In considering whether you are disabled, Social Security must consider all factors that will make it difficult for you to work. "Work" is defined as consistently performing work activity--8 hours a day, 5 days a week--on a "regular and continuing basis." Three of the many factors that must be considered include concentration, persistence and pace:
CONCENTRATION - which is the ability to remain focused well enough and long enough to perform the work. It is generally agreed that most work requires an individual to concentrate up to 2-hours at a time without a break or having to be redirected; and for a total of 8 hours during a working day. Concentration may be restricted by pain, anxiety, depression, panic attacks, fatigue or dozens of other reasons. Most vocational experts will testify that being off task more than about 10 percent of the time will result in not being able to hold any full-time job.
PERSISTENCE - basically is the ability to work for 2 hours at a time (without a break) and for 8 hours per day, and to do so 5 days per week on a regular and continuing basis. If a person is able to work 5 or 6 hours a day, but not 8, they are disabled. If an individual is able to work 3 or 4 days per week, but not 5 days, they are disabled. Vocational experts will generally concede that if a person is absent more than 1 or 2 days per month on a consistent basis, they cannot hold a job. Also, if they are able to sit, stand and walk (in combination) less than 8 hours per day on a consistent basis, they are not able to hold a job.
PACE - refers to the ability to turn out the required amount of work in the required amount of time. All jobs require that a certain amount of work be performed every 8 hours. If an individual, for example, can produce only 70 percent of the expected work, he cannot meet the pace required. If he or she can turn out all of the work required but it takes 12 hours instead of 8 hours, he or she cannot meet the pace requirement. Pace is also affected by pain, restricted range of motion, restricted standing, sitting, walking, lifting, bending, etc.
What will be considered when concentration, persistence and pace are evaluated by Social Security?
1) Your medical records should provide objective medical evidence of a condition or conditions which may reasonably be expected to limit concentration, persistence or pace. If pain is a consideration, there should be objective medical evidence for the source or cause of the pain (Example: an MRI showing herniated discs or degenerative disc disease).
2) If mental disease, such as anxiety, depression, panic disorder, PTSD, schizophrenia, etc. are involved, detailed records from a licensed psychologist or psychiatrist will be needed.
3) A medical source statement by one of the claimant's treating physicians will be most useful. There is a particular form used for this.
You need a specialist to review and evaluate your medical records, then present an effective argument to Social Security why you cannot meet the concentration, persistence or pace required of jobs in the national economy. An attorney or non-attorney disability specialist may be your best bet in formulating a case that you can't meet the concentration, persistence and pace required to handle full-time work.
ABOUT THE FORSYTHE FIRM - SOCIAL SECURITY JUSTICE
The Forsythe Firm - Social Security Disability Specialists - 7027 Old Madison Pike NW, Suite 108, Huntsville AL (256) 799-0297
Tuesday, November 7, 2017
THE INTERNET IS NOT RELIABLE FOR DISABILITY INFORMATION
DANGER: Don't count on the internet to tell you whether you qualify for Social Security disability. This may lead you in the wrong direction, and cost you a lot of money. Here's an example:
Thomas recently had back surgery and was forced to quit working because of unrelenting back pain and trouble standing, walking, bending and lifting. He went online and googled "disability for back problems."
The internet directed Thomas to the Social Security listings for musculoskeletal impairments. Tom saw a long list of complicated symptoms the Listings required and decided that his condition wasn't nearly bad enough for apply for benefits, so he didn't. A year later, still not able to work, Thomas contacted an attorney. The attorney filed for benefits and Tom was approved.
Here's the problem with relying on the Listings on the internet: You do not have to meet those listings to be approved. In fact, most people who are approved for disability benefits do not meet the listing.
The "listings" are automatic approvals for the worst, most catastrophic conditions. There is a mandatory 5-step process that Social Security must use to decide if you are disabled. Claimants who "meet a listing" are approved early, at Step 3. I would say less than 5 percent of those who get approved will meet a listing.
Those claimants who do meet a listing, however, may be approved at Step 4 or Step 5 (where most claimants get approved). If you depend on meeting a listing, only 5 percent would win and 95 percent would lose. So, the listings are not what you need to look at.
Here's my advice: Do not rely on some website (even my own) to determine whether or not you qualify for benefits. Let a professional evaluate your specific situation. Factors that must be considered are: your age, your education, your past work experience and your medical conditions (both physical and mental).
No two cases are alike. Another bad thing is trying to judge your situation according to the experience that somebody else had. For example, they denied Uncle Billy, who was even sicker than I am, so they will deny me, too. Or conversely, they approved Uncle Billy in just 2 weeks, and he isn't near as sick as I am, so they should certainly approve me. Uncle Billy has absolutely no bearing on your case. You are unique because you...
THE FORSYTHE FIRM
Social Security Disability Representatives
Huntsville, AL
Phone (256) 799-0297
MY WEBSITE IS PRETTY RELIABLE FOR GENERAL INFORMATION
Thomas recently had back surgery and was forced to quit working because of unrelenting back pain and trouble standing, walking, bending and lifting. He went online and googled "disability for back problems."
The internet directed Thomas to the Social Security listings for musculoskeletal impairments. Tom saw a long list of complicated symptoms the Listings required and decided that his condition wasn't nearly bad enough for apply for benefits, so he didn't. A year later, still not able to work, Thomas contacted an attorney. The attorney filed for benefits and Tom was approved.
Here's the problem with relying on the Listings on the internet: You do not have to meet those listings to be approved. In fact, most people who are approved for disability benefits do not meet the listing.
The "listings" are automatic approvals for the worst, most catastrophic conditions. There is a mandatory 5-step process that Social Security must use to decide if you are disabled. Claimants who "meet a listing" are approved early, at Step 3. I would say less than 5 percent of those who get approved will meet a listing.
Those claimants who do meet a listing, however, may be approved at Step 4 or Step 5 (where most claimants get approved). If you depend on meeting a listing, only 5 percent would win and 95 percent would lose. So, the listings are not what you need to look at.
Here's my advice: Do not rely on some website (even my own) to determine whether or not you qualify for benefits. Let a professional evaluate your specific situation. Factors that must be considered are: your age, your education, your past work experience and your medical conditions (both physical and mental).
No two cases are alike. Another bad thing is trying to judge your situation according to the experience that somebody else had. For example, they denied Uncle Billy, who was even sicker than I am, so they will deny me, too. Or conversely, they approved Uncle Billy in just 2 weeks, and he isn't near as sick as I am, so they should certainly approve me. Uncle Billy has absolutely no bearing on your case. You are unique because you...
- are a different age
- have a different work history
- have a different medical history
- will have a different judge
- probably have a different education level
- ...and are just different in a hundred other ways
THE FORSYTHE FIRM
Social Security Disability Representatives
Huntsville, AL
Phone (256) 799-0297
MY WEBSITE IS PRETTY RELIABLE FOR GENERAL INFORMATION
Sunday, September 11, 2016
DISABILITY: THE ESSENTIAL QUESTIONS (AND ANSWERS)
1)
At what age may I apply for Social Security disability (SSDI)?
Answer: Adults may apply any time before your full retirement age. (If
you were born in 1948, for example, your full retirement age is 66).
Children may apply any time prior to age 18. There are special rules for adults who became disabled prior to age 22.
2) What monthly benefit may I expect from SSDI? Answer: The benefit amount will vary based on your average wages and work history. The maximum monthly benefit in 2016 is $2,639. The average monthly benefit is $1,166.
3) Can my spouse or dependent children also receive benefits? Answer: Yes, dependents may qualify for benefits based on the wage earner's disability. Dependent grandchildren may also be eligible. A spouse who is caring for a disabled wage earner's dependent children under age 16 may also qualify.
4) Will I get Medicare insurance with my disability benefits? Answer: Yes but there is a waiting period. Medicare starts 29 months after the official onset date of disability for SSDI claims. Note that this is 29 months from the disability onset, not from the date of your decision. SSI beneficiaries get Medicaid and there is no waiting period for Medicaid.
5) If my doctor tells me I am disabled and cannot continue working, are disability benefits automatic? Answer: No. You must still apply and prove to Social Security that you are disabled according to their rules. Many times, such individuals are denied and must appeal in order to get benefits. Appeals must be filed within 60 days of denial.
6) I saw my doctor today and he does not think I will be able to continue working much longer. May I apply for Social Security disability now and keep working until I am approved? I want to have my claim approved before I stop working. Answer: No, the system does not permit this. You must not be working at substantial gainful activity when you apply for disability benefits. If you are, you will be denied at Step 1, regardless of the medical evidence.
7) I am 64 years old and retired. I worked for more than 40 years. I've been receiving Social Security early retirement benefits for about 2 years. I've been healthy until now. Recently, however, I was diagnosed with a severe illness for which there is no cure. Since I am already receiving Social Security retirement, may I file a disability claim?
Answer: Yes, you may. You are under full retirement age and it appears you have adequate work credits to support a claim. Also, I assume your recent impairment will last for 12 months or more (the duration requriement), so you may file a disability claim and try to prove disability. As long as you are not working, your present income does not matter for a Title 2 (SSDI) claim. If your claim is successful, your monthly benefit will be increased to the amount you would have received at full retirement age (payable from the onset date of your disability). Also, you may qualify for earlier Medicare coverage, in the event you are not yet 65 when your case is decided. You may continue to receive your retirement benefits while your disability claim is being decided. Even if you eventually do not get a favorable decision on the disability claim, it will have no impact on your retirement benefits, which you will continue to receive. So, you risk nothing by filing for disability. A final thought: At age 62, it may be easier to win a disability claim, compared to a younger individual, thanks to the medical-vocational guidelines.
________
If you have a Social Security disability question that was not answered here, or on one of our many blog posts, please call the Forsythe Firm in Huntsville, AL at (256) 799-0297.
There is no charge or obligation for a consultation.
2) What monthly benefit may I expect from SSDI? Answer: The benefit amount will vary based on your average wages and work history. The maximum monthly benefit in 2016 is $2,639. The average monthly benefit is $1,166.
3) Can my spouse or dependent children also receive benefits? Answer: Yes, dependents may qualify for benefits based on the wage earner's disability. Dependent grandchildren may also be eligible. A spouse who is caring for a disabled wage earner's dependent children under age 16 may also qualify.
4) Will I get Medicare insurance with my disability benefits? Answer: Yes but there is a waiting period. Medicare starts 29 months after the official onset date of disability for SSDI claims. Note that this is 29 months from the disability onset, not from the date of your decision. SSI beneficiaries get Medicaid and there is no waiting period for Medicaid.
5) If my doctor tells me I am disabled and cannot continue working, are disability benefits automatic? Answer: No. You must still apply and prove to Social Security that you are disabled according to their rules. Many times, such individuals are denied and must appeal in order to get benefits. Appeals must be filed within 60 days of denial.
6) I saw my doctor today and he does not think I will be able to continue working much longer. May I apply for Social Security disability now and keep working until I am approved? I want to have my claim approved before I stop working. Answer: No, the system does not permit this. You must not be working at substantial gainful activity when you apply for disability benefits. If you are, you will be denied at Step 1, regardless of the medical evidence.
7) I am 64 years old and retired. I worked for more than 40 years. I've been receiving Social Security early retirement benefits for about 2 years. I've been healthy until now. Recently, however, I was diagnosed with a severe illness for which there is no cure. Since I am already receiving Social Security retirement, may I file a disability claim?
Answer: Yes, you may. You are under full retirement age and it appears you have adequate work credits to support a claim. Also, I assume your recent impairment will last for 12 months or more (the duration requriement), so you may file a disability claim and try to prove disability. As long as you are not working, your present income does not matter for a Title 2 (SSDI) claim. If your claim is successful, your monthly benefit will be increased to the amount you would have received at full retirement age (payable from the onset date of your disability). Also, you may qualify for earlier Medicare coverage, in the event you are not yet 65 when your case is decided. You may continue to receive your retirement benefits while your disability claim is being decided. Even if you eventually do not get a favorable decision on the disability claim, it will have no impact on your retirement benefits, which you will continue to receive. So, you risk nothing by filing for disability. A final thought: At age 62, it may be easier to win a disability claim, compared to a younger individual, thanks to the medical-vocational guidelines.
________
If you have a Social Security disability question that was not answered here, or on one of our many blog posts, please call the Forsythe Firm in Huntsville, AL at (256) 799-0297.
There is no charge or obligation for a consultation.
Friday, April 15, 2016
WHY THE 'FUNCTION REPORT' WINS DISABILITY CLAIMS
Social
Security disability is awarded base on a claimant's limited ability to
function. It is not awarded based on diseases, but on functional
limitations.
The primary way Social Security evaluates your functional ability is by a detailed questionnaire that they refer to as "the ADL (Activities of Daily Living) questionnaire. The official name of the document is the "Function Report."
The Function Report is an 8-page document with Sections A-D and it contains approximately 60 questions.
I understand the temptation to ignore this form (just not bother with it) or to fly through it quickly because you feel it is a waste of time. This is a crucial mistake. You should spend a lot of time with this form. In fact, this form should be your constant companion for a couple of days until it is completed lovingly, comprehensively, thoughtfully and very, very completely.
The Function Report will ask you things like:
If your application is denied (about 70% will be), the judge who hearings your appeal with use this same Function Report to evaluate consistencies in your symptoms and the credibility of your complaints. This Function Report literally stays with you from the day your file your claim until the appeal is decided, perhaps 24 months later in some cases.
If you are unable to understand or complete the Function Report in loving, comprehensive detail--get someone who can help you: a relative, your pastor, a friend, etc. If you are represented by an attorney or advocate, he/she will understand this form and help you complete it correctly. But for heavens sake, do not ignore the form or (just as bad) fly through it checking boxes just to say you finished it. (That's how I used to do my homework, with equally dismal results, I might add).
The primary way Social Security evaluates your functional ability is by a detailed questionnaire that they refer to as "the ADL (Activities of Daily Living) questionnaire. The official name of the document is the "Function Report."
The Function Report is an 8-page document with Sections A-D and it contains approximately 60 questions.
I understand the temptation to ignore this form (just not bother with it) or to fly through it quickly because you feel it is a waste of time. This is a crucial mistake. You should spend a lot of time with this form. In fact, this form should be your constant companion for a couple of days until it is completed lovingly, comprehensively, thoughtfully and very, very completely.
The Function Report will ask you things like:
- Do you cook your own food? How long does it take you? What do you cook?
- Do you spend time with others?
- What are your hobbies? How often do you do them?
- Do you go places on a regular basis?
- When you go out, how do you travel?
- Do you get along well with others?
- Do you need help caring for others or pets?
- Do you need help with bathing, getting dressed, or feeding yourself?
- How do your illnesses, injuries conditions affect your sleep?
- Are there things you used to do that your disability now stops you from doing?
If your application is denied (about 70% will be), the judge who hearings your appeal with use this same Function Report to evaluate consistencies in your symptoms and the credibility of your complaints. This Function Report literally stays with you from the day your file your claim until the appeal is decided, perhaps 24 months later in some cases.
If you are unable to understand or complete the Function Report in loving, comprehensive detail--get someone who can help you: a relative, your pastor, a friend, etc. If you are represented by an attorney or advocate, he/she will understand this form and help you complete it correctly. But for heavens sake, do not ignore the form or (just as bad) fly through it checking boxes just to say you finished it. (That's how I used to do my homework, with equally dismal results, I might add).
Sunday, April 3, 2016
USING OPINION EVIDENCE TO WIN DISABILITY
There are 2 types of medical evidence in a disability claim: objective medical evidence and opinion medical evidence.
Objective medical evidence consists of things like X-rays, laboratory tests, MRIs or CAT scans. These are found in your doctor's records.
Opinion evidence is quite different. Opinion evidence is where your doctor or professional renders an opinion on how your medical condition affects your ability to perform certain functions.
For example, an MRI may show that you have 2 herniated discs in your lumbar spine. This is objective evidence. It is what it is. The doctor may then give an opinion as to how long you can sit, stand or walk. That is opinion evidence. If your doctor states: "The patient would be limited to lifting no more than 10 pounds occasionally, sitting no longer than 30 minutes, standing no longer than 15 minutes at a time, or walking no more than 300 feet," that is opinion evidence.
Opinion evidence is used to form "residual functional capacities," that is, what is the most work like activity that an individual can perform on a sustained basis? This will be use by decision makers to determine what type of jobs, if any, the claimant would be able to perform. This, in turn, will determine whether the claimant meets the rules for Social Security disability benefits.
We should note here that broad, general conclusions by doctors are not useful. For example, the statement, "It is my opinion that this patient is not able to perform any type of work and is totally disabled," is not useful. This conclusion is reserved solely to the Commissioner of Social Security under the federal regulations (20 CFR 404.1527(d); SSR 06-03(p); SSR 96-6(p), etc.).
A doctor's statement that addresses the patient's ability to sit,stand, walk, lift, carry, push, pull, concentrate, make decisions or perform other specific work related functions can be very useful opinion evidence.
Objective medical evidence consists of things like X-rays, laboratory tests, MRIs or CAT scans. These are found in your doctor's records.
Opinion evidence is quite different. Opinion evidence is where your doctor or professional renders an opinion on how your medical condition affects your ability to perform certain functions.
For example, an MRI may show that you have 2 herniated discs in your lumbar spine. This is objective evidence. It is what it is. The doctor may then give an opinion as to how long you can sit, stand or walk. That is opinion evidence. If your doctor states: "The patient would be limited to lifting no more than 10 pounds occasionally, sitting no longer than 30 minutes, standing no longer than 15 minutes at a time, or walking no more than 300 feet," that is opinion evidence.
Opinion evidence is used to form "residual functional capacities," that is, what is the most work like activity that an individual can perform on a sustained basis? This will be use by decision makers to determine what type of jobs, if any, the claimant would be able to perform. This, in turn, will determine whether the claimant meets the rules for Social Security disability benefits.
We should note here that broad, general conclusions by doctors are not useful. For example, the statement, "It is my opinion that this patient is not able to perform any type of work and is totally disabled," is not useful. This conclusion is reserved solely to the Commissioner of Social Security under the federal regulations (20 CFR 404.1527(d); SSR 06-03(p); SSR 96-6(p), etc.).
A doctor's statement that addresses the patient's ability to sit,stand, walk, lift, carry, push, pull, concentrate, make decisions or perform other specific work related functions can be very useful opinion evidence.
Wednesday, March 30, 2016
VETERANS SOMETIMES GET FALSE INFORMATION ABOUT DISABILITY BENEFITS
Unfortunately, disabled veterans sometimes get wrong information, even from Social Security.
Sometimes, we have known of disabled veterans being told, in effect, that they cannot apply for Social Security disability benefits because they are still receiving military pay, or "still working." However, the Wounded Warrior program permits disabled vets to apply for disability when they are receiving active duty pay if they are on medical leave, performing restricted duties or under therapy in a military treatment facility.
Social Security's website states the following:
Active duty status and receipt of military pay does not, in itself, necessarily prevent payment of Social Security disability benefits. Receipt of military payments should never stop you from applying for disability benefits from Social Security. If you are receiving treatment at a military medical facility and working in a designated therapy program, or on limited duty, the government will evaluate your work activity to determine your eligibility benefits.
Even if you are told by someone at a Social Security office that you do not qualify for disability benefits, check this with another qualified source. Social Security personnel are generally well trained, hard working and well meaning individuals who do excellent work. But, like in all other areas of life, mistakes are made. That's why you have attorneys and advocates to assist you with protecting your rights under the Social Security Act and to make sure that you get all the benefits you are entitled to, even when a mistake is made.
If you need to just check out a Social Security disability claim, or appeal an unfavorable decision, please feel free to contact the Forsythe Firm here in Huntsville for a no cost, no obligation discussion. (256) 799-0297.
Sometimes, we have known of disabled veterans being told, in effect, that they cannot apply for Social Security disability benefits because they are still receiving military pay, or "still working." However, the Wounded Warrior program permits disabled vets to apply for disability when they are receiving active duty pay if they are on medical leave, performing restricted duties or under therapy in a military treatment facility.
Social Security's website states the following:
Active duty status and receipt of military pay does not, in itself, necessarily prevent payment of Social Security disability benefits. Receipt of military payments should never stop you from applying for disability benefits from Social Security. If you are receiving treatment at a military medical facility and working in a designated therapy program, or on limited duty, the government will evaluate your work activity to determine your eligibility benefits.
Even if you are told by someone at a Social Security office that you do not qualify for disability benefits, check this with another qualified source. Social Security personnel are generally well trained, hard working and well meaning individuals who do excellent work. But, like in all other areas of life, mistakes are made. That's why you have attorneys and advocates to assist you with protecting your rights under the Social Security Act and to make sure that you get all the benefits you are entitled to, even when a mistake is made.
If you need to just check out a Social Security disability claim, or appeal an unfavorable decision, please feel free to contact the Forsythe Firm here in Huntsville for a no cost, no obligation discussion. (256) 799-0297.
Saturday, March 26, 2016
"RECENT WORK TEST" FOR SOCIAL SECURITY DISABILITY
If you stopped working more than 5 years ago, you do not have coverage for disability with the Social Security Administration.
You need to have recent work to be eligible for disability benefits. You must have worked at least 20 out of the last 40 quarters, or more simply put, you must have worked 5 out of the last 10 years.
If you stopped working at a job that pays FICA tax more than 5 years ago, you will not be able to get disability benefits, no matter how much you paid into the system. That money remains in the trust fund (pool) until you reach retirement age.
Your Date Last Insured (DLI) is the date you stopped being insured for disability claims with Social Security. If a disability begins after the DLI, it is not covered. This is one more good reason not to delay in filing a claim as soon as you feel you have become disabled.
You need to have recent work to be eligible for disability benefits. You must have worked at least 20 out of the last 40 quarters, or more simply put, you must have worked 5 out of the last 10 years.
If you stopped working at a job that pays FICA tax more than 5 years ago, you will not be able to get disability benefits, no matter how much you paid into the system. That money remains in the trust fund (pool) until you reach retirement age.
Your Date Last Insured (DLI) is the date you stopped being insured for disability claims with Social Security. If a disability begins after the DLI, it is not covered. This is one more good reason not to delay in filing a claim as soon as you feel you have become disabled.
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