Social Security Disability Law: News and Facts

There are many reasons a Claimant loses his/her Social Security Disability case. I have compiled a few main reasons I see people lose their case.  1.Lack of medical treatment: This is generally the number one reason people are denied Social Security disability benefits. The Social Security disability program requires medical proof that you suffer a severe condition that affects your ability to work. If you have not sought treatment from a doctor for your condition there is no evidence that you really suffer from this condition, other than your word. And frankly, Social Security will not rely on your word when determining eligibility. To often a Claimant will talk about their mental health problems, but they have no mental health treatment or they get some medicine from their family doctor. This does not help your case. If you can not afford to goto the doctor, find a free clinic or a clinic that has a sliding scale for paying.  2. You are able to work: The second reason Claima...

 The new Listings involving the musculoskeletal system are more restrictive and difficult to prove. In general, meeting or equaling a listing is difficult. With these new listings, social security is certainly making a statement that if you are found to meet one of these listings then there is absolutely no question as to your physical ability. You are most certainly disabled if you have the medical evidence to support a disability under the new musculoskeletal listings. One important takeaway from the new listings is that your medical provider must properly document all of your limitations in the physical examination section of their treatment notes. It is not helpful for your medical provider to simply copy and paste notes from the prior visit. Your doctor must do an actual examination every time and note those limitations in the physical examination. It is also important if your doctor recommends the use of an assistive device for the doctor to not only include that recommendati...

 A closed period of disability is the period of disability with a definite beginning date and a definite ending date that the adjudicator establishes at the time of adjudication. In other words, the date you became unable to work opens the disability period and the date you are able to return to work closes the period of disability. Therefore, unlike an open period of disability benefits, a closed period of disability benefits has a definite beginning and end date. To qualify for closed period disability benefits, the disability must persist, or must have persisted, for at least twelve months. In addition, you must file an application within 14 months after the disability ended. Or, if you miss this deadline but can show that your failure to file a timely application was due to an impairment, you may be able to file an application between 15 and 36 months after the disability ended. If you were disabled for at least a year but were able to return to work while you awaited a decisio...

The Social Security Administration evaluates each claim using a comprehensive list of medical conditions, the Disability Evaluation Under Social Security, commonly referred to as the Blue Book. The idea is that the SSA can quickly locate a condition in the Blue Book and determine whether your condition qualifies you for disability benefits. There are two parts to the book: Part A is used to evaluate Adults (individuals 18 years or older) and Part B is used to evaluate children (under the age of 18). The SSA separated the book into two parts because some illnesses affect children much differently than adults and thus need to be evaluated under different conditions. Both parts divide general impairments into categories (part A has 14 while part B has 15) where each category lays out the restrictions and specifications for a condition to qualify for benefits. When you are in the initial application process or in the request for reconsideration phase, the Blue Book can help you determine w...

 1. Use or abuse drugs and/or alcohol The use or abuse of drugs and/or alcohol can easily result in a denial of benefits. If your drug or alcohol use is deemed to be contributing to your physical or mental limitations then you will not qualify for benefits. The Social Security Administration (SSA) does a materiality test. This test will determine if you were to abstain from all drugs or alcohol if your conditions would continue to be as severe. If the answer is yes then your drug or alcohol use will be deemed non-material to your disability claim. However, if your drug or alcohol use is exacerbating your physical or mental conditions then your use will be material and your case denied. The best practice is to abstain from all drug and/or alcohol use. Any drug or alcohol use holds a negative connotation, which can affect your credibility with SSA. If SSA views you as a liar it will be a lot more difficult to obtain SSD benefits. 2. Be Uncooperative with SSA employees For SSA to make...

Systematic lupus erythematosus, more commonly known as lupus, is an autoimmune disorder that causes your immune system to attack your own tissue and organs. This is a chronic inflammatory condition that may affect multiple body systems including joints, skin, kidneys, blood cells, heart and lungs. Your immune system is the part of the body that fights off bacteria, viruses and germs. When suffering from an autoimmune condition your body cannot tell the difference between the body’s healthy tissues and unhealthy germs. Because the body cannot tell the difference the body will attack and destroy healthy tissue. Lupus is typically a difficult condition to diagnosis as it often mimics other conditions.The most common signs and symptoms of this condition include: -fatigue  -fever - joint pain  -rash  -shortness of breath - chest pain - headaches However, a blood test, imaging, or urinalysis may be used to diagnose the condition. There are varying levels of severity with lupus....

Carpal Tunnel Syndrome is caused by a pinched nerve in your wrist, often resulting from repetitive motions of the hand. The symptoms of this medical condition are numbness, tingling, and/or weakness in your hand and/or arm. It can also cause difficulty picking up or carrying objects. More severe cases affect both hands and/or both arms. If you are experiencing numbness or tingling in your hands the first step you should take is contacting your doctor. Depending upon the severity you may want to consider going to the emergency room. Hand numbness could be a result of a very serious medical condition like Carpal Tunnel Syndrome or uncontrolled diabetes. There are many reasons you may be experiencing numbness in one or both of your hands. The prudent thing to do would be to consult your physician. Carpal Tunnel Syndrome is diagnosed by a review of your symptoms, a physical examination, and most often, through a nerve conduction test called an EMG. An EMG  checks to see how well the el...

What exactly is Fibromyalgia and how does Social Security Disability look at it? Fibromyalgia is defined as a long-term chronic condition that causes multiple health-related issues. These include: 1. General fatigue 2. Pain and tenderness in the muscles and skeletal system 3. Disturbances in sleep and cognitive functions The difficulty with fibromyalgia is that it is often difficult to diagnose. Symptoms often mirror other conditions, and there is no definitive test used to diagnose the condition. What Are the Symptoms of Fibromyalgia? Historically, individuals are diagnosed with fibromyalgia if they have confirmed pain in 11 out of 18 possible “tender points.” These tender points include but are not limited to the following: 1. Back of the head 2. Tops of the shoulders 3. Upper chest, hips, knees, and outer elbows Pain in these trigger points varies case-to-case. The pain can range from a mild discomfort to a more intense, almost unbearable level. For example, if you or your spouse ex...

Less than 15% of cases in the Appeals Council get sent back to the lower court for a new hearing. This is a very low percentage of cases. These are the main reasons in 2020 that the Appeals Council returned cases for new hearings on the percentages associated with the reasons.  15.7 Treating Source - Opinion Rejected Without Adequate Articulation 8.7 Claimant Credibility - Failed to Discuss Appropriate Credibility Factors 6.7 Treating Source - Opinion Not identified or Discussed 5.2 Other 3.1 *RFC - Mental Limitations Inadequately Evaluated 2.9 Mental Disorder Not Adequately Considered 2.7 Claimant Credibility - Other Issue 2.2 Treating Source - Weight Accorded Opinion Not Specified 2.0 Impairment Incorrectly Found "Not Severe" 2.0 *RFC - Other

Arthritis is a condition with swelling and tenderness of one or more joints. The common symptom includes pain and stiffness in joints.   There are many types of arthritis that affect people. The two main forms of joint pain are rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis is an auto-immune disorder that affects the lining of your joints. After some time, it can harm your joint ligament and bones resulting in stiffness and pain. Osteoarthritis happens when ligaments in your joints wear out over time. If your arthritis confines your daily movements, or activities you may qualify for Social Security Disability benefits. Treatments vary depending on the type of arthritis. The treatment focuses on reducing symptoms and improving quality of life.  The most common symptoms in the initial stages are: 1. Joint pain- knee or hip pain 2. Swelling 3. Redness in the joints 4. Tenderness in joints 5. Loss of appetite 6. Fever Your level of disability depends o...

Medical records are probably the most important part of a social security disability case. The more documentation you have, the easier it is to win. It’s also important to know that a specialist is better than a family doctor.  The Social Security Administration expects patients to be treated by doctors who have experience working with your particular impairment. For example, if you have a heart problem, you may need the care of a cardiologist. For an immune impairment, such as rheumatoid arthritis, you may need the specialized care of a Rheumatologist.  Similarly, for a Psychiatric impairment, such as bipolar disorder, depression, or anxiety, seek out the care of a psychiatrist, psychologist, or qualified therapist.  Social Security may give more credence to the opinion of a specialist in your particular condition rather than a general practitioner. Be as precise and descriptive as possible when visiting your doctor. This will help your doctor keep your doctor informed a...

Sjogren's syndrome is an autoimmune disorder that is characterized by dry eyes and a dry mouth. As well as having dry eyes and a dry mouth, people with Sjogren's syndrome sometimes experience prolonged fatigue, skin rashes, a persistent cough, swollen salivary glands, involuntary weight loss, malaise, and joint pain. Sjogren's syndrome may progress from causing dry eyes and dry mouth to damaging other parts of the body, such as kidneys, liver, lungs, and nerves. People with Sjogren's syndrome often have other immune system disorders, such as lupus or rheumatoid arthritis. However, if the disorder is aggressive, more severe symptoms may occur, including: -Fever -Tooth decay or loss of teeth -Problems swallowing and/or speaking -Swollen eyelids -Joint pain or stiffness -Significant weight loss Some people with Sjogren's syndrome also develop kidney and liver problems (including cirrhosis), as well as peripheral neuropathy (tingling and numbness in your hands and feet)...

When you apply for Social Security Disability benefits, you will have to complete a Work History report for all jobs you have performed in the past 15 years. This does not look like a very important form, but it is. Social Security is not using it to check to see if it matches their payroll information or anything like that. Rather, it will be used to determine what kind of work you have done in the past.  To many pople make their previous work description easier than it was performed. Take your time completing this form. Think about the work. The harder the job was, the more difficult it will be for the judge to say you can perform your past work. The easier the job description and detail you give, the easier it will be for the judge to say you can do your past work and you lose your case. Remember, you need to write down how long you had to stand, walk, reach, and handle. Take the maximum amount; do not try to average it out. It is okay if the categories equal more than the hours...

Social Security Judges require that your impairments be documented with medical evidence. The strength of a disability claim often depends on the nature and quantity of the medical treatment received. The more impairments you claim for and treat for the better your chances of winning your Social Security Disability case. Medical evidence from the doctors who are currently treating you can be persuasive to Social Security because your doctors tend to know your medical history in more detail than other sources (such as a Social Security doctor who sees you one time). Treating doctors can provide an opinion about your condition that may be more convincing than your medical records alone. In my experience the number one reason why judges deny cases has to do with lack of compelling evidence. This could take the form of gaps in treatment – when four, six or more months elapse between doctor visits. Lack of medical treatment could also mean that the judge expects to see treatment from a spec...

The Social Security Administration (SSA) is generally skeptical of disability claims based solely on chronic fatigue syndrome (CFS). Claims are rarely approved at the initial or reconsideration levels, and even at the hearing level, most Administrative Law Judges (ALJs) are reluctant to pay benefits except in the most compelling cases. I recommend to clients to keep a daily log of the nature and severity or their symptoms, and submit a copy to Social Security prior to the hearing. Statements from third parties, including family members, neighbors, or former co-workers, can also prove helpful in documenting the extent of your impairments There's no single test to confirm a diagnosis of chronic fatigue syndrome. There is no cure for chronic fatigue syndrome. Symptoms can mimic those of many other health problems, including: 1. Sleep disorders. Chronic fatigue can be caused by sleep disorders. A sleep study can determine if your rest is being disturbed by disorders such as obstruc...

 Most of the time, headaches are not severe enough to stop a person from working. However, migraine headaches are more than just a normal headache. Migraine is a neurological condition that can prevent people from living their day-to-day life. If you are applying for Social Security Disability because of Migraine Headaches you should treat with a Neurologist or other specialist for them. SSA will not give Migraine Headaches as much weight if you just see your family doctor.  People describe the pain they experience during migraine as: 1. throbbing 2. pulsating 3. pounding Other symptoms that a person may experience with migraine include: 1. nausea 2. vomiting 3. sensitivity to light 4. sensitivity to sound Visual disturbances are also common with migraine and can include: 1. loss of vision 2. flashing lights 3. zig-zag lines For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such ...

 Timely, Accurate, and Adequate Medical Evidence To many times I speak with potential clients or people who are representing themselves and they have not gone to the right doctors or taken the proper tests or they have a hearing scheduled and they have not updated any of their medical records. People expect social security to update their medical records. Social Security does not update medical records once the case is at hearing stage unless you ask for help. You are expected to update your own medical records. You must submit all the medical records whether they are favorable or unfavorable to your case. You must have all medical records filed at least 5 business days prior to your hearing.  Providing the Social Security Administration with timely, accurate, and adequate medical evidence will not only increase your chances for approval for your initial application but also will also greatly reduce or potentially eliminate the need for the SSA to gather additional medical doc...

 Acceptable Medical Sources The SSA regulates the sources of your medical documentation to make sure it came from a medical professional or an “acceptable medical source.” Once the SSA confirms your sources of medical documentation are valid, all documentation you gave the SSA will be considered while determining whether or not you qualify for disability benefits. Below are the medical sources the SSA considers acceptable: 1. Licensed physicians (medical or osteopathic doctors) 2. Licensed or certified psychologists (such as school psychologists) 3. Licensed optometrists (for visual disorders only) 4. Licensed podiatrists (typically for foot and/or ankle impairments only) 5. Qualified speech-language pathologists (speech or language impairments only) I do not think chiropractic treatment holds great weight with judges. You are better off seeking treatment from a MD or DO.  In several instances, the SSA will ask your treating physician, doctors, psychologists and/or any other m...