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Tag: Grid Rules.

What Is Traumatic Brain Injury?

Posted on by Ken LaVan

Traumatic brain injury (TBI) usually happens when you suffer an injury to the brain.  Usually, this can be caused by different events.  The most common include falls, car accidents or sports injuries.  Most people recover well from symptoms caused by the injury.  However, sometimes symptoms can last much longer. 

Symptoms of traumatic brain injury

Traumatic brain injuries can cause many different symptoms.  These can include difficulty thinking, feeling slowed down or difficulty concentrating.  Traumatic brain injuries can cause physical symptoms.  These include headaches, nausea or vomiting or feeling tired.  Traumatic brain injuries can also cause mood symptoms.  Mood symptoms include irritability, sadness or anxiety.  Traumatic brain injuries can also interfere with sleep. 

Social Security disability benefits for traumatic brain injury

You can apply for Social Security disability if you have a TBI.  However, you must meet certain requirements to receive benefits.  Generally, your condition must interfere with your normal daily activities.  Additionally, your symptoms must keep you from working for at least 12 months.  To qualify for Social Security disability insurance benefits (SSDI) you also must have worked a certain number of years recently. 

Social Security definition of traumatic brain injury

Social Security provides a listing of impairments, known as the “Blue Book”.  The Blue Book provides specific conditions you must meet to qualify for disability benefits.  Typically, the listings consider the most extreme severity of symptoms.   Social Security considers traumatic brain injury under listing 11.18. 

Listing 11.18 traumatic brain injury

Social Security considers traumatic brain injury as brain damage caused by skull fracture, a closed head injury or penetration by an object into the brain tissue.  To qualify under the listing you must show:

  • The inability to control the movement of at least two extremities (either an arm and a leg or two arms or two legs AND
  • Extreme difficulty in balancing when standing or walking, standing up from a seated position or using the arms OR
  • “Marked” physical problems and a “marked” limitation (for at least 3 months post-injury) in any one of the following:
    • Thinking
    • Interacting with others
    • Finishing tasks
    • Regulating emotions and controlling your behavior

Meeting the listing for traumatic brain injury

Social Security defines marked as more than moderate but not extreme.  “Marked” means having a serious limitation in that area of functioning.  “Extreme” means not being able to function in that area at all. 

What if my traumatic brain injury doesn’t meet the listing?

Many people will not meet the listing for traumatic brain injury.  However, you can still get disability benefits.  Specifically, you need to show that your traumatic brain injury limits your functioning and keeps you from working.  If you don’t meet the listing, Social Security considers your residual functional capacity (RFC).  Your RFC includes the most you can do despite your conditions. 

Example 1:  traumatic brain injury and Social Security disability

For example, Donald had a car accident and hit his head.  He lost consciousness when he hit his head.  Following his accident, Donald started having frequent headaches.  He started having problems with his balance.  Donald also started having trouble remembering things and concentrating.  He became irritable easily.  Social Security found that Donald’s symptoms would cause him to miss work frequently.  They also found that he would not be able to stay focused throughout a work day.  Therefore, Social Security approved his case. 

Medical evidence for traumatic brain injury

Social Security needs evidence showing that your symptoms cause severe problems.  Therefore, you must provide medical evidence related to your traumatic brain injury.   Generally, medical evidence includes your doctor’s notes, test results and imaging.  Your doctor should document:

  • Any physical problems using your arms or legs
  • Difficulty with balance or coordination
  • The frequency and severity of ongoing symptoms such as headaches or blurred vision
  • Behavioral changes in your mood or personality
  • Problems with focus or concentration 
  • Side effects from medications  

RFC forms for traumatic brain injury

Frequently, traumatic brain injuries cause both physical and mental symptoms.  An RFC form can help explain how your condition impacts your functioning.  It should be very detailed.  It should include all of your symptoms and treatment.  Your doctor should include both your physical and mental limitations.  An experienced disability advocate can provide these forms to you. 

Social Security grid rules

Social Security uses a chart called the Medical-Vocational guidelines, known as the “grid rules”.  They use this chart to help evaluate your disability claim.  These grid rules make it easier for people over 50 to win their disability case.  The grid rules make it even easier for people over 55.  The grid rules allow Social Security to approve your case if you can’t do your past work, even if you can do other types of less physical work. 

Example 2: grid rules over 50

For example, Paula, 53, suffered a TBI.  Her symptoms included frequent headaches, poor sleep and difficulty concentrating.  Paula previously worked as a cashier and warehouse worker.  Social Security found that Paula could not stand or walk for long periods.  They also found she could only perform simple and routine tasks.  She was not able do either of her past jobs.  Social Security found she could do simple, seated jobs.  However, under the grid rules, Paula was approved for benefits. 

Example 3: grid rules over 55

In another example, Bob worked as a mail carrier.  He suffered from a TBI.  Following his injury, he started having seizures.  He also suffered from weakness in his arms and legs and mood swings.  Social Security found that Bob could not return to his job as a mail carrier.  Social Security found that he could do other less physical jobs.  However, since Bob was 57 years old, the grid rules applied.  Social Security approved his disability claim. 

Call Now for a Free Case Review, 800-700-0652

Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

Can I Get SSDI if I am 60 years old?

Posted on by Ken LaVan

Can I Get SSDI if I am 60 years old? You can get disability benefits up until full retirement age.  Currently, full retirement age is 66 and 2 months.  Generally, winning a disability claim gets easier for people as they get older.  

SSDI vs. Early Retirement

You can file for early retirement benefits once you turn 62.  However, collecting early retirement rather than filing for SSDI has some drawbacks.  If you take early retirement, your benefit amount will be permanently reduced.  The amount Social Security reduces your benefit depends on the number of months you have until your reach full retirement age.  If you apply and get approved for SSDI, you will receive 100% of your monthly benefit.  That benefit continues when it switches over to Social Security when you reach full retirement age.

Filing for SSDI at 60 years old

SSDI benefits can be time consuming and challenging.  However, if you have the proper documentation to support your claim, you can win your claim.  SSDI requires that your medical conditions prevent you from working.  Additionally, you must be incapable of working for at least 12 months.  Luckily, Social Security can make it easier to receive SSDI when they are close to retirement age.

SSDI at 60:  medical evidence

Social Security has to figure out how your conditions interfere with your daily activities.  They do this by reviewing your medical records.  Therefore, you need to see your doctors regularly for your conditions.  Additionally, you should be in treatment with specialists.  Frequently, records kept by specialists document your symptoms and problems better than your general doctor.  Your doctors can also help your claim by completing a form explaining how your conditions impact your functioning, known as an RFC form. 

SSDI at 60:  grid rules

Social Security considers several factors to decide if a person qualifies for SSDI.  These factors include a person’s age, education, residual functional capacity (RFC) and their work history.  Your RFC includes what you can do despite your medical conditions.  Once Social Security figures out your RFC, they consider the grid rules.

SSDI at 60: applying the grid rules

Once Social Security figures out your RFC and you past work, they will look to the grid rules.  Basically, the grid rules allow Social Security to approve your SSDI claim even if you can do other work.  Social Security has separate charts for different physical categories.  Specifically, they include sedentary, light and medium physical categories. 

SSDI at 60:  Your past work

In order to apply the grid rules, Social Security must categorize your past work.  The grid rules only apply if you can’t return to any of your past work.  Social Security only considers past relevant work.  Past relevant work includes work you’ve done within the past 15 years.  Additionally, it should have resulted in significant earnings.  Temporary or part-time jobs might not count as past relevant work.  Your past work gets classified under one of the physical categories. 

SSDI at 60:  your job skills

Social Security looks at the type of skills required to do your past work.  Social Security considers whether any skills you learned at your previous jobs could be used to do something else.  If you do, Social Security considers them “transferable skills”.  Generally, people who performed semi-skilled or skilled jobs will have developed skills they could use doing something else.  This can make it harder to apply the grid rules.  However, at age 60, there must be little to no additional training or adjustment.  Some jobs require such specialized skills, Social Security will decide that the worker doesn’t have transferable skills. 

SSDI at 60: your RFC

Your RFC can include both mental and physical limitations.  Social Security evaluates your ability to perform activities required for you to work.  You must show that your medical conditions interfere with your daily activities.  Social Security reviews your medical records to figure out your RFC. 

Example 1:  applying the grid rules at 60

Julia, a 61 year old woman applied for SSDI due to coronary artery disease and high blood pressure.  She also suffers from depression.  Julia previously worked as a cook.  Her job required her to lift and carry up to 50 pounds at times.  Social Security found that she could not perform her job as a cook.  She had no transferable skills.  Social Security awarded Julia disability benefits. 

Example 2:  applying the grid rules at 60

Frank, a 60 year old man applied for SSDI due to a right shoulder injury.  He previously worked as a janitor.  He also had past work as a construction worker.  Frank has difficulty lifting and carrying heavy items with his right arm.  In fact, he can’t pick up more than 15 pounds.  Social Security found that Frank could perform light work.  Frank has no transferable skills. Therefore, Social Security approved Frank’s SSDI claim. 

Disability Help Group:  SSDI at 60 case study

For example, Matthew applied for SSDI because he had arthritis in his knees.  He was 62 years old and worked as a fork-lift operator in a warehouse for many years.  Matthew had only visited his primary care doctor.  His doctor gave him a referral to physical therapy.  Unfortunately, Matthew as denied for SSDI.  He then contacted Disability Help Group for help with his appeal.  Our advocate suggested that he get x-rays and imaging of his knees.  She also suggested that he get a prescription for the cane he used.  Matthew followed his advocate’s advice.  On appeal, Matthew’s additional medical evidence helped show that he could not return to his job as a fork-lift operator.  Therefore, Social Security applied the grid rules and approved his case. 

Call Now for a Free Case Review, 800-700-0652

Make sure you start your SSDI and VA disability claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

What is a Residual Functional Capacity Form?

Posted on by Ken LaVan

What is a Residual Functional Capacity Form? Residual functional capacity (RFC) forms can help support your Social Security disability claim.  RFC forms explain how your symptoms impact your ability to perform work activities.  Social Security does not award benefits on your diagnosis alone.  Therefore, you must show that your medical conditions keep you from being able to work. 

What is my residual functional capacity?

Residual functional capacity (RFC) is defined as the most you can do despite your medical impairments.  An RFC can include both mental and physical limitations.  Your RFC is very important.  First, Social Security looks at whether your condition meets one of the medial listings.  Most conditions won’t be severe enough to meet one of the medical listings.  Therefore, Social Security needs to look at your residual functional capacity.   

How does Social Security use residual functional capacity forms?

An RFC form helps Social Security understand how your conditions impact your ability to perform activities. The forms are used by SSA’s Disability Determination Services (DDS) office to process your claim.  A Social Security medical consultant reviews your medical records.  They complete an RFC form based on the information they have.  Additionally, they will provide an explanation for their findings.  Next, Social Security looks at whether or not your RFC lets them approve your claim. 

Physical Residual Functional Capacity forms

A physical RFC form includes questions about your ability to do things like:

  • How long  you can sit, stand or walk at one time or in an 8 hour work day
  • How much weight you can lift or carry
  • If you need an assistive device such as a cane, walker, wheelchair or crutches
  • Using your arms and hands for activities such as reaching, pushing, pulling, gripping or grasping objects
  • If pain, fatigue, other symptoms or side effects from medications cause limitations with concentration, persistence or pace

Mental Residual Functional Capacity Forms

A mental RFC form includes questions about your ability to do things like:

  • Your ability to understand, remember or carry out instructions or interact with others such as supervisors, co-workers or the general public
  • Your ability to maintain attention and concentration
  • If your symptoms interfere with your ability to show up to work, arrive on time or have to leave early

Residual Functional Capacity forms for your doctors

Your treating doctors may also complete an RFC form.  Having your doctor complete an RFC form can be very helpful.  After all, they should know more about your health than anyone else.  An RFC form should be very detailed.  It should include all your medical symptoms and conditions.  It should also include all of your treatment and any side effects from medications. 

The importance of residual functional capacity forms

Social Security considers more than just your diagnosis.  They need to understand how your conditions affect your functioning.  Therefore, even if you think your medical evidence is strong, RFC forms can help strengthen your case.  Many times, medical records do not clearly translate how your symptoms impact your functioning.  Specifically, your doctor’s RFC form can:

  • Provide your treating doctor’s opinion about how significantly your conditions impact your functioning
  • Provide your doctor’s opinion in the specific way Social Security evaluates functioning
  • Can help win your disability case especially if you are appearing before an Administrative Law Judge

How a residual functional capacity form can help win your case

Social Security considers your age, education and work background when evaluating your claim.  If you are under the age of 50, you must show that you cannot work at all.  Social Security will consider other types of work, not just the work you have done in the past.  An RFC form can help explain why you may not be able to work on a full time basis.

Example 1: Residual functional capacity forms

For example, say you are under the age of 50 and worked before as a cashier.  You have a back injury that interferes with your ability to do this type of work.  You also have side effects from your medications that make you drowsy.  In an RFC form, your doctor states that you cannot sit for more than 4 hours or stand or walk for more than 2 hours in a work day.  Your doctor also states that you have problems with attention and focus due to your medications.  These limitations help support your disability claim because it shows that you could not work a full 8 hour day. 

Residual functional capacity forms and the Grid Rules

Social Security recognizes that it may be harder for older individuals to learn new work.  Therefore, there are more favorable rules for people 50 or older.  These rules are known as the Grid Rules.  They are even more favorable if you are 55 or older.  Essentially, the Grid Rules consider your age, education and work background.  If Social Security finds that you can’t go back to work you’ve done in the past 15 years, you might be disabled. 

Example 2: Residual functional capacity forms and the Grid Rules

For example, Ellen, a 53 year old woman previously worked as a cashier.  She filed for disability because she developed osteoarthritis in her knees.  She can no longer stand or walk for long periods of time.  In an RFC form, her doctor stated that shecould not stand or walk for more than 2 hours a day but can sit for at least 6 hours a day.  Her doctor also reported that she needed a cane when walking.  She cannot work as a cashier.  Even though she can do seated work, the Grid Rules allowed Social Security to approve her case. 

Example 3:  Residual functional capacity forms and the Grid Rules

In another example, Adam, a 57 year old, previously worked as a janitor.  His job required him to lift and carry over 50 pounds occasionally.  Adam injured his back and can no longer perform his job duties.  In an RFC form, Adam’s doctor reported that Adam could not lift more than 20 pounds.  He also reported that Adam could only stand or walk for 4 hours a day.  Even though Adam could do other work, the Grid Rules allowed Social Security to approve his case. 

Disability Help Group, Call Now for a Free Case Review, 800-700-0652

Make sure you start your claim the right way and apply for all the benefits you deserve. Contact us now for a free consultation.

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