The Law Offices of Robert J. Delaney- Social Security

 

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Introduction

 

Social Security Disability (DIB) is a monthly benefit program for people who have worked AND paid Social Security or FICA taxes for a certain minimum time.

Supplemental Security Income (SSI) Disability is a federal benefits program intended to aid disabled folks.  There is no work requirement for SSI disability.

Both programs are administered by the Social Security Administration.  One applies for the programs at any Social Security Office or one can look in the phone book under U.S. Government, call the Social Security office, and they will send you the necessary forms.


What documents will I need?

Take your birth certificate, marriage license, childrenís birth certificates (if they are minors, a larger family amount may be paid).

If you are applying for SSI, additionally take your asset and income information, bank books, income tax returns, pay check stubs if you are working part time or make a work attempt.

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What are the tests for disability?

A person is disabled if, according to medical evidence, he is unable to walk, sit, lift, bend, carry, focus or concentrate (your functioning level), due to a mental or physical illness, that would cause Social Security to conclude you could do no jobs that exist in significant numbers in the national economy and, that disability has lasted, or is expected to last, for a period of one year or more.

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What will Social Security do to help me with my disability claim?

They will take your list of doctors and hospitals and therapists, with addresses, that you provide them and request and review all copies of your relevant medical records.

They will contact by phone or in writing a friend or relative whose name you provide, and interview them about how you are able to do your daily activities.

Every time you call the Social Security Office on the phone or go into the office the attending caseworker will make a report on your functioning level during the contact.

They will often send you to a doctor of their choice at their cost for a physical or mental examination (or both).  The doctor will make a report on his examination and his opinion of your functioning level.  You do not have a choice about going to this exam.  Your claim will be dismissed if you donít.  Social Security administrators will have another doctor review the entire written file and give an opinion on your functioning level.  (This doctor never sees you.  He only looks at the written medical evidence in your file.)

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Do I need an attorney to help me?

I recommend you go through the first two stages, called the initial claim stage and the reconsideration stage, without an attorneyís help.  Why pay an attorney if thereís enough medical evidence in your file for you to have a successful claim?

I recommend you do not do the third stage, a hearing before an Administrative Law Judge, without an attorney.  We work on the basis of 25% of the past due benefits plus expenses.  You pay expenses only if we do not have a successful claim.

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What does an attorney do to help?

He orders and analyzes a copy of your evidence file, figures out what medical evidence is missing, and writes your doctors and asks them to fill in the missing medical evidence.  He prepares and submits a ďClaimantís Statement,Ē which is a summary of your impairments, symptoms, limitations and argument.  He goes to the hearing and argues why you should be considered disabled based upon the Social Security rules and the medical evidence.

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What are the most common mistakes made by disability applicants?

1.   Social Security rules do not permit consideration of:
a.   whether you can find a job
b.   whether anyone will hire you
c.   whether your doctor or mother or spouse thinks you are able to work or not.

      Too many folks incorrectly assume one or more of the above.

      Social Security only considers:
d.   whether you can work or not; and
e.   doctorís opinions about your functioning level

Social Security reserves to itself the decision regarding whether you can work or not and doesnít accept or consider anyone elseís opinion on this ultimate question. What they look for is opinion about your ability to function (walk, sit, lift, carry, bend, push/pull, climb, drive, focus, concentrate, stay on task, follow directions). From these functioning opinions, Social Security concludes whether you are disabled or not, whether you can work. 

2.      Social Security will get all your necessary medical records for your claim.

Social Security will request all your medical records and does a good job following up.  But if your main doctor supporting your claim doesnít send in your records, Social Security wonít subpoena your records and make sure all records are considered.  Pretty often you have to go get missing medical records yourself and give them to Social Security. Social Security makes you sign a statement when you file a claim that although they will help you get medical information, you are the one responsible for getting the medical evidence to support your claim.

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Is there anything else I can do to help?

Yes, you can get two or three friends who see your functioning difficulties often to write letters about how and when you have had difficulty functioning.  Again, the important matters for them to talk about are your functioning levels, particularly the problem areas. If one doctor says you can function well enough to work and another one says you can't, these letters may tip the decision in your favor.

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What happens at the Administrative Law Judge Hearing?

Your claim has been denied in the first two paper stages.  You retained an attorney, and now you are taking the 80-mile trip to the Administrative Law Judge Hearing.  These are usually held in downtown Indianapolis on the third floor of the Market Square Building on the southeast corner of Delaware and Ohio Streets.  Park in the 5-story parking garage directly to the east of the Market Square Building on Ohio Street. Go to Room 300, the Waiting Room, check in, and go through security.  There are six small courtrooms and we will be told which one we will be in when it is time for our hearing.  The court reporter will come get us when itís our turn.  Sometimes hearings scheduled before you run longer and you get started late.  Sometimes you get started early.

In the courtroom will be you, your attorney, the judge, a recording secretary, and sometimes a Vocational Expert (jobs expert) and a medical doctor.  Sometimes there are no experts.  If a medical doctor is there, he will testify about his opinion of what evidence there is on your functioning level in your medical evidence record.  The vocational expert will testify based upon various assumptions what jobs you can and cannot do. 

Usually the hearing starts with the judge explaining the process of the hearing, swearing you in, then asking you questions.  I will then ask you questions about the other information we want the judge to know that he didnít ask about.  Most judges set aside one hour for the hearing.

Usually you do not know what the judgeís decision is going to be when you leave the hearing.  Most judges have their written decisions out in 30 days.

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How long does the process take?

It is not quick.  It can take anywhere from 9 to 18 months after you request the hearing before the Administrative Law Judge for your hearing to occur.  Itís a long line, first come, first served.  The only way to jump ahead in the line is to be homeless.  Some folks write their Congressman to ask for help in speeding up the process.  Iíve never been able to tell if that ever helped one move ahead in line.  It certainly doesnít hurt.

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What is the key to a successful claim?

The most important part of a claim is getting good medical opinion evidence on functioning limitations to back you up.  It always comes down to the quality of the evidence. The most common thing I find from reading these very large files (thatís how I spend chunks of my weekends) is much evidence about illnesses and symptoms, but little or no medical evidence about limitations.  My job is to identify and help you get the missing medical evidence.  If your doctor wonít help, I canít help.  Sometimes one has to go to another doctor.  Sometimes the doctors believe you can work.  Usually it is a matter of asking your doctor the right questions and getting them to put those opinions in a written report.

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