Maine Social Security Disability Lawyer

There is No Partial Disability for Social Security

I get inquires regarding partial disability every now and then. Potential claimants believe they may qualify for partial Social Security disability benefits. They could still work a bit, but can no longer do the same job, or earn the same income, they earned before.  Or perhaps, due to their medical condition, their earnings have dropped significantly because of lost time at work.

The Veterans Administration awards partial disability. And often in workmen's compensation claims, you will see a doctor's opinion that the patient has a certain percentage disability. But these are generally medical-based findings. A Social Security disability determination also has a vocational element.

With Social Security disability, it is all or nothing. Either you can work or you can't. If you are working and earning wages more than $1,000 gross pay per month (that's substantial gainful activity for 2010), then you do not qualify for disability (there are some limited exceptions, such as Impairment Related Work Expenses; so if your income is very close to $1,000 per month, do not assume that you can't qualify for disability; talk to a Social Security disability lawyer). There is no partial disability for Social Security.

When Social Security assesses your ability to work, they must assess your ability to work full-time, on a regular and continuing basis. So this "all or nothing" approach can benefit certain claimants, who may retain an ability to work part-time. Those claimants are still eligible for full disability benefits.

Representation for an Initial Disability Claim

This question brought a reader to my blog recently: Can a lawyer represent a claimant for a Social Security initial determination? 

The answer is yes. You do not have to wait until you receive a denial letter to seek the help of an attorney. 

There are some good reasons to get a lawyer involved early in a claim for disability benefits. In my view, it is particularly important for claimants over the age of 50 to have help when applying for Social Security disability benefits.

Is a GAF Score of 65 Too High?

Every now and then I see a claim involving mental impairments where the GAF score assessed in the clinician's treatment notes is higher than you want to see as a disability lawyer. 

A GAF score of 65, for example, normally would not denote a disabling mental impairment. However, most of the GAF scores in a disability case are assessed in periods when claimant is not working. The GAF score would not necessarily remain as high should the claimant attempt to work.

This reasoning is recognized in Social Security's regulations and rulings. 20 C.F.R. Part 404, Subpart P, Appendix 1, § 12.00C3 states:

We must exercise great care in reaching conclusions about your ability or inability to complete tasks under the stresses of employment during a normal workday or work week based on a time-limited mental status examination or psychological testing by a clinician, or based on your ability to complete tasks in other settings that are less demanding, highly structured, or more supportive.

Social Security Ruling 85-15 states, in part:

The reaction to the demands of work (stress) is highly individualized, and mental illness is characterized by adverse responses to seemingly trivial circumstances. The mentally impaired may cease to function effectively when facing such demands as getting to work regularly, having their performance supervised, and remaining in the workplace for a full day. A person may become panicked and develop palpitations, shortness of breath, or feel faint while riding in an elevator; another may experience terror and begin to hallucinate when approached by a stranger asking a question. Thus, the mentally impaired may have difficulty meeting the requirement of even so-called "low stress" jobs.

First Circuit case law echoes this conclusion. See Lancellotta v. Sec'y, H.H.S., 806 F.2d 284 (1st Cir. 1986), which cites Ruling 85-15 and notes its requirement for an individualized consideration of the claimant's reaction to the stress of the workplace.

In summary, a GAF score of 65 is not what you want to see as a Social Security disability attorney for a claim relying principally on mental impairments. But it is not the end of the world, and the GAF score should be put in a proper context for the U.S. administrative law judge deciding the claim.

Timeline for Your Social Security Claim

I am frequently asked about the timeline for a Social Security claim. How long does it take?

The initial consideration of your claim usually takes 4-5 months. If your claim is denied and you appeal,  the next step depends upon where you live. 40 states, including Maine, use an intermediate Reconsideration step in the claim process. In 10 "prototype" states, denied claims proceed directly to a hearing by an administrative law judge.

For states with Reconsideration, that process usually takes another 4-5 months. Claims that are denied at Reconsideration and are appealed will go to a hearing.

The wait time for a hearing varies dramatically in different regions of the country. In Maine, the average processing time is just about 9 months, which is a country-leading performance. In other parts of the country, average claim processing times are significantly longer, and can be as long as 24 months.

Tip: To shorten your wait, appeal a denied claim right away.

Social Security Disability - Quarters of Coverage

Social Security disability is an insurance policy, and you gain that insurance coverage through the Social Security taxes that you pay when working. Social Security counts each quarter that you work as 1 credit.

How long do you have to work before you are initially covered for Social Security disability? It depends upon your age.

Before age 24, you need just 6 credits earned in the 3-year period prior to the onset of your disability.

Between age 24 and 31, you need to have credit for working half the time between age 21 and the onset of disability. For example, if you become disabled at age 27, you would need credit for 3 years of work (12 credits) out of the past 6 years (between ages 21 and 27).

Age 31 and older, you need to have earned 20 credits within the 10 years prior to the onset of disability. Further, you must have the total number of credits shown in this table.

Question Regarding On the Record Requests

This search query brought a reader to this site today: how strong does your case have to be to request an on the record decision?

An on the record request asks Social Security to grant your case "on the record" without a hearing. This request is for claims awaiting a hearing at Social Security's Office of Disability Adjudication and Review (ODAR).

An on the record (OTR) decision can only be fully favorable. You cannot lose your case on the record. Rather, if the OTR request is denied, your claim simply goes back in line for an eventual hearing.

Your claim should be clear cut for a good chance at an OTR decision. A strong case would have not just strong medical evidence, but also clear evidence of your functional limitations. If it is clear from the record that the five-step sequential evaluation process would yield a finding of "disabled," then an OTR request is a good idea. It also helps if DDS made an error in its earlier decision.

One group of claimants that are good candidates for OTR requests are those who are over the age of 50 (or better yet, over the age of 55), are clearly unable to perform their past relevant work, and are limited to unskilled work. Social Security's Medical-Vocational Guidelines direct a finding of "disabled" for such claimants, so an OTR decision is a strong possibility.

Of course, a Social Security attorney can help you with an on the record request.

Should I apply for Social Security Disability?

I am asked this question on a regular basis: Should I apply for Social Security disability benefits? 

People who unable to work and are thinking about filing a claim for disability benefits will often contact me. They don't know how the Social Security system works, and perhaps they have heard some horror stories about the disability claim process. So they call me.

I enjoy these conversations, because they are very helpful to the people who call. We talk for a while, and I ask the caller some questions. A typical conversation goes something like this:

Are you working now? No.

When was the last time you worked? June of 2008.

What is keeping you from working now? The caller describes his or her impairments.

Are you being treated by a doctor? Yes. We talk more about the doctor(s).

What kind of work did you used to do? The caller tells me, and we talk about the types of work he or she has done in the last 15 years, and whether the person ever had a "desk" job.

How old are you? The caller tells me.

For callers under age 50, I describe the requirements of sedentary work. Could you do a sedentary job? I don't think so.

At this point, depending upon our conversation, I have usually learned enough to evaluate the claim under Social Security's sequential evaluation process. I often tell the caller: You should apply for disability benefits.

We then discuss the different ways to apply for disability benefits (in person, by telephone or online), and what to expect from the Maine Social Security claim process or the New Hamsphire Social Security claim process (they are actually different).

If you live in Maine or New Hampshire, I would be happy to have this conversation with you. You can call me, or you can complete the free evaluation form, and I will call you. 
 

Attorney fees

I am frequently asked questions about attorney's fees from prospective Social Security disability clients. This is understandable. Many claimants are unfamiliar with the contingency fee arrangement used for Social Security claims. Some are concerned that retaining an attorney will cost them money at a time when they are not working and need every penny.

To explain how attorney fees are handled in Social Security disability claims, I have added a new About Attorney Fees page to this blog. A permanent link to the new page has been placed in the "Important Topics" section on the sidebar.

For more on attorney fees for Social Security disability claims, you can read the SSA's description of the fee agreement process. Additionally, Wisconsin Social Security attorney Donald Chewning has a recent article on the topic.

A Medical Source Statement Helps with Social Security Disability

This question brought a recent visitor to this blog: Does a medical statement from my doctor help with social security disability?

The short answer is YES! A medical source statement from your treating physician regarding your functional limitations is usually the most powerful evidence available for a Social Security disability claim.

It is not just common sense that your treating doctor knows you best. Social Security regulations (see 20 C.F.R. 404.1527(d)(2) and Social Security Ruling 96-2p) state that your doctor's opinion, in ordinary circumstances, is more important than the opinions of other doctors who may have examined you just once, or not at all.

A medical opinion from the treating doctor is so important that when I receive one, I write a handwritten note to thank the doctor for taking the time to complete the medical source statement. I actually have special stationery for this. I want to let the doctor know just how important the opinion is for the patient's disability claim, and how much the effort is appreciated. I do this because medical source statements win claims.

Sedentary exertional level

This query brought a visitor to my blog: What is the sedentary exertional level for SSA?

Social Security classifies the physical exertion requirements of jobs as sedentary, light, medium, heavy and very heavy. See 20 C.F.R. 404.1567. Social Security gives those terms the same meaning as they have in the Dictionary of Occupational Titles.

The sedentary exertional level involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like files or other small items. Although a sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary. Jobs are sedentary if walking and standing are required only occasionally, and the other sedentary criteria are met.

Since being on one's feet is required "occasionally" at the sedentary level of exertion, periods of standing or walking should generally total no more than about 2 hours of an 8-hour workday, and sitting should generally total approximately 6 hours of an 8-hour workday. Further, most unskilled sedentary jobs require good use of the hands and fingers. See Social Security Ruling 83-10.

The sedentary exertional level is an important landmark in the Social Security disability landscape.

If there are no sedentary jobs in a claimant's past relevant work, a claimant over 50 who is limited to unskilled sedentary work will win at step 5 via the medical-vocational guidelines.

However, a claimant under the age of 50, or a claimant over 50 with job skills that readily transfer to a significant range of skilled sedentary work, will need additional limitations to prevail. 

Social Security FAQs

An excellent set of Frequently Asked Questions About Social Security Disability Benefits has been published at the Social Security Perspectives blog. There are 63 questions in all, each with helpful answers.

The FAQs offer excellent information and insight about the Social Security disability process, and are definitely worth reading. Well done.

Google Search Question - 3

This Google search question led a recent visitor to the blog: Can disability go retroactive from the onset date rather than the date you apply for benefits?

I will answer that question right now.

Disability benefits are never paid retroactively from the onset date, because by definition you were not disabled prior to your onset date. However, both your onset date and your filing date are relevant to the determination of your benefits. 

For an SSI claim, benefits begin on your filing date if your claim is granted. There are no benefits available prior to your filing date for SSI, regardless of your onset date.

For Social Security disability, retroactive disability benefits are paid for up to 12 months prior to your filing date, depending upon the interrelation beween your filing date, your onset date and the 5 month waiting period. 

Benefits begin 5 months after your onset date. However, retroactive benefits do not extend further back than 12 months prior to your filing date. Let's look at an example.

Google search Question - 2

This Google search query landed a visitor on my blog: What should I do after being denied by the social security appeals council?

I am going to answer that question right now.

The Appeals Council is the last word on your claim from the Social Security Administration. Your next step is U.S. District Court. You have just 60 days from the date of the Appeals Council decision to file this action. If you want the help of an attorney, find one right now - don't wait till the end of the 60 day period.

You can also file a new claim with Social Security, and start the process all over again. If your claim was a Title II disability claim, your onset date would be the day after the ALJ decision on your previous claim. Check to ensure that your date last insured is not prior to date of the the ALJ's decision. If your claim was for SSI, you can file a new claim anytime. Your onset date will be the filing date of the new claim. 

Google search Question

From time to time I look at the web statistics for this blog, and how visitors get here. Sometimes a visitor follows a link from another blog, or comes via my Social Security disability website. But often people land here when they use an internet search engine, such as Google.

The stats show the exact search terms that lead a vistor to this blog. I have been intrigued to see that some people type in a whole long question when they search, rather than just using keywords. For example, I had a recent visitor who conducted this search: what does it mean when an administrative judge requests a review of title and positions from a claimants work record by vocational expert?

I am going to answer that question right now.

It means that the ALJ is considering whether or not you can return to your past relevant work at step 4 of the sequential evaluation process. After the vocational expert (VE) characterizes your past jobs, the judge will ask the VE whether or not a person with your limitations could return to any of those previous jobs. If the VE answers yes, you have probably just lost your disability claim. If the VE answers no, the judge will then proceed to step 5 of the sequential evaluation process. The judge may then ask the VE if there are other jobs available to a person with your impairments. Hopefully the answer to this question is also no.

Vocational expert testimony is complicated, and it often a determines whether or not your claim is granted. Please do not attend a disability hearing without a Social Security disability attorney.