Having a plan or strategy is very important to winning your Social Security disability appeal.
Judges
have very limited time to spend on a case. They are required to issue
up to 700 decision a year, or over 50 per month. One case may have
thousands of pages of medical records and other documents to review.
Your attorney or representative can help the judge, and your chance of
winning, by pointing out what the judge needs to know.
- Is this claimant insured for benefits?
- What kind of past work did the claimant do?
- Does he or she meet a Listing or grid rule?
- Are there any transferable skills?
- Does the medical record support the alleged onset date? If so, where?
These are things the judge must know to decide the claim.
A
good representative will read and analyze the medical records, which
are the foundation of every case. The important evidence will be
pointed out to the judge. Are there MRIs or imaging studies to prove
the alleged impairments? Where can they be found quickly?
Do
any of the treating doctors provide an opinion on the claimant's
ability to perform work-like activities? How do these opinions limit
the claimant's residual functional capacity?
Then
we come to the claimant's testimony. It's very important that the
claimant has been prepared and knows what to expect--and how to answer.
The testimony should match up with what the doctors say in the records.
Award
rates among Social Security judges are lower now than at any time in
the past 30 years. A lot of things have to line up and make sense for
the judge.
I
always provide the judge with a pre-hearing brief. That means that I
give her a step-by-step view of the case and why the federal regulations
allow benefits to be paid. The brief condenses hundreds (or thousands)
of pages of medical evidence into 3 or 4 pages that can be read in
about five minutes. So, I try to help the judge make efficient use of
his/her time.
A
lot of times I can answer difficult or technical questions for the
judge. This can also help to get a favorable decision out more quickly.
It's
risky to walk into a hearing and just hope for the best. Those kind of
hearings often don't go well for the claimant. It's much better to
have a legal roadmap of where you want to go and how to get there.
That's worth paying the attorney/representative a fee when your case is
successful.
So,
talk to a representative early in the process. I think most people who
appoint me to represent them decide after just a few minutes that I can
add value to their case. I have to think so, too, or I won't take the
case. The best of all worlds is when the claimant and representative
work well together as a team.
______________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike NW, Site 108
Huntsville, AL 35806
"Across from Bridge Street"
CALL (256) 799-0297
https://forsythefirm.wixsite.com/website
Attached to a new 1.3 trillion dollar spending bill, Congress provided a $480 million increase in Social Security's budget. The hope is that this will reduce the backlog in disability claims, now forcing the average applicant to wait 600 days for a judge to decide if they can get disability benefits or not.
In fiscal year 2017, 10,000 people died waiting on Social Security to make a decision. Claimants are encouraged not to work after they apply for disability--because working may cause a judge to believe the claimant is not disabled. Therefore, many claimants go without essentials. Many lose homes, cars, health insurance, life insurance, even their marriage.
$100 million of the increase will target reducing the disability backlog by hiring more judges and support staff. $280 million will go to updating information systems, allowing judges and staff to work through cases faster.
While $480 million may seem like a lot of money, advocates who work with the disabled say it's a drop in the bucket.
Social Security has gone for 10 years without any real increase in its budget. At least, the new appropriation may keep the wait from getting longer and longer.
_____________
The Forsythe Firm
Social Security Disability Advocates
7027 Madison Pike - Suite 108
Huntsville, AL 35806
Call us for a free consultation
(256) 799-0297
Update: 2/24/20. I am happy to report that the wait time to get a hearing in north Alabama has been greatly reduced. We are no longer waiting 2 years for a hearing. Often, we get scheduled in 5 to 8 months after the appeal is filed. Good news for claimants.
I recently had a hearing before a judge who asked my client, "Why are you not able to work?" My client replied, "Because of depression." The judge said, "Everyone tells me that."
Judges hear from so many claimants who say they are depressed that they (the judges) often dismiss it. But when does depression translate into a disability?
The answer is--when symptoms become severe enough to interfere with the ability to perform the functions of the workplace.
Every job has certain functions that require mental abilities. These include, but are not limited to:
- remembering, understanding and completing simple instructions
- making simple work related decisions
- adjusting to routine changes in the work environment
- responding appropriately to supervisors, co-workers and the public
- Maintaining concentration, persistence and pace
Depression, anxiety and other mental disorders can interfere with the ability to work. However, these severe limitations must be documented by medical evidence. Here is what Social Security decision makers want to see:
- Treatment by a qualified mental health professional (psychologist or psychiatrist)
- Compliance with recommended treatment (take your medications)
- Preferably, a Treating Source Statement from your doctor, specifying restrictions you would have in a work environment.
The question is not whether you are depressed. The question is how will depression restrict your ability to work on a "regular and continual basis?"
__________
THE FORSYTHE FIRM
Social Security Disability Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
Call for a Free Consultation
(256) 799-0297
SOCIAL SECURITY JUSTICE - WEBSITE
If Social Security denied your claim for disability benefits, there is a high probability it was a mistake.
How do I know this? Because at least one-half of these denied claims will be paid when reviewed by an appeal judge.
When you apply for disability, Social Security sends your file to a state agency called the Disability Determination Service (DDS). Nobody at DDS ever sees you. In most cases, no doctor examines you. Quite often, no doctor even reads your medical file. A decision that you "do not meet our rules for disability" of often made by a non-medical professional (a clerical worker, basically)--called a "Single Decision Maker" or SDM.
When your case gets to an appeal judge, the opinion of the SDM is entitled to no weight. If you can present medical evidence that would reasonably restrict your ability to work, your claim is likely to be paid at the appeal level.
Since the opinion of the agency's Single Decision Maker is entitled to no weight legally, the opinion of your doctor may then be the only opinion in your file. If so, your doctor's opinion should be "of great weight." If I were handling your appeal, I would seek to obtain evidence from your treating physician(s) that demonstrates your inability to perform work activities "on a regular and continual basis," the Social Security requirement for disability.
Here's the bottom line: If Social Security denies your disability claim, appeal immediately. Your chances just get better with the appeal.
Remember, there is a strict 60 day deadline to file the appeal.
Unfortunately, I see cases regularly that could have probably won on appeal--but the claimant failed to appeal within the deadline. Failure to appeal in a timely way may cost you to wait months or years while you file a new application and wait for it to go through appeals. In some cases, failing to appeal a claim leaves you in a position in which you cannot even file a new claim because your "date last insured" has expired.
Don't Delay. Appeal Today.
Your odds just get better when you appeal.
In fact, your odds are about twice as good on appeal compared to the original application level.
THE FORSYTHE FIRM
Social Security Disability Representation
"Free consultations - No fee unless you win"
Huntsville, AL
Call Us (256) 799-0297
SOCIAL SECURITY JUSTICE - WEBSITE
Being disabled means different things to different people. To get a benefit from the US Government, however, you must meet their definition of disability.
For non-blind individuals below the age of 50, being disabled according to Social Security means not being to perform any job that exists in the United States economy.
Further, a claimant must show that this disability has lasted, or is expected to last, 12 consecutive months OR to end in death. So, no short term disability benefits.
You can see the bar you have to jump if you are not yet 50 years old--and high the bar is.
Let's take the case of Larry. He is 47 with a high school education. Larry has worked for 12 years as a construction foreman, on his feet all day, lifting up to 50 pounds frequently and up to 75 pounds at times. His doctor has diagnosed degenerative disc disease in the lumbar spine, causing moderate central canal stenosis and radiating pain into the hips and legs. The doctor has restricted Larry to lifting no more than 20 pounds occasionally. He also restricted Larry to standing/walking no more than 4 hours per day. So, his last work cannot be performed.
Up until 12 years ago, Larry worked as a counter sales associate for a wholesale plumbing supply store. Here, he lifted no more than 10 pounds frequently and 20 pounds occasionally--but was on his feet 6 to 8 hours per day.
Social Security denied Larry's claim for SSDI benefits. He appealed and took his case before an administrative law judge. Here is what the judge decided:
Larry cannot perform one of his "past relevant jobs." He cannot perform the work as a construction foreman. However, this does not make Larry "disabled" under Social Security rules. What about the other job as a plumbing sales associate?
The judge found that Larry is also unable to perform his past job as an inside plumbing sales associate because he would need to sit about once an hour due to back pain and he would not be able to stand/walk for the 6 hours required each day in that job.
So, Larry cannot perform any of his past relevant work? Is he disabled? Not according to Social Security.
Because Larry is under age 50, there is one more step. Are there any jobs in the national economy that Larry would be able to perform? (Whether Larry can find one of this jobs is not considered).
The answer is, Yes, Larry can perform some jobs at the sedendary exertion level. These are jobs that can be performed mostly while sitting--needing to stand/walk no more than about 2 hours out of an 8-hour day. The vocational witness gave 3 examples of jobs that Larry can do:
Also, the judge found that
Your doctor's opinion is the most important evidence in your Social Security disability application or appeal. It is more important than medical records, consultative reports, statements by friends or even the opinion of Social Security's own doctor.
Especially if you are headed for an appeal of your disability benefits, your doctor's opinion is essential and vital. Some things you should know:
1) Social Security will not request your doctor's opinion. You or your representative must do so on your own initiative.
2) Social Security may send you to one of their consulting doctors for an examination. Usually, it isn't worth the paper it's written on. It is most often used to deny your benefits.
3) You doctor's opinion must meet certain evidentiary requirements. The doctor may not ssimply say that you are disabled or that you aren't able to work. The doctor must gives the specific reasons why you can't work in functional terms: limitations in sitting, standing, walking, lifting, bending, concentrating, remembering, understanding, etc. Only Social Security can reach the decision that you are disabled. There is a form I like to use for doctor's opinions.
WHY YOUR DOCTOR'S OPINION IS SO IMPORTANT
1) It may be the only opinion in your file. If so, it is the opinion Social Security will probably rely on to decide your case. If you were denied, many times the decision to deny benefits was made by a "single decision maker" or SDM. This is a Social Security employee who is not a doctor. In a hearing or appeal, her opinion cannot even be considered. However, your doctor's opinion will be considered.
2) Your own doctor has examined and treated you; therefore, is in the best position to understand your conditions, symptoms and limitations. Even if Social Security sends you to one of their consulting doctors for an exam, it is a one-time encounter with a doctor who has never seen you before. It will last 20 to 30 minutes. This is a very limited exposure to a doctor who knows nothing about you. Your doctor's opinion is worth a lot more weight.
3) Most judges value the opinion of a doctor who has treated you over a long period of time, as opposed to one who only saw you once. A lot of judges will ask the attorney/representative, "Do you have any opinion evidence form a treating doctor?" They look for it because they know that a treating doctor knows the claimant's symptoms and limitations.
Judges will vary in their preferences and, while they follow the same set of rules, will conduct hearings differently. Your representative will know what evidence to present, how to present it and how to most effectively argue your case. ("Argue" here means to "present" or "make a case for...").
If you are a member of the armed forces, or a recently disabled veteran who needs Social Security disability benefits, please contact my firm in Huntsville. We will work closely with you to gather medical evidence and opinions, develop your case and present it to the proper authorities for a resolution.
We will never ask you for money.
When your claim is decided in your favor, Social Security will withhold the fee you have agreed to pay us and send it to us directly--based on the amount of your back pay. If you do not receive back pay, there will never be a fee for any service we provide.
Social Security Justice - Website
Call US: (256) 799-0297
Veterans or disabled military personnel get denied for disability benefits for the same reasons other people get denied.
1) The state system which makes disability decisions uses a flawed process that denies up to one-half of all applications erroneously.
2) The initial decision making process errors on the side of Social Security. They assume there is too much fraud and abuse in the system, so they are overly skeptical--even of legitimate claims.
3) Their attitude seems to be: Deny the claim, let a Social Security judge sort it out.
WHAT CAN YOU DO?
Appeal the denial as soon as possible but absolutely within 60 days of the decision notice. After that, you lose appeal rights.
Get a professional to walk you through the appeal and hearing process. It is a legal process where you must prove that Social Security made a mistake and you are legally entitled to benefits. It is complicated.
Submit additional medical evidence that the original decision makers may not have seen. This will include more recent medical records and, especially, opinions from your treating physicians. Your attorney or advocate knows exactly what the appeals judge needs/wants.
Prepare well for your hearing. Your advocate/attorney is instrumental in this preparation because he/she has attended hundreds or thousands of these hearings and knows the ropes.
Take advantage of any regulation that helps you (a) get an earlier hearing and (b) allows you to collect maximum back payments. For example, a veteran with a 100 percent permanent, total VA disability rating can qualify for expedited processing which saves months or years. However, you must petition for this and submit documentation.
The Forsythe Firm here in Huntsville is experienced with veterans/military claims. We will provide a free consultation and assist qualified claimants with no upfront cost and no fee until approved and paid. We are located next to Redstone Arsenal, Gate 9, at the intersection of Old Madison Pike and Governors West (directly in front of Bridge Street). It would be our pleasure to assist you.
______________________
The Forsythe Firm
Social Security Disability Advocates
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE FOR VETERANS
FREE CONSULTATIONS PAY US ONLY IF YOU WIN!
US military personnel may get expedited Social Security disability payments if they are disabled while on active duty. They may submit applications prior to leaving active duty under certain circumstances.
If a member of the armed forces or a veteran has a 100 percent permanent and total disability rating from the VA, Social Security will grant expedited processing of claims.
The Forsythe Firm has experience when it comes to dealing with these claims. We offer free consultations and we never charge a fee unless your claim or appeal is settled favorably and you receive back payments. There are no upfront payments to us.
Our office is located in Research Park near Redstone Arsenal, gate 9. We are directly in front of the Bridge Street Town Centre.
Please call us for a free appointment.
(256) 799-0297
https://forsythefirm.wixsite.com/website
You can get free legal representation for your Social Security disability claim or appeal.
"Free" as in no upfront cost, no charge for a consultation, and a guarantee of no fees ever unless you win and collect back pay from Social Security.
What does this representation include?
- Filing a complete, error free application
- Assistance in gathering medical records
- Correspondence/mediation with Social Security
- Answering all your questions
- Filing an appeal if required
- Preparing for the appeal hearing
- Attending the hearing as your representative
- Making sure you get full benefits and back pay.
We handle Social Security cases from all over Alabama and middle Tennessee. We will sit down with you in our office, prepare your application and forms and stay with it during the long process toward a decision. If we represent you, we cover all expenses--such as buying required medical records and doctor's reports--until your claim is favorably settled.
Call us here in Huntsville for a free, local consultation.
The Forsythe Firm
Social Security Disability Representation
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
"Across from Bridge Street"
https://forsythefirm.wixsite.com/website
You
have a Social Security hearing coming up on your disability claim. You
approach your doctor about filling out a form to support your claim.
The doctor is busy but offers to give you a letter, instead. Here's an
example of a doctor's letter:
"Mr.
Joe Claimant has been a patient of mine for over 20 years. He suffers
from back pain, migraine headaches, high cholesterol, high blood
pressure and depression. In my opinion, Mr. Claimant is not able to
work and is fully disabled." Signed [John M. Doctor, MD].
Why Social Security judges will probably ignore this letter?
The letter draws a conclusion that only the Commissioner of Social Security is able to reach, under the law. (20 CFR 404.1527).
Doctors
are not permitted to decide who is disabled under the federal
regulations. The fact that your doctor believes you are disabled is not
dispositive.
It
would be far better if your doctor specified why you cannot work. For
example, if he provided your restrictions on such activities as sitting,
standing, walking, bending, lifting, crawling, kneeling, crouching,
paying attention, remembering, etc. Doctors are permitted to assess your
individual functional limitations, but not to draw conclusions about
whether you are disabled.
There
is a form that I like to use for doctors. It's called a Medical Source
Statement. Some people call it a Residual Functional Capacity form.
It nearly always carries more weight with Social Security decision
makers, especially judges, than letters do. The reason is obvious: the
form keeps doctors away from drawing conclusions and allows them to
estimate functional restrictions, according to Social Security
regulations.
I will provide this form free to anyone requesting it.
___________
THE FORSYTHE FIRM
Social Security Disability Representatives
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
https://forsythefirm.wixsite.com/website
