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Category Archives for Strategies for winning

Unlock Thousands in Social Security Disability Back-Pay with the Borderline Age Rule

One often-overlooked rule in Social Security disability cases can mean the difference between approval and denial—or even add thousands of dollars in back pay to your client’s award. That rule? The “Borderline Age” regulation. You can read the actual regulation at https://secure.ssa.gov/poms.nsf/lnx/0425015006

I’ll exactly how the borderline age policy works in Social Security disability cases, why it matters, and how strategic use of this rule can significantly increase a claimant’s past due benefits. I have used the borderline age policy in several recent cases without any push back from judges and the net result meant thousands of dollars added to lump sum payments for my clients.

WATCH A SHORT VIDEO ON THE BORDERLINE AGE RULE

What Is the Borderline Age Rule?

The Borderline Age Rule comes into play when a claimant is close to aging into the next higher age category defined by the Social Security Administration (SSA). These categories are:

  • Younger individual: 18–49
  • Closely approaching advanced age: 50–54
  • Advanced age: 55–59
  • Closely approaching retirement age 60+

SSA uses these categories to determine how easily a claimant can adapt to other work, which is a critical factor in disability decisions under the Grid Rules (also known as the “Medical-Vocational Guidelines).” I publish a website explaining how the grid rules work – you can find it at https://gridrules.net. Continue reading →

Winning Social Security Disability Claims for Lyme Disease: What Works for Me

Lyme Disease and Social Security disabilityAs a Social Security disability attorney, Lyme disease cases represent a complex, frustrating, and often misunderstood type of disabling chronic illness. While the acute phase of Lyme disease is widely recognized and typically responsive to antibiotics, a subset of individuals develop long-lasting symptoms—often referred to as “chronic Lyme disease” or “Post-Treatment Lyme Disease Syndrome” (PTLDS). These cases are challenging both medically and legally, particularly when pursuing Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.

In this blog post I will discuss winning strategies that I have used over the past few years to develop a compelling case for benefits based on Lyme disease.

Lyme Disease – the Basics

Lyme disease is caused by a bacteria called Borrelia burgdorferi, transmitted by ticks. While early-stage Lyme disease is well understood, PTLDS is still gaining wider medical acceptance. A recent Johns Hopkins study found that 14% of early-diagnosed patients developed prolonged symptoms such as fatigue, musculoskeletal pain, and neurocognitive impairment. More recently the Wall Street Journal published an article entitled “Chronic Lyme Disease Acceptance Grows Among Doctors After Years of Debate.”

Interestingly, the aftermath of COVID-19 has offered the public and medical professionals a clearer picture of how infectious diseases can lead to persistent, debilitating post-viral syndromes. I believe that this context helps Social Security judges understand chronic Lyme within the broader framework of post-infectious disability syndromes. Continue reading →

Continuing Disability Reviews – What You Need to Know

continuing disability reviewWhen you are approved for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), that approval is not necessarily permanent. SSA is putting increasing efforts into conducting Continuing Disability Reviews (CDRs) to determine whether you still meet the medical criteria for disability. Members of Congress – both Democrat and Republican – are encouraging SSA to conduct more reviews because the Social Security trust fund is running out of money and they see CDRs as a tool to keep the disability trust fund solvent, and to avoid making difficult political decisions about actually fixing the problem.

In this post, I will explain what a CDR is, how the process works, the strategic decisions you must make if you receive a notice of intent to terminate benefits, and how ongoing medical treatment is your strongest line of defense.

 

Continue reading →

Comedian John Oliver Explores the Social Security Disability Mess

Comedian John Oliver takes a cynical and very funny look at the Social Security disability and SSI system.  For those of you caught up in the nonsense, the humor may be a little bittersweet but hopefully the attention he brings to Social Security disability will result in some positive changes.

Your SSI Payment is Not Enough? Can You Apply for SSDI to get More Money Each Month?

If you are receiving SSI payments you know that your monthly check does not go very far. In 2022, the maximum an individual can receive from SSI is $841 per month. Obviously $841 per month does not go very far.

Do you have the option to “upgrade” to SSDI disability benefits?

Unfortunately the answer to this question is most likely “no.”

SSDI is only available if you have sufficient earnings credits based on past work you have done and taxes paid into the Social Security system. If you applied for and were awarded SSI in the past, that means that you met SSA’s definition of “disability” but that you did not have enough credits for SSDI.

Both SSI and SSDI use the same definition of disability – that being a person is disabled if he/she can no longer perform substantial gainful activity due to a medically determinable condition that has lasted or is expected to last 12 consecutive months or result in death. Continue reading →

How to Win Your PTSD Social Security Disability Case

Why does Social Security make it so difficult to qualify for SSDI benefits due to PTSD and what do you really need to win?

I have represented hundreds of clients in PTSD cases – some are military veterans who served our country in Iraq, Afghanistan, Bosnia and many other places. Their PTSD often arises from seeing bombs explode nearby, seeing fellow soldiers or civilians killed by roadside bombs, or sometimes just living for months under unrelenting stress, never knowing from one minute to the next whether your life will be at risk.

Other PTSD cases arise from sexual abuse, physical abuse, and emotional abuse from childhood or from a previous relationship or even a toxic work environment.

Still other PTSD cases arise from severe emotional trauma like losing a child or a spouse to violence or an accident.

How could SSA deny any of these cases? Continue reading →

Mental Health Disability Claims: Do You Have a Winning Case?

mental health disabilityI have written about this issue before but, given the stress of the coronavirus pandemic, I think this question deserves another look because just about every case evaluation I see contains allegations of some mental health concern.

I suspect we will be dealing with the repercussions of Covid-19 for years. In Atlanta, where I live, it seems that every night we see news stories of road rage shootings and other violent crimes.

Entire sectors of the economy have been devastated, causing upheavals in the job markets. How many restaurants have closed over the past year? How many men and women in the hospitality, tourism or travel industries are out of work? And for those who remained employed, many had to adjust to working from home while balancing child care and school-from-home obligations.

It is certainly no wonder that daily stress – whether financial, interpersonal or otherwise – has resulted in more cases of clinical depression and anxiety disorders. Hardworking men and women who might have been struggling with depression or social anxiety but was “getting by” now find the pressure of adapting to a post-pandemic world simply too much.

Here is some of what I see from potential clients in case evaluation requests:

“I cannot physically, mentally and at times emotionally work more than a few hours a week. I have noise intolerance with voices, music, and sounds, especially higher pitches. I have to wear noise cancelling ear phones and they don’t fully help. I cry at times from overstimulation which could be even from thinking, planning or riding in a vehicle. I cannot drive.”

“I have severe depression and anxiety and I can no longer focus on my work. And I had suicidal thoughts I am writing this right now it is 4:35 in the morning. I don’t sleep and I am taking antidepressants like mirtazapine 45 mg and am always sleepy and tired.” Continue reading →

How and Why Social Security Makes it Extremely Difficult to Change Lawyers

Several times a month I hear from a potential client who expresses dissatisfaction with their current attorney (or non-attorney representative) and wants me to review their claim for possible representation. In some cases the potential client has already dismissed the representative and is looking for new representation.

Unfortunately Social Security makes it complicated to change attorneys – although it can be done.

Delays in Your Case Arise from SSA’s Massive Dysfunction

First, I would tell anyone who is thinking about firing their current representative to think twice about this step. The Social Security Administration is massively dysfunctional and most of the time the long delays in disability cases is not the representative’s fault.

A recent article in the Washington Post describes this dysfunction in very stark terms – SSA has effectively been closed for in person access for almost two years (since the beginning of the pandemic) with no projected re-opening in sight. SSA employees are working at home, often without necessary equipment or access to needed files.

According to SSA’s own statistics, the “head count” of Social Security employees in 2021 was less than it was in 2008 despite a massive increase in the number of baby boomers retiring and demand for Social Security’s services. Callers to SSA’s “800″ number are routinely put on hold for hours before having their calls disconnected.

If you want to get a sense of what is going on “inside” SSA take a moment to read what a Social Security field office manager has to say about the state of operations. Statements like “we are a disaster and holding it all together on the back of managers that are breaking” and “many agents don’t have updated mail machines so we must weigh envelopes individually and seal them by hand. The process takes hours. After outgoing is done all day – we handle incoming. Hundreds of documents from the public daily in some cases. Items go missing regularly” don’t inspire a lot of confidence. Continue reading →

What does it take to win a Social Security disability claim based on a mental health impairment in 2022?

In my Social Security disability law practice I am seeing an increasing number of case inquiries from men and women struggling with mental health issues like depression, anxiety, and PTSD. This surge in inquiries is in addition to our case inquiries from potential clients who are dealing with more organic mental illnesses like schizophrenia or the after effects of traumatic brain injury.

Like many others, I suspect that the Covid pandemic is a trigger for increasing numbers of depression and anxiety related claims. Onsite work is stressful both because of concerns about becoming infected and because fewer workers are being asked to do more.

Remote work has changed the social dynamic of employment. More people work alone with only occasional electronic interaction with co-workers or customers. Rambunctious school aged children may or may not be home, depending on whether a school system had to close for a week or month.

Every day I speak to several very stressed out potential clients to tell me that they simply do not have the mental energy or capacity to remain in the workforce. Some have quit while others have been fired for excessive absences or lack of productivity. Continue reading →

What You Need to Win a Mental Health Disability Case if You Treat at the VA

Can you win Social Security disability benefits based on a mental health issue like PTSD, anxiety, depression or bipolar disorder if the only records in your case file are VA (Veterans Administration) medical notes?

My experience over the past few years has been that you can win Social Security disability for mental health claims using VA records but it is becoming increasingly difficult to win benefits with only VA records. This is true even in the case of veterans who have a 100% service connected VA disability rating.

VA Disability Ratings Are Not Binding on Social Security

I have always found it odd that a VA disability determination is not binding at all on the Social Security Administration. VA disability is different from Social Security in that the VA system issues ratings in percentages whereas Social Security is “all or nothing.” You can have a 70% VA rating but there is no equivalent in Social Security – either you are 100% disabled or you are not disabled at all.

You may be frustrated and disappointed that your 100% VA disability rating is not binding in any way on Social Security in disability determinations.’

I fully understand the frustration of military veterans who are struggling with PTSD, depression, anxiety and perhaps a variety of physical problems who cannot understand why they have to go through another disability adjudication process after they have fought the VA for months or years. Continue reading →

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