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How to Qualify for Social Security Benefits PDF Print E-mail
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I. How to Qualify for Social Security Benefits
A. Military and Social Security Benefits
The earnings of people who serve in the military services on active duty or on active duty
for training have been covered under Social Security since 1957. Inactive duty service in
the armed forces reserves (such as weekend drills) has been covered by Social Security


since 1988. However, people who served in the military before 1957 did not pay into
Social Security directly, but their records are credited with special earnings for Social
Security purposes that count toward any benefits that might be payable. Additional
earnings credits are given to military personnel depending on when they served. This fact
sheet explains how and when these special earnings are credited and provides other
general information military personnel need to know about the benefits available from
Social Security.
1. Paying Social Security And Medicare Taxes
While you're in the military service (from 1957 on), you pay Social Security taxes the
same way civilian employees do. Those taxes are deducted from your pay and an equal
amount is paid by the U.S. government as your employer. In 1999, the tax rate is 7.65
percent up to a maximum of $72,600. If you earn more than that, you continue to pay the
Medicare portion of the tax, 1.45 percent, on the rest of your earnings.
2. Social Security "Credits"
You earn Social Security credits when you work in a job covered by Social Security.
Before any benefits can be paid on your record, you must have credit for a certain amount
of work covered by Social Security. In 1999, you earn four credits (the maximum) if your
annual earnings are $2,960 or more. (You earn one credit for each $740.) The amount
needed for each credit will increase in future years to reflect increases in average wages.
The number of credits you need to qualify for Social Security depends on your age and
the type of benefit you might be eligible for. Nobody needs more than 40 credits (10
years of work or military service) to be eligible for Social Security. In some situations,
you can qualify with less than 40 credits.
3. Applying For Social Security Benefits
There are many kinds of benefits available from Social Security besides those for
retirement and disability. Members of your family and your dependents can receive
survivors benefits if you should die. There's also Medicare coverage and Supplemental
Security Income (SSI) payments. For more information about these benefits, ask Social
Security for a copy of the booklet, Understanding The Benefits (Publication No. 05-
10024).
84
When you apply for Social Security benefits, you'll be asked for proof of your military
service (DD Form 214), or information regarding your reserves or National Guard
service.
4. If You Get Both Social Security And Military Retirement
You can get both Social Security benefits and military retirement. Generally, there is no
offset of Social Security benefits because of your military retirement. You'll get your full
Social Security benefit based on your earnings. However, your Social Security benefit
may be reduced if you also receive a government pension based on a job in which you
didn't pay Social Security taxes. Ask Social Security for a copy of the fact sheet, A
Pension From Work Not Covered By Social Security (Publication No. 05-10045).
Social Security survivors benefits may affect benefits payable under the optional
Department of Defense Survivors Benefit Plan. Check with the Department of Defense or
your military retirement advisor for more information.
5. SSI For Children
SSI pays monthly benefits to people with low incomes and limited assets who are 65 or
older or blind or disabled. If you have a child who gets SSI, those payments may continue
if you’re stationed outside the United States (including Puerto Rico and U.S. territories
and possessions) while in military service and the child lives with you. Your child must
have received SSI the month before you reported for duty.
6. A Word About Medicare
If you have health care protection from the Department of Veterans Affairs (VA) or
under the CHAMPUS or CHAMPVA program, your health benefits may change or end
when you become eligible for Medicare. You should contact the VA, the Department of
Defense or a military health benefits advisor for more information.
73. Earnings Added To Military Records For Social Security Purposes
The "credits" mentioned in the previous section determine if you are eligible for Social
Security. The amount you get from Social Security depends on your earnings averaged
over much of your working lifetime. Generally, the higher your earnings, the higher your
Social Security benefit.

Under certain circumstances, special earnings can be credited to your military pay record
for Social Security purposes. These extra earnings may help you qualify for Social
Security or increase the amount of your Social Security benefit. The extra earnings
credits are granted for periods of active duty or active duty for training. (No additional
earnings are granted for inactive duty training, and Social Security cannot add extra
earnings credits to your earnings record until you file for Social Security benefits.)
Here's when the additional earnings are granted:

a. Service In 1978 And Later
For every $300 in active duty basic pay, you are credited with an additional $100 in
earnings up to a maximum of $1,200 a year. If you enlisted after September 7, 1980, and
didn't complete at least 24 months of active duty or your full tour, you may not be able to
receive the additional earnings. Check with Social Security for details.

b. Service In 1957 Through 1977
You are credited with $300 in additional earnings for each calendar quarter in which you
received active duty basic pay.

c. Service In 1940 Through 1956
If you were in the military during this period, including attendance at a service academy,
you did not pay Social Security taxes. However, your Social Security record may be
credited with $160 a month in earnings for military service from September 16, 1940,
through December 31, 1956, under the following circumstances:
- you were honorably discharged after 90 or more days of service; or
- you were released because of a disability or injury received in the line of duty; or
- you are still on active duty; or
- you are applying for survivors benefits and the veteran died while on active duty.
You cannot receive these special earnings credits if you're already receiving a federal
benefit based on the same years of service. But there is one exception to this rule: if you
were on active duty after 1956, you can still get the special earnings for 1951 through
1956, even if you're receiving a military retirement based on service during that period.


8. For More Information
You can get recorded information about Social Security coverage 24 hours a day by
calling Social Security's toll-free number, 1-800-772-1213. You can speak to a service
representative between the hours of 7 a.m. and 7 p.m. on business days. Our lines are
busiest early in the week and early in the month, so, if your business can wait, it's best to
call at other times. Whenever you call, have your Social Security number handy.
People who are deaf or hard of hearing may call our toll-free "TTY" number, 1-800-325-
0778, between 7 a.m. and 7 p.m. on business days.
You also can reach us on the Internet. Type http://www.ssa.gov to access Social Security
information.

The Social Security Administration treats all calls confidentially--whether they're made
to our toll-free numbers or to one of our local offices. We also want to ensure that you
receive accurate and courteous service. That's why we have a second Social Security
representative monitor some incoming and outgoing telephone calls.

B. Organizations to Find Legal Representation for Social Security Claims
NOSSCR: National Organization of Social Security Claimants’ Representatives -
http://www.nosscr.org/
Established in 1979, the National Organization of Social Security Claimants'
Representatives is an association of over 3,300 attorneys and paralegals who represent
Social Security and Supplemental Security Income claimants. Our members are
committed to providing high quality representation for claimants, to maintaining a system
of full and fair adjudication for every claimant, and to advocating for beneficial change in
the disability determination and adjudication process. To reach NOSSCR: (800) 431-
2804, or e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

C. General Information
To qualify for benefits, you must first have worked in jobs covered by Social Security.
Then you must have a medical condition that meets Social Security's definition of
disability. In general, we pay monthly cash benefits to people who are unable to work for
a year or more because of a disability. http://www.socialsecurity.gov
Benefits usually continue until you are able to work again on a regular basis. There are
also a number of special rules, called "work incentives," that provide continued benefits
and health care coverage to help you make the transition back to work.
If you are receiving Social Security disability benefits when you reach age 65, your
disability benefits automatically convert to retirement benefits, but the amount remains
the same.

Let's look at the requirements more closely:

In addition to meeting our definition of disability, you must have worked long enough--
and recently enough--under Social Security to qualify for disability benefits.
Social Security work credits are based on your total yearly wages or self-employment
income. You can earn up to four credits each year. The amount needed for a credit
changes from year to year. In 2003, for example, you earn one credit for each $890 of
wages or self-employment income. When you've earned $3,560, you've earned your four
credits for the year.
The number of work credits you need to qualify for disability benefits depends on your
age when you become disabled. Generally, you need 40 credits, 20 of which were earned
in the last 10 years ending with the year you become disabled. However, younger
workers may qualify with fewer credits.

IMPORTANT: Remember that whatever your age is, you must have earned the required
number of work credits within a certain period ending with the time you become
disabled. Your Social Security Statement shows whether you meet the work requirement
at the time it was prepared. If you stop working under Social Security after the date of the
Statement, you may not continue to meet the disability work requirement in the future.
The definition of disability under Social Security is different than other programs. Social
Security pays only for total disability.
No benefits are payable for partial disability or for short-term disability.
Disability under Social Security is based on your inability to work. We consider you
disabled under Social Security rules if you cannot do work that you did before and we
decide that you cannot adjust to other work because of your medical condition(s). Your
disability must also last or be expected to last for at least one year or to result in death.
This is a strict definition of disability. Social Security program rules assume that working
families have access to other resources to provide support during periods of short-term
disabilities, including workers' compensation, insurance, savings and investments.
To decide whether you are disabled, we use a step-by-step process involving five
questions.
They are:
1. Are you working?
If you are working in 2002and your earnings average more than $780 a month, you
generally cannot be considered disabled. If you are working in 2003 and your earnings
average more than $800 a month, you generally cannot be considered disabled. If you are
not working, go to Step 2.

2. Is your condition "severe"?
Your condition must interfere with basic work-related activities for your claim to be
considered. If it does not, SSA will find that you are not disabled. If your condition does
interfere with basic work-related activities, go to Step 3.
Is your condition found in the list of disabling conditions?
For each of the major body systems, SSA maintains a list of medical conditions that are
so severe they automatically mean that you are disabled. If your condition is not on the
list, SSA has to decide if it is of equal severity to a medical condition that is on the list. If
it is, SSA will find that you are disabled. If it is not, then go to Step 4.

3. Can you do the work you did previously?
If your condition is severe but not at the same or equal level of severity as a medical
condition on the list, then SSA must determine if it interferes with your ability to do the
work you did previously. If it does not, your claim will be denied. If it does, proceed to
Step 5.

4. Can you do any other type of work?
If you cannot do the work you did in the past, SSA wants to see if you are able to adjust
to other work. SSA considers your medical conditions and your age, education, past work
experience and any transferable skills you may have. If you cannot adjust to other work,
your claim will be approved. If you can adjust to other work, your claim will be denied.
Most people who receive disability benefits are workers who qualify on their own records
and meet the work and disability requirements we have just described. However, SSA
wants to point out some situations you may not know about:
If something happens to you, benefits may be payable to your widow or widower with a
disability if the following conditions are met:
-He or she is between ages 50 and 60.
-The widow or widower meets the definition of disability for adults.
-The disability started before your death or within seven years after your death.
NOTE: If your widow or widower caring for your children receives Social Security
benefits, he or she is eligible if disability starts before those payments end or within seven
years after they end.
You should apply at any Social Security office as soon as you become disabled. You may
file by phone, mail or by visiting the nearest office. You can find out the name and
address of the closest Social Security office here. If you want to apply by phone call our
toll-free number, 1-800-772-1213, and we will set up a time for your local Social
Security office to contact you.
If your application is approved, your first Social Security benefit will be paid for the sixth
full month after the date we find that your disability began.
For example, if your disability began on June 15, 2002, your first benefit would be paid
for the month of December 2002, the sixth full month of disability. Social Security
benefits are paid in the month following the month for which they're due. This means that
the benefit due for December would be paid to you in January 2003, and so on.
In most cases, you will continue to receive benefits as long as you are disabled. However,
there are certain circumstances that may change your continuing eligibility for disability
benefits. For example, your health may improve to the point where you are no longer disabled. Or, like many people, you would like to go back to work rather than depend on your disability benefits. SSA encourages you to do so, and they have special rules called "work incentives" that can help you make the transition back to work. These incentives include, but are not limited to, continued monthly benefits and Medicare coverage while you attempt to work on a full-time basis.

The law requires that SSA review your case from time to time to verify that you are still
disabled. SSA will you if it is time to review your case, and we still keep you informed
about your benefit status. You should also be aware that you are responsible for letting us
know if your health improves or you go back to work. In general, your benefits will continue as long as you are disabled. However, the law requires that SSA review your case periodically to see if you are still disabled. How often SSA will review your case depends on whether your condition is expected to improve.
If medical improvement is "expected," your case will normally be reviewed within six to
18 months after your benefits start.
If medical improvement is "possible," your case will normally be reviewed no sooner
than three years.
If medical improvement is "not expected," your case will normally be reviewed no sooner
than seven years.
Two things can cause us to decide that you are no longer disabled and to stop your
benefits.
Your benefits will stop if you work at a level SSA considers "substantial." In 2003,
average earnings of $800 or more per month ($1,330 or more per month if you are blind)
are usually considered substantial.
Your disability benefits will also stop if we decide that your medical condition has
improved to the point that you are no longer disabled.
You are responsible for promptly reporting any improvement in your condition, if you
return to work, and certain other events as long as you are receiving disability benefits.
The booklet SSA sends to you when your application is approved explains what you need
to report to us.
If you're like most people, you would rather work than try to live on disability benefits.
There are a number of special rules that provide cash benefits and Medicare coverage
while you try to work. SSA call’s these rules "work incentives." For more information
about Social Security work incentives, see Working While Disabled...How We Can Help .
http://www.socialsecurity.gov/pubs/10095.html

Social Security Disability (SSD) for People with Mood Disorders.
http://psycom.net/depression.central.ssd.html
II. Simple Steps To Use When Fighting Your SSD Case
by Linda Fullerton This e-mail address is being protected from spambots. You need JavaScript enabled to view it President/Co-Founder - Social
Security Disability Coalition
A. Social Security pays only for total disability
Social Security pays only for total disability. No benefits are payable for partial disability
or for short-term disability. You are disabled under Social Security rules if you cannot do
work that you did before and if they decide that you cannot adjust to other work because
of your medical condition(s). You have a valid claim if you have been disabled or are
expected to be disabled for 12 consecutive months, or your condition will result in your
death. You should file your claim within 12 months of the date you first became disabled
- Social Security will only pay monetary benefits for a maximum of 12 months prior to
the date of your application. This is true regardless of what date you became disabled. To
decide whether you are disabled, SSD uses a step-by-step process involving five
questions. Are you working? - If you are working and your earnings average more than
$800 a month, you generally cannot be considered disabled. If you are not working is
your condition "severe"?. Your condition must interfere with basic work-related
activities for your claim to be considered. If it does not, they will find that you are not
disabled. Is your condition found in the list of disabling conditions? For each of the major
body systems, SSD maintains a list of medical conditions that are so severe they
automatically mean that you are disabled (The "Bluebook of Listings and Impairments").
If your condition is not on the list, they have to decide if it is of equal severity to a
medical condition that is on the list. If it is, they will find that you are disabled. Can you
do the work you did previously? If your condition is severe but not at the same or equal
level of severity as a medical condition on the list, then they must determine if it
interferes with your ability to do the work you did previously. If it does not, your claim
will be denied. Can you do any other type of work? If you cannot do the work you did in
the past, SSD looks to see if you are able to adjust to other work. They consider your
medical conditions and your age, education, past work experience and any transferable
skills you may have. If you cannot adjust to other work, your claim will be approved. If
you can adjust to other work, your claim will be denied. If possible get a copy of your
personnel file from your previous employer (contact the human resources dept - give
them authorization to send it to you and tell them why you want it - for SSD reasons)
documenting how many days you were absent from work (attendance records, sick days,
doctor's excuses, leave of absence, warning letters etc) due to your illnesses before you
could not work any longer. Keep a copy for yourself send one to SSD.
90
SSR 82-53 TITLES II AND XVI: Basic Disability Evaluations Guides
http://www.ssa.gov/OP_Home/rulings/di/01/SSR82-53-di-01.html
SSR 83-20: TITLES II AND XVI: Onset of Disability
http://www.ssa.gov/OP_Home/rulings/di/01/SSR83-20-di-01.html
SSR 86-8: TITLES II AND XVI: The Sequential Evaluation Process
http://www.ssa.gov/OP_Home/rulings/di/01/SSR86-08-di-01.html
SSR 82-52 TITLES II AND XVI: Duration of the Impairment
http://www.ssa.gov/OP_Home/rulings/di/01/SSR82-52-di-01.html
SSR 73-7c: SECTION 223(d) - (42 U.S.C. 443(d) – Disability Insurance Benefits –
Duration of Inability to Engage in Substantial Gainful Activity
http://www.ssa.gov/OP_Home/rulings/di/03/SSR73-07-di-03.html
SSR 85-28: TITLES II AND XVI: Medical Impairments That Are Not Severe
http://www.ssa.gov/OP_Home/rulings/di/01/SSR85-28-di-01.html
SSR 88-3c: SECTIONS 223(d) AND 1614(a)(3) Of the Social Security Act
(42 U.S.C. 423(d) AND 1382c(a)(3)) Disability – Validity of the Severity of Impairment
Regulation
http://www.ssa.gov/OP_Home/rulings/di/01/SSR88-03-di-01.html
SSR 82-63: TITLES II AND XVI: Medical-Vocational Profiles Showing an Inability to
Make an Adjustment to Other Work
http://www.ssa.gov/OP_Home/rulings/di/02/SSR82-63-di-02.html
SSR 82-62: TITLES II AND XVI: A Disability Claimant’s Capacity to do Past Relevant
Work, In General http://www.ssa.gov/OP_Home/rulings/di/02/SSR82-62-di-02.html
NOTE: Once you are approved there is no time limit on disability benefits. You will
continue to receive a disability benefit as long as you continue to be disabled and
otherwise meet work or other eligibility requirements. However, your case will be
reviewed periodically to see if there has been any improvement in your condition and
whether you are still eligible for benefits. If you are still eligible when you reach full
retirement age, disability benefits will automatically be converted to retirement benefits.
B. Take as active a roll as possible in fighting your own case
If you cannot handle it get a family member to help you the less YOU do the longer it
will take to process your claim. The actual time it takes to process your claim may be
more or less based on the State you live in - disability determinations are made by a
Disability Determination Service in the State where the disability applicant lives. These
State agencies are required to comply with federally prescribed policies and procedures,
which helps assure that the programs are administered consistently from State to State.

The nature of your disability; how quickly SSD can obtain medical evidence from your
doctor or other medical source; and whether it is necessary to send you for a medical
examination. As further assurance of consistency, samples of the State agencies'
determinations undergo an extensive quality assurance process performed by Federal
reviewers (Currently 7 out of 10 applications get randomly selected by computer for this
process). Unfortunately, this
additional review may cause delays in some cases.
FLOW OF CASES THROUGH THE DISABILITY PROCESS - Fiscal Year 2002 Data
http://www.ssa.gov/disability/disability_process_welcome_2002.htm
MAKE SURE TO CHECK OUT THIS CHECK OUT THIS CHART:
http://www.ssa.gov/disability/disability_process_frameset.html
NOTE: This data is what you are REALLY up against when fighting a claim - taken right
off of SSA's own website. No matter what anyone (SSD workers, lawyers etc) tells you,
these figures are the true facts. Also the GAO considers Social Security Disability to be a
HIGH RISK area for 2003 so things are expected to be much worse when the 2003
reports come out. This information is important - not to scare or discourage you, but to
show how bad the system is and how important it is that you do EVERYTHING possible
here to speed up your claim so it does not fall into those statistics. The current system as
it stands is set up to discourage you so they can rob you of your money or in hopes that
you will die in the process of trying to get your benefits - then they don't have to pay
you! DON'T GIVE THEM THAT SATISFACTION - DON'T BE A VICTIM OF THE
SYSTEM - TAKE ACTION NOW - DON'T BE SAD - GET MAD!!!!
C. Have Doctors are Supportive of Your Claim
If your primary care doctor or any other doctor is unsupportive of you/your diseases/SSD
claim - get rid of them immediately and find a new one. You will almost surely be denied
if your primary care physician/specialists do not support your claim. Some tips on "How
To Talk With Your Physician About
Supporting Your Disability Claim: can be found at:
http://www.immunesupport.com/library/showarticle.cfm?ID=3022
SSR 96-2p: POLICY INTERPRETATION RULING TITLES II AND XVI: Giving
Controlling Weight to Treating Source Medical Opinions
http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-02-di-01.html
SSR96-5p: POLICY INTERPRETATION RULING TITLES II AND XVI: Medical
Source Opinions on Issues Reserved to the Commissioner
http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-05-di-01.html

D. Seeing Specialists
Make sure you see and get properly diagnosed by any specialists for your medical
problems - make sure to mention/document all PHYSICAL and MENTAL problems you
may have - ALL are important factors when filing for SSD. (EXAMPLE - Many people
who are disabled suffer from depression in some form as a result - so it is important that
if you have that problem that is diagnosed properly/documented and included in your list
of illnesses). Try all possible options to treat your disease before filing for a claim - SSD
needs to see that you are trying to get better but that treatments have little or no affect on
your condition.
SSR 96-4p: POLICY INTERPRETATION RULING TITLES II AND XVI: Symptoms,
Medically Determinable Physical and Mental Impairments, and Exertional and
Nonexertional limitations http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-04-di-
01.html
E Get Copies of ALL Your Medical Records
Get copies of ALL your medical records and tests - keep a set for yourself and send a set
to SSD
F. Make Copies of All of Your Records
Anytime you fill out any paperwork for SSD make copies of it for yourself before
sending it back to them
G. Filling Out Forms
When filling out SSD forms answer ALL questions as to how you would feel on your
WORST day. NEVER downplay your symptoms or exaggerate them either Explain in
detail the frequency, severity and duration of your symptoms and limitations and how
they limit your ability to work and function on a daily basis. If you have problems filling
out their forms (due to concentration, memory, pain) - make sure you mention that on the
form and if it took you several days/weeks to fill them out, or if you had to have someone
else do it for you - mention that too.
SSR 96-3p: POLICY INTERPRETATION RULING - TITLES II AND XVI:
Considering Allegations of Pain and other Symptoms in Determining Whether a
Medically Determinable Impairment is Severe.
http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-03-di-01.html
SSR 96-7p: POLICY INTERPRETATION RULING TITLES II AND XVI:
EVALUATION OF SYMPTOMS IN DISABILITY CLAIMS: Assessing the Credibility
of an Individual’s Statements.
http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-07-di-01.html
H. Make a List of ALL Medications/Supplements You Take
Make a list of ALL medications/supplements you take. Be sure to list anything that you
are allergic to or other reason why you cannot take a medication/treatment that a doctor
has recommended (do not use the reason that you cannot afford it). Always ask for and
have your doctor give you SAMPLES whenever possible especially for new medicines
that they may want you to try - they get tons of them from drug reps - you just need to
ask for them. If for some reason they don't have samples - get a trial prescription
(a few days/one week) so you are not paying tons of money for something you may not
be able to take because of allergies or nasty side effects. Keep a daily diary of the
intensity and frequency of your symptoms, pain and how it limited your activities that
day. Note the things/activities that may have made your symptoms worse. Make copies
of all of this information - keep one for yourself, give one to each of your doctors and
send one to SSD.
I. Go through the Doctor's Bluebook of Listings
Find all the listings you meet and copy and paste them into a document - keep a copy for
yourself - send one to SSD
http://www.ssa.gov/disability/professionals/bluebook
http://www.ssa.gov/disability/professionals/bluebook/index.htm
NOTE: Fibromyalgia/CFS claimants - see these documents:
SSR 99-2p: POLICY INTERPRETATION RULING TITLES II AND XVI: Evaluating
Cases Involving Chronic Fatigue Syndrome (CFS)
http://www.ssa.gov/OP_Home/rulings/di/01/SSR99-02-di-01.html
Chronic Fatigue Syndrome and Fibromyalgia Patients: Should You File a
Disability Claim?
http://www.immunesupport.com/library/showarticle.cfm/id/3900
Completing Disability Forms: Five Critical Tips to Keep in Mind for Chronic
Fatigue Syndrome and Fibromyalgia Patients
http://www.immunesupport.com/library/showarticle.cfm/ID/3487
J. Get copy of Residual Functional Capacity Questionnaire
Make copies for ALL your doctors to fill out and in your own words make up a letter
answering all the questions - make sure to include how these diseases affect your life.
You may wish to revise this sample to better reflect your own limitations, then ask your
doctor to fill out your own version instead of whatever DDS sends:
http://pbcers.org/rfcq.htm. A guide for providers on what to include in a report on your
disability - read this and write your own to give to your doctor so he knows the answers:
http://www.ssa.gov/disability/professionals/greenbook/ce-adult.htm
http://www.ssa.gov/disability/professionals/greenbook/ceevidence.
htmhttp://www.ssa.gov/disability/professionals/greenbook/ce-guidelines.htm
http://www.ssa.gov/disability/professionals/greenbook/ce-general.htm
SSR 96-8p: POLICY INTERPRETATION RULING TITLES II AND XVI: Assessing
Residual Functional Capacity in Initial Claims
http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-08-di-01.html
SSR 96-9p: POLICY INTERPRETATION RULING TITLES II AND XVI: Determining
Capability To Do Other Work-Implications Of A Residual Functional Capacity For Less
Than a Full Range of Sedentary Work
http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-09-di-01.html
SSR 85-16: TITLES II AND XVI: Residual Functional Capacity For Mental Impairments
http://www.ssa.gov/OP_Home/rulings/di/01/SSR85-16-di-01.html
K. Write All Your Elected Officials
Write all your elected officials and if you get any responses make copies - keep a set for
yourself - send a set to SSD http://www.congress.org
L. Helping Doctors Fill Out Paperwork
Offer to help your doctors fill out any paperwork that they may get from you or SSD.
M. Get Statements from Family, Friends, Co-Workers and Doctors
Ask your close family, friends, previous co-workers and doctors to write letters (on 8-1/2
x 11" paper) on your behalf stating how your illnesses affect your life and how they have changed you. Make sure they mention both physical and mental changes in your condition. The letters should include their background/relationship to you - how they know you, how long they have known you and your conditions. They should end with a statement as to why in their opinion you cannot work ANY type of job. Have them get the document notarized (many banks will do this for free) Up to four is sufficient. Make copies - keep a set for yourself and send one to SSD.
N. Keeping Doctors Appointments
If SSD asks you to see any doctors make sure you keep the appointment and audio/video
tape record the visit - get copies of all that doctor's findings. Be very honest and specific
about your condition. DO NOT wear make up or dress fancy - act, dress, look, function
like you would on an average day. Make sure SSD doctors know that you have followed
all medical recommendations you were given by your doctors and what affect they are having on your condition. If you have not been able to follow doctors recommendations due to side affects that have been problematic to your condition make sure you alert the SSD doctor to that as well. If possible have someone drive you to the appointment who knows about your medical conditions (family/close friend) and whom can also tell the doctor how these diseases affect your life. SSR 96-6p: POLICY INTERPRETATION RULING TITLES II AND XVI:
Consideration Of Administrative Findings of Fact By State Agency Medical and Psychological Consultants and Other Program Physicians and Psychologists At The Administrative Law Judge and Appeals Council Levels of Administrative Review; Medical Equivalence
http://www.ssa.gov/OP_Home/rulings/di/01/SSR96-06-di-01.html
O. If Your Case Has Been Denied
If your case has been denied - file your appeal IMMEDIATELY in person if possible (no
longer than 60 days). VERY IMPORTANT: get copies of all the records in your SSD
file including ALL claim examiners notes and any doctors reports from doctors that SSD
had you see - it is your right to have them.
Note: federal law allows you to reopen the prior claim within one year of the date of the
initial denial for any reason. You can reopen a previous claim within four years of the
initial denial if SSD finds good cause to do so. Even if you cannot reopen a previous
claim you should be able to file a new SSD application if it has been five years or less
since you last worked full time.
SSR 92-1p: POLICY INTERPRETATION RULING: Request Under the Privacy Act or
The Freedom of Information Act for Access to Records and For Disclosure Of Material
Maintained by the Office of Hearings and Appeals
http://www.ssa.gov/OP_Home/rulings/di/08/SSR92-01-di-08.html
P. Use the SSD Website
Use the SSD website - it has lots of useful info and never be afraid to contact them by
phone to ask questions as to the status of your claim: Website: http://www.ssa.gov or
Phone: 1-800-772-1213
You can conduct your Social Security business 24 hours a day, including weekends and
holidays. You can ask to speak to a representative from 7 AM to 7 PM on business days.
Some of the services available include scheduling an appointment, changing your
address, and signing up to send your Social Security check directly to your bank. You
can also use their automated services 24 hours a day to request services such as a
replacement Medicare card or Social Security Statement, and a variety of other forms and
publications. Their phone lines are busiest early in the week and early in the month, so if
your business can wait, it's best to call at other times.
Q. SSA IG
If you feel that you are being treated improperly report it immediately to the SSD Office
of Inspector General and Office of Public Inquiry:
Inspector General's Office
Allegation Management Division
PO Box 17768
Baltimore MD 21235
Phone: 1-800-269-0271/410-965-8882
Rene Johns - Phone: 410-966-9158
Danny Johnson - Phone: 410-966-9158
Fax: 410-966-9201/410-597-0118
E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Social Security Administration Office of Public Inquiries
Phone: 410-966-3000
Contact: Mary Ann
R. Utility Shutoff
If you are facing utility shutoff, foreclosure on your house or bankruptcy due to waiting
for your claim to be processed - make copies of any letters/notices and send them to
SSD/elected officials and your lawyer
if you have one requesting a dire needs review of your case
S. Pre-Hearing Review
If you have been denied and have been waiting too long to get a hearing - look into
getting what is called a Pre-Hearing review of your case.
SSR 97-2p: POLICY INTERPRETATION RULING TITLE II AND TITLE XVI:
Prehearing Case Review by Disability Determination Services
http://www.ssa.gov/cgibin/cqcgi/@ssa.env?CQ_SESSION_KEY=BOGBIVBZRZWG&CQ_CUR_DOCUMENT=3&CQ_RESULTS_DOC_TEXT=YES
T. Taping Testimony
If you have a hearing scheduled bring any new medical evidence, family, friends, doctors
to speak on your behalf and ask to record it on audio/video tape. Be very honest and
specific about your condition. DO NOT wear make up or dress fancy - act, dress, look,
function like you would on an average day. If possible have someone drive you to the
hearing who knows about your medical conditions (family/close friend) and can also tell
the judge how these diseases affect/have changed your life. Make sure judge knows you
have followed all medical recommendations you were given by your doctors and what
affect they are having on your condition. If you have not been able to follow doctors recommendations due to side affects that have been problematic to your condition make
sure you alert the judge to that as well.
U. Representation
You may chose to fight your case alone (it is NOT mandatory to have a lawyer) or seek
legal/advocate representation. You can hire a lawyer - very important to actively keep
after a lawyer if you hire one. Since they get paid 25% of your retro pay or current cap of
$5300 it is in their best interest for your case to drag on - the longer it takes to process the
more they get. You may be able to take advantage of legal-aid or pro-bono services.
You can get a paralegal or in some cases free
advocacy from the Centers for Independent Living in your area:
http://www.abledata.com/Site_2/ind_lvng.htm
Disability Legal and Advocacy Resources:
http://www.makoa.org/legal.htm
III. Social Security Programs and Web Resources
Applications for this program can be obtained through this website:
http://www.ssa.gov/applyforbenefits/
For more information on this program and how to apply, call Social Security's toll-free
number: 800-772-1213. People who are deaf or hard of hearing may call Social
Security's toll-free TTY number: 800-325-0778
Social Security Disability Coalition: FREE knowledge and support with a focus on
reform of the Social Security Disability System
http://groups.msn.com/SocialSecurityDisabilityCoalition
Site you can go to get your questions answered about Social Security
http://www.severe.net/
Links to Social Security Disability Ratings
http://208.56.213.87/listings.html
General Accounting Office Report Number - GAO-02-322, dtd February 2002, Social
Security Administration: Disappointing Results From SSA’s Efforts to Improve the
Disability Claims Process Warrant Immediate Attention, clearly states, that based on the
GAO’s research we are approaching a crisis level in the process and that immediate steps
must be taken to remedy the rising backlog of cases pending. This report further states
that previously implemented costly changes in 10 Prototype states, and the nationwide
Hearings Process Improvement Initiative implemented nationwide, are having negligible
results, and in some cases, depending on which initiative you are looking at, are
increasing processing times. To access this report go to the General Accounting Office
site at http://www.gao.gov. On the left hand side of the screen you will see a search box
98
titled Full Text Search. Type in GAO-02-322 and hit enter. This will open the associate
PDF file for you. The report is approximately 33 pages long.
IV. Providing Medical Evidence to the Social Security Administration for
Individuals
A. Guide for Health Professionals
When an individual applies for Social Security disability benefits, we must decide
whether he or she is disabled under the law. We base our decision on information you
provide and other evidence, including information provided by the individual. The
following guidelines will help you understand the kind of information we need.
B. Definition of Disability
Under Social Security law, an individual is considered disabled if he or she is:
-- unable to do any substantial gainful work activity because of a medical condition (or
conditions), that has lasted, or can be expected to last, for at least 12 months, or that is
expected to result in death;
-- or, in the case of an individual under the age of 18, if he or she suffers from any
medically determinable physical or mental impairment of comparable severity.
The medical condition(s) must be shown to exist by means of medically acceptable
clinical and laboratory findings. Under the law, symptoms alone cannot be the basis for a
finding of disability, although the effects of symptoms may be an important factor in our
decision whether a person is disabled.
If the medical evidence alone shows that a person is clearly disabled or not disabled, we
decide the case on that information. Otherwise, we go on to consider other factors, such
as functional capacity in light of the person's impairment(s), age, education, and work
background. For a child under age 18, we generally consider the child's ability to function
independently, appropriately, and effectively in an age-appropriate manner.
C. What We Need From You?
We need information from you that will help us to determine the existence, severity, and
duration of the person's impairment(s).
Your report should include a thorough medical history, and all pertinent clinical and
laboratory findings (both positive and negative) from your examination of the person.
Copies of laboratory results should be provided if available. Also, provide the results of
any mental status examination, including any psychometric testing. Longitudinal clinical
records and detailed historical notes discussing the course of the disorder, including treatment and response, are very useful for us since we are interested in the impact of the illness over a period of time.
You should also include a statement of your opinion about what work-related activities
the person can still do despite his/her impairment. Tell us your opinions about both
physical and mental functions and, to the extent possible, the reasons for your opinions,
such as the clinical findings and/or your observations of the person. These opinions should reflect the person's abilities to perform work-related activities on a sustained basis, i.e., 8 hours/day and 5 days/week. Your descriptions of any functional limitations you noted throughout the time you treated the patient are very important. Examples of work related functions include:
--Physical work-related functions: Walking, standing, sitting, lifting, pushing, pulling,
reaching, carrying, and handling.
--Mental work-related functions: The ability to understand, remember, and carry out simple instructions, the ability to use appropriate judgment, and the ability to respond appropriately to supervision, co-workers, and usual work situations, including changes in a routine work setting.
D. The Claim Adjudication Team
Our adjudication team consists of a physician or psychologist and a specially trained
disability examiner working in the disability determination services (DDS) in the State in
which the claimant lives.
If the team believes there is not enough information to make a decision, they may call or
write you to find out if you have the needed information. If you do not, they may ask you
or, in some circumstances, an independent medical source, to provide the information by
performing tests or an examination for a fee paid by the DDS.
Social Security law requires that a disabling impairment be documented by medically
acceptable clinical and laboratory findings. Statements merely recounting the symptoms
of the applicant or providing only a diagnosis will not establish a medical impairment for
purposes of Social Security benefits. We must have reports documenting your objective
clinical and laboratory findings. Thus, it is essential that you submit all objective findings
available concerning your patient's condition, even if they relate to another disorder or
establish that the person has a different condition.

 

 
 

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