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Dennis Teachout’s Blog about Social Security Disability

The Administrative Law Judge

The person who presides in a Social Security disability hearing is an Administrative Law Judge (ALJ). Although many judges do not wear judicial robes and you will not be expected to stand up when the judge comes into the room, the Social Security judge is entitled to the same respect that you would pay to a court judge.

The judge’s job is to issue an independent decision about your entitlement to disability benefits, a decision that is not influenced by the fact that your case was denied at the time of your initial application and on reconsideration. In fact, more than half of judges’ decisions nationwide are in favor of the claimant. These are the best odds of winning at any step in the entire Social Security appeals system.

The informal Social Security hearing is not what we call an “adversarial” hearing. That is, there is no lawyer on the other side who is going to cross-examine you. Judges usually do not “cross-examine” a claimant. The judge is neither your adversary nor your opponent: the judge’s job is to find out the facts about your disability claim.

Many people, by the time they get to a hearing before an Administrative Law Judge, are angry at the Social Security system. Their applications for disability benefits have been denied twice, often without any logical reason given for the denial. This system is cumbersome. It is time-consuming with all of its appeals and delays, and it is frustrating.

But, it is important not to take your anger out on the judge. The judge did not create this system. The judge is not responsible for the problems that you have had with the system. Since the judge probably already knows all of the problems with the Social Security appeals system, you do not need to explain these problems. It also isn’t helpful to ask the judge any questions about your case. For example, don’t ask, “Why have I been denied?” “Why has it taken so long for me to have a hearing?” and so forth.

The only time you should ask the judge a question is when you do not understand what is being asked of you. Judges and representatives sometimes ask simple questions in complicated ways. This is a shortcoming of the legal profession. Don’t be intimidated by it. If you’re not sure you understand a question, don’t be embarrassed to ask politely for an explanation.

The best way to treat the judge is with the courtesy and candor that you would show an old friend whom you haven’t seen for several years—someone that you want to bring up-to-date about all of your problems. In other words, it’s okay for you to talk to the judge in “regular” words. You do not have to use lawyer words or doctor words. In fact, it’s much better if you do not use such terminology; instead, talk to the judge the same way you would talk to an old friend.

General Information About the ALJ Hearing

The Social Security Hearing Room

A Social Security hearing room is nothing more than a small conference room. It may have a few official trappings such as the seal of the Social Security Administration or an American flag.

Hearing rooms are always equipped with a conference table. There also may be a small table for the judge’s assistant. Usually there is a judge’s desk on a small riser that is slightly above the level of the conference table where you will sit.

The Recording Equipment

Each Social Security hearing room has its own recording equipment, which will be used to record your hearing. Because your hearing will be recorded, it is important for you to speak clearly when you answer questions. The microphones are very sensitive to sound so they will pick up your testimony from anywhere in the room if you speak loud enough for the judge to hear you. However, shaking your head won’t do; neither will pointing at a part of your body without stating out loud what part of your body you are pointing at. Also, “uh huh” and “huh uh” answers do not transcribe as well as “yes” and “no” answers. So try to say “yes” and “no” if you can.

Persons Present in the Social Security Hearing Room

You will be seated at the conference table along with your representative. Under some circumstances the judge may call a vocational witness or a doctor to testify. If so, they will be seated at the conference table.

Also seated at the conference table (or perhaps at a small table next to the conference table) will be the judge’s assistant who operates a computer, which is used to make a CD-ROM that will contain the recording of the hearing.

You are allowed to bring witnesses and, if you wish, observers into the hearing room. But the hearing is private. Anyone present other than the judge, the judge’s staff and witnesses called by the judge must have your permission.

Social Security Disability Hearings Are Informal

Social Security disability hearings are much less formal than court hearings. They were designed so that they would not be a threatening experience. The Social Security Administration (SSA) recognizes that if you can relax as much as possible, you will be the best witness for yourself. It’s okay to let yourself be yourself.

Although this is an informal hearing, there are a couple of procedures that are necessary to follow:
•You and all witnesses will testify under oath.
•It is important when you are testifying that you not ask anyone else in the room to help you answer questions and that your witnesses or friends do not chime in to help you testify. Only one person is allowed to testify at a time.

Advice for Your Social Security Disability Hearing

Preparing for Your Disability Hearing

Arrive Early

Unless your representative asks you to be at the hearing office at a specific time, arrive for your Social Security disability hearing about a half an hour early. Any earlier is not necessary no matter what your Notice of Hearing may say about coming early to review your file. Your representative has already reviewed your hearing exhibit file. It isn’t necessary for you to review it (although you may if you want to). Social Security disability hearings usually start on time, so whatever you do, don’t be late.

What to Wear

A lot of people ask what to wear, whether they should dress up for their Social Security disability hearing.

You do not need to dress up, and you do not need to wear the same clothes that you would wear to a wedding. This is an informal hearing. You may wear whatever makes you comfortable (within reason).

Don’t Talk About Your Case

Social Security disability hearings are serious business. Don’t make jokes. Don’t even talk about your case before or after your hearing in the waiting room, in the hallway, in the elevator or anywhere else where a stranger can overhear. A Social Security employee may misinterpret what you say and get the wrong impression about you, and there may be a lot of Social Security employees in the building.

Turn Off Your Cell Phone

If you have a cell phone with you, don’t forget to turn it off before the hearing starts.

Social Security Disability & U.S. Veterans

One of the most rewarding parts of my practice is working with United States military veterans. Veterans make incredible sacrifices during their service years, including not only being apart from their families, but also facing the constant threat of serious physical and psychological injury. While physical injuries are often readily apparent and undeniable, the serious psychological effects of military service on veterans are not always as easy to identify.

What cannot go overlooked are recent reports that 2012 saw a record 349 suicides by military personnel, a number which “far [exceeded the number of] American combat deaths in Afghanistan” the same year.[1] The article went on to note that “Iraq and Afghanistan war veterans suffering from depression, post-traumatic stress or substance abuse” appeared to be one of the main groups facing significant risks. (Id.)

Compounding the negative and predictable psychological effects of having experienced combat is what some have described as the stigma in the military of seeking out help for one’s psychological problems. During “the course of a soldier or officer’s training, we inculcate in them a vicious and emotional resistance to weakness”, and “teach them to bear their own load as well as their buddies’.” (Id.) One vet remarked that during service “[m]y mind was my saving grace, and to hear that it was now my biggest burden when I returned from a tour with post-traumatic stress sounded like a joke.” (Id.)

Unfortunately, the increasing number of military suicides is quite alarming, and suggests that returning veterans are increasingly coming to terms with the intense psychological stressors they experienced during their service.

Fortunately, one resource available to mentally stressed, unemployed veterans is Social Security Disability. I have personally helped numerous veterans through the process of obtaining their benefits for diagnoses including Post-Traumatic Stress Disorder (PTSD), Depression, Anxiety, and Intermittent Explosive Disorder – not to mention for numerous debilitating physical diagnoses as well.

For veterans interested in applying for Social Security Disability benefits, the most important thing they can do is consistently get treatment for their condition(s). Doing so serves two purposes: (1) Treatment is helpful to the individual who seeks it out because therapy is about confronting and dealing with psychological pain, not hiding from it; and (2) The burden of proof for receiving disability benefits is on the individual claiming disability, meaning that success depends on the kind of clinical medical evidence that is best obtained from consistent treatment.

Remember, it takes a great deal of courage to seek out help, and asking is not a sign of weakness, it is a sign of strength. Secondly, you’ve served your country and earned your right to benefits if you are no longer able to work because of either a physical or mental disability (or combination of both).

Proving Disability: The 5 Step Sequential Evaluation Process

As you may have heard or read in the news lately, getting Social Security Disability benefits can be a long and arduous process – and the burden of proof is on the applicant. To evaluate and make a determination of disability, the Social Security Administration uses a “5 Step Sequential Evaluation Process”. Although the 5 step process may look simple at first glance, there can be enormous complexity at each step of the evaluation.

Step 1: Is the Claimant engaged in “Substantial Gainful Activity”?

I always tell clients, “It doesn’t matter what physical or mental condition[s] you have. If you are making money at a certain level per month [Substantial Gainful Activity], you are not disabled by Social Security standards.”

Currently, employee earnings over $1,040 per month are considered Substantial Gainful Activity and, if made on a consistent basis, will lead to an automatic determination that you are not disabled. Keep in mind that under Social Security regulations your condition must have lasted, or be likely to last, for more than one year. This means that you cannot have consistent earnings above the level of Substantial Gainful Activity for a least one year to initially be considered for disability benefits.[1]

Step 2: Does the Claimant have a “severe, medically determinable impairment”?

Having a severe, medically determinable impairment means having more than just a series of complaints. Saying, “I have back pain”, “I don’t feel good”, “I’m depressed”, or “I’m tired all the time” are complaints – not conditions established by a treating physician.

“Medically determinable” means that your condition has been recognized and diagnosed by a doctor. “Severe” means that your condition results in some form of functional limitations, either from a physical or psychological perspective (or combination of both), which would affect your ability to work. The degree and severity of your functional limitations are most relevant at Steps 3, 4, and 5.

Step 3: Is the Claimant’s impairment so severe that it “meets or equals a Listing”?

The Social Security Administration has put together a series of medical “Listings” which are used to determine whether your condition is so severe that you are automatically disabled. The Listings have some flexibility so that even if you don’t meet the Listing exactly, you may be found to equal it, resulting in a finding of disability. Listings can be very detailed and always require strong, “objective medical evidence”[2] in order to be satisfied.

Overall, the number of individuals found disabled because they meet or equal a Listing is very small. Hence, most individuals fall into what is called a “Step 4 and Step 5″ analysis. Of all the steps involved in the process of proving one’s claim for disability, numbers 4 and 5 can be the most complicated.

Step 4: Is the Claimant capable of performing his/her “Past Relevant Work”?

“Past Relevant Work” consists of any work you have performed in the past 15 years at the level of “Substantial Gainful Activity”. Whether you can still perform any of that work may be determined by a Social Security judge or a “vocational expert” – an expert on jobs and how they are performed in the local and national economy.

By analyzing the requirements of how your past relevant work is generally performed, and taking into consideration any functional limitations resulting from your physical and/or psychological condition, the vocational expert will determine whether you can still perform any of that work.

If the expert determines that you can perform any of your past work, you will be found not disabled. If the expert determines that you cannot perform any of your past work, we move Step 5.

Step 5: Is the Claimant capable of performing “any other jobs”?

A determination of whether you can perform “any other jobs” means looking at other available jobs in the local and national economy, no matter how unskilled, menial, or uninteresting. “Available” for purposes of this step does not mean that an employer is hiring; it means that any given occupation is still being performed in significant numbers in the United States nationally, regionally, and locally.

Using a similar analysis of how other jobs are performed, combined with any functional limitations resulting from your physical and/or psychological condition, the vocational expert will once again render an opinion if there are a significant number of jobs that you can perform.

To be successful in your claim for disability, you must generally prove that there is no full-time employment that you can still do[3], either because of a physical or mental condition, or a combination of both.

Why You Should Avoid Pension “Cash Out” Agreements if You’re a Disabled Vet

Soldiers who have been left permanently disabled as a result of injuries they sustained during their service to our nation are often entitled to veterans disability benefits; however, these payments may not be enough for many to make ends meet—especially in the San Francisco area where the costs of living are some of the highest in the nation.

These financial struggles may force many disabled veterans to consider using a service that would allow them to “cash out” their pensions or other disability payments. It’s important for veterans to know this may not be wise though, as the contracts that are used to bind these agreements are often not designed in favor of the veteran.

According to an article from the Sacramento Bee, the contracts may contain stipulations that require veterans to pay multiple fees and commissions that, in the end, result in a disabled individual receiving far less money than their pension or payments were worth.

If you’re a disabled veteran and have found yourself struggling financially,Disability Professionals LLC wants you to know that there are other options available. Some of the resources you may have in your area include nonprofit organizations that can offer work or financial assistance. You may qualify for grants and other benefits, such as Social Security Disability benefits or Supplemental Security Income as well.

We hope these tips help to get you the financial assistance you deserve.

What Are the Common Causes of a Traumatic Brain Injury?

The Centers for Disease Control and Prevention estimate that 1.7 million Americans will suffer a traumatic brain injury (TBI) this year. Of those individuals, 1.3 million will seek medical attention, while 275,000 will be hospitalized and another 52,000 will lose their lives. So what are the most common causes of brain injuries today? A new study shows the answer to that question changes with age.

According to an article from NPR News, the most common causes of brain injuries are different depending on how old you are. For children younger than age 12, falls from elevation are listed as the cause of a majority of brain-related injuries. As children grow and become teenagers though, assault becomes the leading cause for a TBI. Such injuries accounted for almost one-quarter of all TBIs sustained by teens between the ages of 13 and 17.

Sports related injuries and car accidents were also listed as a common cause of brain injuries.

So what should you do if you or a loved one has sustained a head injury? Disability Professionals LLC say the first step that should be taken is to seek the medical attention you need. Only then should you attempt to document the case by getting information from witnesses and taking pictures. Finally, discuss your legal options with a qualified legal representative.

Mental illnesses come with unique challenges, including for Social Security

Millions of people suffer from a mental illness of some type. If left untreated, serious mental health conditions are life-threatening and can affect whole families.

For the last 65 years, May has been Mental Health Awareness Month. As the month comes to a close, many psychologists, social workers and people suffering from a mental illness can celebrate the strides in treatment and social awareness regarding mental illness. Still, there is a long way to go.

Too often people with mental illness feel as though their condition is a personal or moral failing, rather than an illness with an underlying physical cause. People with depression, anxiety, and post-traumatic stress disorder too often feel as though they need to “tough it out” or are bad or lazy people. The Mayo Clinic recently issued several recommendations for people suffering from mental illness that may help overcome these feelings. The Mayo suggests:

· Getting help. Treatment can reduce symptoms and identify the underlying issues.

· Not feeling shame. Illnesses of all type can strike at anyone. Acknowledging a mental health condition can help overcome low self-esteem and destructive thinking.

· Not isolating. Speaking to trusted friends and relatives can help. People with mental illness often feel alone. They are not.

· Remembering that an illness can improve. While mental illnesses can feel overwhelming, a person is more than a mental illness, and things can improve.

Mental illness and SSDI

Social Security Disability insurance is a federal program that helps people who are unable to work because of a disabling condition. The Social Security Administration recognizes several mental illnesses as disabling. However, in practice it can be more difficult to obtain SSDI because of a disabling mental condition than other medical conditions. The symptoms of a mental illness are not always readily apparent. Nonetheless, the SSA recognizes the following mental conditions, among others, as potentially qualifying for SSDI:

· Schizophrenia

· Autism

· Depression

· Anxiety

· Bipolar disorder

· Alzheimer’s and dementia

· Substance abuse disorders

In order to qualify for SSDI, an applicant must prove that he or she is unable to work beyond the substantial gainful activity (SGA) level for one year or more. The amount of earnings the SSA considers “substantial” depends on the disability.

The SSA will also require evidence of a mental illness. For depression, for example, a person must demonstrate severe symptoms, such as delusions or “marked difficulties in maintaining social functioning.” For substance abuse, the addiction must have physically impaired a person’s health or caused brain damage to the extent that working is impossible.

Not all people with severe mental illness exhibit obvious signs, however. A person with bipolar disorder may feel and act fine for days, then experience several days in a row where it is nearly impossible to get out of bed. For such conditions, thorough and organized medical documentation is necessary in order to get approved for SSDI benefits.

The first priority for people suffering from a mental illness is to get medical help immediately. People who have a mental illness and who are unable to work should also contact an experienced Social Security Disability to discuss their legal options and help with daily living expenses.

New bill attempts SSDI reform for the terminally ill

Facing a terminal illness is among the most difficult experiences a person may have to confront. The emotional and physical pain following such a diagnosis can render a person incapable of day-to-day activities, let alone the ability to work. In addition, priorities shift, and a terminally ill person is more interested in spending time with family, friends or finishing up with good works done in the past than dealing with finances, insurance or other now mundane matters.

Still, those financial and insurance burdens still exist and must be dealt with. And for individuals who have paid into Social Security but can no longer work, Social Security Disability benefits may provide for help with day-to-day living and medical expenses.

Under existing law, there is a five-month waiting period before an individual can receive SSDI benefits, which provides money for basic costs for disabled people. For terminally ill individuals with a short life expectancy, however, that five-month waiting period can render this benefit irrelevant.

With that in mind, three U.S. Senators, John Barrasso (R-WY), Mike Enzi (R-WY, and Sherrod Brown (D-OH) introduced a bill that is meant to help terminally ill individuals receive the help they need sooner. The “Expedited Disability Insurance Payments for Terminally Ill Individuals Act of 2013″ would allow people whose medical condition results in a life expectancy of six months or less to receive:

· Half of SSDI benefits within the first month of diagnosis

· Three-quarters of monthly benefits for the second month

· Full benefits for the third and all following months up to one year

There are qualifiers in the proposed legislation. Should an individual beat the odds and live longer than one year after a terminal diagnosis, a portion of the benefits received during the first five months will be deducted from following payments. Terminally ill patients who live three years or longer after their diagnosis will receive 95 percent of benefits. In addition, in order to avoid abuse of the legislation, should it pass, two separate doctors must diagnose the terminal illness, and those doctors must not be in the same physician group.

The bill also includes provisions that would have the Social Security Administration commissioner submit yearly reports to Congress noting how many terminally ill people received early benefits and how many of those people lived beyond six months and how many lived past one year. The report also would show how much was spent and would include recommendations on preventing fraud, waste and abuse.

For terminally ill people, the earlier the benefits, the better

Social Security Disability Insurance can provide a lifeline for those people facing end-of-life decisions. For terminally ill patients, however, SSDI benefits can be a day late and a dollar short.

The proposed bill is still in committee, although it will have until 2015 to pass. While this legislation is a good attempted step towards helping people who desperately need it, a disabled individual may not be able to navigate what can be a complicated and convoluted process. Disabled individuals and people facing a serious or terminal illness should contact an experienced SSDI attorney to guide them through the process and fight for their deserved benefits.

New Rules for Student Loan Debt Discharge for Workers with Disabilities

Sustaining a disability later in life can have widespread consequences that affect the individual not only physically, but also emotionally and financially. Many disability diagnoses are accompanied by exorbitant medical bills. In addition, some people newly diagnosed with disabilities may find themselves unable to perform their current job responsibilities. In such situations, options exist to assist the individual in adjusting to his or her new way of life.

Social Security disability benefits are one avenue of support for workers who are no longer able to perform their job duties. In addition to Social Security disability benefits, workers who have completed some type of higher education and have outstanding student loans may be able to have their debt forgiven.

Workers with unpaid federal student loans may be eligible for “Total and Permanent Disability (TPD) discharge” of their debt if they are “unable to engage in any substantial gainful activity because of a medically determinable physical or mental impairment.” The impairment must either “be expected to result in death,” or last for a “continuous period of not less than 60 months,” according to the U.S. Department of Education.

New rules, recently proposed by the Education Department, seek to improve the student loan forgiveness program, as many have complained it is inefficient and ineffective. In fact, a February 2011 investigation by ProPublica found that many individuals with disabilities continued to be held responsible for their student loan debts due to deficiencies in the system. Some even had their Social Security disability benefits garnished to pay off their student loan debt.

New Proposed Rules for Student Loan Forgiveness

The Education Department’s proposals are intended to eliminate redundant steps in the loan forgiveness process and to provide increased transparency when an application is rejected.

Most notably, those with student loan debt will now be required to submit just one application to the Education Department to discharge their debt. In the past, applicants were obligated to submit to an initial review by the loan holders. Not only did that requirement complicate the process, but it also prevented many otherwise eligible borrowers from presenting their applications to the Education Department, as the loan holders had the ability to reject applications without government review.

In addition, the Education Department will take steps to increase its communication with applicants. The Department will now have to provide a “detailed explanation” when an applicant is denied, and must communicate with a representative retained by the applicant, such as an attorney. According to the ProPublica report, in the past, the Education Department often failed to identify a reason for rejecting a discharge application.

The investigation found that of 106 complaints, 36 percent of the applications had been rejected because the applicant’s doctor had not sufficiently answered requests from the department for more information. Rather than informing applicants of the deficiency, though, the Education Department sent letters merely stating the application was denied due to a “medical review failure.” Despite the issues perceived by the Education Department, 23 percent of those applicants had already been determined to be disabled by the Social Security Administration.

Should the Education Department Rely More Heavily on SSD Decisions?

While past critics of the loan forgiveness process for borrowers with disabilities applaud these reforms, many argue that the most obvious change, with the greatest potential to streamline the process, has been ignored. They contend that the most efficient method would have been to eliminate the Education Department’s disability review altogether, and rely on the findings of the Social Security Administration.

Since 2008, the definition of disability used by these two departments has been similar, both requiring that the individual be unable to “engage in substantial gainful activity.” The Education Department has argued, though, that the legal standard is different, since Social Security disability benefits can be stopped if a recipient is able to return to work. By contrast, once a student loan is discharged, the obligation to pay back the debt is gone forever.

The process for applying for Social Security disability benefits can be complex. An experienced California Social Security disability attorney can ensure the rights of individuals with disabilities are protected.