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The Social Security Administration uses a 5-step sequential evaluation process to determine whether or not you will receive disability benefits.

Step 1: Are You Working?

Step 1 determines if a person is “working”, according to the Social Security Administration definition. Earning more than this amount a month as an employee is enough for disqualification from receiving Social Security disability benefits. If you are self-employed, the determination is more complicated, and a Social Security disability lawyer can help.

Step 2: Is Your Condition Severe?

Step 2 evaluates whether your medical condition is severe enough to significantly limit your ability to perform basic work activities. In addition, the impairment must last, or be expected to last, for a continuous period of not less than 12 months or result in death.

Step 3: Is Your Condition A Listed Impairment?

Step 3 asks if the impairment meets or equals a medical “listing.” The Social Security Administration uses more than 150 categories of medical conditions, called “listings.” You can browse the Social Security listed impairments for adults. These conditions are severe enough to presumptively preclude a person from working. If you “meet or equal a listing” you will be granted benefits. If you do not meet a listing, the SSA proceeds to Step 4.

Step 4: Can You Do Work You Did Previously?

Step 4 explores your ability to perform work you have done in the past 15 years, despite your physical or mental impairments. If the Social Security Administration finds that you can still perform this past relevant work, benefits are denied.

It does not matter at step 4 if your former employer would not hire you, or if the place where you worked is no longer in business, or if all those jobs are now done in China. All Social Security does at this step is match your physical and mental residual functional capacity with the requirements of your former job.

If you cannot perform your past relevant work, then the process proceeds to the fifth and final step.

Step 5: Can You Do Any Other Type Of Work?

Step 5 determines what other work, if any, the person can perform. Social Security considers your age, education, work experience and physical/mental condition to make this determination. If Social Security finds that you cannot make the transition to other work, you will be granted benefits.

Because Social Security considers your age at this step, there are special rules for claimants over the age of 50.

Social Security explains the five-step sequential evaluation process at 20 C.F.R. 404.1520.

Knowledge of the 5 step sequential evaluation process is critical to making a successful Social Security disability claim. An experienced Social Security lawyer can help you with your disability claim.

Your mental health condition can be the basis for a successful Social Security disability or SSI claim, if the condition is severe enough to prevent you from working.
 
Simply having a diagnosis such as “anxiety,” “depression” or “bipolar disorder,” is not enough for the Social Security Administration to grant you benefits. Rather, you must show that your mental health condition is severe enough to keep you from sustaining employment.

Social Security has several listed impairments that correspond to specific mental health conditions or diagnoses.  The most frequently seen are Affective Disorders and Anxiety Disorders.  Affective Disorders include Depression and Bipolar Disorder.  Anxiety Disorders comprise 5 different conditions, including Generalized Anxiety Disorders, Phobic Disorders, Panic Disorders, Obsessive Compulsive Disorders, and Post-traumatic Stress Disorder or PTSD.

We will work with your psychiatrist, psychologist, therapist or counselor to help with your Social Security claim. We will seek their opinion regarding the severity of your mental health condition.

Also, we can help these medical professionals to translate your mental symptoms into functional limitations that the Social Security Administration will use to evaluate your claim.

As a general rule, it is important for those with mental impairments to have a Social Security disability attorney to help with the Social Security disability or SSI process.

If you are wondering if your mental health condition is severe enough to receive disability benefits, and you live in Maine or New Hampshire, please ask for a free case evaluation.

If your disability claim is denied after a hearing with an administrative law judge, you have the right to request review of that denial by the Social Security Appeals Council. The appeal must be taken within 60 days of the date of the ALJ’s unfavorable decision. You can read more about the Appeals Council review process here.

Writing an Appeals Council request for review is something of an art form. I think the "two minute rule" is the best way to approach your appeal. You should write your request for review so that the person reviewing the appeal can tell in two minutes that the judge made an error, and that the claim should be remanded for a new hearing.

To accomplish this, make pinpoint cites to the ALJ’s decision – give the page, the paragraph and the line number for each alleged error in the decision. Also give a pinpoint cites to the exhibits – by exhibit number, page and paragraph – that demonstrate that the judge erred. And if you are citing to a digital recording of a hearing, you can cite to the hour, minute and second of the statement you want to reference. Accurate, pinpoint citations save a great deal of time for the person reviewing the appeal.

As always, keep your argument short and focused. My requests for review are rarely over three pages.

Many people applying for Social Security disability are over the age of 50, and have worked hard for their entire adult life. But now, due to a medical condition, they can’t do their job any longer, and have been unable to find other work. Many of these workers are denied benefits when they apply for disability, despite a lifetime of paying into the Social Security system.

The Social Security Administration has special rules for claimants over 50.  If you are over 50 and can no longer do the sort of work you have done in the past, then Social Security must take your age into account when considering whether or not you can do other work. These rules are embodied in the Medical-Vocational Guidelines, which are used by the SSA to determine disability at at step 5 of the sequential evaluation process.

If you are over 50 years old and are limited to unskilled sedentary work, Social Security will presume that you are unable to transition to other work due to your age. This can make a huge difference in a claim.  A person limited to unskilled sedentary work may lose his disability case at age 48, but will win it at age 50.

At age 55, it gets even better. A claimant limited to unskilled light exertional work is presumed to be unable to transition to other work. 

An experienced attorney can use these presumptions to help win your disability case.

It is very important to remember that you do not get the benefit of these rules until step 5 of the disability evaluation process. So it is critical to rule out your past relevant work at step 4.

Your past relevant work comprises all of the jobs that you have had during the past 15 years. If you still retain the residual functional capacity to perform any of these jobs, your disability claim will be denied at step 4. If Social Security determines that you can perform your past relevant work, your claim will never get to step 5, where you would have benefitted from the favorable presumptions due to your age. For this reason, it is particularly important for disability claimants over 50 to have the assistance of a capable Social Security attorney.

If you are wondering if your medical condition is severe enough to receive disability benefits, and you live in Maine or New Hampshire, please ask for a free case evaluation.

The Appeals Council is now connected to Social Security’s electronic system. So now it is possible to check on the status of an Appeals Council request for review at the local Social Security office.

I checked on the cases I have at the Appeals Council from the Saco, Maine office this week. It took less than a minute. It is very efficient to check the status at the local office, which is oriented towards customer service.

An Appeals Council request for review may also be filed at the local office.

Recently I had a prospective client come to my office after receiving an unfavorable decision from an administrative law judge. The claimant was unrepresented at the Social Security disability hearing.

I have now read the decision and reviewed the record, and the claim easily could have been granted at the hearing had there been a little development from a lawyer. A lawyer develops a theory of the case, and then develops evidence in support of that theory of the case. Since the claimant was unrepresented, none of that was done.

I will write an Appeals Council request for review, and it is possible that the claim will be remanded for a new hearing. But if I had been brought in before the hearing, rather than after, the client might already be receiving benefits.

Please, please do not go to your Social Security administrative hearing without a Social Security disability lawyer.

Your date last insured (DLI) can be an important date for your Social Security disability claim. Social Security disability is an insurance program, and a portion of the FICA payroll taxes withheld from every paycheck pays the disability premium. However, if you stop working, you stop paying the premium. Eventually, your disability insurance will lapse. The date your insured status ends is called the “date last insured.”

The DLI can be a trap for a disability claimant. To prevail with a Social Security disability claim, you must show that your were disabled prior to your date last insured.  It does not matter how badly disabled you are today. If you cannot demonstate that you were disabled prior to your DLI, you will be denied disability benefits. You still may be elegible for SSI benefits, but you must qualify financially for SSI benefits.

The Maine Social Security disability and SSI claim process may require several stages. Maine attorney Gordon Gates can help you with each stage of the Social Security disability claim process.

The first stage is the review of your initial application. The Social Security Administration sends your case to a state agency in Augusta – Disability Determination Services – to gather additional information and to make an initial determination on your claim. That determination is usually made within a three or four months.

If your case is denied (and most claims are denied at this stage), then you must request Reconsideration within 60 days of your initial denial. Your claim is then reevaluated, and Social Security will consider any new evidence that is submitted.

If your case is denied again (and most cases are denied again at this stage), you must request a hearing before an Administrative Law Judge within 60 days.

The hearings for Maine residents are conducted at the Office of Disability Adjudication and Review (ODAR) in Portland, Maine. The hearings are either held in person or by video conference. Videoconference hearings are also held in Augusta, Bangor and Presque Isle. At the hearing, the judge will review the medical evidence, hear your testimony, and may obtain testimony from a medical or vocational expert witness.

Additionally, the Maine judges ask for a hearing brief from your legal representative. The hearing brief sets forth the background facts of your claim, the medical evidence, and a “theory of the case” telling the judge why your claim should be granted under the Social Security disability evaluation process. I think the hearing bief is very important, and I have listed ten top reasons to write a hearing brief.

There are currently six judges permanently assigned to the Portland, Maine hearing office.

For most claimants, the ALJ hearing is the last stage of the process. However, if your claim is not granted by the ALJ after a hearing, you may file an Appeals Council Request for Review within 60 days of the date of your ALJ decision. If the Appeals Council grants your request, it will remand your case for a new hearing. On rare occasions, the Appeal Council will grant a claim outright, without remanding the case back to the ALJ.

If your claim has still not been granted after the Appeals Council stage, and you believe strongly that the ALJ made an improper decision in your case, you can file suit against the SSA in U.S. District Court. The suit must be filed within 60 days of the Appeals Council denial. In Maine, the Social Security appeals are heard in federal court in Portland by Magistrate Judge John H. Rich, III.

If you have a Maine Social Security disability or SSI claim, please contact Gordon Gates today. I will be happy to discuss your Social Security disability or SSI claim. There is no charge for a consultation, and if you retain me you will pay no fee unless you are granted benefits.

A New Hampshire Social Security disability or SSI claim is often a two stage process. The first stage is the review of your initial disability application. The Social Security Administration sends your case to a state agency in Concord – Disability Determination Services – to gather additional information and to make an initial determination on your claim. The initial determination is usually made within a three to four month period. 

If your case is denied, then you must request a hearing before an Administrative Law Judge within 60 days.

The administrative hearings are usually conducted in Manchester, New Hampshire. The hearings are either held in person or by videoconference. At the hearing, the judge will review the medical evidence, hear your testimony, and may take testimony from a medical or vocational expert witness. The judge will often ask your representative to make an opening statement telling the judge the factors which support the disability claim.

Additionally, it is my practice to prepare a hearing brief for the judge. The hearing brief sets forth the background facts of your claim, the medical evidence, and a “theory of the case” telling the judge why your claim should be granted under the Social Security disability evaluation process.

There are currently eight judges permanently assigned to the Manchester, New Hampshire hearing office: Judge Debra Boudreau, Judge James D’Alessandro, Judge Edward Hoban, Judge Ruth Kleinfeld, Judge Robert Klingebiel, Chief Judge Paul Martin, Judge Thomas Merrill and Judge Dory Sutker. 

If you have a New Hampshire Social Security disability claim, it is very important to select a Social Security disability lawyer who is familiar with the New Hampshire judges, because one of these judges will decide your case.

For most claimants, the ALJ hearing is the last stage of the process. However, if your claim is denied, you may file an Appeals Council Request for Review within 60 days of the date of the judge’s unfavorable decision. If the Appeals Council grants your request, it will remand your case for a new hearing. On rare occasions, the Appeal Council will grant a claim outright.

If your claim has still not been granted or remanded for a new hearing after the Appeals Council stage, you can file suit against the SSA in U.S. District Court. The suit must be filed within 60 days of the Appeals Council denial.

If you are a New Hampshire resident and have a Social Security disability or SSI claim, please contact Gordon Gates today. You can call me toll free at 1-888-200-4484, I will be happy to discuss your case.

There is no fee unless you are awarded benefits.

Social Security disability insurance is called "insurance" for a reason. You pay a premium from every paycheck, and receive disability coverage in return. How much is the premium? See this table.

15.3% of your wages are withheld for Social Security. Your employer pays 7.65% and you pay 7.65%. If you are self-employed, you pay the entire 15.3% yourself. Of this amount, 10.6% is for Social Security "retirement," 2.9% is for Medicare, and 1.8% is for disability insurance.