2. Irrelevant evaluation factors. SSA has a strict definition of disability that ignores many real-life aspects of the job market. Difficulty finding a job, thinking that no one will hire you with your condition, believing you could not pass a job-required physical, or even knowing that the pay you would receive for the work you can do is too little to live on … all of these important real-world considerations do not matter to the Social Security Administration (SSA) when evaluating your claim for benefits.

Proof from doctors

3. Medical evidence. As is the case with most legal claims, what counts in disability evaluations is what you can prove. If no medical records exist to support your claim of disability, you are unlikely to be successful. SSA figures that if your medical condition is severe enough to keep you from working, then it should justify doctor visits, tests, diagnosis, and treatment.

4. Failure to follow treatment. SSA expects you to try to get better. That means doing what your doctor prescribes. If you do not believe that your doctor’s recommended treatment will help, then be sure your doctor documents the treatment’s odds of success or failure.

5. Keep good records. Conversely, if you do follow your doctor’s prescribed treatment, document your efforts. Without records, you are unlikely to remember the date of every doctor visit, lab test, medicine taken, and therapy received. Obtain the business cards of every doctor you see and file them. Save your pill bottles. Keep notes of your pain and other medical events.

Evidence from you

6. Symptoms vs. diagnosis. SSA does not expect you to be an expert on medical conditions. Even if you are, SSA would rather learn about your impairment from your doctor and your medical records. What SSA wants to receive from you are details about your symptoms. For example, how severe is your pain? Is it constant or intermittent? What aggravates your pain? What reduces it? Do you suffer from shortness of breath or fatigue? No one knows your symptoms better than you. Do your best to explain them in detail without exaggerating or minimizing. Do not omit or gloss over any lesser conditions just because you have one severe condition and several minor ones.

7. Physical restrictions. What can’t you do? Sit for lengthy periods? Stand and walk? Lift and carry? Bend, twist, kneel, and stoop? Manipulate objects with your hands? Social Security disability is a functional program. SSA will focus on your limitations rather than your diagnosis.

8. Effect of symptoms and restrictions. How does your medical condition affect your daily activities? Tell SSA about the impact on your personal care (hygiene, dressing, bathing), errands and housework (driving, shopping, cleaning), and social functioning (hobbies, sports, interaction with friends and family).

Final point

9. Consistency, accuracy, and honesty. Contradictions, errors, memory lapses, and discrepancies all work to erode your credibility, and nothing will sink your claim faster than questions about your truthfulness.

• Are you gainfully employed? No
• Do you have a severe impairment? Yes
• Will your impairment last 12 months or result in death? Yes
• Does your disability meet one of SSA’s listed impairments? If yes, you qualify. If no …
• Are you able to work? No

When should I apply for disability benefits?

Unless you have an obvious long-term disability, the best time to apply for Social Security disability benefits is 6-9 months after you stop working.

What does a disability lawyer do?

The big-picture answer is: analyze what needs to be proven to win benefits, figure out how to prove it, and gather the necessary evidence. Some of the specific tasks are:

• Obtain reports from treating doctors that are consistent with Social Security regulations
• Refer claimants to specialists for additional reports that answer questions raised by Social Security regulations
• Obtain a vocational expert’s evaluation of the claimant’s ability to work
• Ask that a prior application for benefits be reopened
• Seek a waiver of a time limit
• Request subpoenas to insure the presence of crucial witnesses or documents
• Advise the claimant on how best to prepare for and testify at the hearing
• Object to improper evidence or procedures at the hearing
• Cross-examine adverse witnesses
• Present a closing statement
• Submit a written summary of the evidence and argument
• If the claimant wins, make sure the SSA correctly calculates benefits
• If the claimant loses, request review of the hearing decision by the Appeals Council

How long will I wait for a disability hearing?

It can take up to two years from request until a hearing is held and a decision issued, but the time varies from state to state.

What are hearings like?

They are private, held in a small conference room, and last an hour or so. You will be asked about your education, training, work experience, symptoms, limitations, and daily activities.

What if I don’t file my disability appeal on time?

If you have not filed your appeal within 65 days of the date on your denial letter, you have to start over with a new claim. That new claim may result in the loss of back benefits.

What is the biggest mistake made by disability applicants?

Because the majority of appeals are granted at a hearing, failing to appeal a denial to the hearing level is the number one error … and unfortunately very common.

While the outcome of your Social Security disability claim may be difficult to predict, the process by which the Social Security Administration decides your claim is quite predictable. In every case, the Social Security Administration employs a “5-step sequential evaluation process” to determine if an applicant is “disabled,” as that term is defined by the Social Security rules and regulations. The 5-step process requires the Social Security decision-maker to address the following questions, in the following order:

Step 1: Are you engaged in “substantial gainful activity”?

“Substantial gainful activity” is work that involves significant physical or mental activity, and that is usually done for pay or profit. If you are employed in “substantial gainful activity,” then your application for Ohio Social Security disability benefits will not be approved, no matter how severe your impairment is.

Step 2: Do you have a “severe” impairment?

The purpose of Step 2 is to weed out frivolous claims. If you have a medically determinable impairment that imposes more than minimal restrictions on your ability to work and is expected to last longer than 12 months or result in death, then you have a “severe” impairment.

Step 3: Does your impairment “meet or equal” a Listing impairment?

The Listing of Impairments is a set of criteria for disability found in the Social Security regulations. The Listing describes over 100 medical conditions that would ordinarily prevent a person from engaging in any gainful activity. If the medical signs, findings and symptoms of your impairment meet or “medically equal” the medical signs, findings and symptoms of a Listing impairment, then the Social Security Administration will find that you are disabled by virtue of your medical impairment alone. If you do not “meet or equal” a Listing, then the Social Security Administration will consider other, non-medical factors relevant to your ability to work, in Steps 4 and 5.

Step 4: Can you perform “past relevant work”?

To get past Step 4, you must prove that you are incapable of performing any “past relevant work.” In general terms, “past relevant work” is any substantial gainful activity you have performed in the past 15 years. Think of the easiest job you have held in the past 15 years. If you are no longer capable of doing that job, then you cannot perform “past relevant work.”

Step 5: Are you able to perform other work?

If you cannot perform past relevant work, then, in this final step of the sequential evaluation process, the Social Security Administration will determine whether you can do any other work that exists either in the Columbus metropolitan and central Ohio region or in significant numbers in the national economy. In making this determination, the Social Security Administration will evaluate your “residual functional capacity” (that is, what you are capable of doing, despite your disability) and related vocational factors (your age, education, work experience) to see if you could adjust to performing different work than you have done in the past. If not, then you will be deemed “disabled” according to the Social Security regulations, and your claim for Ohio Social Security disability benefits will be approved.

If you have speciic questions regarding your claim, please contact us at (614) 545-9998 for a free claim evaluation or visit www.ColumbusDisability.com

Employers must provide notice of your right to continue your health care coverage. This notice has specific requirements and must be delivered within a specific time frame.

If your employer failed to provide you with the required notice, you may be entitled to receive up to $110 per day for each violation even if you were not able to afford to continue your benefits.

If you have lost your health benefits due to a change in your employment status and did not receive the required notice from your employer you may be entitled to receive compensation for the violation.

Please contact Eric Jones at (614) 545-9998 for free evaluation of your case.  There are no fees unless you receive a monetary award.

Although the rules and regulations that apply in determining if you qualify for benefits are very complex,  the actual application process is not as difficult as most people think.  The application can be completed online in the privacy of your own home. 

Applying online for disability benefits offers several advantages:

• You can start your disability claim immediately.  There is no need to wait for an appointment;
• You can apply from the convenience of your own home or on any computer; and
• You avoid trips to a Social Security office, saving you time and money.

You can use the online application to apply for benefits if you:

• Are age 18 or older;
• Have worked and paid Social Security taxes long enough to qualify;
• Have a medical condition that has prevented you from working or is expected to prevent you from working for at least 12 months or end in death; and
• Live in the United States or one of its territories/commonwealths.

The Social Security disability application process involves 4 easy steps:

• Step 1. Review the Adult Disability Checklist for details about what you will need before starting the online process. 
• Step 2. Fill out the online Disability Benefit Application to provide us with information regarding eligibility for payment. 
• Step 3. Fill out the online Adult Disability Report to provide us with medical and work history.  
• Step 4. Fill out, sign and mail or take the Authorization to Disclose Information to the Social Security Administration to your local Social Security Office.

It is very helpful and strongly recommended that you gather the following information before you begin the applicaiton process:

•  
  • Military Service discharge information for all periods of active duty.
  • W-2 Form (or your IRS 1040 and Schedules C and SE if self-employed) from last year.
  • Social Security Number(s) for your spouse and minor children.
  • Checking or savings account number and bank routing number, if you want Direct Deposit for your benefit checks.
  • Name, address and phone number of someone we can contact who knows about your medical conditions and can help with your claim.
  • Names, addresses, phone numbers, patient ID numbers, and dates of treatment for all doctors, hospitals, and clinics. 
    NOTE: You may want to refer to any Medical Records you have.
  • Names of medicines you are taking and who prescribed them.
    NOTE: You may want to have your medicine bottles available.
  • Names and dates of medical tests you have had and who sent you for them.
  • Types of jobs and dates you worked for your last 5 jobs.
  • Information about any insurance or workers’ compensation claims you filed, such as claim number and name, address and phone number of insurance company.

Chronically delinquent patients know that collection agencies can’t initiate legal action without hiring an outside attorney, which is generally cost prohibitive.  Thus, collections calls and letters are frequently ignored.  Since we are a law firm, we are more effective than collection agencies in motivating delinquent patients to pay you for the care you provided to them.

Since we are a law firm and not just a collections agency, we have the power to file suit, obtain judgments, execute on judgments, garnish wages and bank accounts, etc.  You are not charged any additional fees for these legal services.  Furthermore, we will not recommend legal action unless we have verified that the patient has the ability to pay but simply refuses to do so and we will not pursue legal action against one of your patients without your prior consent.  Our fees are strictly a percentage of the amount we recover. Thus, you will only receive checks from our office and you will never receive a bill from us.  

You can be confident that we are doing all that is possible to provide you with impressive recoveries by providing:

•  A professional staff of experienced attorneys, debt collectors, skip tracers and asset locators;
•  A fully integrated state-of-the-art collection management system with sophisticated reporting capabilities to keep our clients fully informed on our efforts;
•  An innovative and customized letter series;
•  Extensive high volume processing capabilities;
•  Advanced skip tracing techniques; and
•  Evening and weekend staff.

Contact Eric Jones at (614) 545-9998 or email ejones@ericjoneslaw.com for more information.

Greetings all from Columbus ODAR,

This month, we’d like to up to date on some changes and activities since we were last in touch.

We are on the verge of getting final approval for an expansion of the office, taking over the rest of the floor. This is great news for us. Columbus has been understaffed for years with our judge to support staff ratio. This has been like the rest of the nation, partly due to budget constraints in the past. However, while other offices have been able to catch up, we’ve been limited by space in the office. We anticipate that the new space will include another hearing room and we anticipate adding another ALJ. Additionally, the new space will include a “spoke” for the National Hearing Center. These facilities, as we understand it, are stand alone offices with smaller video hearing rooms. In Columbus, the NHC space will be apart from Columbus ODAR. We’ll provide systems support, but it will be independent of us in every other way. We don’t have a timeline yet, but we’ll keep you posted as this exciting project moves forward.

Many of you know that Toledo and Akron ODAR offices are opening this month. Just last week, about 120 individuals received ALJ appointments and several of them will be assigned to those two offices. With judges and staff starting from scratch, we expect it will be a while before they schedule significant numbers of cases. Columbus has offered any help we can to both offices as they train staff and judges. There is still no decision on service area realignment (Lima, Mansfield), but again, we’ll let you know.

Speaking of the National Hearing Center, we recently transferred 400 of our oldest cases to the St. Louis NHC and will be transferring 300-400 monthly. You can expect to hear from them directly. We have made the conference room we converted to a video hearing room and one of our regular hearing rooms available to them to schedule hearings

I hope all of you in the area are responding to the effort to form the new CBA Social Security committee. Please contact Julie Hall or Ken Karlock for details. This committee has been a long time coming and we at ODAR are looking forward to this relationship as we work together to best serve your clients.

Finally, I’m pleased to advise that Judge John Montgomery, currently in the Cincinnati office, has accepted an offer to transfer to Columbus, effective August 29. Judge Montgomery was a staff attorney in Columbus for many years and we welcome him back.

More in September. Until then, stay cool!

John R. Allen

Chief U.S. Administrative Law Judge

Social Security Administration / ODAR

(Posted by Law Office of Eric A. Jones, LLC)

Contact Eric Jones at (614) 545-9998 for more information or questions about your disability case.

This summer the IRS began contacting hospitals, universities and medical residents who filed FICA refund claims to provide additional information about the refund process.  Institutions, except those with pending law suits involving medical resident FICA tax, that employed medical residents should have by now received Letter 4608, Medical Resident FICA Refund Claims, Employer Notification, which was mailed at the end of May 2010.

WHO IS ELIGIBLE FOR FICA TAX REFUND?

Employers (hospitals and medical schools) and individual medical residents, interns and fellows are eligible to receive refunds if a timely refund claim was filed by them or the institution that employed them.  The refunds are limited to individuals who were residents, interns or fellows from January 1, 1995 through March 31, 2005.  The deadline to file a FICA tax refund claim has expired but even if you did not file FICA tax refund claim on your own behalf you may still be eligible for a FICA tax refund if your employer filed a timely claim.

WHAT SHOULD I DO TO CLAIM MY REFUND?

Hospitals, universities and other institutions that filed for FICA tax refunds during the affected tax periods are likely in the process of contacting you to provide additional information regarding any possible refund that you may be entitled to receive.   Typically, you will be requested to consent to the institution receiving your share of the refunded FICA taxes and the institution will then send it to you.  It is anticipated that the refund process will take several months.  However, you should not delay in contacting the institution that employed you during your medical residency, intern, or fellowship to confirm that they filed a FICA tax refund claim and to confirm that they have your current contact information.

FICA TAX AFTER APRIL 1, 2005 IRS RULE CHANGE

The IRS has not conceded that the FICA tax student exception applies for tax periods ending after April 1, 2005 when the IRS changed its regulations.  The revised IRS regulations related to FICA tax exceptions has been challenged in court by hospitals.  On June 1, 2010, the U.S. Supreme Court agreed to resolve the issue concerning the availability of the student FICA tax exception for medical residents, interns and fellows after April 1, 2005.

OTHER TAXING MATTERS

FICA tax refunds are not counted as taxable income, however, the IRS intends to pay interest on the FICA tax refunds and the interest paid is subject to tax in the year it is paid.  You should contact your tax professional for more information on this subject and to discuss your specific tax situation.

Additionally, your eligibility for and calculation of social security benefits (either current or future) may be affected in the event of a refund, depending on your personal circumstances. If you consent to the refund claim, you will be issued a Form W-2c which will reflect a reduction in your earnings for social security benefits purposes. Whether social security benefits that you are receiving currently or in the future are impacted by a reduction of wage credits as a result of the refund will depend on your particular facts and circumstances. You should contact your local Social Security Administration office with any questions regarding your particular situation.

If you have any additional questions please contact Eric Jones at the Law Office of Eric A. Jones, LLC at (614) 545-9998 or email ejones@ericjoneslaw.com.