Articles Posted in Social Security (SSDI & SSI)

While receiving disability benefits can greatly improve the lives of Pennsylvania individuals who are unable to work, applying for these federal benefits can be a challenge.  Understanding the necessary documentation and requirements can help the process of securing benefits.  Pennsylvania Social Security Disability lawyers can provide guidance through the application steps and help individuals understand whether they qualify for benefits.

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First, when determining disability qualifications, it can be helpful to rely on the Blue Book, which is a publication entitled Disability Evaluation under Social Security.  This book gives detailed descriptions of conditions and disabilities that qualify individuals for benefits.  It contains an overview of Social Security programs and explains the requirements of both Social Security Disability Insurance and Supplemental Security Income.

Additionally, the Blue Book lists acceptable sources of medical information and makes clear that medical evidence from professional health care workers is likely considered the most accurate. As the final section of the Blue Book, the listing of impairments includes disease groups, further broken into sub-points.

In order to secure Social Security disability benefits, the Social Security Administration requires that applicants show they are disabled, based on the Administration’s definition of “disability.” In earlier blog posts, we have written about the importance of meeting all of the criteria in order to successfully secure benefits.  The disability requirement essentially rests on demonstrating an inability to engage in work, or gainful activity, for at least 12 months. In addition to making clear that a physical or mental disability hinders an ability to work, the duration requirement must be met.
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Next, it must be determined that claimants qualify for Social Security programs.  There are different requirements depending on whether individuals seek Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Pennsylvania Social Security attorneys can help claimants file for Social Security disability benefits. Generally, applicants will be required to present a strong work history. The work history report is a form, available online through the Social Security Administration website. While it is more difficult to apply for Social Security disability benefits if you do not present a strong work history, it is not impossible. In essence, it may be more difficult to prove what you have earned and show that you qualify for Social Security benefits.

Generally, for the work requirement, individuals must have worked one “quarter” each year over the past decade.  The requirement is a sliding scale. For those workers who are not yet old enough to have worked 10 years, or who are nearing retirement, the requirement is lessened. To calculate the duration you have worked in terms of quarters, individuals receive credits that count toward their benefit coverage.

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Requesting a residual functional capacity questionnaire can be an important aspect of a successful claim for Social Security benefits.  Pennsylvania Social Security claimants must ensure that their treating physician appreciates the seriousness of their medical conditions. Significantly, a treating physician must understand that these medical problems affect their ability to function.

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Treating providers should be willing to express to the Social Security Administration (SSA) the severity and the nature of medical conditions.  By describing the extent to which an individual is affected by their medical condition, it will be clear how the condition affects an ability to function at work.

Residual Functional Capacity (RFC) is defined as the most that an individual is capable of performing, despite their physical and mental limitations.  Determining a Social Security claimant’s RFC helps the SSA assess the persistence and severity of symptoms.  This determination comes after it has been established that an individual has been suffering from a medically determinable impairment.

Social Security Disability benefits are available to individuals with multiple sclerosis.  While some men and women suffering from symptoms of multiple sclerosis use walkers or wheelchairs, others experience long-term remissions and can work successfully.  Doctors may assess individuals with multiple sclerosis and determine that the symptoms do not prevent them from working full-time. In turn, this makes it challenging for those individuals to secure Social Security benefits.  However, there are ways for Pennsylvania Social Security claimants to strengthen a claim for benefits that may otherwise be borderline.

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Reporting symptoms to health providers is critical.  Doctors should be made aware of how multiple sclerosis affects daily tasks.  By documenting all of the medical symptoms and providing these records to the Social Security Administration, a claim for benefits will be strengthened.   Since disabilities are evaluated by Social Security according to medical criteria, it is important to particularly note the effects of multiple sclerosis on the musculoskeletal system, for example.

Loss of function that affects people impaired by multiple sclerosis can include a range of symptoms. Examples of symptoms that can specifically affect an ability to work include:

When suffering from a medical condition that renders you disabled and unable to work, you may be eligible for Social Security Disability benefits or monthly Supplemental Security Income benefits.  Individuals with the conditions of Irritable Bowel Syndrome (IBS), Colitis, and Crohn’s Disease may be entitled to Social Security Disability benefits.   Ensuring that a case for benefits is properly presented may require the assistance of a skilled attorney who understands Social Security rules and regulations.  To receive Social Security Disability benefits, you must be deemed disabled –  not capable of engaging in substantial gainful employment.  Medical evidence is necessary to support a successful claim for benefits, and understanding how to set forth a strong claim can help ensure a successful conclusion.

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Disorders that may be considered in the digestive system include IBS, as well as other diseases and syndromes.  In order to prove a disability, medical evidence is typically presented by the claimant. The first step in presenting a strong case for disability benefits is to receive treatment from specialists skilled in treating the condition.  Treatment with a specialist is important for any condition that is considered severe and disabling.  For individuals suffering from gastrointestinal conditions, a gastroenterologist would be the specialist most likely seen, and testing may include x-rays, CT scans, blood work, and other laboratory testing.  Invasive diagnostic tools, such as a colonoscopy and an endoscopy, may be required to assess the cause of the condition.

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Meeting the duration requirement under the Social Security Disability Act requires that claimants seeking disability benefits prove their severe medical impairment has lasted, or will last, 12 months or longer.  Those conditions that are fatal would also meet the duration requirement.  This “duration” provision is interpreted strictly by the Social Security Administration, and for those Pennsylvania residents seeking Social Security disability benefits, it is important to abide by this rule. Denials of disability claims are common when individuals fail to meet the duration requirement, in some cases by failing to assert proper medical evidence, and in other cases by failing to fully understand the details of the requirement.

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According to the Social Security Act, “disability” is an “inability to engage in any substantial gainful activity” due to medically determinable physical or mental impairments that are expected to last for at least 12 months. The language here is intended to exclude from entitlement to Social Security disability all those conditions that are of shorter duration.  Also excluded are those conditions that would allow an individual to return to work within a few months.  One example may be a back surgery, which may cause an individual to miss an extended period of work, but it may not require a recovery time of a year or more.

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Substance abuse can affect a claim for Social Security benefits, making it difficult for disabled individuals in Pennsylvania to secure the benefits to which they might be entitled by law.  In some circumstances, those suffering from a disability may be abusing prescription medications or alcohol.  Pennsylvania Social Security Disability attorneys can help strengthen claims for benefits by ensuring that all rules and regulations are met and that a disability is unrelated to the impact of this abuse or addiction.  Understanding the impact of substance abuse and the importance of abiding by prescribed medications is important to a successful disability claim.

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The Social Security Administration makes clear in their Code of Federal Regulations that in order to receive benefits for a disability, claimants must abide by their physician’s prescribed treatment.  Section 404.1530 lists exceptions, which are acceptable reasons for failing to abide by treatment.  These reasons include situations in which the treatment is large in scope or risky.

Another component of receiving disability benefits is making sure that drug addiction or alcoholism is not a contributing factor that is material to the determination of disability.  Substance Use Disorders, as termed by the Social Security Administration, are evaluated to determine whether claimants have “drug addiction and alcoholism” that contributes to their disability.  When a claimant is addicted to drugs or alcohol, they will not be considered disabled if this addiction is a contributing factor to the determination that they are disabled.  Essentially, the question is whether the drug or alcohol addiction is the material disability, or whether another impairment is responsible for the disability.

Receiving treatment for symptoms that have rendered you unable to work is critical to a successful Social Security claim. When evaluating a potential disability, the first step is to examine whether there is a medically determinable impairment that can be expected to cause the symptoms at issue.

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The Social Security Administration has set forth their methods of evaluating symptoms and what they consider a symptom. In detail, this Social Security Ruling states what will be considered a symptom of an impairment, regardless of whether it is pain, dizziness, fatigue, or another symptom. An individual’s statements are not enough to establish a physical or mental impairment or a disability.

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Administrative Law Judges conduct Social Security hearings in order to determine whether applicants are eligible for Social Security Disability (SSD) or Supplemental Security Income (SSI).  Often, claimants are denied benefits once, or potentially two times.  While the hearings are informal, they can include various professionals, including an attorney, a vocational expert, a medical expert, and a court reporter.

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The purpose of a hearing is for the claimant to testify regarding their need for benefits.  They must show that they are disabled, as defined by law.

Typically, the judge asks questions of the claimant in order to understand the case.  When an individual is represented by an attorney, the attorney may ask questions that elicit a response providing the judge with important details.  A representative, such as an experienced disability lawyer, can help provide complete and helpful answers at a disability hearing.

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Individuals suffering from medical conditions that prevent them from working are encouraged to apply for Social Security, since the law requires the Administration to consider the combined effects of these conditions when determining eligibility.  Federal law mandates that Social Security take into consideration the combined effects of impairments when they make headachea decision about whether an individual qualifies for benefits. Applicants are encouraged to list all of their medical conditions, including minor ones, when applying for disability.

As the Social Security Administration completes its five-step evaluation process, they will look at the combined effects of your medical problem. In some cases, the combined effects of mental, emotional, or physical impairments may be disabling, even if the separate conditions may not be.  The critical element for Pennsylvania residents applying for Social Security is to communicate to their medical care providers all of their symptoms.  This allows for a complete record before the SSA.

According to the law, the first step is to determine whether an individual can engage in substantial gainful activity. If so, the individual will be deemed capable of work and not disabled. The second step in the evaluation process focuses on assessing impairments that may affect the ability to work.  Severe impairments substantially interfere with the ability to perform work-related tasks, both physical and mental.  These can include walking, bending, lifting, following directions, and communicating with supervisors and co-workers. Non-severe impairments are those that are not disabling on their own but can exacerbate symptoms of other conditions that may lead to a determination of disability.

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