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Shelly Mark, Senior Attorney

SS Video Blog – What To Expect At Your Hearing

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Natalia Jofre: Hello and welcome to Hill & Ponton’s 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 at the firm.
Natalia Jofre: So in our last blog we were talking about the hearing day. So you’ve waited all this time to get your hearing, now you actually go to the hearing. We talked about how you should dress, what you should do, what you can expect that day. Now we’re gonna talk about when you’re in the actual hearing per se.
So when you go into the room, I mean what is it like? Can you describe to them a little bit about what it’s like?
Shelly Mark: Sure. You’re not going into a courtroom, a large courtroom. You’re going to go into a smaller type room and you will be seated. The attorney will be seated next to you. The judge will be across the room on a podium and there will be two side tables, one of which is gonna have a court reporter who’s going to be obviously keeping everything on record, should you need that in the future. And then there’s also the possibility that there may be a vocational expert and also a medical expert, which I think we’ll probably get into those on another point.
When we go into the hearing you do have to be sworn in, so the judge will ask all the parties to swear in. And then from that point, we will begin taking testimony. The majority of the testimony is going to be about age, education, past work, why you stopped working, and then why you haven’t been able to go back to work.
Clients always ask me, “Why aren’t you gonna answer for me?”
Natalia Jofre: Yeah Shelly, why aren’t you gonna answer for them?
Shelly Mark: And the reality is I can’t. These questions are gonna be directed to the client either by myself, from myself or from the judge. And they are gonna have to answer on their own.
Natalia Jofre: When you … I mean because then it kind of begs the question, what is your role there? You can perhaps like direct the questioning, or if you feel as though the judge has gone down a line of questioning that may showcase an unfavorable light on some of their answers, you could maybe sometimes ask questions that would counter that, right?
Shelly Mark: Absolutely. The variances in these hearings are very minimal, but the biggest one is whether the judge is going to ask the client the questions directly or whether the judge is going to let the attorney do that. Obviously as the client’s attorney, if I’m allowed to ask the questions I’m gonna ask them in a way that I know prevents the case in the most favorable light. If the judge is the one that does the direct questioning of the client I get to question the client after. And so that’s when I’ll be doing any clarification or covering anything that the judge did not cover, or trying to … Whatever it is. In a lot of cases, the judge may focus on something that I find to be irrelevant, so I may need to ask some questions to clarify that it’s not really as important as it came across.
And of course we’re there as the client’s advocate, so if they don’t understand a question or they need to take a break. Anything like that they can always turn to us for assistance.
Natalia Jofre: Okay great, so that’s helpful to understand. And then you can also argue law right? Like you can say, “This person is disabled because they meet this listing or that ruling or because of this combination of factors they should be found disabled.” Or whatever.
Shelly Mark: Exactly. The judge is gonna expect us to, as attorneys, to come in with a theory of our case. So it does have to be based on the law. So we will, in our hearing memo and in all of our argument letters or anything that we submit throughout the file, we’re going to be presenting those legal arguments. But we will be presenting them again the day of the hearing.
Natalia Jofre: Okay great. Well, next blog I think we’ll talk about then these other experts that can be present at your hearing. They’ve become pretty prevalent so we’ll talk about those. In the meantime, if you have any questions feel free to visit our website or call our office, otherwise thanks for joining us.
Shelly Mark, Senior Attorney

Video Blog – SS – Day of the Hearing

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Natalia Jofre: Hello and welcome to Hill and Ponton Social Security Disability Blog. I’m Natalia Jofre, the Social Security Section Director here at our firm.
Shelly Mark: And I am Shelly Mark. I’m the Senior Social Security Attorney with the firm.
Natalia Jofre: So the last couple of blogs we’ve been talking about the different claims levels, and then we talked about the hearing level and what happens before the hearing, and now today we’re going to talk about what actually happens at the hearing. First, I think we should talk a little bit about scheduling because people get very thrown off. We had talked about when you get that letter it doesn’t mean you’re going to get a hearing in 65 days. Then when they actually schedule it you normally have about two or three months worth of notice, right?
Shelly Mark: Right, that’s correct.
Natalia Jofre: All right. Then comes the actual day of the hearing, and that’s when the magic happens. So what can they expect? I know that people see Law and Order and stuff like that on TV and …
Shelly Mark: And it’s definitely not that. Unfortunately, it’s not that exciting. But it is a really important day obviously. You know, people have been waiting a very long time. It’s always really important to be prepared, to know where you’re going, and make sure that you arrive at least 30 minutes early for your hearing. It’s never a bad idea, if you have a lot of anxiety, to drive it before your hearing, just to know where you’re going so that you feel more comfortable driving there the day of, especially if you have a lot of anxiety or something like that.
But the only thing that you’re going to need to bring with you is a photo ID. You receive some forms from social security asking you to bring your medications and all your medical records. As long as they’re represented, at least our clients, of course, all of that’s done for them. So they just really need a photo ID. There will be a security guard there that they’re going to sign in with, and there are private meetings rooms there so we meet with our clients 30 minutes prior to the hearing to go over everything again, answer any last-minute questions, and then again to just try to get people to be at ease about the process.
Natalia Jofre: Yeah, because they do get there and they’re a little nervous, right? Generally.
Shelly Mark: Yes.
Natalia Jofre: Another biggie, leave your cell phone in the car, right?
Shelly Mark: Yes.
Natalia Jofre: Oh, in this age of cell phones, boy do a lot of people have to go back to their cars.
Shelly Mark: I tell people, bring a book or something if you can’t sit still for that long.
Natalia Jofre: Yeah, because sometimes the hearings run long or the judge has a delay or whatever, so you could just be sitting in that lobby.
Shelly Mark: Right. You definitely could. The hearing itself usually lasts about 45 minutes on average, and then again after the hearing, I like to sit with the clients again after the hearing for 10, 15 minutes to go over how everything went and then answer any questions that they have. Our goal is to make sure when they leave there that day that they understood what happened, and they understand procedurally what happened, and then also kind of how we feel about how the judge viewed their case.
Natalia Jofre: Oh, yeah.
Shelly Mark: But we do not get a decision the day of the hearing. That is something that clients do expect. We try to make sure we tell them at the pre-hearing conference, it is about 5% of the time that we may get a decision the day of a hearing. But I always tell clients, “Please do not expect that.”
Natalia Jofre: Yeah, because it’s not the norm.
Shelly Mark: No, it is definitely not the norm at all.
Natalia Jofre: And it’s really frustrating for people because they feel like, I’ve been waiting for this day 36 months now, normally by the time they get there, and they’re like, “What do you mean the judge isn’t going [inaudible 00:03:48] a decision?” It’s not the time to be snide or snippy or make comments about that either. This person’s going to basically decide your livelihood, so …
Shelly Mark: That is another thing people ask about is, does the judge make the decision on their own? And that is, yes, the judge takes into account the medical records, everything in the file, and of course all the testimony of the client.
Natalia Jofre: Then in terms of how they get dressed, because we’ve seen people are like, “Oh, I’m going to court, I’m going to dress up today.” But then that’s not normally how they would present themselves.
Shelly Mark: Right. A kind of rule of thumb that I advise clients is to dress comfortably. There’s no reason to overdress. There’s also no reason to underdress. But you know, wear what you would wear if you were going to a doctor’s appointment or you were going to dinner with your family or something like that.
Natalia Jofre: That’s a good guideline.
Shelly Mark: Yeah.
Natalia Jofre: So not over and not under, right? You also want to look appropriate.
Shelly Mark: Right. No graphic tees or …
Natalia Jofre: Yeah, no graphic tees, that’s a good tidbit. Okay, great. Well, there’s other people in the hearing room. We’re going to be talking about them so that you can further understand the dynamic the day of the hearing. We’ll talk about that in our next blog. In the meantime, if you have any questions, feel free to visit our website or call our office. Thank you for joining us.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – SS Pre-Hearing Preparation

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Natalia Jofre: Hello, and welcome to Hill & Ponton’s Social Security Disability blog. I’m Natalia Jofre, the social security director for our firm.
Shelly Mark: I am Shelly Mark, I’m the senior social security attorney with the firm
Natalia Jofre: The last couple of blogs we’ve been talking about the hearing level, and once you get to that level, now we’re going to talk about what occurs. You’ve waited now about a year-
Shelly Mark: Right.
Natalia Jofre: To just get to the hearing level, now you’re actually waiting for your hearing to be scheduled, and it’s actually scheduled. Do you want to let them know a little bit about what happens?
Shelly Mark: Sure, at that point when I say that they’re actually scheduled, they’re probably about close to 24 months from when we actually filed the request for hearing. At that point, with our clients, what we like to do is a pre-hearing conference. That’s where you will be scheduled with an attorney, and the attorney will contact you and do about 45 minutes to an hour of a conference preparing you for your hearing.
Basically, we want you to feel comfortable the day of your hearing, so we’re going to talk to you about your judge, their personality, and how they like to hold their hearings because they all are very different, too. We do get to work with them very frequently, so we have a good understanding of what they like and what they don’t like.
We’ll talk to a client about what kind of questions are going to be asked of them the day of their hearing, what kind of time … how long is it going to last, just what to expect so that we can kind of put them at ease as much as we possibly can.
Natalia Jofre: Yeah, and you work really hard, too, at figuring out and making sure that you have their full medical history, you know all of their doctors, all of their hospitals, what medications they’ve taken, what they’re currently on, and everything else because that’s huge. The medical treatment is probably the biggest factor other than testifying at the hearing.
Shelly Mark: That’s exactly right, Natalia. We pride ourselves with having the complete file when we go to the hearing. The one thing we don’t want to do is walk into a hearing after our firm has had it for coming up on 36 months and not have a complete record. We work really hard with our clients to make sure that they’ve let us know all of their providers, so we can request the records. If we don’t know about them, obviously we can’t get the records.
At the pre-hearing conference, we’ll go over all of that again just to make sure that everything is in the file and ready.
Natalia Jofre: Even for claimants that choose to represent themselves, the new rule is that all of it has to be in, no questions asked, five days before the hearing.
Shelly Mark: That’s a very good point.
Natalia Jofre: That’s the absolute deadline, right?
Shelly Mark: Yes.
Natalia Jofre: If you don’t have absolutely everything in, they can either postpone or reschedule … basically, the same thing, reschedule your hearing.
Shelly Mark: That’s correct, and if you submit records after that, or after your hearing, they do not have to consider them.
Natalia Jofre: Wow.
Shelly Mark: It’s really a case by case basis as far as whether the judge is going to consider that evidence. That again comes back to the fact that it’s taken so long for you to get a hearing date that there’s an expectation there that you should have had plenty of time to prep your file.
Natalia Jofre: Sometimes it’s not easy to get those last minute records. If you’ve had recent medical treatment … and I know that we have good working relationships with a lot of doctors and so hopefully, we’re usually able to get them but it’s not a certainty if you don’t know where to even start.
Shelly Mark: It’s very helpful for us as attorneys to have a complete record so that we can complete a memo. We do like to submit a memo that just briefly goes over the client’s file and explains the medical treatment and their past work and all that, so if it’s really beneficial for us, as well, to have a complete file prior to the hearing that we know everything that has taken place.
Natalia Jofre: Okay great. Well, next time we’re going to talk about what happens at the actual hearing, so if you want information on that, please join us. Otherwise, you can visit our website or call our office if you have any questions. We’ll see you next time.
Shelly Mark: Thank you.
SS Video Blog - SS Disability Hearing Level Forms
Shelly Mark, Senior Attorney

Video Blog – SS Hearing Level – Forms

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Natalia Jofre: Hello and welcome to Hill and Ponton’s Social Security disability blog. I’m Natalia Jofre, the Social Security section director for our firm.
Shelly Mark: And I’m Shelly Mark, I am the senior Social Security attorney.
Natalia Jofre: In our last couple of blogs we’ve been talking about the hearing level, which is the third level through the Social Security claims process and where basically you’re waiting for a hearing date to go before a judge in order to..
Shelly Mark: And waiting.
Natalia Jofre: And waiting and waiting some more, because on average it’s 24 months. Some jurisdictions are 18 months, but even … it’s not the same for everyone. We have clients that are in at the same hearing office and some wait 12 months and some wait 30 months. So it’s an average of 24. Nationwide it does vary from hearing office to hearing office. Just so you know, it’s not the same across the board. Some states have less of a waiting period. At the hearing level, when you’re waiting for your hearing date to be scheduled, Social Security or the hearing office is going to send you some forms to fill out. These are extremely important, right? Because they’re the snapshot, they’re the update that the judge is going to get of you and your case and whatever your current situation is, especially with your medical treatment right now.
Shelly Mark: Right.
Natalia Jofre: The first forms they send you is the medical treatment forms where you basically need to write down …
Shelly Mark: Your doctors that you’re seeing at the time so that the judge will know which providers you’re currently seeing. I think it’s also a way for the judges to know who they need to be seeing updates from. You don’t really want to put on there doctors that you’ve seen in the past but that you’re not seeing anymore, because they’re going to be wondering when it gets to the hearing, “Okay, why didn’t I get any updates from these doctors?” That’s a current medical provider list, so you want to make sure it’s just the doctors that you’re currently going to.
Natalia Jofre: Big deal, because if they do see this whole … it’s not the time for you to give all of this historical data. One, it complicates or convolutes everything that you’re submitting and secondly it’s probably a waste of your time.
Shelly Mark: True.
Natalia Jofre: Another form is your medications form. This also speaks to what current medications you’re taking, what are their dosages, who prescribed it, and that’s another tip-off for the judge right, to know who’s currently treating you.
Shelly Mark: Exactly. They do usually want to know if you’re taking these medications, which doctors are you seeing that are actually prescribing them. It is important to make sure that if you can, make sure that your dosages are as accurate as you can. If you’re using an attorney, they should be able to help you with that medication list. If not, you may want to maybe request a copy of your doctor’s progress notes from an appointment that you’ve been to, because it’ll list off the medications with the dosages and you can just transfer that onto the form.
Natalia Jofre: We often times see that a medication may not necessarily be a disabling or contributory factor, but side effects are. We’ve had a lot of clients that because of the combination of side effects that have from medication that they have to take, sometimes their side effects are as disabling as the condition itself. If you have … vertigo’s a big one. The significant dizziness or significant nausea. If it makes you vomit, like with chemotherapy and things like that you see it, but it doesn’t even have to be that extreme of a form of treatment. Right?
Shelly Mark: No no.
Natalia Jofre: We have some clients that take just normal maintenance medication that makes them very, very sick, so all of that gets considered.
Shelly Mark: Definitely.
Natalia Jofre: And then another form would be the work history. That’s a biggie.
Shelly Mark: It’s a biggie and it ties into us in our previous blogs where we’ve gone over the work history form a bit and talked about how important it was that at the initial level and at any point talking about the work history that everything stays consistent. It’s really important when you’re completing the work history form to make sure that you’re accurately representing … that you’re telling Social Security the right job that you did for the … it’s not as necessarily important what company it is, but what your position was and how long you worked there and then you want to … any physical demands. Were you standing, were you walking, were you lifting anything heavy? What were the requirements of the actual job that you were performing?
Natalia Jofre: Super, super important and the judge will go through your work history with a fine-tooth comb because you’re basically claiming you’re unable to do any of the type of work you did in the past. That’s a key to proving your claim.
Next blog, we’ll talk some more about what happens at the actual hearing. Please join us then. For now if you have any questions, feel free to visit our website or call our office, and thank you for being with us.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – SS Hearing Level – What To Do

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Natalia Jofre: Hello and welcome to Hill & Ponton’s disability blog. I’m Natalia Jofre, our Social Security Section Director.
Shelly Mark: I am Shelly Mark. I am our Senior Social Security Attorney.
Natalia Jofre: The last blog we talked about the hearing level, and basically once you get to this level, this is what social security would call the third level of your case. In other words, you’ve been denied at the initial level, you were denied at the reconsideration level, you filed an appeal, you’re now at the hearing level, and basically they’ve sent you a letter that says that they’ve received your appeal. Your case is with the hearing office, and it’s going to take, on average, 24 months to get a hearing date. They’re going to send you a letter letting you know that they got it, and that they’re going to notify you within 65 days of your hearing date. We basically told you that doesn’t mean your hearing is going to be in 65 days. It means that they’re just going to give you 65 days notice once they are ready to schedule it, which will really mean about 24 months later.
Now that the case is pending, what’s important to do at the hearing level?
Shelly Mark: Like we talked about, from the client’s standpoint, it’s really important to maintain their doctors appointments. Make sure they’re getting any kind of testing that they would need. If they have a back injury, but their MRIs are from 2010, and they have insurance, they might just want go ahead and ask their doctors to update some of their tests. They need to make sure their records are up to date and make sure that their personal information, their contact information, their address is up to date. That way when they are scheduled for a hearing, they’ll actually be ready for it.
Natalia Jofre: Yeah. The other thing that social security is going to do, or the hearing office is going to do, is they’re going to send the claim and some forms to complete and to submit.
Shelly Mark: Right.
Natalia Jofre: They range, I would say, the first one, well, they’re all important, but there’s one regarding medication. When you’re completing that form, I think that one of the important things that people tend to bypass is they don’t put all of their current medications or they include medications they’re no longer taking. Can’t that create problems then at the hearing?
Shelly Mark: Yeah. It can. Any discrepancies on the forms can really create issues at hearing because even though it may be just a very honest mistake or just a misunderstanding, it can create a credibility issue. Meaning that if the person’s saying on their daily living activities form that they’re able to take the dog out and walk the dog, and take the trash out, and clean the house, and all of these things, and then we get to a hearing and the judge asks them in the hearing, “Do you do any cleaning?” And they say, “No. I’m unable to do any cleaning of any kind.” I have had judges say, “Well, that’s not what your form says that you submitted.”
You want to be really careful when you’re answering all of those forms that you do it very accurately and with knowledge of what’s supposed to be on the forms.
Natalia Jofre: Yeah. What’s your reality. Don’t try to make it so severe where I never do anything. I never go to the store. I never cook. I mean, because then that’s going to open the door for, “If you never cook, how do you eat? What do you eat? Who prepares your meals? How often? How do you get fed?” Same thing with the store. I mean, “Where’s your stuff coming from, then? Does somebody go out? Do you have a personal shopper? Do you have a child or a sibling or someone that comes and does your shopping for you?”
You have to be mindful of when I say this, what is the consequence of that. Judges live in the real world too so they’re looking for realistic answers.
Shelly Mark: Mm-hmm (affirmative). On the flip side of what Natalia’s saying, if you are able to clean your house and you’re filling your forms out, what I try to tell people is that when you answer the questions, answer them, but make sure that you include any accommodations that you make for yourself. “Yes, I clean my house,” is one answer. Another answer that may be the exact same, but more appropriate, would be, “Yes, I clean my house for an hour and then I have to rest for two hours.” Or, “Yes, I clean my house, but it takes me three days, where it used to take me four hours.”
Natalia Jofre: Right.
Shelly Mark: You want to make sure that you’re putting the accommodations that you’re having to make for yourself to be able to do those activities.
Natalia Jofre: Yeah. There’s other forms, very specific forms, that get issued at the hearing level that you have to complete and submit, so we’ll talk about specifics on those forms in our next blog.
Shelly Mark: Okay.
Natalia Jofre: Alright. Thanks for being with us today. If you have any questions in the meantime, feel free to contact our office or visit our website.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – SS Hearing Level – Time Frame

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Natalia Jofre: Hello and welcome to the Hill & Ponton Disability Blog. I’m Natalia Jofre, the social security director for our office.
Shelly Mark: I am Shelly Mark, I’m the senior social security attorney with our firm.
Natalia Jofre: In our last blog, we talked about the reconsideration level, which is basically the second level to a disability claim, and we talked about, at the end, they’re going to send your claim back to the local office. They’re going to make a decision or they’re going to issue you their decision. They’re going to send that to you. Then you have the option to either not continue your claim or if you’re approved, obviously, then you need to look at whether you need to file an appeal, what date they approved you by. That’s very detailed. We would need to dedicate a few blogs to that in itself.
Shelly Mark: Right.
Natalia Jofre: Like we said before, 95% of claims are denied. Most people have to file another appeal. Once again, very specific forms need to be completed and submitted. I would say, especially to our veterans, because I know that in the past or when you’ve filed things with the VA, it used to be that you could send them a letter, or you could let it be known that you wanted to appeal. That is not going to suffice for Social Security. Social Security wants these very specific forms completed, submitted. They need to be received within a specific time frame: 60 days plus five mailing days. You can’t just call them. You can’t just let them know. You do have the option to either visit their office, make an appointment and go there, or submit your own appeal online, or submit it by mail. Once again, we recommend that you send it return receipt requested so that somebody actually has to sign and confirm that they received your appeal. Then I would save that little receipt like gold.
Shelly Mark: Right.
Natalia Jofre: Sometimes it looks like, “Oh, they got my appeal-“
Shelly Mark: Right.
Natalia Jofre: “… they must be handling it.” Then you don’t hear anything for six months, and you’re like, “I wonder what happened?” Then you contact them and they either tell you, “Oh, we never got it,” or, “it’s in backlog.” If they can’t find it, that’s your way to prove that you actually submitted it.
Shelly Mark: Right.
Natalia Jofre: Once you actually send it and they actually receive it, then the next thing they do is they send a letter confirming that they received your appeal and that your case is now with the Hearing Office. This actually recently changed. This letter will say that they need to give you at least 65 days notice before your hearing date. Does that mean that you’re going to have a hearing in 65 days?
Shelly Mark: I was just about to say that that is an extremely misleading letter. The average wait time that we experience here in Central Florida and in most jurisdictions that we work in is 18 to 24 months to get a hearing date from when the appeal for a hearing is filed. A lot of people think that it’s from when they file their initial claim and that’s not true. It’s from when we actually file the request for a hearing with a judge. The 65 days, that letter just means that they have to give you 65 days notice so that you have time to get your records and get your file in the order that it needs to be before your hearing. The hearing is not going to be scheduled in 65 days.
Natalia Jofre: Yeah. Even once it is and once they actually schedule it, they could schedule a hearing now, for six months now, for three months from now. It doesn’t even mean that it’s going to be immediate. What it is a really good time and a really good reminder for you to do is start getting your medical records. Start getting your updated medical records. If you haven’t been to the doctor, go back. This is just letting them know we have your case, but now it’s going to sit here for a while.
Shelly Mark: Right.
Natalia Jofre: Yeah.
Shelly Mark: I always explain to clients that once we file their request for hearing, that their file literally gets in line and it just stands there, and it waits, and it waits, and it waits, and it waits until it gets further down the line to where it’s actually getting scheduled. Really, the most proactive thing you can do during that time is to make sure your medical records are up to date. Make sure that you’re getting doctors opinions if you feel you have doctors that are supportive of your claim. Make sure you’re going to the doctor. Make sure that you’re keeping your address up to date. That’s very, very important. Basically, you just want to set yourself up so that when you are scheduled for hearing, you’re not at a point where your file is a mess, because it’s hard to explain, after you’ve waited for 24 months, why you haven’t gotten everything together.
Natalia Jofre: Yeah. And just to reiterate that one more time, because they do ask us about that all the time. They’ll say, “I’ve already been waiting for a year, so that means I only have a year left before I get a hearing.” That’s not the case. The waiting period for the hearing date actually starts from actually the date that you received this letter, from the date that this letter is issued, because that is their confirmation that they now have the file.
Shelly Mark: Sure, which is even later than it’s actually filed.
Natalia Jofre: Right.
Shelly Mark: Yeah.
Natalia Jofre: So we’ll be talking about the hearing level some more in some future blogs. In the meantime, if you have any questions feel free to call our office or visit our website. Until then, we’ll see you next time.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – Request for Reconsideration – Part 2

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Natalia Jofre: Hello, and welcome to Hill & Ponton’s Disability Blog. This is Natalia Jofre. I am the Social Security Section Director here for our firm.
Shelly Mark: I am Shelly Mark. I am the Senior Social Security Attorney with the firm.
Natalia Jofre: In our last blog we talked about if you’re denied you can file an appeal. It’s called a Request for Reconsideration. We made some recommendations regarding how to actually submit that appeal to Social Security and pitfalls that you should basically avoid when doing that. So, now once it’s actually submitted, your local law office is going to forward it to your disability determinations office.
There, it’s going to get assigned to an examiner, and that examiner’s going to look at whether they feel that you are now disabled. So, in other words, they’re going to reevaluate your claim and whatever information you have submitted since the initial application. They’re going to ask you a series of questions. They may send you for a doctor’s evaluation. They will definitely send you forms to complete, which are basically an update of everything you gave them the first time around.
One of the issues that we see a lot of our clients encounter is that they don’t want to complete those forms. They feel like nothing has changed. This isn’t important. Social Security’s playing games. They’re trying to compare what I said now to what I said before and so they’re trying to trick me, and nothing has changed, so I’m not going to fill these out.
Shelly Mark: Right.
Natalia Jofre: Huge mistake.
Shelly Mark: Right.
Natalia Jofre: Right.
Shelly Mark: Yeah. It’s a huge mistake because there’s, the likelihood is that it’s going to be another denial unless there’s some information that would change the examiner’s opinion as to why this decision should now be a favorable decision, when at the initial level it was unfavorable. What happens at that point is that if it is a denial we have to go to the third level of Social Security or the hearing level and request a hearing with an administrative law judge, which is fine; however, there’s a very lengthy wait to actually get the hearing.
Natalia Jofre: Yeah. So, whether it’s a very slim chance that you’re going to be approved at the reconsideration, and that is a reality. On average, 95% of cases are denied again, but the thinking behind that is that I don’t want to complete this because nothing has changed. You really should still complete those forms and submit them, for a couple of reasons.
One being that the longer you take to submit them, the longer Social Security is going to take to issue a decision, so it’s going to increase your wait time. Secondly, if you either don’t fill it out and don’t submit it or don’t respond to their request for contact, they’re going to put in your decision that you were either noncompliant or that you were denied because you didn’t basically give them the information that they wanted, or that you were a contact problem. All of those things will reflect negatively on you and your claim once you have to go before a judge at the hearing level.
Shelly Mark: Definitely. Those forms at the initial and the reconsideration level, they stay part of the file the entire time. Even when we go to hearing, during the hearings on several occasions, judges have referenced them specifically as to whether why didn’t this person go to their examination or why didn’t they complete these forms, or why are their forms different than what they’re saying now at the hearing. So, it’s really important that they are accurate.
Natalia Jofre: I have seen claims where basically the person gets to the hearing level, and if the judge feels that the claim wasn’t evaluated properly or thoroughly at the reconsideration level, we’ve seen them send them back.
Shelly Mark: Mm-hmm (affirmative). Yeah.
Natalia Jofre: I mean, it’s not common but it has happened a few times, and so you should just avoid all that by cooperating with them and giving them what they want at that level.
Shelly Mark: Yeah. Definitely. If you’re represented by an attorney, then if it were our client, we would definitely be encouraging them and advising very strongly to complete the forms or ask us for any assistance with the forms.
Natalia Jofre: Yeah. So, once you submit all of that information, the disability examiner will make a decision. They’ll then send it back to your local office. Your local office will actually issue you the decision, and that’s when you’ll know if you were either approved or denied. Like I said, 95% of cases are denied. So, if that happens, you then need to file another appeal, and I think we’ll talk about that some more in our next blog.
Shelly Mark: Great.
Natalia Jofre: All right. Well, thanks for joining us. If you have any questions, please feel free to contact our office or visit our website. Otherwise, we’ll see you next time.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – SS Request for Reconsideration – Part 1

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Natalia: Welcome to the Hill & Ponton Disability blog. I’m Natalia Jofre, our Social Security Section Director.
Shelly: And I’m Shelly Mark, I’m our Senior Social Security Attorney.
Natalia: We wanted to talk to you today about what happens if you’re denied at the initial level, which we talked about in our last blog, and what your basic options are. If you’re approved, congratulations. It is somewhat of a rarity, because 85% of cases are denied, but if you’re denied then you can file an appeal and request what’s called reconsideration. That will now basically put you at the second level of the social security claims process.
In order to file an appeal, you have to complete very specific forms. You can get these online, you can submit your appeal online, you can go into your local social security office, or you can mail in your appeal. We recommend probably that you file it online because it is the fastest way to submit your appeal and cuts down on your wait time. That’s what we do for our clients. If you go to your local social security office, make sure you get their really early, or perhaps you can try and make an appointment.
If you mail your appeal, we strongly recommend that you send it certified return receipt so that way you have proof that it was actually received by the social security office because-
Shelly: They have a history of not receiving things that are actually sent to them.
Natalia: Right. They lose things a lot, and you don’t want it to come down to your word against there’s because the only options gonna be for you to start all over again. You have 60 days to file an appeal, plus five mailing days. That sounds awkward but it can come in very, very handy because let’s say you get your denial, you get sick, and time sort of passes you by, you had a total of 65 days then however, you want to make sure that it’s actually in their office within that time period because it’s technically 60. Go ahead.
Shelly: One thing that I don’t know about you, but I’ve noticed before is some of our clients may be aren’t at a permanent address while they’re filing their disability claim, and a lot of times at this point in their claim their correspondence may be sending to an address that they’re not at all the time, so they run into issues where they’re not getting the decision in a timely manner so that they can file an appeal.
Just a point to remember, make sure whichever address you’re using with social security is either your address, or if it is a different address, that it’s somewhere that someone’s gonna be notifying them as soon as the documents come in.
Natalia: That’s a really big deal. If you are having your denials or your mail in general sent to a relatives home, or a friends home, make sure that you are checking in with them frequently because social security is not going to accept, “My friend didn’t tell me that I got this denial.” As a reasonable explanation for why you didn’t file an appeal on time.
What they would accept would be something like you were hospitalized and you couldn’t, you physically weren’t able, or you mentally weren’t able. You know, if you were in a psychiatric facility, or if you were in a coma clearly you couldn’t file your own appeal. If it’s basically, “Well you know, my mom got it and she didn’t tell me, or they were on a twiddy house vacation fro two weeks and when we got back the mailbox was full.” None of that’s gonna be a legitimate explanation for them in order to file your appeal late.
I think next we’ll talk about what you actually do, and what actually happens once you file that appeal and where it goes, and what you can expect to happen next in our next blog.
Shelly: That sounds great.
Natalia: All right, great. Well thanks for joining us. If you have any questions feel free to call our office or visit our website.
Shelly: Thank you.
Shelly Mark, Senior Attorney

Video Blog – Filing an Initial Level Claim

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Natalia Jofre: Welcome to the Hill and Ponton Social Security Disability blog. I’m Natalia Jofre I’m our social security director.
Shelly Mark: My name Shelly Mark I am the senior social security attorney.
Natalia Jofre: We’re going to talk to you today about the initial level. The initial level is basically when you file a claim for social security disability benefits what you need to do, where you need to go and what all that entails.
Shelly Mark: Exactly. The initial element of social security is when the person first decides to and then actually files the claim of disability benefits.
Natalia Jofre: In previous blogs, we’ve talked about what are the basic prerequisites in order to file for benefits and you shouldn’t be working and all sorts of stuff like that. So when you’re actually going to file, you’re either going to call social security’s 1-800 number or you can visit your local office. The waiting periods are going to vary depending on where you live.
What I will say when it comes to waiting periods is social security will give you a pamphlet that says they have to give you a decision or that they will give you a decision in about 90 days and this is nationwide, they send this to everyone and they’re under no obligation to actually render a decision within that time period. They’re just basically trying to give you a ballpark idea of how long it’s going to take.
Shelly Mark: Right.
Natalia Jofre: We know a lot about ballpark time frames.
Shelly Mark: That’s correct. They like to give ballparks but not actually have any deadlines.
Natalia Jofre: Yeah. When you file the application if you do it by phone, they’ll then send you the actually application in writing for you to then review, make any corrections regarding any information they either recorded wrong or maybe you have rethought and might need to change. You make those corrections, you sign that written application and send it back. Obviously if you do this in the office, they just keep it while you’re there.
We normally recommend that people file online because it is much, much quicker. And you can do that by going to their website ssa.gov dot gov. It’s just faster and you’re giving all the information directly whereas to if you need to wait for an appointment with social security to actually talk to you and take this information either by phone or even going to their office. We’ve seen backlogs of two months just to get an appointment.
Shelly Mark: Wow.
Natalia Jofre: So you’re application’s going to be taken at the local office. Whichever local office and the way your office is basically assigned to you is based on your address and your zip code specifically. Once they’ve actually taken your application at the local office then they’re going to send it onto the office of disability determinations also in your local area. And then they’re going to evaluate your claim to see whether you meet the medical requirements to qualify for benefits. At the local office.
So let me go back a little bit. At the local office they’re going to look at do you meet the technical requirements. In other words, have you worked enough or is your income low enough, depending on which benefit you’re applying for. If you’re a widow, has it been within, all sorts of technical requirements. And then they send it to the office of disability and normally they send them forms, right?
Shelly Mark: Right.
Natalia Jofre: To fill out.
Shelly Mark: Definitely.
You’re going to receive forms about your functional ability to perform activities, very simple activities as far as cooking and cleaning and maintaining hygiene and then you’re also going to be sent forms about the work history. Really important to make sure when they fill these forms out that they’re very accurate. If you’re represented by someone, we would recommend that if they have any questions whatsoever they should definitely ask about those because the forms will become a part of the file and they’ll still be referenced and used all the way at the hearing.
Natalia Jofre: Which is super critical because if they start finding discrepancies in between what you said when you initially applied and what you’re now saying when you’re before a judge, they’re going to hone in on that and try to use it against you.
After you submit all of your forms and they get all of your medical records then they’re going to send it to a medical person and that person’s going to review your claim medically. Then they’re going to render a decision. If there’s a recommendation for you to be approved, they’re going to send it to another office out state and they’re going to either uphold that decision to approve it or if they’re just going to deny it, they’ll deny it locally and then the actual local office will send you the written decision.
And we’ll get into more about what you do after that happens.
Shelly Mark: Right. What would you say, Natalia what percent of cases do you think are approved at that very initial level?
Natalia Jofre: Here in Florida, well I think that this pretty much applies nationwide. I would say that 85% of cases are denied at the initial level. A very high percentage. The ones that you see get approved are the ones that meet some strict compassionate allowance or it’s expected that the person is going pass away in the very near future. Pretty extreme cases. But 85% of cases are denied on average.
Shelly Mark: And maybe we’ll discuss what to do if you’re actually denied at the initial level next.
Natalia Jofre: Yeah, we’ll do that in our next blog. So thanks for joining us, if you have any questions, feel free to call our office or visit our website.
Shelly Mark: Thank you.
Shelly Mark, Senior Attorney

Video Blog – SSDI Benefits – Additional Information

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Natalia Jofre: Hi and welcome to the Hill and Ponton Social Security Disability blog. I’m Natalia Jofre, I’m the director for our social security section.
Shelly Mark: I’m Shelly Mark, I am the senior social security attorney.
Natalia Jofre: We just wanted to give you a little bit of additional information. We previously talked about disability insurance benefits, otherwise known as regular disability benefits, and we told you the onset date and other benefits that can work in conjunction with that one. We just wanted to give you a little bit of additional information because, first of all, we have a lot of clients get confused with SSI, which is income based, but we wanted to let you know that disability insurance benefits are not affected by income for the most part.
Shelly Mark: That is correct. You can receive a private pension or a county retirement or the state retirement or some other form of income, and it’s not going to affect your disability, nor will family income, so your spouse’s income or anything like that will not affect it.
Natalia Jofre: You can be a millionaire and qualify for disability insurance benefits. There are a handful of benefits like workers comp, federal retirement benefits, it has to be that specifically, that can affect disability insurance benefits, but that has more to do with like, state/federal offsets than it has to do with household income and that that’s why it’s affecting your benefit.
Then the other thing we wanted to tell you is that with disability insurance benefits you also get Medicare. That is a huge medical benefit, and like we told you before, there’s a 24 month waiting period from the date you became entitled to that benefit. You do have to pay for it. The premium is somewhere in the ballpark between $100 and $200 a month, but you are able to get private healthcare or treatment with your Medicare benefits.
Shelly Mark: That is correct.
Natalia Jofre: That’s another huge bonus.
Shelly Mark: Definitely, and Medicare is very widely accepted. It’s very good insurance, and you will receive that 24 months after your entitlement date. It’ll be from when you’re found to be disabled, minus that five month waiting period we talked about.
Natalia Jofre: Yeah. All right, so that’s it for today. If you have any questions feel free to call us or visit our website, and we’ll see you next time. Thank you for watching.
Shelly Mark: Thank you.