San Diego Social Security Disability Lawyers Explain Why Applying Isn’t Always Easy

San Diego Social Security disability lawyers regularly help applicants apply to receive benefits if they are unable to perform any easy work they have done in the past. This may seem like a simple process, but San Diego Social Security disability attorneys frequently need to guide clients through the often complicated yet necessary procedures.

Defining the Term “Disabled”

San Diego Social Security disability lawyersSan Diego Social Security disability attorneys are aware that the Social Security Administration defines the term “disabled” in a particular way. “Disabled” applicants are those who can no longer complete any “past relevant work,” and must meet the following criteria:

  1. The applicant must have been employed in the occupation within the last 15 years or 15 years prior to the most recent disability requirement check (whichever was earlier).
  2. He or she must have performed the work for a significant period of time. (Any applicants unsure about whether their work qualifies should consult their San Diego Social Security disability lawyers.)
  3. The applicant must have earned a certain amount of money throughout the working period.

Qualifying for Benefits

San Diego Social Security disability lawyers may test whether an applicant may qualify for disability benefits by following a two-step process:

  • The San Diego Social Security disability lawyers will first conclude which occupation fits the “past relevant work” criteria and is the least strenuous.
  • Then, they may investigate why the applicant can no longer perform the occupation.

Level of Exertion Required to Perform Job Duties

An applicant will not qualify for benefits if his or her San Diego Social Security disability lawyers cannot show that he or she is unable to complete a former job of average difficulty. In addition, the Social Security Administration will ask the San Diego Social Security disability attorneys whether the applicant’s past performance corresponded to the difficulty level of each position.

Medical-Vocational Guidelines

The Social Security Administration will utilize the Medical-Vocational Guidelines to determine a candidate’s degree of disability. San Diego Social Security disability lawyers will need to prove that the applicant cannot perform any commonly available job.

Contact Us

Many candidates find the application process confusing. If you are disabled and would like to apply for benefits, consult with San Diego Social Security disability lawyers at the San Diego Disability Law Group by calling 619-338-9000.

Breast Cancer and Compassionate Allowances – Comments by San Diego Social Security Disability Attorneys

The Social Security Disability Attorneys at the San Diego Disability Law Group recently represented a 47 year old woman with Breast Cancer. When she first contacted our office her claim for disability benefits had already been denied by the  Social Security Administration and the time limit to file a Request For Reconsideration had already passed. To make matters more complicated, most of her treatment had occurred in Mexico and most of her medical records were written in Spanish. Her claim was essentially dead in the water.

In reviewing her disability papers, our attorneys  noted that she had filed part of the documents necessary  for a Request For Reconsideration in a timely  matter but had failed to file an essential form ( SSA-3441 – Disability  Report-Appeal). We immediately prepared and forwarded the form and then contacted the Social Security  Administration on her behalf. We were able to convince  them to accept  her untimely  appeal and her Spanish medical records without the usual requirement that they be translated into English. This was especially important since her masectomy surgery had been performed in Mexico.

We then began the process of documenting her condition for the Social Security Administration. Our client has recently received  some treatment in San Diego. We obtained copies of her records which contained a pathology report showing that her breast cancer had  spread to her lungs. We then contacted  her San Diego oncologist and convinced her to complete a Residual Functional Capacity  Questionnaire detailing our client’s inability to function in a work environment. The Residual Functional Capacity Questionnaire, the pathology report and several letters from our client’s friends and family  detailing her inability to function in a work environment were forwarded to the Social Security Administration. 

The San Diego Social Security Disability Attorneys at the San Diego Disability Law Group were able to get our client her Social Security Disability Benefits within a matter of weeks after she contacted our office.

The Social Security Disability Attorneys at the San Diego Disabilty Law Group  wrote to the Social Security Administration and asked that they consider their client’s claim under a Compassionate Allowance . The Social Security Administration has acknowledged that it “has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.” Compassionate Allowances are a way  of quickly identifying diseases and other  medical conditions that invariably qualify under the  Listing of Impairments based on minimal objective  medical information. Compassionate Allowances allow the Social Security Administration to target the most obviously disabled individuals for allowances based on objective  medical information that they  can obtain quickly. Compassionate Allowances is not a separate program from the  Social Security Disability Insurance or Supplemental Security Income programs.

According to the Social Security Administration, Compassionate Allowance conditions “are selected using information received at public outreach hearings, comments received from the  Disability  Determination Services, counsel of medical and scientific experts, and research with the National Institute of Health (NIH). ” They also consider which  conditions are most likely to meet their current definition of disability. There are currently over 200 conditions that can qualify for Compassionate Allowances.

Individuals with Compassionate Allowances conditions may  receive a decision on their  claim in a matter of weeks instead of months or years. The time varies depending on how quickly Social Security can obtain copies  of the medical records, whether  a medical exam is necessary, and whether the claim is  randomly selected for quality assurance. 

If you, a friend, or family  member would like to discuss any  of the over 200 conditions that qualify for Compassionate Allowances just call any of the San Deigo Social Security Disability Attorneys at the  San Diego Disability Law Group at 619-338-9000.

 

 

San Diego Social Security Disability Attorneys Comment on Obesity and SSDI/SSI Benefits

We recently  had a case involving a young claimant who was five  feet six inches tall and weighed over 350 pounds. She had a BMI over 50. In addition, she had  been diagnosed with scoliosis (a sideways curvature of  the  spine associated with pain but  not  neurological impairment),lumbar spondylosis (stiffening or fixation of the vertebrae) and hypo joint mobility. She had a high school diploma but no work experience. She took daily pain medication but still woke up  several times per night due to the  pain. This caused her  to  be groggy and not  mentally  focused during the  day.

One of the issues in the claim involved what effect her obesity was having on her underlying orthopaedic  conditions. In order to properly  present her claim we had to research to  what extent obesity  is  considered by the Social Security  Administration.  According to the Social Security Administration, obesity is a complex, chronic disease characterized by excessive  accumulation of  body fat caused  by a  combination of factors i.e. genetic, environmental and  behavioral. Obesity is a risk factor that  increases an individual’s chances of developing impairments in  most body  systems.

The National Institutes of Health established medical criteria for  the  diagnosis  of  obesity. These guidelines classify overweight and  obesity in adults  according to Body Mass Index (BMI). BMI is the  ratio of  an individual’s weight in kilograms to the  square of his or heightin meters.  For adults, both men and women, the  guidelines describe  a BMI of 25-29.9 as overweight and a  BMI of 30.0 or above as  obesity. The guidelines  further recognize three levels of obesity. Level I includes BMIs of 30.0 – 34.9. Level II includes BMIs of 35.0 – 39.9. Level III, termed extreme obesity includes BMIs greater than 40.

Prior to October 25, 1999, there was an actual SSA listing  for obesity (9.09). The  listing was  deleted because the Social Security  Administration believed that the criteria in the  listing were not  appropriate indicators  of  listing-level severity in that they did  not represent  a degree of  functional limitation that would  prevent  an individual from engaging  in  any  gainful activity.

Although the listing was  deleted, the Social Security  Administration still recognizes obesity as a medically determinable impairment. On September 12, 2002 they  issued a Policy Interpretation Ruling (SSR 02-1p) regarding the  evaluation of  obesity.

In the  ruling SSA reminds adjucators that “obesity  is  a medically  determinable  impairment and that adjucators should consider its effects when evaluating disability”. The  ruling also reminds adjudicators that the combined effectss of obesity  with other impairments can be greater than the  effects of  each of  the  impairments considered  separately. They  also instructed adjudicators to  consider the  effects of obesity when assessing  an individual’s residual functional capacity.

The ruling provides that the Social Security Administration will find that “obesity  is a severe impairment when, alone or in combination with another medically determinable physical or mental impairment(s), it significantly limits an individual’s physical or mental ability to do  basic  work activities.” They  will also consider the  effects of any symptoms  (i.e. pain or fatigue)that could limit  functioning.

In our case we believe that we were able to show that the claimant’s obesity combined with her underlying orthopaedic conditions significantly limited her physical and mental ability to do  basic  work activities.

The San Diego Social Security Disability Attorneys with  the  San Diego Disability  Law Group will help you present the strongest claim possible for Social Security Disability  based  on obesity  and other limiting conditions.

If you or a friend or family member has a Social Security Disability claim or question, contact the Social Security Disability Attorneys at the  San Diego  Disability Law  Group for a free consultation at 619-338-900.

 

 

Social Security Disability (SSDI & SSI) and Reflex Sympathetic Dystrophy (RSD)

SAN DIEGO DISABILITY ATTORNEY COMMENTS ON SOCIAL SECURITY DISABILITY AND REFLEX SYMPATHETIC DYSTROPHY

We presently  have  a client who has  been diagnosed with REFLEX SYMPATHETIC DYSTROPHY (RSD) also known as COMPLEX REGIONAL PAIN SYNDROM (CRPS).  RSD is a unique clinical syndrome that may  develop following trauma, severe or minor. Claimants with RSD typically report burning, aching, or searing pain that  starts out at  the  site  of the  trauma and can then spread to other limbs or parts of the body. In our  case, our claimant is a 30 year old women who fractured her finger playing football. She had surgery on the  finger but it  ever healed properly. She can’t bend  it  or  make  a fist. After the  surgery  her hand  started to swell and tingle. She also had a burning , searing pain first in the injured hand and then in her other, non-injured hand. Thereafter she developed symptoms all over  her  body  including both her  lower extremities. The pain and spasms are so bad that both her feet contract inward during an episode making it extremely difficult for her to walk. She certainly  can no longer do her  job  as a certified nurses assistant.

The Disability Lawyers  with  the  San Diego Disability Law Group analyze  each case according to the sequential evaluation process applied to all initial Social Security insurance claims and all adult SSI claims i.e. 1) Is the  claimant presently engaged in substantial gainful activity; 2) Does the  claimant have  a severe impairment; 3) Does the impairment meet or  equal a listed impairment; 4) Does the impairment prevent the  claimant from performing past relevant work and 5) Does the impairment prevent the  performance of other work considering the claimant’s age, education and prior work experience.

The Social Security  Administration publishes a Listing of Impairments with medical evidence requirements which, if met, are conclusive of social security disability. Sometimes however, a severe condition like REFLEX SYMPATHETIC DYSTROPHY is not  listed in the Listing of Impairments but is addressed in a Social Security Policy Interpretation Ruling.  In preparing this case,  the Disability Lawyers at the San Diego Disability  Law  Group referenced SSR 03-02P ” EVALUATING REFLEX SYMPATHETIC DYSTROPHY SYNDROME/COMPLEX REGIONAL PAIN SYNDROME”.

SSR 03-02P acknowledges that RSD/CRPS is a chronic  pain syndrome most often resulting from trauma to a single extremity and that patients typically report persistent, burning, aching or searing pain that is initially localized to the site  of the  injury. The degree of pain is often out of proportion to the severity of the precipitating injury and cases  have  been reported to progress and spread  to other limbs, or to remote parts of the body (Like  in our  case).

The Social Security Act defines “disability” as the inability to engage in any  substantial gainful activity by  reason of any  medically determinable physical or mental impairment which can be  expected to result in death or which has  lasted or can be  expected to last for a continuous period of not less that  12 months. The act also requires that the impairment result form anatomical, physiological, or psychological abnormalities that can be  shown by  medically  acceptable clinical and laboratory diagnostic  techniques.

     SSR 03-02P states that, for purposes  of Social Security disability evaluation, RSD/CRPS can be established in the presence of persistent complaints of pain that  are  typically out  of proportion to the  severity of any documented precipitant and one or more of the following clinically documented signs in the  affected region at any time following the documented precipitant: 1) Swelling; 2) Autonomic  instability i.e. changes in skin color or texture,changes in sweating(decreased or excessive sweating); 3) changes is skin temperature; 4)Abnormal hair or nail growth;  5) Osteoporosis; or 6) involuntary  movements of the  affected region of the  initial injury.

The Disability Attorneys with  the  San Diego Disability  Law Group know that it  is important in RSD/CRPS cases to present longitudinal treatment records which document the above referenced  criteria in order to make the strongest case possible for RSD/CRPS claimants.

As a claimant with  RSD/CRPS it is extremely  important for you to continually tell you  treating doctors about your symptoms and the  effect that your symptoms have on your  activities of daily living and your ability to function. Develop a longitudinal medical record that clearly documents your RSD/CRPS symptoms. Documenting your symptoms will enable your Disability Lawyer to present the  best claim possible.

If you or any  friend or family  member  has a Social Security Disability claim or question, contact the Disability Attorneys  at  the  San Diego Disability Law Group for a free consultation at 619-238-9000.

 

 

                   

 

    

 

 

 

San Diego Disability Attorney Comments on Residual Functional Capacity Case

Under the Social Security Act, a claimant is considered “disabled” if (1) she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less that twelve months and (2) the impairment is of such severity that she is not only unable to do her previous work but cannot, considering her age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.

     On October 26, 2012, the 9th Circuit Court of Appeals issued its ruling in the case of  Hill v. Astrue, 2012 DJDAR 14911. In this case, the ALJ  found that Ms. Hill had not engaged in substantial gainful activity and that she had severe medical impairments but, when considering her residual functional capacity, he ignored the evaluation of Hill’s treating psychologist who found that Hill’s combination of “mental and medical problems makes the likelihood of sustained full time competitive employment unlikely”.  

     The 9th Circuit Court of Appeal found this to be an error. It ruled that, in order to reject a treating physician’s opinion, the ALJ has to give clear and convincing reasons because the opinion of a treating doctor can be rejected only for specific and legitimate reasons that are supported by substantial evidence. The court found that the ALJ failed to give any reasons for rejecting the treating doctor’s opinion let alone clear and convincing reasons. The case was reversed and remanded for further hearing.

     This case points out how important it is for claimant’s to establish and maintain a relationship with their treating doctor’s since the ALJ must consider and give greater weight to the treating doctor’s opinion. The disability attorneys with the San Diego Disability Law Group find that treating physician’s are more likely to complete a Residual Functional Capacity Questionnaire when they have seen the patient regularly. Additionally, the information needed to complete the questionnaire will generally be in their medical records. In the questionnaire the physician  states what the patient can still functionally do; i.e. how long can she stand, sit or walk; can she kneel, stoop, bend or climb stairs; how many pounds can she carry or lift; does she need to take frequent breaks. It’s a important piece of evidence and might make the difference between receiving your benefits and having your claim denied.

     If you or a family member need a San Diego Disability Attorney or have a question regarding Social Security Disability please contact the San Diego Disability Law Group at 619-338-9000 or contact us through our website at www.sandiegodisabilitylawgroup.com

SSA and FIBROMYALGIA by San Diego Disability Law Group

A recent issue of the NOSSCR (National Organization of Social Security Claimants’ Representatives) Social Security Forum had a interesting article on why claimants with Fibromyalgia and Chronic Fatigue Syndrome(CFS) often times have a difficult time obtaining social security benefits due to the lack of objective medical findings inherent in these  conditions and how a new Social Security Ruling could help overcome this obstacle.

On July 25, 2012 Social Security Ruling (SSR) 12-2p was issued. SSR-12p states that fibromyalgia may  be a “medically determinable impairment” when it is established by appropriate medical evidence and can be the  basis for a finding of disability. Once fibromyalgia is established as a “medically determinable impairment” it will be considered in the  sequential evaluation process to determine whether the person is  disabled. It is still the  claimant’s burden to provide “sufficient objective evidence to support a finding  that  the  person’s impairment so limits the person’s functional abilities that it  precludes him  or her  from performing any substantial gainful activity”.

Now in cases involving fibromyalgia and chronic  fatigue syndrome, once fibromyalgia and chronic  fatigue syndrome have been established, SSA will consider all of the  evidence in the  case record to evaluate the intensity and persistence  of the claimant’s  pain or other symptoms to determine the extent to which the symptom’s limit the person’s capacity for work.

In addition to the physicians diagnoses based on objective criteria, Attorneys  with  the San Diego  Disability Law Group  make sure that their clients provide  the administrative  law judge with as much longitudinal evidence of symptoms and treatment as possible, as well as reports from family and friends of how the claimant’s impairments affect his/her activities of daily living or ability to work.

If you or a family member has  a question regarding Social Security Disability please contact the San Diego Disability Law Group at (619) 338-9000.

For more information regarding Fibromyalgia visit: www.niams.nih.gov/Health_Info/Fibromyalgia; www.mayoclinic.com/health/fibromylagia; or www.rheumatology.org.

 

Excuses for Tardy Appeals

All is not necessarily lost if you don’t get your Social Security Disability appeal filed on time. The Social Security Administration (SSA) regulations recognize several excuses as “good cause” for missing the appeal deadline. An experienced San Diego Social Security attorney can help you establish good cause, or, even better, help you meet the time requirement in the first place.


Procedure for Raising Excuse

The first thing you need to do with a tardy appeal is get it filed. If it has clearly missed the deadline, you’ll need to include a detailed letter telling the SSA exactly why you are filing late.
If the SSA finds that your explanation amounts to “good cause,” it extends the deadline, magically making your late appeal a timely appeal.

Who Determines “Good Cause”

The SSA’s lengthy Program Operations Manual System gives the authority to decide if there is “good cause” to the “individual from the component that has the authority to adjudicate the appeal being filed.” In practical terms, this means that the official who determines good cause depends on which filing is late:

• If the Request for Hearing is late an administrative law judge (ALJ) determines good cause
• If the Request for Review of Hearing Decision is late, the Appeals Council determines good cause
• If the deadline to file in federal court was missed, the Appeals Council again determines good cause

What Excuses Amount to “Good Cause”

There are SSA regulations describing, at general level, what amount to “good cause”:

• The specific circumstances which led to the untimely filing
• Whether the claimant was misled by any action of the SSA
• Whether the claimant understood the time requirement

A more specific regulation provides that SSA will consider whether the claimant had any physical, mental, educational, or linguistic limitations—including any lack of facility with the English language–which prevented a timely filing, or which prevented the claimant from understanding or knowing about the need to file a timely request for review.

SSA has issued a Ruling on the lack of mental capacity, which states that tardiness will be excused when claimants lack the capacity to understand the procedures for requesting review, and had no one legally responsible for prosecuting the claim, such as “a parent of a claimant who is a minor, legal guardian, attorney, or other legal representative.” In applying this standard of mental incapacity, it doesn’t matter how much time has passed since the decision the claimant wants to appeal.

Reasonable doubt about the claimant’s capacity is resolved in favor of the claimant.

Get Help

Establishing good cause is something best left to an experienced disability attorney in San Diego. Get the help you need to protect your right to benefits; call George Heppner  and Aline Gaba at (619) 338-9000.

Social Security Hearings

The San Diego Disability Law Group Explains the Nature of Your SSD Hearing

If you have to appeal your denial for Social Security disability benefits in a hearing before an administrative law judge, you may be anxious about your hearing and curious as to what you should expect.

All that each judge is required to do according to Social Security regulations is look fully into the issues at hand, question you and any witnesses you bring, and accept into evidence any materials you bring that help prove your case. The Social Security Administration also has a manual called HALLEX that outlines some of broad procedures. However, there is not a strict procedure for administrative law judge hearings. Outside the broad HALLEX guidelines, most of the details are left to each individual judge’s discretion.

Beyond that, however, hearing procedures can vary wildly. Some administrative law judges prefer to ask witnesses many specific questions, while some will ask only a few open ended questions and expect your Social Security disability representative to direct witness testimony with follow up questions. The length and scope of the administrative law judge’s opening statement can also vary wildly. Administrative law judges may ask witnesses to remain in the waiting room until it is their turn to testify, or they may allow all the witnesses into the room.

You should not let this worry you, however. With a knowledgeable Social Security disability representative in San Diego by your side, you will enter that hearing prepared, regardless of how it is structured.

If you have been denied benefits, call the experienced Social Security disability representatives, Aline Gaba and George Heppner, at the San Diego Disability Law Group, for a free consultation.

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