Doctors in private practice often contract with Social Security to perform consultative medical exams on claimants. These exams are called CEs for Consultative Examinations. You may be sent to a "Social Security doctor" if there isn't enough recent medical evidence in your file for a decision.
Again, these doctors don't work for Social Security. They run their own private practices. They agree to do examinations for Social Security for a certain fee per exam, which Social Security pays.
A lot of these doctors are fair and try to do a good job. However, some of them are just jerks, and I'm being blunt on purpose.
Usually, a patient can tell what kind of doctor she is dealing with the moment she sets foot in the examination room. My clients frequently complain that consulting doctors were rude, inconsiderate, condescending, disinterested and rushed during the consultative examination (CE).
Here are things that a doctor has written about some of my clients in the past. I have to say that this particular doctor is worse than average, and obviously is not one of my favorites.
"The patient told me he does not smoke. However, I thought I detected the smell of tobacco on him while performing my exam." [So, there is a new medical smell test now?]
"This patient arrived in a large pickup truck. I watched him as he parked, got out of the truck without any sign of pain and walked into my office without a limp." [Is she doing a medical examination or an FBI investigation on a criminal suspect?]
"He stated that he could not sit more than 15 minutes at a time because of pain in his mid-back. However, I had him sitting in the exam room for over 45 minutes and he didn't stand up once. He didn't complain of back pain and his expression didn't indicate any discomfort whatsoever." [She not only is a good doctor but a mind reader as well. She can tell when a person's back hurts just by glancing at him].
The patient complains of back and leg pain and the inability to sit for prolonged periods without elevating her feet. Prior to calling her to the exam room, I observed her sitting in my waiting room for at least 30 minutes and I observed no sign of discomfort whatsoever." [Sounds like there's no reason for an exam. The doc can determine everything just by peeking through the knothole in her door].
The thing that disturbs me most about this doctor is the obvious lack of fairness and objectivity. The doctor has a very obvious bias or prejudice against Social Security disability and those who seek it. She clearly believes that anyone trying to get disability is a malingerer or fraud. She seems to think any benefits awarded will come out of her own pocket. Not only that, but she treats those who come into her shabby office as if they were criminals under investigation. They are not. They were once hard working citizens who became disabled and have applied for Social Security disability benefits (which they paid for and may be entitled to). And, of course, the obvious failure of the doctor to even try to be objective is concerning. With this particular doctor, I have not seen even one single exam where I felt she made any attempt to be fair or objective. Her obvious goal is to get the claims denied and she dedicates herself to it with a passion. She obviously has her own agenda here, and it shows. I don't expect much out of a consultative examination but I do expect at least the attempt at objectivity. Again, some doctors are fine, even though they rarely help us win cases. All I ask for is fairness and some politeness.
What should you do if you encounter one of these ugly doctors during a consultative examination (CE)?
Things not to do: Don't argue or antagonize the doctor. Be as cooperative as you can and do what is asked of you if possible.
Things to do: If you experienced problems with rudeness, extreme brevity of the examination, or an obvious attitude from the doctor, complete the exam, then just leave quietly. When you get home, write down a few of the observations you made at the examination. Write down the time when the exam began and when it ended. (Can a doctor really do a thorough exam in 9 minutes)? If the doctor made statements that you found offensive, write them down while they are fresh on your mind. You can share this with your attorney-representative.
The main thing to remember is: You must attend the consultative examination if one is scheduled. Failure to show up will probably get your claim denied for non-cooperation. You need to cooperate with the doctor to the best of your ability, even if he/she is non-professional.
Finally, I want my clients to know that Social Security decisions are generally made on evidence from their own doctors or providers, not by consultative doctors. That's why it is so important to have your own regular physician who follows your treatment. Records from your own doctor are much better than anything provided by any one-time consultative exam (CE). See your own doctor regularly and keep him/her aware of your medical and functional problems. Try to remain compliant with recommended treatment.
Helping the disabled in North Alabama and Middle Tennessee: Social Security applications, appeals and hearings. Free Consultations. (256) 799-0297
Thursday, September 27, 2018
YOUR CONSULTATIVE EXAM (CE) AND HOW IT IMPACTS YOUR DISABILITY CLAIM
Individuals who apply for SSDI benefits may be sent to a "Social Security doctor" for a consultative exam (CE).
These examinations are scheduled and paid for by Social Security when there is not enough recent medical evidence in the file on which to base a decision.
The doctors who perform these exams do not work for Social Security. They are in private practice and hire themselves out under contract to perform exams for Social Security. Many different kinds of doctors do this. The only requirement is that they must be a licensed physician.
Here are common complaints you hear every day about these doctors:
Doctors with a strong bias against Social Security disability will look for ways to attack the claimant's credibility. I have actually known of doctors making statements like this:
"I smelled smoke on the patient's breath during the exam, although he says he does not smoke." (In short, "He is a liar").
"I observed the patient getting out of his big pickup and walking across the parking lot to my office. He did not limp or show any evidence of being in pain." (In short, "He's a big fake").
"The patient says he is is not able to sit for more than 15 minutes due to back pain, but I observed him sitting in the waiting room for 25 minutes and he didn't show any signs of being in pain." (In short, "I can tell who hurts and who doesn't)!
Here's the truth about consultative exams: They are not given to determine your state of health or to see whether or not you are disabled. They are scheduled so that Social Security decision makers can close your case and meet the technical requirements to make a decision.
So, must you attend a CE? The answer is yes, or risk being denied for non-cooperation. If you must attend the CE, are there any suggestions that may be of value to you? I offer 10 suggestions below:
1. Arrive a few minutes early. Never push your appointment to the last minute. It irritates the doctor. I've seen doctors refuse to do the exam because the claimant was late.
2. Have someone drive you to the hearing and go into the waiting room or lobby with you. Don't arrive alone.
3. Take all your prescription medicine bottles or a list of all those drugs with you.
4. Try to be cooperative with the doctor. If you can't do everything the doctor wants (heel-to-toe walking, tandem walking or touching your toes), explain why you can't: it causes too much pain in your back, etc.
5. Don't be shy about telling the doctor what your functional problems are. When the doctor asks why you stopped working, be sure you give a disability related answer. Don't say, for example, "I felt like I was old enough to quit," if your real reason for quitting was excessive pain or difficulty standing, walking or sitting.
6. Don't exaggerate your problems but don't play down your health issues, either. Most people really don't want to be on disability and have a hard time admitting that they are disabled. Don't go into a consultative examination with the "Oh, I'm doing pretty well" attitude. The doctor will take it seriously and it will soothe her conscience (if she has one) when she tells Social Security that there's nothing wrong with you and you just need to go back to work.
7. Don't do obviously dumb things. Don't be tempted to hobble into the consultative exam on crutches when you normally don't use crutches. Don't wear a cervical collar if it wasn't prescribed by your doctor and if you don't need a cervical collar. These theatrical props are worse than exaggerations, they are dishonest and are sure to get you denied. Be aware that you may be observed from the moment you drive into the parking lot until you drive away. Most doctors probably don't do this but I know of a few who admit to it. They think they are CIA operatives.
8. Don't volunteer more information than you need to. Some claimants hurt their cases by telling the doctor things that he doesn't need to know: about the grandchildren, pets, hobbies, trips, vacations, gambling (hitting the jackpot),....the list goes on and on. What seems like harmless and friendly chit-chat with the doctor may put a knife in your back with Social Security. Things may get taken out of context or misunderstood. Less is usually better. Focus on the exam! The doctor is not your friend.
9. Don't contradict yourself. Let me give just one example (there are many others). A person tells the doctor he does not smoke or use any tobacco product. Yet, the doctor smells cigarette smoke on the patient's clothes. A non-smoker, and especially a doctor, can spot a smoker fifteen miles away on a clear day, and eight miles away on a rainy day. It is obvious. If you do smoke, just admit it. If you don't smoke, don't wear clothing to the exam that has ever been anywhere near cigarette smoke! If your spouse rides to the exam with you, no smoking in the car! In fact, if your car has been smoked in, rent or borrow a car for the exam. I'm not kidding here. I've had this happen. There is one doctor in Huntsville who has a very anti-disability mentality. She will go out of her way to find things like this and rat you out to Social Security in hopes of getting you denied. The fact that you smoke isn't the real problem. The problem is lack of credibility or being dishonest. The problem is telling the doctor that you don't smoke, then the doctor smelling smoke on you. Avoid that. If you smoke, just say, "Yes, I do smoke." They won't deny you for that.
10. Don't ask the doctor if he thinks you are disabled or if he thinks you have a good disability case. The doctor will not decide whether you are disabled. It's not his job. Asking him that question will probably go into his report and it will look bad to the real decision makers. Basically, let the doctor do his thing and cooperate the best you can, then leave quietly and quickly. Get out of there! No chit-chat. Have the person who brought you to the exam drive you home.
By the way, if you've had a bad experience with a consultative "Social Security doctor," email me. I'd like to know about your experience.
__________
THE FORSYTHE FIRM
Charles W. Forsythe
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Me: forsythefirm@gmail.com
These examinations are scheduled and paid for by Social Security when there is not enough recent medical evidence in the file on which to base a decision.
The doctors who perform these exams do not work for Social Security. They are in private practice and hire themselves out under contract to perform exams for Social Security. Many different kinds of doctors do this. The only requirement is that they must be a licensed physician.
Here are common complaints you hear every day about these doctors:
- "The examination was incredibly short; lasted only a few minutes
- "The doctor was rude."
- "The doctor seemed to think that nobody should be on Social Security disability. He disapproves of the program, and it shows."
Doctors with a strong bias against Social Security disability will look for ways to attack the claimant's credibility. I have actually known of doctors making statements like this:
"I smelled smoke on the patient's breath during the exam, although he says he does not smoke." (In short, "He is a liar").
"I observed the patient getting out of his big pickup and walking across the parking lot to my office. He did not limp or show any evidence of being in pain." (In short, "He's a big fake").
"The patient says he is is not able to sit for more than 15 minutes due to back pain, but I observed him sitting in the waiting room for 25 minutes and he didn't show any signs of being in pain." (In short, "I can tell who hurts and who doesn't)!
Here's the truth about consultative exams: They are not given to determine your state of health or to see whether or not you are disabled. They are scheduled so that Social Security decision makers can close your case and meet the technical requirements to make a decision.
So, must you attend a CE? The answer is yes, or risk being denied for non-cooperation. If you must attend the CE, are there any suggestions that may be of value to you? I offer 10 suggestions below:
1. Arrive a few minutes early. Never push your appointment to the last minute. It irritates the doctor. I've seen doctors refuse to do the exam because the claimant was late.
2. Have someone drive you to the hearing and go into the waiting room or lobby with you. Don't arrive alone.
3. Take all your prescription medicine bottles or a list of all those drugs with you.
4. Try to be cooperative with the doctor. If you can't do everything the doctor wants (heel-to-toe walking, tandem walking or touching your toes), explain why you can't: it causes too much pain in your back, etc.
5. Don't be shy about telling the doctor what your functional problems are. When the doctor asks why you stopped working, be sure you give a disability related answer. Don't say, for example, "I felt like I was old enough to quit," if your real reason for quitting was excessive pain or difficulty standing, walking or sitting.
6. Don't exaggerate your problems but don't play down your health issues, either. Most people really don't want to be on disability and have a hard time admitting that they are disabled. Don't go into a consultative examination with the "Oh, I'm doing pretty well" attitude. The doctor will take it seriously and it will soothe her conscience (if she has one) when she tells Social Security that there's nothing wrong with you and you just need to go back to work.
7. Don't do obviously dumb things. Don't be tempted to hobble into the consultative exam on crutches when you normally don't use crutches. Don't wear a cervical collar if it wasn't prescribed by your doctor and if you don't need a cervical collar. These theatrical props are worse than exaggerations, they are dishonest and are sure to get you denied. Be aware that you may be observed from the moment you drive into the parking lot until you drive away. Most doctors probably don't do this but I know of a few who admit to it. They think they are CIA operatives.
8. Don't volunteer more information than you need to. Some claimants hurt their cases by telling the doctor things that he doesn't need to know: about the grandchildren, pets, hobbies, trips, vacations, gambling (hitting the jackpot),....the list goes on and on. What seems like harmless and friendly chit-chat with the doctor may put a knife in your back with Social Security. Things may get taken out of context or misunderstood. Less is usually better. Focus on the exam! The doctor is not your friend.
9. Don't contradict yourself. Let me give just one example (there are many others). A person tells the doctor he does not smoke or use any tobacco product. Yet, the doctor smells cigarette smoke on the patient's clothes. A non-smoker, and especially a doctor, can spot a smoker fifteen miles away on a clear day, and eight miles away on a rainy day. It is obvious. If you do smoke, just admit it. If you don't smoke, don't wear clothing to the exam that has ever been anywhere near cigarette smoke! If your spouse rides to the exam with you, no smoking in the car! In fact, if your car has been smoked in, rent or borrow a car for the exam. I'm not kidding here. I've had this happen. There is one doctor in Huntsville who has a very anti-disability mentality. She will go out of her way to find things like this and rat you out to Social Security in hopes of getting you denied. The fact that you smoke isn't the real problem. The problem is lack of credibility or being dishonest. The problem is telling the doctor that you don't smoke, then the doctor smelling smoke on you. Avoid that. If you smoke, just say, "Yes, I do smoke." They won't deny you for that.
10. Don't ask the doctor if he thinks you are disabled or if he thinks you have a good disability case. The doctor will not decide whether you are disabled. It's not his job. Asking him that question will probably go into his report and it will look bad to the real decision makers. Basically, let the doctor do his thing and cooperate the best you can, then leave quietly and quickly. Get out of there! No chit-chat. Have the person who brought you to the exam drive you home.
By the way, if you've had a bad experience with a consultative "Social Security doctor," email me. I'd like to know about your experience.
__________
THE FORSYTHE FIRM
Charles W. Forsythe
7027 Old Madison Pike, Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Me: forsythefirm@gmail.com
Tuesday, September 25, 2018
IF DISABIITY APPEALS WERE EASY.....
A disability appeal takes you face-to-face with an administrative law judge for a hearing.
If these hearings were easy......
....60 percent of claimants would not be denied at hearings....
....90 percent of claimants would not get representation...
.... There would be no work for Social Security attorneys....
.... And you would have a pretty fair chance all on your own.
However, only about 4 out of 10 claimants win their benefits at the hearing. About 6 out of 10 are denied if you go by national averages for 2016 and 2017.
Over 90 percent of claimants know better than to appear before a judge unrepresented.
There is plenty of work for Social Security attorneys, and
Your chances are a lot better if you are represented at your hearing!
What is the main advantage of having an attorney or non-attorney advocate help with your hearing?
I think the main advantage is simply that the representative knows the rules and regulations and what it takes to prove your case. He knows what works and what doesn't.
Your representative can only be paid if your case is successful. The small attorney's fee is a good trade off for a large back pay settlement and potentially a lifetime of benefits.
____________
THE FORSYTHE FIRM
Huntsville, AL
PHONE (256) 799-0297
E-Mail Us With Questions: forsythefirm@gmail.com
If these hearings were easy......
....60 percent of claimants would not be denied at hearings....
....90 percent of claimants would not get representation...
.... There would be no work for Social Security attorneys....
.... And you would have a pretty fair chance all on your own.
However, only about 4 out of 10 claimants win their benefits at the hearing. About 6 out of 10 are denied if you go by national averages for 2016 and 2017.
Over 90 percent of claimants know better than to appear before a judge unrepresented.
There is plenty of work for Social Security attorneys, and
Your chances are a lot better if you are represented at your hearing!
What is the main advantage of having an attorney or non-attorney advocate help with your hearing?
I think the main advantage is simply that the representative knows the rules and regulations and what it takes to prove your case. He knows what works and what doesn't.
Your representative can only be paid if your case is successful. The small attorney's fee is a good trade off for a large back pay settlement and potentially a lifetime of benefits.
____________
THE FORSYTHE FIRM
Huntsville, AL
PHONE (256) 799-0297
E-Mail Us With Questions: forsythefirm@gmail.com
Saturday, September 22, 2018
WAYS TO HURRY UP MY SSDI DECISION
It's a well known fact that it usually takes 2 years or more to get Social Security disabiilty benefits. But is there a way to speed up this agonizingly slow process?
There are some things that will help avoid needless delays:
1. Provide Social Security will full and correct names and addresses of your treating doctors, hospitals, clinics, counselors or other providers. Social Security orders medical records by mail and a full mailing address with zip code is essential. You cannot simply say, "Dr. Smith at Lakeshore." This vague information can hold up a case for months while Social Security tries to figure out which Dr. Smith at Lakeshore? Ultimately, they will order records from the wrong doctor, wait months for a reply, then get a note that says, "We have no records of a patient with this name." Take time to provide full, complete information on providers. Don't guess at doctor's addresses or phone numbers.
2. Return all forms to Social Security right away. After you file your application, the Disability Determination Service (DDS) will mail you a large pack of forms to complete and return. This packet will typically include:
Failure to fill out and return any of these questionnaires will result in one of two negative actions: Social Security will delay making a decision for weeks or months because they do not have the forms, or they will deny the claim because of "lack of sufficient evidence to make a decision."
3. Return phone calls to Social Security or the Disability Determination Service right away. Usually, a phone call from these people is nothing to worry about. They may simply need a piece of simple information that was omitted from the application, such as a correct date of birth, last date you worked, etc.
Keep in mind that the "disability specialist" at the Disability Determination Service who is assigned to your case is very busy. He or she may be handling 80 other cases at the same time. Therefore, he/she can only spend so much time on your case. Make it easy for them by providing full information, returning forms and phone calls on time, and doing whatever you can to help move the case along.
There are some things that will help avoid needless delays:
1. Provide Social Security will full and correct names and addresses of your treating doctors, hospitals, clinics, counselors or other providers. Social Security orders medical records by mail and a full mailing address with zip code is essential. You cannot simply say, "Dr. Smith at Lakeshore." This vague information can hold up a case for months while Social Security tries to figure out which Dr. Smith at Lakeshore? Ultimately, they will order records from the wrong doctor, wait months for a reply, then get a note that says, "We have no records of a patient with this name." Take time to provide full, complete information on providers. Don't guess at doctor's addresses or phone numbers.
2. Return all forms to Social Security right away. After you file your application, the Disability Determination Service (DDS) will mail you a large pack of forms to complete and return. This packet will typically include:
- Work History Report and
- Function Report
Failure to fill out and return any of these questionnaires will result in one of two negative actions: Social Security will delay making a decision for weeks or months because they do not have the forms, or they will deny the claim because of "lack of sufficient evidence to make a decision."
3. Return phone calls to Social Security or the Disability Determination Service right away. Usually, a phone call from these people is nothing to worry about. They may simply need a piece of simple information that was omitted from the application, such as a correct date of birth, last date you worked, etc.
Keep in mind that the "disability specialist" at the Disability Determination Service who is assigned to your case is very busy. He or she may be handling 80 other cases at the same time. Therefore, he/she can only spend so much time on your case. Make it easy for them by providing full information, returning forms and phone calls on time, and doing whatever you can to help move the case along.
Friday, September 21, 2018
3 THINGS DISABLED VETERANS NEED TO KNOW ABOUT BENEFITS
In spite of the negative things you may hear about how poorly the government treats veterans, the United States has made provisions to care for qualifying disabled veterans.
I want to give you 3 things that every veteran needs to know about Social Security disability benefits:
1. Veterans are covered by both the Veterans Administration (VA) benefits and Social Security disability benefits (SSDI). During your years of military service, the government withheld Social Security taxes from your pay and placed the money into a special government trust fund. This trust fund is used to pay a benefit if you become disabled. Therefore, SSDI benefits are not welfare. They are something you paid for, just like any other insurance program.
2. Receiving a VA disability and/or retirement check will not disqualify you from getting full SSDI benefits. Social Security will pay benefits in addition to any VA benefits. One benefit does not reduce or interfere with the other benefit.
3. Veterans may qualify for SSDI benefits even without a 100 percent VA disability rating. However, if you have a 100 percent (permanent and total) VA benefit, you may qualify for expedited claim processing at Social Security. This means that a claim that could usually take up to 2 years to be decided may be decided in a matter of weeks or just a few months.
I should also point out that Social Security has it's own set of unique rules about disability. Veterans must make an application for SSDI benefits, submit medical evidence and often have a hearing to be approved. It isn't automatic. It isn't uncommon for the state agencies to deny Social Security applications at the initial level, thus requiring an appeal hearing for the veteran to be approved.
My firm has been helping disabled veterans with the Social Security disability process for years. Our Huntsville office has the capability to help handle applications, appeals and hearings. Our services are always free unless you are approved and recover back pay from Social Security.
_____
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
"Across from Bridge Street"
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Me: forsythefirm@gmail.com
I want to give you 3 things that every veteran needs to know about Social Security disability benefits:
1. Veterans are covered by both the Veterans Administration (VA) benefits and Social Security disability benefits (SSDI). During your years of military service, the government withheld Social Security taxes from your pay and placed the money into a special government trust fund. This trust fund is used to pay a benefit if you become disabled. Therefore, SSDI benefits are not welfare. They are something you paid for, just like any other insurance program.
2. Receiving a VA disability and/or retirement check will not disqualify you from getting full SSDI benefits. Social Security will pay benefits in addition to any VA benefits. One benefit does not reduce or interfere with the other benefit.
3. Veterans may qualify for SSDI benefits even without a 100 percent VA disability rating. However, if you have a 100 percent (permanent and total) VA benefit, you may qualify for expedited claim processing at Social Security. This means that a claim that could usually take up to 2 years to be decided may be decided in a matter of weeks or just a few months.
I should also point out that Social Security has it's own set of unique rules about disability. Veterans must make an application for SSDI benefits, submit medical evidence and often have a hearing to be approved. It isn't automatic. It isn't uncommon for the state agencies to deny Social Security applications at the initial level, thus requiring an appeal hearing for the veteran to be approved.
My firm has been helping disabled veterans with the Social Security disability process for years. Our Huntsville office has the capability to help handle applications, appeals and hearings. Our services are always free unless you are approved and recover back pay from Social Security.
_____
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
"Across from Bridge Street"
Huntsville, AL 35806
PHONE (256) 799-0297
E-Mail Me: forsythefirm@gmail.com
ODDS OF GETTING DISABILITY: 20 PERCENT VS. 50 PERCENT
If you go by the national averages, the odds of getting Social Security disability with a simple application is only about 20 percent.
The odds of getting disability benefits with an appeal hearing is about 50 percent.
The no-brainer conclusion is: Always file an appeal because that's where the benefits get paid!
But, I hear you saying, an appeal is a whole lot of trouble!
Yes, it is. But it can pay you over half a million dollars during the remainder of your lifetime. It can make the difference between living in financial desperation and being fairly independent and secure.
Getting a disability check is not where most people want to be. However, if a severe illness or injury has made you unable to keep working, disability benefits are a lot better than no income. And the Medicare benefits that come with a disability award can help you continue to get top medical care and treatment, even from specialists.
Social Security has become the gateway for most persons with disabilities not only to survive but to actually continue their independence and way of life.
But we must approach disability benefits with a couple of very clear understandings:
1. Over 75 percent of initial applications for benefits will be denied using a very mechanical process of elimination. State agencies called the Disability Determination Service will deny the vast majority of applications. So, don't expect too much with your application.
2. After you file an appeal, you will get a personal hearing before an administrative law judge (ALJ). Your odds are much better here if you can provide objective medical evidence that you are no longer able to work.
In conclusion, if you have been denied Social Security benefits, get a lawyer-advocate and file an appeal. (Appeals must be filed within 60 days of the denial or you lose appeal rights). Virtually everyone, almost without exception, should appeal a denied claim, assuming that you meet the basic technical rules for benefits, such as......
______
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
EMAIL ME: forsythefirm@gmail.com
The odds of getting disability benefits with an appeal hearing is about 50 percent.
The no-brainer conclusion is: Always file an appeal because that's where the benefits get paid!
But, I hear you saying, an appeal is a whole lot of trouble!
Yes, it is. But it can pay you over half a million dollars during the remainder of your lifetime. It can make the difference between living in financial desperation and being fairly independent and secure.
Getting a disability check is not where most people want to be. However, if a severe illness or injury has made you unable to keep working, disability benefits are a lot better than no income. And the Medicare benefits that come with a disability award can help you continue to get top medical care and treatment, even from specialists.
Social Security has become the gateway for most persons with disabilities not only to survive but to actually continue their independence and way of life.
But we must approach disability benefits with a couple of very clear understandings:
1. Over 75 percent of initial applications for benefits will be denied using a very mechanical process of elimination. State agencies called the Disability Determination Service will deny the vast majority of applications. So, don't expect too much with your application.
2. After you file an appeal, you will get a personal hearing before an administrative law judge (ALJ). Your odds are much better here if you can provide objective medical evidence that you are no longer able to work.
In conclusion, if you have been denied Social Security benefits, get a lawyer-advocate and file an appeal. (Appeals must be filed within 60 days of the denial or you lose appeal rights). Virtually everyone, almost without exception, should appeal a denied claim, assuming that you meet the basic technical rules for benefits, such as......
- You have the work credits needed to be covered by the Social Security Act; and
- You are not currently working at substantial gainful activity.
______
Charles W. Forsythe
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
EMAIL ME: forsythefirm@gmail.com
Sunday, September 9, 2018
BACK PAIN AND SOCIAL SECURITY DISABILITY
There are 33 moving parts in the human spine. And the spine is one of the most overworked parts of the body. No wonder, then, that we have so much back pain. As we age, the spine begins to degenerate. We develop a natural disorder that doctors call degenerative disc disease.
Social Security awards more benefits for back or musculoskeletal disorders than for any other impairment.
How Will Social Security Evaluate Back Pain?
1. They will want to know what is causing the pain. You need a diagnosis by a doctor, preferably an orthopedic specialist, which is based on X-rays, MRI or other tests. You can't get disability benefits merely with a subjective complaint of back pain. You need to establish the cause, whether it is degenerative disc disease, spondylosis or neural forminal stenosis. This is the important starting place.
2. You will need medical records to establish the onset, duration and severity of symptoms. In essence, when did the symptoms begin, how long have they lasted and how bad are they?
3. Use medical records to show Social Security what treatments or interventions have been tried to make you better. Have you taken medicines, steroid injections, nerve blocks, physical therapy...,etc.? Social Security generally wants to see that you have tried reasonable medical treatment and that it has failed to make you better.
4. Demonstrate how your back problems limit your ability to perform the functions normally required in a work environment. In other words, how is your ability to lift, stand, walk, sit, reach, crouch, kneel, grasp or handle limited by your impairment(s)? Remember, there are several categories of functional limitations:
The best claims are when your attorney can go in and say: "My client has degenerative disc disease with a herniated disc at the L4-L5 level verified by an imaging study; this causes severe pain in the back radiating to the right lower extremity and Dr. Pillman states that this restricts the ability to stand to not more than 2 hours per 8-hour day, to walk no more than 1 hour per day and to sit no more than 3 hours per day. Also, Dr. Pillman opines that the claimant is restricted to lifting no more than 10 pounds occasionally.
Why is this such a good case? Because it defines the medical problem very specifically, leaving nothing to guesswork. It also translates the medical problem into vocational problems. The claimant can't work because he can't sit,stand, walk or lift enough to get through an 8-hour work day. This meets the federal definition of being disabled.
A very weak case would simply go in and say, "My client has some pretty bad back pain, we don't know why, and he feels he would be unable to work." This is a nearly certain denial.
___________
Charles W. Forsythe
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
E-MAIL US: forsythefirm@gmail.com
Social Security awards more benefits for back or musculoskeletal disorders than for any other impairment.
How Will Social Security Evaluate Back Pain?
1. They will want to know what is causing the pain. You need a diagnosis by a doctor, preferably an orthopedic specialist, which is based on X-rays, MRI or other tests. You can't get disability benefits merely with a subjective complaint of back pain. You need to establish the cause, whether it is degenerative disc disease, spondylosis or neural forminal stenosis. This is the important starting place.
2. You will need medical records to establish the onset, duration and severity of symptoms. In essence, when did the symptoms begin, how long have they lasted and how bad are they?
3. Use medical records to show Social Security what treatments or interventions have been tried to make you better. Have you taken medicines, steroid injections, nerve blocks, physical therapy...,etc.? Social Security generally wants to see that you have tried reasonable medical treatment and that it has failed to make you better.
4. Demonstrate how your back problems limit your ability to perform the functions normally required in a work environment. In other words, how is your ability to lift, stand, walk, sit, reach, crouch, kneel, grasp or handle limited by your impairment(s)? Remember, there are several categories of functional limitations:
- Exertional Limitations: Difficulty sitting, standing, walking, lifting, pushing or pulling.
- Postural Limitations: Difficulty bending, stooping, kneeling, crouching, crawling, climbing, etc.
- Mental Limitations: Difficulty concentrating, focusing, understanding, remembering, interacting with others, etc.
- Environmental Limitations: Difficulty with extreme hot or cold temperatures, odors, humidity, vibrations, dust, fumes or pulmonary irritants.
The best claims are when your attorney can go in and say: "My client has degenerative disc disease with a herniated disc at the L4-L5 level verified by an imaging study; this causes severe pain in the back radiating to the right lower extremity and Dr. Pillman states that this restricts the ability to stand to not more than 2 hours per 8-hour day, to walk no more than 1 hour per day and to sit no more than 3 hours per day. Also, Dr. Pillman opines that the claimant is restricted to lifting no more than 10 pounds occasionally.
Why is this such a good case? Because it defines the medical problem very specifically, leaving nothing to guesswork. It also translates the medical problem into vocational problems. The claimant can't work because he can't sit,stand, walk or lift enough to get through an 8-hour work day. This meets the federal definition of being disabled.
A very weak case would simply go in and say, "My client has some pretty bad back pain, we don't know why, and he feels he would be unable to work." This is a nearly certain denial.
___________
Charles W. Forsythe
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PH (256) 799-0297
E-MAIL US: forsythefirm@gmail.com
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