Category Archives: Social Security

Media Portrays Social Security as an Avenue to Benefits for the Unemployed – WRONG! It's Not That Simple…

The Social Security Administration turns down many worthy applicants when they first apply.

Today’s post comes from guest author Susan C. Andrews from Causey Law Firm.

     There is a lot in the news these days about the Social Security Disability Program, with some pundits suggesting people are getting on benefits simply because they are unemployed, or because they claim to be injured or ill when in fact they are able-bodied and fully capable of working. Every day, all day, I work with people filing for Social Security Disability benefits. So I work with the program’s rules – yes, there are rules for deciding these cases – it is not enough just to claim to be disabled. And I come face to face with individuals who are struggling, sometimes with a major health issue such as cancer, or rheumatoid arthritis, or Multiple Sclerosis. Other folks have multiple health problems that have combined to force them from the labor market. All of them have medical records, often reams of them, documenting diagnoses, chronicling surgeries and other treatment regimens. This is one big thing I think the general public does not know: a person must have one or more diagnoses from a qualified physician that could account for the symptoms and limitations he or she is reporting to Social Security. There must be convincing medical documentation. Much of my day is spent obtaining and reviewing the medical records of my clients, and ensuring that the decision-makers at Social Security also see them.

…the medical condition must be not only serious, but also prolonged.

     Many people are not familiar with Social Security’s definition of disability or the program’s rules, so they do not realize that the disabling medical condition or conditions must be serious enough to have prevented the person from working for AT LEAST 12 continuous months. If the individual has not yet been out of the labor market for a period of at least one year, it must be very clear that this will be the case. In situations where there is doubt about this, Social Security typically turns down the claim. I have had callers who have been unable to work for a few months while going through chemotherapy treatment for cancer, but have been able to get back to work in less than one year. They do not qualify for Social Security Disability benefits. So the medical condition must be not only serious, but also prolonged.

     One broadly held belief about Social Security Disability is, in fact, true: The Social Security Administration turns down many worthy applicants when they first apply. It is necessary to appeal (the first appeal is called a Request for Reconsideration). Often, a second denial follows. Then it is necessary to request a hearing in front of a judge. For a person who is too sick to work, not feeling well, and home alone trying to navigate this system, it can be daunting. One of the joys of my practice is our capacity to lend support to such individuals, to take the reins of the case and drive it forward, so my client can concentrate on taking care of herself or himself while I and my staff handle the legal stuff.

     We are able to offer representation to people at any stage in the process, including initial application. We are happy to talk with callers who are weighing their options, and simply need information in order to know whether to apply for benefits in the first place. There is no charge for such calls, so do not hesitate to contact us if you have questions about Social Security Disability.

Photo credit: Thomas Hawk / Foter.com / CC BY-NC

Skilled Maintenance Services Can Be Covered by Medicare

Today’s post comes from guest author Jon Gelman from Jon Gelman, LLC – Attorney at Law.

A settlement was recently reached in a pending Federal Court case tht will benefit Medicare beneficiaries who require skilled services. The Centers for Medicare and Medicaid Services (CMS) will no longer require that a patient “improve” inorder to be entled to services. Jimmo v. Sebelius, No. 11-cv-17 (D.Vt.), filed January 18, 2011

“New policy provisions will state that skilled nursing and therapy services necessary to maintain a person’s condition can be covered by Medicare.”

See: “Settlement Reached to End Medicare’s “Improvement Standard”

Read more about Social Security

Aug 11, 2012
The Social Security Administration has added to its list of compassionate allowances a pulmonary condition that has been identified as arising out of exposures to burn pits fumes and dusts in Iraq and Afghanistan.
 
Aug 03, 2012
“If a worker becomes eligible for both workers’ compensation and Social Security disability insurance benefits, one or both of the programs will limit benefits to avoid making excessive payments relative to the worker’s past …
 
Aug 13, 2012
An employer cannot stop paying workers’ compensation benefits merely because the injured worker was awarded Social Security Disability benefits. In fact, the premature termination of temporary disability benefits was …
 
Nov 03, 2012
The Social Security Administration has added to its list of compassionate allowances a pulmonary condition that has been identified as arising out of exposures to burn pits fumes and dusts in Iraq and Afghanistan.