The Power of the Elderly: Social Security Disability and Advanced Aged individuals
As a society, we spend alot of time mourning and pining over the inadequacies and mistakes that constantly arise in our young generation (For purposes of this discussion, the young generation is anyone under 50). The entertainment community is still reeling from the death of Teen Idol Corey Haim. We are still anxiously watching the rehabilitation of Tiger Woods. The sports world is closely following Marion Jones. We won’t even talk about the countless Lindsey Lohan, Nicole Richie and Brittney Spears sitings that tend to dominate the airways.
I understand that this information may be pertinent. And let’s get one thing straight, I’m RIGHT in the mix of those people who are following all of this extraneous information (I would be a hypocrite if I denied that I didn’t want to know how Britney Spears was doing with her kids).
But the thing that blows my mind is the power of the elderly. Which is why some people who are applying don’t fully appreciate why the Social Security Disability regulations tends to be more favorable for those over the age of 50.
For those of you who don’t know, the Social Security Administration puts people in 5 categories when it comes to applying for Disability claims:
1) Childrens: 17 years and younger
2) Younger Individuals: 18 years to 49 years
3) Closely Approaching Advanced age: 50 - 54 years
4) Advanced Aged: 55 - 59 years
5) Closely Approaching retirement age: 60 years to 64 years.
The regulations tend treat those individuals who are over the age of 50 differently because those individuals have a tendency to have been in the work force for a more significant period of time. Therefore, their ability to adapt to other jobs may be diminished as time progressed.
However, there’s another thing that people underestimate. It’s not something that is readily written in the regulations. CREDIBILITY! Especially if the person is someone who has CONSISTENTLY worked for years and years and is still trying.
Don’t believe me? Not trying to say that these persons should apply for disability but keep these thoughts in mind:
1) Michael Jackson, 50 - before he died, you could arguably say that there are few people who could dance with him at his age.
2) Chuck Norris, 70 - he still does work out videos, he still teaches, and his still considered one of the baddest martial artists of all times.
3) Tina Turner, 70 - she got finished with a tour, a TOUR in Europe and for those who have never seen her, she dances NON stop!
4) Betty White, 80 - she’s still doing movies and do I need to remind you that her commercial was the number 1 Super Bowl commercial and there was a FACEBOOK drive to get her on Saturday Night Live??
You know why these people STAND out? It’s because there is something inherently credible about someone who continues to work despite their age and the underlying health problems that come along with it. You respect those people because they don’t make any excuses. They HIT IT!!
Now, don’t get salty and think that if you’re young and you’re not working that I’m calling you out. I’m doing that at all. I just need you to understand how powerful a statement that it sends when an elderly person has had a long and continuous work history. This information demonstrates to the Social Security Administration that a person was dedicated and committed to sustaining their livelihood. In addition, in the end, most of these people would RATHER be working than receiving benefits. Am I saying that this is going to guarantee their receiving benefits?? NO. Am I saying that it helps? DAMN RIGHT!
Remember, the very essence of Social Security requires individuals to work and pay into the system. The system can’t work unless you work. When an elderly person applies, it says alot about their credibility. SSA may give a little more deference to what they have to say when they complain of aches and pains because if their record shows they are a WARRIOR, they know that WARRIORS don’t whine!
The Social Security process is long but it does value those who truly are dedicated to contributing to its long term progress. Don’t sleep on the Power of the Elderly.
A reflection on Tragedy: Hurricane Katrina and Social Security Disability
With the devastation surrounding the earthquakes in Haiti, Chile, and now Taiwan, these disasters started to remind me of the devastation that occurred in New Orleans as a result of Hurricane Katrina.
I don’t think some people truly appreciate how certain services can be fundamentally SHUT down when hit with a natural disaster. Of course, we know that power, lights, water, police services, bus services, blah, blah, blah, will shut down. But you don’t really appreciate how devastating a situation can be until you see spill outside of those communities into your own.
When Katrina occurred, there were ALOT of Louisianans who migrated to Florida. I had the opportunity to represent a few of those individuals. Now, I know you’ve heard me scream a THOUSAND times about how YOU bare the responsibility of proving that you are disabled. I have stressed that you need to get your medical records and YOU have to demonstrate that you are disabled through medical evidence.
Well, how would you feel if you couldn’t prove it because ALL of your medical records were destroyed? I am mean, that’s what I was faced with when I was representing some of the survivors. I ran into all kinds of problems. I had some places where the buildings were destroyed. Some places, they would not release ANYTHING until they could a detail inventory. It was crazy. I mean if you have a condition like the young lady named Prudence who won an Oscar yesterday (Prudence Mabhena is 21 yr old and she is from Zimbabwe. She is suffering from arthrogryposis, a condition that deforms joints and cost her both her legs. ), your condition may be self evident. But imagine trying to prove you’re disabled due a bad back and you don’t have your MRIs or diabetes and all of your lab work is gone.
But wait. What if you couldn’t prove who you are?? I had a few people who had their drivers license and SS card but sometimes, SSA requires your birth certificate. Well, that building was GONE!!
Now, I gotta take the time to give a shout out to the Social Security Administration. Their offices were obliterated and their workers were literally providing services in other states. I mean, they were working at other offices and STILL processing claims. It was crazy.
Part of the reason I’m reflecting on this situation is because we have literally seen 3 major disasters occur in the last few weeks. It is so easy to underestimate how much pressure it puts on a country to have to rush and provide stability to an environment when these things happen. Sometimes, the effects can have a much longer consequence than we give credit.
Be thankful.
I’m going to call my congresssman to speed up my Social Security Disability case. Will that work??
This situation comes up alot and I have mixed feelings about the topic but I thought I should share with you my opinion and hopefully it will help you out.
Everybody knows that the Social Security disability process is long. Unfortunate, but it is true. Almost once a month, I will get someone who will say to me that they plan on “calling the media”, “calling the governor”, “starting a twitter campagin”, ‘Calling their congresswoman / congressman” or some other prominent elected official. A lot of times when this happens, I get asked the almighty question: “WILL THAT WORK?”.
Well, I have not had the pleasure or distinction of working for the Social Security Administration. However, I’ve had the chance to talk to a few of the personnel at different locations. Of course, these are just my opinion based on my experiences:
ADVANTAGE
1) May elevate the level of imporance
Public officials are fully aware of their requirement to serve their constituents. In some situations, cases that have been designated as a “Congressional inquiry” or some other type of inquiry may have an added amount importance attached to it.
2) Added advocate
It’s great that you have a representative (i.e. attorney or non attorney) but every little bit helps. The joy of involving your elected official is that it demonstrates that you have someone else speaking on your behalf.
3) May highlight the significance of your situation
If you’re in a dire need situation, the fact that you have an elected official speaking on your behalf may help to bring to light your situation.
4) Some have resources dedicated so this helps
Depending on who you contact, some elected officials who have individuals or sections specifically dedicated to working on cases like this for their constituents. They can, also, point you to useful resources.
5) If your case is good, this may help your case.
If you have a strong case with alot of supportive medical evidence, SSA is usually swamped with alot of information so they could have easily overlooked your case. This situation may help to bring your case to light.
DISADVANTAGE
1) SSA is the feds NOT the state
Now, there is nothing wrong with contacting your councilwoman or your mayor or governor. Let’s be real here there. Would you really call your mayor if you had a problem with the IRS? Just like, would you go to Congresswoman if you had a problem with your state tax collector? The answer is NO! Not trying to be stank but the FEDS are probably only going to respond to the FEDS.
2) You can’t threaten an agency
I can’t tell you how many times I’ve told people that you can NOT threaten an agency! Well, you CAN but it does no good. You’re talking about an agency that processes thousands of cases every day involving people who are hurt, sick, and can’t work. They are REALLY not moved because you yell, or your cousin is somebody, or you know somebody who works for the government. Let’s keep it i real.
3) The Media knows its bad already
Go ahead and run down to Channel whatever and tell the reporters how bad and how slow Social Security is. NEWS FLASH!! They know already. Not trying to be nasty but the problem with the delay is one that has been in existence for a while so they probably are not going moved to do a late action news report on the Social Security process.
4) They are already swamped so why make a bad situation worse
I always tell people that you have to go through the process. It’s frustrating but it is what it is. However, you may be making your situation is decide to dedicate yourself to raising as much HELL as possible. I’m not saying that it will delay your case but think about how you would feel if someone was on YOUR back for merely doing your job. You can do the math.
5) If your CASE is bad, you may make your situation worse.
And OOOOOOOO, looky heya!! Everybody thinks their case is the BOMB!! Recognize this fact. You need to check yourself. If you haven’t been to a doctor in years or you have information in your file that would significantly HURT your case, do I even need to mention that you will effectively get ‘The HOOCHIE LIPS” (and if you don’t what those lips look like, think about the look you have when you think someone is trying to make their situation worse than it is) from SSA if you try to make noise with a bad case?
I am a firm believer that everyone should avail themselves the use of their elected public official. These individuals are there to serve you. In some cases, it helps. Just remember that your public servant is there to serve and not be used as a sword.
PLEASE don’t act a fool at a Social Security Consultative Evaluation
Now, I know that sounds so simple. In your mind, you’re probably thinking “What does that have to do with anything?”. Well, as silly as it may sound, you may be completely surprised by the amount of people who truly “lose their mind” when it comes to these evaluations.
Usually, at some point of the social security process, the government is going to ask you to attend a consultative evaluation. These evaluations are usually with a physical or a mental doctor who will evaluate your situation and prepare a report which will be used as evidence in your disability case.
It’s amazing the amount of times that I’ve had to give this speech but I think it’s time that I share some things to any of you who find yourself being scheduled for a consultative evaluation:
1) If you don’t go, they use the fact that you didn’t go to deny you AND that information goes in your file.
Most people don’t realize that COMPLIANCE with going to appointment that SSA sets up for you and PAYS FOR is considered when evaluating your case. So don’t think that just because you decide to NOT show up that it won’t affect your case. Trust me. It will.
2) Don’t go thinking they are going to TREAT you like you are their patient.
Read my lips, “THEY ARE NOT YOUR DOCTOR!”. So many times, people think that these doctors are there to treat them like their own doctors. Don’t get me wrong. In some cases, you may establish a relationship with the doctor that might evolve into a doctor - patient relationship. Just remember, you are there to see them ONE time so don’t expect too much.
3) They are only focusing on what YOU said was wrong so don’t go in there ADDING a bunch of stuff you never said before.
Remember all of those posts that I wrote about being consistent on your forms? Well, be CONSISTENT in what you say to the doctors as well. These evaluations are not your time to start giving a laundry list of things that you have NEVER brought up before.
4) Get ready because the appointment will probably be short.
It’s amazing because people get really upset when they find themselves IN and OUT of an evaluation in 15 minutes. I always tell me to not expect too much when you go to these appointments.
5) You may only get one shot so BE on time, BE honest, and DON’T BE a jerk
Let me tell you RIGHT now, if you go in there and act a FOOL, they will tell you to leave and it WILL go in your file. If you lie, it WILL go in your file. If you’re rude, it WILL go in your file. So just remember that this is part of the process and roll with it.
6) Don’t be slick because if they SEE IT they will write it.
I once had a client who alleged that he had a back problem that required a cane and the moment he walked out of the appointment, he put the cane under his arm and walked to the car. Now, what do YOU think happened when the medical personnel from the doctor’s office saw him walking?
7) You don’t know what they are going to write so don’t think what they will tell you will be in the report.
On so many occasions, I have to remind people that they can’t rely SOLELY on what the doctor says. Just because they tell you that they think you should get disability, doesn’t mean that they will write it in the file.
Whatever happens there will be a part of the record.
If you are nasty, if you change your story, if they think you’re faking, if you showed up late, you NAME it, they will put it in the report.
I know it’s hard but I have to constantly remind people that YOU have the burden to approve your case. Don’t think that SSA is trying to help you with anything. It’s on YOU!
Never understand what is happening in the mind: Mental Health conditions and Social Security Disability
Mental Health conditions are some of the most devastating conditions that can afflict a human beings. Most of the time when we hear about them, they usually are in relations to two circumstances:
1) Somebody popular
Chynna Phillips of the pop group Wilson Phillips checked herself into rehab for anxiety over the weekend, her manager, Lizzie Grubman, tells PEOPLE exclusively.
2) Something traumatic
Thursday, Joseph Andrew Stack flew a small airplane intentionally into an IRS building. The IRS had 199 people who worked there. Joe Stack set his house on fire, left what is being considered a suicide note, and then flew his Piper Cherokee PA-28 into the Austin, Texas IRS building.
The brain is always going to be considered a mysterious organ. Of all parts of the body, this part is the one that continues to baffle the medical community. So it should come to know surprise that it can be difficult to ascertain the severity of a mental health conditions.
The mental health community relies heavily on a variety of different diagnostic testing, personal history, and mental status examinations to try to get a picture of how severe the mental health condition may be. It’s tough but the information these providers obtain is valuable and necessary if you are attempting to obtain medical benefits.
Regularly, I get asked by my clients what types of things does Social Security look for when trying to determine the severity of the medical condition. Here’s a few things you should consider:
1) The type of doctor tells alot.
I hate to tell you but SSA tends to give a bit more deference to a Psychiatrist or a Psychologist who is treating your mental health condition. There is nothing wrong with your family doctor but a specialist (Psychiatrist or a psychologist) tends to get greater favor. Now, before you ask, there is nothing wrong with going to a Mental Health counselor. However, it is helpful if the counselor is working with you in conjunction with a psychiatrist as part of a mental health plan.
2) The type of medicine you take says alot
Some medications give a clear indication of the significance of your mental health condition. There’s nothing wrong with Paxil or Zoloft. However, Risperdal and Geodon gives an indication of a much more serious mental health condition.
3) The BIG 4 things you need to know (Concentration, Memory, Crowds, Stress)
These are normal questions that are asked that you should give some thought to HOW you are going to respond. How is your concentration? Do you forget things? If you do, what do you do if you need to remember things? How are you around crowds? How many people is TOO many people?
4) Other THINGS MATTER
You have to remember that how you function in your day to day life matters. If you say that you can’t be around more than one person att a time but you go to church every other day (where you would expect to be MORE than one person), your response may be viewed as suspect.
5) Involuntary Admission
In Florida, the term “BAKER ACT” refers to an Act that permits for the involuntary admission of an individual into immediate psychiatric care for a short period of time. Every state calls it by a different name but this usually refers to a situation where a person expresses an intent to harm him or herself or someone else. These admissions may indicate the presence of something more severe.
6) STAY AWAY from the DRUGS (ILLEGAL DRUGS)
Let me blunt. Mental Health and Illegal drugs don’t mix. And when you’re applying for disability, you force SSA to try and figure out WHAT came first (the drugs or your mental health condition) and more important, do you get better if you’re NOT using drugs.
Like I said in the beginning, mental health disorders are tough and millions of people affected by these disorders are able to live productive and functioning lives. However, it’s important to realize that if you’re alleging that you are disabled due to your condition, you must understand that the few things I mentioned above may have a lasting impact on your ability to obtain disability benefits.
The hardest part about proving you’re disabled is relying on the medical treatment you are STUCK with
Today, a report was issued regarding the healthiest counties out 3000 counties nationwide.
Overall, the report found least healthy counties have childhood poverty rates more than three times higher than the healthiest counties. Residents of the least healthy counties are 60 percent more likely to be hospitalized for preventable conditions, a sign of poor primary care. A third of zip codes in the least healthy counties have at least one grocery store, compared to almost half of zip codes in the healthiest counties.
http://www.countyhealthrankings.org/
Of course, this information is probably not going to be broadcast on twitter, facebook or myspace. And with the winter olympics and the BACHELOR going on, few will truly appreciate the impact of this report.
What does this report tell you? Quite simply, as stated in one article, “Looking at each state’s best and worst further illuminates a well-known trend: The least healthy counties tend to be poor and rural, and the healthiest ones tend to be urban or suburban and upper-income. ” http://www.chicagotribune.com/health/chi-ap-us-med-countyhealth,0,2482605.story
Unfortunately, this doesn’t help the millions of people who are applying for Social Security Disability benefits. Why am I stressing this point? Quite simply this. The person bears the burden of proving they are disabled. The government doesn’t have to prove a thing. However, this presents a unique situation when you are sick, you aren’t working and you ‘DON’T HAVE INSURANCE’. So what do you do when you have those things striking against you? Well, you can either go to the free clinic, go to the Emergency Room, or get on the county health insurance.
Here’s how it gets tricky but you gotta try:
1) Ask about free clinics
You gotta ask your health care provider, the ER, social worker, county services, or non profits about free medical clinics. I always tell people that free medical treatment is better than NO medical treatment.
2) Find out if you qualify for county health insurance
Every county is different so you want to check to see if you qualify for any type of medical insurance that the county may offer. You don’t know unless you try. AND, if it’s available in your county but you haven’t tried to get it, it may count against you.
3) if you have a “SHARE OF COST”, make sure you understand what it means
A ‘SHARE OF COST’ basically means that you are responsible for a certain amount and anything above that, the government will pay. However, it gets funky because some people don’t understand how that works so you want to make sure you get a complete explanation so you can get treatment.
4) Go to the ER if your condition gets worse.
The Emergency Rooms are flooded every day. Unfortunately for some people, the only primary treatment they can get IS the ER. Don’t be afraid to go to the ER. At least you can get something if you HAVE to get treated.
5) Make SURE you tell SSA that you’ve done ALL of these things
I can’t tell you how many times I’ve had people who literally didn’t do anything. They didn’t go to the county. They didn’t go to the ER. They didn’t go to the free health clinic. AND YET THEY STILL say they can’t get any medical treatment. You gotta try in order to show SSA you made the effort.
I know that is difficult but you have to make the best of what you have available because in the long run, only YOU can prove that you are disabled.
Cancer and Social Security Disability benefits: Not as easy as you think
Today, I was going through my normal surfing like most people do and realized that Bo Griffin, former TV Host of HGTV’s “The Big Reveal” passed away due to Cancer. She was experiencing pain in her back and was unaware that she had cancer. Unfortunately, her bought with cancer was fairly short as she died with a few weeks of its discovery. She was diagnosed with intestinal cancer. The news of her death spread fairly quickly (thanks to the advent of social media, twitter, and you tube).
However, upon hearing of her death, I instantly thought about Roger Ebert, noted movie critic, and his widely publicized bought with Thyroid Cancer. He was successful in his fight but it left him with the inability to speak.
The thing that really resonated to me was the distinctive difference between the two types of cancer. In Ms. Griffin’s case, she had no knowledge of the cancer and it overwhelmed her quickly. In Mr. Ebert’s case, a radical procedure saved his life yet the possibility of it returning still remains.
I’ve represented a number of people who have had different types of cancers over the years and I have found that each one presents a unique set of circumstances as they relate to Social Security Disability benefits:
1) Suspected Cancer versus Cancer
The word “Cancer” is a terrifying word. Like HIV and AIDS, there is no known cure for cancer. As such, you can use chemo, surgery and radiation but you may not totally keep it from reoccurring. For purposes of Social Security, it’s important to know the difference between being diagnosed with Cancer and being ’suspected’ of having cancer. Usually ’suspected’ comes into play when the doctor has a reason to believe that some type of nodule or growth or something that has alerted them to the possibility of cancer. However, for Social Security purposes, this doesn’t not guarantee the receipt of disability benefits.
2) No two cancers are the same
Under the Social Security regulations, individuals may be found disabled if they meet the criteria for certain medical impairments that are listed in the regulations (The listings). Most people don’t realize that Social Security maintains several listings of different types of cancers. As such, just merely being diagnosed with cancer by itself doesn’t guarantee an immediate favorable result.
3) Remission sometimes means Recovered
Cancer is a devastating condition. The treatment that people have to go through in order to combat cancer can be painful and traumatic. However, most people don’t realize that it is not uncommon for people who have gone through the treatment to go back to their normal lives. As such, Social Security can be tough on some cases where the person has completed the treatment and their doctor has given them a clean bill of health.
4) Remission and BEYOND: How are you doing now?
Most people have to follow an aggressive follow up routine to make sure that the cancer doesn’t come back. Some people come out of the treatment with no problems or any residual problems. The key is ‘how are you doing now’? Most people don’t understand that Social Security wants to know if you are still having problems and MORE IMPORTANTLY, does your doctor know that you are still having problems?
5) Cancer and the TERI case
TERI stands for Terminally Ill. These cases are usually expedited because the person has a high likelihood of dying in a short period of time. I had the opportunity to represent my client’s mother when her cancer returned. Due to the aggressive nature of the cancer, she received disability benefits in less than a month. Unfortunately (god rest her soul), she passed a few months later.
I’ve had a few cases where I’ve literally watched someone deteriorate before my very eyes and so I take Cancer very seriously when clients complain that they believe they are disabled due to cancer. The word, by itself, doesn’t guarantee a result. Keep in mind that even though cancer is devastating, you must realize that you may need to provide SSA more in order to demonstrate that cancer is disabling to you.
The BIG THREE (Asthma, Diabetes, Hypertension): Be careful. YOU control how these conditions affect your Social Security Disability claim.
Ok, before I get started, let me get one thing straight. I am not saying that you should not put any information about these conditions in your Social Security Claim. That is NOT what I am saying. However, these conditions are unique in a variety of ways:
1) You control whether they get better
HYPERTENSION - in most situations, proper diet and proper exercise can go a long way towards making your situations better. It’s important that you take the opportunity to follow your treatment regiment.
ASTHMA - there are some things that you can do to prevent asthma attacks. You can avoid certain chemicals, dusts and fumes. You can avoid certain exercises and heat. You can avoid certain conditions.
DIABETES - like Hypertension, proper diet and proper exercise can go a long way. It’s important that you take the opportunity to follow your treatment regiment.
2) You control whether they get worse
Ok, here’s the part where I get GUTTER so get ready to get your feelings hurt.
HYPERTENSION - I don’t give a damn HOW much you like that bar-b-q fish sandwich. 1000 mg of salt is a 1000 mg of salt. Recognize this part as well. If your doctor is telling you that you need to lose weight, this is NOT a request. If you are obese and your diet is bad, it’s not going to help your case or your health.
ASTHMA - Repeat after me “SMOKING AND ASTHMA DON’T MIX”! That’s right, dammit, put the Black and Milds down. I down care how much you need to suck on that stick in order to relax. If you have asthma, you better learn to eat an apple.
DIABETES - I know you don’t like raw vegetables and OOOOOOOO, that haagen daas looks good. Back AWAY from the table. Like Hypertension, some things just don’t mix.
3) Doctors can put information in your case that may be harmful to your case
There are two words that doctors can put in your notes that are DEVASTATING to your claim:
UNCONTROLLED - in most instances, this word can mean two things. One, your condition is so far gone that it doesn’t matter what you do, you can’t get it under control. Or TWO, your condition is not being controlled by you. In any event, you don’t want a judge to decide which one of these she wants to pick.
NONCOMPLIANT - this word is like a written FORK. If it’s there, you’re done as far that condition is concerned. Unless you can give a great reason why you haven’t been doing what the doctor TOLD you to do (that’s what non compliance means), then a judge may determine that you aren’t TRYING to get better.
Most people don’t realize that they bear the burden of proving they are disabled. As such, you must take all necessary to make sure you do what you need to do.
What the hell happened to all of my old (Prior) Social Security Applications and why can’t I go back to the old application date?
Oh, I know you know about this one. You get ready for a hearing and you are told that they are going to look at your case from a particular date of application but you KNOW that you have filed a few times before and YOU want to know WHY are they NOT considering those old applications. And why is this important? It’s because you KNOW that you’ve been disabled for a while and you think they need to understand so they don’t cut out your benefits. Will, let me get YOU right so get ready to read!!
Ok, ok, I’m sure quite a few of you have heard me give a break down of different things relating to Social Security but today, I have go over a topic that I get asked THOUSANDS of time. It’s really weird from a technical standpoint so I’m going to break it down into two parts. Part I is titled LEGAL talk and this is where I will discuss the various standards that Social Security relies on to make their determination. Part II is titled BEAT talk and this is the part where I will discuss how people tend to get into this situation and the little things that you do that may impact your ability to get your old application reopened.
PART I - LEGAL talk
If you get denied on your application and you refile, you may be able to request your prior file be re-opened. However, for purposes of my discussion, I’m going to give you a hypothetical scenario so you can see how this work. In the course of the discussion, I will rely on references 20 CFR 404.988, 20 CFR 404.989, 20 CFR 416.1488, and 20 CFR 416.1489.
HYPO: Let’s say that you filed an application on JANUARY 1, 2006 and you got your initial denial on MAY 1, 2006. Here’s what may happen if you re-file again on the below listed dates:
1) RE-FILE DATE DECEMBER 31, 2006 (It should be able to re-open automatically)
The regulations provide that if you re-file a new application, for any reason within 12 months from the date of the notice of the initial determination, it can be re-opened automatically (either by requesting it or SSA may do it by themselves). So under the example I just provided you, since you filed a new application within the 12 month window from MAY 1, 2006, you can re-open your JANUARY 1, 2006 application.
2) RE-FILE DATE JUNE 1, 2009 (Depends on your type of case and it depends on your reason for asking)
Here’s the point where you need to know what kind of case you have. If you have a case under Title II (which is Disability Insurance Benefits), you can request a re-opening because your reapplication occurred within 4 years of the May 1, 2006 determination (4 years from your initial determination in this hypothetical). However, under Title XVI (Supplemental Security Income), you only have 2 years from that date to ask. Since you were denied on May 1, 2006, you had up until May 1, 2008 to file a new application and ask for the old one to be re-opened. Since you re-filed on June 1, 2009, you are not within the window. Now, remember what I said in point #1. Within 12 months of the initial determination, you can ask for it to be re-opened for any reason. Beyond that 12 months (but within the window, DIB within 4 years and for SSI within 2 years), you gotta have a good reason. And here is what they consider:
(1) New and material evidence is furnished;
New meaning something that relates to the period of time to explain WHY you didn’t re-apply right away and it must be relevant (MATERIAL) to your case.
(2) A clerical error in the computation or recomputation of benefits was made; or
(3) The evidence that was considered in making the determination or decision clearly shows on its face that an error was made.
3) RE-FILED because you found out and realized that someone was using your information and SSA applied their information to you.
You can RE-FILE and ask for a Reopening, for any time if,
(1) It was obtained by fraud or similar fault ;
(2) Another person files a claim on the same earnings record and allowance of the claim adversely affects your claim;
(3) A person previously determined to be dead, and on whose earnings record your entitlement is based, is later found to be alive;
(4) Your claim was denied because you did not prove that a person died, and the death is later established—
(i) By a presumption of death; or
(ii) By location or identification of his or her body
PART II BEAT Talk
Alright, now that we got the legal MUMBO jumbo part out of the way, let me get down to the DIRTY and tell you why it is sometimes difficult to get your old applications re-opened:
1) Your last application is so long ago that there is NO way they are going to re-open it.
The one thing I wanted to make clear is that there are timelines for requesting your old applications to be re-opened. I’m sorry if you applied in 1994 and you have been out of work the entire time. However, if you can’t show that there was some fraud involved or someone used your information or something else as referred to above, SSA is NOT going to go ALL the way back to 1994 if you reapplied beyond the SSI (2 year) and DIB (4 year) window.
2) You were in prison during the time between your current applications and your new one.
Now, in theory, if you’re within the period of time, you could request a re-opening. Let’s say under the hypo I provided, you were denied on May 1, 2006, you went to prison on May 30, 2006 and you didn’t get out until November 1, 2007. So you reapplied that day and you want to go back to May 1, 2006. Of course, you got a good reason. You were in prison. You way have a good reason but (under the regulations), they can’t pay you for any time you were in prison. Now, if you have DIB claim where you are indicating that you were disabled up to a year before the application, you may want to request the re-opening. However, if you have an SSI claim, you can only get paid from the date of the application so why would they re-open that old application?
3) “I didn’t know I could appeal”.
I have heard this one a MILLION times. Now, let’s get real. Unless you have a cognitive problem or you have a low IQ or you were under some type of extreme emotional or physical situation, you are probably NOT going to get ANY sympathy from Social Security for the “I didn’t know I could appeal” reason. Those decisions that SSA generate are SO detailed that they explain two or three times about your RIGHT to appeal.
4) “I was going through some things” (You better be specific, dammit, and it better be good and you better have proof).
Now, let’s be honest here. You are going to have some situations where you are in a devastating circumstance. Your loved one died. You went through traumatic divorce. Something of that nature. In some instances, SSA may be sympathetic. However, SSA is not dumb. They are going to want SOMETHING to demonstrate that you did go through what you went through to support your assertion.
5) You were working.
And this is another one I’ve seen. people, the FIRST step of the SSA process is “Are you performing a Substantial Gainful activity?”. In other words, are you working? Say (like under the HYPO), you applied on Jan. 1, 2006. You were denied on May 1, 2006. You went back to work. Now, it’s not that simple. If you only worked a few weeks or you tried a month here and a month there with no success, you might get some sympathy (depending on your reason for not working). However, if you went back to work on May 2, 2006 and worked until June 2008 and you earned $14000 a year but now you’re saying that you were struggling and so you can’t do it, you might get the hoochie lips from SSA. Why? Did i mention that you earned $14000 a year? and OH, SSA knows that you earned $14,000 so if you can’t explain how you worked under some special set of circumstances, you are probably not going to get that old application re-opened.
I I know that so many people find themselves reapplying for disability benefits so I wanted to make sure that I took the opportunity give some insight into how this situation works so you can understand why your old applications may or may not be affected.
Will someone PLEASE tell me how Long Term Disability will affect my Social Security Benefits??
I can’t tell you how many times I have found myself in the position of having to explain how a person’s Long Term Disability program will affect their Social Security disability benefits. I have seen more people PISSED off, angry, and upset because they didn’t have a full appreciation of how that program would affect their benefits.
With that being said, let me give you a few tips that may help you out along the way:
1) If you don’t know BEFORE you sign up, Call your carrier and ASK!!
If you’re thinking about applying for Long Term Disability, check with your carrier and find out how your LTD program will be affected by Social Security. It’s important to have this information available to you in the very beginning.
2) If you have signed up and you don’t know, Call your carrier and ASK!!
So many times, people will start the process of applying for Social Security and think that their LTD benefits and SSD benefits will go ‘hand and hand’. Don’t let yourself get caught off guard. Ask as soon as possible.
3) It sucks but you may have to reimburse them.
I hate to be the bearer of bad news but some LTD policies require you to reimburse them if you receive monies during the same time they are paying you. You might want to know that ahead of time.
4) It stinks even more but your LTD benefits may be reduced after you get disability benefits.
Be careful. Sometimes, you are sitting over there doing the NEW math and thinking that you will get money from LTD and your SSD. This point may be true but it is possible that they may reduce your benefits to account for the SSD money you are getting so you need to be ready.
5) It stinks the MOST but your LTD benefits may STOP after you get disability benefits.
OOOOOOO, this is point that makes people HOTTER than fish grease. Let’s say you’re getting $1000 a month in LTD benefits and then a year from now, you start getting $1200 in SSD. So in your mind, you’re thinking “BAM! $2200 a month? We ROLLING!”. And then what happens? you are only getting $1200! Say what? Who bumped their head? Well, it might have been you if you haven’t checked your policy and your policy has a provision that STOPS your LTD once you get your SSD.
6) They want to know about the status so get READY or you may have problems.
I know this will get on your nerves but they are going to want to know REGULARLY about your SSD process. For some policies, if you don’t have an active claim, you don’t get any money.
7) Don’t wait until AFTER you get your benefits to contact your LTD carrier to find out how it will be affected.
Most people get the SHOCK of their life because once they have gone through the 2 years or so of waiting for your SSD benefits and you think it’s cool and then BOOOOO YAAA! you get your SSD benefits. your back pay goes to your LTD carrier and you stop getting LTD checks. NOW, you are mad and don’t want to do. Unfortunately, you may not be able to do anything.
Now, don’t get me wrong. LTD programs are AWESOME! THey provide some well needed money when you’re sitting over there waiting on the SSA process to unfold. Just recognize this point. The LTD program may not be designed (depending on your policy) to keep you covered forever so you need to EDUCATE yourself about what it covers so you don’t get surprised.
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