Having a plan or strategy is very important to winning your Social Security disability appeal.
Judges
have very limited time to spend on a case. They are required to issue
up to 700 decision a year, or over 50 per month. One case may have
thousands of pages of medical records and other documents to review.
Your attorney or representative can help the judge, and your chance of
winning, by pointing out what the judge needs to know.
- Is this claimant insured for benefits?
- What kind of past work did the claimant do?
- Does he or she meet a Listing or grid rule?
- Are there any transferable skills?
- Does the medical record support the alleged onset date? If so, where?
These are things the judge must know to decide the claim.
A
good representative will read and analyze the medical records, which
are the foundation of every case. The important evidence will be
pointed out to the judge. Are there MRIs or imaging studies to prove
the alleged impairments? Where can they be found quickly?
Do
any of the treating doctors provide an opinion on the claimant's
ability to perform work-like activities? How do these opinions limit
the claimant's residual functional capacity?
Then
we come to the claimant's testimony. It's very important that the
claimant has been prepared and knows what to expect--and how to answer.
The testimony should match up with what the doctors say in the records.
Award
rates among Social Security judges are lower now than at any time in
the past 30 years. A lot of things have to line up and make sense for
the judge.
I
always provide the judge with a pre-hearing brief. That means that I
give her a step-by-step view of the case and why the federal regulations
allow benefits to be paid. The brief condenses hundreds (or thousands)
of pages of medical evidence into 3 or 4 pages that can be read in
about five minutes. So, I try to help the judge make efficient use of
his/her time.
A
lot of times I can answer difficult or technical questions for the
judge. This can also help to get a favorable decision out more quickly.
It's
risky to walk into a hearing and just hope for the best. Those kind of
hearings often don't go well for the claimant. It's much better to
have a legal roadmap of where you want to go and how to get there.
That's worth paying the attorney/representative a fee when your case is
successful.
So,
talk to a representative early in the process. I think most people who
appoint me to represent them decide after just a few minutes that I can
add value to their case. I have to think so, too, or I won't take the
case. The best of all worlds is when the claimant and representative
work well together as a team.
______________
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike NW, Site 108
Huntsville, AL 35806
"Across from Bridge Street"
CALL (256) 799-0297
https://forsythefirm.wixsite.com/website
Most
Alabama workers are covered by Social Security disability because they
pay FICA withholding tax out of every paycheck. This provides coverage
against long term disability and loss of income.
However,
Social Security can be difficult to deal with and there are complex
rules that must be met before they will part with any money. It can
take anywhere from 4 months to 4 years to get approved.
Here
is the sticky part. Social Security will often agree that you cannot
perform the work you once did. However, they will say that you can
still perform some jobs which exist in the national economy.
These jobs are often unskilled minimum wage jobs, such as hand packager,
inspector or copy colater. It doesn't matter that you can't actually find one of these jobs.
If you
file an application and are denied (as up to 75% are), you have 60 days
to file an appeal. The appeal puts you in line for a hearing before a
US administrative law judge (ALJ), who can review your case and give you
a new decision. Your odds before the judge are much better, especially
if you are represented by counsel who understands the system and how to
navigate it.
HOW CAN YOU PAY FOR EXPENSIVE LEGAL COUNSEL?
You
don't have to. Social Security forbids an attorney or representative
to charge you any fee unless your case is decided in your favor and
results in back payments. In that case, Social Security will withhold a
small portion of your back pay and pay the legal fee directly. You
keep most of your back pay and 100 percent of your monthly benefits.
If
you need help with a Social Security disability application or appeal,
please invest 15 minutes in a phone call to our firm for a free initial
consultation. We never ask you for money and our experienced disability
advocates have been handling cases like yours for over a decade.
_________
THE FORSYTHE FIRM
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
"Across from Bridge Street"
CALL (256) 799-0297
SOCIAL SECURITY JUSTICE WEBSITE
At step 3 of the sequential process, Social Security must determine your "residual functional capacity," or RFC, they call it. This is basically the maximum you can do in terms of work-related activities--such as sitting, standing, bending, lifting, reaching, etc. For mental impairments, it judges ability to concentrate, remember, understand and follow simple instructions, etc. The judge will normally use one of two methods to determine your RFC:
1. He/she may plow through your medical records and simply make up an RFC, which is rather arbitrary. This is scary and unless the claimant has a devastating health condition, often leads to a denial. Bad idea
2. The judge may look back at the RFC used by the state agency that originally denied your claim and use the same RFC at the hearing. Since this RFC got your claim denied in the first place, it will get you denied again at the hearing. Also a bad idea.
So, what's the alternative? The better idea is for you or your attorney/advocate to give the judge a valid residual functional capacity, so he/she does not rely on either 1 or 2 above. In other words, provide your own RFC.
How do you get this residual functional capacity? It has to come from one of your treating doctors. The form I use is called a "Medical Source Statement" or MSS for short. The MSS form should be customized to fit the claimant's particular impairments. For example, if the impairment is fibromyalgia, the MSS form should be tailored to that particular ailment. If the impairment is mental--such as depression or PTSD, there is another form for that. I often customize my own forms to fit the claimant's particular symptoms, such as pain, fatigue, lack of concentration, poor memory, etc.
IMPORTANT: Social Security will not ask for or obtain this form from your doctor. An RFC is not part of the doctor's routine medical records. It's up to each claimant or attorney to provide this form to the doctor, ask for it to be completed, then submit to Social Security before the hearing takes place.
The use of a properly completed and appropriately customized RFC/MSS form can make a vast difference in the outcome of a Social Security disability case at hearing. In fact, it may be the key piece of evidence and may be given "controlling weight" in the judge's decision.
CAUTION: Do not make the following mistakes in regard to the RFC/MSS form:
A) Do not assume Social Security will have this done, or that the Social Security doctor who examined you will fill out this form. Even if he does (very unlikely), it will not help you--guaranteed. It needs to come from YOUR doctor.
B) Never assume that the RFC is part of your doctor's routine medical records. It never is.
C) Do not get the RFC/MSS form completed by a nurse practitioner (CRNP), chiropractor, therapist, counselor or anyone besides a licensed Medical Doctor (MD or DO), or a licensed psychologist (Ph.D. or Psy.D) for mental issues. If you have a vision impairment, a licensed optometrist can complete the form--but only with regard to vision problems. Not all medical professionals are considered "acceptable medical sources" by Social Security. Doctors (MD or DO) are acceptable. So are licensed psychologists (Ph.D. or Psy.D)--but NOT therapists, counselors, social workers, nurse practitioners, chiropractors, etc.
Summarizing. The following professionals may sign your RFC/MSS form:
- Doctor of Medicine (MD) or Doctor of Osteopathy (DO). This includes psychiatrists, who hold MD degrees.
- Licensed psychologist holding either the Ph.D. or Psy.D (doctorate) degree and properly licensed by the state.
- Licensed optometrist for vision problems only.
I try to never go to court without a supporting medical source statement form the doctor. I find that most of my winning cases include a treating doctor's RFC.
Here are basic guidelines that may give you an idea if you can qualify?
- Are you now off work because of a severe impairment? (If still working at substantial gainful activity, you will not be approved).*
- Have you been unable to work for at least 12 consecutive months, or do you expect to be unable to work for at least 12 months? (Short term disability is not covered by SSDI).
- Have you worked at least 5 years out of the most recent 10-year period? Most people need at least 40 quarters of covered work to be eligible. Exceptions apply to very young workers who aren't old enough to meet this rule.
- Is there objective medical evidence of a severe physical and/or mental impairment? In other words, can we get medical records from doctors, hospitals or other healthcare providers to document your medical condition(s)? Objective evidence is a must for a successful claim.
If you answered YES to all these questions, you may have a solid disability claim. Beware that up to 80 percent of claims are initially denied and require an appeal to win. Don't give up if you get denied. Many of the denials are actually wrong and can be overturned on appeal. We tell our clients to expect an appeal: it's part of the process, the rule, not the exception.
____________
* In 2018, substantial gainful activity refers to work in which a person earns at least $1,180 per month before tax. This amount changes slightly from year to year. It refers only to income derived from work, including self-employment income.
Psychological or mental disorders certainly affect an individual's ability to work. A great many disability claims boil down to a person's ability to consistently perform the mental tasks of work. So, Social Security does pay for severe psychological impairments--such as depression, PTSD, panic disorders, schizophrenia, anxiety, etc.
DOCUMENTATION. My experience tells me that mental impairments need special documentation and evidence. First, there needs to be a history of treatment by a mental health professional, either a psychiatrist or licensed clinical psychologist. (Nurse practitioners are not helpful with Social Security claims). Second, the patient must be compliant with recommended treatment. Third, the doctor needs to provide a statement detailing how the patient is restricted in the ability to perform specific work-related activities.
Problems that often arise with this type of claim:
- There hasn't been enough work history, or not enough recent work, for the required quarters of coverage. The claimant is "not insured" by Social Security.
- The claimant has little or no medical treatment for mental disorders.
- The claimant has had some medical treatment but is not non-compliant (refuses or neglects to make medications, does not follow up with doctors appointments, etc.).
- There has been some medical treatment but not by a mental health professional--often a nurse practitioner has been used, which Social Security does not recognize as an 'acceptable medical source.' Even family practice doctors don't get the same weight as a psychiatrist or licensed psychologist.
- A history of drug or alcohol abuse can hurt any claim, especially one based on mental health issues.
It isn't enough for the claimant to tell the judge that he is depressed, despondent, nervous or has panic attacks. There must be medical evidence of severe, ongoing and chronic problems that would convince a judge that the claimant cannot work.
All this having been said, many of our clients do get approved for disability based on mental disorders. Before we move forward with a case, we evaluate the available evidence and try to get more evidence when appropriate.
Social Security is now trying to schedule hearings by video-teleconference (VTC) instead of in-person. What's the diffference and do you really want a hearing by VTC?
Hearings, of course, are held when Social Security denies a claim and the decision is appealed. It goes before an administrative law judge (ALJ) for a new decision and resolution. The hearing is the only time the claimant meets face-to-face with a decision maker.
Claimants are entitled to meet face-to-face with a judge. However, there are rules that must be met to exercise this right. If an in-person hearing is not properly requested, a VTC hearing may be scheduled by default.
How to opt out of a video teleconference? Shortly after your appeal is filed, Social Security will send you a packet of information and forms. One of the forms involves a notice of intent to schedule a hearing by VTC. The claimant must opt out by checking the proper box on this form, signing it and returning it to Social Security within the deadline. Once that is done, an in-person hearing will be scheduled.
Why do some claimants and their attorneys object to hearings by video teleconference? A few reasons:
1) Some people simply prefer to be in the same room with the judge for a hearing.
2) Sometimes, there can be audio problems with the VTC format. I was recently at a hearing where I could barely hear the judge. I've been at other hearings where the vocational witness could not be heard. These potential technical problems are eliminated with in-person hearings.
3) There may be more uncertainty about who the judge will be with a VTC. While you cannot pick the judge, nor predict who it will be, at least with a live hearing you will get a judge from the local hearing office. But with a VTC, a judge can be from Baltimore, Philadelphia, Atlanta or St. Louis--or anywhere.
Aside from these factors, a video hearing is conducted just like an in-person hearing. The procedure is the same. So, is there any advantage to having a hearing by VTC? The only one I can think of is indefinite. A VTC may (emphasize may) be scheduled a little sooner than an in-person hearing, just because it is more flexible and accomodates the judge's schedule.
I think each claimant should have a discussion with his or her representative before making a decision on a video teleconference. If either the claimant or representative has a strong preference or objection, I think that should determine the matter.
_______
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
SOCIAL SECURITY JUSTICE: WEBSITE
Military personnel are entitled to apply for Social Security disability as soon as they become unable to perform their regular military duties. They do not have to wait for discharge.
The Forsythe Firm has successfully helped military personnel and veterans to obtain SSDI benefits for almost two decades. Consultations are free and we will never charge a fee unless we settle your case favorably and with back payments to you.
We are located in the Bridge Street area, adjacent to Redstone Arsenal, Gate 9.
SERVICES OFFERED BY THE FORSYTHE FIRM
- Filing of applications and forms to start your claim
- Collection of medical evidence to prove your claim
- Help with getting maximum benefits and back pay
- Problem solving - keeping your case moving to resolution
- Appeals and hearing representation (if required)
- Local, full service firm dedicated to Social Security disability (We do nothing else).
THE FORSYTHE FIRM
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
Research Park - Across from Bridge Street
PHONE (256) 799-0297
SOCIAL SECURITY JUSTICE - OUR WEBSITE
Social Security does not pay for impairments or disabilities that last for less than 12 months. There is no short term disability benefit with Social Security.
You must have at least one impairment that has (a) lasted for at least 12 consecutive months, (b) is expected to last for at least 12 consecutive months, OR (c) is expected to result in death.
Does this mean that I should wait 12 months to file a disability claim? No, absolutely not. As soon as you have a medical condition expected to keep you from working for at least 12 months, you should file a claim immediately. However, if your doctor says you will be able to return to work within 12 months of the onset of your condition, you would not meet the duration requirement.
May I file a disability claim before I stop working? No. If you are still working full-time, you are not legally disabled according to Social Security rules, regardless of how much pain you have or sick you are. There is an exception for part-time work where earnings are less than $1,180 per month (before tax).
__________
The Forsythe Firm
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
Free Consultations
Never a fee until you get paid
SOCIAL SECURITY JUSTICE - WEBSITE
The Forsythe Firm assists individuals in north Alabama and middle Tennessee Social Security disability claims:
- Filing the initial applications for you
- Help obtaining medical records and evidence
- Mediation with Social Security / the Government
- Appeals
- Hearing representation and preparation
There
is no charge for our services until your claim is approved and you
receive back pay from Social Security. Free consultations.
BASIC REQUIREMENTS FOR SSDI BENEFITS:
- Sufficient
work history to be covered. For most folks, this is 5 years of work
out of the most recent 10 year period. Rules are different for very
young individuals.
- A
medical impairment severe enough to prevent you form working at any
full-time job. This impairment must have lasted or be expected to last
for at least 12 consecutive months (called the "duration requirement").
- There must be medical evidence to prove your severe impairment(s), that is, doctor's records.
- You cannot now be working at substantial gainful activity (earning at least $1,180 per month) from your job or work activities.
What Happens When You Contact Us?
When
you call us, we will talk to you on the phone for a few minutes and get
some basic information about you and your disability. We want to find
out if you meet the requirements to file an SSDI claim.
We
will usually set up a free in-office consultation where you come in and
speak to one of our experienced advocates face-to-face. We may then
take an application and help you complete all the forms needed to file
an SSDI claim. We will file the claim for you so you never have to go
to the Social Security office. We will thoroughly explain the process,
the time frame and what to expect.
When Do I Pay You a Fee?
All
of our work is free until you win your Social Security claim and
receive back pay. You will pay no deposit, costs or any other fees
until that happens. If you do not win and receive back pay, we will
never charge you a fee. So, you pay only if you get a good result. If
we take your case, we pay all costs associated with it until it settles
favorably.
Tell Me About Your Firm
The
Forsythe Firm is a local organization specializing in Social Security
disability. It's all we do. For 15 years, we have helped thousands of
claimants with Social Security disability. We work with clients all
over north Alabama and in middle Tennessee. Our advocates handle every
phase of Social Security claims--from filing the initial application to
appearing before administrative appeals judges, to appeals at the
Appeals Council level, if required. The advocate that you meet for your
first consultation will stay with you case until it settles. You will be
a person with a name and face at our firm, not just a claim number.
CONTACT US
Most contacts with our firm begins with a simple phone call. (256) 799-0297.
OUR WEBSITE: SOCIAL SECURITY JUSTICE
The Forsythe Firm assists individuals in Athens and Limestone County with Social Security disability claims:
- Filing the initial applications for you
- Help obtaining medical records and evidence
- Mediation with Social Security / the Government
- Appeals
- Hearing representation and preparation
There is no charge for our services until your claim is approved and you receive back pay from Social Security. Free consultations.
BASIC REQUIREMENTS FOR SSDI BENEFITS:
- Sufficient work history to be covered. For most folks, this is 5 years of work out of the most recent 10 year period. Rules are different for very young individuals.
- A medical impairment severe enough to prevent you form working at any full-time job. This impairment must have lasted or be expected to last for at least 12 consecutive months (called the "duration requirement").
- There must be medical evidence to prove your severe impairment(s), that is, doctor's records.
- You cannot now be working at substantial gainful activity (earning at least $1,180 per month) from your job or work activities.
What Happens When You Contact Us?
When you call us, we will talk to you on the phone for a few minutes and get some basic information about you and your disability. We want to find out if you meet the requirements to file an SSDI claim.
We will usually set up a free in-office consultation where you come in and speak to one of our experienced advocates face-to-face. We may then take an application and help you complete all the forms needed to file an SSDI claim. We will file the claim for you so you never have to go to the Social Security office. We will thoroughly explain the process, the time frame and what to expect.
When Do I Pay You a Fee?
All of our work is free until you win your Social Security claim and receive back pay. You will pay no deposit, costs or any other fees until that happens. If you do not win and receive back pay, we will never charge you a fee. So, you pay only if you get a good result. If we take your case, we pay all costs associated with it until it settles favorably.
Tell Me About Your Firm
The Forsythe Firm is a local organization specializing in Social Security disability. It's all we do. For 15 years, we have helped thousands of claimants with Social Security disability. We work with clients all over north Alabama and in middle Tennessee. Our advocates handle every phase of Social Security claims--from filing the initial application to appearing before administrative appeals judges, to appeals at the Appeals Council level, if required. The advocate that you meet for your first consultation will stay with you case until it settles. You will be a person with a name and face at our firm, not just a claim number.
CONTACT US
Most contacts with our firm begins with a simple phone call. (256) 799-0297.
OUR WEBSITE: SOCIAL SECURITY JUSTICE
If you are still working at 'substantial gainful activity' you cannot apply for Social Security disability.
It
doesn't matter how sick you are or how unable to work you may be --
working a full-time job disqualifies you for SSDI benefits. Generally,
you have to quit work first then apply for Social Security disability.
This
puts many people in a bad financial position, especially since it may
take months or years to get approved for Social Security.
Here is the specific rule about working:
In
2018, you are considered to working at 'substantial gainful activity'
if you are earning wages, salary or commissions of at least $1,180 per
month before tax. This also applies to self-employment income. It does
NOT apply to non-earned income (money you receive without working for it
(alimony, child support, investment income, rent, disability or pension
payments, etc.).
If you work part-time and earn less than $1,180 per month, you may still be able to apply for SSDI benefits.
QUESTION:
"I still work full-time and earn over $1,180 per month. However, I
work in tremendous pain and my doctor says I should quit work. Can I
apply for SSDI benefits?"
ANSWER:
No. As long as you continue to work and earn the Substantial Gainful
Activity (SGA) amount, you cannot apply for SSDI or SSI benefits.
QUESTION:
"If I can't keep working until my Social Security disability is
approved, how am I to survive financially during the long SSDI
application process?"
ANSWER:
There is no good answer. But you cannot work and apply for SSDI at the
same time. If your employer offers a disability insurance program
through your job, check to see if you could qualify for those benefits
if you have to stop working. Also, consider whether you can work
part-time and earn less than the SGA limit ($1,180 per month). That may
allow you to apply for SSDI while working part time.
QUESTION: "So, how long is it realistically going to take to get Social Security Disability benefits started?"
ANSWER:
The time will vary for each individual. 3 to 4 months to get the
initial decision is average. If an appeal (hearing) is required, it can
take 2 more years due to the national backlog of appeals. There are a
few rare exceptions for dire need where hearings can be arranged sooner,
such as in the case of terminal illness, homelessness and a few other
exceptions.
My
office will be glad to provide you with a free, no obligation
consultation. Perhaps we can give you more direction on your claim and
some advice on how to proceed. We never charge a fee unless (a) you
appoint us to represent you, (b) you eventually win your claim, and (c)
you are able to get past due benefits from Social Security.
___________________
THE FORSYTHE FIRM
Social Security Disability Representation
7027 Old Madison Pike NW - Suite 108
Bridge Street Area
PH (256) 799-0297
SOCIAL SECURITY JUSTICE: WEBSITE
You applied for Social Security disability. They sent you for an examination, then denied your claim. IT IS PROBABLY A MISTAKE.
Never assume that Social Security decisions are correct or legal. In many cases they are neither. Like any other large organizations, Social Security makes errors and poor judgments. Those mistakes are corrected in the appeal process.
RULE NUMBER 1: If your disability claim was denied, appeal within 60 days.
RULE NUMBER 2: See Rule Number 1.
How is the appeal process different? First, you will appear before a high level decision maker (judge) who understands the ins-and-outs of Social Security law. You get to sit 10 feet from the judge and talk about your disability.
Second, you get to take your attorney or professionally trained advocate with you to the hearing. This representative understands the errors made in the denial decision and how to approach the judge for a new and more favorable decision.
At the hearing, the judge is not bound by any decision made previously. He or she will give you a completely new decision.
What are the disadvantages of an appeal? None. You have everything to win and you risk nothing. You cannot be charged a legal fee unless you win, so no risk there.
________________
The Forsythe Firm
Practice Limited to Social Security Disability
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
Social Security Justice - The Forsythe Firm
"Never a fee unless you win your case"
Responding
to the severe backlog of hearings and the long wait time to get a
hearing, Social Security is now doing a large percentage of their
disability hearings by Video-Teleconference (VTC).
But do you really want to have your hearing by VTC?
You have a choice. You can opt out of video hearings, if you do so according to the rules. (More on that later).
The
major advantage of a video-teleconference is that it shortens the wait
time for a hearing. However, my research indicates that it only
shortens the wait time by 1 or 2 months. Therefore, you are waiting 20
months instead of 21 or 22 months, not a significant reduction.
What
is the approval rate of VTC hearings vs. in-person hearings? Again, my
research indicates that in-person hearings result in awards about 5
percent more often than video hearings. A 5 percent increase may not
sound like much, but it is significant.
What
if you want to opt out of a VTC and insist on an in-person hearing
where the judge is in the same room with you, not on a TV screen? Here
is the rule you must follow:
Social
Security will send you a written notice that you they may schedule a
hearing for you by Video-Teleconference. This is normally in a packet
of materials sent out a few months after you submit your appeal. Once
you receive this notice, you must object to a VTC in writing within 30
days of the date of notice. A form is sent with the notice for this
purpose.
There
may be instances where attending a hearing by video-teleconference is a
good idea. An example would be if you are in a hearing office with
very low award rates. A video hearing may give you a better chance but
there are, of course, no guarantees.
Need
help with a Social Security disability claim or appeal? Get a free
consultations and case evaluation by calling the Forsythe Firm here in
Huntsville. (We work with clients all over Alabama and middle
Tennessee).
THE FORSYTHE FIRM
Practice Limited to Social Security disability
7027 Old Madison Pike NW - Suite 108
Huntsville, AL 35806
(256) 799-0297
SOCIAL SECURITY JUSTICE - MORE INFORMATION
