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Tag: Social Security disability

Adam Neidenberg Disability Help Group

Posted on by Marissa-DHG

Adam Neidenberg is co-founder of Disability Help Group. He has been litigating claims since graduating law school in 1996.  Once he became an experienced trial attorney, he began focusing on representing disabled individuals.  Mr. Neidenberg has represents thousands of disability claimants and provides training to Disability Help Group advocates by teaching them how to assess legal issues, present evidence in cases, and cross examining experts. 

Adam Neidenberg is an Expert Disability Advocate

Adam Neidenberg has achieved much in life and feels a sense of pride in his ability to help disabled people receive the disability benefits they deserver. Some of Mr. Neidenberg’s educational and professional accomplishments include:

  • Firstly, University of Florida, Undergraduate Degree, 1993. 
  • Secondly, Hofstra University, Juris Doctor, 1996. 
  • Thirdly, Florida Bar Association
  • Fourthly, 11th Circuit Federal District Court
  • Moreover, United States Court of Veterans Appeals for Veterans Claims. 
  • Finally, Department of Veterans Affairs Accredited Attorney.

Getting the Help You Deserve

Mr. Neidenberg provides specialized services in disability law.  Disability Help Group’s experienced advocates can help you with your Social Security disability or Veteran’s disability claims.  We can help you understand which are the most advantageous disability rules for your claim.  Mr. Neidenberg and Disability Help Group help you build the strongest case possible. 

The Application Process

Mr. Neidenberg and his dedicated team help you file your disability claim.  We focus on making sure your disability application is accurate and complete.  Complete applications give you a better chance of winning your case at the earlier stages of the disability process. 

Understanding the Disability Process

Mr. Neidenberg and his team make sure you are in good hands during the Social Security disability process.

  • Firstly, provide an educated staff to answer your questions
  • Secondly, check on the status of your case regularly
  • Thirdly, ensure Social Security processes your case correctly
  • Fourthly, make sure documentation is submitted timely

Adam Neidenberg is an Experienced Hearing Advocate

Adam Neidenberg and Disability Help Group prepares you for you for your disability hearing.  Your advocate fully reviews your file.  We obtain any missing medical evidence you need and will discuss with you the questions the judge will ask you.  In addition the the administrative judge, there may be a vocational and/or medical expert that may be involved in your hearing.

Adam Neidenberg and Disability Help Group know what it takes to win your case. 

Case Study 1: Adam Neidenberg Disability Help Group

Donald had a car accident and hit his head losing consciousness.  Following his accident, Donald started having frequent headaches.  He also had problems with his balance, memory, and concentration. As a result, he became irritable easily.  After applying for disability, Social Security denied Donald’s case twice.  Donald hired Adam Neidenberg as his disability advocate. When we reviewed the file, it was clear that his doctor did not provide the necessary descriptions of Donald’s symptoms. Therefore, it was necessary to resolve the issues with the medical evidence. Once the issues were resolved, Donald had a hearing in front of an administrative law judge who found that Donald missed work frequently and determined that Donald met the Social Security disability rules and his case was approved.

Case Study 2: Adam Neidenberg Disability Help Group

Anne injured her neck in a car accident.  She required cervical spinal fusion surgery, however, surgery did not help improve her symptoms.  Likewise, she developed numbness and tingling in her arms., causing her problems using her hands.  Disability Help Group made sure that Social Security received all of Anne’s records.  Anne’s advocate suggested certain tests that could help her case, also provided additional forms for Anne’s doctor to complete.  Ultimately, Social Security found that Anne was unable to work and approved her case. 

Working with a Disability Expert 

The Social Security Disability process and rules can seem very confusing. For example, there several states in the process, an initial application, reconsideration, hearing, appeals council, and federal appeals. In addition, within each stage in the process there are has various forms that need to be completed and distinct rules that need to be followed. It is important that you hire an expert that understands how to apply the rules to your case that will benefit you. For example, Social Security has a rule that makes it easier for people over the age of 50 to win their case.

Case Study 3: Adam Neidenberg Disability Help Group

Janet, a 51 year old woman, applied for disability based on coronary artery disease, depression and anxiety.  She previously worked as a medical assistant.  She was unable to continue working because she suffered from frequent chest pain and swelling in her legs.  Due to her depression and anxiety symptoms, she had trouble concentrating and remembering things.  After being denied for disability by Social Security, Janet hired Disability Help Group.  Thereafter reviewing her file, we found that Janet did not provide Social Security with her psychiatrist’s information.  Her advocate requested her psychiatrist’s records and with the addition of these records, the judge found that Janet could not stand for long periods of time.  She also could not perform complex tasks.  Therefore, she could not return to work as a medical assistant.  Since Janet was over the age of 50, the judge was able to approve her 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.

How Receiving Social Security Disability Can Help You Get VA 100%

Posted on by Ken LaVan

How Receiving Social Security Disability Can Help You Get VA 100%. Receiving Social Security disability can help you get a 100% VA rating.  However, receiving Social Security disability doesn’t guarantee a 100% VA rating.  It can be used as powerful evidence for your VA claim.  Although, these decisions only help if you can show your conditions are service-connected. 

VA disability benefits

VA disability benefits require that you meet certain conditions.  You must have a current diagnosis.  That diagnosis must be service-connected.  You must also show a medical nexus or connection between your diagnosis and in-service incurrence.  The VA considers your disability service-connected if your medical condition:

  • Firstly, Was directly caused by military service
  • Secondly, Occurred while in the military
  • Thirdly, Was aggravated by military service or
  • Finally, Caused by conditions that are service-connected

VA disability rating and TDUI

Disability ratings range from 10% to 100%.  Next, it can be hard to earn a 100% disability rating when you have more than one disability.  Fortunately, the VA provides an alternate route to total disability rating based on individual unemployability (TDUI).  The VA considers your ability not only get a job but also to keep a job.  You meet the conditions for a TDUI rating if your disabilities prevent you from working and:

  • You have a single service-connected rating or have a combined disability rating of 70%

Social Security disability helps establish a current diagnosis

Firstly, SSDI looks at your medically determinable impairments (MDI).  Secondly, Social Security considers any condition that has an impact on functioning as an MDI.  Thirdly, a Social Security hearing decision includes a list of your disabilities.  Therefore, your Social Security approval helps determine your diagnoses. Receiving Social Security Disability Can Help You Get VA 100%. Call Now for a Free Case Review.

Social Security disability helps establish service-connection

Frequently, applicants for Social Security disability have to testify at a disability hearing.  During the hearing, the judge asks a lot of questions about your disabilities.  Often, applicants provide detailed explanations about their conditions.  They also explain when conditions started.  A Social Security hearing decision includes a summary of testimony.  Therefore, your Social Security hearing decision helps establish service-connection. 

Example:  Social Security hearing decision helps establish service-connection

Likewise, a veteran applied for disability benefits for PTSD.  During the hearing, he testified that he witnessed a young girl get hit by a vehicle while on patrol during his service.  He also testified that since his service, he started blacking out and became violent.  He testified that he didn’t sleep well, had significant paranoia and was very depressed.  The judge’s decision included the veteran’s testimony, helping to establish that his PTSD was connected to his service. 

Social Security disability helps establish severity

Social Security has a difficult standard to meet for eligibility.  You must show that your medical conditions prevent you from working in any job.  A judge’s decision must explain why a case meets the requirements for disability.  The decision includes specific reasons how significantly medical conditions impact a person’s functioning.  Therefore, a Social Security disability decision can help explain how severe your conditions are. 

Example:  Social Security hearing decision helps establish severity

Hence, a veteran applied for Social Security disability due to a lower back impairment, depression and anxiety.  During the hearing, the veteran testified that he injured his back during his service.  He could no longer perform his duties as a postal worker.  As a result of his chronic pain and limitations, he developed significant depression and anxiety symptoms, requiring medication and therapy.

In his hearing decision, the judge explained that his lower back condition caused significant limitations with standing, walking and sitting.  The judge also explained that his depression and anxiety symptoms caused significant problems concentrating.  The veteran provided the VA a copy of the decision, which helped him qualify for TDUI. 

Example:  Social Security hearing decision helps establish severity

For instance, a veteran applied for Social Security disability due to a traumatic brain injury.  He suffered from episodes of aggression, poor memory and difficulty getting along with others.  In his hearing decision, the judge referred to evidence in his record documenting that he needed a lot of help with his daily activities.  Specifically, he needed help with medication management and reminders to take care of his personal hygiene. 

His mother took him to all of his medical appointments and helped manage his bills.  His medical records documented that he could become very aggressive often.  The Social Security judge determined that the veteran would not be capable of maintaining any job.  The decision helped increase the veteran’s VA disability rating. 

Getting help with your Social Security and VA disability claims

Both Social Security and VA have complicated application processes.  The process can be even tougher when Social Security or the VA issues a decision that completely ignores the evidence.  Working with an experienced advocate helps increase your chances of getting approved.  They know how to turn a loss into a win.  An experienced advocate can analyze your case and help you receive maximum benefits.  It helps to have knowledgeable experts on your side. 

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.

Getting Both Social Security and VA Veterans Disability Benefits

Posted on by Ken LaVan

You can get both Social Security and VA Veterans disability benefits.  In fact, disabled veterans often apply for both types of benefits.  However, there are differences between Social Security and VA disability benefits. 

What is the difference between Social Security and VA Veterans disability benefits?

Social Security has two types of disability benefits. Social Security disability insurance benefits (SSDI) require that you have worked.  Unlike SSDI, Supplemental Security Income (SSI) benefits don’t require that you’ve worked.  However, you must meet certain financial requirements.  The VA offers veterans disability benefits only for individuals who have served in the armed forces. 

Social Security vs. VA Veterans disability benefits

SSDI and SSI have the same definition of disability.  You must have medical conditions that keep you from working. You must be unable to work for at least 12 months.  Social Security doesn’t award partial disability.  VA disability requires that your medical conditions are connected to your service.  Unlike Social Security, VA disability does award partial disability benefits.  VA disability compensation rates range from 10-100%, in 10% increments. 

Can I work and receive Social Security or VA Veterans disability benefits?

If you are working, you may not qualify for Social Security disability.  Social Security considers work earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you will not qualify for Social Security disability.  For 2020, SGA is earnings S1,260 per month or more (before taxes).  You can still qualify for Social Security disability benefits if you earn less than SGA.  However, any work may make it harder for Social Security to approve your claim.  Unlike Social Security, veterans can work while receiving VA disability benefits unless they receive Total Disability Based on Individual Unemployability (TDIU.)   

Do my VA Veterans disability benefits affect my Social Security disability?

VA veterans disability benefits don’t affect your SSDI payments.  You can receive both VA and SSDI payments at the same time.  However, VA benefits will reduce your SSI payments.  SSA considers VA benefits as “unearned income.”  Social Security will deduct unearned income on a dollar for dollar basis except for a $20 exclusion.  In other words, Social Security reduces your SSI benefits by the amount of your VA payments. 

Social Security and the VA follow different rules.  Getting approved for one doesn’t increase your chances of getting approved for the other.  However, Social Security considers evidence from the VA.  Similarly, the VA considers your Social Security records.   

Expedited Social Security disability claims for veterans

Fortunately, Social Security can fast-track certain cases for veterans by expediting the process for veterans with a 100% VA rating.  You should identify as a “Veteran rated 100% P&T: when filing your application.  You should also provide your VA rating notification letter.  Additionally, Social Security fast-tracks case for Wounded Warriors.  You should tell Social Security that your injuries happened while on active duty.  

Social Security application process

Firstly, Social Security considers their listing of impairments, known as the Blue Book.  Secondly, the Blue Book has very specific medical requirements.  Thirdly, it can be very difficult to meet one of the listings.  Finally, Social Security considers your residual functional capacity or RFC.  An RFC includes both physical and mental limitations. 

  1. Social Security looks at your medical evidence to figure out your RFC. 
  2. They ask you to attend an appointment with one of their doctors, sends you for an exam when they need more information about your conditions. 

VA veterans disability application process

Veterans go through a VA-directed medical review.  The VA uses military doctors and other health personnel to evaluate veterans for their disability.   Similarly to SSDI, the VA may ask you to attend a VA claim exam, known as a C&P exam. 

Disabled veterans and your age

Social Security has special disability rules the older you are.  They look at a chart known as the Medical-Vocational guidelines to evaluate your claim called the “grid rules.”

Example 1:  applying the grid rules over 50

For example, Jane, a 54 year old veteran, applied for disability due to degenerative disc disease and right shoulder impairment.  She previously worked as an x-ray technician.  Jane received a lot of treatment at the VA hospital.  However, she had surgery at a civilian hospital.  Her medical records included documentation that Jane had difficulty standing and walking.  She also had trouble using her right arm.  Social Security found that she could not return to work as an x-ray technician.  Since she is over the age of 50, Social Security applied the grid rules and approved Jane’s claim. 

Example 2:  applying the grid rules over 55

As another example, Scott, a 59 year old veteran, applied for disability due to arthritis in his hips.  He previously worked as a construction worker.  Scott needed a hip replacement and needed a cane for walking.  Social Security reviewed his records from the VA.  They determined that he could not return to work as a construction worker.  Since he couldn’t return to his past work, the grid rules allowed Social Security to approve his claim. 

Getting help with your Social Security and VA veterans disability claims

Hiring an experienced disability advocate can increase your chances of getting approved.  Firstly, your advocate helps you with your application and can make sure you provide all necessary information.  Secondly, your advocate walks you through the process.  Thirdly, they can answer all of your questions and help you understand all of the rules.  Last, your advocate knows what it takes to get your case approved, you need an expert on your side.

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.

How Do I Appeal an SSDI Denial?

Posted on by Ken LaVan

How Do I Appeal an SSDI Denial? Has Social Security denied your claim for SSDI benefits?  You may think filing a new claim can be better than appealing.  However, you should appeal any denials.  Re-filing can delay the appeals process.  Your chances for getting SSDI benefits improve when you appeal. 

Where do I appeal an SSDI denial?

You can file an appeal several ways.  First, you can appeal your denial online.  This can be the easiest way to appeal an unfavorable decision.  Second, you can file an appeal with your local Social Security office.  If you have a representative, they can help you file an appeal of your SSDI denial. 

How long do I have to file an appeal?

You have 60 days to appeal an SSDI denial.  Social Security gives you an extra 5 days to allow you to receive your denial in the mail.  Therefore, you have a total of 65 days from the date on your denial to appeal your SSDI claim.  If you don’t file within the 65 days, you may have to re-file your claim.  Social Security allows you to file an appeal in more than 65 days if you have good cause for missing your deadline.

What is good cause to appeal an SSDI denial for missing your appeal deadline?

Good cause can include several reasons.  Social Security considers:

  • What circumstances kept you from making the request on time;
  • Social Security’s action misled you
  • Whether you didn’t understand what you needed to do to appeal
  • Whether you had any physical, mental, education or language limitations that prevented you from appealing on time

Examples of good cause for missing your deadline

  • You were very sick when the appeal was due and couldn’t have contacted Social Security yourself or through someone else.  You would need proof that you were seriously ill.
  • There was a death or serious illness in your family
  • Records needed for your appeal were destroyed by an accident or fire.
  • You never received your denial notice
  • Some other type of unusual or unavoidable circumstances and you could not reasonably be expected to have met the deadline

What information should I include in my appeal for SSDI denial?

Most importantly, you need to include updated treatment information on your appeal.  You should tell Social Security about all the doctors you’ve seen since filing your application.  You should include any emergency room visits, also include any hospitalizations.  On appeal, Social Security looks at any new or missing information that might change their minds. 

Why was my SSDI claim denied?

Many people receive a denial for SSDI benefits the first time they apply. Understanding why Social Security denied your claim can help increase your chances on appeal.  Specifically, you will know what your claim was missing or where your claim can be improved.  Common reasons include:

  • Lack of medical evidence
  • You are working
  • Not following your doctor’s orders
  • Ignoring requests

SSDI denials for lack of medical evidence

Frequently, Social Security denies claims because there was not enough medical proof to show your condition keeps you from working.  You must show that your symptoms cause serious problems in your functioning.  Therefore, you should see your doctors regularly.  Additionally, you should see specialists for your conditions.  Often, specialists keep better records about your symptoms and problems better than a general doctor.  They focus on specific information Social Security needs to approve your SSDI benefits. You need to Appeal your SSDI Denial on time or you will have to start over.

SSDI denials for working  

Social Security defines disability as the inability to work for at least 12 months.  Therefore, if you are working, you may not qualify for SSDI benefits.  Social Security considers earnings over a certain amount “substantial gainful activity” or SGA.  If you earn over the SGA limit, you won’t qualify for SSDI.  If you have not been out of work for at least 12 months, you won’t qualify for SSDI. 

SSDI denials for not following your doctor’s orders

If you don’t follow your doctor’s recommendations, Social Security could deny your case.  Your doctor’s treatment plan shows that you cannot work due to your condition.  Without a treatment plan, Social Security can have trouble establishing that your condition impacts your work ability.  This also includes taking prescribed medications correctly.  Additionally, when you don’t follow your doctor’s orders, Social Security can decide that your limitations would be less serious if you followed their recommendations.  This can result in an SSDI denial. You need to Appeal your SSDI Denial on time or you will have to start over.

SSDI denials for ignoring requests

Often, Social Security requires additional information to process your SSDI claim.  This may include more information about your treatment or work history.  Social Security may not be able to make a decision without this information.  When you don’t respond to their requests, Social Security denies your claim for failure to cooperate. 

Get help appealing your SSDI denial

If you’ve been denied for SSDI benefits, you should consider working with a disability advocate.  Hiring a disability advocate can significantly increase your chances of winning.  A disability advocate makes sure you don’t miss any deadlines for appealing.  They can help get your claim on the right track for winning your claim. 

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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Who Qualifies for Social Security Disability?

Posted on by Ken LaVan

You can qualify for Social Security disability if you have a medical impairment or combination of medical impairments that keep you from working.  Your conditions must keep you from working for at least 12 months.  Social Security offers two types of disability benefits.  These include Social Security disability insurance benefits and Supplemental Security Income benefits.

Qualifying for Social Security Disability Insurance Benefits

To qualify for Social Security disability insurance benefits (SSDI), you must have worked a certain number of years.  Additionally, you must be between the ages of 18 and 65 years old.  You do not need to be a US citizen to qualify for SSDI.  Any worker with a valid Social Security number who paid into Social Security may file for benefits. 

Qualifying for Social Security Disability and Work Credits

You receive work credits each year that you work and pay taxes.  Generally, you need to earn a total of 20 work credits to qualify for SSDI benefits.  However, your work needs to have done recently.  Like other insurance programs, your coverage ends after a certain amount of time from when you stop working.  Unfortunately, if you stopped working more than five years before filing, you may not currently qualify for Social Security disability insurance benefits. 

Qualifying for Social Security Disability and Your Date Last Insured

Your date last insured (DLI) is the last date you can qualify for SSDI benefits.  Your DLI depends on when you last worked.  Typically, your DLI expires five years after you stop working.  However, if your earnings were low or inconsistent, your DLI may be less than five years.   For example, if you stopped working in 2020, your DLI would expire in 2025. 

Qualifying for Social Security Disability with an Expired Date Last Insured

  1. You may still qualify for SSDI benefits even if your DLI has expired. 
  2. Show your disability began before your DLI expired. 
  3. Medical evidence that shows you couldn’t work before your DLI. 

Example 1:  qualifying for Social Security disability with an expired DLI

As an example, Susan stopped working in 2012 when her lupus symptoms interfered with her ability to work.  As a result, her DLI expired in 2017.  Susan would need to show that her lupus symptoms prevented her from working before 2017. 

Qualifying for Social Security Disability:  Dependent Spouses and Children

Under SSDI, a disabled individual’s spouse and dependent children can receive partial dependent benefits.  Social Security pays benefits in addition to the disabled individual, called auxiliary benefits.  Spouses may qualify for additional benefits if they have a child under the age of 16.  They may also qualify if they are at least 62 years old.  Children may qualify if they are:

  • Under age 18
  • A disabled adult before the age of 22
  • A high school student under the age of 19

Qualifying for Supplemental Security Income Benefits

Unlike SSDI, you do not need to earn any work credits to file for Supplemental Security Income (SSI) benefits.  Social Security bases SSI eligibility on your income, assets and resources.  Additionally, both adults and children can file for SSI benefits.  For children, Social Security considers their parents’ income, assets and resources.  Dependent children or spouses do not receive payments under SSI. 

Income Guidelines to Qualify for SSI Disability Benefits

SSI benefits are considered a “means-tested” benefit.  Therefore, you must meet certain income guidelines to file.  To meet the SSI income requirements,

  • You must have less than $2,000 in assets (or $3,000 for a couple)
  • Have a very limited income
  • Are a US citizen (there are very few exceptions to this)

Example 2:  qualifying for SSI

For example, David hasn’t worked in many years.  He recently was in a car accident.  He suffered from a very serious back injury.  David lived with his parents and received food stamps.  He did not have any money in his bank account.  Since David had very little income and resources, he was able to file for SSI.  

Qualifying for SSDI and SSI

Sometimes, you can file for both SSDI and SSI benefits at the same time.  You earned enough work credits for SSDI.  You also meet the financial requirements for SSI.  Commonly, Social Security calls this “concurrent benefits.” 

Example 2:  qualifying for SSDI and SSI

For example, Janet worked consistently in the past.  However, she had to stop working due to her medical conditions.  Now that she is no longer working, she doesn’t have any income.  Janet applied for state assistance or relies on others for financial help.  Janet can file for SSDI because of her work history.  Additionally, she can file for SSI because she now has a limited income. 

Medically Qualifying for Social Security Disability Benefits

Social Security also looks at your medical conditions.  Social Security considers whether your medical conditions fall under their listing of impairments, known as the Blue Book.  Typically, the Blue Book requires that your medical conditions meet very specific requirements.  If your condition doesn’t fall under the listings, Social Security will look at what you can still do despite your impairments.  Social Security calls this your residual functional capacity.  If Social Security determines that your medical conditions keep you from working, they will approve your disability benefits. 

Working With a Disability Advocate

Hiring an experienced disability advocate greatly improves your chances of getting approved.  A disability advocate will explain both the medical and non-medical rules for qualifying for disability benefits.  They can help you file applications and appeals.  Most importantly, they prepare you for a hearing if that becomes necessary.  Specifically, your disability advocate reviews your file.  They also make sure all the necessary medical evidence has been submitted. 

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.

What is a Disabling Condition?

Posted on by Ken LaVan

What is a Disabling Condition? Social Security considers any medical condition disabling if it keeps your form working.  However, your conditions also must keep you from working for 12 months or longer.  Social Security has a list of specific conditions that will automatically qualify you for benefits, known as the “Blue Book.” 

Disabling Conditions Under the “Blue Book”

The Blue Book lists different medical conditions that qualify for disability benefits.  However, you must meet certain conditions.  Generally, the requirements under the Blue Book describe the most severe cases of any condition.  The Blue Book generally categorizes conditions by body system or function.  Although there is a separate disability listings for adults and children under the age of 18.  Above all they also include a listing for growth impairments. 

Listing of Medical Impairments

For adults, medical conditions that qualify for disability benefits include:

  • Musculoskeletal system, special senses and speech, respiratory disorders , cardiovascular disorders
  • Digestive system disorders, genitourinary disorders, hematological disorders, skin disorders
  • Endocrine disorders, congenital disorders affecting multiple body systems, neurological disorders, mental disorders, cancer and immune system disorders

Getting Disability on a Diagnosis Alone

Social Security has very few conditions that qualify you for benefits on a diagnosis alone.  These include ALS, an organ transplant and certain cancers.  Not all cancers will automatically qualify your for benefits. 

How do you Meet a Listing Level Impairment?

The Listings of Impairments set out the requirements for how severe the symptoms must be to qualify you for disability benefits.First, your doctor must diagnose you with a disability found under the listings. Second, Social Security needs to review your medical records.  They look at your doctors’ treatment notes and test results.  If you haven’t had the clinical or laboratory tests required in the listing, you should ask your doctor to perform them. 

Example 1: when your disabling condition meets a listing

For example, Donna has degenerative disc disease and herniated discs in her lower back.  Donna requires a walker for standing and walking.  She has an MRI documenting both the degenerative disc disease and herniated discs.  Her treatment records show that she has limited motion in her lower back.  She also has muscle weakness, decreased sensation and positive straight-leg raise testing.  Her doctors have continued to document these problems in her records.  Donna meets the listing under 1.04 for disorders of the spine. 

Disabling conditions and medical equivalence

If you do not meet the specific requirements under the Listings, you can medically equal them.  Social Security understands that there are many ways to diagnose and document the same illness.  Your disability may “equal’ a listing if it does not quite meet all of the requirements under the listing.  For example, the listing may require a specific result on a specific lab test.  However, you were given a different test that showed the same results.  SSA may find that your disability equals the listing.  Medical equivalence can be found if:

  • Your medical impairment is at least equal in severity and duration
  • But does not quite match the requirements under the listing.  

What if your Disabling Condition isn’t in the Listings?

You can still be found disabled if your disability isn’t found in the listings.  Social Security can still find you disabled if you can show that your conditions keep you from working.  Some examples of other disabling conditions include: Carpal Tunnel Syndrome; Fibromyalgia; Chronic Regional Pain Syndrome; Reflex sympathetic dystrophy; or Celiac Disease.

What if your Disabling Condition Doesn’t Meet or Equal the Listings?

If your disabling condition doesn’t meet the listings, Social Security considers your residual functional capacity or RFC.  Your RFC is what you are able to do despite your medical conditions.  An RFC includes both physical and mental limitations.  Social Security looks at your medical evidence to determine your RFC.  They will also consider RFC forms that are filled out by your doctors.  

What Medical Evidence is Considered?

Medical evidence for the period of time that you became disabled and unable to work will be used to determine if you are disabled, it is helpful if your treatment is continuous and ongoing.  Firstly, medical evidence can include your treatment notes and physical examinations. Secondly, imaging such as MRIs, x-rays, CT scans or nerve testing. Thirdly, blood work or biopsy results. And, lastly, pulmonary tests or mental health records.

Disabling conditions and your Age

Social Security has special disability rules the older you are.  If you are over 50 years old call us immediately to see if you qualify as an older individual. The older you are, the easier it can be to win your case. 

Example 2:  Applying the Grid Rules

For example, Justin, a 57 year old man previously worked as a painter.  He needs a cane, applied for disability because he injured his knee, trouble in standing and walking.  His medical records include MRIs and x-rays of his knee documenting his injury.  His doctors have also documented that he has pain and limited motion of his knee.  Since he is over the age of 55, the grid rules allow Social Security to approve his claim. 

 Contact us now for a free consultation.

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.

Related Articles

Tips for Getting SSDI Disability

Posted on by Ken LaVan

Tips for Getting SSDI Disability.  Applying for Social Security disability benefits can be frustrating and takes a lot of time.  Unfortunately, Social Security denies a lot of applications.  In some cases, it can take several months to years before a case is approved.  However, you can follow some tips that can help you. 

Tips for Getting SSDI Disability 1:  Understanding what you are applying for

Social Security offers two different types of disability benefits.  First, Social Security offers disability insurance benefits (SSDI) for people who have worked.  You must have earned enough work credits to apply for SSDI benefits.  Second, Social Security offers Supplemental Security Income (SSI) benefits for people who meet certain financial requirements.  You must be of low income, assets and resources to apply.  Both types of benefits require that your medical conditions keep you from working for at least 12 months.  You cannot file for SSDI or SSI if you are still working. 

Tips for Getting SSDI Disability 2:  Understand the disability process

The disability application process can take several months before you receive a decision.  Therefore, you should file your application as soon as you can’t work.  Your local Social Security office processes your application.  However, they do not make any decisions on your claim.  Instead, your claim is sent to Disability Determination Services (DDS).  DDS assigns a claims adjudicator.  The claims adjudicator will:

  • Gather your medical records
  •  Send you additional forms
  • Schedule an appointment with a Social Security doctor if necessary 

Once DDS receives all of your medical records, a Social Security doctor reviews your file.  They determine what you can do despite your medical impairments, known as your residual functional capacity (RFC).  Your RFC determines whether you qualify for disability benefits. 

Tips for Getting SSDI Disability 3:  Be prepared when filing your application

Naturally, disability applications require a lot of information.  Providing complete information gives you a better chance of winning your case.  Most importantly, you should provide all of your medical treatment information on your application.  This should include all doctors you have seen for the conditions interfering with your ability to work.  It should also include any emergency room or hospital visits.  However, you should only provide treatment information for the time that you have been unable to work. 

Providing your work history

You will also need to provide your work history.  Social Security only requires your work history for the last 15 years.  You should provide a clear description of your past work.  Social Security may deny your case if they don’t categorize your past work accurately.  This work history should include:

  • The date you last worked
  • The name of your previous employers
  • Your job title
  • The dates that you approximately worked for each employer

Tips for Getting SSDI Disability 4: Getting your doctor to complete an RFC form

Your treating doctors should complete an RFC form even if you think your medical evidence is strong.  Many times, medical records don’t clearly translate how your symptoms cause problems doing things.  Your doctor’s RFC form should be as detailed as possible.  It should include both physical and mental limitations.  A simple statement that you cannot work will not be enough.

Tips for Getting SSDI Disability 5: Understand the disability rules

Generally, Social Security disability requires that your medical conditions keep you from working at all.  However, Social Security uses a chart called the Medical-Vocational guidelines to evaluate your disability claim.  These guidelines are known as the “grid rules”.  The grid rules make it easier for older people to win their case.  Typically, if you are over the age of 50, the grid rules can allow Social Security to approve your case even if you can do other work.  The rules are even more favorable if you are over age 55. 

Tips for Getting SSDI Disability 6:  Stay in Treatment

You must provide proof that your medical conditions interfere with your ability to work.  Therefore, you need to see your doctors regularly for your conditions.  If you don’t see your doctors, Social Security can’t evaluate your conditions.  Additionally, you should follow all recommendations and take medications as prescribed.  If you don’t follow your doctors’ recommendations, Social Security could deny your case. 

Tips for Getting SSDI Disability 7: Get Treatment with Specialists

Typically, you should be in treatment with specialists.  Frequently, records kept by specialists record your symptoms and problems better than a primary doctor.  They focus on specific information that Social Security needs to approve your disability benefits.  This can include special tests or examinations.  It can also include your doctor’s opinion to explain how your conditions impact your functioning.  This can especially be true for any mental health impairments.  Generally, receiving medication from your primary doctor will not be enough to document your mental health conditions.  

Check on the Status of Your Claim

Checking on the status of your claim can be important.  It allows you to make sure Social Security handles your case properly.  You can check to make sure your doctors’ records were received.  You should confirm that they received any forms you completed.  Lastly, it ensures that you don’t miss any important deadlines. 

Appeal Denials

Tips for Getting SSDI Disability. Social Security often denies claims.  You should appeal any denials.  Re-filing a new application doesn’t help getting approved for benefits.  It only can delay the appeals process.  Frequently, Social Security denies you for the same reasons.   Your changes for getting approved improve when you appeal an unfavorable decision.  In fact, most cases have the best chance for approval at the hearing level. 

Work With a Disability Advocate

Navigating the Social Security disability process can be overwhelming and exhausting.  Social Security requires a lot of information and paperwork.  Working with an experienced disability advocate ensures that Social Security gets the information they need to process your claim.  You disability advocate walks you the process and answers all of your questions.  They regularly check on the status of your case, files any necessary appeals, valuable advantage at the hearing level. 

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.

What is the SSDI Back Pay Calculator?

Posted on by Ken LaVan

What is the SSDI Back Pay Calculator? Frequently, if Social Security approves your disability claim, you will receive back pay.  Back pay refers to the payments for months between your application date and your approval date.  Social Security calls to your approval date as your onset date.  Sometimes, back pay can go back further than the filing date.  Several factors considered include:

  • Your disability onset date
  • Your application date
  • The five month mandatory waiting period for SSDI

SSDI vs. SSI

Social Security offers two types of disability benefits.  To qualify for disability insurance benefits (SSDI), you must have worked a certain number of years.  To qualify for SSI, you must meet certain financial requirements.  Many times, you can qualify to apply for both types of benefits.  For example, you worked for many years.  However, once you stopped working, you no longer have an income.  You now rely on food stamps and help from family members.  Since you paid into Social Security, you can file for SSDI.  Additionally, you meet the financial requirements for SSI because you don’t have any income or assets.  You will want to use the SSDI Back Pay Calculator.

SSDI back pay

Under Social Security disability insurance benefits (SSDI), you can receive benefits back to the application date.  However, you can also qualify to receive retroactive benefits.  Retroactive benefits are paid for the months between when you became disabled and when you applied for benefits.  Additionally, retroactive benefits can go back one year before the application filing date. It is important to use the SSDI Back Pay Calculator.

Example:  SSDI back pay and retroactive benefits

For example, Sue filed for benefits on June 1, 2019.  Social Security found that she became disabled back in January 2018.  However, her retroactive benefits can only go back to June 2018, one year before she filed her application. 

SSDI Back Pay Calculator: SSDI back pay and the 5 month waiting period

Social Security does not pay back pay for the first five months after your disability began.  You start receiving benefits at the beginning of the sixth month.  Typically, the 5 month wait period can be much shorter than the time it takes for Social Security to approve your application. 

Example:  SSDI back pay and the 5 month waiting period

As another example, Don was found disabled as of January 2020.  Social Security approved Don’s claim in September 2020.  Don has to wait five months from January before his benefits start.  Therefore, his back pay goes back to June 2020.

Back pay for SSI

Unlike SSDI, Social Security doesn’t pay retroactive benefits for Supplemental Security Income (SSI) benefits.  Social Security cannot pay you before your filing date.  Under SSI, back pay starts one month after the filing date. 

Example:  back pay for SSI

Sarah filed for SSI benefits in January 2020.  She told Social Security that she became disabled in August 2017.  Social Security found Sarah disabled.  However, her back pay started in February 2020, the month after she filed for SSI benefits. 

SSDI Back Pay Calculator: Back pay and your onset date

When you file for disability benefits, you tell Social Security when you became disabled.  Social Security refers to this date as your alleged onset date.  Generally, your onset date should be the date you stopped working.  It can also be the date of an injury or illness.  When Social Security finds you disabled, this date becomes your established onset date (EOD).  Your EOD also determines when your back pay starts. 

When Social Security finds a different onset date

Sometimes, your EOD doesn’t match your alleged onset date.  This happens when Social Security finds that your disability began on a different date than what you put on your application.   Common reasons Social Security finds a different EOD include:

  • A change in age categories – there are more favorable rules for disability the older you are.  Specifically, they are more favorable for people over the age of 50.  Therefore, Social Security can find you disabled once you reach the older age category. 
  • Medical records and treatment – Social Security relies on medical records to decide if you qualify for disability benefits.  So if your treatment started later, your condition worsened over time or if something new happened, Social Security can find you disabled at a later date based on your medical records. 

Example:  back pay and your EOD based on your age

For example, Donna filed for disability benefits.  She told Social Security her disability started in February 2019.  However, she turned 50 years old in September 2019.  Social Security found she met the disability requirements when she turned 50.  As a result, her back pay started in March 2020, five months after her established onset date. This is how you use the SSDI Back Pay Calculator.

Example:  back pay and your EDO based on your medical records

Gary filed for disability benefits due to back pain.  He told Social Security his disability started in October 2018, when he stopped working.  Gary didn’t start seeing a doctor until February 2019.  He continued to see his doctor regularly.  His doctor ordered an MRI of his back in March 2019.  The MRI showed severe degenerative disc disease.  Hemet the disability requirements based on the MRI report.  Therefore, his established onset date was March 2019.  His back pay started in September 2019. 

SSDI Back Pay Calculator: How does Social Security pay your back pay?

Social Security pays your back pay in lump sums.  However, Social Security releases your back pay in different ways for SSDI and SSI.  For SSDI, Social Security sends you one lump sum payment.  This includes all of your back pay and retroactive benefits.  Unlike SSDI, Social Security sends your SSI back pay in installments.  They split these installments into three payments.  Social Security sends these installments six months apart.  Social Security does this because you cannot have more than $2000 at any time in order to receive your current monthly SSI payment. 

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

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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. 

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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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Cervical Neck Fusion and Social Security Disability

Posted on by Ken LaVan

Cervical Neck Fusion and Social Security Disability. You may qualify for Social Security disability benefits if you’ve had a cervical neck fusion.  However, you must show that you still can’t work.  Many different problems can cause neck pain and other symptoms.  Typically, degenerative disc disease, whiplash, herniated discs and arthritis can cause ongoing symptoms. 

Cervical neck fusion and neck impairment symptoms

Neck impairments can cause many different symptoms.  These symptoms may include:

  • Pain
  • Limited movement of the neck or shoulders
  • Headaches
  • Shooting pain down the back or arms
  • Numbness and/or tingling

Getting Disability for Cervical Neck Fusion

You may qualify for Social Security disability benefits for your cervical neck fusion or impairments.  However, you must show that your symptoms are severe.  They must cause problems doing normal activities.  Additionally, they must keep you from working for at least 12 months. 

Social Security provides a listing of impairments, known as the “Blue Book.”  The Blue Book provides specific conditions that you must meet to qualify for disability benefits.  Social Security doesn’t have a specific listing for a cervical neck fusion.  However, they do provide a listing for spinal disorders under 1.04. 

Listing 1.04 – Disorders of the Spine

To meet Social Security’s listing for your neck problems, you must show that the nerve root or spinal cord has been affected.  Additionally, you must show:

  • Evidence of nerve root compression, limited movement of your spine and muscle weakness with loss of feeling or reflexes, or
  • Spinal arachnoiditis, a painful disorder caused by inflammation that causes you to have to change positions every two hours

Getting disability if you don’t meet the listing

Many people will not meet the listing for their cervical neck impairments.  Fortunately, you can still get disability benefits.  Specifically, you need to show that your neck problems limit your functioning and prevent you from working.  Social Security assesses your residual functional capacity (RFC.)  Particularly, Social Security considers:

  • 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
  • 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

Example 1:  cervical neck fusion and Social Security disability

For example, Anne injured her neck in a car accident.  She required a cervical spinal fusion surgery.  Despite surgery, she continued to have severe pain and difficulty moving her neck.  She also still had problems using her hands due to numbness and tingling.  Social Security determined that she could not lift or carry more than ten pounds but could sit for six hours.  Additionally, Social Security found that she had serious problems using her hands throughout the day.  Therefore, she was unable to do even simple seated jobs.  As a result, Anne was approved for disability benefits. 

Social Security Grid Rules

Social Security uses a chart called the Medical-Vocational guidelines to evaluate your disability claim.  These guidelines are known as the “grid rules”.  The grid rules make it easier for older people to win their case.  Social Security understands that it may be harder for older people to do new or different work.  They will look at the grid rules if your impairments do not meet the conditions under the Social Security medical listings.

Example 2: cervical neck fusion and the grid rules

For example, Brad, a 57 year old man previously worked as a janitor.  He filed for disability because he developed degenerative disc disease in his neck.  He had cervical spine surgery.  Unfortunately, he continued to have pain in his neck.  His doctor told him he couldn’t lift more than 10 pounds.  Social Security found he couldn’t perform the duties required to be a janitor.  Under the grid rules, Social Security approved Brad’s claim. 

Medical evidence needed for cervical neck fusion and neck impairments

You must provide medical evidence to document any problems related to your neck problems.  Generally, medical evidence includes your doctor’s treatment notes, test results and imaging.   Most importantly, you should have MRI evidence of your cervical spine.  Also, your doctor should document:

  • Any pain with movement of your bones or joints
  • Problems moving your neck
  • Problems using your hands
  • Difficulty traveling places without assistance
  • Difficulty performing activities of daily living such as shopping, cooking, cleaning, using public transportation, bathing or getting dressed

Cervical Neck Fusion and Social Security Disability: RFC Forms

An RFC form can clearly explain how your conditions impact your functioning.  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 indicate all your medical symptoms and conditions.  It should also include all of your treatment and any side effects from medications.  An experienced disability advocate can provide these forms to you. 

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. If you have already applied for SSI or SSDI, call immediately to make sure your case is still pending and was filed correctly. You may be entitled to significant compensation.  Contact us now for a free consultation.

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