If you are 55 years old or older and can no longer perform your past job, you may be eligible for Social Security disability benefits or Supplemental Security Income (SSI).

If you are 55 years old or older and can no longer perform your past job, you may be eligible for Social Security disability benefits or Supplemental Security Income (SSI).  Social Security’s regulations contain medical-vocational guidelines(also know as “the Grids”) that consider a person’s age, education and work experience along with his or her medical conditions when determining disability. These rules recognize that it is more difficult to find work as a person gets older (even above age 50) and is limited by the physical demands of work activity because of a medical condition.

Social Security will initially evaluate your case and determine whether your medical impairments meet their definition for disability outright by referring to specific medical criteria known as the Listings.  However, if your condition (or combination of impairments) does not meet or equal Social Security’s initial requirements, it will be evaluated under the Grids by determining what level of physical activity you are still able to perform along with your age, education level and any acquired work skills.  In many situations, someone who is age 55 and limited to sedentary or light work will be considered “disabled” by Social Security’s guidelines.

Can I work while my application for disability is pending with the Social Security Administration?

A common dilemma for people applying for disability is financial.  How are they supposed to meet their family’s basic survival needs if their condition prevents them from working?  The problem is compounded by what can be a lengthy administrative process, i.e., a long delay, before an application is approved.  How do people survive in the interim?  Should they return to work despite their condition, putting their health in further jeopardy?  Will the judge view this limited work as a showing the claimant has the ability to work full time?

Unfortunately, there are guidelines  rather then a definitive answer.  Generally speaking the definition of disability under the Social Security Act is the  inability to engage in “substantial gainful activity” for at least a 12 month period due to a medically determinable impairment.  The disabling impairment can be mental or physical or a combination of both.  The Social Security Administration sets a monthly amount of earnings which it considers substantial gainful activity.  For the year 2014, that amount is $1070 gross earnings per month.  Consistent earnings over that amount will prevent you from being eligible to collect disability benefits even if your actual medical condition itself otherwise meets the medical criteria for disability.

As a result, one is permitted to work while their application for disability benefits is pending. However, the amounts they are allowed to earn are quite limited.  Earning more then the allowed substantial gainful activity amount on a consistent basis can disqualify you from obtaining any benefits, notwithstanding the severity of your condition.  Even earning the amount limit for a few months may bring work ability issues into question.  This work activity becomes a question of fact for an administrative law judge as to the true capability of a claimant.  While we have the ability to make a number of arguments in favor of disability and limited working potential, judges have significant discretion in this area.

According to the American Diabetes Association, about 25.8 million American children and adults suffer from some form of Diabetes. The full name of this condition is diabetes mellitus, and there are two major types: type 1 and type 2. Both are chronic disorders that can result in serious complications. One may be entitled to social security disability benefits if complications from a diabetes mellitus diagnosis prevent that person from working. Diabetes mellitus is listed under listing 9.00 of the Social Security Administration’s (SSA) Impairment Listing Manual.

Both type 1 and type 2 diabetes mellitus disrupt the body’s production of several hormones, including insulin, which is important for absorbing glucose from the bloodstream into body cells. This disruption is generally manifested in 1 of 2 ways: Hyperglycemia or hypoglycemia, both of which carry their own complications that may result in a person’s inability to work.

Both types of diabetes mellitus cause hyperglycemia, or an abnormally high level of blood glucose, which can produce acute and long-term complications. These complications include Diabetic ketoacidosis which may result in complications like dehydration, electrolyte imbalance, and insulin deficiency. Several problems can result from treatment, including cardiac arrhythmias, intestinal necrosis, and cerebral edema and seizures. Further, chronic hyperglycemia can result in disabetic retinopathy, coronary or artery disease and peripheral vascular disease, diabetic gastroparesis, diabetic nephropathy, as well as others. Each of these individual complications resulting from hyperglycemia due to diabetes mellitus are evaluated under different listings by SSA.

Another complication resulting from diabetes mellitus is hypoglycemia, or an abnormally low level of blood glucose. This can lead to complications including seizures, loss of consciousness, or altered mental and cognitive functioning, which are evaluated by SSA under separate listings.

Proving disability based on a diagnosis of diabetes mellitus may be complex because the claim will likely be based on multiple complications rather than a diagnosis of diabetes mellitus alone. Our law office frequently deals with disability claims arising out of a diagnosis of diabetes mellitus. Enlisting the help of an experienced social security disability attorney may be essential to your claim for benefits. Feel free to call should you have any questions.

You may be concerned about the ways in which the current government shutdown will affect your disability benefits, or how your application for disability benefits will be effected.

While the government is, in fact, “shut down” for the time being, some essential parts remain open. This holds true with respect to the Social Security Administration (SSA). While parts of SSA will shut down until Congress once again funds the government and the shutdown ends, other parts will remain functional. One thing that will be unaffected by the shutdown is the payment of Social Security Disability and Supplemental Security Income (SSI) benefits. The payment of these benefits will continue without interruption.

With regard to pending applications for benefits, local offices will continue to process new applications and requests for reconsideration. Additionally, previously scheduled hearings are expected to be conducted. However, the real change comes with regard to scheduling new hearings and the Appeals Council. Currently, SSA will not be scheduling new hearings and the Appeals Council will not be reviewing new cases.

In sum, people will continue to receive their Social Security Disability Insurance and Supplemental Security Income (SSI) benefits. Those with a scheduled hearing will still have their hearing. Also, those who would like to file a new application, request for reconsideration, or request a hearing may do so. However, there will be delays in scheduling those hearings and receiving decisions from the Appeals Council.

During this time, we will continue to work hard for each and every one of our clients. We expect SSA to be fully operational in the very near future, although we cannot be certain when that will be. Until then, if you have any questions feel free to call and we will do our best to answer any questions you may have about your claim.

Any health condition that impairs a person’s ability to breathe can be extremely traumatic and debilitating. One such condition is Asthma, which is a relatively well-known impairment characterized by constriction and inflammation of the airways that makes it difficult for the afflicted individual to breathe. A diagnosis of Asthma can have a substantial effect on a person’s ability to work, and may lead to entitlement for disability benefits.

The Social Security Administration (SSA) evaluates Asthma under Section 3.03 of the Impairment Listing Manual. In order to meet the criteria of Listing 3.03, a person must have a diagnosis of asthma with either Chronic Asthmatic Bronchitis or Attacks.

If a person has Asthma with Chronic Asthmatic Bronchitis (3.03A), that individual will be evaluated under Listing 3.02A, which sets forth criteria for chronic obstructive pulmonary disease. Listing 3.02A evaluates an individual’s impairment by utilizing the results of a lung functioning test. You may view the chart on which a person’s results are evaluated here:

https://www.ssa.gov/disability/professionals/bluebook/3.00-Respiratory-Adult.htm#3_02

Alternatively, a person may have Asthma with Attacks rather than Chronic Asthmatic Bronchitis. If this is the case, the person will be evaluated under listing 3.03B. The listing’s definition of “Attacks” can be found in section 3.00C- “prolonged symptomatic episodes lasting one or more days and requiring intensive treatment, such as intravenous bronchodilator or antibiotic administration or prolonged inhalational bronchodilator therapy in a hospital, emergency room or equivalent setting.” Also, a person must have an attack every 2 months or at least 6 times a year. An evaluation period of 12 months is required in order to determine the frequency of attacks.

As with any claim for disability benefits, it is important to have a strong history of continuing medical treatment. This is especially important for conditions that effect your ability to breathe, since often times SSA will evaluate your condition by examining medical test results and doctor’s opinions about your condition. If you do not meet the criteria set forth in a listing, SSA will conduct a Residual Functional Capacity analysis to determine if your condition prevents you from being able to work.

If you have any questions regarding your disabling condition, please feel free to give us a call.

With the increased popularity of the internet and various social media websites, many people may be wondering  how the information they post on the internet may effect their claim for Social Security Disability Insurance benefits (SSDI) or Supplemental Security Income (SSI).

Fortunately, the Social Security Administration (SSA) has included a new section in the Hearings, Appeals and Litigation Law (HALLEX) manual regarding the use of information obtained from the internet when adjudicating cases. Generally, an Administrative Law Judge (ALJ), as well as other staff within the hearing office, may not rely on information from the internet unless it has been verified by a Cooperative Disability Investigations Unit (CDIU).

The ALJ, along with other hearing office staff, are not to conduct independent searches for information about claimants on the internet. If this were done, it could compromise an individual’s personally identifiable information (PII). ALJ’s, as well as other SSA officials, have a duty to protect PII at all times- including while off duty. If, while adjudicating a claim, an ALJ comes across information from the internet that was entered into the record by a SSA or state agency employee at an earlier level in the process, the ALJ will not consider that evidence.

There are, however, some situations in which an ALJ may consider information from internet sites. These include situations in which the information has been verified by the CDIU and associate with the record, and also when the information was submitted by the claimant or the claimant’s appointed representative. If a disability claim reaches the Appeals Council level, the case analysts are to abide by a similar set of rules regarding information obtained from the internet.

For more information, the sections of HALLEX regarding information from the internet can be accessed here: https://www.ssa.gov/OP_Home/hallex/I-02/I-2-5-69.html

The disability claim adjudication process can be a lengthy and intricate one, and not something you should undertake without an attorney. Feel free to call our office should you have any questions.

Multiple Sclerosis, or MS, is a neurological disorder that frequently effects an individual’s ability to engage in gainful activity. It can be disabling while at other times, an employee with MS may seek an accommodation under the ADA.

If you have MS and file a claim for disability benefits, the Social Security Administration (SSA) will evaluate the severity of your disorder under listing 11.09 of the Impairment Listing Manual.   Listing 11.09 is divided into 3 paragraphs: A, B and C. Paragraph A provides criteria for evaluating disorganization of motor function, a symptom characteristic of a diagnosis of MS. Paragraph B references other listings for evaluating visual and mental impairments caused by MS. Finally, paragraph C provides criteria for evaluating the severity of an individual with MS’s impairment when there is no muscle weakness at rest, but develops on activity due to fatigue.

The disorganization of motor function required to meet the severity level of Listing 11.09A is described in paragraph 11.04B. To satisfy Listing 11.09A, disorganization of motor function associated with MS must be significant and persistent in at least two extremities, and result in sustained disturbance of gross and dexterous movements, or gait and station. Some examples of this disorganization of motor function include paralysis, tremors, or other involuntary movements. See paragraph 11.00C for more about the definition of “disorganization of motor function.”

A diagnosis of MS can result in various mental and visual impairments. An individual experiencing these types of symptoms will be evaluated under listings 2.02, 2.03, 2.04, or 12.02 rather than the traditional MS Listing 11.09. Sometimes the limitations in motor function of a person with MS will be present when that person is engaging in some type of activity, but not when that individual is resting. These types of cases are evaluated under paragraph 11.09C. The impairment in motor function must be reproducible upon a physical examination.

As with any claim, it is important that the person seeking benefits is receiving ongoing, regular medical treatment. In order to meet the severity level of listing 11.09, an individual’s limitations must be well documented by a doctor.  Even if your conditions do not meet the severity outlined in listing 11.09, you may still be eligible to receive benefits if your conditions result in your inability to function or maintain work skills. Please feel free to call should you want to discuss these issues further.

Heart failure (CHF) is a condition that effects the heart’s ability to pump enough blood to body tissues, and may effect a person’s ability to work and entitle that person to receive disability benefits. There can be multiple causes of CHF, including hypertension, cardiomyopathy rheumatic, congenital, or other heart disease. To qualify as disabled for chronic heart failure, the Social Security Administration analyzes it under Listing 4.02.  In order to meet the severity level under listing 4.02, an individual must meet the criteria of both parts A and B of that listing. Both of the two main types of heart failure (predominant systolic dysfunction and predominant diastolic dysfunction) are reviewed under this regulation.

Meeting the criteria in part A of Listing 4.02 requires a showing of either systolic or diastolic failure. Systolic failure requires evidence of left ventricular end diastolic dimensions greater than 6.0 cm or ejection fraction of 30 percent or less during a period of stability. Diastolic failure requires evidence of left ventricular posterior wall plus septal thickness totaling 2.5 cm or greater with an enlarged left atrium greater than or equal to 4.5 cm, with normal or elevated ejection fraction during a period of stability.

Meeting the criteria in part B of Listing 4.02 requires that an individual’s CHF results in at least one of several specific symptoms which are outlined in parts B(1)-(3) of that listing. To satisfy part B(1), an individual must show that the symptoms of CHF result in a significant inability to independently initiate, sustain and complete activities of daily living. To satisfy part B(2), an individual must show that they have had three or more episodes of congestive heart failure within a consecutive twelve month period. Finally, satisfying part B(3) of listing 4.02 requires that an individual demonstrate an inability to perform an exercise tolerance test at a workload equivalent to 5 METs or less.

As with any claim for disability benefits, it is important that you receive proper treatment for your conditions. This is particularly important for heart conditions, as most of the evidence considered by SSA in these types of claims will be objective test results. Even if your conditions do not meet the severity outlined in listing 4.02, you may still be eligible to receive benefits if your conditions result in your inability to function or maintain work skills. Our attorneys deal with these complicated issues on a frequent basis and with a high success rate.  Feel free to call if you want to discuss these issues further.

Seizures and Epilepsy are neurological disorders that affect a person’s ability to perform tasks, sometimes even simple tasks, and leave many individuals unable to work. The Social Security Administration (SSA) classifies Epilepsy as a neurological disorder under Listing 11.02 and 11.03 of the Impairment Listing Manual. We say individuals with purpose here as there are many types and levels of seizures, and they have a wide variety of effect on that individual.  Disability applicants certainly can receive benefits but SSA bases a determination on the severity and frequency of the seizures, potentially in combination with other health issues.  Social Security will first examine the frequency, duration and severity of the applicant’s seizures. To meet Listing 11.02 for convulsive epilepsy, grand mal, seizures must occur more frequently than once a month. To meet Listing 11.03 for nonconvulsive epilepsy, petit mal, seizures must occur more than once weekly. Both Listings require that the applicant have frequent seizures despite at least 3 months of prescribed treatment. The applicant must also show that at least one seizure meets the detailed description of a typical seizure. This includes tongue bites, injuries associated with attack, postical phenomena, presence or absence of aura, and sphincter control.  https://www.ssa.gov/disability/professionals/bluebook/11.00-Neurological-Adult.htm

The applicant also plays an integral role in the success of winning a disability claim based on seizures.  The applicant should keep a written diary to document the frequency and severity of seizures. Further, the applicant must stay compliant with prescribed treatment and medical advice in order to prove that the 3 month prescribed treatment requirement is fulfilled. Further, consistent medical treatment can help win the case because Social Security also analyzes the aftermath of seizures. Medical records document how the seizure affects the applicant afterwards and can help prove the claimant’s inability to sustain gainful employment.

If the applicant’s seizures and epilepsy are not severe enough to meet Listing 11.02 or 11.03, it is still possible that the seizures, along with other disabling conditions, prevent the applicant from sustaining gainful employment.

Knee, elbow and pain in any major joint, no matter the cause, can severely limit your  daily activities but also your ability to work. Disability issues for joint pain and dysfunction are categorized under Listing 1.02.  In order to qualify, you must show an anatomical deformity in the effected joint, along with chronic pain or stiffness that limits the range of motion and functioning of the joint. You must also be able to show signs of joint space narrowing, bony destruction, or ankylosis of the affected joint through medically acceptable imaging, such as an x-ray.

Listing 1.02 also distinguishes between major weight bearing joints like the hip, knee, or ankle, and major peripheral joints in upper extremities like the shoulder, elbow, or wrist. In order to meet listing 1.02(A), your condition must meet the above conditions and involve at least 1 major weight bearing joint resulting in your inability to ambulate effectively. In order to meet listing 1.02(B), your condition must meet the above conditions and involve at least one major peripheral joint in each upper extremity, resulting in your inability to perform fine and gross movements effectively.

The inability to ambulate effectively and the inability to perform fine and gross movements effectively are not general terms, but rather specific criteria defined by the SSA. For an explanation of what it means to not be able to ambulate effectively or to not be able to perform fine and gross movements, please see sections 1.00(B)(2)(b)-(c) of the Impairment Listing Manual here:  https://www.ssa.gov/disability/professionals/bluebook/1.00-Musculoskeletal-Adult.htm#1_02

As with any claim for disability benefits, it is important that you get appropriate medical treatment for your conditions, and one must also recognize that these issues are not viewed in isolation.  Our clients typically have other medical issues that also effect their ability to work.  . Even if your conditions do not meet the severity set forth in this listing, you may still qualify for benefits depending on your ability to function and maintain work skills.