Winning Your Social Security disability case
What are typical cases you see? Back to Top
Our firm handles many different kinds of disability cases. You can download our client intake forms by clicking on the link. Feel free to mail or fax us your intake form for a free telephone case evaluation. Here are a few typical case areas and how we approach them:
1. Mental Health cases - Mental illness and mental health problems can strike people of any age or background. I have found that Judges accept as disabling cases involving long term, severe depression, schizophrenia, bipolar syndrome and other mental illnesses. A key to winning this type of case is to show extended treatment, even if the counseling is with a County Health Department. Psychiatric hospitalizations and suicide attempts are seen as strong evidence of a significant problem. In mental health cases, Social Security usually refers the claimant to an independent psychologist for a consultative evaluation. Psychologists, like judges, see ongoing treatment as evidence of a long-standing problem.
2. Back pain cases - It has been my experience that judges expect to see objective evidence of back pain, specifically MRI evidence of significant disc herniation. X-ray evidence is usually not very helpful, and chiropractic treatment is given very little weight. In addition to objective evidence, I have found that judges like to see evidence that a claimant has tried to work through his pain - evidence of unsuccessful work attempts can include employment records or statements from ex-co-workers or supervisors.
3. Diabetes - Diabetes is a very common disease and many people are afflicted. As such, I have found that in order to win a case based on diabetes, we must show severe complications, such as vision problems, organ damage (i.e. kidney or liver), and/or peripheral neuropathy (numbness and burning in hands and feet). I usually look for clients who have suffered with diabetes for many years and who have been unable to control their blood sugar despite compliance with regular medical care.
4. Arthritis - Like diabetes, arthritis is very common in the population. The most common form of arthritis is osteoarthritis, which is commonly associated with getting older. In order to win an osteoarthritis case, I look for older clients with significant deformity in their hands, feet, knees or spine and regular medical treatment. Other forms of arthritis, such as rheumatoid arthritis, often strike younger people, and are often more severe. Rheumatoid arthritis cases are usually strong cases.
5. HIV/A.I.D.S. - The Social Security regulations provide that HIV cases should be granted when lab reports show very low T-cell levels. My experience has been that most judges view HIV cases somewhat liberally and will grant benefits even if the lab reports do not demonstrate full-blown A.I.D.S. Many HIV cases also involve depression, which can provide another theory for recovery. Again, regular treatment and a supportive treating physician is very helpful.
6. Intestinal, stomach, liver and kidney diseases - It has been my experience that internal organ diseases often produce very significant work activity limitations. For example, a person with irritable bowel syndrome might be able to function at work for a time, but would not be able to maintain employment because of frequent absences or excessive unscheduled breaks at work. A record of regular medical treatment and written support from a treating physician are necessary.
How does age and education factor in to a Social Security evaluation? Back to Top
Social Security recognizes that the older a person is, the harder it will be for that person to adjust to changes in the working world. Similarly, a claimant's limited education or intellectual ability is a vocational factor. For Social Security purposes, a claimant who is less than 50 years old is considered a "younger individual" and is not entitled to any specific consideration due to age. At age 50 and again at age 55, special rules making it easier to qualify are put into place for claimants with physical impairments who have limited schooling.
If you are 50 or older, I can advise you if these special rules, called the "grids," apply to you. Under the grids, if you are 50 years or older, your impairment is a physical problem and you have a limited formal education or no significant work skills, you can be found disabled even if there are some “sit-down” or “light” jobs you can still do. The idea behind the grids is that people over 50 with limited work skills and education will have a more difficult time re-entering the work force. Please ask if you want to know whether the grids apply to you.
Do I Have to Meet a Social Security “listing” in order to win? Back to top
There are basically two ways to win a Social Security case. If your medical condition meets a Social Security listing, you win automatically. The “listings” are medical definitions published by Social Security. Most major diseases are described in one or more listing categories. Not only does a listing describe a specific medical condition, but the evidence Social Security wants is also included. You can read examples of two common listings:
My experience has been that many people who meet a listing are approved early on in the process since the medical descriptions in the listings are very conservative. In other words, if a Social Security adjudicator, who may or may not have a lot of medical training, can recognize that your condition meets a listing, you are likely to be very sick. It has been my experience that in order to win a case on the listings, you will need extensive medical records and, ideally, a statement or questionnaire on the listing completed by a treating physician. At Ginsberg Law Offices, P.C., we have prepared questionnaires on most of the listings, thereby enabling your doctor to answer questions about the listings by checking off boxes or completing short answer questions.
It has also been my experience that most approved cases are not “listing level” cases. Thus, the second way to win a Social Security case is by proving that your “functional capacity” for work has been so diminished by your medical or mental health condition that you would not be a reliable employee. Most cases I see are won on the “functional capacity” basis.
If I don’t meet a Social Security "listing" can I still win? Back to Top
As noted above, most Social Security cases are decided based on the work activity limitations resulting from one or more medical problems. I use the listings as a framework to identify what is wrong with you medically, but the big picture has to do with identifying specific work limitations that leave you unable to perform work. Unfortunately, if you do not meet a listing, you can expect to wait months or even years before your case is scheduled for a hearing. I am hopeful that these long SSI and SSDI hearing delays are temporary and that SSA is successful in implementing is new disability decision making process.
What if I lose at the hearing? Is my case over? Back to Top
If the Judge concludes that you are not disabled (an unfavorable decision), or if the Judge finds you disabled, but at a later date than you contend (a partially favorable decision), you can appeal the decision to the Appeals Council. As before, your appeal must be filed within 60 days. Usually, the Appeals Council will only consider legal challenges to the Judge's decision; therefore, it is wise to have a lawyer prepare your Appeals Council brief. At Ginsberg Law Offices, we sometimes accept Appeals Council cases from clients who had another lawyer appear with them at the hearing, but we are very selective. If you want my firm (or any other firm) to evaluate your Appeals Council case, do not wait - the earlier we see the case, the better.
Every judge has his or her own technique for hearing cases. Click to learn more about Atlanta Social Security disability local rules and customs.
How will my workers' compensation case affect my Social Security case? Back to Top
Your worker's compensation case may have a very significant impact upon your Social Security case. In terms of your benefits, your worker's compensation payments may totally offset your Social Security payments - in this case, it may not be possible for my office to handle your case on a contingency since there may be no back benefits. In other cases, your worker's compensation settlement can be structured as a lifetime pay out, thereby reducing or eliminating your worker's compensation offset.
If you have a worker's compensation claim, it is crucial that you advise us about it so we can properly advise you about Social Security. If you are not represented by an attorney in your worker's compensation case, we offer our clients the benefit of our expertise and experience in both worker's compensation and Social Security Disability.
What if I have a Long Term Disability policy and am receiving LTD benefits? Back to Top
It has been my experience that most LTD carriers require claimants to apply for Social Security since Social Security benefits can reduce the amount of money that the LTD carrier must pay over the course of a claimant's lifetime. In addition, the Medicaid and Medicare benefits that accrue to Social Security beneficiaries can reduce the health insurance costs to a LTD carrier. Our office has established ongoing relationships with most of the LTD carriers who issue coverage in the Atlanta area. In most (but not all) situations, LTD carriers can assist our office in obtaining Social Security benefits and the end result to you will be the same or more monthly cash benefit. If you are covered by an LTD policy, please let us know.
Summary Back to Top
Social Security Disability and SSI are programs that provide monthly payments to individuals who cannot work. If you have a serious medical problem, ongoing medical treatment and/or a supportive doctor,
and you cannot perform at a job, we would be pleased to speak with you about Social Security Disability. Please feel free to email Jonathan Ginsberg, or fax us a completed intake form for a free case review. There is never a charge for phone calls and we are happy to answer your questions. Call Jonathan Ginsberg at 770-393-4985.
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