This is just a post to update you on what I have been doing, and to inform you of new content being added to my site. I have recently completed my latest Social Security disability newsletter and it will go out on Monday. This is the first newsletter I have sent out in some time due to my caseload and frequent traveling for hearings out of state. The newsletter will go out on Monday so if you have not done so already feel free to sign up to receive it. I have also been working on a sample favorable and unfavorable decision that you would get from an ALJ at the hearing level of your Social Security disability claim.  I plan to add this to my website so you can see what a decision from a judge looks like and how they are written.  I have also recently added to pages on individual states and a section on cancer and SSD. I have also recently written on my other blog about how the hiring of new ALJs and other employees at the hearing level have not reduce the wait times due primarily to the increase in number of claims. The increase in the number of claims is due both to the baby boomer population and the rising unemployment rate. However, the steps SSA is taken to reduce the backlog has at least been able to keep the processing time (500 days avg) the same as it was last year despite the increasing claims. Remember to check back as I am always adding new updated information to this website so make sure to bookmark it. As always I wish you luck with your SSDI or SSI claim.

Even though Social Security is only supposed to send you to an exam by one of their doctors if the evidence provided by your own medical source is inadequate to determine disability and if additional information that is required is not received from your treating doctor, most SSD and SSI cases will include an exam by at least one consultative examination paid for by the Social Security Administration. Sometimes these exams may help to prove you are disabled, however, in my experience, most of these exams tend to be less favorable to your claim then reports received from treating doctors. This is why it is so important for you to get your treating doctor's medical records and an opinion by way of report or RFC form as to your limitations from your medical condition. If SSA has an opinion of your limitations from their own doctors and none from yours, chances are they will evaluate your claim based on the consultative examining doctor's opinions about your condition. These exams are supposed to be done by doctors with the appropriate medical specialty for your medical condition. However, it is always a good idea to check the credentials of the examining doctor to see if they have assigned an appropriate doctor for your medical condition. If the Dr. examining you has a specialty that does not pertain to your medical condition this can be valuable information for you to use to discount or minimize the impact of unfavorable medical report from a consultative examiner. The report from the CE should include your main complaints, a history of your medical condition, a description of his findings based on his exam, history and laboratory tests. A CE should also include the results of any tests performed, a diagnosis and prognosis and a statement as to what you can still do despite your impairment. Many of these exams are lacking particularly in the area of showing your limitations from your medical condition. A CE may be ordered at any stage of the process. Your best defense against a CE unfavorable to your claim is an opinion by your treating doctors that support your disability. If your treating doctors opinion is supported by the medical evidence it is supposed to be given more weight than that of the Social Security Administration's CE exams. The weighing of your evidence by the adjudicator of your Social Security disability claim is an extremely important part of the process and is evaluated by the decision makers in your claim for benefits.  One note I would like to make is that a letter from your doctor that simply says "you are totally and permanently disabled" is not sufficient.  I can not tell you how many times I have heard from people that they can not understand how they lost because their doctor sent in a letter saying they are disabled.  You need a full report supported by the medical evidence in the file that explains your limitations that would prevent you from working. 

If you apply for Social Security disability benefits and receive the denial try not to become too discouraged. SSA has several layers of appeals. If you lose at application you can appeal the decision and new people will look at your claim with any additional evidence you submit and make a new determination. This is called the reconsideration stage and if you lose at this stage, which is highly likely given the average denial rate is anywhere between 80 and 90% you can then request a hearing. At the hearing stage a decision will be made by an administrative law judge. One advantage of having a hearing is that you will have an opportunity to testify and tell your story of why you are disabled. Social Security Disability cases are usually much more developed at this stage as well. Even if you lose at a hearing you still have an opportunity to appeal again. This is called requesting a review from the Appeals Council. Their job is to look at the decision the ALJ made and determine if the decision was proper under the law or  if some mistakes were made by the ALJ. You can win at this level, but most times your request for review is either denied or they send it back for a new hearing with instructions. Lastly, if you are denied review by the appeals Council you have the option to file a suit in US District Court. In all of these appeals you have 60 days from the date you received the decision to request an appeal. Social Security will assume that you received your decision five days from the date of that decision. If you miss the deadline and have good reason for doing so you may be granted an extension to this time limit. At all of these levels it is important to know that all appeals must be in writing. This is very general information and I go into more detail about each of these levels of appeals in this website. Remember, the quickest way to be denied your SSDI or SSI claim is to not file your appeal in time.

When you are awarded your Social Security disability benefits many of you are surprised to find out that you have to wait two years and five months from the date Social Security found you became disabled to get your Medicare benefits. This is called the 24 month waiting period. This means that you must have been receiving benefits for 24 months before you are eligible for Medicare. The additional five months is the five month waiting period from the date you are found to be disabled that you do not get benefits for. In the House of Representatives and the Senate there are presently bills to get rid of this waiting period for individuals with life-threatening conditions. In addition these bills if passed would slowly get rid of the 24 month waiting period over the next 10 years. The plan calls for the waiting period to be reduced to 18 months starting in 2010 and will be reduced two months each year until the year 2019. So if the bills are passed it would mean by the year 2019 there would no longer be awaiting period for Medicare. The way the law is now there is only two situations in which the waiting period does not apply. It does not apply for disabled claimants with end-stage renal disease and for those with Lou Gehrig's disease. It is expected that Social Security would make a list of conditions that would not be subject to the 24 month waiting period. Those of us who practice Social Security disability law know the hardships that many of our clients face in getting medical treatment while waiting for their Medicare benefits to begin. Hopefully, this new legislation will carry through and solve this very difficult problem for those who win their Social Security disability benefits. This should not be confused with Medicaid which is granted right away in most states for individuals granted SSI disability. It will be interesting to see if the legislation is passed as it has been introduced or if it will be changed or voted down altogether. I have never been able to understand why this waiting period exists in the first place. If the waiting period were eliminated many disabled individuals would be able to get proper treatment for their disabilities which may even lead to more people on disability being able to go back to work in a quicker period of time due to better medical treatment before it is too late. This information comes from the NOSSCR Forum.  NOSSCR is one of the groups supporting this bill to help get the 24 month waiting period for Medicare eliminated for Social Security disability claimants.

Recent statistics show that most Social Security disability cases that win at application or reconsideration are those cases that meet or equal a listed impairment. In fact 58% of claims that win at these stages are found to meet or equal the listings. That means that of all the Social Security disability claims that win before a hearing only 42% do not meet a listing.  The medical listings are set up into categories of impairments that have strict criteria that need very specific medical findings that must be supported by the record and a doctor's opinion. SSA decides if a case meets or equals a listing at step three of the process. If they find that you do not meet a listing then they will next determine whether you can perform any of your prior work in the past 15 years. If they find that you cannot perform your past work you then move to step five of the process. At this step they take into consideration your age, education and past work experience to determine if there is a substantial number of other jobs you could perform.  The types of cases most found to meet or equal the listings before a hearing in a Social Security disability case are those with mental disabilities. The second most common disability to meet the listing at this stage is the cancer listings. The third most common is those with neurological disorders. So do not be discouraged if you do not win at application or reconsideration because it can be very difficult to meet or equal a listed impairment. The listings are set up to be difficult to meet because one is found disabled based only on the medical records and doctors opinions without consideration to the other factors such as your age education or work experience. The good news is that when you have a hearing you have an opportunity to tell your story of how your condition limits you. Credible testimony from a claimant in a SSDI or SSI hearing can go a long way in proving your disability at the hearing level. You also may have favorable expert testimony and a lawyer to present your case before the judge.  The above statistics are from an SSA audit report dated March 2009 from the office of Inspector General SSA.

The NOSSCR conference is this week, which is a Social Security Disability lawyers seminar and I look forward to reporting back any information I learn while attending this conference. Some topics that will be covered at the seminar, and reported on in my website, will be the new changes to several of the medical listings of impairments. It will including the changes in regards to inflammatory arthritis, HIV and the changes in the child's SSI listings. Much of this information I have already updated on in this website, but after the conference I hope to have new insight into these changes so that I can keep you informed of the latest developments. It is always my goal in this website on Social Security Disability to update it as frequently as possible and provide you with recent relevant content. I am also looking forward to attending a session on the recent developments in the case law for the years 2008 and 2009. I have also not sent out a newsletter in quite a while due to the large amount of work I have had to do my practice. But it is my intention to get out of newsletter this week as well. If you have not signed up for my newsletter please do so. I include in this newsletter relevant information on SSDI and SSI claims, what is new in SSA law, and helpful tips on how to give yourself the best chance to win your SSD or SSI claim. I also plan to add additional information to my website regarding the increase funding to the Social Security Administration and how that money is being spent. I will be focusing on SSA's plans to open additional offices and hire new employees. I will provide where these new hearing offices are going to be opened and when they will be opened. So bookmark the site because you may want to check back soon and check your states page to see if they will be adding any new ODAR offices in your area. These new ODAR offices are being opened to help reduce the backlogs in some of the most backlogged states. I reported earlier about the opening of two new national hearing centers and there is plans for more. I would also like to take this opportunity to wish all mothers a happy Mother's Day. As always, I wish you luck in your Social Security Disability and SSI claims.

Almost all Social Security disability lawyers charge 25% of past due benefits not to exceed $5300. The $5300 cap will be going up to $6000 in June. What this means is that your lawyer only get paid if you with your case and he will get the lesser of 25% or the cap amount. However, in most cases you will also have to pay for the cost of obtaining any medical records and reports from your doctors. Most medical facilities charge anywhere from nothing to about a dollar a page. Reports and residual functional capacity forms can sometimes be obtained free from your doctor, but oftentimes the doctors will charge for the time spent in preparing these documents. There are a few things you can do to reduce the costs of getting medical records. First, you can have social security send for your medical records. However, do not expect them to send for specialized reports or residual functional capacity forms, and it is a good idea to check with them to make sure they received the medical records you told them about. Since SSA will normally not send for these reports or forms you will either have to pay for them or speak to your doctor and explain your financial situation and, hopefully they will do this for you at a reduced cost or for free. Keep in mind that a doctors time is valuable and many doctors are not willing to do reports or forms without getting paid. If you have a good relationship with your doctor, the best way to get these reports and forms as cheaply as possible is to set up an appointment with them and bring the forms with you to that appointment so they can do whatever evaluation is necessary and get paid for their time. Although getting reports and forms filled out by her doctor can sometimes be expensive, they are well worth it in terms of giving you the best chance to win your case. Without reports or residual functional capacity forms filled out by your treating doctors then you will have to rely on what the Social Security doctors feel your limitations are based on the medical evidence in the file. Even though the Social Security doctors are supposed to give an unbiased and fair assessment of the limitations, chances are your treating doctor who is much more familiar with your situation, will in most situations show limitations greater than those found by the SSA doctors. Keep in mind, that although getting reports and forms filled out by your treating doctors can sometimes be expensive if you win your case it will by far outweigh the costs in getting these documents. A lawyer is helpful in that they can explain to your doctor what Social Security is looking for in an opinion from them. A simple letter from your doctor saying that you are permanently and totally disabled is practically useless in a Social Security disability case. SSA wants to know your diagnosis, treatment and how your medical conditions limit you from being able to work.