Questions? 1-888-477-2363

Archive for category: Featured

You are here: Home / Social Security / Featured
Shelly Mark, Senior Attorney

Video Blog – SS – Proving a Claim Prior to DLI

/in , /by

Natalia Jofre: Hi I’m Natalia Jofre, I’m the Director of the Social Security section here at Hill & Ponton.

Shelly Mark: And I’m Shelly Mark, I’m the senior Social Security attorney.

Natalia Jofre: So welcome back to our Social Security Disability blog. In our last blog we talked about date last insured, what is it, and we told you that it has nothing to do with health insurance or any kind of privatized insurance. It’s basically an expiration date, if you will, for you to qualify for Social Security Disability benefits. So when you work or you pay into Social Security tax, it designates a date last insured and so you then have to prove that you’re disabled prior to that date in order to qualify for benefits.

So we told you that for the most part in order to qualify for Social Security Disability you need to have worked and paid into Social Security tax for five out of the last ten years. The next segment we’ll get into how much. Okay, because it differs, but if you have enough earnings quarters and you have a date last insured, where a variable comes into play is let’s say you last worked in 2008. That would mean that you were insured probably through 2013 and so you’re gonna have to prove that you were disabled prior to 2013 in order to qualify for benefits. But now we’re in 2017-

Shelly Mark: Right.

Natalia Jofre: And you want to apply and either you might think, well I’m past my expiration date or Social Security tells you, no, you’re past your date last insured, so you can no longer qualify for benefits. That’s not technically true. If you can prove that you were disabled prior to 2013, then you should still be able to qualify for benefits. This can happen for many disabled people, but we do see it happen a lot with veterans.

Shelly Mark: Definitely.

Natalia Jofre: Because they come back from being in service or they’re getting their own VA benefit and so they feel like, I don’t really need to do this, or they think I’m still going to be able to go back to work and then they usually have a couple of failed work attempts and they can’t. Can you sort of expand on that?

Shelly Mark: Sure. We see this a lot with veterans. I have a client now who was found to be disabled by the Veteran’s Administration back in 2007. He had already been out of work at that point but he was advised by someone not to file for Social Security because there would be some type of an offset, which you know based on our prior filmings that we’ve had, that’s not true, but he didn’t know that at the time. He just now filed in 2016, but because his date last insured was 2009, we’re able to use the evidence from the VA’s findings from 2007. So in that situation, because his date last insured was 2009, even though he filed in 2016, we can still fight to have the claim approved, but we can only use evidence that is prior to 2009. Prior to that date last insured. But as long as there’s sufficient evidence during that time frame to find him disabled, then Social Security will still have to pay them.

Natalia Jofre: So, what we’ll talk about in our next blog, because I want you to sort of really sink this information in, is when we’re talking about evidence, what kind of evidence do you need to prove your case in general, but more importantly prior to your date last insured.

Shelly Mark: Definitely.

Natalia Jofre: Let’s do that and we’ll focus on that.

Shelly Mark:  That sounds good.

Natalia Jofre: Okay good. So in the meantime, if you have any questions or concerns, feel free to visit our website or call our office.

Shelly Mark: Thank you.

Shelly Mark, Senior Attorney

Video Blog – What Is Your Date Last Insured?

/in , /by

Natalia Jofre:  Hi, I’m Natalia Jofre. I am the Director for our Social Security section here at Hill and Ponton.

Shelly Mark: And I am Shelly Mark. I am the Senior Social Security attorney.

Natalia Jofre: We’re here today to talk to you about what a date last insured is. When you file for Social Security disability benefits, a lot of times Social Security will tell you what your date last insured is, or whether you have an expired date last insured. The date last insured is really, really important because it could make the difference between you qualifying for regular benefits or not. We’re going to actually do a series on date last insured all for itself because it is very complex.

Shelly Mark: Yes definitely.

Natalia Jofre: First of all, will you kind of explain to everyone what it is?

Shelly Mark: Sure. The date last insured is a date where an individual’s eligibility to receive benefits under the disability program expires. To be eligible for Social Security disability someone has to have worked five out of the past 10 years. When they stop working, basically their clock starts ticking as to when their date last insured is going to expire. They have to prove they were disabled by that date to actually receive Social Security disability.

Natalia Jofre: A lot of people will call us and ask us and they’ll say to us things like I have health insurance, or now I don’t have health insurance, so does that mean that now my date last insured is expired, or that I need to get health insurance in order to be able to qualify for disability benefits. Date last insured is a Social Security term. It has absolutely nothing to do with insurance through healthcare or any other program for that matter. If you’re getting long-term disability benefits, short-term disability benefits, workers comp, unemployment, that has nothing to do with that. Just keep in mind that date last insured is a Social Security term and it has nothing to do with any kind of privatized insurance.

Shelly Mark: Absolutely.

Natalia Jofre: Now there are some benefits, or some exceptions, to where if you haven’t worked five out of the last 10 years you can still qualify for benefits. It’s a matter of proving you’re disabled prior to your date last insured expiring, but we’ll talk about that in our next blog because this is enough to kind of simmer on just for today. We’re going to give it to you in morsels so it’s a little bit more digestible if you will.

Shelly Mark: Yes. Sounds great.

Natalia Jofre: You agree?

Shelly Mark: Yes, definitely.

Natalia Jofre: Sounds good, so we’ll see you next time. In the meantime, if you have any questions or concerns, feel free to call our office or visit our website.

Shelly Mark: Thank you.

Shelly Mark, Senior Attorney

Video Blog – Appeals Council and Federal Court

/in , /by
Natalia Jofre: Hello and welcome to Hill & Ponton Social Security Disability Blog, I’m Natalia Jofre. I’m the director for our Social Security section.
Shelly Mark: And I am Shelly Mark, I am the senior Social Security attorney.
Natalia Jofre: So in our last blog we talked about when you get an unfavorable decision, what that means, and now we’re going to talk about, okay, so you’ve been denied, what can you do next?
Shelly Mark: Right.
Natalia Jofre: So I would say the first option would probably be to file an appeal to the Appeal’s Council.
Shelly Mark: That’s correct.
Natalia Jofre: So first of all, you have 60 days to file an appeal, plus five mailing days. We strongly encourage you not to rely on that.
Shelly Mark: Yeah, don’t wait until the 60th day.
Natalia Jofre: Don’t do that. The sooner you file your appeal the better because then that also means the sooner you’re going to get a decision.
Shelly Mark: That’s right.
Natalia Jofre: And by the way, it takes a ridiculously long amount of time to get a decision, so you want to really submit that appeal as soon as possible. Now of course, if … and we see this happen all the time, people say, “Social Security sent me my decision, and it got lost, and they mailed it on April 1st, and now it’s May 25th. And it’s not my fault.” Well, that’s why they give you the five mailing days.
Shelly Mark: Right.
Natalia Jofre: Do we recommend that you still wait and be like, “Oh well, I’m going to only take 60 days from this date.” No, always get your appeal in within the 60 day deadline if you can.
Shelly Mark: Yeah.
Natalia Jofre: Because if not, it makes them look at everything closer.
Shelly Mark: Yeah.
Natalia Jofre: So if you file an appeal to the Appeal’s Council, do you want to explain what the Appeal’s Council is?
Shelly Mark: Sure, the Appeal’s Council is basically the oversight for all of our judges at the hearing offices. Their job is to review judges’ decisions, both favorable and unfavorable, and deny, or award, or remand any. 95% of the time I would say if we’re getting a favorable decision from the Appeal’s Council, it’s a remand. And what that means is that they’ve decided that the judge did commit error, and that they are going to remand the case back down to the judge with very specific instructions. So it may be to take further vocational expert testimony, or it may be to address the client’s anxiety disorder that wasn’t addressed. That is … remand just basically means send back down. So the case is sent back down to that judge for another hearing, where the client will then go with their attorney to the judge for a remand hearing.
Natalia Jofre: Now here’s the kicker, and this is the question we always get, “Am I going to see a different judge?” And the million dollar is no.
Shelly Mark: No.
Natalia Jofre: You’re going back to the same judge that denied you the first time around.
Shelly Mark: Right.
Natalia Jofre: So people get used to … you know, when you file an application, you get denied, it goes to the examiner, if you get denied it goes to a different examiner, and so people are accustomed to a different person is going to review your case and your decision and see if you … if a different decision should’ve been made.
Unfortunately, when the Appeal’s Council remands the case, it’s going back to the same exact judge. Sometimes variances can happen, so like if your judge-
Shelly Mark: Right.
Natalia Jofre: Retired, or was transferred, or if now you’re in a different state, okay, then yes, you’re probably going to go to a different judge. But 99% of the time you’re going back to the same judge who’s going to have another hearing, and try to make themselves the decision that they made a mistake.
Shelly Mark: Right.
Natalia Jofre: And reverse their own decision.
Shelly Mark: Right.
Natalia Jofre: So …
Shelly Mark: It’s a … the way … if the decision is just something that maybe the judge overlooked, or maybe the judge was having a bad day, and we all do, I don’t mean that lightly-
Natalia Jofre: Right.
Shelly Mark: I know that people wait years for this, but it does happen, mistakes are made. I’ve had remand hearings with judges that are just as kind as they can be, and they’re like, “This wasn’t addressed in our first hearing, I’m going to apologize about that, we’re going to do that today,” and the claims are awarded.
And sometimes, unfortunately, you do have other judges that are … frustrated that they’re having a remand hearing, and they may not-
Natalia Jofre: You did a good job saying that nicely.
Shelly Mark: They may not be as willing to correct errors. They may be willing to un-accept that it was actually an error. So it is a risk-
Natalia Jofre: Yeah.
Shelly Mark: As to whether or not you’re going to go back before a judge that has the … that will have the ability to objectively look at their decision. Again, I think that’s why it’s really important to be working with counsel that knows these judges, and works with them. Because we know if it’s a judge, and the decision is kind of out in left field compared to where-
Natalia Jofre: Yeah.
Shelly Mark: They would normally be, we think, “Well, let’s appeal this, because I think if we get this back before this judge, they’re going to grant it.”
Natalia Jofre: Right.
Shelly Mark: And then there are others that we would be, “We’re not going to appeal this, because there’s no way they’re going to change their mind.”
Natalia Jofre: Yeah. So two other options, if you do get denied by the Appeal’s Council, you can then go to federal court.
Shelly Mark: That’s correct.
Natalia Jofre: Very difficult, very, very difficult to win in federal court.
Shelly Mark: It’s difficult to win in federal court, it’s not impossible. It is expensive, and it takes a lot of time.
Natalia Jofre: Yeah. So, that’s …
Shelly Mark: And the new claim. There’s a lot of different reasons-
Natalia Jofre: That’s the other option, and that’s a good one.
Shelly Mark: Why we would or wouldn’t file a new claim. In a lot of cases, like you were saying, circumstances change. The severity of the condition may be changing, or the person’s age may be changing. In situations like that, it may make more sense just to file a new claim.
Natalia Jofre: You know what I’ve had happen in several cases, is they’ll go the hearing, and they’ll get denied, and they were disabled, but for whatever reason the judge didn’t feel it was severe enough, and then I’ve had a lot of cases where after the hearing, they either had a car accident, I’ve had several where that’s happened, a really bad car accident, or they’ve had a catastrophic diagnosis of like stage three or stage four cancer, or something like that. Or like being diagnosed with Parkinson’s Disease-
Shelly Mark: Right.
Natalia Jofre: Or some other neurologic disorder, where now it’s like you can’t submit that evidence, because it’s not supportive of the claim they’ve had up until now, it’s already after the hearing, it’s already gone to the Appeal’s Council, blah, blah, blah-
Shelly Mark: Right.
Natalia Jofre: But now with this added event and all of the problems it’s caused and the symptomology and the disease, now for sure it should be enough for them-
Shelly Mark: Right.
Natalia Jofre: To be found disabled. And a lot of those cases do get approved-
Shelly Mark: Right.
Natalia Jofre: With a new claim.
Shelly Mark: That’s exactly right, and we’ve just filed a few recently to where the age group … you know, you may be 54 on the day of your hearing, and you’re still in that age category to where your file can only be reviewed based on those statutes from 50 to 54, and our counsel clients, we can appeal it, but the reality is the judge didn’t really make an error-
Natalia Jofre: Yeah.
Shelly Mark: He applied the right statutes, but if we refile it, you’re going to turn 55 and we have very good luck with having those approved early on.
Natalia Jofre: Yeah.
Shelly Mark: When they’re switching into those age groups. So it’s always important to really look at whether you want to file an appeal. A lot of people always want to file an appeal, just because they’re frustrated, they’ve waited two, three years and they don’t like the idea of losing the entitlement to their past due benefits.
Natalia Jofre: Yeah. That’s the biggie. But if it means you’re going to wait another two years, and you’re also going to end up again empty handed-
Shelly Mark: Right.
Natalia Jofre: Then perhaps filing a new claim is the better way to go, especially if you have an increased chance of being approved.
Shelly Mark: Right. And one other thing you have to be really careful about when you’re deciding to appeal, is whether you have a DLI issue. We’ve talked about date last insured some. I’ll just say that we’ll probably discuss that in a future video blog, but you’re only eligible for disability benefits so long after you stopped working, and if that time period is going to expire while you’re waiting for an appeal, you have to realize that if that’s denied, you cannot file a new claim.
Natalia Jofre: Okay.
Shelly Mark: So any time we have a client that’s really close on a DLI, my advice would definitely be the new claim.
Natalia Jofre: To file and … yeah. So we’ll talk about date of last insured next time.
Shelly Mark: That’s a good idea.
Natalia Jofre: Okay, great. Well for now, thanks for joining us. If you have any questions feel free to visit our website or call our office.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – Unfavorable Decision

/in , /by
Shelly Mark: Hello and welcome to Hill and Ponton Social Security and Disability Blog. I’m Natalia Jofre, the director for our Social Security Section.
Natalia Jofre: And, I am Shelly Mark. I am the Senior Social Security Attorney.
Shelly Mark: So, in our last few blogs, we’ve talked about what happens at your hearing, getting your decision, when it’s a fully favorable decision, when it’s a partially favorable decision, and now, unfortunately, we’re going to talk about what happens if you get an unfavorable decision, which basically means, you lost.
Natalia Jofre: Basically, means that your case has been denied by the judge.
Shelly Mark: Yeah.
Natalia Jofre: So, you’re not going to be entitled to any benefits. No past due benefits and no future benefits.
Shelly Mark: So, you have several options. I mean, first of all, I think that we should talk a little bit about … we have seen many cases where the person is genuinely disabled. Did everything right. Should have been approved. Is truly and genuinely disabled. Had the medical evidence to prove it. You know, we’ve had cases where get the decision and we’re just like “How did this happen?”
Natalia Jofre: Right.
Shelly Mark: And, so it’s not, unfortunately, I mean, some judges do have higher and lower approval ratings than others. Right?
Natalia Jofre: Right.
Shelly Mark: So, sometimes that’s a factor.
Natalia Jofre: Oh, absolutely, and certain jurisdictions have judges that are more favorable/less favorable, so location plays a part. You know, there’s so many different reasons, but just like Natalia said, I mean the reality is we have very good cases. We have strict criteria with our intake and we get unfavorable decisions. So, we’re in the situation where we have to counsel the client on what do we feel like we’re going to do next.
  In most cases, with our clients, there is always a next step because we do feel like the person is really disabled and something just happened. I guess the judge just disagreed with us or maybe the judge didn’t feel like there was enough evidence to prove the claim or, maybe the judge felt like there was some work out there that the person could do.
Shelly Mark: Right, because sometimes, you know, you have a vocational expert in the hearing and so maybe, sometimes, you get a vocational expert, which obviously you didn’t hire. They’re hired by the judge.
Natalia Jofre: Right.
Shelly Mark: That comes off, out with this off the wall job they feel the person can do or the medical expert, you know, talks about some evidence. And, sometimes we’ve seen judges hyper-focus on a negative piece of evidence and almost disregard everything else that was supportive of a finding of disability. Because, we pride ourselves on really …
Natalia Jofre: Strong …
Shelly Mark: Yes.
Natalia Jofre: Strong cases.
Shelly Mark: We’re really are thorough in our evaluation of cases and we don’t want to represent people that aren’t legitimately disabled.
Natalia Jofre: Right.
Shelly Mark: So when we go to a hearing, you know, it’s because we really do feel that they should be found disabled.
Natalia Jofre: One thing that I would say, too, with these unfavorable decisions is that clients get really upset when they read them. Understandably so. This is their life, and they find … what they always tell me is this isn’t fair. The judge didn’t talk about the appointments that I had with my orthopedic or they didn’t talk about everything that I said about how difficult it is for me to walk. And, I just always tell my clients. You have to try to remember if you can, that this is like an outcome based opinion.
  What I mean by that is, the judge has made a decision whether he’s going to deny or grant the claim and then, like you were talking about in our last video, it then goes to the decision writers. So, this decision writer has to go through the file, and put into the decision the evidence that supports the judges finding.
Shelly Mark: Mm-hmm (affirmative)-
Natalia Jofre: So, it does tend to be a very one-sided decision.
Shelly Mark: Right.
Natalia Jofre: That doesn’t mean that those things weren’t in the file. It doesn’t mean that the judge didn’t take them into consideration. It’s just, in a lot of cases, they may not be very accurately reflected.
Shelly Mark: Yeah. And, sometimes we do get unfavorable decisions when, for example, the person was authentically disabled, but for example, they were unable to have ongoing medical treatment because they couldn’t afford it. Or, they were younger and now they’re a little bit older, but for the period of time that they were claiming disability, the judge still felt that they should be able to do some type of work because they were considered a younger individual. So sometimes, when the circumstances change, they can then file a new claim, which is one of the options and, basically have a much better chance of being approved in a new case.
  But, we’ll save that for our next blog. So, the next blog, we’re going to talk about: what can you do.  What appeals can you file, what happens at those levels, or is filing a new claim, perhaps, a better option for you? So, we’ll talk about that next time.
Natalia Jofre: Okay.
Shelly Mark: In the meantime, if you have questions, feel free to visit our website or call our office and we thank you for joining us.
Natalia Jofre: Thank you.

 

Shelly Mark, Senior Attorney

SS Video Blog – Partially Favorable Decision

/in , /by

Natalia Jofre:  Hello, and welcome to Hill & Ponton Social Security Disability blog. I’m Natalia Jofre, the Social Security Director.

Shelly Mark:  I’m Shelly Mark, I’m the Senior Social Security attorney.

Natalia Jofre:  So, in our last blog, we talked about fully framed rule decisions we all celebrated right?

Shelly Mark:  Yay.

Natalia Jofre:  You waited this long. You won your case, that’s great. Now, what happens when your decision says, partially favorable.

Shelly Mark:  Right, people get really excited, because it says favorable and they kind of skip over the partially part.

Natalia Jofre:  Yeah.

Shelly Mark:  What that means is that the judge has agreed that you’re disabled, but he or she has disagreed as to when.

Natalia Jofre:  Mm-hmm (affirmative).

Shelly Mark:  So, you may have alleged that you became disabled in January of 2014 when you stopped working, but the judge may find that you became disabled in June of 2016, and there’s a variety of different reasons why that may be the case. The biggest thing to know there is that you can appeal it.

Natalia Jofre:  Right.

Shelly Mark:  You do have 60 days from the date of the decision to appeal it. However, you need to be really careful in doing so, because your entire file is at risk, meaning that any future adjudication also includes whether or not you’re disabled.

Natalia Jofre:  Yeah.

Shelly Mark:  So, they can come back and say, “You know what? We disagree. We don’t think you’re disabled at all.”

Natalia Jofre:  So, that’s huge.

Shelly Mark:  It’s a big risk.

Natalia Jofre:  People, many times, are willing to take that huge risk. So, you have to look at, is it worth it?

Shelly Mark:  Right.

Natalia Jofre:  And if you appeal, and we’re gonna be talking about the Appeals Council in one of our next blogs, but if you appeal it, it’s not like, oh well, I’m gonna go back to the same judge 60 days from now and just have him see … you know, have a hearing and talk about this, and say, “I thought I was disabled in 2014, and you said I’m not disabled until 2016.” What’s gonna actually happen is you’re gonna have to wait probably an average of 24 months to get another hearing. You’re gonna go before the same judge. Really, your evidence hasn’t changed.

Shelly Mark:  Right.

Natalia Jofre:  They really can’t consider other evidence either. At that point, the record is closed.

Shelly Mark:  Right.

Natalia Jofre:  So, you’re not gonna have any different information, and you put yourself at risk of them taking it all away.

Shelly Mark:  Yeah.

Natalia Jofre:  We’ve seen it happen.

Shelly Mark:  Yeah, we’ve seen it happen.

Natalia Jofre:  Yeah.

Shelly Mark:  And it’s bad, because then you end up with an overpayment, as well as losing your benefits.

Natalia Jofre:  So, that means you have to give all the money back.

Shelly Mark:  Yeah.

Natalia Jofre:  You don’t want to do that.

Shelly Mark:  That’s hard to do when you’re not working.

Natalia Jofre:  Right.

Shelly Mark:  So, one of the biggest things to do when you receive a partially favorable decision is to determine why. These judges, they’re smart, they’re giving you this onset date for a reason. It could be because maybe you stopped working in 2014, but you didn’t have the MRIs done until June of 2016.

Natalia Jofre:  Mm-hmm (affirmative).

Shelly Mark:  So, legally, the judge can’t grant your claim until the medical evidence is there for them to base their decision on. Another example would be, maybe you stopped working in 2014, but you turned 55 in June of 2016.

Natalia Jofre:  Right.

Shelly Mark:  So, at that point, you’ve changed into a different age group, and you’re at an advanced age, and the statutes changed. So, usually, there is a reason why it’s a different onset date. We definitely go through with our clients and explain to them exactly why, and counsel them on whether to appeal or not.

Natalia Jofre:  Yeah, and we’ve talked about the different age groups in a past blog. So, like Shelly said, when you talk about your 55th birthday, we’ll amend sometimes onset dates of disability to the 55th birthday, because the same rules for a person that’s 50 to 54 don’t apply to a person that’s 55 to 59. The older you get, the easier it is. So, the just might say, “Well, you didn’t really meet these rules at age 54, but hey, now you meet them at age 55. So, that’s why they’re approving that different onset date of disability.”

Shelly Mark:  Right, and that’s a really good outcome because the judge could just say, “They didn’t change their onset date until their 55th birthday. We’re gonna deny it, and they can refile.”

Natalia Jofre:  The other thing that we see a lot is with, like if you were getting unemployment benefits.

Shelly Mark:  That’s true.

Natalia Jofre:  They don’t want to pay you twice. So, in other words, you were getting unemployment from 2014 through let’s say, June through 2016, so the judge says, “Okay, I’m gonna give you benefits as of July of 2016.” Why? Because they feel like, unemployment already paid you. I’m not gonna pay you again for those same months.

Shelly Mark:  Right, yes. And when you’re on unemployment, you have to remember that you’re saying that you’re able and available to work, and when you’re filing for disability, you’re saying that you’re disabled and unable to work.

Natalia Jofre:  Judges do not like that contradiction. They do not.

Shelly Mark:  And our clients, we would always council to change the onset date to after any unemployment benefits.

Natalia Jofre:  Yeah, so those are all reasons why you can get a partially favorable decision, but it’s always best … you have to review it and see what’s best for yourself.

Shelly Mark:  Yeah, definitely.

Natalia Jofre:  So, then our next blog, we’ll be talking about what happens if you get an unfavorable decision. But, for now, if you have any questions, feel free to either call us, or visit our website, and thank you for joining us.

Shelly Mark:  Thank you.

Shelly Mark, Senior Attorney

SS Video Blog – Fully Favorable Decision

/in , /by

Natalia Jofre:     Hello, and welcome to the Hill and Ponton Social Security Disability Blog, I’m Natalia Jofre, the Social Security Section Director.

Shelly Mark:      And I’m Shelly Mark. I’m the Senior Social Security Attorney.

Natalia Jofre:     So in our last blog we talked about after you go to the hearing, what happens.

Shelly Mark:      Right.

Natalia Jofre:     When you get that decision. So when you get the actual decision, it can be a fully favorable decision, a partially favorable decision, or an unfavorable decision.

Shelly Mark:      That’s correct.

Natalia Jofre:     So first things first, let’s talk about a fully favorable decision, which will mean you’ve won.

Shelly Mark:      Right.

Natalia Jofre:     Great news.

Shelly Mark:      Yes.

Natalia Jofre:     What happens.

Shelly Mark:      Everybody says, “What does it mean?” What does it mean? Basically, a fully favorable decision is exactly what it sounds like, it means that the judge is agreeing with the fact that you’re disabled, and the judge is agreeing on when you became disabled.

Natalia Jofre:     Okay.

Shelly Mark:      So, you basically have been awarded your disability benefits since you alleged you originally became disabled.

Natalia Jofre:     Right. And so that’s what one, like we said before you have to check that to make sure that they got the actual date right.

Shelly Mark:      Right.

Natalia Jofre:     We’ve seen discrepancies.

Shelly Mark:      Oh, yeah.

Natalia Jofre:     Many times in the past, unfortunately. And so if it says fully favorable, then it’s going to take probably a good 90 days before they see their past due benefits?

Shelly Mark:      Yeah, probably so.

Natalia Jofre:     Right. So once they win, it’s going to either go to the local office, so if it’s SSI only, it’s going to go to the local office. And the local office is going to basically calculate, okay, how much can you get in retroactive benefits.

Shelly Mark:      Right.

Natalia Jofre:     Or in monthly benefits. And in monthly benefits. If it’s dib only, which is regular disability only.

Shelly Mark:      Right.

Natalia Jofre:     It’s going to go to an out of state payment center and depending on what your social security number is, is where it’s going to do, depending on your age, depending, depending on several factors, if it’s widows, if it’s regular.

Shelly Mark:      Right.

Natalia Jofre:     If it’s, yeah. And then they’re going to determine what your past due benefits are, and what your monthly check will be. Normally, your monthly check’s going to start within about 60 days from the favorable decision. Your retroactive benefits are going to normally come within about 90 days. Where it gets a little dicey, is when it’s for regular disability and SSI combined.

Shelly Mark:      Right. Yeah. It tends to take longer because you have two payment, especially if they split it it seems.

Natalia Jofre:     Yeah.

Shelly Mark:      If they split it and send part of it to the disability processing and the other to the local office, it seems like it does take a bit longer. I think it seems to me like the SSI side of things may hold up-

Natalia Jofre:     It does.

Shelly Mark:      -the disability a little bit.

Natalia Jofre:     Yeah. Like they, the actual out of state payment center, can’t pay you anything until your file is cleared at the local office. Well, imagine with social security’s backlog, that can sometimes take months before they even get to it and this is even if you’re not owed anything. Even if you say, “You know what, I’m going to waive my right to SSI, I don’t want any SSI, I just want to get my regular check.” They still need to wait for the local person to basically sign off on that, say it and forward it to the payment center out of state.

Shelly Mark:      And that’s one of the reasons right when we know that we get a technical SSI denial, we don’t appeal that.

Natalia Jofre:     Right.

Shelly Mark:      That way that we don’t have to have the client wind up waiting on that at the end. And by that, I just mean earlier in the claim-

Natalia Jofre:     Yes.

Shelly Mark:      -we tend to file both an SSI and a disability application for our clients at the beginning and then if there is an SSI denial due to over income, we call that a technical denial, we do not appeal that, because we know that person’s not eligible and it prevents them from ending up with that situation at the end.

Natalia Jofre:     What’s really important though in that situation is you want to make sure that there’s been no change in income. So you know with SSI, it’s month to month.

Shelly Mark:      True.

Natalia Jofre:     So, just because you didn’t qualify technically based on your income a year ago, maybe the same doesn’t hold true anymore. Maybe there’s been a change in your income.

Shelly Mark:      Yeah.

Natalia Jofre:     Maybe your spouse lost their job.

Shelly Mark:      Or divorced.

Natalia Jofre:     Or maybe whoever was helping you, exactly, maybe you got divorced. So you want to always make sure that that’s the case before you waive any rights.

Shelly Mark:      Right. For sure.

Natalia Jofre:     Another important thing that tends to come out in the decision, is if you’re going to be reviewed.

Shelly Mark:      Definitely.

Natalia Jofre:     Right, because it’s not-

Shelly Mark:      That’s the last sentence.

Natalia Jofre:     Yes.

Shelly Mark:      The very last sentence of the decision, and it gets overlooked a lot. But in a lot of cases, especially for younger individuals, the judge is going to say that in 24, 26 months, we’re going to pull this file to review it to see if you’ve had any medical improvement.

Natalia Jofre:     Yeah. So people ask us all the time, is this for life?

Shelly Mark:      Right.

Natalia Jofre:     We’re going to talk about that in a future blog, you know, reviews, how often do they happen, do they always happen, why do they happen, what you have to have ready because that is a very extensive subject in of itself.

Shelly Mark:      Sure. Yeah.

Natalia Jofre:     But just know that sometimes in the fully favorable decision, they’ll actually tell you, this is how soon we’re going to be reviewing you.

Shelly Mark:      Right, yeah, absolutely. And you can almost expect it if you’re a younger individual because Social Security is very reluctant to say that you’re permanently disabled at say 35 or something.

Natalia Jofre:     Yeah. All right. So we’ll talk more about the decision in our next blog. For now, we thank you for joining us, if you have any questions in the meantime, please feel free to visit our website or give us a call.

Shelly Mark:      Thank you.

 

Shelly Mark, Senior Attorney

Video Blog – SS – After the Hearing

/in , /by
Natalia Jofre: Welcome to Hill and Ponton’s Social Security Disability Blog. I’m Natalia Jofre, the Director for Social Security Section.
Shelly Mark: And I’m Shelly Mark, I’m the Senior Social Security Attorney.
Natalia Jofre: So in our last blog we talked about whose at a hearing, how long it takes to get there, the different people that can attend the hearing and then here comes the end of the actual hearing and people think the judge is gonna hit the hammer and is gonna say, “You’re getting disability,” or “You’re not.” People also mistakenly believe that this is a lifetime benefit, we can get into that some of time but are you normally gonna get a decision that day?
Shelly Mark: No, I would say less than five percent of the time do we actually get a decision that day and even in the cases, the five percent that we get a decision, that’s really just the judge telling us. It’s not like they hand us a written decision. Either way, you have to wait approximately 60 days to get the written decision from the judge. Now, that’s just the judge’s decision, that’s not a payment and then once you get the decision, of course, you’ll know whether it was a favorable or unfavorable and depending on that, what step would be next.
Natalia Jofre: And Social Security, they’ll be the first to tell you, first of all, the judge will tell you it’ll be about 60 days before you get a decision in writing, whatever. Nothing happens until you get that decision in writing. The other thing is the Hearing Office will tell you the judge said 60 days but don’t call us before 90 days.
Shelly Mark: That’s true.
Natalia Jofre: Because sometimes they have their own backlogs and so after the judge makes his decision, it has to go to an actual decision writer, they write out all the legalese, then the judge reviews it, then he signs off on it. And that brings me to another point that when you get that decision, like we review our decisions very thoroughly, even if it says at the top, full favorable decision or unfavorable decision. And we’ll cover that in another blog. We have to verify that, the date that they were actually claiming they were disabled from is the date that’s referenced, that, that’s the date that was approved, did that date differ, when are they gonna be entitled to benefits, are they saying that they need to be reviewed within 24 months or whatever? So the decision itself contains a lot of information and some people mistakenly kind of take it at face value, where you have to really know how to review it thoroughly to make sure that everything you were asking for is actually being awarded, right?
Shelly Mark: Exactly. Yeah, there’s a whole lot of information in the decision and it needs to be reviewed very thoroughly because there are a lot of … There can be a lot of variances compared to what you’re actually asking for to what you’re ultimately ending up within the judge’s decision. Also, what Natalia said about why does it take the 60 to 90 days? People always ask and that’s exactly right, it’s that it goes from the judge to a decision writer and they draft a decision, your decision will be an analysis of all the evidence in the file and then the judge has to sign off on it. So it is a bit of a back and forth.
Natalia Jofre: And then they’ll be the first to tell you that once the judge actually makes the decision and you receive it, then it doesn’t stay with the Hearing Office. Then it goes to an out-of-state payment center, if it’s for regular disability benefits for them to calculate your benefits and pay them or if it is SSI only or SSI is involved, it’s gonna go to the local office. And sometimes it gets split, sometimes it goes to the local office and then to the payment center. So all of this adds to your wait time.
Shelly Mark: Right. Absolutely.
Natalia Jofre: Unfortunately.
Shelly Mark: Right.
Natalia Jofre: It’s not I get a decision today or I get a decision 90 days from now and then I gotta wait to get paid. We help people navigate that, we know based on their social security number where it’s gonna go, how long it’s gonna take, what they need to get in order to process it may be a little bit more quickly but it’s not fast unfortunately, nothing in social security is.
Shelly Mark: Unfortunately not and I think it’s important to make sure that somebody that knows how to read those decisions is reviewing it for you to make sure that everything is what it should be.
Natalia Jofre: So, in our next blog, we’ll talk about what happens if you get a fully favorable decision. And so we’ll do that next time.
Shelly Mark: Okay.
Natalia Jofre: All right.
Shelly Mark: Thank you.
Natalia Jofre: If you have any questions in the meantime, visit our website or call our office. Otherwise, we’ll see you then. Thanks.
Shelly Mark: Great, thanks.
Shelly Mark, Senior Attorney

Video Blog – SS – Hearing Witness

/in , /by
Natalia Jofre: Hello, and welcome to the Hill and Ponton Social Security Disability blog. I’m Natalia Jofre, the Director for our Social Security section.
Shelly Mark: I am Shelly Mark. I am the Senior Social Security Attorney.
Natalia Jofre: In the last couple of videos we’ve done, we’ve been talking about the hearing level, what happens at the hearing level, who can be in the room, or who is normally within the hearing. We’ve talked about the judge, the court reporter, the claimant, a medical expert, and a vocational expert. The other person that can be in a hearing is a witness.
Shelly Mark: That’s correct.
Natalia Jofre: Sometimes people want to have witnesses at their hearings. Not all judges want witnesses. Can you tell people a little bit about how that works?
Shelly Mark: Sure. Everyone has a right to have a witness testify on their behalf. However, there is a little bit of, I wouldn’t say reluctance, but the judges really prefer to hear all the testimony from the claimant themselves. They usually don’t really need a witness, unless there’s going to be some information given that is in addition to the claimant’s testimony.
  In situations to where maybe someone is not verbal, that’s very important. We’ve had cases with mental health, to where maybe the person doesn’t find their symptoms as severe as their spouse or their parent does. We definitely need a witness in those cases.
  One thing that we do is we will do a third party statement right before the hearing, and we’ll have the spouse or the parent write a statement. We’ll turn that into the judge right before the hearing, and then we’ll ask the judge at the hearing, “Do you want to speak to this person?” Most of the time they’ll say no, that the statement is sufficient.
Natalia Jofre: That’s great. Normally, the witness is going to be a family member or a very close friend. Normally in Social Security Disability hearings, other than the medical expert or the vocational expert that the judge orders, you don’t have to take your own physicians to testify on your behalf, or your own employer. Lots of times people ask us about that. That’s really not the case, right?
Shelly Mark: No, no, that’s not the case. If it was a witness that you would be calling, it would usually just be a third party. The person that’s closest to them, that can give the judge some more information. Really with the doctors, all we really need to submit is a narrative or a statement from the doctor about the client’s symptoms.
Natalia Jofre: The only other situation that comes to mind is obviously if the claimant is a child. If the child, obviously under age 18, normally then the primary person testifying is the parent, but the child is normally asked to be in the room.
Shelly Mark: Absolutely.
Natalia Jofre: Right, so that they can observe them?
Shelly Mark: Right. In a lot of the cases that I’ve had that are children, the judge wants to speak to the child as well. Usually, they do take testimony of the child and the parent. In some cases, we have parents that want to do all of the talking for the child, and that may not be the way it actually plays out in the hearing. The judge may actually go to the child for testimony.
Natalia Jofre: Okay, great. In our next video blog, we’re going to be discussing what happens after the hearing. We’ll see you then and we thank you for joining us.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – SS – Hearing Medical Expert

/in , /by
Natalia Jofre: Hello, and welcome to Hill and Ponton Social Security Disability Blog. I’m Natalia Jofre, our Social Security section director.
Shelly Mark: And I am Shelly Mark, I am our senior Social Security attorney with the firm.
Natalia Jofre: The last couple of blogs, we’ve talked about hearing level, getting here, how long, what happens the day of. Last one, we talked about vocational expert, because a lot of times the judges call vocational experts. The other type of expert they like to call in is a medical expert. Can you explain who that person is, and why they need to be there?
Shelly Mark: Sure. The judges use medical experts frequently in cases to give them, basically, doctor’s opinions regarding the client’s conditions. Obviously, the judges can read the records in the file, just like we can, but we’re not doctors. So I can make an argument that the client meets a listing based on the severity of their spinal condition, but I can’t give a doctor’s opinion that that actually happened.
In a lot of cases, the judges will ask for a medical expert. Obviously, if it’s something like an orthopedic issue, they’ll ask for an orthopedic. If it’s someone with mental health, they may ask a psychiatrist to testify. Again, this person is completely independent of Social Security, and basically their role there is to read all of the records in the file and give their professional opinion as to one, whether the client meets one of those listings that we talked about previously. So they’ll go through and they will talk about why or why not the client does or does not meet that listing.
If they find that they do not meet the listing, the medical expert will go even further, and they will give what we call a residual functional capacity. All that means is that they’re going to tell the judge, based on this person’s limitations, this is the type of work that they can perform. Based on their physical limitations, they may only be able to perform sedentary work. The judge is going to use that testimony when he talks to the vocational expert, and when he asks them questions.
Natalia Jofre: Sometimes throughout the Social Security claim, Social Security sends claimants to see one of their doctors, or a medical exam that they pay for. Would you put the medical expert in that same category, to where they’re working for Social Security, or is it like the vocational expert, where they’re really an independent testimony source per se?
Shelly Mark: They are really an independent testimony source. We review the examinations that clients are sent to through Social Security earlier on in their claim. Frequently, obviously, because they’re in every file, and the difference between those opinions and the opinions of the doctors at the hearings are very, very different. The doctors are extremely objective. Medical experts are extremely objective.
I personally really like having medical experts at the hearings, because our cases usually speak for themselves, and so if we can have a doctor present to testify, they may easily conclude that our client meets a listing. Whereas, if I go in and argue that the client meets a listing, again, I’m not really a doctor, so the judge can take my argument under advisement. But if the doctor says they meet a listing, then the hearing is over. The person is disabled.
Natalia Jofre: Wow. So it could really work to their benefit?
Shelly Mark: Absolutely.
Natalia Jofre: Great.
Shelly Mark: We’ve actually, in many cases, we’ve asked for a medical expert. If we feel like the claim is at the level that the person really needs to be evaluated as to whether they meet a listing, then we will ask for a medical expert to be present, so that that can happen.
Natalia Jofre: Okay. They don’t necessarily have to grant what you’re asking for-
Shelly Mark: They do not.
Natalia Jofre: … but you can ask.
Shelly Mark: That’s right. We still ask. And a lot of times, we do end up with it. Another, at least in my own experience, one thing that I’ve found is usually when the judges ask for a medical expert, it’s because they also have a good feeling, based on the evidence, that the person may meet a listing. Or that the person may have a favorable testimony from the doctor.
Natalia Jofre: Once again, it’s verifying that opinion.
Shelly Mark: Exactly.
Natalia Jofre: Okay. Great! If you have more questions, feel free to visit our website or call our office. Otherwise, we thank you for joining us.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – SS – Hearing Vocational Expert

/in , /by
Natalia Jofre: Hello, and welcome to Hill and Ponton Social Security and disability blog. I’m Natalia Jofre, our Social Security section director.
Shelly Mark: And I am Shelly Mark. I am our senior Social Security attorney.
Natalia Jofre: So our last couple of blogs, we’ve talked about when you get to the hearing day, what to expect the day of your hearing, who is in the hearing or what happens. Now we’re going to talk about one of the main experts at that they’re now calling at a lot of hearings. This used to not be as common as it is now, but it’s a vocational expert.
Shelly Mark: That’s correct.
Natalia Jofre: We get calls all the time, who is this person? What are they gonna do? Are they gonna be opposing me in terms of … So, can you explain to people what a vocation expert is and I guess their function is in the hearing?
Shelly Mark: Sure. The vocational expert is now used in 99% of all the hearings that we do. Their role in the hearing is to advise the judge and get testimony on the type of work that the client used to do, and then the type of work that they could or could not do, depending on their physical or their mental limitations.
The one important thing for clients to know is that the vocational expert will be answering questions from the judge and from the attorney, but they will not be asking them any questions unless it’s simply to clarify some type of what they did in the past.
Natalia Jofre: So, it’s not as if they’re going to ask the claimant directly questions or what did you do or might you do or how intense with this or that?
Shelly Mark: No, they will not. If they have a question for the client about any of the work that they used to do, they would ask that to the judge, and then the judge would ask the client that question.
Natalia Jofre: Okay.
Shelly Mark: But they’re basically there to do, in a nutshell, is there to describe the claimant’s past work and then they are going to say whether or not they can do that past work or other work, based on the limitations that the judge tells them. So the judge is going to say, “Well, if this person were limited to only standing or walking two hours a day and only lifting 10 pounds throughout the day, could they perform their job as a heavy equipment operator?”
Then that vocational expert is, in their opinion, going to say whether they could perform that job or whether they could perform other work. Without getting too complicated, this ties back to a few of our previous blogs when we talked about how important it was to accurately describe the past work of the claimant.
Natalia Jofre: Because a lot of their information or a lot of what they know, or they think they know, they’re going off of that form you previously completed, right?
Shelly Mark: That’s correct. They’re going off of that form and the testimony, but I have had judges find the client to be not credible because their testimony was not matching that form, which is why Natalia and I have been very adamant that those forms are really, really important all the way to the actual hearing day.
Natalia Jofre: And this is why.
Shelly Mark: Yes. That’s exactly right.
Natalia Jofre: The judges started … you know, we mentioned that you used to not always have a vocational expert and you don’t have to have one, but most judges now are electing to have them because it really does provide them with objective evidence, per se or objective testimony
Shelly Mark: Right.
Natalia Jofre: Before judges would make their decisions and they were very rarely questioned and so on and so forth, whereas now they’re under a great deal of scrutiny to not approve claimants or to make sure that they’re approving claimants that they’re absolutely certain are disabled. They’re under a lot of pressure.
Shelly Mark: They are.
Natalia Jofre: So this, kind of like to offset that pressure where, this objective party is there to just provide testimony based on their work history and what their expert opinion is.
Shelly Mark: Right. And a lot of people think that this is an employee of Social Security and that’s not true. The Social Security Administration does pay them for their service, but they are not in any way, shape or form connected to Social Security. Most of these individuals have worked as job coaches or vocational experts or with vocational rehabilitation for decades. The majority of them do a really good job at classifying the client’s past work and then answering the judge’s questions.
Natalia Jofre: Okay. Great. Next blog, we’ll talk about medical experts, which is the other kind of expert you can have at a hearing, so if you’d like, join us then. If you have any questions in the meantime, feel free to visit our website or call our office. Thanks for joining us.
Shelly Mark: Thank you.