Seeking to 'pick your brains'...
Just Suzie
people here.
Jack---I get the impression you do or have worked for Social Security
and really know all the 'ins & out".
First, let me assure you that I am not Michelle and that all people who
post using Webtv are not crazy!
I know pretty much nothing about SS Disability, so I have lots of
questions and any information would be greatly appreciated.
I'll start with my basic questions, then go from there.
First: I've heard that the older you are, the more likely you are to be
approved for disability and quicker it's likely to get approved.
Is that generally true?
2--How long does approval take? I've heard that almost no one gets
approved at first application and that the sucess rate to be approved it
quite high if you are persistant, but that it may take 3, 4, 5
submissions and as many years.
How accurate is that?
3--Obviously, approval and speed of such is based on reasons for
application for disability--for instance, I would image that if you
became a para- or quadrapaligic, went blind, or some such thing that
would be almost beyond dispute, approval would be all but assured and
probably relatively quickly, right?
My problem is progressively worsening arthritis. When I went to my dr
recently (who has been my primary care and I've been seeing regularly
for probably about 10 years), she told me that she thought that it was
time for me to think about applying for disability.
I'm also guessing that having the support of my long-time PCP will be
pretty helpful, correct?
Since I'm starting with almost no knowledge of how the system & process
works, I'll stop with those basic questions for now and ask more and
give more pertenant details later.
Thanks in advance for any help, advice, and/or support anyone can offer!
Suze
Kris
I'm not knowledgeable other than my teeny litle world of exoperience.
having support of several MDs and a history of treatment will, imho, help a
lot. I would also suggest you get at least one specialist MD to attest to
your degree and permanence of limited ability for gainful employment.
be aware that your income will be based on the max over the last 10 years
from the time you apply, so don't stop for a while, and THEN apply, as I
did.
But you are correct, Jack has tons of experience and we are blessed to have
him.
--
Kris
Jack
wrote:
>First: I've heard that the older you are, the more likely you are to be
>approved for disability and quicker it's likely to get approved.
>Is that generally true?
'
>2--How long does approval take? I've heard that almost no one gets
>approved at first application and that the sucess rate to be approved it
>quite high if you are persistant, but that it may take 3, 4, 5
>submissions and as many years.
>How accurate is that?
>3--Obviously, approval and speed of such is based on reasons for
>application for disability--for instance, I would image that if you
>became a para- or quadrapaligic, went blind, or some such thing that
>would be almost beyond dispute, approval would be all but assured and
>probably relatively quickly, right?
>My problem is progressively worsening arthritis. When I went to my dr
>recently (who has been my primary care and I've been seeing regularly
>for probably about 10 years), she told me that she thought that it was
>time for me to think about applying for disability.
>I'm also guessing that having the support of my long-time PCP will be
>pretty helpful, correct?
If the severity level of your impairment satisfies certain regulatory
criteria, your impairment is allowed regardless of your age. If the
severity level of your impairment falls short of the criteria, the
case can still be allowed based on the combination of your impairment
and your age, education, and work experience. A person who is older,
less educated, and less skilled is more likely to be allowed in those
cases.
The allowance rate at the initial level is 30-40%. If you are denied
and you file a reconsideration appeal, the allowance rate is 20%. If
that is denied, you request a hearing in front of an administrative
law judge. 60-65% of these are allowed. If you are still denied, you
may request Appeals Council review but they usually do not overturn
the ALJ's decision unless the decision is not based on substantial
evidence, or there is an error of law, or a policy issue. The AC does
not substitute its judgment over the ALJ. If you're still denied, you
appeal to the Federal courts.
An initial claim takes 3 1/2 months on average for the decision. A
recon claim takes 3 1/2 months also. But you may have to wait over
two years before you appear before the ALJ and even longer for a
decision by the AC.
Certain classes of cases are put on a fast track and the decision is
often reached in less than a week, e.g., liver cancer.
Your treating physicians' opinions are very important but they must be
stated in the proper context. For example, instead of saying that you
are disabled or cannot work, they should relate how much you can lift
/ carry; how long you can sit, stand/walk in an 8-hour day; how
frequently you can crouch, stoop, etc.
Even though your treating physicians' opinions are important, their
most important contribution to your case is their objective evidence,
such as X-ray findings, range of motion studies, and prescribed
medications.
If your MDs' opinions are well-supported by the objective findings,
SSA must give those opinions controlling weight.
Just Suzie
Jack, you gave me such a wealth of information, and I am very greatul.
I will make sure I get the range of motion studies. Over the last 5
years or so, I have had 3 or 4 sets of x-rays and 2 MRIs, but the last
was about a year ago. I'm seeing a new orthopeadic guy in a few weeks,
so I expect he will want new x-rays.
Although the arthritis is my main problem, I have some other health
issues, such as quite significant hearing loss.
I am 61 and am currently working, and have been at this job for a little
over 14 years, but it's just getting to be too much. I have trouble
getting in & out of my vehicle to even get to work, but you know, you do
what you have to do the best you can.
I do have to hire a neighbor to mow my lawn since I cant, and I pay his
wife from time to time to do some of my housework that I just am not
able to do myself.
If I go off work on short term disability that my employer covers, I'm
guessing my best course is to apply for Social Security disability
pretty much right away, correct?
Would there be an opportunity in the initial filing for statements from
co-workers and neighbors to offer their observations of my physical
limitations?
Thanks again for your responses and help!
Suze
Jack
wrote:
>Thanks to both Kris and Jack for your responses.
File your application ASAP after you stop working. List all of the
treating sources who have treated you for the alleged disabling
impairments. And be sure to say that the impairment is the reason you
stopped working.
SSA is looking for 1) objective medical evidence 2) your own
statements as as to how pain affects your daily activities 3) your
treating physicians' opinions stated in the proper format.
Lay evidence from neighbors etc. has the least probative value. It is
considered only when other evidence stated above is unavailable, such
as when someone is trying to establish that their disability began in
the distant past when for whatever reason evidence of higher probative
value no longer exists.
_______
The automatic allowance criteria are here:
http://ftp.ssa.gov/OP_Home/cfr20/404/404-ap10.htm
Scroll down to the musculoskeletal system. If your impairment falls
short of these criteria, an allowance is still possible based on the
combination of medical and vocational factors of age, education, and
work experience. Those criteria are found here:
Nonna Yabisness
JustM...@webtv.net (Just Suzie) wrote:
> I am 61 and am currently working, and have been at this job for a little
> over 14 years, but it's just getting to be too much. I have trouble
> getting in & out of my vehicle to even get to work, but you know, you do
> what you have to do the best you can.
It may be worth noting that if you are still working when you file
that will be a problem.
The idea of disability is that you cannot work and have ceased
working.
--
Nonna
Just Suzie
I feel reasonably well informed on the best way to proceed, thanks to
you.
Another question though:
I've read here about 'back pay', and that if approved, you get a lump
sum payment to cover what you would have gotten from the day (or maybe
month) you filed.
Do you know if during part of that time I am getting short term
disability payments through my employer, would I still get that lump sum
'back pay' from SS, or would the amount I've received from my employer's
disability benefits be deducted?
Again, my thanks.
Suze
Jack
wrote:
>Wow, thanks so much, Jack, for a wealth of information.
Your SS benefits may be offset if you receive disability pmts. from
your employment with a Federal, State, or local govt. agency, or if
you receive worker's compensation from a pvt. sector employer based on
an injury or illness suffered / aggravated at work.
Other types of disability pmts. from a company in the pvt. sector thru
an insurance program are not offset by SSA. Whether your co. requires
you to reimburse them when you receive SSA benefits is something
you'll have to ask your employer. Usually this is not the case
though.
VA benefits are not offset nor is unemployment compensation.
The two to be concerned about are WC pmts. and disability pmts. based
on your work with a govt. agency.
________
http://www.socialsecurity.gov/pubs/10153.html#6
(...)
If you receive other disability benefits
Social Security benefits for you and your family may be reduced if you
also are eligible for workers� compensation (including payments
through the black lung program) or for disability benefits from
certain federal, state or local government programs. You must tell us
if:
�You apply for another type of disability benefit;
�You receive another disability benefit or a lump-sum settlement; or
�Your benefits change or stop.
(...)
Just Suzie
I work in the private sector and I pay a small portion of the
disability insurance premiums and my employer pays the balance of the
premiums as part of our benefit package.
If my work would require me to pay back any disability benefits that I
get from them
if I am later approved for SS and get paid again from the government,
that would be fair.
I'm trying to anticipate most possible scenarios and inform myself so I
can try to be prepared.
Thanks again.........I may be back with more question ; )