Social Security Alphabet Soup

Social Security Alphabet Soup

A client recently informed me that she had no idea what I was talking about, and asked me to speak in regular English. I had just told her that the ALJ at OHO would pose a hypo to the VE based on an RFC tied to the psych CE what could be clearer?

As with many governmental agencies, the Social Security Administration (SSA) has its own unique language composed of acronyms.  Initial contact with SSA is usually made at the local District Office (DO), where a claim for Social Security Disability (SSD, Title 2) and/or Supplemental Security Income (SSI, Title 16) benefits is filed. The claims are not actually adjudicated by SSA at this level of review (Initial), but rather by Disability Determination Services (DDS, the State Agency). At DDS, the claim is handled by a Single Decision Maker (SDM, Adjudicator), with input from a medical consultant (MC) and/or a psychological consultant (PC). You will never meet an MC or PC, unlike a Consultative Evaluator (CE), who is hired by DDS to examine you.

Read More: The Value and Cost of Medical Records in a Social Security Case

If the claim is denied at Initial, a Request for Reconsideration (Recon) must be filed within 60 days. At Recon, SSA again sends the case to DDS, to be reviewed by a different Adjudicator and MC/PC.

If the claim is denied at Recon, a Request for Hearing must be filed within 60 days, and the file is sent to the Office of Hearings Operations (OHO). This is a new name for this office, which until last month was called the Office of Disability Adjudication and Review (ODAR). People who have been doing this work for a few years recall when OHO/ODAR was called the Office of Hearings and Appeals (OHA). The only thing more fun than obscure acronyms is randomly shifting acronyms.

At the disability hearing at OHO, the Administrative Law Judge (ALJ) may call on the services of a Vocational Expert (VE) and/or a Medical Expert (ME, which in the past has also been dubbed a Medical Advisor or MA). As with MC/PCs, the VE/MEs have never met you. The ALJ is required to make a finding of Residual Functional Capacity (RFC) and to determine if you are capable of Past Relevant Work (PRW). If your RFC is inconsistent with PRW, the ALJ will determine (with the assistance of the VE) if there are any other jobs you can perform – often referred to as a Step 5 finding.

Assuming you are found disabled by an ALJ, be aware that most claims are reviewed every 3-7 years. This is called a Continuing Disability Review (CDR). If your claim is denied by an ALJ, you may file an appeal with the Appeals Council (AC), and possibly Federal District Court (FDC).

Hopefully, this will guide you through the fundamentals of SSA-speak. A qualified representative can translate the more advanced acronyms – or, like my bewildered client, you can simply ask everyone to speak English.

Have more questions about social security and disability? Give us a call. We are here to answer your questions and assist with all your legal benefits needs.

More information:

How to provide for yourself while waiting for social security benefits

Factors that can end social security benefits

 

What does Title II and SSD Mean in Social Security Disability

Social Security Disability has many components and can get overwhelming especially if you are just looking into social security disability for the first time. Some common questions about social security disability include Title II and SSD. What do these terms mean?  What does Title II and SSD Mean in Social Security Disability

Title II Benefits and SSD refer to the monthly benefits that you receive after your  Social Security Disability Claim is approved.  

Title II benefits  are monthly benefits that are received from the Social Security Administration once a disability claim is approved. These benefits are not needs-based benefits and because of this, there are no income or asset restrictions to be able to qualify for monthly payments under Title II. In order to qualify for these benefits, you must suffer from a long-term or permanent disability that is expected to last for at least 12 months in order to qualify. This condition must also be severe enough to keep the benefactor from doing any sort of work activity that could be gainful work. Applicants of Title II benefits must also have enough work credits earned from paying taxes into the social security system while working.

Read more: What are Continuing Disability Reviews?

SSD is social security disability insurance it is also referred to  as “workers disability,” SSDI, Social Security Disability, or DIB (Disability Insurance Benefits). These fall under Title II of the Social Security Act. To qualify for SSD you must have worked for a certain number of years in a job where Social Security Taxes (FICA) were paid. More specifically you need to have earned enough work credits.You can earn up to four work credits in a year. The number of work credits you need to be approved depends on your age at the time of disability. For example, a 50-year-old applicant will need 28 work credits or to have worked for seven years with at least five years in the last 10 since applying for SSD. You also need to have a medical condition that meets the Social Security Administration’s definition of disability. These benefits are available only to anyone suffering from a condition for a year or longer and that you are not able to perform “substantial gainful activity” (SGA). If you are currently working and make over a set amount ($1,130/month in 2016 and $1820 for blind applicants in 2016)the Social Security Administration will find that you are able to perform SGA and you do not qualify for SSD. If you are approved for benefits you will not begin receiving payments until five months after disability. It is likely you will not be approved until about six months to a year after so in many cases payments start shortly after a claim is approved and will receive back pay starting with the six months after your condition began. This is your disability onset date.

Read more: Beware of Disability Scammers

You will continue to receive these monthly benefits as long as your medical condition prevents you from working. The Social Security Administration will perform a CDR or continuing disability review on your case every one to three years to determine if your condition has improved at all.

It is estimated that about three in every ten workers at the age of 20 will have a disability before reaching a retirement age. In an effort to help pay bills many of these people will apply for social security disability with the Social Security Administration. Once a claim is approved Title II benefits begin and the applicant receives monthly payments, in some cases family members like dependent minors of approved applicants may also obtain Title II benefits.

Anyone interested in applying for Title II or SSD may want to consider hiring a qualified Social Security Disability attorney as they can increase your chances of receiving needed disability benefits.

 

Student Loan Forgiveness for Disabled Individuals

Student Loan Forgiveness for Disabled IndividualsIf you are “totally and permanently disabled” (TPD), you may qualify for a discharge of your federal student loan debt.

There are 3 ways to prove TPD:

  • A finding by the Department of Veterans Affairs (DVA) that you are unemployable due to a service connected disability;
  • A finding by the Social Security Administration (SSA) that you are disabled and not subject to a continuing disability review within the next 5 years; or
  • A certification from a physician that you cannot work because of a medical or mental impairment for at least 60 months.

This TPD discharge process was signed into law in 2012, and has been available since July 1, 2013, but many people who are eligible for debt relief have been unaware of the program.

On April 12, 2016, President Obama announced a plan to help disabled people with federal student debt apply for TPD discharge. The Department of Education and the SSA have been working together to identify disabled borrowers for whom medical improvement is not expected. So far they have identified about 387,000 people who could benefit from the program. Letters are being sent out to inform them of the issues, and to invite them to apply for debt forgiveness.

If you believe you may qualify for TPD student loan discharge, you can find the forms to apply at https://www.disabilitydischarge.com/Forms

Be aware that discharge may have federal tax consequences, as the amount of the forgiven debt may be considered taxable income. Before taking advantage of the TPD discharge process, you should consult with a tax specialist.

When to Call a Social Security Disability Lawyer

When to Call a Social Security Disability Lawyer

You are disabled and cannot work, and have either filed a Social Security disability claim , or are thinking about it. When should you call in reinforcements? A legal representative can help you at any stage of the process, but it is important to understand the costs and benefits of hiring one.

How much will it cost me?

The Social Security Administration (SSA) has issued guidelines for how legal representatives should be paid. Most reputable firms adhere to these guidelines through the administrative hearing level of appeal (the fee structure changes if appeal to Federal District Court becomes necessary).

If you are successful, you will receive a back-award of benefits for the period you have been waiting. Your representative’s fee will be 25% of this back-award or $6,000, whichever amount is less. Most representatives will front the costs of your claim (primarily the cost of obtaining copies of your medical records), and will ask you to reimburse those out-of-pocket costs when you receive your back-award. You usually do not have to come up with any money before or during representation – everything is settled at the end when you get your back-award of benefits. If you do not receive a back-award, no fee is owed, but you may still be responsible for reimbursing costs.

So when is the best time to call a Social Security Disability Representative?

The earlier the better. If you have not yet filed a claim and are contemplating the idea, you may want to call a disability lawyer to determine if you may be eligible, and what to expect from the process. Most representatives are more than happy to provide information over the telephone, without charge.

Depending on your particular circumstances, a representative can help file the initial application, or direct you to the SSA office where the application can be filed. In our office we help clients file applications, unless there is an issue that needs to be handled directly by the SSA office. That in-person appointment usually takes 1-2 hours.

Many people who apply for social security disability wait until after their claim has been denied to hire an attorney. About 1/3 of the claims are approved by SSA at the Initial level, without the assistance of a representative. In those cases, not having a representative will save you the cost of a fee.

If you have applied for disability and your claim has been denied, do not despair. Keep in mind that 2/3 of the claims are denied by SSA at the initial level of review. At this point, legal representation is recommended. Not only does legal counsel help with the success of your case it can keep things moving in the right direction to get you the disability benefits you need and deserve. In cases involving a terminal illness or extreme financial issues such as foreclosure, a lawyer can request an “on the record” decision, which is an approval based entirely on the medical record, without the need for a disability hearing.

For more information on social security disability claims please contact the team at Maddox and Laffoon. We are here to listen and help.

3 Reasons to Go Local When it Comes to a Disability Lawyer

There’s a lot more that goes into preparing your Social Security case than you probably realize. Beyond the monetary amount you’re applying for, you’re trying to get back your quality of life. You have enough hurdles to go through with your disability and the last thing you need is to go through the headache of having to hold a job you’re not physically and/or mentally able to do.

As you start your application for Social Security disability insurance (SSDI), you realize that there’s a lot more that goes into it than answering some questions. You must submit medical evidence, doctor’s notes, and more.3 Reasons to Go Local When it Comes to a Disability Lawyer

Having a lawyer who knows the law and your condition is a must during this process. The outcome is important to you, so you must hire the right lawyer for your case.

THREE REASONS TO GO LOCAL:

A local lawyer can meet with you face-to-face. If your application ends up going before a judge, you might have to appear in court. You don’t want to meet your lawyer for the first time on the day you have your case heard. With a local lawyer, you can meet numerous times before you go to court, giving you more confidence and peace of mind during this hard time.

A local lawyer can meet with your doctor and other expert witnesses. In part, your application requires you to prove that your disability prevents you from working. This includes sedentary work as well as manual labor. To prove this, you need statements from your doctor and others in your community. A local lawyer knows and often has relationship with the people within your community and can work with each person to prepare a strong application or appeal.

A local lawyer is more easily “at the ready” and available. When you work with a lawyer who is active in your community, you know that you can always easily contact them if you ever need anything. The process of filing a claim and getting benefits can certainly be daunting. So, it’s invaluable to have a professional you can reach out to for a second opinion at any given time.

Your application is too important to leave to just anyone. Get the quality of life you deserve by working with a local attorney who understands your community and your specific needs.