specific symptoms and limitations people seeking benefits must establish. For instance, an applicant with an anxiety-related disorder must document flashbacks, compulsions, avoidance behaviors, panic attacks or certain physical symptoms. The applicant must also prove he or she cannot function outside of the home or perform regular daily activities.

Applicants can document these signs and symptoms with observations and statements from treating physicians. Statements from close personal sources can also help establish the effects of an emotional illness. Applicants also must prove they meet Blue Book criteria with supporting medical evidence. This could include records of psychological or neurological evaluations, testing and treatments.

Other emotional illnesses

If a condition does not meet Blue Book requirements, an applicant may still receive a medical-vocational allowance. The SSA awards allowances to people who cannot reasonably work due to their impairments. As Social Security lawyers in Chicago can explain, the SSA may consider various symptoms or limitations a person faces, including:

  • Cognitive issues, such as deficits in memory, focus or persistence
  • Difficulty functioning appropriately in social settings
  • Physical symptoms, such as fatigue, low energy levels or sleep disturbances
  • Adverse side effects of medication used to manage the emotional illness

When awarding an allowance, the SSA considers the cumulative effects of any conditions the individual suffers from. Applicants who suffer from a combination of impairments may be likelier to receive benefits through a medical-vocational allowance.

Unfortunately, documenting the disabling effects of an emotional illness can be challenging, since objective evidence is often limited. Victims of emotional illnesses may want to consider partnering with Social Security lawyers in Chicago when seeking benefits. An attorney may be able to provide advice on securing documentation that meets the SSA’s strict standards.

 

How does the ADA work with SSD benefits?

social security benefitsClaims under both systems may be acceptable

Many people who live with disabilities in Illinois struggle to perform their jobs. If employers don’t offer reasonable accommodations, these employees may claim discrimination under the Americans with Disabilities Act. If a disability prevents gainful employment, employees may also seek Social Security Disability benefits. These claims may seem contradictory. However, as any Social Security attorney in Illinois knows, ADA claims do not render people ineligible for SSD benefits.

Distinct claim criteria

ADA and SSD claims hinge on different premises. In an ADA claim, a worker contends he or she could perform a specific job with reasonable accommodations. SSD claimants allege they cannot perform their past jobs or any new work.

The terms of an ADA claim may seem to undermine an SSD claim. However, any Social Security attorney in Illinois can explain that SSD claims don’t account for reasonable accommodations. A disabled worker may be able to perform a job with accommodations, but not under other circumstances.

Furthermore, an individual’s ability to work is not always considered during SSD claims. People may qualify as disabled by meeting requirements in the Social Security Administration’s “Blue Book” of impairments. People also may receive medical-vocational allowances, based on factors such as age, work experience and functional ability. Occasionally, people found disabled through either process might be capable of working in some capacity.

Concurrent claims

The Supreme Court ruled on this issue in 1999. The case involved an employee who suffered a stroke and associated effects that prevented her from working. She sought SSD benefits, but then her condition improved and she resumed work. The SSD application was denied. Days later, the woman was terminated for her job performance. She requested reconsideration from the SSA. Then, before the SSA approved the claim, she filed an ADA claim.

The Fifth Circuit Court held that the woman’s SSD application prevented her from pursuing an ADA claim. However, the Supreme Court reversed this decision and reached the following conclusions:

  • Sometimes, the same facts may reasonably support valid ADA and SSD claims.
  • The apparent contradictions between these claims are not strong enough to justify negative presumptions against claimants.
  • In these cases, claimants must reconcile any irregularities between their two claims.

If a claimant secures SSD benefits or wins an ADA claim, the outcome may impact the other claim. However, filing a claim within one system does not automatically invalidate a claim under the other system.

Understanding how SSD claims interact with other claims can be challenging. People who may have grounds for two claims should consider consulting with a Social Security attorney in Illinois. An attorney may be able to offer advice on potential complications and interactions between the claims.

 

New treatment could help ease seizures

pCoupleInDistress_7196060_sEpilepsy is a seizure disorder that arises from electrical disturbances in the brain. These seizures can cause uncontrollable movements, confusion and loss of consciousness. Epilepsy is incurable, and treatments to address symptoms are not always effective. As any Chicago Social Security attorney knows, epilepsy often adversely affects victims’ functional abilities and daily lives. Fortunately, epilepsy patients in Illinois may now find relief through medical marijuana treatment.

Possible benefits, complications

In 2014, Illinois lawmakers approved the use of medical marijuana to treat epilepsy, according to the Belleville News-Democrat. Adults and children who suffer from epilepsy may now legally use a special cannabis strain, Charlotte’s Web. This strain contains low levels of psychoactive THC and high levels of the cannabinoid CBD, which offers medical benefits.

The effectiveness of medical marijuana in treating seizures is unclear. Researchers have not clinically tested the efficacy of Charlotte’s Web. One study found that less than one-third of children who used this strain experienced fewer seizures. However, some anecdotal evidence indicates the substance may reduce seizures.

Unfortunately, some people may have difficulty accessing this treatment. State law requires one Illinois doctor to recommend medical marijuana before an adult can use it. Children need two recommendations. Many epilepsy patients see neurologists in neighboring states, who are ineligible to make recommendations. Local doctors may also hesitate to recommend the drug. Thus, many state residents with epilepsy may miss out on this new treatment.

Addressing disabling epilepsy

People who suffer from debilitating, unmanageable epilepsy may face challenges performing regular activities. If epilepsy precludes employment, victims may be eligible for Social Security Disability benefits. As a Chicago Social Security attorney can explain, victims must first meet financial criteria. Next, victims must prove they meet medical criteria. Victims may qualify for benefits in multiple ways, including the following:

  • Meeting the “Blue Book” listing for convulsive epilepsy. The listing specifies that seizures must occur monthly, despite three months of treatment. These seizures must occur during the day or occur nocturnally and produce daytime fatigue.
  • Meeting the “Blue Book” listing for non-convulsive epilepsy. Under this listing, seizures must occur at least once per week after three months of treatment. The seizures must cause unusual behavior, unconsciousness or other disturbances.
  • Receiving a medical-vocational allowance. If functional limitations associated with epilepsy prevent a person from working, the person may qualify for an allowance.

People seeking SSD benefits should provide extensive documentation. This includes treatment history, EEG results, descriptions of a typical seizure and confirming statements from physicians. Victims also must prove they have followed prescribed treatments. As any Chicago Social Security attorney understands, SSD benefits are not available if medication can effectively manage epilepsy.

 

Will federal lawmakers improve Social Security Disability or cut it?

pHandsShowingChart_shutterstock_156640544New rules could force changes to SSDI program

Social Security Disability Insurance provides essential support to many Chicago residents who cannot work due to disabling conditions. In December 2014, the Social Security Administration reported that over 8 million Americans under age 65 draw on SSDI. Unfortunately, as most disability lawyers in Chicago know, projections show the SSDI fund is depleting. The program could soon face significant cuts or reforms under the terms of a recent House rule change.

Coming shortages

The SSDI fund may be exhausted as soon as 2016, according to Forbes. If new funding is not secured, 9 million insured workers could face a 20 percent decrease in benefits. Additionally, 2 million spouses and 160,000 children who collect spouse’s or dependent benefits may see reductions.
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4 conditions that may automatically qualify for Social Security Disability

Disabled boy in walker in front of playground

Benefit approval likely for certain severe conditions

Any Chicago disability attorney knows that qualifying for Social Security Disability benefits is rarely certain, no matter how disabling a condition is. However, the Social Security Administration identifies certain medical conditions that are almost always debilitating enough to merit benefits. People who suffer from these conditions usually qualify “automatically” for benefits, provided they meet the SSA’s non-medical criteria.

Automatic medical approval

The SSA recognizes 225 Compassionate Allowances conditions, which qualify for benefits if they meet set medical criteria. The following four conditions are included in the list and commonly found disabling:

  • Early onset Alzheimer’s disease. Alzheimer’s disease causes irreversible changes to the brain, affecting memory, language and personality. In people younger than 65, the condition may significantly limit ability to work. The SSA accepts family history, onset history and cognitive examinations as evidence to support the diagnosis.
  • Muscular dystrophy. Muscular dystrophy causes irreversible muscle damage and can affect the eyes, lungs, heart or brain. Some victims experience muscle contractions or must use wheelchairs. The SSA recognizes three types of disabling muscular dystrophy and specifies acceptable medical evidence for each. Genetic testing, biopsies and immunostaining of tissue are potentially admissible tests.
  • Certain cancers. The SSA recognizes various cancers as disabling, including breast, bladder and liver cancer. Some cancers, such as head, neck and ovarian cancer, must spread or prove inoperable to qualify for benefits. Others, such as acute leukemia, qualify for benefits under any circumstances.
  • Heart transplant graft failure. Organ rejection after a heart transplant can cause heart failure, while the use of immunosuppressive medications to prevent organ failure can introduce adverse side effects. These include heightened risks of infection, cancer or kidney damage. The SSA requires MRIs and professional evaluation to diagnosis heart transplant graft failure.

These four conditions frequently qualify for SSD benefits; however, people claiming benefits for these conditions still must meet other SSA criteria.

Financial considerations

To collect SSD benefits, applicants must have sufficient earnings records. Typically, applicants need 40 credits, with 20 credits accrued over the last decade. However, the requirements vary based on age. Younger applicants need fewer credits. The amount of income that equals one credit changes annually. In 2014, $1,200 of income represents one credit. In 2015, $1,220 of income is worth one credit. Workers can only earn four credits per year.

Social Security benefits are not available to people who are engaging in substantial gainful activity. This is work with income exceeding $1,070 per month in 2014 and $1,090 per month in 2015. Work yielding lesser income may also be considered SGA, depending on the nature of the work. People engaging in SGA are ineligible for benefits, regardless of how serious their medical conditions are.

What is the SSA’s Blue Book?

Social Security Cards Representing Finances and Retirement

Guidelines for disability claim evaluations

The Social Security Administration’s book Disability Evaluation Under Social Security can play a decisive role in disability claims, as any Social Security attorney in Illinois knows. This book, commonly called the “Blue Book,” establishes medical criteria for Social Security Disability determinations. People seeking SSD benefits can use the book to understand how their claims will be evaluated.

Book structure and contents

The Blue Book is divided into several sections. The first section provides an overview of the SSA’s benefit programs. It explains the SSA’s definition of disability and the disability determination process. The second section establishes standards for acceptable evidence. The third section contains the list of impairments that the SSA recognizes as disabling.

The impairment listings are divided into two sections, for adults and children. The adult listings are divided into 14 categories or disease groups. These categories are typically based on the nature of the condition or the bodily system the condition affects.

Specific disabling conditions are listed under each disease group. A description of symptoms or functional limitations accompanies each listing. Objective tests or observations needed to document the condition and its effects may also be specified. The SSA automatically considers a condition disabling if it meets the severity and evidentiary requirements established in the applicable Blue Book listing.

Qualifying under a listing

If a person suffers from a listed condition and meets the relevant criteria, the person qualifies for disability benefits from a medical standpoint. However, this does not guarantee that the person will receive benefits. As the Blue Book explains, individuals also must meet other Social Security Disability requirements:

  • A person must have an adequate earnings record. People who have not paid enough money into the Social Security system cannot collect benefits, regardless of how disabling their conditions are.
  • The condition must be expected to result in death or last longer than a year. The SSA will not award benefits for short-term disabilities.
  • The condition must prevent the individual from doing work he or she performed in the past. The condition must also preclude the individual from adjusting to any new type of work.

People who do not meet the terms of a Blue Book listing can still qualify for benefits. However, they may have to provide additional medical evidence and personal information, including work history and educational background.

A person may “equal” a Blue Book impairment listing if his or her symptoms and limitations are equal in severity to those outlined in the listing. Otherwise, a person may qualify for a medical-vocational allowance. The SSA grants this allowance if a person’s remaining functional capacity is deemed too limited to support gainful employment.

How disability payments are calculated

pMarriedCoupleDoingBills_

Determining benefit awards

Seeking Social Security Disability benefits can be an arduous task, as any Chicago Social Security attorney knows. Before applying for benefits, many people in Illinois want to know how much support they may qualify for. Prospective applicants can start by understanding how base benefits are calculated and why those awards may be adjusted.

Benefit calculations

SSD benefits are awarded based on personal earnings records. Financial need and the severity of the disability are not taken into account. If an individual paid Social Security taxes during a job, the employment is included in the earnings record. Work for employers that do not pay Social Security taxes, such as government agencies, is excluded.

The SSA calculates an individual’s average monthly earnings to determine whether the individual qualifies for SSD benefits. In 2014, the SSA counts $1,200 of income as a credit and requires individuals to have 40 credits. Applicants also must have earned half of their credits during the decade before disability onset.

To determine the benefit amount, the SSA uses an income-weighted system. Several resources can help people estimate SSD benefits under this system, including:

  • Benefits calculators. These are available on the SSA website and allow individuals to enter earnings history to generate estimates.
  • Social Security statements. These are also accessible through the SSA website. Each statement includes an estimated benefits section, based on the SSA’s earnings record.
  • Direct contact with the SSA. Applicants can call a local office and get an estimate from a representative.

Besides using these resources to estimate base benefits, individuals may want to consider factors that could increase or reduce their benefits.

Variables affecting benefits

The benefit amount may be decreased if an individual receives other government-regulated disability benefits, such as state disability or workers’ compensation. Public disability benefits are capped at 80 percent of the individual’s income. However, other benefits, including private disability insurance and VA benefits, will not affect the SSD benefit.

Some individuals may qualify for greater awards in the form of back payments or retroactive benefits. Back payments cover the gap between the SSD application and approval dates. Retroactive benefits address the gap between the disability onset and application date.

The mandatory waiting period for disability claims is 5 months. Therefore, back payments are not made if processing took less than 5 months. Similarly, retroactive benefits are not available if the disability began within 5 months of the application date.

Retroactive benefits can cover up to 12 months before the date of application. However, the SSA assumes that the application date is the disability onset date. Establishing an earlier onset date can be difficult; individuals planning to challenge the onset date may need to seek assistance from an attorney.

Common mistakes found on Social Security Disability applications

Unemployed and divorced woman with debts reviewing her monthly bills

Potentially costly errors

Obtaining Social Security Disability benefits is often difficult, even for people in Illinois who suffer from seriously debilitating conditions. Mistakes during the benefit application process are a leading reason for claim denials. People who seek benefits without the help of a Social Security attorney may be especially at risk for making the following missteps.

Undermining credibility

The Social Security Administration evaluates how credible a claim is by considering the applicant’s work history, medical history, current activities and more. When applying for SSD benefits, applicants must not give the impression that they are capable of gainful employment.

Collecting unemployment benefits can hurt an applicant’s SSD claim. Unemployment benefits are awarded to people who can perform work but cannot find employment. SSD benefits are awarded to people who are physically incapable of substantial gainful activity (SGA), or work yielding over $1,070 per month, for a period of at least 12 months.

Similarly, people who are engaged in SGA when they file an SSD claim cannot qualify for benefits, regardless of how the disability affects ability to work. These people would need to reduce their hours or quit working to become eligible for benefits.

SSD applicants must provide records showing they have sought reasonable treatment for physical or emotional health problems. If an individual has not visited a doctor, the SSA may assume the condition is not truly disabling. Relatedly, if an individual has not tried all prescribed treatments, the individual cannot prove the condition is unlikely to improve. The SSA recognizes some valid reasons for failure to seek treatment, including:

  • Financial constraints
  • Religious beliefs
  • Adverse side effects of treatment

Outside of these circumstances, however, a lack of documented treatment can hurt an individual’s claim.

Staying with an unsupportive doctor is another common error. A doctor can provide statements that attest to a patient’s disability, which often act as decisive evidence. A doctor who is busy or doubtful of the disability may be reluctant to complete paperwork, supply records or dedicate adequate time to the claim. In this case, patients should see another doctor.

Filing mistakes

When filing for SSD benefits, applicants should document all disabling conditions. Many people experience mental health issues, such as depression, in conjunction with physical conditions. In some cases, the physical condition may not be severe enough to warrant benefits, but the physical and mental condition together may be considered disabling.

Finally, when filing or appealing a decision, many applicants assume they cannot afford or do not need a Social Security Disability lawyer. However, SSD attorneys work on a contingency basis; they only collect payment if benefits are awarded. Furthermore, working with an attorney can greatly lower an applicant’s risk of not receiving any benefits.