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Ginsberg Law Offices

Month: March 2006

It has been 8 months and I have not heard anything

I applyed in the end of July of 2005 and completed everything that they wanted and now it has been almost 8 months and still nothing I tried calling and she isn’t calling me back and haven’t recieved anything in the mail. –Jessie

Jonathan Ginsberg responds: Jessie, you don’t say where you live, but it appears to me that something is not right. First, after you apply, you should be sent a written acknowledgement of your claim. If you have not received this, then I would be concerned that your case file has been lost.

Second, the wait for an initial decision is usually three to five months. If it has been eight months, that is too long.

I would suggest the following. First, you should call SSA at 800-772-1213 to see if you are in the system. Confirm that they have your correct address and advise the telephone operator that you have not received anything about your claim.

Second, I would send a letter, return receipt requested, to your local Social Security office. If you have the name of an adjudicator, direct your letter to that person. Ask for a status update and also state in your letter that you have not received a denial notice of your initial application and that this letter should serve as your appeal of any such denial.

Finally, I would enlist the help of your Senator’s office. Every U.S. Senator has one or more staff persons who assist Social Security claimants. Sometimes a phone call or letter from your Senator can get the process moving. If SSA has lost your file, you will want to ask them to “rebuild” it while honoring your original filing date.

–Jonathan

Applied 6 months ago – still waiting…

I applied for SSD pension almost 6 month ago and have still no answer. Howe long can SSA try to starve you out. I`m also from Germany and ask myself what`s going on. I know there is a treaty with Germany caled totalisation agreemebt. When I went to SSA and applied for supplement SSD they told me I got enough credits (28) to get disability. That`s all good, but when howe long can they let me suffer so my sittuation is getting just worse? That`s exactly what the Insurance company (workcomp) already tried in the last 4 years. It wold be great if somebody can give me an answer. Thanx in advance. –JD

Jonathan responds: Joachim, thanks for your email. Unfortunately, you are discovering what most disability applicants know – the Social Security system is in crisis. It has been my experience that the typical wait for a decision at the administrative level is about 3 months – if it has been 6 months, I would be concerned. On the web site for my disability book I posted a link to a government report showing that the average case processing time is 3 years, of which SSA employees spend about 7 working days.

SSA has been known to lose files and this is a warning sign. I would suggest that you call the SSA field office that sent you an acknowledgement of your claim being filed to verify that your file is being worked on. You might also want to send in copies of your medical records (sent registered mail, return receipt requested).

It is not clear from your email if you currently live in Germany. If you live in the U.S., I would ask your Senator or federal Congressman for help as well. I also wonder – if you have any medical records from Germany, there may be a translation delay.
In my view any correspondence with SSA should be made in writing with return receipt requested. The bottom line – do not assume that SSA is looking out for you – you need to confirm that they have your file.

Jonathan

Diabetic husband has been struggling for years – has hearing in a few weeks

my husband has juvielle diabetes, depression, numbness in feet, and he can’t do the same work he used to do he has to see a judge in a couple of weeks. He put off getting a lawyer. He has alot of mood swings and can’t hold any job he’s only been able to hold a job for 8 months or fewer and up to a year in the last 15/20 years. He has stomach problems by digesting his food. What do you think about him winning his case? Does he even have a chance by your opinion? –Angie

Jonathan Ginsberg responds: Angie, thanks for your email and I’m sorry to hear about your husband’s issues. Based on what you write, I think that he has a good chance at getting approved for benefits. Here are a couple of thoughts….

First, you need to find out if he is “insured” for Title II disability. As a rule, he needs to have 20 covered quarters out of the last 40 quarters. As there are 4 quarters in a year, that means he needs to have worked for 5 out of the last 10 years. The way the system works if he has earned around $3,000 in a calendar year, he gets credit for 4 quarters. You can find out if he has enough quarters for Title II disability by filling out a form 7004. It is important to know if he is covered because if he is not, he would only be eligible for SSI. And SSI can be offset by your earnings, assets and other factors.

Assuming he is covered, he needs to apply. That’s easy and free – call 800-772-1213. The next step is to build a winning case. Although he can hire a lawyer at any step in the process, in most cases there is not much a lawyer can do until SSA denies his claim. Some folks even wait until the second denial (reconsideration) before hiring a lawyer. I have written a book about winning at the initial and recon levels – see www.disabilityforms.com. My book and course explain how to fill out the forms using the terms and approach most attractive to Social Security.

My book is designed to help people at the initial and recon stages – if you have to request a hearing, I’d say you are better off with a lawyer. My disability lawyer referral link is here. If you hire a lawyer at this late date, your lawyer may (or may not) want to ask for a continuance to make sure that the file is updated.
The way you win is to find a treating doctor who will support your argument that your husband would not be a reliable worker because of unscheduled absences caused by any physical or mental health limitations. The technical term for this is “residual functional capacity.” In other words, what capacity for work remains after you take into account the limitations caused by his medical problems?

One word of caution – I have found that Social Security tends to see things in black and white. Part time work that generates income can confuse the issue – SSA often concludes that if you can work Job XYZ part time then you could probably work a less demanding Job ABC full time.

And finally, I think that your husband may be better off focusing on one of his conditions as the primary reason he cannot work. I have found that SSA is more receptive to a clear theory of disability based on one major problem than disability based on numerous problems.

–Jonathan

SSI recipient having trouble with Medicaid

My nephew has SSI and is having problems with his medical bills being paid. Medicare said he has Medicade and Welfare said no, he has Medicare so no one is paying his medical bill and his bill are getting higher. Who is to pay? They said to get in touch with SSI. Why? –Betty

Jonathan responds: Betty, if your nephew is getting SSI, he is automatically eligible for Medicaid, not Medicare. Medicaid should be paying the bills. I would suggest that you call your local Social Security office as well as the State Medicaid office. Realize that Medicaid is a State operated program that receives funding from the federal government so you will need to call both the State Medicaid office as well as your local SSI (Social Security Administration) office. Sometimes, your federal Senator or Congressional representative can be very helpful in cutting through the red tape.

–Jonathan

What are the rules for my trial work period?

Hi, I have been disabled for a few years now and am thinking about returning to work, I would like to stay under the amount necessary to continue my ssd ? How do I do that? and do I report the income to someone at ss?AND what if I want to TRY returning to work full time? –Valerie

Jonathan Ginsberg responds: Valerie, the answer to your question can be found in SSA publication 05-10003. Basically it provides that for 2005, you can earn $830 per month without being considered “substantial gainful activity” ($860 per month for 2006). If you have never tried to work before you have a 9 month “trial work period” where you keep your benefits no matter what you earn. If you earn less than $590 per month ($620 for 2006) it does not count as one of the 9 trial work period months. You must report all earnings to Social Security. You can call your local SSA office or SSA’s national number -800-772-1213.

ADHD Child SSI claim

Ii just got custody of my nephew from cps and he has been in residential treatment centers in fort worth, we had him tested thru the school system and discovered that he is emotional disturbed and has adhd and boplar disorder2 and also has obsessive defiant disorder we also learned that we had to put him in special education classes because of an issue that he was acting out inappropriately in class(taking his clothes off in front of the other students in the class) The school system suggested that we try to apply for benefits. He is only five years old.
–Felicia

Jonathan Ginsberg responds: Child SSi claims are different than adult disability claims and different rules apply. Generally, to win a child SSi case, you have to show that the child meets a “listing.” Click on the link to view the listing most closely related to ADHD. As you might imagine ADD and ADHD diagnoses are commonly seen in Social Security courtrooms and judges are very concerned that some parents are too quick to label their children as ADHD or ADD. As such it has been my observation that you will need a treatment history and support from a treating psychiatrist or psychologist. You can learn more about the child SSI process by requesting the free report available on the web site for my child SSi disability guide.

–Jonathan

Accrued a lot of debt while on SSI-can they go after my benefits?

I am receiving SSI benefits but have accrued a lot of credit card debt. If the credit card companies sue me can they garnish my SSI check?
–Tracy
Jonathan responds: No, your SSI check is exempt from garnishment. However, if a credit card company sues you and gets a judgment, your bank account could be at risk of a garnishment. In theory SSI money in your bank accout should be protected, but I would not depend on the bank to know that, especially if you use the bank account for regular transactions. You might want to open a savings account that is only used as a deposit account for your SSI or you may want to receive your SSI payments by check.

If you have been considering bankruptcy, be aware that there are new laws in place and new restrictions on discharging recently incurred credit card debt.

Qualified Medicare Beneficiary program

I am the responsible payee for my 43 year old permanently disabled son. He receives social security disablilty benefits of $776. monthy and $42.00 food stamps. The State of Florida pays his Medicare premium of $88.50. monthly.[I don’t know what department of Florida pays it-don’t know how to find that.]

My question is I called Medicare and they informed me of a program called QMB [Qualified Medicare Beneficiary]. Is there such a program in the state of Florida? Also, Why can’t my son qualify for SSI. He is single, lives in his own appartment and IS diagnosed with spina bifida, AADD and bipolar. His psychiotrist informed me that because of his cost share through Medicard is $525 monthly, he will have to pay the difference of $49. a visit. He doesn’t have it!

Can you give me a direction to go to for help for him. He really needs the help as, according to his urologist, his condition will worsen as he ages and might requite surgery in the future. I would greatly appreciate any help you can give me. I have spent days on the phone trying to get answers. I keep getting sent to another agency to no avail.Thank you.

Jonathan Ginsberg responds: Cynthia, I know very little about Qualified Medicare beneficiary programs. My understanding is that this program pays the Medicare Part B premiums for individuals whose monthly income falls below a certain level.

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