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Claimant’s Age Less of a Factor When Disability Impairment is Mental Health

Because Social Security disability cases largely turn on a claimant’s capacity to work, SSA has come to recognize that a claimant’s “employability” ought to be a factor in determining eligibility for disability benefits.

In fact, the “grid rules” are specifically designed to help older, less educated individuals by easing the standards for certain claimants. The grid rules apply to claimants over age 50 who have a physical (not mental health) impairment.

The grids are actually tables that consider age, education and work experience. For example, a claimant who is age 50 to 55, who cannot read and write would be considered disabled even if the claimant could perform sit down work – the thought being that very few sit down jobs exist for such an individual.In general, claimants who are older and less educated will find it easier to qualify for disability even if they retain some capacity for work.

Even in cases where the grid rules do not apply, I have found that Social Security judges tend to be a bit more sympathetic to older, less educated claimants – especially those who have performed physical work during their working life. In theory a 48 year old construction worker might be found “not disabled” if he could perform data entry on a computer, but a thoughtful judge would recognize that such a scenario is unlikely in the real world.

Younger claimants – those in their 20’s and 30’s – generally have a more difficult time qualifying for disability. First, younger claimants may not “look disabled” to a judge and therefore not likely to receive the benefit of the doubt in a credibility evaluation. Secondly, some judges are concerned that by approving a younger individual for benefits, the Social Security system will be on the hook for hundreds of thousands of dollars over the next thirty or forty years, while the disabled individual will lose all incentive to work.

The one area where this generalized bias against younger individuals may not be quite so prevalent is in the cases of claimants disabled by mental illness. True mental illness – such as schizophrenia, severe depression, bi-polar disorder, paranoia, obsessive-compulsive disorder – exist because of brain chemistry imbalances. Age is not a factor. As such a claimant’s youth ususally does not work against him or her.

Earlier this week, I tried a case involving a 35 year old woman who was severely bi-polar and suffered with obsessive-compulsive disorder and anger control issues. My client was young, attractive and well dressed and a casual observer would have no idea about her inner turmoil.

I changed my normal direct examination strategy in this case because I was concerned that the judge (a visiting judge who I did not know) might pre-judge my client based on her appearance. Normally, I go through background material (past work, schooling, education) fairly quickly – often using “leading” questions since my goal is usually to inform the vocational witness about the work history and to get the background information into the record.

Here, I let my client ramble on a bit more about her past work since she had lost just about all of her past jobs because of confrontations with supervisors or customers.

Because of her mental illness, my client experiences a different reality than a non-impaired person. The more she spoke, the more obvious it became that she could not function in a work environment. Because her obsessive activities and paranoia are such a big part of her life, she tends to focus on those issues to the exclusion of other day to day matters. Her testimony suggested that she functioned best in a very controlled environment, even to the exclusion of her husband and other relatives.

I also asked her husband to testify since a mentally ill claimant often lacks the perspective to clearly explain exactly how her behavior differs from the norm. I usually try to find witnesses are in mental illness cases to illustrate the depth of the claimant’s day to day problems. I also asked the claimant to step outside when her husband spoke so that he could be free to speak his mind without having to worry about offending his wife.

At the end of the hearing the judge asked a few questions to the vocational witness, all of which resulted in vocational opinion testimony that this claimant could not function in a competitive work environment.

Fortunately, our judge looked at the evidence, not at the claimant’s appearance and he made the correct decision in this case.

[tags] mental illness and SSDI, grid rules, obsessive-compulsive disorder, paranoia, bi-polar disorder, Social Security disability, vising Social Security judge [/tags]

Working While Waiting for My Disability Hearing – How Will It Affect Me?

Yesterday, I appeared at a disability hearing with a client who had gone back to work for a year during the four year wait for her hearing.  Now she is again out of work.  The complications are increased because her insurability for Title II disability ran out in December, 2004.

She applied in March, 2003, alleging an onset date in March, 2003 based on a badly broken foot and diabetes complications.  She was out of work until November, 2004 when she went back to work “to feed her kids.”  She worked on a mostly regular basis through November, 2005, when she broke her other foot.  She has been out of work ever since.

Here are the issues:

1) if the judge decides that she was “disabled” for Social Security purposes during both periods (March, 2003 thru November, 2004 and November, 2005 ongoing), how does he write a decision and what does he do about the year that she did work?

Does he approve the claimant for a closed period of Title II disability from 3/03-11/04 and then issue a separate ruling approving SSI from 11/05 ongoing?
2) is it fair to hold the claimant’s 11/04-11/05 year of work against her?  Fear of living in a shelter with your kids can motivate almost anyone to suffer thru a lot of agony.

If any of my colleagues who practice Social Security law have any thoughts, please share your input.

[tags] working while applying for Social Security disability, SSDI, trial work, unsuccessful work attempt [/tags]

New Social Security Regulations on the Horizon

The Social Security Administration has once again “re-engineered” itself and its disability adjudication process. Welcome changes include:

  • Quick Disability Determination (QDD) for clearly disabled claimants
  • Medical and Vocational Expert System (MVES)
  • Federal Reviewing Officer (RO)
  • Decision Review Board (DRB) to replace the Appeals Council

This new system will be phased in over the next seven years in various regions of the country. The first States to get a look are Connecticutt, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.

You can read more about the new Disability Regulations on attorney Troy Rosasco’s Disabled Worker Law blog. Troy practices Social Security disability, workers comp, LTD and personal injury work in New York State.

Why is the Judge Scheduling a Post-hearing Medical Exam?

At the end of a hearing can the judge tell you he wants to send you to a doctor because of a medication you are now taking even though it is not the reason you have filed for disability and not give you a decision at the end of the hearing? And than make another hearing date 6 months later?
–Sheryl

Jonathan Ginsberg responds: Yes, the judge can send you out for a post-hearing consultative examination for the purpose of understanding more about your condition. Although you did not specify what the medication is, it is possible that the judge felt that the medical record in your case did not explain why you are taking that medication.

For example, if the medication is for a mental health condition, but your medical record contains no mental health treatment, the judge may feel that he needs additional medical support in order to grant your case. Similarly, if the medication is used to treat alcohol or drug abuse, the judge will want to know more about that as well. Your attorney should be able to explain to you why your hearing is being continued to another date.

Most Social Security judges do not announce their decisions at the end of the hearing. Social Security courtrooms are not secured by baliffs or other security personnel and judges typically issue their decisions in writing. Good luck.

Favorable Decision on Closed Period – When Do I Get Paid?

I have been granted a fully favorable decision in a closed period disability case. I was injured, disabled and out of work for 35 months. My questions is, once awarded, how long until payment, and also, do my children get disability for the time I was out?
–Jill

Jonathan Ginsberg responds: Congratulations on your favorable decision. Usually it takes 4 to 6 weeks for Social Security to process the decision and to issue you a check. If you have eligible dependents, they will get paid as well.

For those who do not know, a “closed period” means that you have been found disabled for a period of time, but not on-going. The closed period ends when a claimant either returns to work or when her medical condition improves to the point where she no longer meets the definition of disability.

[tags] closed period benefits, dependents benefits, favorable decision, Social Security disability [/tags]

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