Social Security Disability Insurance FAQ
The SSDI application process can be confusing, and leave you with more questions than answers. Loyd has put together some of the answers that you need about SSDI claims, appeals, and more, right here in the FAQ section.
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What Will Happen to my Social Security if the Government Shuts Down?
Many New Orleans-area Social Security Disability claimants and recipients are wondering how a government shutdown affects them and their benefit checks, application, and/or hearing.
The government briefly shut down fully twice in under a month in early 2018. On December 22, 2018, the government entered a partial government shutdown after President Trump would not sign the temporary spending bill passed by Congress. This shutdown was only a partial shutdown due to the fact that some departments had already been funded through September 2019. The Department of Health and Human Services which includes Social Security was included in this previous spending bill and therefore was not affected by this partial shutdown.
For 2020, a continuing resolution funded the government from October 1 through December 11. Since then, 4 more temporary extensions have passed. The last short-term resolution passed as Congress came to an agreement on a spending bill to give them time to finalize the details and send the bill to the president for his signature. The bill was flown to the president on Christmas Eve, but he has indicated that he will not sign it unless major changes are made.
Without his signature, the government will enter a partial shutdown on Tuesday, December 29, 2020.
Government shutdowns are often averted at the last minute. Hopefully, that will be the case again this time as well.
Every time a government shutdown is in the news, I get calls asking "Is Social Security affected by a government shutdown?"
Are Social Security Checks Affected by a Shutdown?
The first thing most people want to know is "Will I Still Receive my Social Security Disability Benefits in a Government Shutdown?"
When the federal government shut down in 1995 and again in 2013, all Social Security payments continued to be sent out on time. This included Social Security Disability.
During the 1995 shutdown, which lasted about a month, the Social Security Administration mailed checks throughout the shutdown.
Social Security was able to continue mailing benefits due to the fact that doesn’t need Congress to authorize funds for it each year.
Instead, Social Security benefits are considered mandatory spending and are paid from the program’s trust fund, and therefore, the agency has the funds to continue paying benefits.
In 1995, Social Security maintained enough employees to continue mailing checks without delay.
Since payments are now direct deposited and/or loaded onto debit cards, Social Security continued processing payments during the 2013 shut down with fewer employees than were needed to mail benefit checks during the 1995 shutdowns.
Are Social Security Offices Open During a Shutdown?
Currently, most local Social Security offices are already closed to in-person visits due to COVID-19 precautions.
The Social Security Administration is asking the public to first try to use their online services before calling them.
During a government shutdown, many SSA employees will be furloughed and staffing will be limited. Using online services before calling is still the best course of action.
If you cannot use these online services, you can find the phone number for your local office by using the Field Office Locator.
What Happens to my Scheduled Social Security Disability Hearing in a Government Shutdown?
Most likely, hearing offices will continue to hold Social Security Disability and SSI hearings if a shutdown occurs.
During the 2013 government shutdown, the Office of Disability Adjudication and Review (ODAR) still held previously scheduled hearings, but staffing was limited to Administrative Law Judges (ALJs), medical experts, vocational experts, and security personnel.
New hearings were not scheduled.
Lack of support personnel caused delays in exhibiting files and decisions were not written during the shutdown.
So, if a claimant was waiting for an already scheduled hearing, it in most cases proceeded and was decided.
But, the writing of the decision did not take place, so if benefits were granted, there was a further delay before benefits were paid since the decision was not actually formally written until the shutdown ended.
What Happens to my Social Security Disability Application in a Government Shutdown?
During the Clinton-era shutdown, new Social Security claims were not being processed because the agency furloughed 61,415 employees. As the shutdown wore on, the agency adjusted its plan and recalled workers to start processing new claims. Whether new claims are processed at all or with a delay due to fewer workers will depend on how many employees the SSA decides to maintain and how many they decide to furlough.
The SSA’s 2013 government shutdown contingency plan stated that new and pending Social Security applications would continue to be processed as well as requests for appeals.
However, because these functions are carried out by the state Disability Determination Offices, each state will decide whether to continue these operations or stop them.
The most likely scenario is that applications will be processed but with some delay.
The delay will be dependent on how many employees are retained and how long the shutdown lasts.
Whenever a threat of a shutdown looms, I monitor the situation checking Social Security's contingency plan often.
If the government shuts down again, I will be in touch with all of my current clients to advise them on how this situation will affect them depending upon the current status of their claim.
Should a Witness Testify at my Social Security Disability Hearing?
As a Metairie disability attorney, I am often asked this question by my clients.
My usual response is probably not, but this is a case by case determination.
As a disability attorney, it is my job to help prepare you for your hearing and the questions that will be asked.
You are usually the best person to relay how your medical impairments impact your daily life and talk about the limitations that you deal with as a result of your impairments.
However, in some cases, if either the medical records are not sufficient or if you are unable to adequately explain how you are affected, a witness can be important.
Can I Bring A Witness to my Social Security Disability Appeal Hearing?
A sincere, straightforward person talking about how you are affected by your condition can result in a favorable decision.
Witnesses can be a husband/wife, son, daughter, neighbor, friend, co-worker, supervisor, or anyone else that can provide information on the extent of your limitations.
When deciding whether or not you should use a witness at your hearing, you need to choose only one or two of the best people to help you present your story.
As an attorney, I would never call a witness who I had not at least spoken with in advance of the testimony to see what their impressions are.
Your witness can provide testimony that supports your medical evidence and may add to your testimony.
I often find if I ask a spouse to share how their husband or wife is impacted by the disability, the spouse often relays much more difficulty than the claimant, having a different impression of the impact.
Will a Witness Help my SSDI Hearing?
You need to know before calling a witness whether the witness’s testimony will help your case.
If possible, the best witness is someone who an Administrative Law Judge (ALJ) can view as more objective about your claim as opposed to someone close to you, who is likely to be viewed as less than objective and more willing to help you.
Good objective witnesses are more likely co-workers, supervisors, neighbors, social workers, etc. as opposed to family members and close friends.
Regardless of the witness chosen, the witness should provide observational testimony and not conclusory testimony.
What does that mean? An example of observational testimony is, “I have seen Mary return from the store and need to get her son to unload the groceries.”
Another example is, “While at work over the past few months, I have noticed John needed to get up from his work station and go lay on the floor for about 20 minutes each morning and each afternoon.”
Conclusory testimony is more like, “I know Mary is disabled because I see her come from the store and need help getting inside the house.”
The conclusion is that Mary is disabled. Statements like that can hurt a witness’s credibility.
If you think a witness may be necessary to help prove your claim during the appeals process, you may need an attorney as well.
A Louisiana disability attorney can help you prepare your case and your witness to give you the best chance of success in obtaining Social Security Disability benefits.
Our law firm is dedicated to helping people like you.
How Much Does a Disability Attorney Cost in Louisiana?
As a Metairie area disability attorney, one of the first questions I am usually asked is "How much will this cost me?"
Many people know that a Social Security representative will improve their chances of getting disability benefits.
But, they are understandably worried that they can't afford an attorney or advocate to help them fight for their benefits.
There are many falsehoods and misconceptions out there about how much a disability advocate charges.
What is the Most an Attorney can Charge for Disability?
Here's the great news, an SSDI lawyer will not cost anything upfront.
Federal disability law fees are set by law and cannot exceed 25% of your back benefits.
In many cases, the maximum is $6,000 (if we win at the first hearing). That’s because I generally use the fee agreement process.
AND that amount is ONLY due if I am successful in representing you.
If your claim is denied, you owe no attorney fees.
Fees are only due when/if we win your case.
For example, let’s assume that we are successful in getting your disability benefits.
Your onset date is set 17 months prior to today’s date (that means that SSA will owe you back benefits).
Due to SSA laws, you can be paid 12 months of back benefits in this scenario (because SSA does not pay for the first 5 months).
If your benefit amount is $850 per month, your back benefits would equal $10,200 ($850 X 12).
The attorney’s fee on this amount would be $2,550 ($10,200 X 25%).
If this number were above $6000, then only $6000 would be paid to your attorney.
Will a Disability Attorney Take a Percentage of my Future Benefits?
Here is another important aspect of a disability representative’s fee: you do not owe a fee based on future benefits.
That is, you will not have to keep paying your disability attorney 25% of your monthly disability check.
Once the disability lawyer is paid from the back benefits, that is all you owe with respect to fees.
In some cases, disability attorneys charge costs (which are different from fees) whether your disability claim is successful or not.
What About Costs?
Costs include things such as expenses incurred for medical records, long-distance phone calls, mail, parking at your hearing, and other costs paid to develop your disability case.
As a Social Security disability lawyer in Louisiana, I generally handle the cost issue on a case-by-case basis.
You should ask your disability lawyer (or disability representative) how they charge costs.
One thing to keep in mind if you use a disability representative from a national firm that must travel to your area is whether or not those travel costs will be charged to you.
This could include airfare, rental car, hotel stay, and meals. These costs can get expensive and really decrease the amount you end up with at the end of the day.
While the maximum amount of fees is limited by the law, costs are not limited in the same manner.
Thus, you need to watch costs and be mindful of them when you hire a disability lawyer. In Houma and other places, these costs for national lawyers and advocates can get excessive.
There is a possibility that a disability attorney may get more than the $6,000 if your case involves extensive work (usually because of multiple appeals to and from SSA and federal court).
However, even in that case, the fee charged to you cannot exceed 25% of your back benefits.
In this case, the fee petition process would have to be used. Your attorney would have to file a fee petition and have it approved by the Social Security Administration.
This is a helpful and informative guide that will guide you through some of the common mistakes and errors that lead to unfavorable Social Security Disability decisions.
Don't make a costly mistake that could cause you to lose the benefits that you need to survive! I'd love to send you a copy.
Just click here to receive your free copy of my book 9 Mistakes That Can Disable Your Social Security Disability Claim.
How Long Should I Wait To Apply For SSDI Benefits?
The surprising answer is – YOU DON’T NEED TO WAIT!!
When Can I Apply for SSDI Benefits?
You can file for social security disability benefits on the day that your doctor diagnoses you with a disability, or on the first day that you can no longer work because of your disability.
Many people mistakenly believe that they must be disabled for a certain period of time before they can even apply for social security disability benefits.
You must prove that your disability will last at least 12 months or is expected to result in death.
You do NOT need to wait to apply until after you have already been disabled for 12 months.
This is true for Houma social security disability claimants, Thibodaux SSDI claimants, and even those in Galliano applying for social security disability. In fact, it is true throughout Louisiana and the Nation.
If you have a serious illness, disability, or impairment that will last at least a year (or is likely to result in death – like cancer or Lou Gehrig’s disease), you can apply on the day the illness, disability, or impairment impacts your ability to work.
As my wife often tells our kids, just because you CAN do something, that doesn't mean that you SHOULD.
When Should I Apply for Social Security Benefits?
If you expect to be out of work for a year or longer or you have a terminal condition, you should not delay in filing a claim for Social Security Disability Insurance (SSDI) benefits.
You should file your claim for SSDI benefits as soon as you become disabled.
The longer you wait to file, the longer you will have to wait to receive your disability benefits if you are disabled.
Remember, a large number of disabled individuals, especially in Louisiana, are denied social security disability benefits when they first apply.
Then they have to go through an appeal process, often including a hearing with a judge. Some even have to go to court to have their case approved. The process takes time.
The longer you wait to apply, the longer it takes for the process to get started.
And, if you wait for over a year to apply, you risk losing some of the hard-earned benefits that you are entitled to.
I usually recommend that my Louisiana disability clients apply for social security disability as soon as they can no longer work because of their disabling condition to get the process started.
Is There a Time Limit to Apply for Social Security Disability?
There is no "time limit" to apply for SSDI benefits.
You can apply for benefits at any time after you become disabled.
However, as soon as you, in consultation with your doctor(s), determine that you are unable to work and that you will not be able to work for at least 12 months due to your medical condition, you should file for benefits.
Any delay may result in you losing benefits that you are legally entitled to by waiting longer than necessary to apply.
If you are eligible to receive SSDI (or disability insurance), the Social Security Administration can only pay you retroactive benefits for the 12 months before submitting your application for benefits regardless of your disability onset date.
Therefore, if you wait for more than a year from the date you stop working to apply for benefits, you risk losing more benefits with each month that passes.
For example, one prior client became disabled in 2012 but did not file for disability benefits until 2019. While we were successful in proving he was disabled in 2012 when he stopped working, SSA could only pay him benefits from 2018 forward. He lost benefits he was entitled to from 2012 through 2018. This cost him thousands of dollars in benefits.
Now, this does not mean, that if you have a minor illness or injury that will heal within one year, you need to rush out and apply. Don’t do it. Your claim will be denied, I cannot help you, and you will be taking up valuable resources needed by those truly disabled.
Should I File a Disability Claim?
The information provided here is not advocating that you file a Social Security claim if you are truly capable of working full time.
If you believe that you can do some sort of work on a full-time basis, your medical records are going to reflect that and you will ultimately be found not disabled, no matter how many appeals you file.
The Social Security disability application and appeals process is extremely lengthy and stressful.
Why face financial ruin waiting on Social Security to process an appeal if you can still work?
Even if you eventually win, the amount of disability benefits you receive will likely not replace all of the income you could make by working.
I realize that one of the hardest things for a formerly strong and independent working person to admit is that you need help.
But realize that you are not alone and you have nothing to be ashamed of.
If you are unable to work due to your disability, disability benefits are available to you under the law, and you have earned the right to pursue them and attain them.
You have worked your entire life to pay for these benefits in case you ever needed to use them.
Will I Qualify for SSDI Benefits?
Wondering if you qualify for Social Security Disability?
With our years of experience, we can tell you through this quick, free, and easy SSDI claim evaluator whether or not we believe you have a case and if we can help you!
Do You Qualify? Take the quiz now!
How do I fill out the Adult Function Report for Social Security Disability?
Complete the Function Report questionnaire right away and provide truthful and specific answers!
You only have a limited time to comply (10 days from the date of the letter) with Social Security’s request so don’t delay. But, don’t rush through your answers either.
Your Adult Function Report, also known as SSA 3373, stays on the record through your entire case and cannot be modified.
The Adult Function Report is often used by Social Security to discredit your claim.
The ten-page form asks about your daily activities, personal care, meal prep, household and yard work, hobbies, and social activities.
If you answer any of the questions incorrectly, incompletely, or inconsistently, we can never update your answer.
What Is a Disability Function Report?
If you are filling out an Adult Function Report, Social Security is trying to get an understanding of the activities that you are still able to do (your Residual Functional Capacity).
When you are filling out your Adult Function Report, we recommend you watch our video about Residual Functionality first. In 5 short minutes, Loyd explains the purpose and importance of Residual Functional Capacity.
When filling out forms, always keep your Residual Functional Capacity in mind.
What Do I Say on a Disability Form (SSA-3373-BK)?
Be honest but don’t exaggerate. Be specific about your limitations.
If you do not clearly describe your limitations or give vague answers on your Adult Function Report, Social Security will take that to mean your disability really isn’t that bad and you should have no problem returning to work.
Your Social Security Disability claim will likely be denied.
It's a good idea to consult with an attorney or at least read these tips before you complete the form.
5 Biggest Mistakes on Adult Function Reports
1. Not reading the entire question.
Take your time when filling out your Adult Function Report and make sure your answers match up to the question being asked.
One recommendation our firm makes to clients is to answer the questions separately on another piece of paper first before transferring your response to the form.
This will allow you to work on your answers without messing up the form.
2. Not being clear about how long it takes you to do things.
If you tell Social Security that household chores -- like doing dishes for example -- take you an hour, then Social Security is going to think that you can get things done with no problem.
Be clear when answering questions like this.
Do you have to sit down when you do the dishes? Do you have to take breaks or lie down? Is that hour broken up into several days because you are unable to do them all at once?
3. Not being clear about what you do all day.
Telling Social Security that you “get up, get dressed, eat breakfast, go outside to read, eat lunch, etc…” lets them think you have normal days like everyone else.
Be specific about what you do all day.
Did it take you a long time to get out of bed because your back hurt so bad?
Did you need help putting on your shoes?
How long did it take you to make breakfast? Or did you have help?
Were you so exhausted after making breakfast that you needed a nap? Is that why you had to sit down and read?
4. Not listing the side effects of your medications.
Side effects of medications can cause unexpected limitations. If you tell Social Security you are able to sit for an hour or so, they may think you can perform office work.
You need to speak up about the side effects of your medications and how they affect your ability.
Does your medication make you feel drowsy? Do you need to take naps during the day?
Does your medication have you going to the bathroom more often than normal (frequent urination or diarrhea)? If so, you won’t be getting much work done in an office.
5. Not answering questions consistently.
Consistency is key. It is so important that you answer questions consistently throughout the form.
Being consistent with your answers will help prove your credibility.
Do not answer some questions as if it's a "good day," and some as if it is a "bad day."
If your answers do not match what you have told your doctors or Social Security representatives, it will harm your credibility.
Providing answers like “I sit outside for 3 hours a day” and then saying, “I can’t sit down for long periods of time” doesn't give Social Security a clear understanding of your disability and limitations.
Do not copy SSA-3373-bk sample answers that you find on the internet. Make sure that all answers properly describe you and your limitations.
When filling out your Adult Function Report, make sure your answers fit into the space provided and are short and to the point.
And remember, everything you say on your Adult Function Report is final.
Once your report is submitted to Social Security, no changes can be made.
Need Help Filling Out Your Adult Function Report?
If you are thinking of applying for Social Security disability benefits or have received a denial, you may want to consider hiring an experienced Social Security Disability attorney.
Our firm will take away the burden and anxiety of completing and turning in your Adult Function Report and other forms.
We will walk you through filling out the Adult Function Report (SSA-3373-bk) and all other Social Security forms.
All forms are submitted to our office and are gone over with you to make sure there is a clear understanding of your disability and limitations before we submit them to Social Security.
You will never have to submit any forms or medical records or deal with Social Security by yourself. That’s what you pay us for!
If you are applying for disability and have questions about the function report, it never hurts to talk to or retain an experienced Social Security attorney who can help you properly prepare your case. If you need help with your Function Report call the Offices of Loyd J. Bourgeois at 985-240-9773.
Do I Need An SSDI Representative? Your Chances Improve by 300% If You Have One
I am sure you have heard that you do not need a Louisiana Social Security Disability Lawyer to win your disability case. Well, you heard right.
An often asked question is "do I really need a representative for my Social Security Disability case?" After all, many people claim to have received benefits on their own - you can probably do it as well - right?
Except of course, if you are one of the over 62% (based on the 2009 Social Security Statistical Report) of people who have their social security disability claim denied initially.
Can you win disability without a lawyer?
Yes, but it won't be easy. There's going to be a lot of red tape.
Most of our social welfare policies are designed in such a way where they’re a lot more concerned about preventing people who aren’t eligible from accessing benefits than ensuring that those who are eligible actually receive them. We’re fixated on fraud and abuse, which is extremely low in social welfare programs — something like 1 to 2 percent of cases. And even then, it’s not what people mean when they think of “fraud and abuse.” It’s mostly people making mistakes because they didn’t understand eligibility rules.
The problem with this unjustified obsession with fraud and abuse is that it means 20 to 30 percent of people are unable to access these programs even when they’re clearly eligible for them, because they’ve created all these administrative burdens designed to target people they don’t want on the programs. So it’s a huge disconnect in terms of trying to meet the broader goals of these programs. -Pamela Herd, author of Administrative Burden: Policymaking by Other Means
The statistics show that once your Louisiana Social Security Disability claim reaches the hearing level (or above), you have a significant increase in the odds of being found disabled.
Why is this? While I do not know for sure, I suspect it is because this is the stage that Social Security attorneys get involved and help their clients get benefits.
In 2008, at the hearing level or above, greater than 80% of claimants were awarded social security disability benefits.
So while you may not need a Social Security Disability Lawyer, you may want to get one to help you navigate through the system and improve your chances of obtaining benefits.
Should I hire a lawyer before applying for disability?
A recent study by the Government Accounting Office found typical adults who had representation, by attorneys or others, had a three times better chance of receiving benefits than those who applied on their own! This means your chances improve by 300% if you have a skilled, disability representative on your side presenting your case.
Here are some other interesting tidbits from the study:
Age is an important factor! Those 55 and older were allowed 4.3 times higher than those 35 yrs old.
Type of Impairment is important! Those with heart failure or MS were allowed 4-5 times more often than those with asthma.
Type of claim important! SSDI claims were allowed 1.7 times more often than SSI claims.
The entire report is interesting but the main takeaway is this: I’m no mathematician but I’ll take a 300% better chance any day of the week. What about you?
If you're preparing to apply for Social Security disability or appeal a claim denial, I've written a book 9 Mistakes that Can Disable Your Social Security Disability Claim. This is a helpful and informative guide that will guide you through some of the common mistakes and errors that lead to unfavorable Social Security Disability decisions.
Don't make a costly mistake that could cause you to lose the benefits that you need to survive! I'd love to send you a copy. Just click here to receive your free copy of my book 9 Mistakes That Can Disable Your Social Security Disability Claim.
What should I do when my disability claim has been denied?
Have you applied for Social Security Disability but your claim has been DENIED? If so, you’re in the right place.
You are frustrated because you have submitted your medical records and answered all the questions SSA asked – but you have still been DENIED.
A denied claim is not the end of the road; you have the right to appeal.
How do you appeal a SSDI denial?
Here’s how the process works:
In Louisiana, upon receiving your denial letter, you have 60-days to file a Request for Hearing before an Administrative Law Judge (SSA Form HA-501).
During the hearing, you will likely testify, you or your representative may call witnesses, and there may be governmental paid-for experts that testify.
The testimonies and evidence in your claim file will be carefully reviewed, and a decision will then be made.
If the ALJ’s decision is still not favorable, you may appeal to the Social Security Appeals Council.
Similar to the ALJ, the Appeals Council will review all evidence in your case and either reach a decision itself or refer your case back to the ALJ. It’s important to point out that although the Appeals Court considers every request for review, it may decide to not to consider your request and thus the ALJ’s decision will stand.
If you still disagree with the decision up to this point, your final step is to submit your case to Federal District Court for review. Here, at this final step in the process, a district court judge will review the evidence in the case and order a determination on whether the SSA‘s decision should be overturned.
Although the disability appeal process may seem long and cumbersome, it’s important to note that you do have the right to appeal your case.
It is also important to note that you cannot skip any step. That is, you cannot take your case straight to federal court if you are not happy with the initial decision. You have to go to the ALJ first, then the Appeals Council, before getting to federal court.
Do you know why your application was denied?
The first step to an appeal is knowing why your claim was denied.
The letter the SSA sent you to tell you that your SSDI claim was denied can provide you some insight. But do you know what the letter means when it says – We have determined that you can perform your past work? What about when the letter says – We have determined that you are not disabled from performing work generally available in the region.
Do you know what you need to do to give yourself the best shot of succeeding in your appeal? Do you know what specific medical records can help establish that your disability meets a listing, and thus qualify you for social security disability? Do you how a medical source statement can be used to dramatically increase your chances of success on appeal?
An SSDI attorney familiar with the specific rules and laws of the social security system can be the difference between you getting disability benefits and not.
Did you receive a denial or termination of benefits letter and are unsure of the next steps? We will review your denial letter with no cost and no obligation and give you a detailed strategy for moving forward.
What is an onset date for SSDI?
Your onset date is defined as the first day you are unable to work because of your disability.
What is an Alleged Onset Date?
The alleged onset date, or AOD, is the date you claim on your Social Security Disability application as you became unable to work because of your medical condition.
The onset date may or may not be the same as the date your medical condition was diagnosed or your injury occurred.
A typical AOD is the date last worked.
However, depending on the circumstances and the medical support, the onset date could be after the date last worked.
Why is the date of onset important?
This onset date determines when you were first eligible to receive Social Security Disability Insurance (SSDI) benefits and how far back your "back pay" will go.
For SSDI, Social Security Administration (SSA) can retroactively pay benefits as far back as 12 months before your application date if you were disabled before that date, again subject to the 5-month non-payment period.
There is usually little to be gained from alleging an onset date of more than 17 months before your application since you are not eligible for social security disability benefits for that time period. Here are some examples:
- You apply on January 1, 2020 stating your onset date was January 1, 2019 and are approved with the AOD. You are entitled to benefits starting June 1, 2019. Why? Although SSA can pay you for one year prior to your application date, your five-month elimination period started on January 1, 2019 and ended on May 31, 2019.
- You apply on January 1, 2020 stating your onset date was January 1, 2018 and are approved with the AOD. You are entitled to benefits starting January 1, 2019. Why? SSA only pays for one year prior to your application date (or January 1, 2019) and your five-month elimination period started on January 1, 2018 and ended on May 31, 2018.
- You apply on January 1, 2020 stating your onset date was January 1, 2020 and are approved with the AOD. You are entitled to benefits starting June 1, 2020. Why? Your five-month elimination period started on January 1, 2020 and ended on May 31, 2020.
The exception to this is if your Date Last Insured (DLI) is more than 17 months before your application date. You must select an alleged onset date that is BEFORE your date last insured to be eligible for disability payments. If you did not become disabled prior to your DLI, you are likely not eligible for SSDI benefits on your own record.
*Note: The information about Onset Date and DLI is for SSDI only. For Supplemental Security Income (SSI) claims, SSA can only pay from the date of application OR onset date, whichever is later.
What happens if the ALJ wants to change my onset date?
Some times, a "partially favorable" decision is issued by SSA or the ALJ. One potential reason for this partially favorable decision is because SSA or the ALJ agree you are disabled currently but do not agree with your AOD and instead believe you became disabled at a later date. This can be referred to as an amended onset date.
The impact of such partially favorable decisions is often a person will receive future disability benefits, but the amount of lump sum back payments are reduced or eliminated.
What is an Established Onset Date?
The date that Social Security determines that you became disabled and unable to work is called the established onset date.
To determine your established onset date, the Social Security Administration will look at your alleged onset date, your work history, and your medical evidence. SSA may agree with your AOD or may select its own onset date.
In addition to affecting your lump sum back payment amount, the established onset date can also determine your eligibility for benefits. You must be unable to work for 12 months to be eligible for disability benefits. If you are expected to recover to the point of being able to work and the judge disagrees with your alleged onset date and moves it back, it could mean that there is no longer a full 12 month period where you are unable to work. Therefore, you are not eligible for benefits at all.
How do I select my alleged onset date?
Choosing the correct onset date is very important to your chances of obtaining disability benefits and obtaining the maximum back payment you are entitled to receive.
Selecting a specific onset date is difficult since most likely your symptoms and impairments built up over time. Unless you were injured in an accident, it's not likely that all of your issues began on the same date.
You should pick a date that is supported by evidence in your medical records as well as your work history. If you are having difficulty, consulting with an experienced disability attorney can help.
Often you can tie the onset date to a certain event, either the day you last worked or a major date in your medical history like your date of diagnosis or a date when you were hospitalized.
Other things that can affect your onset date are incarceration, citizenship status, the last day worked, and receipt of or application for unemployment benefits.
Whatever date you choose, make sure the alleged onset date that you select can be supported by medical evidence from around that time period that shows impairments that affect your ability to work.
If you are unsure of what to put as your alleged date of onset on your Social Security Disability application, my office is happy to provide guidance. We've analyzed onset dates for hundreds of disability claims. Give us a call at 985-240-9773.
What is Residual Functional Capacity (RFC)? Social Security Disability Lawyer Explains!
One of the most important concepts in evaluating disability claims is Residual Functional Capacity (RFC) also referred to as Residual Functionality.
The code of federal regulations describe residual functional capacity as follows:
Your residual functional capacity is the most you can still do despite your limitations.” 20 CFR 404.1545; 20 CFR 416.945.
Your case is not about a diagnosis.
People will talk about how long they have had the diagnosis, what medications they take or have tried, and how they know someone else with the same diagnosis who gets disability.
For most, this misses the point.
While a diagnosis is important, a diagnosis in and of itself will not support your disability.
The diagnosis is the starting point.
The focus of your case is establishing the limitations specifically caused by your medical diagnosis or treatment.
Limitations can range from slight - have to pause slightly when standing up from sitting too long - to more severe - have to lie down most of the day due to pain and medication side effects.
What is Residual Functional Capacity?
Residual Functional Capacity is an evaluation of your remaining ability to do things (work) after taking into account all of the limitations your severe medical conditions cause you.
Think of it as “How much can you do & for how long?”.
What is your ability to work?
The Social Security Administration will look at how your medical condition(s) has affected your ability to exert yourself physically for work-related tasks. These are things like:
- How long can you sit?
- How long can you stand?
- How long can you walk?
- Exert yourself physically for various work-related activities (such as sitting, standing, walking, lifting, carrying, pushing, pulling).
- Can you do manipulative and postural activities (such as reaching, handling large objects, using your fingers, feeling, climbing stairs or ladders, kneeling, crouching, crawling)?
- Can you stoop?
- Can you balance?
- Can you tolerate certain environmental conditions (such as high or low temperature extremes, wetness, humidity, noise, dust, fumes, odors, gases, poor ventilation, vibrations)?
- Can you work in hazardous working conditions like around or with machinery?
- Can you work at heights without any protection?
- Do you have any problems seeing, hearing, and speaking?
Your RFC encompasses your mental faculties as well.
- Can you maintain concentration and attention at work for extended periods of time?
- Can you understand and remember instructions and carry out your duties throughout the day and from day to day?
- Can you get along with people in your workplace or the general public?
- Can you cope with changes in the work setting?
- Can you respond appropriately to supervisors, co-workers, and usual work situations?
For example, let’s assume you have chronic back pain and take narcotic pain medications for treatment. Your doctor has told you that the most you can lift is 20 pounds occasionally and less than 10 pounds frequently. Assume further, that as a result of the medication you take to treat your back pain, that you experience drowsiness, fatigue and should not operate heavy machinery. You also cannot sit for longer than 1 hour at a time or stand for longer than 30 minutes before you need to rest.
Knowing these limitations, what can you do?
- You can lift 20 pounds occasionally and 10 pounds frequently.
- You can sit for up to 1 hour.
- You can stand for up to 30 minutes at a time.
- You cannot operate heavy machinery.
- Can you do anything else?
- Are you limited in other ways?
There are a number of other factors that should go into your residual functionality, but these are not always clearly explained in the medical records.
When these other factors are not clearly explained in your medical records, Social Security may find that you can perform these tasks.
Some factors that should be considered are the ability to twist, bend, stoop, reach, grasp, handle/finger, kneel, crawl, and climb.
Additionally, other non-exertional factors can play a role in establishing your residual functionality as well. These factors can include things such as the ability to follow directions, maintain concentration, pace, and persistence, ability to get along with co-workers, reliability (do you show up), and a host of other issues.
Your overall residual functional capacity is your remaining physical and mental ability after taking into account your physical and mental limitations.
Oftentimes, the medical records that I review do not discuss a number of factors essential to a proper determination of your RFC.
The reason is that many of these factors are irrelevant to a doctor’s actual treatment of your medical condition.
However, they are important for Social Security Disability claims because SSA’s determination is focused on your functional ability – not your medical history.
Social Security defines residual functional capacity as sedentary, light, medium, or heavy.
If you do not meet a listing, your RFC needs to be at a certain level to qualify you for social security disability benefits.
Your RFC needs to prevent you from performing your past relevant work and all other types of work that exist in significant numbers.
The specific RFC needed to show that you cannot perform your past relevant work or other types of work is dependent on your age, education, training, and past work history.
Your case is about establishing what your limitations are and how these limitations prevent you from working your past job and/or other jobs.
A thorough understanding of all of the factors that go into an RFC determination is important if you want to have the best chance of success with your SSDI claim.
As an SSDI attorney helping clients nationwide, I can help you understand the residual functionality you will have to prove in order to give your disability case the best chance of success. Give me a call at 985-240-9773.
How do I apply for Social Security Disability benefits?
You can apply for social security disability benefits or supplemental security income benefits in a number of ways.
The best and most reliable method is to go to your local social security office and apply in person. I am listing a few Louisiana Social Security Offices here for your reference:
- 1616 Joe Yenni Blvd, Kenner, Louisiana
- 400 Poydras, Suite 500, New Orleans, Louisiana
- 115 Terry Parkway, Terrytown, Louisiana
- 19375 North 4th Street, Covington, Louisiana
- 205 Arkansas Street, Bogalusa, Louisiana
- 2100 Robin Avenue, Hammond, Louisiana
- 2nd Floor Federal Building 206, 423 Lafayette St., Houma, Louisiana
If an office close to you is not listed, you can find the office that serves you by using Social Security’s Find An Office tool.
You should be aware that the in-person disability application process, while the most thorough, can take a few hours between the waiting and the application.
You should prepare to be there the whole day and have as many records as possible with you.
You can also call in advance for an appointment at 1-800-772-1213.
You can also apply for social security disability benefits online.
Many of our clients are very nervous about filling out these forms alone. Or they make mistakes on the forms that cannot be corrected during the appeals process.
Our firm will take away the burden and anxiety of completing and turning in your SSDI application and related disability forms.
When you hire us, all forms are submitted to our office and are gone over with you to make sure there is a clear understanding of your disability and limitations before we submit them to Social Security.
You will never have to submit anything or deal with Social Security by yourself.
How does Social Security determine if I qualify for SSDI?
Under Social Security rules and federal law, in order to qualify for SSDI, you must have a total disability that has or is expected to last for at least 12 months (or result in death) and you must have worked enough to be insured under Social Security law.
Benefits are not payable for partial disabilities or for a short-term disability.
Social Security defines disability as your inability to do the work you performed before your disability began and the Social Security Administration determines that because of your disability you cannot adjust to other work.
Your disability must also last or be expected to last for at least 12 months or to result in death.