There are three possible decisions for a Social Security disability claim: fully favorable, unfavorable, and partially favorable. A partially favorable decision grants part of a disability claim.
Occasionally, a partially favorable decision makes a determination that you were disabled for a period of time, but are no longer disabled and not entitled to ongoing benefits. This…
Social Security defines by regulation the “acceptable medical sources” that can establish your medically determinable impairments and their severity. Physicians and psychologists are of course included. So are optometrists (only for matters of visual acuity and visual fields) and podiatrists (only for impairments of the foot).
Notably, licensed clinical social workers, counselors and therapists are…
A medical source statement is an opinion from your doctor regarding the nature and severity of your limitations due to your medically-determinable impairments. A medical source statement is often simply a form that is completed and signed by your doctor. The name derives from a section of the regulation describing medical opinion evidence.
The SSA must give controlling …
I had a Social Security disability hearing this week for a closed period case. A closed period means that the claimant was disabled for a period of time, but is not disabled on a continuing basis.
Usually, a closed period occurs because the claimant returns to work at the SGA level prior to the hearing date.
The reentitlement period is a safety net for Title II disability recipients who return to work. The reentitlement period begins at the end of the 9-month trial work period, and lasts for 36 months.
If you cannot continue working at the SGA level due to your disabling impairments during the 36-month rentitlement period, you do not…
"Trial work" is a concept that applies to people already receiving Title II disability benefits. Sometimes Title II recipients will attempt to return to work to see how it goes. Social Security encourages this, and allows a 9 month period for a person to still receive benefits while testing his or her ability to work. However, this trial work can be a trap for the unwary.
Some recipients try working part-time, and may earn less than the SGA amount. They assume their disability benefits will not be affected by this part-time work. After all, they were allowed earn that much when they applied for disability benefits. But the trial work amount is quite a bit less than SGA, and this can cause problems for people who earn more than the trial work amount.
After 9 months of trial work, Social Security can terminate your benefits if you reach the level of SGA. The 9 months of trial are not necessarily consecutive, so a few months here and there of part-time employment can consume the trial work period. The SSA looks at a five-year period for trial work, so that 9th month of trial work can sneak up on you. So what should you do? Continue Reading Trial Work
The Medical-Vocational Guidelines are used by Social Security to determine disability due to exertional impairments at step 5 of the sequential evaluation process. The guidelines, or the "grids," consider a claimant's exertional level (that's the medical part) and the claimant's age, education and work history (the vocational factors). Depending upon these medical-vocational factors, the SSA determines that a person is either disabled or not disabled.
In general, the grids are not where you want to be as a claimant, because the grids direct a finding of "not disabled" in most situations. In fact, every claimant loses under the grids until age 50 (or age 45 if unable to communicate in English).
However, the grids are a two-edged sword. Once you reach the age of 50 (and have no transferable skills or education that allows direct entry to skilled work), the grids direct a finding of "disabled" at the sedentary exertional level. The SSA presumes that the transition to unskilled sedentary work is too difficult for these claimants. At age 55, that same claimant grids "disabled" at the light exertional level.
Let's look at an example to see how the grids operate. Continue Reading The Medical-Vocational Guidelines
If you have monthly earnings above the level of substantial gainful activity, it is problematic for your disability or SSI benefits.
For 2008, the SGA amount is $940. Earnings over that monthly amount can present real challeges to receiving benefits. Depending upon the circumstances, you can be denied benefits (or the benefits you receive…
I recently filed a critical case/dire need request for a client’s claim. A critical case request asks Social Security to expedite a claim at the hearing level. Critical cases are governed by HALLEX I-2-1-40.
Critical cases get priority because they are the most serious claims. There are three situations that constitute critical cases: 1)…
When I meet a new client, I often learn that the client had filed a previous Social Security disability or SSI claim that was denied, but not ever appealed. It happens quite a bit. Depending of the timing, that previous claim can often be reopened. When a claim is reopened, it is like it was appealed in the first place and remains pending.
Reopening is governed by 20 C.F.R. 404.988.
A denied claim may be reopened within 12 months for any reason. The 12 month period runs from the date of the initial denial of the prior claim.
If there is good cause, a prior disability claim can be reopened within 4 years. An SSI claim can be reopened within 2 years for good cause. In most cases, "new and material" evidence is the basis for a finding of good cause.
Let's look at an example of reopening.Continue Reading Reopening a Prior Claim
