Social Security FAQs
Social Security benefits can be paid if someone has only psychological illnesses. The illnesses can include, but are not limited to, anxiety, depression, bipolar disorder, schizoaffective disorder, panic disorder, agoraphobia and mood disorder. The illness, like any other illness, has to be severe enough to prevent you from working either completely or full time. It may be that some days you can work but some days you will be unable to concentrate or unable to even get to work. You do not always have to prove you are totally unable to work, but that you cannot work in what is called a competitive environment. That means showing up five days a week and staying on task eight hours a day. There are even some people with psychiatric illnesses who can work for months at a time but become unstable several times a year for weeks at a time. The point is that Social Security can pay benefits for psychological illnesses for a variety of reasons.
In Pinellas County, there are several facilities that provide psychiatric care. They include Suncoast Center, Boley, PEMHS, and Directions. Sometimes these facilities will allow you to go directly to them, other facilities require a referral from a primary doctor. Some of facilities that have primary care and may be able to refer you for psychiatric care include Community Health Care clinics, Pinellas County Health Department, and other private physicians. When you consult with me, I have the list of potential doctors who may be able to treat you, depending on where you live.
There are really two kinds of social security disability benefits. There is Social Security Disability (SSD) and Supplemental Security Income (SSI).
SSD is disability payments based on what you have paid in to the social security fund over your lifetime, typically from money taken out of wages you have earned. The SSD benefit can range anywhere from as little as $10.00 to as much as $2,000.00 per month. When your benefit reaches a certain point per month, approximately around $600.00, benefits can also be paid to your spouse and/or children. In order to qualify for SSD, you must have worked a certain number of quarters before becoming disabled. You must have worked at least 20 of the past 40 quarters before becoming disabled. A quarter runs from January through March, April through June, July through September, and then October through December. You must earn a minimum amount of money per quarter to count the particular quarter. The 20 quarters do not have to be consecutive (in a row).
There is also a little quirk regarding SSD. Once you stop working, you are not eligible for SSD forever. Rather, you remain eligible for SSD for a specific time after you stop working. Generally speaking, if you have worked consistently for five years, you will remain eligible for SSD for another five years. It becomes complicated when you have worked inconsistently or have waited a long time before applying for social security (SSD) after you have stopped working.
SSI is a different program. SSI is not from the fund that you have paid into. Rather, it pays benefits for people who either have never worked, have worked but have not earned enough quarters, or are getting paid SSD, but the SSD benefit is rather low. Generally speaking, an SSD benefit below $643.00 allows you to also get SSI. SSI pays the maximum amount per month. For example, in 2007, the maximum amount payable per month is $623.00. SSI is affected by other income of yours, your spouse=s income, and any other resources you may have. The rules are complicated and too difficult to explain here, but can be explained more fully when you contact attorney Stephan Freeman at our office.
There is no easy answer to this question. The reason is that the requirements to prove you are disabled differ depending on your age, education, work history, and current medical restrictions. Often, your doctor will not prevent you from working altogether. Rather, the doctor will place restrictions on you that prevent you from doing certain things. Thus, each case has its own unique requirements. If you are under 50 years of age, generally speaking, you have to be able to prove that you cannot work full-time doing any kind of job, not just the kind of work that you have done in the past. It does not make a difference whether or not you had done the work before, what the pay is, or even whether you would be hired to do a particular position. The requirement is that you can do no type of employment.
If you are over 50 years of age, the rules are different. Sometimes, it may be enough to simply prove that you cannot perform the work you used to do. In these types of cases, it will often depend on work capabilities such as how long you can sit, how long you can stand and how much you can lift throughout the day. These limitations can be determined through your testimony with the guidance of your lawyer, and your medical records.
It is very helpful to have a lawyer in order to present your disability testimony properly.
The application process for social security benefits is normally done in one of two ways.
The first, and preferred way, is to apply by computer, on-line. The web address for the Social Security site is: www.SSA.gov. After getting to the website, you will see a choice for disability benefits. Follow the instructions. You will be allowed to complete two of the three required forms on-line. Be sure to print the forms that you have completed. After you complete the two forms, the Social Security Administration will get back in touch with you about completing the third form. There may even be additional forms for you to complete.
The second way to apply for social security benefits is to go to your local social security office and fill out the forms there. Normally, you may have to wait a long period of time at the Social Security Administration office. Usually, they will give you the forms and allow you to come back another time with the completed forms. Or, you can make an appointment by calling 1/800/772-1213 and ask for an appointment with your local office. You can find the address for your local office on the social security website or they can help you with that information when you call by telephone. On the website, there is a section in the lower left corner to determine the address of your local office.
When completing these forms, some of the information they will be looking for is as follows:
- They will need to know what kind of work you have performed for the
past 15 years. They will need to know specifics about the work, such as
how long you had to sit, stand, walk, lift and other specific job duties.
- They also will want to know the names and addresses of all doctors you
have seen for the conditions that currently make you unable to work. If
you have had the condition for a long period of time, it would be best to
give them the names of doctors who have treated you over the years.
- It is also important to explain specifically how these conditions prevent
you from working. In other words, you will need to explain if you are
limited in sitting, standing, walking, lifting, kneeling, crouching, stooping,
including activities of daily living such as cleaning, cooking and so forth.
The SSI application cannot be completed on-line. When you do complete the SSI application, there will be a number of questions about your financial situation. This may require some time on your part.
As always, attorney Stephan J. Freeman is available to help you answers questions about these numerous and complicated application forms.
After you have completed the application, your file folder is sent to a department within the State of Florida called the Office of Disability Determinations (ODD). There, your medical records are ordered. Employees of ODD will send you additional forms to complete. I strongly recommend copying these completed forms before returning them in case they are lost. In addition to completing these forms, I also recommend that you get statements from family, friends and past employers in the form of letters explaining how they see your disabling conditions. I can assist with recommendations as to the kinds of information ODD is looking for in such letters. These statements/letters do not need to be formal, nor do they need to be notarized.
After the above information is gathered, ODD has your entire file folder reviewed by a doctor. Your claim is then either granted or denied. This entire process can take from 6 to 12 months. If your disability claim is denied, you have 60 days within which to file an appeal.
If you file an appeal, this appeal is called a RECONSIDERATION. The same process takes place as in the initial application review, but your file folder is reviewed by a different Aadjudicator@. You may end up filling out the exact same forms as before and, again, please make copies of the completed forms before sending them in to ODD. The reconsideration process often takes from 2 to 4 months. You have a much greater chance of being denied at this level than at the first, or initial, application level. If you are denied during the reconsideration, you then have an additional 60 days within which to appeal.
This next step is called a REQUEST FOR HEARING. This is your request to have a hearing in front of an Administrative Law Judge. This is usually your best chance of winning your claim for disability benefits. All of your medical records will be supplied to the Administrative Law Judge before the hearing. You will have a live hearing with the judge and sometimes there will be other experts in attendance. Unfortunately, it can take quite awhile to get a date for such a hearing. In January of 2009, it was taking about 20 months from the time of the Request for Hearing to actually have the hearing date.
If your disability benefits claim is denied at a hearing, there are still two additional levels of appeal. We are now getting a bit beyond the scope of this brief article and I would suggest that you discuss this further with me, if you would like.
What is my role of the attorneys at Freeman & Freeman? We are at your side assisting you every step of the way in what can be a very long, drawn out process. You will deal with us and not a staff member. While we have very capable legal assistants with whom you will probably speak from time to time, all meetings which you have in my office will be with attorney Stephan Freeman or Bonnie Freeman.
Most people are extremely frustrated and/or intimidated by the government bureaucracy of the Social Security Disability claim process. While most individuals can handle some aspects of the claim process, most often need assistance in with some of the steps along the way. This is how we can help you. We are there to assist you with the process described on our web page.
To go over what we do for you: WE gather all of your medical records and obtain certain types of other records, such as employment records, school records, personal statements from friends and reports submitted to your doctor by us and filled out for your Social Security Disability claim by your doctors. We continuously monitor the process to make sure that it is being handled by the Social Security Administration in as timely a manner as is possible. While we cannot control how fast they do things at the Social Security Administration, nor can we make them process your application any faster than anyone else’s claim, we can check on the status of your claim to be sure that it has not gotten lost along the way. We are also available for the Social Security Administration employees to contact should they feel that they need something additional which you might not have provided them.
In some instances, we try to persuade the Social Security Administration to decide in your favor at the first two levels of the application process. At the hearing level, we do our best to persuade them to decide in your favor without having a formal hearing, where appropriate.
If a formal hearing is necessary, you will meet with us before the hearing to prepare for the hearing. We are available for transportation purposes for attendance at the hearing (which can be in St. Petersburg, Tampa or Clearwater). The transportation is helpful to be sure that you are able to get to the right place at the right time.
Unfortunately, in these times, doctors are busy. Sometimes they do not hear everything you have to say or write down everything you have told them. When you get to a hearing, the records can sometimes miss things or contain inaccuracies. Sometimes you only have a few minutes with the doctor to tell them what is going on before they examine you and then they are gone. Here are a few tips you might use in order to make sure that all of your complaints and symptoms are given to the doctor to complete the medical record.
One tip is to keep a diary, and bring the diary with you to the appointment. (I discuss a diary in another FAQ.) However, it can be mentally difficult to keep a diary. If you are unable to do so, I would recommend that you write down your symptoms on the day of your appointment so that you can tell the doctor. One problem with that method is that if you have good days and bad days, and the appointment is a good day, you may not have symptoms or the symptoms may not be as severe as they ordinarily are. That is the advantage of a diary as it gives a broad picture of your condition. Regardless, whether it is a diary or notes taken the day of the appointment, it is wise to bring one or the other to the appointment. When asked how you are doing, you can tell the doctor that you want to refer to your notes because you cannot always remember to tell him everything that is going on.
You do not need to mention every, single symptom. You want to focus on your main symptoms that you believe are disabling. Sometimes, when you complain about too much, it looks like you are exaggerating or trying to win your case as opposed to trying to get treated. You can tell the doctor that you are applying for disability. You can also tell him that you are represented by an attorney if he asks. You can also tell the doctor that I suggested keeping a diary or bringing notes to the appointment so that the records accurately reflect your symptoms. If you want, you can actually make copies of the diary or your notes and leave them with him to put in the chart. Likewise, the doctor can make copies of the diary or notes to put in the chart. His
Sometimes the doctor puts down statements that are inaccurate. It might be that you are a drug user, smoke cigarettes or the like. In the event that we discover a misstatement in the records, we need to attempt to correct them as soon as possible. You can speak to the doctor at the time of your next appointment. We can write him a letter. It is important to document the mistake and see if we can get a correction in the chart.
One more thing. It is not uncommon for the chart to reflect that the patient is doing well. That often means that relative to the general condition, the patient is doing well. That is to say, the patient may have pain, but it is a good day. When you relay symptoms or how you are doing to the doctor, try to give him a bigger picture than just the day of the appointment. Try to give him a picture of how you have been doing since the last appointment. If you have good days and bad days, tell the doctor just that. If your condition is episodic, which means it only happens from time to time, and on the day of the appointment you are doing well, make sure you mention any episodes that occurred since the last appointment. If you have had surgery, and you are better, but still in a lot of pain, make sure you let the doctor know that.
One of the key ingredients in proving up your case is being able to explain your symptoms. This could be true regardless of the specific condition you suffer from. For example, if you suffer from back pain, the judge will be interested to know the location of the pain, the severity of the pain, what the pain feels like (sharp, achy, tingly), how often you feel the pain and how the pain affects you. If you have diabetes, you will be testing your blood sugar and you may feel the effects of the low blood sugar or the high blood sugar. Further, it is very helpful if you write down your test results on a daily basis to see how well you are controlling your insulin. If you have headaches, the judge will want to know the location of the headache, how often you have a headache and things like that.
The best way to keep track of these symptoms is to keep a diary. It does not have to be fancy. But it should be both legible and in chronological order. When you have a symptom, you should write it down.
For example, if you have headaches, you should write down when the headache started, what it felt like, how long it lasted, what you did during the headache, and how you felt when it actually went away (were you fatigued, etc.). You should write down what you thinkmight have caused the headache. If you took medication, you should write down the medication you took, when you took it, whether it had an effect and the effect it had.
These diaries are invaluable. All too often, when you are at the hearing, you will be asked questions about your symptoms. If you have documentation to back you up, it provides much more credibility for your symptoms. Typically, the diary will be copied and submitted electronically for the judge to review.
If you have a condition that does not allow you to write down in a diary, such as seizures, then you should have anyone who has witnessed the symptoms to write down as much detail as possible.
When you meet with me, I will discuss the specific condition you have and tell you what kinds of things to write down to help document your condition.
Age as a factor in obtaining Social Security benefits: you may be released to work but entitled to benefits
Age can be a key factor in obtaining Social Security benefits. Social Security has determined that people, beginning at age 50, have a significantly more difficult time in learning a new job. They have developed a set of rules that, generally speaking, makes it easier to obtain benefits at 50, 55 and 60. Again, the general understanding is that as people age, it is more difficult for them to learn new skills. In order to understand the rules, one has to understand how Social Security defines different jobs. The starting point is how much one has to lift at a job. There are five main job categories. They are sedentary, light, medium, heavy and very heavy. Generally speaking, if one has to lift 20 pounds or more on occasion, then the job is classified at the least at the light level. As the lifting requirements move up, then a job may be categorized as medium, heavy or very heavy. Sedentary work is defined as lifting no more than 10 pounds on occasion.
Generally speaking, if you are age 50 or above, and had a job that was light or above, and now you are restricted to sedentary jobs, you most likely will qualify for Social Security benefits. The rationale is that the skills you learned at these more rigorous jobs are not transferable to any kind of work where you sit all day long.
The point is that even though your physician may feel you are able to work, you may still be entitled to benefits despite that.
If you are age 50 or above, and believe you may qualify for benefits as described above, please give us a call so we can discuss your specific situation.
Social security benefits can be granted for just psychological disabilities. That is to say, you can be disabled for having psychological problems even though you have no physical limitations. The diagnosis is not as important as the symptoms. Simply having bipolar disorder, depression, PTSD or anxiety, in and of themselves, is not necessarily disabling. The symptoms from those disorders must be serious enough to disable you.
Examples of symptoms that might disable someone would be inability to concentrate, racing mind, inability to get along with others, inability to get out of bed for days on end, inability to leave the house without panic attacks., and serious panic attacks. These symptoms must be severe despite treatment and medication. The symptoms must continue to be serious even than have done your best to get better.
If you are unable to get treatment you can still apply. If you can show that you have made every effort to get treatment, and still cannot get treatment, and your symptoms are very serious, you can obtain benefits. That would also be true if you were getting treatment but were unable to afford your medication.
It is important to report your symptoms to your physician or caseworker. Do not hold back. Do not pretend things are good. Do not try to play the tough person. You need to let the person who treats you know exactly what is going on. You should keep a diary. I have another column within the FAQ telling you ways to keep a diary and what to write down. The diary should be legible. It should be able to be copied so it can be submitted to the Social Security Administration. Other people can assist you in keeping the diary so long as it is your thoughts on the page. They also can complete other forms or write letters outlining how they see you. Those also can be submitted.
If you have psychological symptoms that you believe prevent you from work you should investigate applying for Social Security. I can advise you as to whether the symptoms and the proof are enough to go forward.
Many people are diagnosed with fibromyalgia. . Symptoms typically include muscle aches, generalized pain, fatigue, and the like. The American College of Rheumatologists has set forth criteria to try to help physicians determine fibromyalgia. It is based on a minimum amount of tender points. Tender points are localized areas of tenderness around joints. Fibromyalgia can be diagnosed with the requisite number of tender points, but that is not necessarily required. Treatment can be a variety of things, including medication and physical therapy. My experienc e is such that there does not appear to be any kind of cure for fibromyalgia.
It is unfortunate, but many judges are skeptical about fibromyalgia. However, Social Security does recognize it as a valid disease or disorder and benefits can be paid if one is rendered disabled by the severe symptoms. In order to be successful in obtaining benefits for fibromyalgia, I offer the following. Keep close tabs on your symptoms by using a diary. There is another blog within this section in regard to symptoms. Make sure that your description of your symptoms is detailed. It should include the time of the symptom, a description of the symptom, and how it affects your day to day activities. At the hearing, the judge will want to know what you do day-to-day and how it has affected by your symptoms. The judge will want to know how long you can sit, stand, walk and how much you can lift.
In addition, you probably should let your physician know that you are trying to obtain disability benefits. You should try to get an idea of whether the physician believes you are either unable to work or have severe limitations. After you retain this firm, we can then determine whether we want to obtain a detailed report from your physician outlining those limitations or simply obtain some brief notes from him in regard to your limitations or the need of assistive devices, such as a cane or walker. Do not try to obtain these reports yourself. Sometimes the language used by the physician is inadequate and sometimes it can actually destroy your case. You should also let me know about any financial problems such as eviction, foreclosure or repossession. We try to give the judge a total picture of your life and how these disabilities have affected it. That would include how you have been affected financially, psychologically and physically.
If you have fibromyalgia, do not believe that you will be denied benefits. In the right circumstances, and with the right evidence, we can prevail.
One of the questions that often arises is whether one can work and still claim that one is disabled. The short answer is yes. However, there is more to it than that. Generally speaking, if you gross $1010 per month or more, Social Security presumes you are not disabled. This is true whether you whether you are working full-time, part-time, out of the house, at garage sales or the like. So, if you show up at work in pain, but are able to generate a $1000 a month or more, you will not be determined disabled. Likewise, if you stay home and do little jobs on the side, or take care of some children, or go to the flea market on the weekends and are able to generate $1000 or more a month, you will not be determined disabled. Remember, that is gross earnings. That means before taxes. However, they do not include business expenses nor medical expenses required for work.
An example of a business expense is the cost of gas. Medical expenses for work could include a walker or a specialized van.
If you work, and make less than $1000 per month, you can still make a claim for disability. You need to let your attorney know that you are working. You need to keep track of your earnings on a weekly or monthly basis. You should talk to the attorney before starting work to determine if that is the best avenue to take. If you do work part-time and make a claim for disability, you will have to be able to explain it to the judge why you’re able to work part-time and not full-time. You need to think about that before you start work and after you start work.
People typically work part-time in order to keep from being evicted, foreclosed or having your car repossessed. It is very understandable. Unfortunately, it rarely helps the case, but it is something that must be done.
What is a disability? A disability is a physical or mental limitation which you have which impacts your ability to work. Social Security does not use the word disability. Rather, they use the word impairment. An impairment is anything which significantly impacts your ability to work. As mentioned above, it can be a physical limitation or a mental limitation. A physical limitation can include all kinds of illnesses or injuries. For many claimants, it will be low back pain or neck pain. But it can be anything: allergies, asthma, muscle pain or headaches. As for mental limitations, those limitations can include anxiety, loss of concentration, depression, sleeplessness, lack of motivation and the like. Being disabled typically means that the impairments are severe enough that they prevent you from working at all or prevent you from working full-time.
Even if you have impairments or disabilities, you may not be disabled. As discussed elsewhere, in order to recover disability benefits, you have to either not be working or make less than $1000 per month. Some people believe that if they have an illness or injury,that having that injury or illness in and of itself is disabling. However, if one works, despite having an illness or injury, and makes at least $1000 per month, they are not considered disabled by Social Security.
While this may be confusing, the attorneys at Freeman & Freeman can help determine whether you may be able to prove you are disabled because of your impairments. Give us a call and see how we can help you.
When you turn 50, Social Security treats you differently. This is discussed in another article, but we wanted to focus on the importance of age in making a Social Security Disability claim. This is one of the few times in your life where getting older works to your benefit. In general, Social Security recognizes that as one ages, two things happen. One is the human body is not as strong as it used to be and begins to break down in different ways. Secondly, it is more difficult to learn new skills. Social Security will take both of these factors into account when determining if you are disabled.
For each additional year that you age over 50, this becomes more and more true. As you turn 55, the rules change again and it becomes easier to prove disability. When you turn 60, the rules change yet again and it is even easier to prove you are disabled.
These rule changes are primarily for physical disabilities. Mental disabilities are not taken into account in these specific rule changes. Social Security does take into account mental disabilities at all ages. They take into account all disabilities when determining if one is disabled. However, the focus at age 50 in easing the rules, is a focus on physical limitations only.
As discussed in another article, the rules generally work like this. Social Security first determines the kind of work you have done for the 15 years prior to becoming disabled. If your past employment required you to lift 20 pounds or more occasionally and/or stand or walk at least six hours a day, they ask a second question. What are you currently capable of now? If they determine you are limited to a job where you cannot lift more than 10 pounds and/or cannot stand or walk more than six hours per day, they will usually determine you are disabled. The reasons are somewhat complex, but, in essence, they believe that you do not have the skills to work in a capacity in a sitdown job that is similar any jobs which you did in the past 15 years. In other words, if you used to be able to do work that required lifting more than 20 pounds and/or prolonged standing and walking, and you can no longer do that kind of work, Social Securtiy will typically assume that you are unable to work at all.
Again, this is one of the few times in your life where getting older helps you.
The question often arises whether someone who has applied for Social Security disability and SSI benefits can also apply for unemployment compensation. The simple answer is yes. There is nothing illegal about applying for those benefits. In order to obtain unemployment benefits, there is a requirement to look for work. In the past, this has been able to be accomplished online and by phone call without filing proof. That may change. In order to be eligible for unemployment benefits, you have to be ready, willing and able to work.
However, many judges do not believe they are compatible. They believe that if you are looking for work you were not truly disabled. Thus, it can work against you by obtaining these benefits. I have tried to argue that there are a number of reasons a person may obtain these benefits. The person may be willing to try to work even though they suspect they will fail. I do not think the judges are persuaded. I also argue that one when one is faced with eviction, foreclosure or the like, one is going to pursue any legal benefits they can to survive. I think that is also a very strong argument, but it does not seem to persuade judges.
The bottom line in my mind is that these benefits are available legally. They can help pay your rent, food and the like. When asked by clients, I tell them that if they need the benefit they should pursue it. I let them know the downside, but I think the upside is greater than the downside. That is to say, there is more potential good than potential bad in accepting unemployment benefits.
If you want to apply for unemployment and have a chance to talk with me, that would be a good thing to do. If you have already accepted unemployment benefits, I would keep getting them until we have had a chance to talk.
Should you hire a lawyer to represent you in your claim for Social Security disability or SSI benefits? You might as well ask whether you should perform your own surgery or extract your own teeth. There is a reason that people go to specialists. People hire doctors, electricians and plumbers because they have specialized knowledge that takes years to attain. This is true for most, if not all, professions. It is true for a lawyer. If you try to save money by doing it yourself, usually you get what you pay for.
This is an important time in your life. You need someone who knows what they’re doing. You need someone who can tell you what is happening. You need someone who knows how to handle a Social Security disability or SSI case from pre-application through the payment of benefits. That is what we do. If you have not applied, we talk to you about how long the case will take. We can tell you what, if anything, you can do to prepare to make the case the best it can be. We help with the application process. We monitor the medical progression. We assist you in the appeals. You will be getting forms you will need to complete during the process. If you are unable to complete them on your own, we can assist. We obtain specialized reports if the physicians are willing to do so and if the reports are going to be helpful. We get those records that Social Security does not obtain. We prepare you for the hearing. We give the judge a detailed position of our case. We attend the hearing with you. If we lose at the hearing, we will perform an appeal to the Appeals Council if we think there is a basis for appeal. If you are denied at the Appeals Council level, we will file in federal court to its conclusion.
If you win, we make sure the benefits are paid from the correct date and in the correct amount. We give you informational literature regarding Medicare.
Yes, we do charge a fee. But it is earned. You would be surprised to know the background work we do throughout the case. Most of it you will not hear about. For example, we monitor the appeal process to make sure that no time limits are passed by. That means constant phone calls. We respond to your questions. After we spend time doing the appeal with you, we do follow-up letters to you and the Social Security Administration. When we order records, we often have to follow up with phone calls to prod the doctors to send the records. We review the records in detail. We spend a significant amount of time on the phone that you never hear about.
The bottom line however, is that paying a fee gets you results. You do not have to worry about the process. You do not have to figure what you have to do. You simply live your life, go to your doctor visits, fill out any forms required of you, and you let us do the rest.