5 Pitfalls Of Handling Your Own Social Security Disability Case

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Abraham Lincoln once said “He Who Represents Himself Has A Fool For A Client.”

Once in a while I encounter a person who says “Why do I need to hire someone? Why can’t I just handle it by myself?” I completely respect that you have the right to handle your own claim on your own, but there are several risks you should be aware of. Below is a list of the most common pitfalls in the Social Security Disability claims process that often cause people to be denied.

PITFALL 1 – Approximately 70% Of All Disability Applications Are Denied

Every year the Social Security Administration publishes a statistical report that discloses how many people in the United States apply for Social Security Disability benefits. In recent years the denial rate has been approximately 70%. That number used to be lower, but the government has been under pressure to deny more claims in recent years. People with spinal cord injuries or blindness often get approved at the initial level, but people with less obvious disabilities, such as back injuries or mental illness, usually get denied. Here’s an important point to remember: If you make a statement to the government that you didn’t realize you shouldn’t have said, it can be used against you later. You can’t take it back. An experienced disability advocate can file your application in a way that reduces the chance of denial and positions your case for victory if an appeal is necessary.

PITFALL 2 – If You Get Denied, The Appeals Process Usually Takes 12-18 Months

If you are one of the 70% to get that “Notice Of Disapproved Claim” in the mail, which usually explains that “your condition is not severe enough under our rules,” you only have 60 days to file the first of many appeals. The entire appeals process usually takes 12-18 months to resolve. Many people have no income during this time. If you are receiving State Disability Insurance (SDI), your payments will be exhausted after 12 months, which will leave you with no income. Many people become homeless or go bankrupt during this time due to the extreme financial hardship. An experienced disability advocate can help you either avoid this in the first place or at least navigate the appeals process in a successful way.

PITFALL 3 – The Disability Medical Examiners Are Way Over-worked And Often Skip Important Information

Exactly who are the people that will be making the decision on your claim? At the initial and Reconsideration level your medical records are evaluated by two main people. First is a Disability Analyst, who is not a doctor or nurse. These people are often young with a bachelor’s degree and a couple weeks of training. The second person is a Medical Examiner that is usually someone with an M.D. or a Ph.D. in psychology. These people are usually independent contractors that are paid a flat fee to read your medical records and then write a report explaining their decision. Because it can take a long time to actually read all of your medical records, it’s easier to simply skim through then write a recommendation of “Not Disabled” for insufficient evidence. That way they can get through more cases and bill for more flat fees per day. These people have no accountability either, because Social Security does not allow depositions or the subpoena of these people to be questioned face-to-face about why they said what they said in the report. A disability advocate can reduce the chance of denial here as well by communicating with the Disability Analyst and Medical Examiner to make sure they have seen all your medical records.

PITFALL 4 – The Administrative Law Judges Are Not Your Friend

Once you finally get a hearing before an Administrative Law Judge (ALJ), you may be surprised to learn that a Social Security judge can still deny your case even if your doctor says your disabled. Some judges are rude and believe you’re exaggerating your disability. The ALJ’s often ask very tough questions that are detailed and personal. The ALJ usually does actually read your medical records, however. If you have solid medical records with lots of testing and evidence to prove your case then that will help. But even then, many judges will still deny the case because they believe there is some job you can still do. Without knowing what to expect or how to testify in a way that is convincing, you are at a major disadvantage.

An experienced disability advocate will get access to Social Security’s file, obtain special assessments from your own doctor, write a Memorandum of Law outlining to the judge which medical records in your file support Social Security’s rules for disability, and prepare your testimony for the judge. Here’s another important point to remember: No amount of internet research or books or youtube videos will teach you how to get good at winning an Administrative Law hearing. Only real life experience truly develops winning skills at this point. At Samaritan Disability we have over 10 years of experience winning Social Security Disability hearings.

PITFALL 5 – There May Be Expert Witnesses Called To Testify Against You

This is the trickiest part and perhaps the point where it makes most sense to hire a professional to represent you. Most Social Security Disability hearings before the ALJ will involve a Vocational Expert or a Medical Expert who are called by the ALJ to testify against you. Vocational Experts are very knowledgeable about the economy and certain occupational requirements. They usually testify that you can do some job in the national economy. A Medical Expert may testify that you either do or do not satisfy Social Security’s rules. After their testimony, it’s your turn to question them. Without any experience handling such matters you can end up making your situation even worse! A second consideration is this: if you are able to put on a thoughtful and intelligent cross examination of the expert, the judge may conclude you are capable of working if you can do that. An experienced disability advocate will have his own cross-examination strategy to get these experts to admit you are disabled.

CONCLUSION

As you can see, the Social Security Disability claims process is complicated and often overwhelming. If you are truly disabled, yet too young to retire, then you can’t afford to take foolish risks with this. The fee for hiring a disability advocate is regulated by the Social Security Administration to be 25% of any past due benefits that the advocate can win for you. There is no charge if you don’t win, so you really have nothing to lose and everything to gain. Most of my clients explain the biggest benefit of hiring a disability advocate is the peace of mind they gain by knowing their case is being handled by someone that knows what their doing.

Call our office today at 916-246-2946 and ask for a complimentary 20 minute consultation if you are dealing with a Social Security Disability Claim. We will carefully listen to your situation, answer your questions, then tell you if we think we can help you.

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Inability to Work at even a Sedentary Level

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SSI Financial Requirements

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Supplemental Security Income (SSI) is a federal need-based program designed to provide a basic sustenance to people who are both disabled and poor. I have seen a wide spectrum of people benefit from this program, such as people born with Down’s syndrome, people with severe mental illnesses, and even stay-at-home-moms that become disabled while married but go through a divorce before retirement age. SSI is there to protect anyone who did not have a fair opportunity to work and accumulate their own assets and retirement. The SSI program is arguably the only reason why America does not look like a third world country.

 

This article is by no means exhaustive, but I believe it does provide a basic overview of the SSI financial rules. Specific numbers may vary slightly from state to state. Also, the rules can vary depending on whether you are single or married, and whether you have minor children living with you.

 

Not Enough Work Credits

If you have not worked and paid into the system for at least 5 out of the past 10 years, then SSI will be your only option for income if you become disabled. In addition to proving you’re disabled, SSI also has severe income and asset restrictions that must be met. If your income or assets are too high, you will not be eligible for SSI even if you are disabled.

 

Maximum Income Limits

For a single person, the federal maximum payment for SSI is $733 per month. The State of California adds some money to this to bring it up to $889 per month for those living in California. The federal maximum for a married couple is $1,100, with the California supplement bringing it up to $1,496 per month.

The general rule is this: You are only eligible for SSI if your pre-SSI income is below $889 for a single person or $1,496 for a married person, after subtracting all exceptions and deductions. Additionally, your assets must also be below the limit.

 

What Social Security Considers “Income”

Social Security looks at three types of income: (1) your earned income, (2) your unearned income, and (3) our spouse’s earned income.

If you are working and earning money, even if only a small amount, Social Security will reduce your SSI check by half of that amount plus, $65.

Additionally, if you receive any unearned income, such as VA benefits, a private pension, Workers’ Compensation payments, Child Support, or Alimony, then Social Security will deduct the full amount from the SSI check, minus $20.

Lastly, If you have a spouse or significant other that you live with that works, then half of their earned income will be deducted from your SSI check as “deemed” income, plus $65. Social Security considers someone to be your spouse if you are married and living together, or if you are not married but living together and holding yourselves out as married. Even though you did not earn that money, Social Security assumes that a portion of it will be spent on your support.

 

“In Kind” Support Also Considered “Income”

In addition to looking at any earned or unearned income, Social Security will also evaluate your financial situation and “deem” to you as income any “In-Kind Support.” “In-Kind Support” is any resource that someone gives you, such as food, shelter, or clothing. Social Security will assign a market value of such things as though it were income. However, food stamps, medical care, low-income energy supplements, and reimbursements from a social services agency are excluded.

 

The One-Third Rule

Generally, if you are receiving free room and board then Social Security will reduce the SSI check by one-third, even if the market value is worth more than that. This is very typical of single disabled people that are living with a relative or friend who is helping them out temporarily. Again, this article provides rough approximation, but how this is calculated exactly may vary by state.

 

What You Can Exclude From Your Income      

After adding up all your income and “in kind” support, Social Security then allows you to deduct from that number certain things. The government allows you to make the following deductions:

  1. Deduct $361 per minor child living with you from your total pre-SSI income.
  2. Deduct $20 from your unearned income.
  3. Deduct $65 from the combined earned incomes.
  4. Deduct any impairment-related work expenses (such as special chairs or equipment you need because of your disability)
  5. After this, you may deduct one-half of your spouse’s earned income and one-half of your earned income.

If, after your deductions, your monthly income is more than $889 as a single person or $1,496 as a married person (in California), then you are not likely to be eligible for SSI. However, if your income falls below that amount per month, then you are likely to be eligible for SSI.

 

Asset Limits

In addition to the income limits, a single person cannot have more than $2,000 in assets for SSI. The limit is $3,000 for married couples. This includes cash in the bank, real estate, stocks, bonds, cars, jewelry, and so forth. Social Security will exclude the house you live in, one car, and up to $1,500 in money set aside for funeral expenses or life insurance cash value. If you have more assets than this, then the government expects you to liquidate them to support yourself.

 

We Fight For Your SSI

Even though the rules are complicated, we help you understand the rules and make a winning strategy so you get the maximum dollar amount from your SSI claim.

If you or someone you know is unable to work due to a disability, please call our office today for a free consultation.

How We Help Win Your Case

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Post-traumatic Stress Disorder (PTSD) is a mental disorder that causes flashbacks, panic attacks, nightmares, persistent irrational fear, and irritability. It is almost always the byproduct of some traumatic event that occurred in the person’s life.

Over the years I have seen complaints of PTSD increase dramatically. Certainly military conflicts have contributed to this to some degree, but many of my clients with PTSD where never in the military. Their stories vary widely. I’ve had many clients who were abused by alcoholic parents as a child. Some were the victims of crime. I even had one client that was a truck driver who had a homeless man jump out on the freeway at night in front of his truck. These kind of experiences can have a devastating effect on a person’s mind and ability to work a normal job. Continue reading

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