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

 

How to Prepare for the Social Security Disability Mental Exam

How to Prepare for the Social Security Disability Mental Exam

Preparing for a mental consultative examination (CE) for the Social Security Administration is really just about learning what to expect.

What tests will be done at the examination?How to Prepare for the Social Security Disability Mental Exam

The type of tests done during the CE vary and depend on each case as each case is unique. A reviewer from the Disability Determination Services is the one to request whatever tests they need to be able to obtain a more complete picture of your disability and make a decision regarding your benefits.

What should I bring with me to the appointment?

For mental examinations, most of your appointment will be spent discussing your past and current situation. There are, however, some things you should bring with you:

– your Social Security claim number

– an ID (such as a license or passport)

What questions will they ask me at the examination?

The whole purpose of the examination is to fill in any gaps that your medical records may have. To do this the physician will want to know the following:

– Your medical history. They will want you to tell them your impairments and how they affect your everyday life.

– Your social history. They will want to know about your relationships with family, friends and the public as well as your ability to interact with those in the community. They will also want to know what kinds of social activities you take part in.

– Your educational background, including any difficulties you faced in school.

– Your work background, including attempts to return to work and the results of those attempts.

Although, this is all clearly information that you already know, you will want to think about these aspects before your CE so that you are sure to remember everything and communicate it properly.

Additionally, remember all this information is so that your reviewer is able to gain more complete and ac curate information about you in order to make a decision regarding your benefits. Therefore, it is vital to be accurate and honest with your answers.

What should I write down before the mental exam?

You should write down anything you think you might forget. Remember, the physician needs your most accurate and complete past and present medical and social history. Consider writing down:

– current medications you’re taking

– previous hospitalizations

– treatments you’ve received and the results of them

– previous diagnoses

– any supported living facilities you’ve lived in and when

– criminal history

SEE ALSO:

Is Your Doctor Supportive of Your Disability Case?

If I Move to a Different State Will I Lose My Disability Benefits?

Local Disability Attorneys Versus National Ones

 

 

Disability is No Respecter of Age

Disability is No Respecter of Age

A disability can be crippling…and not just to an individual's body but also to their ability to earn a living. Disability can also harm a family's overall financial plan. It can harm it even more so than the death of the "bread winner" in the family. This is so because the disabled individual still has expenses to pay including medical and that of ongoing care.Disability is No Respecter of Age

The answer to such a family tragedy is a thing called disability insurance. However, many family's financial plans don't include this because they simply don't see themselves ever needing it. This is not wise. Disability insurance should be seen as an essential part of the family unit's financial plan.

Did you know that according to the U.S. Census Bureau in 2010, approximately 19% of the U.S population was living with a disability? Additionally, about 40% of those were individuals of the working force age of between 18 and 64 years old. The Social Security Administration projects that one in four of today's 20-somethings will become disabled before they hit their mid 60s.

As you can see, just as important as saving for retirement or college or having an emergency fund, is also having disability insurance. None of us knows what tomorrow has in store. Therefore, obtaining disability insurance is a basic wise and caring action to do for ourselves and loved ones.

There are three types of disability insurance. They are: employer sponsored plans, private individual insurance and government sponsored plans like Social Security Disability.

Most people assume Social Security will automatically take care of them should they become disabled. This is a common misconception. The reality is it can be very hard to get approved for Social Security disability benefits. In fact, in 2010, about 65% of initial Social Security Disability Insurance claims were denied.

A second misconception the majority of people have is that disability occurs due to accidents. In actuality, most disability occurs due to illness.

The fact is disability can happen to ANYONE at ANYTIME and for reasons you might be surprised by. Do the right thing and educate yourself and prepare yourself as well as your family. 

How do I Prove my Disability with the Social Security Administration?

How do I Prove my Disability with the Social Security Administration?

How to prove disability is a common question for social security and disability attorneys. There are five points that a client can follow to do their very best to prove their disability and medical condition to the Social Security Administration.How do I Prove my Disability with the Social Security Administration?

1) If you want to prove your disability, it is important to have thorough and accurate medical records depicting your journey through treatment and care.  These include records of doctor and hospital visits as well as medications. Many people take this step for granted. However, please make sure you're getting in to see your medical provider for your impairments and symptoms. Disability is determined on the basis of medical records that track your treatment and severity of your symptoms. Disability can also be determined on how often you go to the doctor and what kind of medications you take. Lastly, if you need a specialist, make sure you're seeing one. That too, can make a big difference.

Some people cannot afford medical records. If this is you, look for State programs you can apply for or clinics that will treat you on a sliding scale. Additionally, many drug companies offer free medication these days. Talk to your doctor about taking advantage of those offers.

2) Take charge of your own medical records. Do not assume that Social Security or your doctor are  going to gather all your records for you. Obtain all office visits, xrays, and MRIs for the time you're claiming disability yourself and make sure Social Security gets them.

3)Obtain a statement, declaration, or as a last resort, DETAILED letter from your provider. You want a declaration detailing the severity of your impairment, your symptoms, why you can't work specific tasks and what those tasks are as well as medications you're taking and how they affect you. This will go a long way with Social Security!

4) Get a statement from people who know you and make sure to fill out all forms COMPLETELY. In addition to the declaration from your doctor, it's a good idea to get a statement from someone else who knows you, whether the person is a co worker, friend, or family member. Make sure the statement includes: how they know you, how often they see you, what they do when they're with you, and limitations they've observed about you when they're with you. This statement will be a nice addition to the many forms you'll be given to fill out. Social Security  needs full and complete information to judge your case.

5)Finally, if you go to a hearing, realize you've been denied. In most states in the country, including Washington, it means you've been denied TWICE. If you go to a hearing and you lose, it is near impossible to win a case after that. Therefore, HIRE A LAWYER. A lawyer will give you good advice and preparation and frankly, at this point, you don't want to risk anything. Also, bring a witness to testify before you about your limitations.

Following these five steps are the best things you can do to prove your disability to the Social Security Administration.