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.
