The Disability Expert

A Free Guide to Social Security Disability Insurance and Supplemental Security Income Disability Benefits


 

 

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     I applied twice once in MO. and once in TX. Well, my son was disapproved both times. My son was born 8 weeks premature and doctors then told me to apply; I did and was disapproved. Now my son has severe ADHD and takes multiple medications to function. But doctors again told me to apply, now have been disapproved again. What do I do? 
     You have 60 days to appeal the claim.  Please, see the article Mental Conditions in Children Applying for SSI Disability Benefits for detailed information about how SSA will evaluate your sonís condition.

     I'm 53 and I've been receiving Social Security disability benefits for a back condition, I've had one review only 6 months after the original determination.  When could I expect the next review to be?
     Most reviews are conducted either every 3 years or every 7 years depending on how likely the person is to improve.  Sometimes the reviews are conducted sooner if SSA feels the person is likely to improve.  Usually, a person over the age of 50 with a back problem is unlikely to improve; therefore, I would generally expect such a case to be reviewed only every 7 years.  A review 6 months after the original determination is unusual for a 53 year old with a back condition.  Since I donít know why your case was reviewed so soon in the first place, it is hard to predict when SSA will do the next one. 

     I wrote to you some time back.  I am the 60 yr that has Crohn's  I did receive  my Social Security disability benefits, thanks to your help. It took less than four months, and they paid me over a years back pay.  One questions, do you get the health  insurance from the date they pay you, or back when they said I was disabled.  Either I have to wait two years, or I can get it in 7 months.  I am not sure what date they pick. 
     Congratulations on your disability benefits.  Medicare starts 2 years after your established onset date.  This date may be even earlier than the time period you were paid for because you can only get paid for one year prior to the date you filed for disability benefits but your onset may be earlier than that.  Call your local SSA office and ask when your Medicare will start.
 

     How long does it usually take to hear back from SSD after you go to see one of their doctors? 
     It varies.  SSA may still decide it needs more information and send you for additional tests or examinations.  SSA may decide to write back to your own doctors for more information.  Some doctors who do exams for SSA send in theirs reports within a week or two; others may take a month or more.  Also, your caseworker may be speedy and efficient or your caseworker may be way behind on his or her work.  SSA may make a decision immediately upon receiving the report.  Many factors can affect how long it takes.  If you donít hear something within about three weeks, feel free to call your caseworker and ask what is going on with your case.

     My 51 yr. old father applied for Social Security disability benefits over a year ago.  At the time of application he had lost the use of his right arm and his doctor's believed he had a stroke.  In the last year his condition worsened.  He also is losing the use of his left arm, is extremely unstable, his legs are getting weak and he has trouble walking and his speech is very slurred and at times you cannot understand a word he says.  He was just denied for the first time.  After his denial, 3 different doctors have examined him and all believe he has ALS/ Lou Gerhig's Disease and that his condition is rapidly   progressing.  His inability to work and lack of income has him financially devastated.  He is about to lose his house and is severely behind on all of his bills not to mention the overwhelming medical bills he has acquired.  My question is:  Is there any way to get some sort of expedited decision or a presumptive decision when you have a terminal disease after you have already been denied once?
     The most important thing to do is to file his appeal within 60 days of his denial.  The first level of appeal is called a reconsideration.  A reconsideration usually takes less time than the initial decision.  If you will submit copies of all his most recent medical records documenting the ALS along with the form appealing the decision, you will save SSA lots of time trying to obtain those records.  You cannot get a presumptive disability or expedited decision, but if you do as I suggest, it shouldnít take very long for you to get a decision.

      What kinds of things should my doctor put in the examination asked for by Social Security disability benefits?  I have asked to have my own Dr. do the physical exam and  I'm not sure he has ever written one before.
     SSA will give your doctor detailed written instructions about what is needed in the examination.  Your doctor will be given a list of general instructions for SSA examinations.  Your doctor may also be given a list of specific questions SSA has about your individual case.

      I just won my case for Social Security Disability benefits. My attorney says that I most likely wont see any money for about 4 or 5 months . Is there ANY way to speed this up?
    
If you haven't done so already, you can contact your United States senator or representative and request that he or she contact SSA to try to speed up processing of your payment.  Also, you can call your local SSA office once per week until you receive your money.  This will prevent your case from being lost in the bottom of a big pile of cases on some slow person's desk.  Don't call more often than once per week, though; you don't want to annoy the person who is supposed to be working on your case.   There is not must else you can do.  I have known some people who have received their checks within two or three weeks, and I have known other people who have gotten their checks in seven or eight months.  It varies from one SSA office to the next and from one claims representative to the next.

     Can a person that is disabled receive both social security disability benefits and a pension check?
     Yes.

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     I am on disability in the state of Maine.  Can a person transfer benefits if one was to move to another state?
     If you move to another state, your Social Security disability benefits and/or your Supplemental Security Income disability benefits will continue after your move.  All you need to do is notify SSA of your address change.  Some states supplement the disability benefits with additional state benefits.  If this is the case in your state, then you would lose those additional benefits by moving to another state.  The new state that you move to may give you additional benefits to supplement your disability benefits.

     I was denied on my first application for SSI and filed a request for reconsideration.  They sent me a 7-page form asking questions about my activities of daily living, difficulties with personal needs, shopping, and examples of how I have problems with concentration, finishing a job, following instructions...I'm sure you know these very well.  I'm worried because I sat down with a tablet and ended up filling both sides of ten pages.  Is there such a thing as overkill in giving examples, etc.?
     Examples that emphasize things that you are able to do hurt your case.  Examples that emphasize the things you are unable to do help your case.  It is not the number of examples but the content of the examples that makes a difference in the case.  You are correct that what you write on this form can determine whether your case turns out to be an allowance or a denial; therefore, careful thought should be put into filling out the form.

     I have a question regarding Quality Assurance Reviews.  When the DDS sends a SSDI claim for a QA, are they selected randomly?  Also are most of the DDS decisions sent for a QAR favorable ones or do you know the ratio? 

Some of the cases the DDS makes decisions on are sent to a regional Social Security quality assurance office to check the quality of the work that the DDS is performing.  When the DDS makes a decision on any given case, DDS personnel do not know whether or not that particular case will be among the cases that go for quality assurance review.  Once the DDS inputs the decision into the SSA computer, then the computer notifies the DDS if the case goes to the regional quality assurance unit.  If your case is chosen to go for quality assurance review, it may well mean a delay of many weeks before you receive notification of the decision on your case.  If the regional quality assurance review finds something wrong with the case, then the case is sent back to the DDS for the DDS to fix the mistake.  This may mean that the DDS has to change the decision or that the DDS has to gather additional evidence; after the DDS fixes the case, the case is sent back to the regional quality assurance unit.  Once the regional quality assurance unit determines that a case is completed correctly, the case is sent back to the local SSA office, and the claimant is notified of the decision.  More allowances than denials are sent for quality assurance review.  I donít know the exact ratio. 
 

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     I have fibromyalgia and other very physical injuries (three herniated discs, etc.).  I've been asked to attend a medical evaluation in my local town by an internist.  I'm concerned because most internists don't know much about fibromyalgia.  I've heard that I can request that my own doctor do the exam.  Is this true?  What if the claims examiner resists or denies?  Does my right supercede?
     SSA is required to try to schedule the consultative examination with the claimantís treating physician.  Only if that is not possible does SSA then schedule it with a different doctor.  The courts really are tough on SSA on this issue; therefore, SSA tries to be really careful to schedule exams with the treating physician if possible.  I suggest that you call the disability determination specialist handling your case and ask why it was not scheduled with your treating physician.  Sometimes exams are not scheduled with the treating physician because the treating physician is not of the needed specialty.  Sometimes the treating physician has told SSA in the past that they will never do exams for SSA for any patient.  Sometimes SSA calls the treating physician and the treating physician refuses to do the exam on that particular patient.  If the treating physician has a history of doing inadequate/poorly performed examinations, then SSA will schedule the exam with somebody else.    Sometimes treating physicians are booked months in advance, and then SSA can schedule with somebody who can do the exam in a timely manner.  Treating physicians refuse to do SSA exams for a variety of reasons.  Sometimes, the treating physician does not want his patient to blame the treating physician if he or she is denied disability benefits.  Sometimes, the treating physician does not feel that SSA pays enough for examinations.  Sometimes, treating physicians feel that SSA requires too extensive of reports.  If SSA fails to schedule the examination with your treating physician without good reason, then that would certainly be one reason to appeal the decision. For both your fibromyalgia and your herniated disk, SSA will be seeking range of motion, loss of strength, any sensory loss or other neurological deficits as well as other information.   SSA is very specific about what kinds of information that is required on its internist examinations.  An internist would be able to provide the type of information that SSA needs on such a case.

My mother will be 65 in March of 2003.  The problem is, she has cancer and is not seeking treatment due to the fact that she has no insurance.  Is there any way that she could qualify for Medicare early?  She does not need SSI, however, medical bills will deplete her savings.  I do not have her exact diagnosis, but I am sure that it is bad (stage 4 or so).  Please answer as quickly as possible, I plan to get her an appointment in my area and get her treated as soon as possible. 
     When somebody is approved for SSDI, there is a 2-year waiting period before the person starts receiving Medicare benefits; therefore, being approved for SSDI benefits will not help her to receive Medicare any earlier.  If she is already receiving retirement benefits, being approved for SSDI will mean an increase in the size of her monthly payment.  When somebody is approved for SSI disability benefits, the person then receives Medicaid immediately.  However, since you say your mother does not need the money, I suspect her income and resources may be too great to qualify for SSI benefits.  Please, see my article Cancer and Social Security and Supplemental Security Income Disability Benefits to see how SSA decides if cancer is disabling.  Also, please visit The American Cancer Society website for more information about resources in your community that may be able to help you.

     I currently receive Social Security Disability Insurance for PTSD. Am I eligible for SSI? 
     Maybe.  SSI is a need-based program.  You must have below a certain level of income and resources to qualify for SSI benefits.  Your SSDI benefits count as income.  Sometimes a person whose SSDI monthly benefit is small can also qualify for SSI benefits.  Call your local SSA office and ask them to evaluate your income and resources to see if your currently qualify for SSI benefits.  

     Can you please tell me what the term " I agree to pay my attorney the maximum fee of the lower of 25% of my past due benefits" means? Also can you tell me if my attorney gets me ssi and ssdi benefits can he or she get 25% or less of both? Please help me with this tangled mess of a language term from SSA.  
     Your attorney gets 25% of your past due benefits or $5,300 whichever is lowest.  This means that SSA will compute 25% of your past due benefits.  If this amount is $5,300 or less, then this is the amount your attorney will be paid.  If 25% of your past due benefits is more than $5,300, then your lawyer will get $5,300.  If you obtain both SSDI and SSI, then your lawyer gets 25% of both for a total not to exceed $5,300.

     I recently received a stab wound to the heart. I am out of work for at least three months and while I was in the hospital I filled out a disability form and my mother sent it in. Unfortunately that was the beginning of December and it is now January 8th and I have not yet received anything by mail. I called and they said that they have not received my claim for Social Security disability benefits. 
    
If SSA did not receive your application, call SSA back and have them send you another one.  To qualify for disability benefits, a personís disabling condition must keep him or her from working for at least 12 months in a row.  SSDI and SSI are not short-term disability programs.  Please, see the article How Long Must Your Impairment Last to Qualify for Disability  Benefits? for more information about the duration requirement.

     I have been disabled for 3 years.  I am 50 years old. I worked in supermarket. I have a hearing in Feb. I started working 14 months ago light duty making 600 per month. Its my only income. I have carpal tunnel both hands, 2 surgeries.  I have cervical radiculopathy.  My lawyer said because Iíve been working this will hurt my case and I should go for the closed period for 14 months instead of full disability.  If I do this, I will still be disabled making 600 per month.  
     Your attorney has reviewed everything in your file (at least I hope he or she has).  Therefore, he or she is in a better position to make an informed decision than I am based on the limited information in this question.  A closed period is a period of time which SSA pays back benefits to a person who was disabled but is not currently disabled.  The person must have been disabled for at least 12 months in a row to be eligible for a closed period.  The period of disability must have ended within the 14 months prior to the time the person applied for disability benefits.  One reason a period of disability can come to an end resulting in a closed period of disability is that the person is now engaging in substantial gainful activity.  In 2002 and 2003, if a person is earning over $780 per month, he or she is generally considered to be engaging in substantial gainful activity.  If a person had been engaging in substantial gainful activity, ceased engaging in substantial gainful activity for at least 12 months due to a physical or mental disability, and then returned to work earning money at the substantial gainful activity level, then he or she might ask for a closed period for the period of time he or she was not engaging in substantial gainful activity.  Another reason that a period of disability can come to an end resulting in a closed period of disability is that the personís disabling condition has improved to the point that it is no longer disabling.  For example, imagine the person who has a head injury and as a result has frequent grand mal seizures for over 12 months in a row that keeps him or her from working.  Then, due to a change in medication or just having time to heal, the personís seizures cease, and the personís medical condition is clearly no longer disabling.  Then the person might be eligible for a closed period of disability for the time period in which his or her condition met SSAís requirements for disability. 

     Do you have to quit work to start the disability process? I was denied once already but I need the insurance. It's like being between a rock and a hard place. 
    
On 2003, you must be earning less that $800 per month to apply for disability benefits.  People who can continue to work should continue to work as long as they can. 
The people who are being found disabled by SSA donít have to wonder whether or not to quit working; the people being found disabled by SSA cannot work and continuing to work simply is not an option. 

   I have had fusion surgery on my lower back and still have degenerative disc disease, osteoarthritis, and 2 more ruptured discs in my lumbar spine and 1 ruptured disc in my neck. My ability to function in my opinion is non-existent due to pain and medicine affects, walking, sitting, bending, standing etc. Is the 50 year old rule hard and fast? I am 49 years and 4 months old ran bulldozers and heavy equipment. Will it come down to my ability to function daily? Dr says to apply for Social Security disability benefits. 
 
      When I first started working as a disability determination specialist, SSA was pretty lax about the age 50 rule; people who were 49 Ĺ were often treated as if they were 50.  In recent years, SSA has become pickier about waiting until the person is actually 50.  At age 50, it does become easier to qualify for disability benefits.  At age 55, it becomes even easier to qualify for disability benefits.  This is because SSA believes that as a person ages he or she becomes less able to adapt to other types of work.  Once a person reaches the age of 50, his or her past work and education play an increasingly important role in the outcome of his or her disability claim.  How you are able to function is ultimately the question that will decide whether or not SSA considers you disabled.  To decide how well you are able to function, SSA will look at all your medical records.  SSA will pay particularly close attention to any statements that your doctor makes about how your condition affects abilities you need in order to work.  For example, statements like ďMr. Smith is restricted to lifting 20 pounds on an occasional basis and 10 pounds on a frequent basis due to his back problemsĒ are given particular weight by SSA.  SSA also looks at your description of your daily activities when deciding how well you are able to function. 

     I am currently out of work on leave of absence, and I know that I will never be able to do my job or any other job that requires me to stand or walk on my feet. I want to work, and I have contacted our local dept of rehabilitation.  Voc Rehab they said after I get all my medical records together, they would look them over and see what they think I could do. I have many other medical problems with my back, shoulders, elbows, hands (had surgery), and knees as well as my feet. My doctor is currently running blood test for RA or maybe diabetic neuropathy or maybe peripheral neuropathy. Some of my foot problems are known and some are not, but my feet have been in extreme pain since 1995 and I have had MANY cortisone shots, but the doctor says no more. My question is, if the rehabilitation department says they don't think there is anything I could do, would that help me with a claim for Social Security disability benefits? If so, can I get a written statement from them saying they find there is nothing they think I can do? 
     Having Voc Rehab decide that they donít think that there is any type of work that you can do does not help you with your SSDI claim.  SSA uses an entirely different set of laws, regulations, and court rulings when deciding whether or not somebody is able to work.  SSA will make up its own mind about whether or not you are able to work.  Please, see the article Disability Evaluations for Other Programs for more information.

      My mother is collecting SSDI since 1991.  My mother started receiving benefits when she was 53.  She was scheduled for a CDR at 3 years.  She had one at age 57, which she passed.  However, since then, she has not had a CDR. I heard from someone that the SSA generally does not continue to do CDRs on recipients after they attain 60 years of age.  Can you tell me the CDR rules regarding older age recipients, such as those over age 60 and 65.  My mother will be 65 this June.  I know her disability benefits will be named "retirement" benefits at that time.  Does SSA in fact do CDRs on recipients after age 60/65...or is there an age when they stop doing them considering the person's advanced age?  Or are they subject to CDRs until they pass away? 
     Once a person is receiving disability benefits, his or her case is scheduled for periodic reviews to make sure he or she is still disabled.  These reviews are called Continuing Disability Reviews (CDRs).  All people receiving disability benefits are scheduled for CDRs regardless of their age.  Most cases are reviewed either in 3 years or in 7 years.  Permanent impairments are scheduled for a review in 7 years.  Impairments that might improve are generally scheduled for a review in 3 years.  If an impairment is very likely to improve, the case may be scheduled for review in less than 3 years.  Once a person turns age 65, disability benefits do become retirement benefits; since a person does not have to be disabled in order to receive retirement benefits, CDRs are no longer performed.  Until the person reaches age 65, however, the person is subject to CDRs.  From a practical standpoint, however, your mother has little to worry about from a CDR. Sometimes SSA has very little funding to perform CDRs and gets behind on its scheduled reviews.  At other times, CDRs are considered a high priority and the agency performs its scheduled reviews more promptly. How promptly reviews are performed may also vary from state to state.  The case of a person who will be age 65 in the next 6 months certainly is not a high priority.   Even if your mother were to receive a letter today saying that SSA is reviewing her case, she would have little to worry about.  It would take SSA at the very least another month to gather the needed medical evidence to determine if she is still disabled (probably longer).  Even if SSA were to decide that she is no longer disabled, it wouldn't be all that bad because once SSA decides somebody is no longer disabled, SSA continues to pay benefits for another two months before ceasing benefits.  She is so close to age 65, SSA would have little to gain by trying to stop her disability benefits at this point.  The cost of processing all of the appeals involved in stopping her payments would be more costly than just going ahead and paying her disability benefits for the next few months.  Even though SSA could do a CDR up until she is 65, SSA has nothing to gain by doing so.  Once she turns 65, she will not have to worry about reviews anymore.  

To read more questions and answers on general issues about Social Security and Supplemental Security Income disability benefits, click here.

          

 

 

 

 


 
 

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