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What If I Don’t Fit Exactly Into Disability’s Age Categories?

What if I Don’t Fit Exactly Into Disability’s Age Caegories? by Scott Bowers

In order to receive Social Security disability benefits, the Social Security Administration (SSA) must find that you are unable to do a full time job due to your medical conditions. The general rule is that they cannot consider whether someone will hire you, or whether you can find a job. However, because the SSA recognizes that older workers may have more trouble adapting to new types of employment, it will consider factors other than just your medical conditions when you reach a certain age.

            The SSA groups disability claimants into 4 basic categories:

1. Younger individuals (18 through 49)

2. Closely approaching advanced age (50 to 54)

3. Advanced age (55 and over), and

4. Closely approaching retirement age (60 and over)

If you are in the first age group, the SSA will not consider you disabled if you are capable of ANY kind of work, including sedentary, unskilled work (i.e., simple jobs that do not require lifting over 10 pounds, or standing/walking for prolonged periods of time). However, if you are in the closely approaching advanced age, you could still be found disabled even if you are able to do sedentary work, depending on your education and past work experience.

            However, what happens if you are about to turn 50 in a few months, but have serious medical issues that limit your ability to work? Luckily, the SSA recognizes that you do not just instantly become disabled the day you turn 50. Thus, if you are within a few days or few months of changing age categories, the SSA may deem you to be older than you are. However, there are some rules to this, and it does not happen automatically.

            First, “within a few days to a few months” does not have an exact definition, but it does mean a period of less than 6 months. Thus, if you are 53, the SSA will not consider moving you to the advanced age category.

            Second, there must be a “borderline age situation.” This means that in addition to being close to the next age category, using your actual age would result in a denial AND moving you to the next category would result in an approval. For example, if you are able to do light work (i.e., some standing and some sitting, and lifting up to 20 pounds occasionally), and you are 3 months from your 50th birthday, you would be denied in either age category.

            Lastly, there are 4 factors that must be considered:

1. Time period

2. Education

3. Past relevant work (PRW)

4. Residual functional capacity (RFC)

There are many considerations that go into arguing these factors (i.e., they cannot be double weighed – that is if education is already factored when deciding if it is a borderline age situation, it cannot again be a factor when considering an allowance). Thus, it is always recommended that you seek the help of an attorney for your disability 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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Does Social Security Consider Anything Other Than My Medical Conditions

In order to receive Social Security disability benefits, the Social Security Administration (SSA) must find that you are unable to do a full time job due to your medical conditions. The general rule is that they cannot consider whether someone will hire you, or whether you can find a job. However, because the SSA recognizes that older workers may have more trouble adapting to new types of employment, it will consider factors other than just your medical conditions when you reach a certain age.

The SSA groups disability claimants into 4 basic categories:

  1. Younger individuals (18 through 49)
  2. Closely approaching advanced age (50 to 54)
  3. Advanced age (55 and over), and
  4. Closely approaching retirement age (60 and over)

 

If you are in the first age group, the SSA will not consider you disabled if you are capable of ANY kind of work, including sedentary, unskilled work (i.e., simple jobs that do not require lifting over 10 pounds, or standing/walking for prolonged periods of time). However, if you are in the closely approaching advanced age, you could still be found disabled even if you are able to do sedentary work. At this age category, the SSA decision-maker will look, with the help of a vocational expert (i.e., an expert on jobs and employment related matters), to see whether you have skills that could be used in sedentary work. These skills could come from your education (i.e., a college degree or vocational training), or your past work (i.e., whether you had the power to hire and fire employees, set schedules, or do bookkeeping). If you do have skills, you would be found not disabled. If you do not have skills, you would be found disabled. When you are in the next age categories, you can still be found disabled if you do not have skills that would transfer to light work, even if you are capable of that type of work (i.e., jobs that involve lifting up to 20 pounds, and standing/walking about half the day, and sitting the other half).

There are also other ways to prove that skills are not transferable, even if you do have them. One way is if you have a severe psychological condition that would prevent you from doing skilled work. Due to the complicated nature of these rules, it is always a good idea to hire an experienced disability attorney to help you navigate this complex system.

 

By Scott J. Bowers

The Myth of Widespread Social Security Disabilty Fraud

We have all heard them – those friends or relatives who claim they know someone who is collecting disability who shouldn’t be.  Why do we pay our taxes for those freeloaders, the argument goes.

I always like to ask those that complain about social security fraud if they have reported the suspected fraudster to the authorities.  The answer is always no.

While there is little doubt that there is fraud in the disability system, there is NO evidence that this fraud is rampant.

Here are some facts that cannot be ignored or discounted:

It is not easy to get approved for social security disability.  The vast majority of people who apply are denied.  Approximately 65 percent of applicants are denied at the initial level, and about 85 percent of applicants are denied on reconsideration.  Of those that appeal to the hearing level in front of a judge, about 50 percent are approved.

Many reasons exist for denying applicants.  Claimants can be denied because they haven’t worked enough to qualify for SSDI.  To qualify a claimant must have worked for five out of the last ten years prior to application and paid into the social security system while doing so.  Others are denied for medical reasons.  To get approved, the claimant must have a physical or mental disablitiy that is severe and is expected to last at least 12 months.

The social security administration requires solid medical documentation in making its determination of phisyical or mental disability.  If a claimant is not treating with a valid medical provider such as an M.D.. it is very unlikely the claimant will be approved.  It is not easy to “pretend” you are disabled. Usually when a claimant is disabled, ongoing and lengthy treatment with a specialist is a given.  A record lacking such evidence is frowned upon by the Social Security Administration.

The statistics show that people who apply for disabiltiy have much higher death rates than the general population.  It is pretty difficulty to fake ones death.  People on disability are up to six times more likely to die than people in their age group who don’t receive benefits.

The solution is not gut the system of much needed funding, but rather to detect and frett out fraud when it occurs.  The social security disability system is a lifesaver, and you can be assured that the vast, vast majority of those receiving benefts are legitamately disabled.

For more information see:  The Center on Budget and Policy Priorities report on the disability system.  https://www.cbpp.org/research/chart-book-social-security-disability-insurance

 

By Michael J. Cerniglia

Social Security Disabiltiy Attorney

Hoglund Law Firm

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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Domain #5 – Caring for Self

If a child has a severe impairment(s) that does not meet or medically equal any listing, the Social Security Administration (SSA) will then look to see if the child functionally equals the listings.  To functionally equal the listing, the child’s impairments must result in marked limitations in two domains, or extreme limitation in one domain.

The fourth domain used by SSA is called 5. Caring for Self.  In this domain, SSA will focus on how well the child takes care of themselves, physically and mentally.  As children age, they should become more independent with regards to making their own decisions.  Children should be able to know the difference between what is right and wrong.  They should understand what their physical and emotional needs are and how to control their thoughts and maintain their well-being.

For more information, please contact one of the attorneys at Hoglund, Chwialkowski & Mrozik.

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 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

Reopening a prior Disability Claim

Often, Social Security Disability claimants have previously applied for benefits, unsuccessfully. In these situations, it is always a question as to whether the previous application can be reopened in a current claim. Many factors are involved in answering this question. Generally speaking, however, it must be said that reopening a final decision from an administrative law judge is an unlikely occurrence, as great weight is given to previous decisions absent clear evidence that the decision was incorrect. Often claimants continue to allege that they have been disabled since their previous application, which then presents the possibility of reopening that claim.

First, the current application must allege an onset date that involves the previous application period, otherwise there is no need to examine the previous application, as it is not at issue in the case unless the argument is made

Second, a prior claim must be related to the current claim. This means that a previous application for schizophrenia cannot be reopened in a claim alleging only degenerative disc disease. In other words, the conditions alleged in the previous application must be involved in the present application.

Third, the age of the claim is relevant. If the previous claim is less than a year old, either a Disability Insurance Benefits (DIB) claim or a Supplemental Security Income (SSI) claim may be reopened at will by the Social Security Administration. If the claim is more than a year old, Social Security may reopen an SSI claim that is two years old or less if there is good cause. For DIB claims, any claim four years old or less may be reopened for good cause. “Good cause” generally means new evidence is available or that an egregious error occurred.

While reopening previous claims is possible, it generally is not likely. Consult with your Social Security Disability Attorney to determine if it is wise to attempt to reopen a previous claim.

 

By Adam Kachelski

Domain #4 – Moving About and Manipulating Objects

If a child has a severe impairment(s) that does not meet or medically equal any listing, the Social Security Administration (SSA) will then look to see if the child functionally equals the listings. To functionally equal the listing, the child’s impairments must result in marked limitations in two domains, or extreme limitation in one domain.

The fourth domain used by SSA is called 4. Moving About and Manipulating Objects. In this domain, SSA will consider how well a child moves their body from one place to another and how they move and manipulate things. The SSA will look at both gross and fine motor skills.

Some areas of moving the body will include rolling, rising up from seated position, raising head and arms and legs. They will look at how the child transfers from one surface to another and how they move forward and backward when crawling, walking, and running.

With regards to moving and manipulating objects, SSA looks at how the child pushes, pulls, lifts, or carries objects. SSA will evaluate how the child controls their upper extremities in carrying objects. They will even consider eye hand coordination to manipulate small objects.

For more information, please contact one of the attorneys at Hoglund, Chwialkowski & Mrozik.

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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Social Security Domain #4 – Health and Physical Well-Being

If a child has a severe impairment(s) that does not meet or medically equal any listing, the Social Security Administration (SSA) will then look to see if the child functionally equals the listings.  To functionally equal the listing, the child’s impairments must result in marked limitations in two domains, or extreme limitation in one domain.

The fourth domain used by SSA is called 4. Health and Physical Well-Being.  In this domain, SSA considers the physical effects of physical and mental impairments of the child.  Unlike the other domains, this domain does not address typical development and functioning.  This domain addresses how such things as recurrent illness, the side effects of medication, and the need for ongoing treatment affect a child’s body.

It is important to remember that the cumulative physical effects of a child’s physical or mental impairment(s) can vary in kind and intensity, and can affect each child in a different way.  As with all other domains, SSA does not consider the limitations in this domain unless it results from a medically determinable impairment(s).  However, it is very unlikely that a child who has a significant problem in this domain does not have an impairment that causes the problem.

 

For more information, please contact one of the attorneys at Hoglund, Chwialkowski & Mrozik.

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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Social Security Domain #3 – Interacting and Relating with Others

If a child has a severe impairment(s) that does not meet or medically equal any listing, the Social Security Administration (SSA) will then look to see if the child functionally equals the listings.  To functionally equal the listing, the child’s impairments must result in marked limitations in two domains, or extreme limitation in one domain.

The third domain used by SSA is called 3. Interacting and Relating to Others.  In this domain, SSA will consider the child’s ability to initiate and respond to exchanges with other people, and to form and sustain relationships with family members, friends, and other people.  This would include all aspects of social interaction in all different areas of the child’s life.

Also, because communication is essential to both interacting and relating, SSA considers speech and language skills that a child would need to speak intelligibly and to understand and use language of their community.  The ability to interact and relate with others begins at birth.  A child begins to us his/her ability in early infancy when they bond with a caregiver.

As with limitations in any domain, SSA does not consider a limitation in the domain unless it results from a medically determinable impairment(s).

For more information, please contact one of the attorneys at Hoglund, Chwialkowski & Mrozik.

 

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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Award Letter Issue: Current Workers Comp

Often clients who have disability claims will also have workers comp claims. When there are workers comp benefits involved, there sometimes will arise difficulties with the award letters when social security is calculating payments. Sometimes, the award letters will state that claimants are currently receiving workers comp benefits, when in reality, they have not received benefits in possibly years. Social security factor in these benefits immediately. This upsets clients, because their present benefit amounts are reduced.

In these situations, it is the payment center that intentionally processes the claims like this. If a claimant is still currently receiving workers comp, this prevents them from potentially getting overpaid. While it does not seem like it, and must be explained to the clients, this benefits the clients by preventing an overpayment. The discrepancy is fixed by providing proof that they are no longer receiving benefits through the Stipulation for Settlement and the Award on Stipulation. We then ask to re-calculate the benefits so that the claimant will get the correct amount. While this appears on the surface to be a mistake, many clients will question this and chalk it up to a mistake on SSA.

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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Transferability of Job Skills

An important part of the Social Security Disability analysis arises, especially if the claimant is over 50, as to whether the person has obtained skills from his or her prior work that could transfer into an easier, less demanding job. SSR 82-41 explains the concepts of “skills” and “transferability of skills” and clarifies how these concepts are used.

Skill is defined as knowledge of a work activity which requires the exercise of significant judgment that goes beyond the carrying out of simple job duties and is acquired through performance of an occupation which is above the unskilled level (requires more than 30 days to learn). It is practical and familiar knowledge of the principles and processes of an art, science or trade, combined with the ability to apply them in practice in a proper and approved manner. This includes activities like making precise measurements, reading blueprints, and setting up and operating complex machinery. A skill gives a person a special advantage over unskilled workers in the labor market.

Transferability is defined as applying work skills which a person has demonstrated in vocationally relevant past jobs to meet the requirements of other skilled or semiskilled jobs. Transferability is distinct from the usage of skills recent learned in school which may serve as a basis for direct entry into skilled work.

SSR 82-41 also explains the difference between a “skill” and a “trait” explaining that the qualities of “alertness,” “coordination and dexterity with the use of hands or feet for the rapid performance of repetitive work tasks” are traits and not skills. “It is the acquired capacity to perform the work activities with facility (rather than the traits themselves) that gives rise to potentially transferable skills.

Finally, SSR 82-41 specifically provides that the ALJ set forth findings of fact regarding the issue of transferability of skills. SSR 82-41 states “When the issue of skills and their transferability must be decided, the adjudicator or ALJ is required to make certain findings of fact and include them in the written decision. Findings should be supported with appropriate documentation. When a finding is made that a claimant has transferable skills, the acquired work skills must be identified, and specific occupations to which the acquired work skills are transferable must be cited in the State agency’s determination or ALJ’s decision. Evidence that these specific skills or semiskilled jobs exist in significant numbers in the national economy should be included (the regulation take administrative notice only of the existence of unskilled sedentary, light, and medium jobs in the national economy).

Transferability of skills is an important part of the disability analysis and can potentially lead to a denial. It is the last step in the disability analysis to decide whether someone should be determined Disabled. Vocational expert testimony is extremely important and can seem to vary based off who is testifying. Having an experienced attorney represent you who knows the regulations and the right questions to ask during cross examination can potentially make the difference between winning or losing a claim for benefits.

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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Overpayments and Social Security

Social Security overpayment. How does it happen and what can you can do about it? There are things that will be your responsibility even after your claim is approved but, we will discuss that a little later. So how can you be overpaid you ask? It is true that Social Security is a Federal Agency and they have access to your employment history or earnings if you will. Well, there are other things that may play into how your income is determined by Social Security. Let’s look at one possible scenario.

You have been approved for Supplemental Security Income more commonly known as SSI. This is a needs based program. Which means that it is based on income and assets. Assets are things that you own like a car, cabin or savings bonds to name just a few. So now let’s add to that, that your family helps you out by paying your rent and utilities and you didn’t let Social Security know that. Social Security is not privy to items that you are receiving from family and/or others if you do not make them aware of them. But under Social Security rules, your family’s assistance with rent and utilities is considered a gift or as Social Security calls it an in-kind payment and looked at as unearned income and counts toward your total income when calculating your SSI payments. Your total income can only be up to a certain amount gross (meaning before taxes are taken out) to qualify for Supplemental Security Income (SSI).

Now take into account, that Social Security may only review your claim every three years or so. You guessed it, you now may have an overpayment issue with Social Security because during their claim review the fact that your family has been helping out has now come to light. Now Social Security has to refigure what you should have been getting paid and the overpayment will need to be paid back. If the amount of in-kind monies take you over the total income threshold allow by Social Security for an extended period of time, your benefit might be stopped altogether once the overpayment has been taken care of.

Remember that there are many different scenarios that might end in a person being over paid. Before you panic, first make sure that you were truly overpaid. Social Security can make errors too. Then even if you were overpaid, there are ways that you can get the overpayment waived. Social Security should be able to get you the information on how to appeal or try to get a waiver for your overpayment or here is a link that might be of assistance. https://www.socialsecurity.gov/pubs/EN-05-10098.pdf

I want to leave you with this thought. If you are receiving benefits from Social Security that are need based (SSI) you need to remember that you are responsible to let Social Security know if there are changes in monies you receive. Since they might count toward your total income and thus may cause your payment amount to change. This will help you in not being overpaid and wondering how you are going to repay the money. If you are in doubt whether Social Security needs to know about it or you just do not understand something that Social Security sends you, ask them to explain or contact an attorney to get assistance. Overpayments add up quickly and can become overwhelming to deal with along with your disability.

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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Technical Requirements for Social Security Disability Benefits

There are many people who suffer from severe impairments that make them unable to work. However, the Social Security Administration (SSA) will not evaluate the severity of the impairment until the claimant’s technical eligibility is addressed. There are two programs that SSA pays disability benefits through, but many people do not understand the technical eligibility aspect.

Disability Insurance Benefits (DIB), also called SSDI, is based off of an individual’s work history. The SSA looks to a credit based system to determine if one qualifies for DIB. The amount of credits an individual needs will vary depending on the age of the person. An important thing to understand is that a person may be eligible under this program at one point, but that eligibility does not last forever. A claimant must have worked long enough and recent enough to qualify. An Individual will run into problems when he has long gaps in his work history or if it has been a long time since he last worked.

Supplemental Security Income (SSI) is a needs based program. The claimant can be found eligible if he never worked a day in his life, but his financial situation must show a need for the benefit. The technical requirements for eligibility vary depending on whether the claimant is married or single, but both can only have a certain amount of assets to qualify. A single person is limited to having a maximum of $2,000 in assets, where as a married person can have $3,000 in assets. Certain assets such as the home a person lives in and a vehicle are excluded from this calculation. Additionally, one applying for SSI should be aware that a spouse’s income could disqualify a claimant for SSI.

If the technical requirements are not satisfied, then it does not matter how severe an individual’s impairment is because he will not be eligible for disability benefits. To get a better understanding of these two programs, it is beneficial to meet with an experienced disability attorney.

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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