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Social Security Disability Benefits for People Affected by Cancer

May 14th, 2014 No comments

Individuals and families dealing with a cancer diagnosis face any number of life challenges while battling the disease and undergoing treatments.  Often, the disease and the treatments make it impossible for people dealing with cancer to continue to work.

All forms of cancer can qualify you for Social Security Disability benefits if your condition is severe and advanced enough, and over 40 forms of cancer automatically qualify you for Social Security Disability benefits. If you have one of these forms of cancer, you will qualify for a compassionate allowance, which will allow you to start receiving Social Security disability benefits and Medicare much more quickly (generally within three weeks) than other Social Security Disability claimants. You can check the Social Security Administration (SSA)’s list of qualifying conditions on their website at www.ssa.com.  

Some forms of cancer can cause pain and fatigue, which can make it impossible to perform physical work. Additionally, many of the treatments used to fight cancer can cause debilitating symptoms which make physical activity impossible. Assuming you don’t have a form of cancer which qualifies you for a compassionate allowance, the extent and severity of your cancer’s impact on your ability to perform physical tasks will be considered in determining if you are qualified for Social Security Disability benefits. Make sure that all physical limitations are clearly detailed in terms of what you can and cannot do on your Social Security Disability application.

Many people are in professions that do not involve performing physical labor and are considered sedentary work. The SSA defines sedentary work as work which requires you to sit for extended periods of time and to lift less than 10 pounds. Sedentary work often involves education, people skills, or manual dexterity. Cancer can and does often affect a person’s ability to work with people and his or her manual dexterity. You will want to make sure that all physical and mental limitations to employment are clearly and thoroughly mentioned in your Social Security Disability claim.

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Denial of Social Security Disability Insurance (SSDI)

March 24th, 2014 No comments

When applying for South Security Disability Insurance SSDI) payments the first challenge is the lengthy application and generally an interview at the local Social Security office. Most claimants get rejected at this initial stage.

There are two difference types of denial; the medical denial and the technical denial.

A medical denial is sent by Social Security to the claimant, stating that SSA has not found the claimant’s conditions disabling enough to keep the claimant from going back to any type of job, not just the claimant’s previous job. SSA will spend 4-6 months analyzing the claimant’s medical records and past work history before making a decision about whether they meet the SSA’s criteria of disabled. The medical denial will commonly state specifically why the claimant is not considered disabled and list the records that were used to make this decision. If a medical denial is received, it should be appealed right away.

 A technical denial means that a claimant has not met the basic non-medical requirements to qualify for disability benefits. There are two types of technical denials:

  • Disability Insurance Benefits (DIB) technical denial. If you have not worked enough in the past to be eligible for DIB (generally you must have worked at least 5 out of the past 10 years) and earned enough work credits, then you are technically ineligible for DIB.
  • Supplemental Security Income (SSI) technical denial. SSI is a welfare-based disability program. To qualify, you must have a limited income and resources.

Once you have been rejected, you will have to file an appeal. A lot of documents have to be gathered and filed. With disability processing times often at well over a year, it is essential that you ensure your claim is being processed correctly.

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Does Your Condition Qualify for Disability?

January 10th, 2014 No comments

The Social Security Administration (SSA) uses what is commonly referred to as the “Blue Book” to determine if an individual will meet the Social Security definition of disability. The “Blue Book” is a list of impairments with detailed requirements for when the SSA should judge a medical condition to be disabling.

But what if your impairment doesn’t match the any of the listings? The SSA allows you to “equal” a listing because not every condition or level of severity is included. You might have had different testing that shows a disability than the test that is listed in the Blue Book. Perhaps you have a combination of impairments that on their own are not severe enough to qualify but combined are severe enough for you to be eligible for disability benefits. While it can be frustrating to appeal a decision and argue your case, it is possible to get disability for a condition not listed in the Blue Book if you can prove the condition renders you unable to work.

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Understanding the Criteria for Disability used by the Social Security Administration

January 8th, 2014 No comments

Understanding what disability criteria the Social Security Administration (SSA) uses to determine whether claimants are eligible for benefits can make the difference in whether or not you are approved. In part, disability examiners use a list of impairments known as the “Blue Book” to determine if an individual will meet the Social Security definition of disability.

The Blue Book is a list of impairments with detailed requirements for when the SSA should judge a medical condition to be disabling. Each impairment in the listing specifies a degree of medical severity which, if the applicant’s condition meets or exceeds it, presumes that any type of substantial work can’t be performed. The listings cover most common impairments.

The Blue Book is divided into two main parts, one for adults with disabilities and one for children under the age of 18 with disabilities. Each of these parts is divided into sections which contain information about different types of disabilities. The major body systems addressed within the Social Security disability handbook are as follows: Musculoskeletal, Special Senses (Vision and Hearing), Respiratory System, Cardiovascular System, Digestive System, Genitourinary System, Hematological Disorders, Skin Disorders, Endocrine Disorders, Multiple Body Systems, Neurological, Mental Disorders, Neoplastic Diseases (Cancer), and Immune System Disorders .For each major body system, the Blue Book contains a list of disabling conditions.  These listings are intended to help physicians and health professionals to better understand the specific information that should be furnished with a Social Security Disability application in order to prove that the claimant qualifies as “totally disabled” under the strict definitions provided by the SSA.

 

Because illnesses and injuries have varying degrees of severity, the Blue Book sets out the requirements for how severe the symptoms, clinical findings, and laboratory tests for a particular impairment have to be  to ensure that the condition is severe enough for an automatic approval. If your condition doesn’t match a listing, the SSA goes through a longer determination process to see if you’re disabled, but if you can match a listing, the process stops there.  The most recent edition of the Blue Book is available online at http://www.ssa.gov/disability/professionals/bluebook.

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The Waiting is Part of the Process

November 15th, 2013 No comments

People assume that when they are disabled applying for benefits they need should be a quick and easy process. Unfortunately, they find they are wrong on both counts. The waiting for benefits is frustrating as people watch their medical bills and other living expenses piling up.

It can be a long, frustrating and arduous process. In fact, the majority of applicants are rejected in their initial written request because they fail to supply enough evidence of a disability. After two rejections and more time passing, their next step is an appeal before a judge.

The statistics are startling across the country and here in Massachusetts. At the Office of Disability Adjudication and Review (ODAR) in Boston, Massachusetts, 14 different administrative law judges (ALJ) conduct Social Security Disability (SSD) hearings and Supplemental Security Income (SSI) hearings. Currently, in Boston, the average wait time for a SSI or SSD hearing is 11.0 months. The average case processing time in Boston is 353 days. The Boston average for winning a SSI or SSD disability hearing is 46%. You may visit the MA ODAR website for additional information. http://www.disabilityjudges.com/state/massachusetts

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Seminar-Social Security Disability

November 24th, 2010 No comments

The National Business Institute recently held a seminar at the Sheraton in Framingham on successful tactics in prevailing in a Social Security Disability hearing. Attorney Lipsey served as keynote speaker, addressing trial strategies at the hearing level. There is a tremendous surge in disability applications due to a combination of factors, including the downturn in the economy and the aging of the baby boomer generation.

Social Security-Treating Physician Rule

April 30th, 2010 No comments

Once a person applies for social security disability, they will be subject to a medical examination by the social security administration. They are usual not that helpful. Those examinations are usually used as the basis for a denial of benefits. An applicant should not be discouraged from moving forward. The applicant’s treating doctor’s opinion will be given more weight by the judge than the social security doctor. Therefore, it is important for the applicant to maintain good communication with his/her doctor so when it is time for that doctor to be called on for their opinion, it will be a favorable report. Please contact attorney Bruce S. Lipsey for further questions. 781-829-9100. WWW. elclaw.com.

Applying for Social Security Disability

April 21st, 2010 No comments

The option is there for an individual who is applying for Social Security Disability benefits to either apply on line herself, apply in person at the local social security office or have my law firm file it for you. Given the fact that there is a waiting period of five months before benefits can start, I would recommend waiting a few months before applying. Please contact me with any questions. Bruce Lipsey, Esq. 781-829-9100. elclaw.com

Attorney’s Fees and Social Security Claims

March 4th, 2010 No comments

Attorneys’ fees in Social Security Disability claims are set by the Social Security Administration’s commissioner. Currently, the fee is based on a contingency (you win). The fee is 25% of the retroactive award, with a cap of $6,000. So, if the retroactive is $10,000, the fee is $2,500 and that is mailed directly by the government to the attorney without the claimant’s involvement. Please contact Bruce Lipsey at Epstein, Lipsey & Clifford, P.C. for more information. 781-829-9100. blipsey@elclaw.com

Does Social Security Have a Lien on 3rd Party Settlements?

February 8th, 2010 No comments

If a person receives SSDI payments as a result of being disabled in a motor vehicle accident and then receives a settlement from the driver responsible for the accident, does Social Security have a lien on a third party settlement?

Based on current regulations and statutes, Social Security does not have a lien, however, pursuant to 42 U.S.C. 1395y(b)(2) (“The Medicare Secondary Payer Act”) provides that Medicare beneficiaries are required to reimburse Medicare for injury-related medical expenses paid by Medicare on a conditional basis for which recovery has been made as legal settlement with a third party. As of January 1, 2010, third party insurers will be obligated to inform Medicare any individual who is seeking a third party settlement who may be entitled to Medicare. Therefore, it is very important to identify at the beginning of a case whether or not their will be a potential Medicare recovery so that we can properly coordinate which Medicare paid medicals are related with the third party insurer and so that proper funds can be paid to Medicare at the time of settlement.

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