Claimant Educational Blog Portal

|0.00|> Fees and disability cases are controlled by federal law.<|5.16|><|5.16|> The basic fee is 25% of the back pay and we’re fee capped at $7,200.<|10.36|>

0.00|> When it comes to the topic of how long do you need to be off work before you file for<|7.00|><|7.00|> disability, there is no set rule or law on point. What I tell most people is you’re supposed<|13.16|><|13.16|> to be disabled for 12 months or expect to be disabled for 12 months. So when you’ve<|18.40|><|18.40|> been off work for a little while or you think you’re going to be off work for an extended<|22.76|><|22.76|> window of time, that’s when you call and that’s when we file.<|28.00|><|28.00|> When you pick up the phone, we’ll answer and do the work for you.
When it comes to the paperwork to start your disability claim, there’s a lot. There’s documents so we as lawyers can do the work, there’s a contract of employment between myself and my client, there’s medical releases for the law office and medical releases for the agency, and most of the time we file all the other stuff online and it takes 60 to 90 minutes with endless questions about your medical treatment, your work history, your marriage or divorce life, all of that gets put down there. It takes a while and after you’re done you’ll usually get mailed a deluge of other forms like the activities of daily living questionnaire, the pain questionnaire, the third-party questionnaire. Point is there’s a lot of forms. We’ll walk you through it step by step because it’s what we do literally every single day. So when you’re ready, you call. We’ll help.
<|0.00|> When it comes to your medical problems and what it takes to qualify for disability, that’s<|7.00|> a very long-winded and difficult question because so many different things can actually<|11.98|><|11.98|> qualify you. It comes down to knowing what you need to prove to win. But a lot of my<|17.42|><|17.42|> clients I see over half with back injuries, a lot of mental health issues, those can easily qualify,<|28.12|><|28.12|> neurological issues, seizure disorders can qualify, neoplasms, cancers, they all have listings to qualify. There’s even compassionate listings, which are pretty dire medical conditions, but it’s pretty much like instantly qualifying if you fit the criteria. My best advice to you on this is have a heart-to-heart with a lawyer to screen the case and see what they think. and see what they think. So when you need that done, you call, we’ll pick up the phone and we’ll have that conversation
When it comes to your work history, that is important to winning your case because the first thing Social Security will ask is, in spite of your medical problems, can you go back and do your past work? They can’t answer that until they know what you actually did for your past work. And the regulations require that the agency go back 15 years to look at your past work. So that’s why you always hear this 15 year thing. It’s just one of the rules. And they’re going to ask about the physical demands of your work, the mental, emotional, and skill demands and things like that. So you need to be ready to do a 15 year work history and it’s basically your main jobs. And here’s a tip. I get a lot of people who say, for example, they’ve done warehouse work over 10 years for different employers. You can lump them all together and say, for this 10 year window of time, I did warehouse work for various employers, always the same, and you go on to describe that type of work.00:56 A little bit of a shortcut, but perfectly allowable. But again, the short answer is, they go back 15 years because the law says so. When you need help putting your work history together, call us.
When you file for disability, the agency usually looks at one or two years before your onset date of disability. What that really means is when you tell them the date you became disabled, they’re going to look back one to two years to see what’s been going on with you and then they look at your current medicals as well. And that’s just how they look at these cases because they need to know what’s wrong with you, what you’ve been living with, how it’s affected you, and in general they’re going to look back one to two years for that window of time before you became disabled and then look at the window of time after you became disabled. And hopefully there’s a pretty decent shift in your medical care. But that’s one of the reasons why.
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And sometimes in a rare case we’ve got to show somebody was disabled several years in the past so we get a lot of historical medical records to document that condition in years gone by because that’s part of a burden of proof in a particular type of case. I know that’s a lot to swallow and that’s why if you have those questions about how far back in time do I need my medical proof, that’s when you need to call and reach out to a lawyer because we’ll explain it to you as it pertains to your case. When you’re ready, you call.
Hey, when it comes to getting Social Security denials, you need to understand that there’s a hierarchy, there’s a system you work through, there’s levels. When you get that very first denial, you say, what do I do with this? The short answer is you appeal, right? That appeal after your first denial has a name, it’s called reconsideration, it’s a bunch of paperwork, you have 60 days to file your first appeal after you get your first denial. So when you get that denial, the writing is on the wall, they’re not going to pay you. You should call an attorney right away and get the help you need and the help you deserve. So when you get that denial, understand you’ve got 60 days to file a reconsideration. You should probably call me on day 2 so we can get it going right away. You should probably call me on day 2 so we can get it going right away.
|0.00|> You know, as you go through the levels of a disability case, you’ll find out that they’re<|10.00|><|10.00|> just very form intensive and people always ask me, what is a 3441 form?<|14.76|><|14.76|> Why do they keep shoving it down my throat?<|17.04|><|17.04|> The answer to that is, is you file your appeals and that’s at two levels, you file appeals.<|22.56|><|22.56|> You disclose your medical updates and changes in your life to them on a form. That form has a number. That is<|29.34|><|29.34|> the 3441 form. It’s how you tell Social Security, since you last turned me down guys, this is what’s happened in my life. Here’s my medical treatment. Here’s my hospitalizations. Here’s the new medications. Here’s how things have changed since you last took a look at my case. And you tell the government all of that on a mystical form called 3441. And you usually fill that out at least two times in the course of the case.
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Hope that was helpful. When you have questions, reach out to your lawyer. You call, we answer.
As you appeal and appeal again in a disability case, eventually you ask to see a judge. That’s called request for hearing. We always get the question, how long is it going to take for my hearing? The short answer is, there is no set time. The agency does work many years ago. It took two years from the day you asked to see a judge to sit down in a courtroom. Nowadays, we see that well under 12 months because the agency has made great strides. So, when you ask me, how long will it take to get my hearing from the day I ask or file that request for a hearing? Short answer is I’m going to tell you my best guess right now is 6 to 12 months, with most of them hovering in under 6 to 10 months at the present time. Understand that after COVID, we do hearings by phone, we do them by Zoom, and we do them in person. And the agency can send your case file anywhere in the country to a judge to expedite the hearing. For example, if your local hearing office is bogged down and backlogged, they may ship your case out to the West Coast somewhere where they’re running really fast and can handle more cases. The whole point is they’re trying to cut that delay and we certainly appreciate it. But the short answer to the question is, I will tell you six to twelve months at this time on a wait for a hearing.
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But you should call, get up-to-date information, and reach out to your lawyer. When you need that request for a hearing filed, that is the time you absolutely should get a lawyer. Don’t go to court alone. When you’re ready, you call.
Once you’ve filed a request for hearing, eventually you’re going to get some mail from the judge. A lot of it’s confusing, but one packet contains three forms that you’re supposed to fill out. And people always ask me, I got this letter with these three forms, what am I supposed to do with them? Well, my answer is we’re supposed to complete them together is what we’re supposed to do. And then they say, well, I’ve already told them all these things. Yes, I know you have. And now we have to tell them one more time on a form a judge is used to reading. And by the way, we take that opportunity to update your case on your medical treatment. We update your medication list, and we take time to do a very, very good detailed work history. So the judge understands what you did. And so that’s why we do the forms at that point in time. And you know what, when we get a hearing date and we close in on that hearing, we will do those same forms one more time and it’s by way of an update so the judge knows what’s going on with you. So that’s why you get the forms and I understand it feels like it’s the same information over and over since day one and I get that. But you know what, you actually have to do it. We’ll work you through it very fast. So when you get the forms, call your lawyer, work through them, get them filed and move on.
You know, disability cases, they can take a few months to, God forbid, a few years, but it does happen. We always get a question, when do I need to tell my lawyer about medical developments? And the short answer is, if we’re waiting for a hearing, and that’s a 6 to 12 month window, when you have a hospital event, you should tell us right away because we will order those records. There’s no need to wait. If you’re going to your doctor’s on the regular visits or waiting for a court date, we will connect with you usually eight, six to eight weeks before your court date and then we will update everything. So you don’t need to tell me about every doctor visit as it happens. At the lower levels, things happen a little faster. Sometimes your windows of adjudication are four months, give or take, maybe five. At the lower levels, you probably should update your lawyer monthly, but when you have to wait out for a hearing and it’s 6 to 12 months. Hospital events, emergency rooms, MRIs, special scans, tell the lawyer right away. If it’s routine medical treatment, save it for the final update before court. I hope that was helpful. If you’re still a little bit confused, please reach out. We’ll work with you until you understand it very well and we’re always here to help. We’ll work with you until you understand it very well and we’re always here to help.
We get a lot of questions from clients asking, how do we prepare for the hearing?<|7.00|><|7.00|> What am I supposed to expect?<|9.00|><|9.00|> That’s actually a long-winded answer, but the short take on it is to prepare for your hearing,<|15.00|><|15.00|> we get together about six to eight weeks before the court date.<|18.00|><|18.00|> Then we get together again two weeks to ten days before the court date,<|22.00|><|22.00|> and we go over pretty much everything.<|24.00|><|24.00|> We’re going to talk about your medical development, your recent medications, we will go through<|28.84|><|28.84|> your work history, we will talk about the judge you drew, we will tell you what to expect and kind of the order of things. Most hearings run 30 to 60 minutes and we’re going to do some forms and we’re going to talk about the same type of topics that we’ve talked about all along and you’re going to shrug and go, oh my God, this again. We’re going to go, yeah, it’s the same stuff again, this time on a form a judge is used to seeing. That’s how we do it. And then if we don’t have all your medical by the hearing date, we can write the judge before and say, hey, we’re going to need extra time, we’re going to need a subpoena. So there’s a lot of nuances of this that could change based on what you need to prove and what judge you drew. So the best advice is have a heart-to-heart with your lawyer and most lawyers will actually meet with you well before court. When in doubt, pick up the phone and call us. When in doubt, pick up the phone and call us.
When it comes to the actual hearing, we get a lot of questions.<|9.56|><|9.56|> A lot of people want to bring in witnesses, loved ones, family, neighbors.<|13.76|><|13.76|> They’re all going to say, this is what’s going on with me.<|15.64|><|15.64|> And the short answer is, for the vast majority of the hearing, you don’t need witnesses.<|20.28|><|20.28|> They don’t add anything.<|21.28|><|21.28|> Let me start that one over.<|22.28|><|22.28|> I’m just going to do it.<|24.84|><|24.84|> I was saying, I wasn’t saying the words right.<|27.60|><|27.60|> Okay, so we get a lot of questions when preparing for a hearing and people are always asking us, do I need witnesses at my hearing? My neighbor will come in, my husband, my child, my friend will talk about it. We can get anybody to testify for me. And the answer to that question is for the vast majority of hearings, you do not need a witness. Ask yourself, what is that witness going to say or add that you can’t say for yourself? A lot of times I tell people I will use a witness, say for example you have a seizure and I ask what’s a seizure like and you say I don’t know I’m having a seizure I’m kind of out of it I couldn’t tell you. Well okay then I’ll bring in a witness that saw that seizure. Or maybe you’re tremoring a lot you have a neurological disorder and I say you know what’s it like with the tremors? And they say, well, my husband sees me drop everything. Maybe you should ask him and we’ll get a whole different take on what you live with. And those are some limited examples. But for the vast majority of cases, you don’t need a witness. They don’t add anything new. They prolong your hearing. And generally, they don’t add enough to warrant their use. But again, talk to your lawyer about your case and whether you need a witness in your case. lawyer about your case and whether you need a witness in your case.
As we get ready for your court date, certain rules and laws attach and a lot of times we<|11.86|><|11.86|> meet with a client two weeks to ten days out and people say, you know, why do we have to<|16.04|><|16.04|> do this again?<|17.04|><|17.04|> And we say, because of the five-day evidence rule.<|19.04|><|19.04|> And then they say, what is the five-day evidence rule?<|21.80|><|21.80|> The agency evolves over time and they put rules in to stop certain behaviors that have taken place. The five-day<|27.78|><|27.78|> evidence rule basically means five days before your hearing you have to tell the judge what evidence is outstanding or that evidence is most likely going to be barred from being considered by the judge. So what we do is we look at what medical records are still out there requested but not yet in. We write the judge a letter identifying the providers what was requested, how many times we tried, sometimes we ask for a subpoena, and we literally carpet bomb the Social Security Administration with that documentation so we can prove we filed it.
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That way, if you need time after your hearing to finish off the medical proof and get everything in front of that judge, we have the time, and the five-day evidence rule will not bar the judge from considering your case. It’s really a minefield for the lawyers, but we work it aggressively. And when you’re going to confront that, please talk to your lawyer about it and get the right advice for your case. Pick up the phone, we’ll answer.
As we work your disability case and develop it, we have online access to your case file and sometimes we’ll tell clients, hey I’m going to get in the ERE and get your case file for you and people are going, what is the ERE and why do I care? The ERE is an electronic records portal and the agency has your entire case file there and we can download it and we can burn a disk or put it out to a portal that you can access. But basically, it’s the electronic access to your file. And we download them before court multiple times, actually. And if you ever want a copy, all you’ve got to do is ask, and depending on what point in time we get that file, it can be itemized extremely well. So it’s an important piece of evidence, and it’s your electronic case file. So it’s an important piece of evidence, and it’s your electronic case file.
When it comes to hearings, we get a lot of questions about what kind of hearing do I want? I’ve got this form from the judge, it’s confusing. It says I can have a phone hearing, a video hearing, like a Zoom call or something, or in person. What do I want? And what happened is, after COVID hit, the agency tried to keep things open and they did do a lot of work remotely and they gave people choices. They say, okay, we can’t get together, but we’ll have your hearing by phone or by Zoom computer link. And actually, as we speak today, in-person hearings are back. And now as a claimant, someone seeking disability, you have a choice. You can elect a phone hearing, a Zoom video hearing, or an in-person hearing. I can tell you our experience is the vast majority of people select phone or Zoom, and the outcomes of the cases are roughly parallel to what they used to be with all in-person hearings. But if you want that in-person hearing, you can absolutely have it, and I usually have heart-to-heart talks with my clients about whether I think there’s a lot of value for them in an in-person hearing, meaning something I want the judge to visually see about them and their case. But for specific questions, just pick up the phone, talk to your lawyer, you call, we answer. But for specific questions, just pick up the phone, talk to your lawyer, you call, we answer.
When it comes to a hearing and you go through a hearing, there’s almost always a vocational
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witness at all adult disability hearings. People refer to them as the work person, that jobs person, who are they, what are they doing here? And the answer is, when it comes to a disability hearing, the judge has to know certain things about work and jobs. For example, if you lost, I don’t know, three fingers on one hand and your other hand looked like a hook, the question is, are there jobs for people out there who have lost manual dexterity in the right dominant hand and the other hand is available only to assist? Fine manipulations are precluded with the non-dominant hand and you can just get all these weird restrictions. Well, the answer to that is, I don’t know, the judge doesn’t know, but the jobs person, as people refer to them, that is their job. They place injured workers with a variety of restrictions and jobs. And typically what happens is, is you add a whole lot of restrictions onto somebody’s profile. The answer comes back, there’s no jobs for somebody that’s that impaired. And that’s what we strive for as attorneys, to create a picture of someone that has so many restrictions on their physical abilities or their mental health abilities, there’s just not a job out there in the universe for them. But that person, they answer questions about the incidence of jobs that would be appropriate for, in your case, it’d be the restrictions that are appropriate to your health problems. And that’s what they do. And by the way, you don’t need to question them unless you’re alone. Really, it’s for the lawyer to take them down later in time. Get that question all the time. If you need more details, pick up the phone, call, ask, we always answer. call, ask, we always answer.
After many years doing this and many, many hearings, people always ask me,<|7.00|>
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<|7.00|> okay, I had my hearing, how long do I have to wait for a decision? Come on, it’s been<|10.36|><|10.36|> long enough. I understand completely that question. And the short answer is, you will<|15.28|><|15.28|> see decisions from judge come out anywhere from two weeks to three to four months. I will say three-fourths of the decisions<|28.40|><|28.40|> come out in that window of time. Sometimes after hearing there’s some development. Maybe the judge wants you to see a doctor. Maybe we’re waiting on your medical records. That extends that window, but I would say by and large 95 plus percent come out within six months of the court date with the vast majority coming out long before then. Judges understand you’re in a bad spot. You’ve been waiting. They try to get it out in a hurry too. Trust me, I know, they’re people and they mean well, but they want to make the right decision based on the evidence in your case. It always takes a little longer than we would all like. For your particular case and the time frame for a little longer than we would all like. For your particular case and the time frame for your case, call your lawyer. They’ll have the answers
As we discuss disability hearings, people ask me, they say, okay, what are my chances of winning, what are my chances of losing, you know, what’s the end result from a hearing? Well, you can imagine if you go to court at a disability hearing, typically you either win or you lose. In a few cases, you come out somewhere in the middle as well, and people are like, what does that mean? Well, let’s say you feel you’ve been disabled for two years now and you go to court and the judge says, you know, I understand you think you’ve been disabled all this time, but you know when you had that car wreck and shattered your hip about nine months ago? I’m pretty convinced since that event, you couldn’t work at all and I’m willing to pay benefits from that date forward. So that’s like getting a slice of the pie, but not the whole pie. You don’t get your two years of back pay. You get nine months of back pay. We call that partially favorable decision. So again, your outcomes are you win it all, you lose it all, or you get a partially favorable decision.
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Sometimes they get dismissed, nobody shows up for court, and the judge messes with it, we try to contact you, no contact, they get dismissed sometimes too, that’s another outcome. But by and large, it’s win, lose, or partially favorable.
As we talk about hearings and in the wonderful event that the judge rules in your favor,<|9.56|><|9.56|> they call that decision come back fully favorable.<|13.12|><|13.12|> Sometimes my clients call and say, what does that mean?<|14.68|><|14.68|> I go, you won.<|15.68|><|15.68|> It means you won.<|16.68|><|16.68|> And they go, great.<|17.88|><|17.88|> How long will it take to get paid?<|19.04|><|19.04|> And I laugh and I say, oh wow.<|21.44|><|21.44|> There’s two types of disability claims we see most of the time.<|23.48|><|23.48|> It depends which title of the U.S. code it was brought under, but there’s people call<|26.96|><|26.96|> it SSI and SSDI.<|29.00|><|29.00|> SSI processes locally.
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Normally, you will start your money within 30 days for monthly checks. Back pay takes a little longer. SSDI processes at regional payment centers. It can take a little bit longer. Normally, your checks start in 60 days, sometimes quite a bit sooner. Back pay is normally out within 45 to 90 days. These are just normal times. There’s always outliers. I have some people who have been fighting for a year for their back pay. I have some people who got their back pay in two weeks.
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But by and large, the run-of-the-mill thing is within 30 to 90 days of a favorable decision, your money’s flowing and you’re in a much better place. Again, if you have issues with when your money’s coming, call your lawyer. We can run some interference for you, shake it loose. I’ve even filed lawsuits to get my clients paid when the agency seems to have totally forgotten about them. Anyway, if you have trouble, reach out. We’ll try to help.
When we talk about hearings and outcomes, not every single case a judge sees can be
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paid and sadly some of them lose. That decision will be styled unfavorable at the top of the first page and that means you lost. It’s a tough conversation to have with anybody, much less clients who put their heart and soul in this case and lawyers who worked it like it was their own. You do have a right to appeal. You have a right to appeal within 60 days of that decision. And I usually have a heart-to-heart with my client about what the best course of action is. In some cases you can refile. In some cases you appeal. And in some cases people maybe get back to work, grab a job offer and kind of let it go. But if it’s unfavorable, it means you lost, benefits are not going to be paid, and a 60-day clock ticks for you to do the appeal. When that happens, call your lawyer, have that heart to heart talk as long as it takes till you understand your options and the path forward. And I wish everybody the best of luck and when you have those things to confront and you’re one of my clients, don’t hesitate to reach out. you’re one of my clients, don’t hesitate to reach out. We will talk about it and we will figure out the best path.
After a judge turns you down, people ask what do I do, and normally we appeal, right?<|10.00|><|10.00|> And you have a 60 day window to appeal, and people go, where does this appeal go?<|13.64|><|13.64|> Do I get another hearing?<|14.76|><|14.76|> The short answer is it goes to this group of appellate judges that are known as the<|18.92|><|18.92|> appeals council.<|20.36|><|20.36|> They sit in Falls Church, Virginia, and they rule on appeals and no, you don’t get to appear<|24.24|><|24.24|> in front of them.<|25.24|><|25.24|> That would be extremely rare.<|26.84|><|26.84|> It’s all done on paper.<|27.68|><|27.68|> So when you file that appeal, which is paperwork with the Appeals Council, and usually as a lawyer we would brief that to them as well, the question is how long is it going to take for them to rule? There is no set time for them to rule. I’ve had appeals get lost and take two years. I have had appeals come back in 30 days for some ungodly known reason. But I will tell you the vast majority of appeals, like 90 plus percent, pop out in under 12 months.
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And I would say about 50 percent we get results in under six months. So it’s just a window of time and it’s a bit of a moving target. And we can always go online and check the status of the appeal and see what’s what when people call. So when you want to know how long it takes or where your case is sitting in that appellate queue, you, call your lawyer. With online access we can look it up while you’re on the phone. To your success.
After a judge turns you down, people ask what do I do, and normally we appeal, right?<|10.00|><|10.00|> And you have a 60 day window to appeal, and people go, where does this appeal go?<|13.64|><|13.64|> Do I get another hearing?<|14.76|><|14.76|> The short answer is it goes to this group of appellate judges that are known as the<|18.92|><|18.92|> appeals council.<|20.36|><|20.36|> They sit in Falls Church, Virginia, and they rule on appeals and no, you don’t get to appear<|24.24|><|24.24|> in front of them.<|25.24|><|25.24|> That would be extremely rare.<|26.84|><|26.84|> It’s all done on paper.<|27.68|><|27.68|> So when you file that appeal, which is paperwork with the Appeals Council, and usually as a lawyer we would brief that to them as well, the question is how long is it going to take for them to rule? There is no set time for them to rule. I’ve had appeals get lost and take two years. I have had appeals come back in 30 days for some ungodly known reason. But I will tell you the vast majority of appeals, like 90 plus percent, pop out in under 12 months.
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And I would say about 50 percent we get results in under six months. So it’s just a window of time and it’s a bit of a moving target. And we can always go online and check the status of the appeal and see what’s what when people call. So when you want to know how long it takes or where your case is sitting in that appellate queue, you, call your lawyer. With online access we can look it up while you’re on the phone. To your succe
So we discuss appealing your case and say you’ve been to a judge and that judge has
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turned you down. We talk about appealing, right? And that appeal goes to this group known as the appeals council. People then ask, hey, you know, since I saw the judge, I had this hospital event, I had some medical treatment, I got a new MRI, I had surgery, can we get that evidence and throw it into the appeals council and will it help? When it comes to evidence submitted after a judge’s decision, there are some special rules on point. The best way to understand it in a very simple fashion is we can submit the evidence. Whether they look at it and whether they make use of it is up to them. It’s pretty much discretionary as to what they do with it. So yes, you can submit it. We can argue that it’s material, it’s new, it changes the outcome and try to get their attention. But if they won’t look at it, they’re under pretty solid law that they don’t have to. But we usually put it in there anyway if it’s good proof. Talk to your lawyer, see what they think, and generally speaking, we will try. But again, your case, have the heart-to-heart with your lawyer and see what the best path is. But there are rules on evidence after a judge’s decision is issued. But there are rules on evidence after a judge’s decision is issued
People ask me, have I gone as far as I can go inside the Social Security Administration and what’s next? The highest appellate body inside the SSA that we use is called the Appeals Council. If they turn you down, meaning they will not disturb the decision of the judge and that decision was unfavorable, that’s it, that’s the end of the line with Social Security. You do have a right within 60 days of an appeals council decision to file a federal civil action. That is a lawsuit in federal court, the named defendant is the Social Security Administration, and you would be the named plaintiff. Now, do we file those all the time? No, we don’t. We’re very, very selective about what we take into federal court. Because, unlike what you see on TV, unlike law and order and LA law and all that other stuff that’s been out there forever. Okay, in these cases there is no new trial, there is no jury, there is no new evidence. We go in on a transcript of evidence which is a cold hard stack of paper.
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We argue the agency was wrong because, and whatever our theory is in your case, the U.S. attorney answers on behalf of Social Security and says, no, the agency was right the whole time, this person is not and was never disabled and you should pay us fines or fees or something for having to mess with this and judge rule in our favor. We write a brief, they write a brief and the judge decides and that’s pretty much how it goes. So we’re very selective what we take into federal court because the standard that the federal court has to use when they look at your lawsuit, the standard is substantial evidence. Easy way to understand that, if any reasonable mind could have looked at this this transcript of evidence, this proof in your case, and reached the same decision Social Security did, you lose.
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So the agency gets a lot of deference. So you do have a right to file that federal lawsuit within 60 days of the appeals counsel denial, but we’re very selective as most lawyers about what we take into federal court. But yes, we still do. We still sue as much as we want, and we still knock on that door and try to knock it down as much as we can. For your case, call your lawyer. Have a heart to heart. If your lawyer won’t do it, try to get one of the lawyers to at least look at it and see if it’s viable for federal court. Hope that helped.
When it comes to winning or losing a disability case at any level inside Social Security, there’s a certain body of rules. We refer to it as the grid. It’s these guidelines that exist in an appendix to the Code of Federal Regulations. And the grid is literally a chart. If your education is this and your age is this and you’re limited to say sedentary work or light exertional work, you look up on the grid and it says disabled or not disabled. By and large, most of the things on the grid say not disabled, right, because this is Social Security, right. So the grid rules are a framework that is used by the lawyers and the agency to try to fit you into some part that works for you based on your physical limitations, your education, your past work, your transferable skills. And by and large, what happens is as you get older, it gets a little easier to win. You get a break at age 50, you get a bigger break at age 55, and at age 60 there’s also some breaks. So if we can fit you into the grid to win your case, we will. If the grid would direct a decision of not disabled, we obviously try to keep you off that grid, right? And we’re pretty successful at that. That’s what the grid is in a simplest explanation I can give you. As it pertains to your particular case, ask your lawyer. If you’re asking us, pick up the phone call. We will answer and tell you. We will answer and tell you.
A lot of times we spend more time with the case not winning it but with the problems<|7.00|><|7.00|> with the payment stream after the case. Social Security sometimes cuts off money to good<|11.84|><|11.84|> people who’ve won the case for a variety of reasons. Some people call and say, they cut<|15.80|><|15.80|> me off, why? Well, the first thing I say is, did you get a letter about that? Can you read<|21.32|><|21.32|> it to me? Because I sure didn’t get the letter because they don’t send me all the stuff they<|24.28|><|24.28|> send you. People normally, please don’t tear your letters up because you’re mad and throw them away,<|29.56|><|29.56|> you need to keep them and get them to your lawyer, right? A lot of times it’s got to do with maybe you went back to work and that’s a factor in the case. Maybe they put you under review to see if you’re still medically disabled and they decided that you’re no longer disabled, you’ve improved and you can, you know, go sling concrete or something, maybe that’s the situation. Maybe it was processed wrong and you were never supposed to win and they want all the money back. That has happened in the past. So what you need to do is take a breath, call, look for the letter. If you don’t have a letter, you can call the 800 number or visit the local office and just get an idea of what’s going on. And then you come to me with that idea and we can sit down and talk. I get those calls at least monthly. And normally it’s they went back to work, they processed the benefits in error. Oh yeah, I was under medical review, I lost some forms and they cut me off or I failed to show up for a medical evaluation, they cut me off. So is it fixable is the bigger question. The answer is sometimes. Again, it’s very fact dependent and I talk to people every week with issues like that. I don’t charge them to talk with them, but I do try to get them to a better place. I can’t help them all, but if it’s somebody I can help, I do tell them that. Anyway, call your lawyer and please don’t throw away your mail. don’t throw away your mail.
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Anyway, call your lawyer and please don’t throw away your mail.
If we think about winning or losing a disability case, the agency considers things and they<|7.00|><|7.00|> have a sequential evaluation. You go from point A to B to C to D and if they can turn<|11.82|><|11.82|> you down at any point, they do it and terminate their evaluation. Your education plays a role<|18.82|><|18.82|> in that and people say, well what is the role of education? Well, sometimes if you have a limited education or GED or less, we can fit you into some rules that will help win the case. In general, the more educated you are, the more difficult the case becomes to get an easy win. Now, sometimes you may not be able to tap into your education. You may have something, a brain injury or severe depression, and it doesn’t matter whether you have a PhD in particle physics. You just can’t tap into it, right? So, sometimes there’s ways to nullify an education, but in general, the more educated are, the harder it becomes to win the case, but there are ways around that. But your education does play a role. What role it plays in your particular case is something to ask your lawyer. And if that’s us, pick up the phone and we’ll tell you.
As we develop a disability case with an eye towards winning and as a lawyer we look at these cases and say, okay, where am I going to fit this in for my theory of the case to win this for my client? And we start delving into the work history and people say, why do I need all these details about my past work? It’s driving me nuts. And I say, look, one of the things Social Security will ask early on is, are you able to do your past work? Until they know what it was you did and how you did it, they can’t answer that question. Next thing is, okay, if you can’t do your past work, can you do other work?
00:36
Right? Because if you can, you still lose. So we have to ask, are there any transferable skills out there that might help you do other jobs? We hope there’s not, and as a lawyer, we try to neutralize all those darn skills. So, if Social Security decides your case, it’s essential to have a very accurate and detailed description of your past work so they know the physical demands, they know the kind of intellectual demands, the skill demands, and importantly, if it’s a hybrid job where you had kind of multiple duties of different aspects of different jobs all combined into one, that is also vital.
01:10
So a good, accurate, detailed job description is to your benefit, and you need to spend the time with your lawyer to work that out and get it on paper and get in front of a judge or whoever the adjudicator is. So if you have questions about how to prepare your work history, you call us. We’ll answer.
You know, we screen a lot of calls and one of the questions I get over and over is, hey, I’ve got to survive. Can I work while my disability claim is kicking around? And the first thing I do is I tell people, understand the question you’re asking is, can I work while I’m applying and have not yet won? Which is very different from the question that, hey, I won, it’s not enough to live on, can I work while drawing? So what I’m going to answer is, can I work while the case is kicking around and I have not yet won? The answer is a qualified yes. When you look at the years, the agency will put out the regulations, and you can call anybody and ask them. They say the substantial gainful activity threshold is, and for 2023, it’s $1,470 a month in gross wages.
00:45
You make that or more on a sustained basis, you’re gainfully employed, and pretty much there is no disability. So I tell most of my clients, can I work while I’m applying for disability? The answer is a qualified yes. The closer you get to 1470, the more you’re flirting with disaster and likely to lose your case no matter what. So I tell my clients, stay well under that threshold, work part-time, whatever you need to do to survive. Be sure and tell your doctors about the difficulties with your work activity. But everybody understands the name of the game is survival while this case is kicking around. There’s a lot of other rules that could come into play, especially if you’re self-employed or you’re working for family or spouses, but by and large ask that question to the lawyer of your choice going over the specific details of your case. A lot of the times there’s a way to work part-time while the case is kicking around and we have decent success with that. And again, don’t confuse it with, can I work part-time while I’m drawing?
01:39
That is a completely different topic and a whole different minefield to your success.
A lot of times we get calls from clients that say, hey I got a letter from Social Security they claim they overpaid me and they want money back. And I frequently say, okay you won the case, right? You were drawing.
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Yes, I did.
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Did you go to work? Yes, I did. So, and they say, can’t I not work after I won the case and I’m drawing benefits because I can’t survive off what they’re giving me. I totally get that mindset that I need more to survive. And the question is, can I work after I’ve won the case? The answer is a qualified yes, you can. There’s something called trial work, which is a nine-month window in any 60-month period of time, which you can make what you want and it’s pretty much sheltered. There’s an extended period of eligibility after that nine months, where
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if you
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stop work because of what disabled you the first time, they’ll expedite the reinstatement of money. And there’s these SGA, substantial gainful activity rules about the detached that can talk about whether your work after you won is really gainful or not or whether it’s sheltered or accommodated. So the answer here is that is a loaded question and it’s very difficult to answer in a vacuum. You should call a lawyer who will take the time to listen to your fact pattern and then tell you what he or she thinks about what’s going on. I get weekly calls on that. A lot of times when they finally catch up with you, you’ve been drawing and they say, oh you need to pay us back. So you’re dealing with multiple issues in that scenario, all stemming from working after you’ve been paid. So the best thing to do is to talk to a lawyer right after the win, get an idea of what the rules are, and if you’re going to go back to work, talk to them again, notify the agency in writing. You’re going to go back to work. I tell my clients, every quarter, send them pay stubs, certified mail, return receipt requested. They can never say they didn’t get it and hold that against you down the road, because they do. So anyway, talk to your lawyer about the specifics. So anyway, talk to your lawyer about the specifics. We’re here for you when you have questions.
When we talk about winning a disability case early on and easy because somebody’s in a<|7.00|><|7.00|> very bad medical state, the agency has a list of conditions that they immediately qualify.<|13.08|><|13.08|> They’re called compassion allowances and it’s a long list of medical conditions that if<|16.84|><|16.84|> you meet the criteria and you can prove it, you win. And as you can imagine, this criteria<|22.60|><|22.60|> And his criteria is pretty dire.<|25.40|><|25.40|> Some of them even depict terminal circumstances.<|28.28|><|28.28|> So the agency bends over backwards to get Compassion Allowances paid very fast. I have people that call me with typically cancer cases and stuff and I just get the biology results, send them in, flag it as a Compassion Allowance. God love that agency. They pick those up quick when we help them and they get those people paid fast. You can Google Compassion Allowances and you can look if your condition is there, but understand you have to meet the very letter of what they’re talking about. It does you no good to get close. You’ve got to get right there on point. When you have questions about whether your case could be held under a compassion allowance, give us a call. We’ll look it up and go over what you need to do. under a compassion allowance, give us a call. We’ll look it up and go over what you need to do
When I talk with my clients about ways we might be able to win their disability case, from time to time I drop into colloquialisms and say, hey, maybe we can pull this case under the listings. And my client says, what are the listings? Well, the listings is short for the listing of impairments, which is an appendix to some federal regulations, which has a whole list. They’ve broken the body systems up into 12 or 14 sections. Think there’s an orthopedic listing, there’s a neurological listing, there’s a vision listing, a hearing listing, and then there’s stuff for your organs, cardiovascular listings. They’re just conditions that if you meet, you win.
00:36
For example, for a heart listing, they look at an ejection fraction of 30% or less and some other criteria. 30% is pretty bad. It’s a measure of your heart’s efficiency pumping out the blood, and at 30% you’re pretty impaired. So you can imagine why they pick 30, right? So it’s tough to meet these listings, but if you find the listings pertinent to you and your condition and you go through and you meet every one of those, we can make a pretty good argument. We’ve got a listings case and then the judge, it’s easy for the judge to pay you.
01:04
Getting close to meeting a listing is not an event. It just doesn’t do you any good. It’s like getting close to something else, but you don’t get to the top of Mount Everest, right? So you’ve got to hit it. A lot of times we would get treating physicians to look at those listings and say, yeah, my client has got this. Or if you don’t have all the criteria, they will say something like, well, they’re missing a couple pieces here, but my God, they’re just as impaired and laid up as somebody described by this thing.
01:27
We would call that equaling a listing and try to get a judge to pay you based on that. So listings can help. They can help you win and win quick. By and large, not a lot of people qualify by meeting the listings and you can see why because they’re depicting some pretty serious dire conditions. But we will analyze your case under that if appropriate. If we can pull another listings and get you a win, we absolutely will. If you have questions as to whether the listings can help you win your case, reach out to your lawyer. And if it’s us, we’ll pick up the phone.
People always ask me, what do I got to do to win?<|5.00|><|5.00|> What medical problem do I need to have so they finally pay me?<|8.00|><|8.00|> And the short answer is there’s not one medical problem above all others that gets paid.<|12.00|><|12.00|> But what I can tell you, there are some common themes that have emerged after 30 plus years of doing this stuff.<|18.00|><|18.00|> I see a lot of people with bad backs, right, and back.<|21.00|><|21.00|> When it talks about your lumbar spine, it interferes with sitting, standing, walking, bending, stooping.<|27.00|><|27.00|> You get a lot of mileage on the back condition.<|30.00|><|30.00|> When it comes to something called affective disorders, think depression, bipolar, anxiety, and stuff like that, you can get a lot of restrictions for people who have to deal with those.
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Can you imagine trying to deal with the general public if you have bad anxiety? You just implode, right? So there’s conditions that you can get a lot of restrictions from, and they’re very common among the population and we see it a lot of these. And a lot of times what we do is we literally stack one condition on another, get these restrictions that kind of weave together and create a profile of a worker who’s just not ready for prime time. So remember, not one condition, sometimes it’s many. We see a lot of spine injuries, a lot of orthopedic injuries, and a lot of affective disorders in the general population.
01:13
And those usually help. Anyway, for your case, you call your lawyer and ask that question directly.
I get a lot of calls from people, hey this is what’s going on with me, do you think I have a good case? Hey, you know, I was in special ed in school back in the day, I’m not sure what my IQ is, but it’s low, does it help? When it comes to intelligence quotient or IQ, the laws were amended several years ago. If you’d asked me this question, IQ as it pertains to winning a disability case, I would have told you it’s a huge factor and the laws are actually favorable. Sadly, over time, those laws are gone. Go figure. But the general idea is, when it comes to your raw intelligence and your education, it does play a role, right? It can limit you to unskilled, simple, repetitive jobs that are typically verbal instructions, not much reading, things like that.
00:44
So a lot of times, depending on the rest of your profile, that’s enough to tilt it in your favor and win the case. So it will play a role. What role it actually plays for you depends entirely on the specific facts and medical problems that are unique to you and your case. That’s something you’ve got to have a heart to heart and sit down with a lawyer to go over. But in general, it’s a help, not a hindrance. For your specific questions, call the lawyer of your choice.
As a lawyer, we think about ways to win the case, enhance your credibility, make that<|7.00|><|7.00|> testimony at the hearing even more meaningful. We get this question from people, you know<|11.14|><|11.14|> I’m on these medications and oh my God, they make me drowsy, they upset my stomach, they<|15.76|><|15.76|> just ruin my life. How does that play a role in my case? And the answer to the question,<|22.00|><|22.00|> the medications as it may help your case, it’s exactly what we just talked about. It’s all about the<|27.80|><|27.80|> side effects, right?<|28.96|><|28.96|> How they affect you, whether they make you tired, whether you get nauseated, whether you vomit, or whatever they’re doing to you, maybe you’re sun sensitive. Here’s the tip though, right? If you aren’t complaining to your doctor about the side effects, they probably don’t exist for us. If it’s not charted, I can’t use it. You can tell the judge all about it, but the judge is really not going to give you a lot of credibility here, because the doctor didn’t chart it. So complain to your doctor and make sure they chart this stuff. You know, some doctors say, well we expect that with this drug, why would I chart it? I don’t chart every little thing. I might for God’s sakes just complain to your doctor and get them to chart it. And another thing you might say is sometimes some medications, right, they don’t play well with others. So maybe your doctor can’t give you an effective medication for your pain because you’re on a liver med, right?
01:15
So maybe we play that role. Your pain is intense because you can’t take a medication for it because it doesn’t play nice with your other medications. So there’s a lot of aspects to this, but talk to your lawyer and for God’s sakes, if we’re going to make a case on side effects, make sure they’re charted by your doctor.
A lot of times we spend more time with the case not winning it but with the problems<|7.00|><|7.00|> with the payment stream after the case. Social Security sometimes cuts off money to good<|11.84|><|11.84|> people who’ve won the case for a variety of reasons. Some people call and say, they cut<|15.80|><|15.80|> me off, why? Well, the first thing I say is, did you get a letter about that? Can you read<|21.32|><|21.32|> it to me? Because I sure didn’t get the letter because they don’t send me all the stuff they<|24.28|><|24.28|> send you. People normally, please don’t tear your letters up because you’re mad and throw them away,<|29.56|><|29.56|> you need to keep them and get them to your lawyer, right? A lot of times it’s got to do with maybe you went back to work and that’s a factor in the case. Maybe they put you under review to see if you’re still medically disabled and they decided that you’re no longer disabled, you’ve improved and you can, you know, go sling concrete or something, maybe that’s the situation. Maybe it was processed wrong and you were never supposed to win and they want all the money back. That has happened in the past. So what you need to do is take a breath, call, look for the letter. If you don’t have a letter, you can call the 800 number or visit the local office and just get an idea of what’s going on. And then you come to me with that idea and we can sit down and talk. I get those calls at least monthly. And normally it’s they went back to work, they processed the benefits in error. Oh yeah, I was under medical review, I lost some forms and they cut me off or I failed to show up for a medical evaluation, they cut me off. So is it fixable is the bigger question. The answer is sometimes. Again, it’s very fact dependent and I talk to people every week with issues like that. I don’t charge them to talk with them, but I do try to get them to a better place. I can’t help them all, but if it’s somebody I can help, I do tell them that. Anyway, call your lawyer and please don’t throw away your mail. don’t throw away your mail.
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Anyway, call your lawyer and please don’t throw away your mail.