WHAT YOU MUST PROVE IN COURT TO GET DISABILITY BENEFITS

If you've applied for Social Security disability benefits, there is better than a 70 percent chance that you will be denied and headed to court to get a second chance at your benefits.  And, while your odds in the hearing are better than at the first level, you can't assume anything.  The administrative law judge will look for certain key ingredients to determine if federal law permits you to receive SSDI benefits.  Here are some key things to focus on during your hearing:

Alleged Onset Date (AOD):  This is the date you have chosen to state as the beginning of your disability.  This is also the date the court will begin payments, if you can prove it.  Two things are essential concerning the AOD:

1. You must not have worked at any substantial gainful activity since the AOD.  That would be disqualifying.
2. You must have medical records to prove that you were disabled on the AOD.  If not, the AOD will be moved forward with the potential loss of back pay and a delayed Medicare eligibility date.

HOW MEDICAL PROBLEMS TRANSLATE INTO FUNCTIONAL LIMITATIONS

Medical records usually establish what diseases or injuries you have.  What medical records don't do is to establish how these medical conditions restrict your ability function:  that is, how long can you sit, stand and walk?  How much can you lift?  How often can you bend, reach, kneel, crouch or crawl?  What are your limitations with the use of your upper extremities (grasping, holding, fingering)?  Taken together, these functional limitations will establish what the court calls your residual functional capacity (RFC).  The RFC, in turn, establishes what kind of work you can still do.  That, finally, determines whether you can get a disability benefit.

So, if the RFC is not established by the medical record, how do you establish it?  The residual functional capacity will be established in one of two ways.  The judge will make one up or one of your treating doctors can provide one for the judge to consider.  The latter method nearly always works out better for the claimant.

So, how does your doctor provide a residual functional capacity for the court to consider?  He/she does it by filling out a form, usually called a medical source statement or a treating source statement.  Two facts about this form:

•  Your doctor does not have this form and has probably never seen it before.  You have to obtain it, present it to your doctor, and beg him/her to fill it out for you.

• A letter from the doctor is not as good as the form; letters are never, ever as thorough and they never, ever cover all the bases.  

Letters from doctors nearly always violate federal rules that make them inadmissible and useless.  For example, most letters from doctors will say something like, "In my opinion, this patient is fully disabled and is not able to work."  Sounds good, but the statement violates 20 CFR 404.1527.  Your doctor is drawing a conclusion which federal law does not permit him/her to do.  The doctor may explain what your specific functional limitations are; however, the decision about whether these limitations constitute disability can be made only by the Commissioner of Social Security under the law.

If it sounds like there are traps and snares in the Social Security adjudication system it's because there are.  If I tried to list all of them, we'd be here all day.  

Best advice?  Hire a professional who knows the traps and snares and how to avoid them.  The value of an attorney or disability advocate is that he/she has traveled this road hundreds of times and knows where the pits and snares are hidden.  You might be able to figure it out eventually by trial and error.  Except, you only get one chance!  You get one hearing.  By the time you figure out how to win one of these things, you will be 104 years old or dead.  You need somebody who has a reasonable chance of winning your benefits for you right now, with just one try.  That spells professional help.
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Charles W. Forsythe
Social Security Representation
Huntsville   Decatur   Athens   Cullman   Florence    Pulaski

CALL US:  (256) 799-0297

E-MAIL ME:   forsythefirm@gmail.com

SOCIAL SECURITY JUSTICE