Articles Posted in SSDI

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On November 7, 2017, the State of Maine citizenry went to the ballot box and passed the Question 2 ballot initiative calling for expansion of Medicaid.   The ballot initiative called for the state “to provide Medicaid through Mainecare for persons under the age of 65 and with incomes equal to or below 138 percent of the federal poverty line.”

Since that time, the present governor, Paul LePage, has refused to order the Department of Health and Human Services (DHHS) to implement Question 2.    Governor LePage, who had vetoed on 5 previous occasions the expansion of Medicaid coverage (which expansion cost would initially be covered by Federal funds to the tune of 90% of the cost), has refused to allow this citizen passed bill to go into effect, thereby thwarting the will of the people.   What elected officials had previously passed on 5 occasions, was now passed by a significant majority (60%) of the citizenry so as to allow individuals making up to approximately $16,000.00 and families of four with an income of up to $34,000.00 obtain health insurance (thereby allowing  anywhere from 70-80,000 indigent Mainers health insurance the can’t otherwise afford to obtain).    Continue reading

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Our office quite commonly represents individuals suffering from headache issues that have become severe, persistent and disabling such that they remain unable to work.   Pursuing such a Social Security disability claim can prove to be a very difficult proposition.

Every claim requires that an individual begin by showing that they are suffering from a medically determinable severe impairment.  The Social Security regulations (and, specifically, 20 C.F.R. §404.1521) requires as follows: “[y]our impairment(s) must result from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques. Therefore, a physical or mental impairment must be established by objective medical evidence from an acceptable medical source.”  This can be easier said than done when it comes to headaches.

There are a panoply of medical conditions that can result in headaches.  However, the more difficult circumstance is where the diagnosis itself is simply that of simply experiencing chronic headaches.

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The Social Security rules and regulations provide a disability claimant with a number of opportunities to appeal should one be denied.   Following an initial denial, a Maine or Massachusetts Social Security disability claimant would appeal the decision by way of filing a Request for Reconsideration  and then, upon further denial, by way of a Request for Hearing before an Administrative Law Judge (ALJ).  A New Hampshire disability claimant, however, gets to bypass the reconsideration process and proceed straight to an ALJ hearing.

Once denied at hearing, claimants may then bring further administrative appeal before the agency (that is, the Social Security Administration (SSA)) by way of a Request for Review of Hearing Decision/Order before the Appeals Council. A denial by the Appeals Council, however, exhausts one’s administrative options.

At the point in time of an Appeals Council denial, a Social Security disability applicant has exhausted their administrative options.  It is important note that the failure to pursue further appeal of the ALJ denial at hearing will result in that decision becoming final under the doctrine of Res Judicata (which means the “matter having been decided”).  Should this take place, it becomes  very difficult, if not impossible, to bring a new claim that would succeed in providing you with benefits prior to date of the ALJ denial.   There are few exceptions to this rule of finality.

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We frequently represent individuals in Social Security disability claims who are suffering from the effects of Post Traumatic Stress Disorder (PTSD), in circumstances that many times involve military Veterans who have served our country.  This may result from involvement in armed conflict or as a result of military sexual assault.  Just as likely is the circumstance where an individual is suffering from PTSD as a result of trauma that they may have experienced from physical or emotional abuse during childhood, in a domestic violence situation or as a result of a crime of violence.

The effects of PTSD can be significant and crippling in terms of one’s ability to function from day to day at home (nonetheless in a work setting).   And yet, understanding the type of treatment and proof required to satisfy the requirements of the Social Security regulations may not be so obvious.

Just as with every manner of Social Security disability claim, it’s important to show that one is suffering from a severe medically determinable impairment which, despite prescribed treatment, has caused one to remain disabled from any manner of gainful employment for what has been, or will be, a year or longer. Continue reading

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There are a number of important considerations to keep in mind when suffering from a seizure disorder as you consider applying for Social Security disability benefits whether you’re in Maine, Massachusetts or New Hampshire.  Understanding how the Social Security Administration (SSA) analyzes such claims can help avoid unexpected surprises down the road.

As with any disability claim before SSA, it is important to understand that one needs to prove that they are suffering from a medically determinable impairment (MDI) that remains severe and disabling, despite prescribed treatment,  for what will be a year or longer.  There are two different ways to qualify for benefits: one is to prove that you meet one of Social Security’s medical listings of impairments  (at step 3 of the sequential evaluation process).

Social Security listing 11.02 addresses epilepsy (seizures) and requires documentation of what are referred to as dyscognitive seizures or generalized tonic-clonic seizures.  Dyscognitive seizures were formerly referred to as “partial complex seizures” for what are deemed to be focal seizures with altered awareness.   These are seizures that involve altered awareness or responsiveness (such as what is also called a petit mal seizure).  The other type of seizure referenced within the listing, generalized tonic-clonic seizures, refers to the type of seizure that involves loss of consciousness and violent muscle contractions.

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Before considering an application for Social Security disability benefits, or for that matter, an appeal of your denial, it is always a good idea to have the advice, and potentially assistance, of a Social Security disability lawyer.  Without even having to call our office, ask yourself these very important questions before you make that next call.

First and foremost, ask yourself what makes you believe that your illness or injury will keep you from working any job, making simply $1180.00 per month (that is to say, undertake gainful employment) on a regular and continuing basis for what will be a year or longer.   If you are unable to clearly answer that question of duration, any application you might bring yourself or with the aid of a lawyer will be lacking conviction in its truth.

Instead, consider whether an attempt at returning to work may be possible and consider waiting to see what course your health might take: the Social Security rules do provide incentives for attempts at returning to work and should you find yourself back out of work shortly thereafter as a result of your medical condition, you will not find that this attempt at work works against you. Continue reading

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The Social Security process is a complex and cumbersome process to say the least.   Without the guidance of a capable Social Security lawyer, it can become overwhelming trying to understand why things are happening the way they are, especially at your hearing.  Why the Administrative Law Judge (ALJ) is turning to a vocational expert in the first place can be confusing.  Even more upsetting to a claimant can be when you hear that vocational expert testify that you can be returning to a job such as a surveillance system monitor (with most wondering what that job even is).

For the ALJ to call a Vocational Expert (VE) to testify is a quite common practice  These individuals are considered experts in the field of vocational placement of workers, with knowledge of the employment landscape both regionally (where the claimant resides) and in the national economy.

The purpose of having a VE at your hearing is to provide the presiding ALJ with an assessment of the types of past work you have performed (within the 15 year period prior to becoming disabled, called your past relevant work), your educational background and the extent to which you have acquired skills that might transfer to occupations other than what you may have performed in the past.   They are then called to testify as to the availability of jobs either regionally or in the national economy that might be available for someone such as you (that is, based on your particular vocational background). Continue reading

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There is nothing more stressful than waiting for your Social Security disability hearing.  Assuming claim is out of Maine or Massachusetts, you have likely been waiting for the better part of 2 years to get in front of an Administrative Law Judge (ALJ) having been denied twice at the initial and reconsideration levels.  Assuming your case is out of New Hampshire, you are only slightly more fortunate as you bypass a reconsideration process which carries with it a very high denial rate: and so you’ve also been waiting for what has likely been a year and a half following your initial denial.

One of the most common questions we hear leading up to our clients’ hearings is what can I do to to prepare?  The first thing we will tell you that is that being nervous is normal and healthy.  We would worry more if our clients weren’t worried.  Obviously, you’ve been sitting at home, unable to go to work and your family’s  financial resources having dwindled.

For many of our clients, their significant other/spouse is gone working during the day (many times working 2 jobs) just to make ends meet.  The only thing you have to do while at home is sit and think what the future holds.  Given this, it’s important to understand that there are things you can do to feel more confident going into the hearing.    Continue reading

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According to a release from the CDC (Centers for Disease Control), more than 100 million U.S. Citizens are suffering from either diabetes or prediabetes.   It is quite common in our practice to represent individuals who are either disabled from working either partly or wholly because of this condition.  For those considering an application for Social Security disability benefits, it’s important to keep a number of items in mind when proceeding with a claim that involves Diabetes Mellitus (DM).

There are two major categories of Diabetes Mellitus (DM): Type I, which is known as insulin dependent diabetes,results from a lack of insulin production in the pancreas as a result of what has been an autoimmune destruction of insulin producing cells.  In turn, the lack of insulin production results in increased blood glucose levels.  Symptoms associated with high glucose levels can include increased thirst, appetite, urination, unexplained weight loss, fatigue or drowsiness, trouble concentrating, headaches as well as blurred vision.   Type I diabetes, has also been known as juvenile-onset diabetes, as it presents most often with children (although it can rear its head at any age).

Type II DM, which has also been referred to as adult-onset diabetes (or non-insulin dependent) diabetes results from a lack of production of insulin by the pancreas, or one remains resistant to the transfer of insulin to one’s body cells (otherwise known as insulin resistant diabetes).  Symptoms can be similar to those present with Type I.  Type II DM is most common with those who are either obese or who have a family history of DM.  The condition can many times be treated through diet and exercise at earlier stages of the illness.  However, where diet and exercise are no longer proving fruitful, oral medication or daily insulin may need to be introduced. Continue reading

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We are many times called by individuals who have been denied their Social Security disability claim (whether it be on their initial claim, reconsideration or at hearing) despite what they inform us is their doctor’s supportive letter.   It is not uncommon to see a disability claimant simply asking their doctor for a letter describing their disability, or a note that says they remain unable to work, and then they are surprised to find that they have been denied nonetheless.

The Social Security Regulations spell out a 5 step evaluation process that is rather complex, and in order to obtain useful information from a medical provider, it’s important to know what needs to be proven in order to qualify for benefits.  First and foremost, one needs to prove that they are suffering from a medically determinable severe impairment in accordance with Step 2 of the sequential evaluation process.  If one has not established through objective medical examination and/or testing that a medically diagnosed condition exists, any opinions from one’s treating doctors that one may be somehow limited in their ability to work cannot even be considered.

Once a medically determinable impairment has been established, it’s important to understand that the Social Security Administration (SSA) has a set of regulations that governs what evidence can be considered (and in what way).   For Social Security disability claims that have been filed on or after March 27, 2017, the Social Security rules have been amended so as to make clear the Agency’s position that no source opinion (whether it is from one’s own medical doctor or from a consultative examiner SSA sends one to, is automatically entitled to a greater weight of consideration).  For claims that have been filed prior to March 27, 2017, a treating source’s opinion is entitled to great weight and deference if in fact it “is well-supported by medically acceptable clinical and laboratory diagnostic techniques” and it is not inconsistent with substantial evidence in the record.  Continue reading