HOW TO HANDLE A SOCIAL SECURITY MEDICAL EXAM

If you apply for Social Security disability, you may be asked to attend a medical examination.  These are called consultative exams  (CE) and are carried out by medical professionals hired by the Social Security Administration.  You will go the doctor's office for the exam, which will typically last about 30 minutes.  (This article talks about physical exams).

The doctor may have a number of questions that Social Security wants answered.  For example, a doctor may be asked to check your range of motion (joints).  In most cases, the doctor will perform a standard exam and make a report to Social Security.

Here are a few general tips regarding this examination:

• Arrive 15 minutes early.  
• Don't smoke before your exam; doctors report this and it turns them off.
  
• Have someone drive you and accompany you to the exam, if possible.
• Take all your prescription medication with you in original bottles.
  
• Be prepared to tell the doctor why you are unable to work:  this must be due to medical and/or mental reasons and you should be specific.
• Be prepared to give the examiner important facts about your medical history:  surgeries, medical providers, symptoms you have regularly.
• Know that you may be watched from the moment you arrive in the parking lot until you drive away at the end of the examination.

 Things NOT to do or say at your exam:

• exaggerate your condition or symptoms - honesty is key.
• minimize your symptoms - just tell it like it is. 
  
• "I could work if it wasn't for (this or that).....
• "I am doing just fine today."  (Will be taken literally)
• Press the doctor for an opinion on whether you are disabled; doctors do not make this decision and they do not approve benefits
• Talk about anything the examiner doesn't ask about:  no talking about family, hobbies, kids, pets, vacations, helping neighbors, sports, etc.

Try to be cooperative with the examiner.  You may be asked to perform certain functions as heel-to-toe walk, bend, touch your knees, perform a straight leg raise, etc.  Put forth a good effort. But if you can't perform the activity just say so.

You should not miss your exam.  Social Security is reluctant to reschedule exams.  If you must reschedule an exam ahead of time, do not call the doctor.  Call your case worker at the Disability Determination Service (DDS) who scheduled the exam for you. Only they can reschedule it.

You will not be charged for the consultative exam (CE) and the doctor you see will not provide any treatment or or referrals and will not prescribe any medications. or refills.

WHY YOU MUST HAVE A DOCTOR TO GET SOCIAL SECURITY DISABILITY BENEFITS

 Social Security relies on medical information from doctors, clinics and hospitals to determine how severe a physical or mental condition is. No matter how disabled you may think you are, the Social Security Administration (SSA) will not pay benefits without precise medical documentation.

The road to disability benefits runs straight through your doctor's office.

When you ask Social Security for a disability benefit you are making an allegation.   That's not enough.  You need proof.   Proof comes from a doctor, clinic, hospital or other source which has documented the severity of your medical or mental condition(s).

 Won't Social Security send me to a doctor after I apply for benefits?

The answer is, yes, sometimes they do.  However. this quick one-time exam is usually not sufficient for approval.  More often than not, Social Security will deny a claim where the only medical evidence is from their consulting doctor.

If you or a loved one are thinking about Social Security disability, we urge you to develop a treatment plan with a doctor or appropriate medical or mental provider for documentation.

If you wish to talk about Social Security disability--or just ask questions--I am always happy to speak to you.  Just call me at (256) 799-0297.  

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Charles W. Forsythe, The Forsythe Firm, 7027 Old Madison Pike, Huntsville, AL 35806.  (256) 799-0297.  The call is free.

WHY CLAIMANTS LOSE THIER SOCIAL SECURITY CASES

Ever wonder why so many Social Security disability claimants are denied benefits?

• The person’s condition didn’t or wasn’t expected to last more than 12 months (4.3%).
• The court didn’t consider the person’s condition severe enough (24.8%).
• The court considered the person able to do their past relevant work (8.6%).
• The court considered the person able to do another type of work (41.8%).

So, during your hearing, you’ll need to prove that you have a long-lasting condition that makes you unable to work. A lawyer can help you make this case. The key word is "prove," which is the work of lawyers or skilled legal advocates.

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Charles W. Forsythe provides assistance for disability claimants in north Alabama. Free consultations (256) 799-0297.

IS SOCIAL SECURITY DISABILITY ENOUGH TO REPLACE YOUR LOST INCOME?

CAN YOUR FAMILY SURVIVE ON SOCIAL SECURITY DISABILITY?

 

 About one-half of American families live pay check to pay check.  45 percent of Americans have only enough savings to last them about one month.

One in four Americans will be disabled before reaching retirement age.

The average wage earner in the United States in 2023 earns $4,326 per month.

The average Social Security disability (SSDI) benefit in 2023 is only $1,483 per month.

Thus, it becomes pretty obvious that Social Security disability alone may not be enough to replace wages lost because of a long term disability. 

There is also another complication:  SSDI can take a really long time to get; long as in a year or two. Since there is a full 5-month waiting period, no one can receive a Social Security disability payment for at least 6 months after a disability begins.  Even this 6 months is  longer than many families can endure.

Why is SSDI So Hard to Get?

The main problem is with Social Security's definition of "disability."  If you are under age 50, disability is defined as being unable to perform any past work OR any other work.  Individuals over age 50 may get disability benefits if they can prove they can't perform any past work which they have done during the past 15 years.  

Another problem:  Social Security requires air tight medical evidence. 

Why Does SSDI Take So Long to Make a Decision? 

For one thing, there are over 1 million persons applying for SSDI benefits in 2023.  There aren't enough personnel, money, computers or other resources to process that many claims efficiently.  Social Security offices fell behind with the pandemic in 2020.  They began to clear some of the backlog in 2021 but have fallen farther and farther behind since then.

In addition to assisting individuals with Social Security claims, I try to educate the working public about Social Security disability's shortfalls.  Unless you have other disability insurance (such as an employer's group plan), there is really nothing else that's going to cover you if you lose all income due to sickness or injury.  

We highly recommend two things to help protect your family from the devastation that often comes with being disabled.  One:  Buy short term and long term disability through your employer if it is offered.  Short term only is not sufficient for reasons explained here.  

Two:  Save a little money consistently.  If you can only save $10 a week while you're working, it will add up to a welcome emergency fund after a while. Most credit unions and banks offer savings plans to help you do this.  Some may offer savings by payroll deduction, which is even more painless.

Finally, if you do become disabled call us here at The Forsythe Firm.  Our only job is explaining your options, helping with paperwork and assisting you through the complex process of Social Security disability.  And we'll never ask you for money.  Your consultation is absolutely free and you won't owe us any fee unless 2 things happen:

    1.  You are approved for benefits AND in addition

   2.  Social Security pays you past due benefits or "back pay."

Reach us in Huntsville, AL at (256) 799-0297 for questions, information or assistance.  We're always happy to talk to you!

 

SOCIAL SECURITY DISABILITY: FREQUENTLY ASKED QUESTIONS

FREQUENTLY ASKED QUESTIONS ABOUT SOCIAL SECURITY DISABILITY

Here are some of the frequent  questions we get at the Forsythe Firm, Alabama's Social Security disability advocates:

1.   Should I file for Social Security disability, called SSDI?

Answer:  That depends on a lot of factors:  your age, education, past work experience and limitations imposed by your medical and/or mental conditions.  All claimants must have a serious condition that has lasted or will last 12 months or more, have worked recently enough to be "insured" under the Social Security Act and be unable now to perform past work or other work in the national economy.  The best way to decide if you should apply is talking to a disability lawyer or advocate who knows what you must prove to get an award.  Fortunately, this conversation is free.

2.  Must I wait 12 months before applying for disability?

Answer:  No.  But you must have a diagnosed severe medical condition that has or will keep you off work for at least 12 straight months.  In short:  Social Security provides no benefit for short term disability (those lasting less than 12 straight months).

3.  How long does the Social Security disability process take?  How long will I wait?

Answer:  Each case is different.  It can and often does take 2 years from the time you file the application.  Unless you have a very obvious disability, you may be denied after a few months, then denied again at "Reconsideration," and then have to appear before a judge for a hearing.  All this can take up to 2 years, but not all cases take that long.

4.   How much will my disability payment be if I am approved?

Answer:  The benefit is different for each claimant because it is based on your total lifetime wages. The average SSDI benefit in Alabama is around $1,600 per month.

5.  What are my chances?

Answer:  Every case is different and stands on its own unique facts.  Here are some averages that shed some light; however, your case is unique.  And your age plays a very important part.

• Application Level - About 27 percent are approved
• "Reconsideration" Level (first appeal) - About 12 percent are approved
• Hearing Level with a Judge - 45 to 50 percent are approved on average

6.  Do I need a lawyer to help me get disability benefits?

Answer:  You are not required to have a lawyer.  But, a study by the US Government Accounting Office (GAO) finds that you are about 3 times as likely to be approved if you use a lawyer or qualified advocate.  While you are not required to have a lawyer, the better question is:  "Should I have a lawyer?"

7.  When should I apply?

Answer:  You should apply when your doctor says you are going to be unable to work for at least a straight 12 months.  If you think you are going to be off work that long due to an illness or injury, you should apply now.  However, you should not apply for disability or impairments that are expected to improve within 12 months to a point you can return to work.  Social Security is for long-term serious disabilities lasting (or expected to last) 12 straight months or more.  If you aren't off work for 12 straight months, there cannot be a benefit.

8.  If I get disability, when does Medicare kick in?

Answer:  Under the law, Medicare begins 29 months from the onset date of disability.  For example, if Social Security finds that you became disabled on July 1, 2023 - your Medicare coverage starts 29 months from that date.

9.  What's this about the 5-month waiting period?

Answer:  Social Security disability (SSDI), also called Title 2, does not pay for the first full 5 months of disability.  Here's an example.  You become disabled under Social Security's rules on July 13th.  You won't qualify for a benefit payment until January 1 of the following year.  You lose July through December to the waiting period, which is actually an elimination period.  (Note: If you claim Supplemental Security Income under Title 16, also called SSI, the waiting period does not apply).  Most individuals do not qualify for SSI, however.

10.  Can I get paid for partial disability and is there a temporary emergency benefit?

Answer:  No.  Social Security doesn't recognize any "partial disability" and it does not have an immediate or emergency benefit.  However,

• If you have a severe condition which is on Social Security's list for "Compassionate Allowance," you may get  a much faster award.

• if your case is recognized as a or "critical case," or you have a "dire need," you could get a faster benefit. 
  

• A terminal illness will qualify for an expedited decision.  

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The Forsythe Firm in Huntsville (256) 799-0297 can help you with Social Security disability claims (SSDI).

 

IN A SOCIAL SECURITY DISABILITY CASE, DOES THE JUDGE MATTER?

DOES THE JUDGE MATTER IN A SOCIAL SECURITY DISABILITY CASE?

 

Yes, the judge matters.  Administrative law judges, called ALJs for short, have tremendous latitude in deciding who qualifies for disability benefits.  And they have little oversight, making them fairly autonomous.

An article in the Charlotte Post & Courier  notes that judges come to wildly different conclusions.

A review of the data shows that "some judges approve just 9 percent of the cases that come before them; others, as much as 96 percent."

In my experience, some judges look for just about any way to deny a claim, while others try to be fair and objective.  

Aside from their award rates, judges differ in the way they hold hearings.  Some judges want the claimant's representative to ask most of the questions while others want to question the claimant themselves.  Some judges press the point on such matters as drug or alcohol addiction but others quietly decide if such issues are material.  Some run very long, detailed hearings but other judges can decide in less time. 

One of the advantages of having a representative/attorney at your hearing is:  he/she will know the judge and understand the type of hearing you will have.

 There is an old adage in the military that says, "The best battle plan only survives the first shot."  My paraphrase is:  "A hearing takes on a life of its own once the claimant is sworn in."

Can the Claimant or Attorney Choose the Judge?

Absolutely not.  Judges are randomly chosen by Social Security and you get the judge you get.  This is fair.  But don't believe that all judges are alike in how they reach decisions or in the way they consider evidence or in their demeanor or attitude.  

What Can the Claimant Choose?

 You can choose your attorney, who is referred to by Social Security as your 'representative.'  You can certainly choose one who is well experienced in Social Security disability, one who knows how to prepare and present a case before a judge, and on who has a good track record. 

Some things you may want to avoid in your representative is one who.....

• has little or no  experience with Social Security disability
• doesn't return phone calls
• you can't meet until the day of your hearing
• who is too far away to meet with you right away
• doesn't seem interested in your case

I recommend that you meet face-to-face with your potential representative and become comfortable with his or her representation.  It doesn't cost a dime more to get top notch representation by a professional who has years of experience and a good track record.

Remember that you can get a free initial consultation without obligation.  No attorney or representative can charge you a fee unless you win your case + collect past due benefits.  

YOU CAN CHOOSE WHO REPRESENTS YOU!  (256) 799-0297

CAN YOU OUTLAST SOCIAL SECURITY'S CAPACITY FOR DELAYS? SSDI

 So, you have applied for Social Security disability (SSDI)?  The question is, can you outlast Social Security's infinite capacity for delay?  

On average, it takes 222 days to get the initial decision on a disability application.  And there is a 7 out of 10 chance the decision will be a denial when it finally comes.  And a majority of these denials are in error.

Claimants may appeal their denial in "Reconsideration," which many see as a rubber stamp for the previous denial.  (The actual denial rate at "reconsideration" is about 90 percent).  "Reconsideration" may add 7 to 12 months or more of additional delay.  (I know of a claim that stayed in reconsideration for 25 months without a decision).

 Many experts and lawmakers have testified that the "reconsideration" process is not needed at all.  Eliminating it would reduce the waiting time for claimants anywhere b7 12 months, maybe more.

After  denial at reconsideration, a claimant may take their case before an administrative law judge for a hearing.  The hearing is a more thorough review and has a higher chance for approval.  The problem is--some claimants die before getting a hearing.

One Social Security disability applicant finally had a hearing scheduled for this month but did not live until the scheduled hearing date, according to David Camp, interim CEO at the National Organization of Social Security Claimant's Representatives (NOSSCR).  

This sad news came after his claim for Social Security disability benefits had been denied initially and again at reconsideration.

"He died from the conditions that he applied with, that went untreated [due to financial hardship], Camp said.  (Words inside brackets supplied).

"He could not live long enough to outlast Social Security's capacity for delay," he said.

Some steps that could be taken by Congress or by the Social Security Administration could ease the backlog of over 1 million claimants who are now waiting for decisions:

1.  Eliminate the Reconsideration process.  Allow denied claimants to take their appeal directly to an administrative law judge and have a hearing.  (That's where most cases will end up, anyway).

2.  The US government should adequately fund the Social Security Administration.  This agency handles three times the work it handled in 2010 but with very little additional funding.  Especially since COVID, the agency is short of experienced employees and without sufficient funding to respond to the crisis of over one million individuals trying to get benefits.

3.  Change the attitude at Social Security and the state Disability Determination Service offices.  Unfortunately, there is a lot of frustration within these offices and the prevailing attitude seems to be:  "It takes as long as it takes and we're doing the best we can.  You just have to wait."

I don't think that a Bandaid, no matter how large or sticky, will fix Social Security disability.  It's a larger problem than that.  1 in 4 Americans will become disabled prior to retirement age and the agency they will turn to for survival is Social Security.  There may be better things to spend taxpayers' money on but I'm having trouble naming them.