October 23, 2014

How Does a Social Security Judge Decide if I have “Transferable Skills” for Grid Rule Purposes?

transferable skillsThis is a good question – the short answer is that judges will look to vocational expert witness testimony to determine whether a claimant has acquired transferable skills.

Your question got me thinking that it might be helpful to review how the grid rules work and to take my readers through a grid rule analysis, so, here you go:

The grid rules, or “medical vocational guidelines” can qualify you for Social Security disability benefits even if you have some capacity to work, but you are not likely to find work because of limited skills and a limited education.

In order to qualify for a finding of disability under the grid rules you must have exertional limitations. This means that your medical issues must impact your physical capacity. Thus, a person asserting disability based on depression, or bi-polar disorder, or schizophrenia could never qualify under the grid rules 1

You can look at the grid rules here.

The grid rules look at several factors: your age, your education, the skill level of your past work and whether or not your past work generated any transferrable skills. SSA lays out these factors in a table divided by grid lines – thus the name.

When a judge applies the grid rules he first must make a decision about your capacity for work. If you are limited to sedentary work, you are more likely to be found disabled under the grid rules than if you are limited to light or medium work.

Let’s analyze how the grid rules work in practice. [Read more...]

  1. Such a person could, however, qualify for disability based on a listing or using a functional capacity argument.

How to Explain Earnings After Your Disability Onset Date

If your earnings record shows salary earned after the date you say you became disabled, you can be sure that the judge in your Social Security disability hearing will ask for an explanation.

Example:  you say you became disabled on April 3, but your earnings record shows income in May, June and July.

In this video I explain  how I advise my clients to respond to questions about post-onset earnings in three common scenarios:

  • unsuccessful work attempts
  • accrued earnings or benefits that are paid after the last date you were physically present at work
  • part time work

No matter what the reason, always discuss with your lawyer work, work attempts or payments received after the date you claim that your disability began.

Fibromyalgia and Social Security Disability: Can You Still Win?

Social Security disability judges are increasingly reluctant to award benefits to fibromyalgia claimants unless these claims meet a certain profile.  Let me tell you about this profile – what is currently working for me in disability hearings I try here in the Atlanta area hearing offices. [Read more...]

Is it Possible to Recover Past Due Benefits for a Disabiling Condition that Began 20 Years Ago

how far back can I go to collect disabilityI recently received an email from a blog reader who tells me that she has recently been approved for SSDI based on a stroke.  However, she was diagnosed with another disabling medication condition 20 years ago but never applied.  Is there anything she can do about the older medical condition and recovering 20 years worth of past due benefits.

Here is my analysis: first, this is a difficult question to answer because I do not have all of the facts.  For example there are circumstances where an informal communication with Social Security could be considered an application.  There are also cases where even an unintentional misstatement by a Social Security employee could toll the statute of limitations.  [Read more...]

Reaction to 60 Minutes Disability Segment: Truth or Fantasy?

what is state of Social Security disability systemThis past Sunday, 60 Minutes aired a segment called Disability USA, in which correspondent Steve Kroft reported on the “alarming state of the federal disability program” which has exploded in size and is about to run out of money.  Kroft interviewed Senator Tom Coburn (who is also a medical doctor), several current and former Social Security employees and former associate attorneys for a national law firm that advertises heavily 1.

The gist of the story is that hundreds of thousands of able-bodied people have been approved for disability and are costing taxpayers millions of dollars.  Further, the story suggested that disability lawyers are culpable in the outsize growth of the disability program because they advertise heavily.  Further, there was an implication that at least some disability lawyers game the system with inappropriate and/or illegal relationships with doctors and judges.  Several of the judges and SSA employees interviewed opined that the disability program has devolved into a last resort unemployment program rather than one focused on people with serious disabilities.

I have no doubt that fair minded American taxpayers who have no experience with the disability program were and are appalled at a system which appears to be out of control and rife with fraud and manipulation. [Read more...]

  1. I have previously written and spoken about Senator Coburn’s efforts to expose fraud and inefficiency in the SSA disability program

Functional Capacity Evaluations: Helpful or Hurtful?

Social Security FCEHere is a question I received from a blog reader:

I have been told I should qualify for disability because of my permanent restrictions set by my FCE. I was put in a light category. What do you think?

Here is my response:

First, let’s clarify what a functional capacity evaluation is and why it is important to Social Security.  Functional capacity evaluations (abbreviated FCE) are a set of tests and evalautions designed to objectively determine your capacity to perform the physical demands of work 1.  A physical FCE will categorize you as:

  • able to perform heavy work
  • able to perform medium work
  • able to perform light work
  • able to perform sedentary work
  • unable to perform sedentary work

Social Security has defined each of these terms – click here for the definitions.

An FCE can be preformed by a rehabilitation supplier, a physical therapist or a physician.  A formal FCE may involve one or two days of testing along with interpretation by a trained health care provider.  An informal FCE may involve a checklist form completed by your doctor. [Read more...]

  1. Here is Wikipedia’s definition of an FCE

Stong Case Undermined by Simple Problem (Maybe)

Weakness Word on Breaking Weak Chain LinksI tried an interesting case this week that illustrates the importance of presenting a complete case to your judge.

My case involved a man in his early thirties with a significant hip problem.  He had been born with a bone deformity in his hip that was surgically repaired during his childhood and he was able to work a variety of physically demanding jobs during his 20’s.

By age 30, however, he was experiencing severe hip pain such that he could not drive a truck or perform his job.  He met with a surgeon and underwent hip replacement surgery.  I should note that surgeons rarely recommend hip replacement surgery for individuals younger than 50 because artificial hips rarely last more than 15 years and current medical technology does not allow for more than two hip replacement over one’s lifetime. [Read more...]

Social Security Disability Again the Subject of Congressional Inquiry

Social Security disability costs too highCBS News reports this morning that the House Oversight and Government Reform Committee will begin hearings on Thursday, June 27 about the role of administrative law judges in awarding benefits.

Critics of the current disability system point to SSA’s own statistics which show that judges currently approve slightly more than half of the claims brought before them (this is down from a 60% approval rate in 2010).  Claims approved at hearings were previously rejected twice by state employees called adjudicators.

Critics also claim that too many judges are approving undeserving cases simply to clear out growing backlogs – the judges complain of quotas – which may delay a hearing date for longer than 12 months.

Others contend that long term unemployed workers claim disability when their unemployment benefits run out 1 [Read more...]

  1. This was the premise of a controversial NPR report entitled Unfit for Work: the Startling Rise of Disability in America – see my video about this story here.

How do I Win for a Medical Condition that Cannot be Seen on a Diagnostic Test

fibromyalgia difficult to diagnoseI get a lot of questions about fibromyalgia and other medical conditions that rely on subjective reporting by patients.  These cases are definitely getting more difficult to win.  Here is a question sent to me by a blog reader that describes an increasingly typical situation:

I'm 41 yrs old and have been suffering for many years with narcolepsy and fibromyalgia.  My sleep disorder actually falls between narcolepsy and idiopathic hypersomnolence.  My family and myself are falling apart because of my disabilities. I've applied for disability in the past and was denied. I'm applying again and wanting to ask you how do i go about applying to prove my disability since its been denied in the past?  How much weight does testimonials from family and friends carry?  How much weight does a signed letter from my doctor saying, i can't work/drive its unsafe, carry?

I am not surprised that you have had a difficult time with Social Security.  As you probably know, Social Security defines disability in terms of your capacity to work a simple, entry-level type of job.  Basically you have to prove that the symptoms of your medical condition or conditions are so intrusive, that you cannot work at any job, full time.

As the person claiming disability you have to prove that you are unable to work – you do this by submitting medical records, and, even better, a functional capacity form completed by your doctor that identifies specific activity limitations.

[Read more...]

SSDI Claimants Can Expect to be Asked About Unemployment Benefits

tough ALJ questionsOver the past several months, I have noted that my SSDI clients are regularly being asked by judges if they have filed for unemployment benefits.  This question used to come up occasionally in the past, but now my clients are almost always asked if they have filed or are receiving unemployment.

The issue is this: when you file for state unemployment, you must assert that you are ready, willing and able to work.  In the past, I would counsel my client to answer the judge’s question by stating that “I am willing and anxious to try to work and I would put forward my best effort to perform any job.  I don’t know if my medical condition would allow me to perform reliably but I would certainly try.”

Given that Social Security’s stated policy is to encourage people with disabilities to return to work, I do not see a huge inconsistency in a claimant who is applying for both unemployment and SSDI.

However, as is the case with part time work, Social Security tends to view things in an “either-or” fashion.  You are disabled or you are not, and there seems to be no middle ground. [Read more...]