Maine Social Security Disability Lawyer

The Social Security Disability Lawyer Blog

Welcome. This site is written for Social Security disability claimants, their legal representatives, and the network of people involved in the disability claim process. For frequent updates, subscribe to the feed.

If you have a Social Security disability claim in Maine or New Hampshire, please contact Gordon Gates or ask for a free Social Security claim evaluation. 

Fibromyalgia - a Life of "Maybe"

A recent article, entitled A Life of "Maybe" With Fibromyalgia & Chronic Fatigue Syndrome notes that fibromyalgia patients live in a world of "maybes." Maybe you will feel all right on a given day, but maybe not. The "maybes" make it hard to maintain a job, a social life, relationships, you name it.

Living in a world of "maybes" is a good description of daily life with fibromyalgia.

In terms of a claim for Social Security disability benefits, Social Security Ruling 96-8p has these claimants covered. According to the Ruling, a person must be able to work on a regular and continuing basis, which means 8 hours a day, for 5 days a week, or an equivalent work schedule. 

If a claimant is unable to work on a regular and continuing basis, a finding of disability is appropriate. In my experience, many claims are granted for those with fibromyalgia on this basis, since there are simply too many "bad days" each month to sustain employment.

Disability Blog Roundup - 2/05

Here is a selection of recent articles from the Social Security disability blogs:

• It is no fun being disabled from the California Social Security Lawyer Blog published by Geri Kahn
• What medical sources are considered acceptable by the SSA? from the Social Security Disability Blog moderated by Jonathan Ginsberg
• 5 Questions About Social Security Answered from the Raleigh Personal Injury Lawyer blog published by Hardison & Associates
• Frequently Asked Questions About Disability Hearings Before Judges from the Personal Injury Social Security Disability blog published by Bob Kraft
• Appealing Social Security Denial Letter | Don’t Delay! from the Wisconsin Social Security Lawyer published by John Jokela
  

Failure to Follow Prescribed Medical Treatment

Every now and then at a Social Security disability hearing, the issue of failure to follow prescribed medical treatment is raised by the administrative law judge. 

You don't want this issue at your hearing. If a claimant has failed to follow prescribed medical treatment, and the prescribed treatment would restore the claimant's ability to work at the SGA level, then the disability claim will be denied. See 20 C.F.R. 404.1530.

An individual who would otherwise be found to be under a disability, but who fails without justifiable cause to follow treatment prescribed by a treating source which the Social Security Administration (SSA) determines can be expected to restore the individual's ability to work, cannot be virtue of such "failure" be found to be under a disability.

The issue of failure to follow prescribed medical treatment is addressed by Social Security Ruling 82-59. The Ruling is a must-read. It is important to know the details of the compliance analysis, because it can salvage a disability claim. Actual failure to follow prescribed treatment is narrowly defined; each of several requirements must be met before a denial on that basis is appropriate.

The requirements are: (1) the treatment must have been prescribed by a treating source; (2) the treatment at issue should be expected to restore the claimant's ability to work; (3) the treatment must have been refused; (4) the refusal must have been without justifiable excuse.

A doctor's recommendation (to stop smoking, or to lose weight, or to get more exercise) is not prescribed treatment. For more on evaluating failure to follow prescribed treatment in the context of obesity, see Social Security Ruling 02-1p at #14.

Portland, Maine Hearing Office Workload Data

The Social Security Administration just published current statistics regarding the workload of the hearing offices around the country, including the Portland, Maine hearing office. 

The Workload Data Report shows the Portland ODAR received 976 appealed claims in Fiscal Year 2010, disposed of 771 claims, and has 2,989 pending claims as of December 2009. That is a lot of pending claims. The current average processsing time is 320 days.

The NETSTAT Report shows "the average time (in months) from the hearing request date until a hearing is held for claims pending in the Office of Disability Adjudication and Review's hearing offices. Allows users to estimate the amount of time they may have to wait for a hearing to be held." A claimant should expect to wait 11 months for a hearing in Portland, Maine.

ALJ Disposition Data

The SSA has just released, and posted on its website, a goldmine of current statistics regarding the Social Security hearing offices (ODARs) and judges.

Check out the ALJ Disposition Data. These Fiscal Year 2010 statistics, which run through December 2009, are the most current available. Notably, the data includes the disposition statistics for new ALJs who have been under the radar until now. The list is alphabetical by judge. Just scroll down to find the ALJ you seek.

Disability Blog Roundup

Here is a sampling of the notable posts from the Social Security disability blogs:

• What’s new in Social Security in 2010? from Colorado Social Security Law published by Tomasz Stasiuk
• Importance of Specialist Care when Experiencing Chronic Pain from the Delaware Disability Law blog  published by Steven Butler
• How important is it for me to keep my Social Security file up to date with new medical records? from the Social Security Disability Blog moderated by Jonathan Ginsberg
• Can You Win a Disability Claim if You Have Little Medical Documentation due to a Lack of Health Care? from My Disability Blog published by Tim Moore
• Pain in Maine: Unemployment Leads to Rise in Disability Applications from the Disability Law Blog published by J. Kevin Morton

Maine and New Hampshire Processing Times

The latest statistics for average processing times for the Social Security hearing offices just arrived. The average processing time for the Portland, Maine hearing office stands at 327 days - just about 11 months. 

Processing time runs from the day the hearing office receives your hearing request to the day a decision is issued. The 327 days is an average. Some claims are resolved more quickly. A claim that goes to hearing and a written decision is likely to take longer.

In New Hampshire, the Manchester hearing office has an average processing time of 421 days - about 14 months. While this is 94 days longer than in Maine, New Hampshire is a prototype state that skips the Reconsideration step. Since months are not being lost in New Hampshire waiting for Reconsideration, claims are actually moving from initial denial to hearing more quickly than in Maine (where 4-5 months are lost at the Reconsideration step of the process).

Return of the Disability Blog Roundup

Back from its holiday hiatus, the Roundup returns! Here are some of the notable recent posts from the Social Security disability blogs:

• Sixth Circuit Says The DOT May Not Be Enough To Justify Denial from Social Security News published by Charles Hall
• I Have Breast Cancer, Why Was I Denied Social Security Disability Benefits from the Delaware Disability Law blog published by Steven Butler
• Substantial Gainful Activity in Social Security Disability from the Raleigh Personal Injury Lawyer Blog published by Hardison & Associates
• What are Social Security auxiliary benefits? from the Colorado Social Security Law blog published by Tomasz Stasiuk
• Social Security Disability and Age: It Does Matter from the Dallas Social Security Disability Attorney blog published by Stanley Denman

Going forward, the Disability Blog Roundup will appear here every other Friday.

SGA for 2010

The substantial gainful activity (SGA) amount for 2010 is $1,000 per month. You can see the SGA amounts since 1975 here.

The SGA determination is step 1 of Social Security's 5-step sequential evaluation. For Social Security disability or SSI, you must have (or expect to have) a 12-month period during which you do not have earnings at the SGA level.

If you are an employee earning more than $1,000 per month, you are probably not eligible for Social Security disability benefits. See 20 C.F.R. 404.1574. I say probably not, because other factors are considered, including IRWEs and UWAs. 

If you are self-employed, the test for SGA is a more complicated. See 20 C.F.R. 1575.

New Year's Resolution: Appeal Your Denied Claim

If you have a disability claim pending with the Social Security Administration, please make the following New Year's resolution: 

    I will appeal my claim immediately if it is denied.

Although you have 60 days to appeal a denied claim, there is no reason to wait. I speak with people almost every week who did not appeal their denied claims within 60 days, and then had to start over by reapplying for Social Security disability benefits.

If you receive a denial letter in the mail, it is a good time to talk with a disability lawyer about your options. But please be sure to appeal that denial right away. 

Happy Holidays

Our offices will be closed for Christmas Eve and Christmas Day, and for New Year's Day.

The Social Security Disability Lawyer blog will maintain a holiday schedule as well: no disability blog roundup on Christmas or New Year's Day. The Roundup will return on the following Friday, January 8th.

Best wishes for the holiday season!

OTR for Christmas

It is always a pleasure to call a client with the news that his or her Social Security disability claim has been granted at the hearing level with an on the record (OTR) decision. 

With the claim granted, there is no further wait for a hearing, and the inevitable stress from worrying about the outcome of the claim comes to an end. It is welcome news.

It is even better to make that call just before Christmas. I just made one such phone call, and it really does put you in the Christmas spirit.