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A Social Security Disability Insider Reveals How SSA Views Part Time Work

There is a social bookmarking site on the Internet called Reddit.com which offers fascinating insight about many topics, including Social Security disability.  Specifically, Reddit has a feature called “Ask Me Anything” where users who have “insider” status volunteer to answer questions from visitors.  For obvious reasons, most of these insiders appear anonymously.

If you search “Social Security disability” you will see that several Social Security adjudicators have volunteered to answer questions about their work. I have never before visited a site where such “no holds barred” information was available and I encourage you to check it out.

I ran across one conversational thread from an adjudicator regarding part time work. The anonymous adjudicator answered a question about how SSA evaluates claimants who show earnings at less than “substantial gainful activity” (SGA) during the time they claim to be disabled [1. In 2013 the SGA limits are $1,070 per month for a non-blind worker.  Since SSA defines “disability” as the inability to perform SGA level work, you could, in theory, be found disabled if you show earnings at less than SGA amounts.]. Continue reading →

Immigrant gets prison time for stealing from the SSA

This past November, Mohammad Husseini was sentenced to six months prison time and ordered to pay back the $111,000 he “stole” from the Social Security Administration. The behind bars59-year-old immigrant from Afghanistan, who became a U.S. citizen in 1978, had been fraudulently receiving Social Security Disability benefits since 1999.

In 1990, Husseini suffered a work-related injury and applied for and received Social Security disability payments, court documents said. Of course, as is always the case when one is approved for benefits, Husseini had to agree to notify the SSA if he again obtained employment at a later date. However, when Husseini got a job in 1999 working for Catholic Charities, he decided he’d take another route.

Instead of using his own Social Security number, he simply gave the charity organization his brother’s Social Security number. This way, his earnings would not be reported to the government, and he could thus continue receiving the Social Security Disability payments despite his work status. Husseini didn’t report his change of work status until April of 2006, after he had already fraudulently collected approximately $111,000 in disability payments.

When Husseini’s case was brought to court, prosecutors sought a swift and severe penalty for his fraudulent actions. The Judge overseeing the case apparently sided with the prosecutors, and Husseini was thus sentenced to jail time and ordered to pay back the money.

Let this be a lesson to anyone who is on disability and then returns to work. Always be sure to report your back to work status if you end up gaining employment while on Social Security Disability!

Millions receive incorrect notice from Social Security concerning benefit payment dates

First of all, I want to say happy 2010 to everyone. 2009 was another year that went by super fast, and I think part of that has to do with the heavy number of hearings we had this past year. In trying to cure the Social Security backlog, Social Security had disability attorneys like me attending hearings it seems just about every week. Although we expect a busy year in 2010, I am sure it cannot possibly rival 2009!

To start off 2010, here’s some news of the most recent Social Security blooper: Close to six million social security recipients thought they had received a very

Doh!
Doh!

special holiday bonus from no other than the Social Security Administration.  Notices received reflected that payments in January 2010 were coming one week earlier than they had in previous years.  This was great news and definitely a welcomed notice for the millions of individuals that require these payments in order to live day-to-day.  However, as quick as these notices came, a corrected notice followed.

The individuals affected are those beneficiaries who normally receive their benefits on the second, third or fourth Wednesday of each month.  In the notices mailed, erroneous information indicated payments would be received one week earlier than the date people were accustomed to receiving their benefits.  All additional information in these notices was correct.

To rectify this matter, the Social Security Administration issued a letter explaining the mistake to all beneficiaries affected.  In a statement issued by Michael J. Astrue, Commissioner of Social Security, he stated,

We apologize for the inconvenience and confusion these incorrect notices will cause.  The problem was caused by an unfortunate human error.  We are correcting the misinformation as quickly as possible, and we are reviewing our processes closely to prevent this type of mistake from happening in the future.  People receiving Social Security benefits in January 2010 should know that their payment will arrive on the same payment day that it has arrived in the past.

As least the Social Security Administration has openly admitted their mistake, has taken swift action to rectify the current problem, and is enacting procedures to prevent any future ones. If you are one of the claimants affected by this mistake, just know that your Social Security payments will continue as normal.

My Wife Had to Quit Her Job Because She Cannot Stand – Is this a Good Case for SSDI?

my wife has diabetes and a host of other problems such as problems ,such as high blood,pressure high  cholesterol rheumatoid   arthritis  in her hands and other joints (birth defect feet problem’s ,) which has caused her to leave her job because she can no longer stand for long periods of times she would like to know,if she has a good case for ss disability?
–Edna’s husband

Jonathan Ginsberg responds: The answer to your question is an absolute "it depends."  As you know, the main issue in any Social Security disability case has to do with the claimant’s capacity for work.  Here are the issues I would consider in your wife’s case:

  1. how old is she?  If she 50 years old or older, the grid rules may apply.  The grid rules make it easier to qualify for disability for people over age 50 with a limited education and medical problems that are physical in nature (such as arthritis and the birth defect).  Under the grid rules, for example, a 50 year old claimant with an 8th grade education would be found disabled even if the claimant could perform sedentary (sit down) work. Social Security recognizes that a 50 year old with a limited education would most likely have difficulty finding an entry level job.
  2. assuming that she is younger than age 50, do her impairments prevent her from performing a sit down type of job?  In your email you state that she cannot stand for extended periods of time?  If she can sit for hours at a time, however, there are plenty of unskilled, sit down jobs that exist in the national economy?
  3. if she experiences a significant level of pain with sitting as well as standing, she could have a good argument for disability.  Pain interferes with attention and concentration and also can make her unreliable at work.  If she is relying on pain as the basis for her disability, she will need the support of a treating doctor.  Here is where a strong "functional capacity" evaluation form would come in handy.  If her doctor agrees to help by "translating" her multiple medical problems into specific work limitations, there is a decent chance that she could be approved.

This is probably a case where it would make sense to hire an experienced disability lawyer.  You do not say where you live, but if you click on the link, you can access my referral panel.

[tags] sedentary work, social security disability lawyer, social security lawyer referral panel, grid rules [/tags]

Working After a Favorable Disability Determination – Potential Problems

Jonathan, I have a question I hope you can help me with. I am a 57-year old computer programmer. In March of 1999 I suffered a stroke, and in July 2002 I filed for SSDI benefits. I was initially rejected but was approved following a hearing. My question is; I have been working full-time since mid_oct of last year, except for a two-month break. When I call the SSA, they either tell me that, if I continue working I will be subject to a CDR, or they tell me the exact opposite, that I can continue to work for three more years and still retain my disability status. I would very much appreciate it if you could tell me which is which, since I have to make a decision in the next two weeks whether or not to continue working. Thank you.

–Morris

Jonathan Ginsberg responds:  Morris, I think you are confusing two different issues.  A CDR (continuing disability review) is a review of your medical condition to determine whether you continue to meet the legal definition of “disability.”  In other words, does your medical condition still meet a “listing,” does your functional capacity prevent you from functioning as a reliable employee, or do you continue to meet the medical-vocational guidelines (the grids).   Often times the presence of an earnings record in a disabled person will trigger a CDR.  Again, the CDR is a medical review.

The 36 month issue falls into a different category.  After you start receiving benefits, you are eligible for a “trial work period” for up to 9 months during any 60 month period.  During that trial month period, you continue to receive your regular benefit even while you work.  Once you have used up your 9 months of trial work, you go into an “extended trial work period” of 36 months (which is apparently where you are now).  During that time, you would receive benefits for any month where your work is not “substantial” ($860 earnings per month).   The extended work period looks at your earnings and has nothing to do (presumably) with your medical condition.

Take a look at SSA publication 05-10095 for more information about the extended trial work period.

Will a Fibromyalgia SSDI Case be Weakened if Depression is Also Diagnosed?

I have a relative that was just diagnosed with Fibromyalgia. She also has herniated discs in her neck and back. Her doctor wants her to see a psychiatrist as well. She has been out of work since March on medical leave and when she could not return, she was terminated.If she applies for social security and is found to also have anxiety or depression does that hinder her case?
–D

Jonathan Ginsberg responds: The quick answer to your question is "no, a diagnosis of anxiety or depression will not hurt your friend’s fibormyalgia Social Security case."

Fibromyalgia is a condition that I see more and more in my practice. It typically affects Type A, overachieving females and is characterized by all over body pain, digestive and balance issues, and pain moving all over the body.

Often it is associated with depression and anxiety – in fact, some physicians believe that there is a mental health component to fibromyalgia.

In pursuing her application for SSDI, I suspect that your friend will find that she will not get approved at the initial or reconsideration appeal levels, but will have to take her case to a judge. At the administrative levels (initial app and reconsideration), SSA employees are given very little latitude to exercise judgment – and fibromyalgia, almost by definition, is a disease of degrees.  Have her visit my SSDI lawyer referral panel when and if she would like to speak with a lawyer.

I find that the best fibromyalgia cases for SSDI purposes are ones that involve multiple conditions and depression/anxiety.

Where depression and anxiety can be a problem is in the long term disability insurance area – since most LTD policies cap benefits at 2 years if the underlying condition is mental health.

[tags] fibromyalgia and social security disability, depression and fibromyalgia [/tags]

I Applied for Benefits Six Months Ago and Have Not Heard Anything – What Should I Do

I applied for SSDI in March, 2006 and I have not heard anything.  Should I call the office or just wait.  I don’t have a lawyer yet – this was my first time applying.
–Brenda

Jonathan Ginsberg responds:  Brenda, you did not say if you applied online or over the phone, but either way you should have received some acknowledgement from Social Security that your claim has been received and is being processed.  If you have heard absolutely nothing at all, I would definitely follow up both by phone (800-772-1213) and in writing to your local Social Security office.  Send your correspondence by certified mail, return receipt requested. 

If, however, your claim was acknowledged, but you just have not received a decision, then I would be less worried as initial application reviews often take six months or longer.  I see nothing wrong with calling Social Security to ask about the status of your case – although do not expect that your call will speed up the process.

With regard to getting a lawyer involved, I would certainly wait until you receive your initial denial notice.  Many people choose to retain counsel to file the reconsideration appeal, although some give recon a shot on their own and wait until the recon denial before hiring a lawyer.   If you choose to proceed on your own, take a look at my Disability Answer Guide book.  If you are more inclined to get a lawyer, I have set up a disability case review form where you can get your case reviewed by me or by one of the lawyers on my panel.

[tags] initial application, SSDI claim, request for reconsideration, initial denial, Disability Answer Guide [/tags]

Back Injuries and SSDI – How do I Win?

If you must take pain medicine on a daily basis, is this taken into consideration?  My disc in my back L-5 and my neck are damaged also my sciatic nerve causes alot of spasms and pain.  I was turned down in 2005 and got frustrated and did
not appeal why do they make it so hard.  My doctor listed as disabled for at least a year now after a head and neck injury the still denied me what do i have to do to get thru to these people?
–Michael

Jonathan Ginsberg responds:  Michael, side effects of medications are a factor that should be taken into consideration by Social Security.  As you may know, there are two ways to win a disability case – you can either meet a listing or you can argue that your functional capacity for work has been so reduced that you would not be a reliable worker at any type of job – even a simple, sit-down, unskilled, entry level type of job.

When arguing functional capacity, medication side effects can create "non-exertional" impairments such as poor concentration, fatigue, and unusually slow pace.  In addition, some medications can cause drowsiness or stomach upset.

Frequently, well-intentioned doctors may not know how to help you.   That is where an experienced Social Security disability lawyer comes into play.  An attorney’s job is to help the doctor translate your medical problems into very specific work limitations and to obtain evidence from the doctor that explains why you would not be a reliable employee.  Most disability lawyers use "functional capacity" checklist forms – this is probably what you need.

If you have not already done so, you should reapply.  If you reapply within 1 year of your initial denial, you can ask for a "reopening" of your prior application for any reason.  Beyond one year, it is more difficult but not impossible.

Best of luck to you.

[tags] back injury and disability, failure to appeal social security denial, residual functional capacity, meeting a listing [/tags]

Doctor’s Records Support Claimant 100% – Why Won’t SSA Grant the Case?

This is a question from a non-attorney claim’s rep:
My client’s claim was denied "no proof of 12 months disability proved etc etc, case in appeal status, 2 medical reports signed by doctor saying claimant could NEVER return towork, another saying "he is not suitable for any job"
and totally disabled since 2002, ALJ judge setting hearing requesting a vocational expert, and now requesting medical records prior to hearing, lastest medical record is 2 months ago stating unable to work in any job??

why the challenge of records? and disability is cancer, and numerous other factors, claimant is 61 and has paid into the system over 40 years, any opinion would be appreciated…….thanks arlene

Jonathan Ginsberg responds: Arlene, I think that the most likely scenario here is that no one at Social Security has bothered to read the claimant’s records. I cannot tell you how many times I have gone to a hearing where the claim should have been approved years before, but no one ever sat down to actually read the records.

At the State Agency level, the adjudicators are overworked and understaffed. If they do not see "magic words" (i.e. that the claimant meets a listing, or if there is any doubt in their minds, they will simply stamp "denied" and pass the file on down the line.

Often what you will find in these cases is a judge who apologizes on behalf of the Social Security Administration for bringing your client in and for making the claimant wait so long for benefits.

Recognize that some judges like to see the claimant face to face and some judges feel as if they have a personal stake in keeping SSA’s money in Ft. Knox. Hopefully that is not what is going on here, but you should be prepared to present your case regardless.

Two other possibilities come to mind. First, is there any issue as to the onset date of the disability? If your client was working part time or if the medical record does not support the alleged onset date the judge may be prepared to grant the case, but may want to amend the onset.

Along those lines, realize that SSA looks at the 10 years prior to disability onset to decide if a claimant is insured. His 40 years of work is only relevant to retirement Social Security. Is it possible that his insurability for Title II has run out?

Another question – are there any records that do not support the claimant, such as records that mention malingering or records that refer to alcohol or drug use. That might be a reason why the judge wants to eyeball the claimant.

Finally, realize that medical records often do not address vocational issues – and work capacity is what Social Security disability is all about. Be prepared to prove your case – conclusory statements from a doctor that the claimant is "unable to work in any job" may not be enough. I like to use functional capacity forms to identify the specific work activities that the claimant cannot perform.

Hope this helps – Jonathan
Ask me for a free case review

Stroke and Kidney Cancer – Does He Qualify?

I had a stroke in Oct of 2004 and received priviate disability until ealier this summer. I then took a ‘lump sum’ pay out with the intention of starting a new business that would allow me to work at home and make a living. This disability company was making ‘noises’ that once they started looking into may case, that after 2 years, I could lose everything. So I took the buy out.

Here’s the problem – I took the money and paid off bills and invested in a business (new one) which is not close to being ready to support. Yet I I was diagnosed with kidney cancer and just had my kidney removed last week. I’m no longer battling the depression, stroke remenents (visual and balance problems) but now I have diabetes type 2 becauase of my last of being able to exercise…and now this. No one will give me a straight answer about the chronic pain from my stroke (whether is will go away) but that chronic pain on my left side, visual issues, balances problems and now kideny problems…do I quality for disability?
–Chris

Jonathan Ginsberg responds: Chris, I think you have a good argument for disability. There are two issues that come to mind:

1) a Social Security judge will want to know if there was some period of time when you invested in the new business when you thought that you were in a position to work. Notwithstanding your concerns about the LTD carrier cutting you off, is it reasonable to assume that had the kidney cancer not arisen you would have been able to pursue this new venture. I don’t know the answer, but that is a question you will likely face.

This question is relevant because it affects your onset date. Might there also be an argument that you have a closed period of disability (from the time of your stroke until the time that you began work on the new business) and currently (assuming that your kidney problems in combination with your other issues leave you unable to work).

2) a second issue has to do with your insured status for Title II. As you may know, SSA looks at the last 10 years prior to onset to see if you have paid in to the system for 5 out of the last 10 years. When you stop working, you obviously stop contributing to your account. Eventually, your insured status runs out. I’m not clear about the dates involved here, but generally, I would think you would want to file for SSDI sooner rather than later and use the date of your stroke as the onset date.

3) many LTD policies have a "reimbursement" provision in which you are obligated to repay the carrier if you recover SSDI benefits for the same time period for which you received LTD benefits. It may be moot if you settled, but you might want to look, just the same.

4) as far as your current status, I would think that your stroke related factors plus the kidney cancer should be enough to impact your capacity to function as a reliable employee. If you have any sort of support from your doctor, I think you should be approved.

Jonathan Ginsberg
Ask me for a free custom case review

[tags] cancer and disability, kidney cancer and social security disability, LTD offsets Social Security, stroke and SSDI [/tags]

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