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Everything You Need to Know About Medical Professionals

In working with Jan Dils, Attorneys at Law, you’ll quickly find that, above all else, we believe that treatment is the most important aspect of any Social SecurityMedical Professional Disability (SSD) and/or Supplemental Security Income (SSI) claim. Without proper medical treatment, you likely won’t receive a favorable decision on your claim—it’s that simple. After all, medical evidence is how we prove that you have a disability. With that in mind, we wanted to provide an overview of different types of medical treatment and explain the differences.

Licensed Medical Doctors

At the very top of the list of medical providers are licensed, medical doctors. A medical doctor has years of training and education specializing in the medical field. Some doctors specialize in certain disciplines and can be considered experts or specialists in a specific medical field. Being diagnosed and treated by a doctor can help you get your claim approved.

Licensed Psychologists and Psychiatrists

Psychologists and Psychiatrists are licensed doctors, too, but they specialize in mental disorders. If you’re claiming that your disability is a result of a psychological condition, such as depression, anxiety, PTSD, bipolar or another mental health condition, you should be treated and diagnosed by a licensed Psychologist or Psychiatrist.

Nurse Practitioners

A Nurse Practitioner is a nurse with an advanced degree in nursing. A Nurse Practitioner can treat and diagnose acute illnesses. The Social Security Administration (SSA) does accept the diagnosis made by a Nurse Practitioner for SSD/SSI, but a Licensed Medical Doctor is preferred. Regardless, continuous treatment will likely help your claim. Keep in mind that if you’ve only been diagnosed by a Nurse Practitioner, SSA may have you seek another opinion from a Licensed Medical Doctor.

Chiropractors

 A Chiropractor is a healthcare professional focused on the diagnosis and treatment of neuromuscular disorders, with an emphasis on treatment through manual adjustment and/or manipulation of the spine.

Most Chiropractors seek to reduce pain and improve the functionality of patients as well as educate them on how they can improve their own health via exercise, ergonomics and other therapies to treat back pain. Just like with a Nurse Practitioner, a Chiropractor’s diagnosis alone may not be sufficient for SSA. A secondary opinion may be necessary from a Licensed Medical Doctor for a favorable decision.

 

Overall, medical treatment is important for any Social Security claim. If you have questions about the Social Security process, give us a call for a free consultation. Our toll-free number is 1-877-526-3457. If you can’t talk now, fill out this form so that we may call you at a better time.

What is a Social Security Payee, and What Do They Do?

It’s no secret that seeking Social Security Disability is a complicated process. For some, financial management is just as complicated. Individuals who are approved for Social Security Disability (SSD) and/or Supplemental Security Income (SSI) and who also have issues with managing their money may have to use a payee.

The large majority of Social Security clients are capable of handling their own finances and don’t need a payee. Some people, however, may have difficulties maintaining their own finances. If so, Social Security reserves the right to assign a payee.

What is a payee, and what do they do?

According to the official Social Security Administration (SSA) website, Social Security’s Representative Payment Program provides financial management for the SSD and SSI payments of beneficiaries who are incapable of managing their SSD or SSI payments. The website goes on to state that they prefer for payees to be friends or family members. However, they realize that’s not always possible. When friends or family are not able to serve as payees, SSA looks for qualified organizations to be the representative payee.

Not everyone can be a payee. SSA will need to approve a person first. They produce a guide that explains how to handle many different situations that a payee may face. This guide is quite comprehensive and covers everything from medical care to nursing home costs.

If you need a payee and don’t have a family or friend who can handle your finances, you’re not out of luck. There are some agencies approved by SSA who can act as a payee on behalf of a Social Security recipient.

So, how is it determined that a payee will be needed/required? The decision is that of SSA, not the recipient. An obvious example of someone who will need a payee would be a child. Everyone will likely agree that children probably shouldn’t be put in charge of their own finances.  Other instances of payee use would be people who are not mentally capable of handling their own finances, such as an individual who has had a severe brain injury or someone with a severe cognitive or mental disability.

It’s a lot of responsibility, but the work a payee does can make a huge difference in the life of someone on Social Security. If you’d like to know more about this program, or if you’d like to talk to us about a free consultation, call our toll-free number at 1-877-526-3457. If you can’t talk now, fill out this form so we can call you at a better time.

What is the difference between an ALJ and a Disability Examiner?

Anyone who has pursued a Social Security disability claim knows that the number of acronyms can become confusing very quickly. For instance, did you know that SGA stands for Substantial Gainful Activity? Another good example is ODAR. Does it stand for Office of Disability Adjudication and Review, or is it Office of Disability Approvals and Reconsiderations? Both sound like they could be correct, and they sound very similar, but only one is right. (It’s the former.) In Social Security, even people have acronyms, and two of the most common are DDS Examiners and ALJ’s. So what do they do?

First, let’s get the letters out of the way. A DDS Examiner is a Disability Determination Section Examiner, and an ALJ is an Administrative Law Judge. On the surface, it may appear that both of these individuals have the same job. But in reality, what they do is different, and their roles come into play at different stages.

A DDS examiner is the first of the two individuals to be involved in your case. He or she is a state employee who is tasked with making the initial and reconsideration decisions on your case. A DDS Examiner is responsible for gathering evidence from you and your medical providers in order to prepare your case for a medical review.  They also evaluate the vocational aspects of your case to determine if you can do your past work or adjust to other types of work.  They then prepare the disability determination notice that will be mailed to you.  (Most claims are denied at the initial and reconsideration levels, but the process is far from over, so don’t be discouraged.)

Like a DDS examiner, an ALJ also makes decisions on your Social Security Disability (SSD) and/or Supplemental Security Income (SSI) claim(s). However, the ALJ makes decisions after you’ve been denied at the initial and reconsideration levels. Also, the ALJ works for a different agency. ALJ’s work for the Office of Disability Adjudication and Review (ODAR.) While DDS is a state agency, ODAR is a part of the Social Security Administration (SSA). This means that ODAR is a federal agency. Here’s a simple way to remember the difference: a DDS examiner doesn’t see you in person. On the other hand, you can request a hearing with the ALJ in person. Not only will your claim be evaluated by the ALJ, but there is a possibility that your claim will also be evaluated by a vocational expert. More people are approved after their ALJ hearing than approved by the DDS Examiner.

The final thing to remember is that an ALJ hearing will take much longer to schedule than a review by the DDS examiner. There is a backlog right now in the Social Security Administration, causing ALJ hearings to currently take about 18-24 months to occur from the time the hearing is requested.

We realize that this process can be confusing—that’s why a lot of people come to us so we can help them navigate the Social Security claims process. If you’re lost in the maze, give us a call for a free consultation. Our toll-free number is 1-977-526-3457. If you can’t talk now, fill out this form.

How College Impacts Your Social Security Claim

Do you know how your education impacts your social security case?

Sometimes I get too involved in the subject I am writing about for a blog. On occasion, I’ll hear a coworker say something and it will spark a bit of inspiration. Both of these things happened when I heard case manager Kelly Fritz talking to a client recently. She was advising the client about college and how it impacts an individual who is trying to get approved for disability. I immediately thought of myself. Granted, most people who know me will tell you that I immediately think of myself in most situations. Kidding aside, I really hadn’t thought about how education plays a part in the disability process. So, I decided to look into it further.

I think it’s obvious that the purpose of social security disability is to determine if you can work or not. That is somewhat of a generalized version of how Social Security works. Unfortunately, it’s not that black and white. However, for this blog, let’s keep things simple. When looking at everyone applying for social security as a whole, we see a diverse group of people with one thing in common; a disability is keeping them from working. Social Security has two ways to determine if a person is disabled; The Social Security Administration (SSA) evaluates applicants for disability in two ways:

  • whether an individual’s impairment(s) meets or equals the criteria of an official disability listing in the Social Security disability handbook (often referred to as the listing of impairments, or the blue book), or
  • whether the individual’s medical and vocational factors, when considered together, prevents he or she from performing any of their old jobs and any other job in the national economy (disability examiners refer to this as a medical-vocational allowance).

To keep things simple, we will just be focusing on the 2nd option. In this case, yes, your education level can make it more difficult to get approved. If an applicant’s disability or impairment doesn’t meet or equal a listing, and the applicant can’t return to his or her former work, the applicant’s age, work history, and educational background are evaluated to determine if an individual has the capacity to perform less demanding work in a competitive workforce.

How can your education level impact your claim? Well, your ability to perform other types of work sometimes comes down to something called transferable skills. Transferable skills are skills that you have acquired through your past jobs or through schooling that you can use in other areas of the work force that are less demanding. Therefore, if you return to school, you may have additional skills that can be used in other jobs even if you are unable to perform your old jobs.

So, yes, college can impact your claim for social security disability. Just keep in mind that this is not the only factor that impacts your claim and we certainly do not discourage you from furthering your education. You also have your age, health, and many more factors to consider. Let us know if you like to learn more about social security. Call us today for a free consultation. Our toll-free number is 1-877-526-3457. If you can’t talk now, fill out this form so that we may call you at a better time.

 

How to Stay Focused on Your Social Security Case During the Summer

Memorial Day just passed, all of the kids are out of school, and we no longer need to pack a hooded sweatshirt when we venture out for the day. Though summer officially starts in three weeks, the unofficial start is here. I just got back from a weekend road trip, and I am eagerly planning a trip to central Ohio later this month. There is so much to do in the summer time regardless if you are planning trips, being one with nature, or even getting pumped for all of the great shows on Netflix. Summer is a lot of fun, but it’s also an ideal time to get distracted from your social security claim that can have negative ramifications in the long run. Today, let’s talk about 5 ways to keep your social security case on point during the summer.

  1. Schedule your appointments accordingly. Just like you and I can’t wait to go on vacation, your doctor likes to go on vacation too. For many smaller offices, the entire staff usually goes on vacation at the same time. So, there may be weeks during the summer that your doctor’s office is not available. However, if your doctor’s office is open during holiday weeks like the 4th of July or Labor Day, you may be able to get in at the last minute if you need to. The bottom line is to keep your appointments up during the summer. You need to have evidence to get approved, so don’t let your appointments slip due to distractions.
  2. Keep up on paperwork. My post office box is about to burst. I am probably the last person who should talk to you about getting the paperwork back into an office. But, once again, it’s easy to get distracted.
  3. Attend your hearing. It takes a very long time to get a hearing scheduled in the first place. If you cancel your hearing with the SSA, it may be several months or more before you actually get rescheduled. Is that extended time worth skipping?
  4. Take your medication as prescribed. This can be difficult for someone like me to preach, but it can negatively impact your health if you don’t take your medication on a regular basis. Now that everyone has smartphones, it’s easy to set an alarm to remind yourself to take your meds.
  5. If you move, tell someone. Most people move in the summer, especially July, so if you happen to move, call your attorney or the SSA and let them know. Failing to do so can result in lost paperwork and missed appointments. A simple phone call can alleviate these issues.

We know summer is supposed to be a time of fun and great memories, we just don’t want your case to slip by the wayside. If you want to have some help with your claim for social security disability, give us a call today for a free consultation. Our toll-free number is 1-877-526-3457. If you can’t talk now, fill out this form, and we will call you back at a better time.

How Does Incarceration Impact Your Social Security Benefits?

It’s funny how pop-culture can impact the types of questions we are asked at the office. Since the popular Netflix original series Orange is the New Black has returned, we have received quite a few questions about individuals curious about what would happen to their benefits if they went to prison. Before we get too deep into this subject, the people asking us about this are not criminals. I am willing to bet most haven’t even taken a pen from a bank. Rather, they are just curious. Or, they like to be prepared because you never know what may happen in your future. Thankfully, the SSA makes this info relatively easy to obtain.

One of the first things to keep in mind is that the length of time you are incarcerated is important. For instance, if you are arrested one evening and held overnight for a small crime, your benefits likely will not be impacted. In fact, according to regulations, you must be incarcerated or at least 30 days before your benefits will be discontinued. Your benefits may be reinstated after your release.

The SSA goes on to state: Although you can’t receive monthly Social Security benefits while you’re incarcerated, benefits to your spouse or children will continue as long as they remain eligible. If you’re receiving SSI, your payments are suspended while you’re in prison. Your payments can be reinstated in the month you’re released. However, if your confinement lasts for 12 consecutive months or longer, your eligibility for SSI benefits will terminate and you must file a new application for benefits.

If you haven’t filed for Social Security benefits before, you can while you are in prison with a few rules. If your institution has a prerelease agreement with the local Social Security office, it will notify the SSA if you’re likely to meet the requirements for SSI or disability benefits. The SSA will get an application from you several months before your anticipated release. That way, they can begin processing your application and your benefits can start as soon as possible after your release. If you’re filing for benefits based on disability, the SSA will gather medical evidence from your doctors to help them decide whether you still meet Social Security’s definition of disability. Family members or a social worker can help you by contacting Social Security to let the SSA know about your upcoming release. A family member also may be willing to serve as your representative payee if your medical condition prevents you from handling your own finances.

If you’ve been released from prison, and have questions about filing for benefits, give us a call for a free consultation. Our toll-free number is 1-877-526-3457. If you don’t have time to talk now, fill out this form so that we may call you at a better time.

Attorney Fee Misconceptions

It’s probably safe to say that filing for social security disability is one of the most difficult things you can do. It likely ranks up there with marriage and moving as the most stressful things a person may take on in their life. Unlike a move or getting married, there is a lot of uncertainty that comes with pursuing a claim for social security. This is especially true if an individual has filed a claim and can’t work because of their disability. You’re looking at months without an income, and you may be nervous about how you will pay your bills. We understand that difficulty. We’ve been representing clients for more than 20 years. And unfortunately, we have seen the wait for benefits increase.

As a law firm, we work hard to get our clients their benefits as quickly as possible. Unfortunately, we can’t speed up the process. It’s beyond our control. However, since our compensation is based on back pay, some people assume that we will drag a case out to make more money. That’s not true. In all honestly, it makes a lot more sense for us to get our clients approved as quickly as possible. Let’s look at a few reasons why it makes no sense for us to wait.

  1. Our fee is a contingency fee. Simply, a contingency fee means that we only win if you get approved. So, the quicker we get a client of ours approved, the quicker we get paid. However, if we are not successful in your case, we don’t charge any attorney fees. So, if we aren’t successful, we will lose money on your case.
  2. There is a cap on the amount we can receive. For social security, the cap is 25% or $6,000 for cases at the administrative level. (We receive the lesser amount of the two.) So, in other words, at a certain point, It would make no sense for us to make a case last longer. If we were to make a case last longer intentionally, it would be of no benefit to us. Most people don’t see the amount of work that actually goes into a case. Keep in mind, the longer a case goes on, the longer we have to pay employees to request records, review files, and manage cases. So, if you consider overhead, we actually have a lot invested in each case.
  3. In other fields, attorneys charge by the hour, and they charge a lot. If we were to charge by the hour for our cases, the amount would far exceed what we charge with our contingency fee. So, once again, it makes more sense for us to get our clients approved as quickly as possible.
  4. The big elephant in the room regarding a law firm purposely waiting for a client’s case to enhance their back pay is unethical. As a law firm, we are subject to review under the West Virginia state bar and ethics committee. If it were true that we were doing this, we would lose our law licenses.

When we went into business 20 years ago, there were countless areas in which we could practice. We chose to focus on social security because we believed that there were a lot of people who needed help getting approved. We are passionate about the law, and we work hard to help people get the benefits they deserve.

If you’d like to know more about our services, of if you’d like to ask us questions about becoming a client, call us today. Our number is 1-877-526-3457. If you can’t talk now, fill out this form, and we will call you at another time.

How Do Auxiliary Benefits Work in Social Security?

Social Security disability is often confusing. Further, there are a ton of special programs and rules that many people don’t realize exist. Recently, while talking Lawyer and Clientwith one of our senior employees, one of these common situations came up. She asked me if I knew anything about “auxiliary benefits.” I must have had a confused look on my face because she immediately started to explain them to me. As I returned to my desk later I realized that if I was confused by this, then surely a lot of our clients were confused by the term too. So, I did what I always do in a situation like this, I turned to Google.

Let’s get the easy part out of the way. What are auxiliary benefits? Essentially, auxiliary benefits are paid to dependent spouses and children of individuals receiving social security.

Who is eligible? This program is only for those individuals pursuing SSDI, not SSI. SSI applicants are not eligible for auxiliary benefits. For a dependent spouse to receive auxiliary benefits, they must be at least 62 years old or have a child who is either under the age of 16 or disabled. For a child to receive auxiliary benefits, they must be a minor (under 18) be found completely disabled before turning 22 or be a high school student under the age of 19.

You may also wonder how much a person will receive when they are granted auxiliary benefits. For the most part, an eligible dependent can receive up to 50% of the disabled person’s benefits. For instance, if a mother was granted SSDI at a rate of $800 per month, her dependent child could likely receive $400 per month. It’s important to note that there is a cap on how much a family can receive. This is referred to as a family maximum. Traditionally, auxiliary benefits are payable to spouses and children of disabled workers.be aware that these benefits are limited. The family maximum for the family of a disabled worker is 85 percent of the worker’s Average Indexed Monthly Earnings (AIME). However, it cannot be less than the worker’s PIA (primary insurance amount) nor more than 150 percent of the PIA.

Auxiliary benefits can be very beneficial for a large family, a single parent, or really anyone with dependents. It’s important to remember that these benefits can be altered if your family size changes. For instance, if you have a child, your benefits may go up. If your child leaves for college or reaches an age higher than the set limit, your benefits may go down.

If you weren’t aware that you could receive auxiliary benefits, or if you did, but need assistance with your claim, give us a call. We’d love to talk to you. Our consultation is free. Just call via our toll-free number, 1-877-526-3457. Or, if you can’t call right now, fill out this form, and we will call you at a better time.

4 Resolutions to Help You Get The Social Security Benefits You Deserve in 2017

It’s a new year and that means that many people are making a lot of New Year’s resolutions. While most people will resolve to lose weight or to save money, it’s Why does Social Security Have a 5 Month Waiting Periodalso a good time to make resolutions for your social security claim too. Now that may seem silly to some, but starting the new year with good habits can help you get a favorable decision. Here are four resolutions to make in 2017 to help your social security claim.

  1. Keep getting treatment. I understand that most of the people reading this blog post hate going to the doctor. I hate going to the doctor too. It’s tough. I believe most people hate it because they fear the unknown or are worried about what news may be delivered. However, neglecting to go to the doctor can mean more issues down the road. When it comes to your social security claim, gaps in treatment can mean an unfavorable decision for your case. Simply put, medical treatment and records are among the most important factors for an individual getting their social security claim approved. Take a moment to think about social security disability in its simplest form. I know that the process is complicated, but think about what it is at its core. Simply, Social Security Disability is a program to aid individuals who have disabilities that no longer allow them to work. To prove you have a disability that prevents you from working, your medical records must show limitations in work-related activities that prevent you from seeking gainful employment for a minimum of 12 months. For that to happen, you must go see a doctor first. Further, it can’t just be once or twice. You need to have consistent treatment.
  2. Keep the SSA and your attorney up to date. Many cases are lost because a client goes missing. Now, these clients do not really go missing, but rather they quit communicating with their representatives and/or social security. If you’re working with a lawyer, you need to let them know when you move, change phone numbers, and have new doctors’ appointments. There are times in a social security case where it may seem as if nothing is happening for months, but then there will be instances in which you’ll need to be contacted multiple times. It’s just the nature of how social security works. If we can’t reach you by phone or through the mail, then we are unable to properly develop your case. In recent years, we’ve made large strides in making communicating with us simple and adaptable. Of course, our clients can call us, but we also make use of an answering service after hours and we have two options for contacting us on our website. Some clients even make use of our Facebook and Twitter profiles to stay in touch with us.
  3. Get organized. This is a tip all of us could stand to benefit from this year. The SSA sends out a lot of paperwork that you should keep in a safe place. There’s also a good chance your doctor sends you a lot of paperwork too. If you’re represented by a firm like Jan Dils, Attorneys at Law, you’ll receive a lot of documents from us as well. Take some time this year to organize all of your documents and records in one place, and make them easy to navigate. It can seem like a daunting task, but you’ll be glad you took the time to do it down the road.
  4. Educate yourself about the process. Social Security is long and complicated. It’s also frustrating. I doubt you’ll get through the process without getting upset a few times. It’s simply the nature of the Social Security disability claims process. If you find yourself in a situation like this, don’t give up. We find that a lot of people get frustrated and then eventually quit pursuing a Social Security claim because they simply don’t understand how it works. Currently, it takes at least 12-18 months to receive a hearing date after requesting one. That does not count all of the time beforehand. That means that many claims last over two years! There are numerous reasons why, but what’s most important is that you know this is likely going to happen to you. Also, you are likely going to be denied. As a firm with over 20 years’ worth of experience, we know this impacts most of the people who file for Social Security. Knowing what to expect ahead of time will better prepare you for the rollercoaster that is the Social Security process. So, how do you prepare? There are a lot of great resources online. The SSA website is a great start, but there are other options. The Jan Dils website features a great blog and many FAQs regarding Social Security. We like to take our clients a step further, To help aid your claim, even more, request a copy of our social security how to guide. There are both physical and electronic copies available.

If you’d like to know more about the types of services we offer, or if you’d like to talk to someone about your social security claim, call us today for a FREE consultation. Our toll-free number is 1-877-526-3457. If you’re not available to chat now, fill out this form so that we may contact you at a later time.

Who Qualifies For Social Security Disability Benefits In West Virginia?

Anyone applying for social security disability benefits in West Virginia will have their submission evaluated by the West Virginia Disability Determination Section. Although this organization solely handles social security disability requests in West Virginia, they are still required to follow federal laws and guidelines, as determined by the Social Security Admission.

As a result, anyone that qualifies for social security disability benefits in another state will still qualify for them in West Virginia and vice versa. In general, an applicant is entitled to social security disability benefits if they are found to be too disabled for any form of prolonged work. An experienced SSDI lawyer can help guide prospective applicants through the process more effectively, but this guide will attempt to look at the different limitations for adult and child applicants.
Adults

When an adult applies for social security disability benefits in West Virginia, the Disability Determination Section will pass the evaluation on to Disability Evaluation Specialist, who will then work on the specific case to determine if the applicant is sufficiently disabled. A person is not considered sufficiently disabled unless they can prove that they are prevented from any meaningful work due to an ongoing physical or mental issue that is expected to continue for at least 12 months. In fact, both West Virginia’s Disability Determination Sector and the Social Security Administration have a list of viable impairments for each major part of the body. By reviewing this list with an SSD lawyer, you can see if your impairment qualifies for social security disability benefits.

Children

Children under the age of 18 that apply for supplemental security income go through a process that is very similar to the one for adults that apply for social security disability insurance benefits. They must still prove that they are medically incapable of performing activities comparable to other children of their age for at least 12 months and that they are otherwise severely limited in their functionality.

Even though the Social Security Administration provides a list of acceptable impairments, this alone does not mean someone’s application will be approved. Evaluation specialists are thorough in reviewing an applicant’s materials and will not hesitate to send a rejection. You can offset this by being thorough in your own application and ensuring that all of your materials have been sufficiently prepared.