Articles Posted in Social Security (SSDI & SSI)

knee x-rayIf you have a medical condition that has left you unable to work, you may need the assistance of disability benefits. Receiving an award of benefits can greatly enhance the quality of life of the recipient. However, the legal processes of your claim for disability benefits can seem daunting. Giving yourself a strong chance of success often means having a detailed understanding of the law, as well as of the procedures and processes that go into putting together a winning case. Your disability claim is far too important to entrust to anyone other than an experienced Pennsylvania Social Security Disability attorney who knows how to give you a good chance to get the benefits you need.

Andrea was a woman from western Pennsylvania facing such a need for disability benefits. In her case, she was seeking an award of disability benefits due to her osteoarthritis in her knees, along with her back and shoulder pain. As part of the process, Andrea underwent a consultative exam in February 2014. That doctor concluded, at the end of his examination, that Andrea could “occasionally lift up to 20 pounds and carry up to 10; sit for two hours at a time and for three total; stand for 15 minutes at a time and for one hour total; walk for 15-20 minutes at a time and for one hour total.”

In reaching her conclusion, the administrative law judge in Andrea’s case relied upon part of the doctor’s opinions but discounted other opinions expressed by that doctor. The ALJ did not explain in her opinion why she accepted the conclusions she accepted and rejected the ones she rejected. Andrea was able to use this lack of explanation to secure a remand of her case after the ruling was an unfavorable one.

public toilet stallIf you are disabled, that disability may permit you to recover disability benefits. In order to do that, you’ll have to file a claim and clear several hurdles along the way. You’ll have to prove that you are, as defined by the law, actually disabled and unable to work. In your case, you will want to make sure that your testimony and your proof are as persuasive as possible. To make sure that your case goes as smoothly as possible, consult an experienced Pennsylvania Social Security attorney.

Andrew was a man whose disability case is an example of how you may be entitled to a renewed chance to obtain benefits, even if you’ve received an unfavorable ruling from an administrative law judge at first. Andrew allegedly had a multitude of medical ailments, including microscopic colitis, bipolar disorder, schizoaffective disorder, panic disorder with agoraphobia, social phobia, and autism.

Andrew brought a Social Security Disability claim based upon his disorders, the symptoms of which he claimed prevented him from working. The administrative law judge who heard Andrew’s case concluded that he suffered from the claimed disorders and that those disorders could cause the symptoms that he listed. The judge, however, also concluded that Andrew was not credible when he asserted that the symptoms were so severe that they totally prevented Andrew from working.

overwhelmed manPeople may have various reasons for taking on the legal system without an attorney. Perhaps they think they can do as good a job as most lawyers. Perhaps they do not wish to divulge the details of their personal affairs with someone they don’t know. In a lot of situations, people decide they cannot afford an attorney. The result of many cases teaches that the opposite is often true:  that you can’t afford not to have legal representation. That includes taking on your disability benefits case. Your benefits are undoubtedly very important to you. Make sure you arm yourself with the knowledge and skill of an experienced Pennsylvania Social Security attorney.

The disability case of a man named Kenyotta shows just how valuable capable counsel can be. Kenyotta filed a disability claim and was judged to be disabled in 1993. Twenty years later, he was deemed to be no longer disabled. Kenyotta asked a disability hearing officer to review the decision, but the outcome remained unchanged. He appealed to an administrative law judge. His hearing before the ALJ was scheduled for Oct. 27, 2015.

Kenyotta didn’t hire an attorney. The importance of this decision was amplified because he did not show up for the hearing. He sent a letter asking for a postponement of the hearing and explaining why he could not attend. The letter, dated Oct. 27, 2015, said that Kenyotta was indigent and could not afford transportation to the hearing. He also made reference to an epileptic seizure and “an ongoing continuous relapse of [his] disability condition.” The ALJ determined that Kenyotta did not have a valid basis for missing the hearing and dismissed his case.

gavelObtaining supplemental security income (SSI) benefits is not as simple as merely filling out an application form, asserting that you have a disability, and then handing over certain information. The process involves very specific rules and very exacting requirements regarding the proof you need in order to obtain an award of benefits. Wherever you are in the process, if you are seeking SSI benefits, it is worth your while to retain the services of a knowledgeable Pennsylvania Social Security attorney.

An unfortunate example of how challenging the process can be was the case of Suzie. Suzie was a woman with multiple medical ailments who applied for SSI in 2012. In her claim, she asserted that she had been disabled for five years due to a collection of problems, including epilepsy, neck and shoulder injuries, partial loss of her right arm, a lower back problem, and COPD.

Suzie had a lawyer at first, when her case went before an administrative law judge (ALJ) and her claim was originally denied. After that, though, she decided to proceed onward through the legal system on her own. She appealed to the federal district court and was not successful. She then took her case to the Third Circuit Court of Appeals, but again, she did not achieve a successful result.

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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