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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  • 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. 

  • Can I get Social Security Disability for Spinal Stenosis?

    WHAT IS SPINAL STENOSIS?

    Spinal stenosis is a condition that causes an abnormal narrowing of the spinal canal and compression of the spinal cord and nerves. Spinal stenosis is most often the result of degenerative arthritis or a result of the aging process, but sometimes a bulging or ruptured disc may be the cause. Spinal stenosis usually occurs in the neck or lower bank.

    The most common types of spinal stenosis are lumbar stenosis and cervical stenosis. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.

    Symptoms, if they occur, include pain, numbness, tingling, muscle weakness, loss of motor control, loss of balance, and impaired bladder or bowel control. Treatment options for spinal stenosis can be surgical or non-surgical.


    CAN I GET SOCIAL SECURITY DISABILITY FOR SPINAL STENOSIS?

    Spinal Stenosis pain and associated symptoms can impact your ability to work. Social Security Disability benefits may be available to you.

    Can I get Social Security Disability for Spinal Stenosis

    If you are not engaging in gainful activity due to Spinal Stenosis, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the evaluation process. (Visit my prior blog post explaining the steps of Social Security’s Sequential Evaluation Process.)

    Generally, to establish Spinal Stenosis as a medically determinable severe impairment, you must show:

    • Objective medical imaging such as MRIs or CT Scans establishing spinal stenosis;
    • Consistent complaints of pain or other symptoms for a period of time and which is not controlled through conservative treatment modalities

    At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For Lumbar Spinal Stenosis, SSA will determine if your condition meets Listing 1.04C – Disorders of the Spine – Lumbar Spinal Stenosis. 

    • 1.04C can be met if your condition
      • Causes lumbar spinal stenosis resulting in pseudoclaudiction established by findings on appropriate medically acceptable imaging,
      • Is manifested by chronic nonradicular pain and weakness,
      • Results in inability to ambulate effectively, which is defined as
        • The inability to walk without the use of a walker, two crutches or two canes,
        • The inability to walk a block at a reasonable pace on rough or uneven surfaces,
        • The inability to use standard public transportation,
        • The inability to carry out routine ambulatory activities, such as shopping and banking, and
        • The inability to climb a few steps at a reasonable pace with the use of a single handrail.

    The key to meeting the listing is to have the appropriate objective medical testing including MRIs or CT Scans which show lumbar spinal stenosis.  In most cases, in my experience, the medical listing will not be met, but having a good knowledge of what you have to prove can help you discuss your case with your doctor.

    If your condition and/or related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your stenosis and pain), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.


    TIPS FOR SSDI APPLICATION FOR SPINAL STENOSIS

    1. Make sure an imaging report (MRI, CT, X-ray) diagnosing Spinal Stenosis is in your medical records. It is important that you “know your medical records.”
    2. Make sure your medical records document ALL of your symptoms and limitations including, but not limited to, numbness, tingling, muscle weakness, loss of motor control, loss of balance, and impaired bladder or bowel control. Your medical records should not just document your pain. Let your doctor how often you feel the symptoms, how severe each symptom is, and how long each episode lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms.
    3. See a specialist. Treatment of spinal stenosis by an orthopedist or neurologist or a chronic pain specialist will carry more weight than the same diagnosis from a family physician or internist professional.
    4. Comply with your doctor’s orders and try various modes of conservative or less invasive treatment, if recommended.
    5. See a mental health professional. If you are suffering from depression or anxiety as a result of the chronic pain and inability to participate in life, see a mental health professional to diagnose, treat, and document these conditions. Pain is often accompanied by or is the cause of mental health conditions. Treatment of the depression can help with the pain.
    6. See your doctor regularly and keep your appointments.
    7. If you can, provide evidence of a long work history.
    8. Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity.
    9. Include information from nonmedical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time.  These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
    10. Keep a journal. Make regular notes about your impairment, level of function, and treatments.
    11. If you need assistance with your claim, contact an attorney who is knowledgeable in obtaining Social Security Disability benefits for spinal stenosis.

    9 Mistakes That Can Disable Your Social Security Disability Claim Book Offer 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.

  • Can I get SSDI benefits for Lupus? Tips for application

    WHAT IS LUPUS?

    Lupus is a chronic, autoimmune, inflammatory disease caused when the immune system attacks its own tissues. It can damage any part of the body (skin, joints, and/or organs inside the body). Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus. There are many kinds of lupus. The most common type, systemic lupus erythematosus (SLE), affects many parts of the body.
     

    CAN I RECEIVE SOCIAL SECURITY DISABILITY BENEFITS FOR LUPUS?

    Can I receive Social Security Disability benefits for Lupus

    Lupus health problems, pain, and fatigue can impact your ability to work. Social Security Disability benefits may be available to you.
    If you are not engaging in gainful activity due to Lupus, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the evaluation process. (Visit my prior blog post explaining the steps of Social Security’s Sequential Evaluation Process.)

    At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. Systemic lupus erythematosus is listed under SSA Medical Listing 14.02, the category of impairments known as the Immune System Disorders – Adult(14.00). To qualify as disabled under this listing, your medical records must show that you meet the following requirements:

    A. Involvement of two or more organs/body systems (such as kidneys and brain or heart and lungs), with:

    1. One of the organs/body systems involved to at least a moderate level of severity
    2. At least two of the constitutional symptoms or signs (severe fatigue or exhaustion, fever, malaise, or involuntary weight loss)

    OR

    B. Repeated manifestations of SLE, with at least two of the constitutional symptoms or signs (severe fatigue, fever, malaise, or involuntary weight loss) and one of the following at the marked level:

    1. Limitation of activities of daily living.
    2. Limitation in maintaining social functioning.
    3. Limitation in completing tasks in a timely manner due to deficiencies in concentration, persistence, or pace.

    To determine if an individual has been correctly diagnosed with SLE and that the listing has been “met,” Social Security follows the guidelines set out in the current Criteria for the Classification of Systemic Lupus Erythematosus, by the American College of Rheumatology. An individual must meet four criteria of the established eleven to be diagnosed with lupus. The criteria include:

    • Malar Rash
    • Discoid rash
    • Photosensitivity
    • Oral ulcers
    • Nonerosive Arthritis
    • Pleuritis or Pericarditis
    • Renal Disorder
    • Neurologic Disorder
    • Hematologic disorder
    • Immunologic disorder
    • Positive Antinuclear Antibody

    Medical evidence proving these symptoms may include doctor observations, electrocardiography, and blood tests, but is also dependent on the type of maladies suffered.

    If your diagnosis does not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your lupus), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.

    TIPS FOR SSDI APPLICATION FOR LUPUS

    1. Make sure a lupus diagnosis is in your medical records. We’ve mentioned this before for long-term disability, but it is also true for SSDI, “know your medical records.”
    2. Make sure your medical records document ALL of your constitutional symptoms and limitations. Let your doctor how often you feel the symptoms, how severe each symptom is and what limitations they cause. Lupus may cause you to have fatigue, chest pain, shortness of breath, vision problems, headaches, and abnormal heart rhythms. These symptoms could make it difficult to stand or walk. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms.
    3. See a specialist. A lupus diagnosis from a rheumatologist will carry more weight than the same diagnosis from a family physician or internist professional.
    4. See a mental health professional. If you are suffering from depression or anxiety, see a mental health professional to diagnose, treat, and document these conditions. SLE is often accompanied by or is the cause of mental health conditions. However, it is important that the actual lupus diagnosis comes from a specialist and not your counselor, therapist, or psychiatrist. (see above)
    5. See your doctor regularly and keep your appointments.
    6. If you can, provide evidence of a long work history.
    7. Do not exaggerate your symptoms or limitations.  Keep all of your statements consistent and truthful.
    8. Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity.
    9. Include information from nonmedical sources to support your medical claims. Gather information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time. These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
    10. Keep a journal. Make regular notes about your impairment, level of function, and treatments.
    11. If you need assistance, contact an attorney with experience in Social Security Disability.  In South Louisiana?  Give us a call at 985-240-9773 or take our quick disability eligibility quiz.

    9 Mistakes That Can Disable Your Social Security Disability Claim Book Offer 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.

  • Do I Need A Witness For My Louisiana Disability Hearing?

    As a Louisiana 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.

    Do I need a witness for my disability 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.In most cases, the medical records are available and provide a good picture of your medical impairments. And, 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.

    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 testimony 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. 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 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 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, you may need an attorney as well. A Houma disability attorney can help you prepare your case and your witness to give you the best chance of success.

  • Can I receive Social Security disability payments for bladder cancer?

    July 17 is Bladder Cancer Awareness Day. Social Security offers expedited disability case processing for over 225 qualified conditions under their Compassionate Allowances program – bladder cancer is one of them.

    Compassionate Allowances are a way for the Social Security Administration to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards. Individuals with bladder cancer may receive a decision on their claim in a matter of weeks instead of months or years. Being diagnosed with a Compassionate Allowance condition does not provide additional money above what an individual is eligible for under the Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) disability programs. The Compassionate Allowance program simply speeds up the receipt of a decision on the claim. 

    There is no special application or form. Individuals with bladder cancer or any other Compassionate Allowance condition apply for benefits using the standard process. SSA will expedite the applications of those with a qualifying condition.

    To qualify for Social Security Disability with bladder cancer, SSA will determine if your condition meets Listing 13.22 for Urinary bladder – carcinoma. To meet this listing, you must show in your medical records that you have carcinoma of the urinary bladder that meets one of the following conditions:

    • With infiltration beyond the bladder wall.
    • Recurrent after total cystectomy.
    • Inoperable or unresectable.
    • With metastases to or beyond the regional lymph nodes.

    If your related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your bladder cancer), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.

    Tips for SSDI Application for Bladder Cancer

    1. Know your medical records.
    2. Make sure your medical records document ALL of your symptoms and limitations and the residual effects you experience. Your medical records should not just document your bladder cancer, they should include notes on your symptoms like how often you feel symptoms, how severe each symptom is and how long each symptom lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms. Make sure any and all side effects of treatment and/or medication are noted in your records.
    3. Have someone assist you with your claim if your memory, concentration, etc. prevent you from completing the forms yourself.
    4. See a mental health professional. If you are suffering from depression or anxiety as a result of the chronic problems and inability to participate fully in life, see a mental health professional to diagnose, treat, and document these conditions.
    5. See your doctor regularly and keep your appointments.
    6. If you can, provide evidence of a long work history.
    7. Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity, if applicable.
    8. Include information from nonmedical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time.  These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
    9. Keep a journal. Make regular notes about your impairment, level of function, and treatments.
    10. If you need assistance with your claim, contact an attorney who specializes in Social Security Disability

    9 Mistakes That Can Disable Your Social Security Disability Claim Book Offer 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.

  • How long do I have to wait for a SSDI hearing after I appeal my denial?

    wait times for SSDI hearing in LouisianaA question I am often asked is “How long will I have to wait for my Social Security Disability hearing?” The wait time can vary greatly from one Office of Disability Adjudication and Review (ODAR) to another. The national average for February 2014 was 11.7 months between the request for an appeal hearing and the hearing date.

    The good news for Louisiana claimants is all Louisiana ODARs have wait times below the national average. The wait times for Louisiana offices in February 2014 were:

    Metairie   7 months
    New Orleans   11 months
    Shreveport   6 months
    Alexandria   8 months

    Shreveport actually had the shortest wait time out of all offices in the nation at 6 months.

    Data on all ODAR offices can be found at ssa.gov

    If you have questions about your Social Security disability appeal or hearing, call New Orleans area disability lawyer, Loyd Bourgeois at 985-240-9773 or submit an online case evaluation.

     

  • How can I qualify for SSDI benefits with multiple sclerosis?

    Multiple sclerosis (MS) is an inflammatory disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This damage disrupts the ability of parts of the nervous system to communicate, resulting in a wide range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). Between attacks, symptoms may go away completely; however, permanent neurological problems often occur, especially as the disease advances.

    While the cause is not clear, the underlying mechanism is thought to be either destruction by the immune system or failure of the myelin-producing cells. Proposed causes for this include genetics and environmental factors such as infections. MS is usually diagnosed based on the presenting signs and symptoms and the results of supporting medical tests.

    There is no known cure for multiple sclerosis. Treatments attempt to improve function after an attack and prevent new attacks. Medications used to treat MS while modestly effective can have adverse effects and be poorly tolerated. Many people pursue alternative treatments, despite a lack of evidence. The long-term outcome is difficult to predict, with good outcomes more often seen in women; those who develop the disease early in life; those with a relapsing course; and those who initially experienced few attacks. Life expectancy is 5 to 10 years lower than that of an unaffected population.

    Some common symptoms of MS include almost any neurological symptom or sign; with autonomic, visual, motor, and sensory problems being the most common. The specific symptoms are determined by the locations of the lesions within the nervous system, and may include loss of sensitivity or changes in sensation such as tingling, pins and needles or numbness, muscle weakness, very pronounced reflexes, muscle spasms, or difficulty in moving; difficulties with coordination and balance (ataxia); problems with speech or swallowing, visual problems (nystagmus, optic neuritis or double vision), feeling tired, acute or chronic pain, and bladder and bowel difficulties, among others. Difficulties thinking and emotional problems such as depression or unstable mood are also common. Uhthoff’s phenomenon, a worsening of symptoms due to exposure to higher than usual temperatures, and Lhermitte’s sign, an electrical sensation that runs down the back when bending the neck, are particularly characteristic of MS.

    Can I receive Social Security Disability benefits for Multiple Sclerosis?

    Multiple Sclerosis can cause symptoms, limitations, and restrictions that can impact your ability to work. Social Security Disability benefits may be available to you if you suffer from MS.

    If you are not engaging in gainful activity due to MS and its symptoms or limitations, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the evaluation process. (Visit my prior blog post explaining the steps of Social Security’s Sequential Evaluation Process.)

    Generally, to establish MS as a medically determinable severe impairment, you should provide:

    At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For multiple sclerosis, SSA will determine if your condition meets Listing 11.09.  To meet this listing, you must show:

    The key to meeting the listing is to have the appropriate objective medical testing and a longitudinal medical history that addresses each of the requirements.  A knowledgeable social security attorney can help you determine if your MS meet the listing.

    If your related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your multiple sclerosis), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.

    • Objective medical testing establishing MS (i.e., MRI results, etc.); and/or
    • Evidence of consistent and repeated symptoms despite treatment.
      1. Disorganization of motor function as described in 11.04B; or
      2. Visual or mental impairment as described under the criteria in 2.02, 2.03, 2.04, or 12.02; or
      3. Significant, reproducible fatigue of motor function with substantial muscle weakness on repetitive activity, demonstrated on physical examination, resulting from neurological dysfunction in areas of the central nervous system known to be pathologically involved by the multiple sclerosis process.

    Tips for SSDI Application for Multiple SclerosisTips for your Social Security Disability application for Multiple Sclerosis from Louisiana SSDI attorney Loyd Bourgeois

    1. Make sure that the medical records diagnosing the Multiple Sclerosis and its progression are included. This is usually done by MRI results but may include other appropriate testing. It is important that you “know your medical records.” 
    2. Make sure your medical records document ALL of your symptoms and limitations and the residual effects you experience. Your medical records should not just document your MS, they should include notes on your symptoms like how often you feel symptoms, how severe each symptom is and how long each symptom lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms. Make sure any side effects of medication are noted in your records.
    3. Have someone assist you with your claim if your memory, concentration, etc. prevent you from completing the forms yourself.
    4. See a specialist. Treatment of MS by a neurologist is important.
    5. Comply with your doctor’s orders and try what is recommended like physical therapy, cognitive training, diet and exercise, smoking cessation, weight loss, etc.  The key is that you want your records to show that you are concerned about your health and are working with your doctor to improve.
    6. See a mental health professional. If you are suffering from depression or anxiety as a result of the chronic problems and inability to participate fully in life, see a mental health professional to diagnose, treat, and document these conditions.
    7. See your doctor regularly and keep your appointments.
    8. If you can, provide evidence of a long work history.
    9. Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity, if applicable.
    10. Include information from nonmedical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time.  These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
    11. Keep a journal. Make regular notes about your impairment, level of function, and treatments.
    12. If you need assistance with your claim, contact an attorney who specializes in Social Security Disability. At Louisiana Disability Law, we have extensive experience with obtaining Social Security Disability benefits and have successfully obtained benefits for clients with Multiple Sclerosis.

    9 Mistakes That Can Disable Your Social Security Disability Claim Book Offer 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.

  • How common is SSDI fraud?

    Reports of Social Security Disability fraud seem to come almost weekly these days. These reports have increased attention to the disability program and led to claims that the Social Security Administration’s program is rampant with fraudulent claims.

    A recent story about New York firefighters making fraudulent claims has helped fuel the debate over SSDI fraud and claims that fraud is the only reason why disability claims have increased in the U.S.

    Despite the media’s claims that the disability program is rampant with fraud, that is simply not the case according to a recent report by the executive director of the Consortium for Citizens with Disabilities and a vice president of Easter Seals. The report points out the exacting requirements necessary to prove that a person is disabled under SSA. To win an SSDI claim, a person must first have worked enough to qualify for benefits, have a severe medical condition that limits their ability to function proven by extensive medical records and reports, and must be so limited that they cannot perform their past work or other available work. To say that obtaining Social Security disability benefits is hard would be an understatement.

    According to the report, less than four in 10 (or 40%) SSDI claims are approved. And, those that do receive SSDI benefits receive only a modest monthly benefit which averages only $1,130. These funds must be used to pay for living expenses, medical care, food and other basic necessities of life.

    While the overall number of Social Security disability applications has increased over time, according to the report, the reasons for the increase are many and varied but mostly result from three things: (1) overall population growth; (2) baby-boomers reaching the age where disability is more likely; and (3) entry of greater number of women into the workplace in the 70s and 80s.

    That is why the claim and reporting that the disability program is full of fraudulent claims is so disheartening. I see sick and disabled individuals every day that need the benefits that they paid for throughout their working life. Having these individuals cast into the same light by the public and the media as fraudsters only serve to further marginalize and stigmatize people at their lowest point.

    Does fraud exist in the SSDI program? Yes, that cannot be denied and they should be rooted out and face the consequences of their actions. But, fraud is not as widespread or endemic as some would have you believe. A few outliers that receive all the attention does not make the entire program a sham. The small amount of fraudulent claims should not be used to justify wholesale changes or further limit access to the necessary and vital benefits.

    To report suspected fraud, you can fill out an online form here.

  • Can I Get Social Security Disability After A Stroke?

    WHAT IS A STROKE? 

    A stroke is a condition in which the brain cells suddenly die because of a lack of oxygen.

    A stroke can be caused by an obstruction in the blood flow or the rupture of an artery that feeds the brain. You may suddenly lose the ability to speak, or have memory problems, or one side of your body can become paralyzed.

    The two main types of stroke are ischemic stroke and hemorrhagic stroke. Both types of stroke result in a lack of blood flow to the brain and a buildup of blood that puts too much pressure on the brain.

    Ischemic stroke – Ischemic stroke is the most common type of stroke and occurs when a blood clot, or thrombus, forms that blocks blood flow to part of the brain. If a blood clot forms somewhere in the body and breaks off to become free-floating, it is called an embolus. This wandering clot may be carried through the bloodstream to the brain where it can cause ischemic stroke.

    Hemorrhagic stroke – A hemorrhagic stroke occurs when a blood vessel on the brain’s surface ruptures and fills the space between the brain and skull with blood (subarachnoid hemorrhage) or when a defective artery in the brain bursts and fills the surrounding tissue with blood (cerebral hemorrhage).

    The outcome after a stroke depends on where the stroke occurs and how much of the brain is affected. Smaller strokes may result in minor problems, such as weakness in an arm or leg. Major strokes may lead to paralysis or death. Many patients are left with weakness on one side of the body, difficulty speaking, incontinence, and bladder problems.

    WHAT ARE THE SYMPTOMS OF STROKE?

    Within a few minutes of having a stroke brain cells begin to die and symptoms emerge. Recognition of the symptoms is important, as prompt treatment is crucial to recovery.

    Common symptoms include:

    • Trouble walking, loss of balance and coordination.
    • Speech problems.
    • Dizziness.
    • Numbness, weakness, or paralysis.
    • Blurred, blackened, or double vision.
    • Sudden severe headache.
    • Confusion.

    Smaller strokes (or silent strokes), however, may not cause any symptoms, but can still damage brain tissue.

    A transient ischemic attack (TIA) may be a sign of an impending stroke – TIA is a temporary interruption in blood flow to part of the brain. Symptoms of TIA are similar to those of strokes but last for a shorter period and do not leave noticeable permanent damage.

    WHAT ARE THE EFFECTS OF STROKE?

    Strokes can range in degree of severity, and the type of damage done depends on where in the brain they occur and how long they last. Strokes can cause death immediately, or cause little limitation. Some of the common and lasting effects caused by strokes include:

    • Weakness, paralysis, numbness. This refers to limitations in movement or motor ability, such as weakness and paralysis in an arm and leg on the same side of the body as a result of the blockage.
    • Speech and language problems. Strokes sometimes produce some degree of loss of ability to understand or express certain aspects of written or spoken language in various combinations (known as aphasia).
    • Personality changes. Strokes may produce personality changes if it is large enough and in the right area of the brain.
    • Vision problems. Usually to one eye only and can affect depth perception, peripheral vision, and cause other vision issues.
    • Balance problems. Strokes can affect balance and ability to walk without producing any actual weakness. Strokes may also cause unilateral neglect, or where the brain does not recognize one of the limbs, which makes it functionally useless.

    CAN I RECEIVE SOCIAL SECURITY DISABILITY BENEFITS FOR STROKE?

    A stroke can cause symptoms, limitations and restrictions that can impact your ability to work. Social Security Disability benefits may be available to you if you have suffered a stroke and have residual symptoms.

    CAN I GET SSDI AFTER A STROKE?If you are not engaging in gainful activity due to a stroke and the effect of residual symptoms, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the evaluation process. (Visit my prior blog post explaining the steps of Social Security’s Sequential Evaluation Process.)

    Generally, to establish a stroke as a medically determinable severe impairment, you should provide:

    • Objective medical testing establishing the CVA (i.e., MRI or CT); and
    • Treatment records detailing your initial hospitalization and ongoing therapy or residual effects.

    At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For stroke, SSA will determine if your condition meets Listing 11.04:

    • 11.04A  requires you to have had a stroke with sensory or motor aphasia resulting in ineffective speech or communication more than 3 months after your stroke.
    • 11.04B requires you to have had a stroke and more than 3 months afterward you have significant and persistent disorganization of motor function in two extremities, resulting in sustained disturbance of gross and dexterous movements, or gait and station.

    The key to meeting the listing is to have the appropriate objective medical testing and a longitudinal medical history that addresses each of the requirements.  A knowledgeable social security attorney can help you determine if your residual effects meet the listing.

    If your related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your stroke), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.

    TIPS FOR SSDI APPLICATION FOR STROKE

    1. Make sure that the medical records diagnosing the stroke are included. This may be an MRI, CT Scan, or other appropriate testing. It is important that you “know your medical records.”
    2. Make sure your medical records document ALL of your symptoms and limitations and the residual effects you experience. Your medical records should not just document your stroke, they should include your physical therapy, speech therapy or other therapy you have undergone. You need to let your doctor how often you feel symptoms, how severe each symptom is and how long each symptom lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms. Make sure any side effects of medication are noted in your records.
    3. Have someone assist you with your claim if your memory, concentration, etc. prevent you from completing the forms yourself.
    4. See a specialist. Treatment of stroke and recovery by a neurologist will carry more weight than the same diagnosis from a family physician or internist professional.
    5. Comply with your doctor’s orders and try what is recommended.
    6. See a mental health professional. If you are suffering from depression or anxiety as a result of the chronic problems and inability to participate in life, see a mental health professional to diagnose, treat, and document these conditions.
    7. See your doctor regularly and keep your appointments.
    8. If you can, provide evidence of a long work history.
    9. Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity, if applicable.
    10. Include information from non-medical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time.  These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
    11. Keep a journal. Make regular notes about your impairment, level of function, and treatments.
    12. If you need assistance with your claim, contact an attorney who specializes in Social Security Disability.  For a free case evaluation, call Loyd Bourgeois at 985-240-9773

    9 Mistakes That Can Disable Your Social Security Disability Claim Book Offer 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.

  • Can You Get Disability Benefits for Coronary Artery Disease?

    WHAT IS HEART DISEASE?

    Heart Disease generally refers to coronary artery disease (CAD) also known as ischemic heart disease (IHD). Heart disease occurs when a substance called plaque builds up in the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol deposits, which can accumulate in your arteries. When this happens, your arteries can narrow over time. This process is called atherosclerosis.

    Plaque buildup can cause angina, the most common symptom of CAD. This condition causes chest pain or discomfort because the heart muscle doesn’t get enough blood. Over time, CAD can weaken the heart muscle. This may lead to heart failure, a serious condition where the heart can’t pump blood the way that it should. An irregular heartbeat, or arrhythmia, can also develop.

    For some people, the first sign of CAD is a heart attack. A heart attack occurs when plaque totally blocks an artery carrying blood to the heart. It also can happen if a plaque deposit breaks off and clots a coronary artery.


    CAN I RECEIVE SOCIAL SECURITY DISABILITY BENEFITS FOR HEART DISEASE?

    Heart Disease can cause symptoms, limitations, and restrictions that can impact your ability to work. Social Security Disability benefits may be available to you if you have suffered from heart disease.

    If you are not engaging in gainful activity due to heart disease and its symptoms or limitations, the Social Security Administration must determine if you have an impairment that is “severe.” This is step 2 of the evaluation process. (Visit my prior blog post explaining the steps of Social Security’s Sequential Evaluation Process.)

    Generally, to establish heart disease as a medically determinable severe impairment, you should provide:

    • Objective medical testing establishing heart disease (i.e., EEG, EKG, stress test results, etc.); and/or
    • Evidence of consistent and repeated attacks despite treatment

    At step 3 of the Sequential Evaluation Process, the SSA determines if your condition meets a listing. For heart disease, SSA will determine if your condition meets Listing 4.04. This is a complex listing that requires substantial medical evidence and knowledge of your specific type of heart disease and objective testing results.

    The key to meeting the listing is to have the appropriate objective medical testing and a longitudinal medical history that addresses each of the requirements. A knowledgeable social security attorney can help you determine if your residual effects meet the listing.

    If your related symptoms do not equal a listing, the Social Security Administration will next assess your residual functional capacity (RFC) (the work you can still do, despite your heart disease), to determine whether you qualify for benefits at steps 4 and 5 of the Sequential Evaluation Process. The lower your RFC, the less the Social Security Administration believes you can do. In determining your RFC, the Social Security Administration adjudicator should consider all of your symptoms in deciding how they may affect your ability to function.


    TIPS FOR SSDI APPLICATION FOR HEART DISEASE

    1. Make sure that the medical records diagnosing the heart disease are included. This may be an EEG, EKG, stress test, nuclear test, or other appropriate testing. It is important that you “know your medical records.”
    2. Make sure your medical records document ALL of your symptoms and limitations and the residual effects you experience. Your medical records should not just document your heart disease, they should include notes on your symptoms like how often you feel symptoms, how severe each symptom is and how long each symptom lasts. Make sure that all your medical problems are adequately documented by your doctor, and that you are receiving the appropriate medical attention for all of your disabling symptoms. Make sure any side effects of medication are noted in your records.
    3. Have someone assist you with your claim if your memory, concentration, etc. prevent you from completing the forms yourself.
    4. See a specialist. Treatment of heart disease by a cardiologist will carry more weight than the same diagnosis and treatment from a family physician or internist.
    5. Comply with your doctor’s orders and try what is recommended like diet and exercise, smoking cessation, weight loss, etc. The key is that you want your records to show that you are concerned about your health and are working with your doctor to improve.
    6. See a mental health professional. If you are suffering from depression or anxiety as a result of the chronic problems and inability to participate in life, see a mental health professional to diagnose, treat, and document these conditions.
    7. See your doctor regularly and keep your appointments.
    8. If you can, provide evidence of a long work history.
    9. Provide examples of unsuccessful attempts to return to work and/or unsuccessful attempts to work in a decreased capacity, if applicable.
    10. Include information from nonmedical sources to support your medical claims. Gather Information from neighbors, friends, relatives, clergy, and/or past employers about your impairments and how they affect your function. Have them document changes that they have seen in your ability over time. These are not given nearly as much weight as testimony from a medical professional, but they don’t hurt.
    11. Keep a journal. Make regular notes about your impairment, level of function, and treatments.
    12. If you need assistance with your claim, contact disability lawyer, Loyd Bourgeois at 985-240-9773 or submit an online case evaluation.Can I get SSDI for Heart Disease?

    9 Mistakes That Can Disable Your Social Security Disability Claim Book Offer 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.