WHAT IS A GAF SCORE

A GAF score is also known as global assessment of functioning. It is used in psychiatry and psychology to get a big picture of the patient.  One explanation used to assess GAF is to “consider psychological, social and occupational functioning on a hypothetical continuum of mental health-fitness.” The scores run from 0 to 100. The higher the number the better the picture. The score of 50 is serious and the score of 60 is moderate. The GAF score can change day to day, month-to-month and year-to-year. A psychiatrist or psychologist will often use a GAF score to give himself or anyone else referencing those records an idea of the overall psychological condition of that person.

Conditions like depression or PTSD do not have a specific score. Rather, the score is based on the opinion of the person giving the score. You could have depression with a score of 90 (minimal symptoms) or a score of 40, which is some impairment in reality testing or communicating (there are other descriptions).

The Social Security Administration is somewhat ambivalent about GAF scores. Some people take the position it is not accurate and some take the position it is accurate. Some take the position they will only accept the score is given by a psychologist or psychiatrist and not a nurse practitioner or the like.

I will say that continuing scores of 50 or below typically will persuade the Social Security Administration that she would be unable to function psychologically in a job.

 

WHAT IF YOUR CHILD SSI BENEFITS ARE TERMINATED AND YOU DID NOT DO AN APPEAL

In order to resume your benefits, you will have to file a new application. Typically, you will have to go to a hearing. That will take around 20 to 24 months. You will have an opportunity to make two applications. You can make an application alleging you are disabled as a child before age 22 and you can make an application alleging you are a disabled adult. Social Security has different rules for proving you are disabled as a child and for proving you are disabled at adult. In my experience, it is much more difficult to prove you are disabled as a child. There are advantages in proving that you are disabled as a child before age 22. The advantages are as follows. First, at such time as either of your parents dies, retires or becomes disabled, you may be able to be paid under their account. At that time, you would receive Medicare instead of Medicaid. However, as mentioned above, it can be quite difficult to prove your disabled as a child before age 22. Until one of your parents dies, retires or becomes disabled, if you are disabled as a child he would receive SSI and Medicaid.

In addition, you can try to prove you are disabled as an adult. Generally speaking, you would prove that by showing that you were unable to perform any job full-time. That can be because of psychiatric and/or physical reasons.

If you prove you are disabled as a child before its 22, you do not need to prove you are disabled adult. However, proving yourself disabled as an adult does not prove you are disabled as a child.

In order to prove your case, you will need to seek medical treatment for those problems that you believe make it difficult for you to work.

You should talk to me if you wish to resume benefits.

IF SOCIAL SECURITY FINDS YOU ARE DISABLED, BUT THE DATE THEY USE FOR THE DISABILITY IS LATER THAN WHAT YOU THINK IT IS, CAN YOU APPEAL THAT?

You can appeal the decision. You normally have 65 days from the date of the decision to appeal it. The appeal will probably be a Request for Hearing. Normally, you can do a hearing online. In these instances, they usually do not allow you to do it online. You will have to do it by mail. You should mail it certified mail, return receipt. That way, you can prove the dates you file the appeal.

Normally I would go ahead and suggest you do the appeal, but you have to be aware of the following. If you eventually go to a hearing, the ALJ can reverse the prior decision and you can lose everything. On the other hand, you may be able to get the back pay. One of the issues will be whether the medical records show that you were unable to work prior to the date that Social Security has picked I have found that if you are over 50, and there are medical records to support a serious condition, you have an excellent chance that the ALJ will award benefits earlier than the date originally awarded. The reason is that if you are over age 50, and your prior 15 years of work has been standing, and now you are limited to a sedentary job, you can be awarded disability even though you can work in a sedentary position. If you are under 50, it is still worth looking into. You can appeal the decision, and, if you find that the records are not going to support an earlier date of disability, you can always withdraw your appeal.

You should hire an attorney immediately so that the appeal can be done in a timely fashion. After you do the appeal, he will have access to the medical records we had access to. Both of you can then make a determination whether it makes sense to go forward or simply accept the benefits as is.

How much money can one make to be entitled to continue to collect SSI are SSD?

That is a difficult question. I will not address the Ticket to Work program. Forgetting that program for a minute, these are the following rules for SSD. If you gross $1040 a month or more, that is interpreted to mean that you are earning substantial gainful activity. If you are currently receiving benefits, you will then enter what is called a Trial Work period (you can enter the Trial Work period for lesser amounts, but typically they will not result in termination of your benefits). Those rules are complicated, but the essence is that you are entitled to work for a few months before your benefits are cut off. Further, even if they cut your benefits off, under certain circumstances you may be entitled to keep your Medicare. If you gross less than $1040 per month, theoretically, that would not reduce your SSD benefits. However, in may alert Social Security that you may have the ability to work and they may review you and determine that you have improved medically and are able to work.

The rules for SSI are little different. Again, there is a complicated formula in determining what monies are counted against your SSI. In essence, the first $80 of earned income is deducted before it is taken into account. They then look at 50% of your gross earned income. There are deductions taken for spouse or children. For example, if you gross $1000 per month of earned income, about $500 per month will be counted against your SSI dollar for dollar. These rules are complicated. He should talk to an attorney to find out more information

Can a person get both SSI and SSDI disability benefits in Florida?

The simple answer is that it depends. One can be paid SSD (Social Security Disability) benefits in Florida. This is typically true regardless of any other assets or income. The question is whether SSI (Supplement Security Income) can be paid in addition to the SSD. In Florida, if the SSD amount is $730 or more, typically SSI cannot be paid. This is true for 2013. The amount may change in the future. SSI currently pays $710 per month in Florida. SSI takes into account other income. However, it excludes the first $20 of that income. Thus, for example, if your SSD were $720 per month, that would count against you at $700 per month and SSI would pay you $10 per month.

COMPLETION OF FORMS AND ACCURACY

Beginning with the application, Social Security is going to have you fill out many forms. Accuracy can be important. If you are unsure, about anything, you would need to specify that. For example, you need to be very accurate about the kind of work you have done for the 15 years prior to the time you became disabled. The date you become disabled is fluid and is not always easy to determine. For example, you may be laid off and then apply for disability. That date is probably not going to be accurate because you probably could still work after you got laid off. You should be accurate about the dates you did the work or, in the alternative, specify you are unsure. You will need to state the names and addresses of all treating physicians and hospitals from at least the time he became disabled. There may be reason to obtain records prior to the time you became disabled. As Social Security pays for the records, it is best to put down too many treating physicians and hospitals as opposed to too few. There’s probably little reason to go beyond five years prior to the time you became disabled.

The other forms that are common are those that ask what you do throughout the day and what kind of pain you are in. I would recommend that you complete the answers on a separate page and attach it to the questions. I would number the answers so they can connect them to the question. I would not be too wordy. That is to say, you need to explain what goes on but not go on forever. You do need to be accurate. If you are unsure, you need to say that you are unsure or do not know the answer. You should never embellish. For example, do not say you use a cane every day if you only use it for long walks. Do not take the cane to an examination unless you use a cane on a regular basis or because it will entail a long walk to the examination.

The bottom line of all is that it pays to be accurate, but it pays to know when you don’t know. As someone notorious recently said, “there are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we know we don’t know. But there are also unknown unknowns. There are things we don’t know we don’t know.”

 So if you are unsure, say you are unsure.

HOW DO YOU PICK A REPRESENTATIVE?

It is not easy to pick someone to represent you in your social security claim. Like picking a doctor, sometimes you have to rely on referrals and sometimes you have to do your own research. Let me suggest some ideas as to whom to pick.

The first question is whether you want an attorney or nonattorney representative. An attorney, or lawyer, is someone who has gone to undergraduate college and then law school. Undergraduate college is typically four years. Law school is typically three years. In order to practice law in a particular state, that person needs to take and pass a state bar examination. They do not have to pass an examination to practice Social Security law. After that point, any additional learning is typically done at their choice. Lawyers in the state of Florida are required to have 30 hours of continuing education, but they do not have to have it in their area of practice.

While there are excellent nonattorney representatives, there are distinct advantages in hiring an attorney. Typically, an attorney is used to litigation in general. They are used to performing discovery, which means finding out about the case through formal procedures. They may be used to ordering medical records and reviewing them if they practice in the area that concerns medical issues. Usually, lawyers who practice in the areas of personal injury and workers compensation are familiar with medical issues. You will want to ask your lawyer whether he practiced in other areas and what those areas are.

Lawyers are familiar with making legal and factual arguments to a judge. They typically are familiar with preparing individuals for hearings and conducting hearings. They are familiar with conducting legal research. You want to ask your attorney his experience not only with Social Security, but any other areas and whether those other areas included making legal arguments, making factual arguments, conducting hearings and performing legal research.

Further, while a nonattorney representative can represent you from the beginning through several layers of appeal, there are two final layers of appeal that they cannot represent you in. If you have lost at a hearing, you can file an appeal to the Appeals Council. If you lose at the Appeals Council, only an attorney can file an action in federal court. This is at the federal trial level. If you lose at the federal trial level, only a lawyer can file an appeal with the Circuit Court of Appeals.

So, it is never an easy decision as to who to hire to represent you. Do your research. You can interview more than one person in deciding who to to hire. Ask questions. Ask them about their education. Ask them about their experience both in Social Security law and any other areas. Ask them why they will be the best person to represent you. Ask them whether you will be dealing with the representative or one of their assistants. Find out how easy it is to call the office and get answers to questions. Find out how they will be able to help you complete forms. Ask them what their policy is in regard to ordering medical records and will kind of preparation they have for the hearing.

Good luck.

A person asked a question as to when he would be determined to be disabled. He was treated by a chiropractor and wanted to know if his opinion would help. Last, he wanted to know when his payments might start.

You have raised several questions. The date you become disabled is called the date of onset. It is the date when all of the evidence shows you are disabled. Proving you are disabled can depend on your education, work history, and age. It can be the date you said you became disabled or it can be some other date that is more appropriate. It can be years ago or it can be very recent. Normally, you have to be disabled for at least 12 months at the time of the hearing. So, for example, you may believe you became disabled January 1, 2010 but all of the evidence supports a finding of March 1, 2012. By the time of your hearing, you would have been disabled at least 12 months.

The second question raised by you is whether the opinion of a chiropractor is adequate to prove disability. Unfortunate, it rarely is. He is what is called a nonacceptable medical source. An acceptable medical source is typically a medical doctor, osteopath or psychologist. There are some other exceptions. Most judges will ignore the opinion of a chiropractor. If you can get treatment with a medical doctor, that is better. If you can get an opinion from that same doctor that sets forth significant limitations, that is even better. Typically, if a physician states you are unable to work or are disabled, that is ignored. Rather, Social Security is looking for the limitations set forth by the physician such as how much you can lift, how long you can sit, how long you can stand and how many hours a day you can work.

The third question raised by you is how far back payment can be made. If you are insured for Social Security Disability, it can pay back up to one year prior to the date of application. If you are entitled only to SSI, the payments begin one month after the date of application. All this depends, of course, on the date of onset. The date of onset may be after the application depending on what you can prove. Further, Social Security Disability does not pay the first full five months of your disability. So, for example, if you are disabled January 1, 2010, the first payment is due June 1, 2010.

MEMORY LOSS, LACK OF CONCENTRATION, DEPRESSION

Very often, an individual will have mental symptoms as a result of physical problems. The physical problems can be all kinds of things. It may be a painful back. It may be a painful neck. There may be neuropathy, lupus or gastrointestinal issues. These physical problems cause chronic pain. Chronic pain can affect the ability to concentrate. It can affect the ability to remember things in the recent past. It can  make you depressed, irritable or even anxious. Even if you do not treat for these mental or psychiatric issues, you should consider what kinds of problems you are having when you make a Social Security disability claim or SSI claim. Preferably, you should determine what kinds of limitations or problems you have before you apply. A limitation is not being able to do what you used to do. So, for example, you may not be able to lift as much or sit as long as you once could. However, you should also consider how your mind is affected by these physical problems. Are you thinking about these problems all of the time? Does it make you unhappy? Does it make you anxious? Do you forget things you used to remember? Do you forget to take your medication or do you forget and leave things on the stove? When you try to focus on the task, does the pain make it difficult?

Even if you’re not treating for these problems, you should tell Social Security. Very often, they will have you evaluated by a psychologist or psychiatrist. That evaluation may result in some limitations in your ability to work that you were unaware of. It can help your case. When you come in to see me or speak to me on the phone, think about what mental limitations or mental problems you have. You should make a list of all the things that bother you. Some of them may not be that important in trying to work. Some of them may not be treated and it may be difficult to prove. However, it is important for the lawyer and for the Social Security Administration to know what it is that is bothering you.

How does a divorced spouse qualify for benefits?

A person can receive benefits as a divorced spouse on a former spouse’s Social Security record if he or she:

Was married to the former spouse for at least 10 years;
Is at least age 62 years old;
Is unmarried; and
Is not entitled to a higher Social Security benefit on his or her own record.
In addition, the former spouse must be entitled to receive his or her own retirement or disability benefit. If the former spouse is eligible for a benefit, but has not yet applied for it, the divorced spouse can still receive a benefit if he or she meets the eligibility requirements above and has been divorced from the former spouse for at least two years.
Generally, we cannot pay benefits if the divorced spouse remarries someone other than the former spouse, unless the latter marriage ends (whether by death, divorce, or annulment), or the marriage is to a person entitled to certain types of Social Security auxiliary or survivor’s benefits.
A person can receive benefits as a surviving divorced spouse on the Social Security record of a former spouse who died fully insured, if he or she:

Is at least age 60, or age 50 and disabled;
Was married to the former spouse for at least 10 years; and
Is not entitled to a higher Social Security benefit on his or her own record.

If the surviving divorced spouse age 60 or over applying for benefits remarried after age 60, or after age 50 and at the time of remarriage was entitled to disability benefits, we disregard the marriage. If a person is already entitled to benefits as an aged or disabled surviving divorced spouse and remarries, benefits continue regardless of the person’s age at the time of remarriage.
The benefits paid to a divorced spouse or a surviving divorced spouse will not affect the benefit amount paid to other family members who receive benefits on the same record.

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