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Who Determines Whether I Am Disabled or Not?

The short answer is the Social Security Administration (SSA); however, the longer and more accurate answer is Disability Determination Services(DDS).

First, SSA will review your application to make sure you meet some basic requirements for disability benefits. They will check whether you worked enough years to qualify. Additionally, they will undergo an evaluation of any current work activities. If you meet these requirements, they will process your application and forward your case to the DDS office in your state. This state agency completes the initial disability determination decision for SSA. Claims examiners and medical examiners in the state agency ask your doctors for information about your condition. DDS is supposed to consider all the facts in your case. They’ll use the medical evidence from your doctors, hospitals, clinics, or institutions where you have been treated and possibly additional information.

Some of the questions they will ask pertain to the following:

  • Your medical condition(s);
  • When your medical condition(s) began;
  • How your medical condition(s) limit your activities;
  • Medical tests results; and
  • What treatment you’ve received.

 

DDS also ask the doctors for information about your ability to do work-related activities, such as walking, sitting, lifting, carrying, and remembering instructions. Keep in mind that it is not your doctors who decide if you’re disabled. Rather, according to the rules it is up to DDS to make that determination. Also, if your medical sources can’t provide the necessary information, DDS may ask you to a consultative examination. Social Security will pay for the exam and for some of the related travel costs.

When DDS makes its determination on your case, they will send a letter to you. If your application is approved, the letter will show the amount of your benefit, and when your payments start. If the application isn’t approved, you typically have the option of appealing the decision.

To learn more about the appeals process, please read “Social Security Denials and Appeals” available through disabilitysecrets.com.

 

By Kevin J. Kohler

The Importance of Choosing the Correct Onset Date

When applying for Social Security Benefits, you will need to fill out the initial application to get your claim started. On this initial application, you will put in the start date of your disability. This date is known as your Alleged Onset Date. It is a date that Social Security will use to build your case.  Sometimes it may not be as easy to pinpoint this date. However, it is strongly recommended that you try and choose as close of a date to when your condition(s) begin to worsen. There are many signs that lead up to figuring this date. One example would be a decrease in your work hours or having to end your employment. It is good to keep a journal of any major medical events that have affected your daily routine. Also, it is important that you speak to your doctor about any disruptions that you are experiencing in you daily routines due to ongoing symptoms. The more information you have in your medical records, the more of a benefit it will be to you when choosing you Alleged Onset Date.

Social Security does not always agree with the date that you have chosen. If Social Security chooses a different date, it will be a later date. Your medical records may support a different date of disability. The change in the Alleged Onset Date(AOD) by Social Security is known as the Established Onset Date(EOD). The newly Established Onset Date(EOD) chosen by Social Security may affect the amount of backpay that you receive. You can Appeal this decision if you do not agree with the date that Social Security has chosen. Having an expert to assist you through the process would help you avoid mistakes.

Please contact one of our attorneys at Hoglund, Chwialkowski, Mrozik, PLLC. today for more information.

 

By Shana Knotts

Can My Doctor Help Me Get My Social Security Disability Benefits?

Q & A with 20+ year Social Security Disability Attorney Andrew Kinney

Q: Can my doctor help me get my Social Security Disability benefits?
A: Yes! But perhaps not in the ways you would expect. I’ll explain.

In our law practice, we purposely do not interact with treating physicians. Our clients make their own health care choices. Our clients go to doctors because they want to get better, or at least improve their quality of life. We explain the law.
The Social Security Disability program is all about the medical evidence. Forget what you hear on TV. Talk is cheap. Regular medical treatment is important. Just as important, though, is developing a treating relationship with certain medical doctors you know and trust. When you treat properly with physicians you know and trust, you create a bread trail of your problems.

This is where your physicians can help you further. Right after your next appointment, ask the doctor who knows you best these things:

1. “Doctor, can you please make sure you document my problems well?”
2. “Doctor, can you please make sure your treatment notes are clear about how I am limited?”
3. “Doctor, I had to apply for Social Security benefits. Would you mind if my attorney sends you a short form to fill out about my limitations?”

It is vitally important that your medical treatment notes document your ongoing medical problems. Attorney forms track Social Security law. While it is unusual for physicians to object to an honest, straightforward approach to your medical care, it can happen. Some physician practices, including the VA, try to avoid “forms,” but they complete them for insurance daily. Some physicians say that they cannot “decide disability,” but they are not. They are simply determining physical and mental limitations for their patients—something they lay out for working patients with injuries all the time. Finally, some physicians think their patients over 50 can still do “desk work.” That is fine. Depending on your past kind of work you can no longer do, the law can still be on your side. Ask an experienced attorney in this area of law.

Your medical providers are trying to make you better. Keep trying to get better, and document the truth about your medical problems. Your Social Security attorney will argue the rest.

Andrew Kinney, Esq., 12/1/15

Can You Lie to Get Social Security Disability Benefits?

Q:  Can you lie to get Social Security Disability benefits?

A:  This question gets to the heart of the misunderstanding about the Social Security Disability program.  Anyone can lie about anything to anyone.  The real question, then, is whether lying can actually secure Social Security Disability benefits.  The short answer:  No.

The public at large is generally unaware about the level of medical evidence necessary to prove disability under the Social Security regulations.  Just having a physical or mental diagnosis is insufficient.  Your limitations must preclude your ability to work under the law.  The law does not allow mere “claims” of disability to prove limitations.  Medical testing and examinations over time must establish significant impairments.

Lying to an MRI won’t impact the results.  Lying to a physician will not change objective examination findings.  Lying to a psychiatrist will likely land you back in the waiting room.  You can try to fake a limp or fabricate headaches, but medical doctors are scientists.  The lack of objective detail will ultimately do you in.

So just how difficult is it to “talk” your way into benefits?  Let’s consider a real life example of a client of mine today who wasn’t lying about anxiety, but nonetheless will be denied benefits.  I had a Social Security hearing today in which my client had significant anxiety.  The lower State Agency level ignored the regulations in failing to get a treating source opinion (nothing new).  A government-paid “medical expert” at my client’s hearing droned on and on to use time, yet misread the file, inferred chemical dependency without a diagnosis, ignored hard evidence of disability from a psychiatrist, and missed another psychological diagnosis altogether.  The point?  Even people telling the truth with sufficient evidence (in this case, anxiety that left her virtually homebound) have a difficult time meeting Social Security’s regulatory standards.

What should you take from this blog?  Those who are approved for Social Security Disability benefits have medical professionals who have diagnosed, examined, and treated them over time.  Offer to open the door for them, not throw them under the bus.  You or a loved one could need these benefits next.

Andrew Kinney, Esq.

 

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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Remote DLI – Seek Social Security Before It’s Too Late.

From:  Joshua Tripp

 

In some cases, where a claimant has not worked recently and there is too many household assets or too much income to be eligible for SSI, the claimants are left struggling to prove disability for many years prior to the current date. This can be very difficult to do and there must be more than just the claimant’s testimony to win the case.

For an example, I recently had a social security claimant who had to go back about ten years to prove disability.  For approval here, it must be shown that the claimant had a disability prior to their date last insured and that their disability has continued.  This requires consistent medical evidence of severe impairment.  Additionally, to bolster the claimant’s medical record of ten years ago, I had the claimant’s current doctor, who was currently supportive of disability, write a narrative of the claimant’s impairments based on the current time frame, along with a review of the prior medical records.  This was helpful to assess that the conditions were as severe ten years as they are today.  He opined that the claimant was unable to work ten years ago and the condition has not improved.  Although this is important, his opinion needs to be supported by the medical record as a whole.  The medical evidence is particularly important for a case with a remote date last insured because it is hard to say the claimant can testify about conditions as accurately ten years ago as they could today.

It is always best to not wait to apply for social security disability.  Waiting can put you in the predicament of having to prove disability many years prior to the application, which is not an easy task.  Contact a social security attorney before it is too late.

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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On-the-Record Reviews by Social Security and Requesting one

On-the-Record Reviews are available to anyone who files a Social Security Disability claim once it has been denied at the lower levels. It is a favorable ruling made by the Administrative Law Judge (ALJ) based solely on the medical evidence in your file. An OTR is done prior to an actual hearing being held.

Once you have requested a hearing on your claim, then your claim is eligible to request an On-the-Record Review. This review can happen in one of two ways. This type of review can be initiated by a hearing officer, which would be the best case scenario. This usually happens if new medical evidence is submitted and upon review by the Social Security it is deemed that with the new evidence that a hearing is no longer needed and a fully favorable decision can be granted. The second possibility is that you will need to request the On-the-Record Review yourself. Along with your request, you will need to provide a detailed explanation that points out the specific medical evidence that proves that you are disabled by Social Security’s rules.

Once you have put in the request for an On-the-Record Review, one of these outcomes should happen. Your claim could be granted based on the evidence in your file or a judge may contact you for more information on your claim. If this were to happen, it would be in your best interest to be as honest and as thorough as possible. Another possibility is, a judge may feel that the evidence is not clear cut enough to approve the claim during an On-the-Record review. If a fully favorable cannot be given based on the records alone, then your claim will proceed to a hearing when a date becomes available. An On-the-Record Review cannot stop your claim from proceeding, unless a fully favorable decision can be reached.

The request for an On-the-Record Review is a great way to possibly expedite a disability claim. There needs to be enough medical evidence to give a clear cut view of the disability that is being claimed so, that the Judge feels that a disability hearing is no longer necessary. Hopefully this helps to navigate the On-the-Record Review process.

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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Pancreatitis and Disability

Pancreatitis, or inflammation of the pancreas, is a condition that may either be acute, having a short and severe episode, or chronic, with frequent flare-ups. The main symptoms are abdominal pain, nausea, and vomiting. Because of the pancreatitis, someone might also have unexplained weight loss, or may develop diabetes. For most people, these episodes are manageable, but for others, it may be so severe as to interfere with their daily functioning and result in a permanent disability.

The Social Security Administration (SSA) does not have specific rules or listings for pancreatitis. It is evaluated on how the symptoms from the disease affect your daily activities. Social Security Ruling 14-3p sets out guidelines to how they evaluate disorders similar to pancreatitis. First, they will consider the medical evidence that supports the diagnosis. Next, they will consider the effect your disease has on your body, and whether those symptoms meet a Listing for disability. For example, if your pancreatitis has caused you to lose weight, your weight loss may be evaluated to see if you meet Listing 5.08, and if the SSA finds your condition meets those guidelines, you may be found disabled. If they don’t find your condition meets a Listing, then they evaluate the combined effect of the condition and the effect it has on your physical activities and your limitations because of it.

Of course, a condition like pancreatitis affects everyone differently, and your symptoms may be different from others. If you have other conditions in addition to the pancreatitis, those conditions will be evaluated in a similar way for SSA to find how it affects you and your daily functioning.

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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Who is Responsible for Obtaining Evidence for Your Hearing?

Have you ever wondered what you are going to use to prove that you are disabled?

Evidence for your disability claim is gathered at each level of your claim. The party that is responsible to collect your evidence changes as you claim moves through the Social Security Disability process.

The evidence that you use for your disability claim mostly comes from the doctors that you see for your disability by way of your medical records. Sometimes if you have a favorable doctor, an assessment form can be sent to him or her to fill out on your behalf. There are assessment forms for either mental or physical disabilities. It should be known, that some medical facilities do not allow their doctors to fill out forms. If your facility is one of these don’t worry, your disability attorney will use your medical records to prove your disability. Even with a form, your attorney needs to back up that form with medical documentation (i.e. Medical records). So see the medical records are the key to proving your disability.

As was mentioned earlier, each time your claim is denied whether it be at the initial or reconsideration levels, your evidence should be updated with any new evidence that became available since the last denial. For the initial and reconsideration levels, the Social Security Administration is the responsible party that should be retrieving any medical documentation that you have made them aware of since the last denial. If you have an attorney, keeping them up to date on the medical facilities you are going to along with proper addresses and phone numbers for them, will make getting the information to Social Security much more efficient. Social Security will send out the request for information based on what you and/or your attorney gives them but, might not follow up if information is not correct.

So it is in your best interest to have proper addresses and phone numbers for the places that you get treatment for your disabilities. I always suggest that the client gets a business card from the places that they treat and to put the first treatment date on the card as well. This will give them a timeline to use throughout the Social Security process. When you reach the hearing level if you have an attorney, it becomes that attorney’s responsibility to get all new medical documentation for your claim. It is still your responsibility to keep your attorney up to date with where you are treating for your disability. If you do not have an attorney, then the gathering of medical evidence fall on you when you reach the hearing level of your claim.

So as you can see, your medical records are your main source of evidence for your Social Security Disability claim. Also that at the initial and reconsideration levels, Social Security is responsible to gather your medical evidence for you. But, once you get to the hearing level, either you or your attorney if you have one takes over the retrieval of your medical evidence. This is your claim and you are the person affected when things do not go as planned. So be an active part in your claim, by updating the treating sources as necessary with proper addresses and phone numbers so, that your medical documents can be easily gathered for review by either Social Security or your attorney. This will give you the best chance at a positive outcome to your claim.

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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Adaptative Functioning


Video Transcription:

Hi, my name is Andrew Kinney.  I’m an attorney at Hoglund Law offices.  I practice Social Security Disability.  Today I’m going to talk a little more about cases involving borderline intellectual functioning.

I have a previous video that discusses the basics of how social security uses definitions of disability to defining impairments with IQ scores.  What I’m going to talk about now is more specific, adaptive functioning.  Adaptive functioning is claimants have been able to survive and actually thrive in a work environment.  That’s a good thing, but that doesn’t always happen.  So if you are pursuing social security benefits on borderline intellectual functioning, or social security calls it mental retardation under listing 1205 C, It is very important for your attorney to know that we have evidence of adaptive functioning.

functioning, because if an individual has shown, despite the work history, they only worked alongside family members or close friends with understanding bosses, they may not have adapted properly. So in those situations, if someone has not adapted then that would be evidence of it, and so I would perhaps have a family member testify at the hearing, that they helped them get the job, they showed up at the job during lunch, they had interactions with the boss.

It comes down to this:  Sometimes jobs that people do look like they’ve adapted and can function well, and that’s a good thing, but sometimes the actual job the way its performed is more toward sheltered workshops or sheltered work.  That sort of work is done with direct supervision and its different than competitive work.

There are other examples of where adaptive functioning comes into play.  For instance, if they went back to school and learned a specific skill or not.  There are also questions about day-to-day activities.  Reading the paper, basic functions, taking the bus.  There are a lot of other examples about what adaptive functioning actually is and it’s important at hearings to get evidence of it.  If you have further questions about adaptive functioning, borderline intellectual functioning in general, or just about getting benefits for social security disability please feel free to call our offices at 1-800-850-7867.  You can also go to www.HoglundLaw.com.  Thank you.

 

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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