June 26, 2013 was a landmark moment for same-sex spouses in regards to applying for Social Security Disability; after reviewing the Defense of Marriage Act of 1996, the Supreme Court decided to adjust some of the concepts behind the act.  Originally, this act made it impossible for same-sex spouses to file for SSI Disability because it was illegal for the Social Security Administration to recognize their partnership as a legal marriage (which is required in order to file for Social Security spouse benefits).  Now, however, the Social Security Administration is working alongside the Justice Department to determine what rules need to be put in place to deal with same-sex spouse claims.  So far they have come up with 3 new policies regarding claims for retirement aged spouses, non-biological children, and transgender individuals.  The first states that retirement aged same-sex spouses may apply for SSI if they were both married and currently living in a state that identifies their marriage as a legal marriage.  The second policy states that if the same-sex couple’s non-biological child is found, by state, to be a possible successor of the parent(s) than they will be eligible for SSI benefits.   The final new policy behind the reformation of this act concludes that a transgender individual is only eligible if the state in which they are applying for SSI views their marriage as legitimate and legal after that individual had gender reconstruction.  Although the Social Security Administration has come up with some new policies after the June court decision, there are still more that are in the process such as: same-sex spousal widow claims, claims from same-sex couples who are not legally married but are in civil unions, and claims for those who are “younger than retirement age caring for an eligible child.”  These last few policies that have yet to be created are currently being worked on, though, so it will only be a matter of time before you will see these policies alongside the other three already created.

 

https://www.marketwatch.com/story/same-sex-couples-await-social-security-clarity-2013-09-20

Although it is difficult for a child with ADHD to be approved for SSI Disability benefits, those with severe ADHD who meet the SSI program’s requirements have a chance of being awarded benefits.  One of the first requirements is that your child shows all of the symptoms of ADHD, which include the following: severe hyperactivity, severe inattentiveness, and severe impulsiveness.  The first requirement is one that applies to both children under the age of 3 and children aging from 3-18 years of age.  Although the requirements are similar, they do differ for these two separate age groups.  Most children aren’t diagnosed with ADHD until they are older than 3 years old, which is why there is need for two separate age group requirements: those under the age of 3 years and those who range from 3 years to 18 years.

The latter group (3-18 years) must have evidence that they have extreme difficulty in at least two of the following four areas in comparison to their peers: issues in cognitive functions, personal functions, social functions, or issues with persistency/ concentration. As previously mentioned, there must be evidence of these difficulties such as medical treatment/documentation, evaluations or notes from teachers and parents regarding the child’s history with ADHD, or results from a type of standardized testing the measures the child’s abilities and/or development.

For children who are younger than 3 years old, the Social Security Administration looks for any evidence of developmental issues that result from ADHD symptoms.  They must see that your child has developmental delays in cognitive functions, personal functions, social functions, concentration, or in their fine motor development.  Being as this particular age group is younger and unlikely to be diagnosed with ADHD just yet, there is a much smaller chance of them being granted benefits.

A couple of other factors that will play into your child’s eligibility is whether or not they work and how well they do in school.  Much like with adults applying for Social Security, there is a limit on how much money a child could make a month all the while still being eligible.  Some older children may have jobs, if this is the case they cannot earn more than $1,040 per month and still be eligible.  In regards to school, the Social Security Administration needs to see how ADHD affects your child in their development.  If ADHD has such a negative effect on their school and learning, it could lead to further issues down the road.  So it is necessary that there is sufficient evidence (such as standardized tests, teacher notes, progress reports, etc.) to prove your child’s ADHD is disabling to their learning and developmental progress.

Having to gather all of the evidence needed to prove your child’s ADHD is disabling enough can be a headache, especially if there is only a small chance they will be approved for SSI Disability benefits.  However, it has been shown that having a lawyer represent your case has a higher approval rate compared to those who chose to represent themselves alone.  So, although chances are small, there is still hope for being approved.

 

https://www.disabilitysecrets.com/adhd-attention-deficit-social-security-disability.html

The first thing to keep in mind if you are incarcerated in prison is that you will not receive Supplemental Security Income (SSI) payments or benefits during the months you are imprisoned, nor are you immediately eligible upon release.  Once you have been incarcerated for 30 consecutive days, your benefits are suspended; if your spouse and/or children are still eligible, though, their benefits will continue. After 12 consecutive months, your benefits are terminated and upon release you must reapply for SSI payments and benefits with documents proving your release.  If you are released before 12 months have passed, your benefits can be reinstated after a month has passed since your release date. Before they can be reinstated, though, you will need to provide the local Social Security office a copy of your release documents.  In regards to your SSI payments, once you are released from prison your payments will start back up that same month. It is important to remember that you can’t receive benefits until you are actually released and have proven that to Social Security as well as prove you are still eligible.

If you were incarcerated before you were receiving SSI payments and benefits and would like to pursue Social Security, you may file while you are in prison. If the facility you are incarcerated at has a prerelease agreement with Social Security all you will need to do is talk with your facility about your desire to start an application for Social Security once your release date is known.  They will then be in touch with Social Security as to whether or not you are eligible.   You will then need to fill out an application months prior to your release date so Social Security is able to process it as soon as possible.  This is optimal because it will mean you can receive your benefits sooner than later after being released.

If the facility you are incarcerated at does not have a prerelease agreement, you will need to contact Social Security on your own once you have your release date.  All you need to do for this is get a hold of a representative there and inform them on your release date and that you would like to apply for SSI payments and benefits.  You will then receive an appointment upon release with a representative at the local office to discuss your eligibility and application process.

 

https://www.socialsecurity.gov/pubs/10133.html

Chapter 4

The First Call.

 

Wednesday, April 6, 2011.  The Law Firm.  8:30 a.m.

“Hoglund Law Offices, Natalia speaking.  Are you a current client or a new client?”

Squeezing the phone receiver hard, Denise responded.  “New client.  I have questions about Social Security.”  Her left palm was wet holding the phone.

“OK,” said the calm voice on the line.  “I’ll put you through to one of our paralegals.”  Hold music followed.

Twenty seconds later:  “Hi, this is Shannon.  Is this Denise?  I have some questions for you.”

Denise understood that this was a screening call.  She was going to be asked questions to determine if she had a good case.  She took a breath.

Shannon continued.  “We are a law firm, and we keep everything confidential.  Let’s start with your full name and address.”  Shannon had a nice, almost cheery, voice.  Denise explained her diagnosis, treatment, and work history.  Denise felt like she was being heard.

“Thank you Denise.  Let me get this information to one of our attorneys to review.  Please hold.”  That startled Denise.  Her throat tensed up.  What if they won’t help me?  What if it actually does cost money up front?  Here it goes.  Denise closed her eyes and took some deep breaths.

The hold music played.  A Spanish guitar on a bad radio signal.  A few minutes later, Shannon came back.  She was bright and cheery – again.

“Denise, you there?”

“Yes.”  She swallowed hard.

“I spoke with the attorney, and he said we could help you.”

Just like that.  Denise felt a sob rising from within her chest.  Her eyes welled up.  “Thank you so much.”

“No problem.  It’s my job.  Remember, we only charge one quarter of back pay if you win.”  Emily was right, she thought.  “Unlike ome other firms, we charge for nothing else.  Hang in there.  You’ll get a packet of paperwork we’ll need you to sign.  We’ll send it out right away.  Please hold.  I’ll get Andrew the attorney on the line.”

This pause was shorter.  A few muddy guitar chords played.  “This is Andrew.  Is this Denise?”

“Yes.”  Things were happening fast.

“I was the attorney here reviewing your claim.  I decided we could help you.  I’ve been doing this work for over 20 years.”  Denise relaxed.  He knows what he’s doing.  “In my experience, Social Security denied you before, but you turned 50 later this year.  Your age now makes a big difference.”

He continued.  “We need to prove you are limited to sedentary work, and you cannot return to your past kind of work full-time.”  He explained the two-year Social Security appeal process, how his firm worked, and then he said, “Does your neurologist know you are applying for disability?”

“Yes, I just brought this up at my last appointment yesterday.”

“Good.  From your treatment and history, it’s likely your doctor knows you are doing as much as you can to get better.  Next time you see your doctor, can you ask him to make sure your records are clear about how you are limited by MS?  We’ll likely ask your doctor for input about how you are doing later.”  Input?  Denise thought.  Law is mysterious.

She answered quickly, “Sure.  He knows me real well.  I just did more testing.”

“Excellent.  It is important that your true limitations are clear in the medical record.  This is what we argue about with doctors at hearings.”  Doctors at hearings?  She was confused.

Andrew spoke with Denise further, answering different questions, especially about Social Security hearings.  “Eventually your case leads to a hearing with a judge,” he said.  “Don’t worry.  It isn’t Judge Judy.”  Denise laughed.  “That’s TV.  You get a private hearing with us there with you.  We are a real law firm, not a corporation, and we plan to hang in there with you.”  Do companies without lawyers do this? Denise thought.  “Our attorneys spend almost every day with judges in our area.  One of us will be with you.”

“You applied before, but never went to a hearing, right?” Andrew asked.

“Right, is that a problem?”

“No,” he said.  “Just verifying.  Most people are denied when they apply.  Social Security contracts with state agencies to filter people out at the first two steps.  They are backward enough to mostly review their approvals.  We find many of their denials inconsistent.  It’s our job to point these problems out at every hearing.  And we often do.”

Denise spoke up.  “I had the chance to buy long-term disability at the hospital I worked at.  I didn’t.  Is that a problem?”

“No.  Private long-term disability insurance has changed since the mid-90’s.  If you got it after that, and then got approved here for Social Security Disability, you have to pay them back.”

“Really?”

“Yes.  The federal government should stop what’s called the ‘Social Security offset.’  Many people end up paying for nothing.”

The lawyer continued, “And remember, Denise, keep treating regularly.  Even with MS, Social Security assumes you are doing better if you aren’t verifying your symptoms from time to time with your doctors.  It’s unfair, but true.”

“Got it.  Mr. Kinney?”

“Andrew is fine.”

“Can you be my lawyer at the hearing?”  Denise felt better asking this.

“I’ll put your request in our computer system.  I do about 350 hearings a year.  It takes about two years and two appeals to get to a hearing.  When that time comes up, they will check if I am available.  It could be someone else here, but I trust them or I wouldn’t work with them.”

“Ok.”  The call ended.  Her body relaxed.  She felt someone was on her side.  She breathed out.  Two years?  Here we go.  Some weight on her shoulders lifted, and she felt less alone.  She took a nap.

 

That night, she had the same dream.  She was thrown into the lake.  This time, a hand reached down from above her head and grabbed her hand.  She woke up, scared and sweaty.

While she realized these nightmares weren’t true, the upcoming year would be her biggest test.

Chapter 3

The Referral.

 

Tuesday, April 5, 2011.  Office of Dr. James Strickland.  9 a.m.

Over the next few years of successive appointments, Denise got to know the staff at her neurologist’s office very well.  They all greeted her as she wound through to the examination room for her neurology appointments.  Emily, her primary nurse, had an experienced eye.  Her cousin, she once told her, had MS.

Emily got Denise through tough times, encouraging her to compete in this race without a line.

 

On this day, after a particularly tough week, Emily took Denise’s blood pressure and asked her an interesting question.  “You’re not working.  Have you applied for Social Security disability benefits?”

After a pause, Denise looked dejected.  “Yes, I did.  That was two years ago.  I was denied.”

“Did you appeal?”  Emily took off the cuff.

“No.  The government said no.”

Emily put her hands in Denise’s and looked into Denise’s eyes.  “Our patients tell me that everyone gets denied at first.  They told me they needed to appeal a few times and get a lawyer.”

“We can’t afford a lawyer.”  The sides of Denise’s mouth turned down as she formed the last word.  “We can barely afford our insurance.”

“Well, a couple of patients have told me about a firm that doesn’t charge unless you win.  A large one.  Right here in the cities.

Denise perked up.  “Do you know if I can apply again?”  Emily nodded no and handed her a piece of paper she grabbed from the examination room drawer.

“Ask them,” said Emily.  A law office name and phone number were on the piece of paper.  Were they on commercials?   “You never know, but I heard they are good.”

Denise thanked her and committed to calling the law fir6m that next day.  She slowly folded it up and tucked it into her back jean pocket.  Emily left the room.

Outside the examination room, a chart rattled against door.  A few minutes later, it opened.  “Good morning, Denise.  You are looking good today.”  Dr. Strickland entered rooms with efficiency.  His jet black hair was parted neatly and streaked with grey.

Sitting across from her, he said, “How are things going?”

“Well, about the same, doctor.  But my right arm is more clumsy now.  I can’t write letters worth reading.”  She laughed to herself.  “My writing looks like I drank a 12-pack.”  She looked up, embarrassed.  “I don’t drink, doctor.”

“I know.”  He nodded gently like an approving father.

“And my recent relapse made my fatigue worse, much worse than before.  Isn’t the medication working?”

Dr. Strickland took a measured breath.  “Yes, these injectable medication regimens can lose their efficacy over time.  We could consider changing it, but my patients have not noticed much short-time improvement doing so.”  He looked at her chart.  Your numbers don’t look too bad.”

“But I’m not feeling well.”  She swallowed hard.  “Doctor.  Do you think I can work?  I mean, do you think I am disabled.”   The question hung in the air.

“Well, Denise, you have relapsing-remitting MS.  You are showing the normal symptoms associated with it, including loss of coordination and fatigue.  Your vision does appear better.  Were you thinking of going back to work?”

“No.  I’m just too tired.  I’m applying for disability.”  Denise looked across at the examination table.  A new examination paper sat on top, drawn from a large supply roll of paper on the side.  It looked like a big roll of toilet paper.  The timing of the thought confused her.

“You certainly have followed our recommendations.  Your recent MRI confirmed the progression of the lesions.  Have you thought about sit-down work, maybe part-time?”

“Yes, I had one at the hospital.  My husband and I could really use the money.  But I’m not coordinated enough anymore to type, and I just cannot function in the afternoon.  I’m a klutz and I just get so tired.”

“Yes, that would be consistent with your objective findings.  I’ll tell you what.  I will perform some extra testing today to confirm how you are doing clinically.  One test reproduces fatigue.  I might not know if you could work at all, but a full-time schedule would seem out of the question at this point.”  He wrote down some notes.

Denise underwent a longer physical examination than normal, moving her arms and walking on her heels.  The tests made her feel tired and clumsy – more than ever before.  Her husband picked her up outside the clinic.  Looking through the car window, she worried about his job.  He takes a lot of time off for my appointments.

Her husband came out to her side of the car and helped her into their old fire red Buick.  Maybe, she thought to herself, I could make appointments late in the afternoon after school and Krissy could pick me up.  Her oldest daughter was a careful driver.  Denise planned to write that down.  Her memory was getting worse.

As her husband buckled his seat belt, she turned to him.  He was looking at her as if he had said something.  “What, honey. Did you say something?”  He nodded his head disapprovingly and started to drive.  Had he really said something?  She was too afraid to ask.

A few minutes later into the trip home, she told her husband about filing a new claim for Social Security disability.  He was quiet for a while.  He was not skeptical by nature, but he never got excited about what he could not see.

Then, with half-effort, he spoke.  “We lost before.  We need good help.”  He became quiet again.  He stared at the road, mouth unmoving.

Looking out the passenger window, she was lost in her thoughts.  The Buick’s engine droned.  To no one in particular, she whispered, “We do.”

She became nervous.  Will the law firm want to help me?  She soon found out.