Welcome! This site is written for Social Security disability claimants, for their legal representatives, and for the network of people involved in the Social Security disability claim process. I hope you find it helpful.
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Effective today, December 1, 2022, the Federal Rules of Civil Procedure (“FRCP”) have been amended to include Supplemental Rules for Social Security Civil Actions under 42 U.S.C. § 405(g).

According to NOSSCR’s email to its members, highlights of the new rules include:

Pleading Requirements for the Complaint
Under the new FRCP Rule 2, a complaint filed in federal court must include the following information:

  • State that the action is brought under §405(g)
  • Identify the final decision to be reviewed, including any identifying designation provided by the Commissioner with the final decision, usually the Beneficiary Notice Control (BNC) Number provided on the ALJ and AC decisions
  • State the name and the county of residence of the person for whom benefits are claimed
  • Name the person on whose wage record benefits are claimed
  • State the type of benefits claimed

Briefing Schedule
Rule 6 provides that “[t]he plaintiff must file and serve on the Commissioner a brief for the requested relief within 30 days after the answer is filed or 30 days after entry of an order disposing of the last remaining motion filed under Rule 4(c), whichever is later.”  Rule 7 provides “[t]he Commissioner must file a brief and serve it on the plaintiff within 30 days after service of the plaintiff’s brief.”  Rule 8 provides “[t]he plaintiff may file a reply brief and serve it on the Commissioner within 14 days after service of the Commissioner’s brief.”

The new rules do not restrict the authority of the district court to grant extensions, but, currently, requests for an extension of time are considered on a case-by-case basis.

If your district has local civil rules with briefing schedules that differ from the new briefing schedule, the new FRCP Supplemental Rules will supersede the existing local rules.

Disability Determination Services (DDS) state agencies make initial and reconsideration determinations on Social Security disability claims. These agencies have had massive turnover in the past few years. I used to work repeatedly with the same group of disability examiners. These days, I am constantly seeing new examiners. Adding to the turnover problem, it takes months to train a new disability examiner. This is causing significant delays with claims at DDS agencies.

In New Hampshire, for example, pending cases at Reconsideration are spending over 180 days in “staging” before a new disability examiner is even assigned. That’s 6 months just waiting for the claim to be assigned. Making a new determinsation will take another 3-4 months. That is just too long.

An ALJ decison regarding TItle II disability usually contains a sentence like this:

The claimant’s earnings record shows that the claimant has acquired sufficient quarters of coverage to remain insured through December 31, 2024.

A successful disability claimant may read that sentence and think that it means that the Social Security disability benefits will terminate on December 31, 2024. But that is not what the sentence means at all.

This language in the decision simply refers to the date last insured, which is the date by which disability must exist to qualify for disability benefits under Social Security’s rules. The date has nothing to do with continuity of benefits once a claim is granted. Do not worry if you see this language in your fully favorable ALJ decision.

If you receive a fully favorable ALJ decision, your disability benefits will continue until you get better, or return to work at the SGA level, or reach retirement age, or die.

Substantial Gainful Activity (SGA) is the amount of money that one can earn and still qualify for Social Security disability benefits. The amount is adjusted each year for inflation, as shown by this table. In 2022, the amount is $1,350. For 2023, the amount goes up to 1,470.

The SGA amount is important for two groups of people:

A person applying for disability benefits must have (or be expected to have) a period of 12 consecutive months with wages below SGA (subject, of course, to the rules for unsuccessful work attempts and Impairment Related Work Expenses).

A person receiving Title II disability benefits can earn up to the SGA amount and still receive benefits (be sure to also take a look at the trial work rules).

 

Last month, my hearings with an administrative law judge (ALJ) to determine medical eligibility for Social Security disability benefits followed the usual, familiar pattern: opening remarks by the judge and then the claimant’s lawyer (me), the claimant’s testimony, and then testimony of a vocational witness regarding the claimant’s past relevant work, and whether various functional limitations would preclude that past relevant work and/or other work. This, broadly speaking, is pretty much the course of most hearings. At the close of the hearing, the judge often will say something like “Thank you for coming today. I will review the record and issue a written decision soon.”

In two of my hearings last month, however, the judge said this, instead: “Based upon my review of the file, your testimony, and the testimony of the vocational witness, I will be issuing a Fully Favorable decision.”

What a difference that makes! While we all have to wait for the written decision to be issued, it gives tremendous relief for the claimant to hear from the judge that the claim for Social Security disability benefits will be granted. There is no uncertainty or worrrying while waiting for the decision. It is an act of grace, really. I wish judges would follow this example more often.

When a concurrent Title II and Title XVI case is awarded, the claim goes to the local Field Office for a determination of SSI benefits. This process takes some time, because the claim specialist at the field office needs to make an appointment to call the claimant to document the claimant’s income and assets to determine financial eligibility (SSI is a need-based program). Then the claim gets sent to the Payment Center, where Title II benefits are calculated, and then the SSI benefits offset the Title II benefits. Therefore, concurrent cases typically take several weeks longer to get paid than straight Title II-only disability claims. This is frustrating, because the SSI claimants are the ones who often need to money the most.

The monthly Title II disability benefit (PIA) is usually greater than the monthly Title XVI SSI amount. And while the SSI benefits begin to accrue on the filing date of the claim, the disability benefit is not paid until after the 5-month waiting period after the onset date. To evaluate these payment issues, you need to compare the filing date with the onset date, and know that the eligibility date for Title II is 5 full calendar months after the onset date.

Continue Reading Title II Offset When a Representative Fee is Involved

When one of my clients is awarded disability benefits, I like to write a short letter to the local Social Security field office, asking them to quickly process the disability claim. I want the local office to send the claim promptly to the Social Security Payment Center for payment.

When the person  awarded Social Security disability benefits is a parent of a minor child (or children), that minor child is entitled to auxiliary benefits. I always provide the child’s name, date of birth, and Social Security number in my letter, to assist the processing of the auxiliary benefits claim.

Represesentation does not end once your client is awarded disability benefits. Making sure that they are paid correctly, and as promptly as possible, is part of the job.

There is article in a national magazine enititled Inside the Kafkaesque Process for Determining Who Gets Federal Disability Benefits. It is most definitely worth reading.

The article begins by describing a (fairly typical) hearing before an Administrative Law Judge, and concludes: “A disability appeal hearing can seem surreal to an outsider.”

Fact check: True

The Social Security Processing Centers calculate and pay a claimant’s disability benefits, once a favorable decision or determination has been made.

The SSA has posted on its site the telephone numbers for the various processing centers. These numbers are for attorney and non-attorney Representatives to call, rather than individual disability claimants.

Disability cases are broken up into two different groups for processing: claimants under age 54 and claimants age 54 and over. From there, you can find the phone number for the correct processing center with the claimant’s Social Security number.

The numbers are invaluable when tracking down a retroactive payment for a client or a Representative’s fee that is overdue.

I frequently talk with people who have applied for Social Security disability. When I ask them why they are unable to work, they often respond “I have been diagnosed with _____.”

Sometimes the diagnosis is just a quick answer to my question. But often, as the conversation continues, there is a belief that, given the diagnosis, it is self-evident that they have symptoms preventing ongoing employment.

But that is not at all how a Social Security disability claim works. Social Security will not “connect the dots” from your diagnosis, to your symptoms, to your functional limitations.

The person claiming disability benefits has the burden to prove the links between the diagnosis, the symptoms, and the resultant functional limitations that prevent employment.

Each element (diagnosis, symptoms, limitations), must be proved.