FAQ

Social Security Disability FAQ

Q: Where do I go for help with my disability, money, medical and family issues?

The Clearinghouse on Disability Information – for all disability-related services, programs and resources in the State of Florida – 1-877-232-4968

Congressman :
Working for Florida’s Sixth District since 1989
2370 Rayburn House Office Building
Washington, D.C. 20515
Phone (202) 225-5744
Fax (202) 225-3973
Ocala
115 S.E. 25th Ave.
Ocala, FL 34471
Phone 352-351-8777
Gainesville
5700 SW 34th St., Suite 425
Gainesville, FL 32608
Phone 352-337-0003
Orange Park
1726 Kingsley Ave., Suite 8
Orange Park, FL 32073
Phone 904-269-3203
United States Senate, 356 Russell Senate Office Building Washington, DC 20510
Main: (202) 224-3041, Toll free: (866) 630-7106
Fax: (202) 228-5171, TTY: (407) 254-5548

DIVISION OF VOCATIONAL REHABILITATION-(may provide assistance for job retraining and sometimes medical care):
2002 Old Saint Augustine Road, Building #A
Tallahassee, Florida 32301-4862
Phone: 800-451-4327
Ocala 352-732-1750 ext. 120 or 352-237-2111 ext. 41530
Gainesville 352-395-5641 or 352-955-2019 (work related injuries)
www.RehabWorks.org 800-451-4327
UNITED WAY CALL FOR HELP 211 www.uwmc.org
Community Legal Services of Mid-Florida, Inc.
352-629-6257 (Marion County)
800-363-2357 (toll-free)

ABUSE. ADULT, CHILD AND DOMESTIC
Hotline Report Abuse or Neglect 800-962-2873
Arnette House Intervention Services for Youth 7 Families 352-622-4432    http://arnettehouse.org/
Children’s Abuse Prevention Services for Abused or Neglected Children 352-334-1330
Children’s Advocacy Center Services for Abused or Neglected Children 352-873-4739
Guardian Ad Litem Volunteer Representative for Abused Children 352-369-2525 www.guardianadlitem.org
Rape Crisis & Domestic Violence Ctr. Adult, Child and Domestic 352-622-8495

ADOPTION
Dept of children & families Foster care licensing 877-822-1995    www.dcf.state.fl.us/programs/childcare

AIDS AWARENESS
AIDS Hotline CDC National STD/AIDS Hotline 24/7 Hotline 800-342-AIDS
American Red Cross Health, Safety and Disaster Services 352-622-3457 www.daytonaredcross.org
Marion County Health Dept. Health Care, Immunizations & Other Serv. 352-629-0137
Mahogany Revue Research 352-671-1117 www.mahoganyrevue.com

CHILDCARE
Childhood Development Services Childcare Resource & Referral, Head Start 352-629-0055

CHILDREN’S HEALTH SERVICES

Childrens Medical Services for eligible Children w/special needs 352-369-2100  http://www.cms-kids.com/
Community Health Services Walk-In Clinic for Indigents 352-732-6599
Early Intervention Program/DEI Developmental Evaluations, Birth to 3 Years www.zerotothree.org
Healthy Start Program for Healthy Moms & Healthy Babies 352-629-0137 www.healthystartflorida.com
Marion County Health Dept. Health Care, Immunizations and other Serv. 352-629-0137

COUNSELING & MENTAL HEALTH
The Centers 352-291-5500
Meridian Behavioral Health 352-374-5600
Arnette House, Inc. Intervention Services for Youth and Families 352-622-4432 www.arnettehouse@geocity.com
Counseling and Resource Center Mental Health Services for All Ages 352-861-8044
Access to services Mental Health/Substance abuse 352-291-5500 www.thecenters.us/
Crisis Line- 24 hrs crisis hot line 352-629-9595 http://suicidehotlines.com/florida.html
Professional Counseling Center Counseling for Those Without Resources 352-402-9967
Rape Crisis & Domestic Violence 352-622-5919    http://ocaladvshelter.org
Save-A-Friend Hotline Anonymous Intervention 877-737-4363
Hope Hotline Suicide Prevention 800-784-2433 www.hopeline.com

DISABILITIES
Shands Indigent Care Program 352-265-0224
Advocacy Center for Persons w/ Disabilities 800-342-0823 www.advocacycenter.org
Association for Retarded Citizens Day Programs and Group Homes 352-387-2210 www.mcarc.com
Division of Blind Services Serves All Age Groups 800-443-0908 www.state.fl.us/dbs/index.shtml
Center for Independent Living Provides Skills for Independent Living 352-368-3788 www.cilncf.org
Developmental Services 352-732-1441 OR 352-732-1447
Disability Hotline Grants Program 888-838-2253
Epilepsy Services Gainesville/Ocala 352-378-4324
Florida Center for the Blind 352-873-4700 http://flblind.org/
FDLRS/Child Find Screening of Pre-School Children for Disabilities 352-591-4300 www.fdlrssprings.org
Isaiah Foundation Respite Care and Training for Care-Givers 352-804-6809
Social Security Administration Benefits to the Disabled 800-772-1213 www.socialsecurity.gov
Vocational Rehabilitation Help to Employ Physically or Mentally Disabled 352-629-1903
We Who Care of Marion County Additional Opportunities for the Mentally Retarded 352-629-1903 www.homesaleflorida.com/wewhocare.htm
Interfaith 352-629-8868

DISASTER AND PLANNING/RELIEF
American Red Cross 352-622-3457 www.daytonaredcross.org
referral 800-334-1447
info 352-671-6891
Free or Low Cost Medications web sites
Pharmaceutical Research and Manufacturer’s 800-762-4636
Partnership for Prescription Assistance 1-888-477-2669
http://www.myrxadvocate.com/
http://www.freemedicinerevolution.com/

Other services
Alcoholics Anonymous 352-867-0660
Arthritis Foundation information line 800-283-7800
Asthma & Allergy Foundation of America 800-727-8462
Attention –Deficit Disorder- Feingold Association of the U.S. 800-321-3287
American Brain Tumor Association 800-886-2282
Florida Brain & Spinal Cord Injury Program 800-342-0778
Y-Me National Organization for Breast Cancer Information 800-221-2141
American Cancer Society- Cancer Support Groups 352-629-4727
American Cancer Society 100-ACS-2345
Fibromyalgia Network 800-853-2929
Habitat for Humanity of Greater Ocala Inc- 352-351-4663
Health and Rehabilitative Services 352-620-3000
American Heart Assoc. 800-242-8721
Hepatitis Information Line 888-4-HEPCDC
National Kidney Foundation 800-622-9010
Leukemia & Lymphoma Society 800-955-4572
American Liver Foundation 800-223-0179
American Lung Association 800-586-4872
Lupus Foundation of America 800-558-0121
Multiple Sclerosis Association of America 800-532-7667
Muscular Dystrophy Association 800-572-1717
Salvation Army 352-629-2004

Q: When will I be eligible for medical benefits?

A: If you have been approved for Title II (DIB) benefits you will be eligible for Medicare. Medicare eligibility begins 24 months AFTER the date you were first eligible to receive money benefits on your application. If you are eligible for Supplemental Security Income, you will be eligible for Medicaid as well. There is no waiting period for Medicaid once you have been found disabled.

Q: Is there a waiting period for Supplemental Security Income (SSI)?

A: No, there is no waiting period for SSI. You must meet certain financial criteria in addition to being found disabled to qualify for benefits under this program. The financial eligibility is determined by your local Social Security office. Payments under the SSI program can go back only as far as the date of the application on which you were approved.

Q: How far back will my benefits go?

A: If you were approved for DIB benefits (Title II), there is a 5 month waiting period from the date of disability before your first payments will begin. The furthest back you are eligible for money benefits is twelve months prior to the date you applied OR the date of your disability, whichever is later.

Q: If I am approved, when will my payments start?

A: Generally, your first monthly check should arrive within 60 days of your favorable decision.  Keep in mind, that you are not eligible for benefits during the first 5 months of your disability under the Title II program.  There are other issues which can affect your back pay.  For instance, if you received workers’ compensation benefits, the Administration will need that information in order to calculate your benefits.

Q: Is it possible to appeal a denial by the Appeals Council?

A: If the appeals council decision is unfavorable, the next step is to file a complaint in federal district court. A federal district court may also affirm, reverse, modify, or remand the appeals council’s decision back to the SSA. We are also able to assist you in the stage of appeal. We are licensed to practice in the US District Court in the Middle District and Northern Districts of Florida.

Q: How do I appeal an unfavorable decision from an Administrative Law Judge?

A: If your claim is denied at the hearing level you have the opportunity to appeal the decision to the appeals council. This appeal must be filed within 60 days of receipt of the unfavorable decision. The appeals council is the highest level of administrative review within the SSA. The standard of review is whether the decision is supported by substantial evidence and whether correct legal principles were applied. The appeals council will review all the evidence. The appeals council may affirm, modify, or reverse the ALJ hearing or remand the case back to an ALJ with specific instructions on any relevant issue. We have been very successful in obtaining remands at the Appeals Council level.

Q: I have been scheduled for a hearing, how can I find out about my judge?

A: The Social Security Administration has a database with a list of the judges and their decisions. This link give you information on how many hearings the judge has held as well as the number of awards and denials by each judge. http://www.socialsecurity.gov/appeals/DataSets/03_ALJ_Disposition_Data.html

Q: What is Residual functional capacity?

A: An individual’s residual functional capacity is his/her ability to do physical and mental work activity on a sustained basis despite limitations secondary to established impairments. In making this finding, SSA must also consider all of the claimant’s impairments, including those that are not severe.

Q: What exactly is a LISTING of IMPAIRMENTS?

A: SSA has a list of conditions and if certain criteria are met, that patient may automatically be considered disabled by operation of that listing. The listed impairments are found for:

§1.00 – Musculoskeletal System.
§2.00 – Special Senses (hearing/vision) and Speech
§3.00 – Respiratory System
§4.00 – Cardiovascular System
§5.00 – Digestive System
§6.00 – Genitourinary System
§7.00 – Hematological Disorders
§8.00 – Skin Disorders
§9.00 – Endocrine System
§10.00 – Multiple Body System
§11.00 – Neurological
§12.00 – Mental Disorders
§13.00 – Malignant Neoplastic Disease
§14.00 – Immune System
You can obtain/view a copy of the full descriptions of these listings by visiting the following website: http://www.socialsecurity.gov/disability/professionals/bluebook/AdultListings.htm

Q: What is considered past relevant work?

A: The term past relevant work means work performed (either as the claimant has actually performed or is generally performed in the national economy) within the last 15 years or 15 years prior to the date that disability must be established. In addition, the work must have lasted long enough for the claimant to learn to do the job and have been performed at substantial gainful activity level.
http://www.ssa.gov/oact/cola/sga.html
If the Administrative Law Judge concludes that the claimant has the residual functional capacity to do his/her past relevant work, the Claimant is not disabled. If the claimant is UNABLE to do any past relevant work, the analysis proceeds to the fifth and last step.

Q:What kind of impairments/limitations will the Administrative Law judge consider?

A: “Non-exertional” limitations often impact a patients’ ability to work. Some non-exertional limitations include:
Inability/limitations to sit or stand for periods of time;
Inability/limitations to handle, grasp, feeling, and/or finger;
Inability/limitations to stoop/bend;
Inability to concentrate on task/chores;
Difficulty remembering/thinking;
Depression;
Anxiety;
Inability to stand and/or walk without an assistive device;
Pain, etc.
All of these limitations affect an individual’s ability to perform a wide and/or full range of work activity.

Q: Who is considered a treating provider?

A: A treating source is defined as the claimant’s physician or psychologist who has provided the claimant medical treatment or evaluation and who has or has had an ongoing treatment relationship with the claimant. If the claimant merely seeks out a medical opinion to support the disability claim, this single examination will not be considered to be a treating source opinion, but rather a consultative examination. http://www.socialsecurity.gov/OP_Home/cfr20/404/404-1513.htm

Q: Why is the opinion of my treating doctor so important?

A: The treating physician’s opinion carries more weight than those of the physicians appointed by the SSA state agencies or even the one time examining physicians whom give opinions after only just one visit. These physicians have only limited review of the medical records whereas the claimants’ treating physicians have a working history of the his/her condition(s).

Q: Will a statement from my doctor help my claim?

A: Many doctors provide written statements that state “my client is disabled and unable to work.” Unfortunately, these statements are NOT enough to make our client’s eligible for benefits. Why aren’t your statements of disability enough?

1. The condition and treatment are not as important as how it is affecting your patients’ ability to work. We have prepared questionnaires which assist us in proving that certain limitations will prevent a claimant/patient from being able to work.

2. “Disabled” according to SSA means that a claimant is unable to RETURN TO ANY WORK, not just the work they did before they were hurt or diagnosed.

3. “Residual Functional Capacity” (RFC) – Many clients may NOT be able to return to work they did in the past, but given age, education, past work experience and RFC, they may be able to perform OTHER work. Therefore, they would NOT be “DISABLED” as defined by the SSA. Link to question about RFC

4. It is ultimately the decision of the Administrative Law Judge whether a claimant is disabled or not.

We have questionnaires directed to treating physicians to help address the specific issues that an Administrative Law Judge will need to analyze. These questionnaires deal with by physical and mental impairments. If your physician is willing to complete these forms, this can be a major advantage in proving the claim.

Read More Here

Q: What is the difference between sedentary, light, medium and heavy work?

A: Sedentary work. Sedentary work involves lifting no more than 10 pounds at a time and occasionally lifting or carrying articles like docket files, ledgers, and small tools. Although sedentary job is defined as one which involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and sitting are required occasionally and other sedentary criteria are met. Light work. Light work involves lifting no more than 20 pounds at a time with frequent lifting or carrying of objects weighing up to 10 pounds. Even though the weight lifted may be very little, a job is in this category when it requires a good deal of walking or standing, or when it involves sitting most of the time with some pushing and pulling of arm or leg controls. To be considered capable of performing a full or wide range of light work, you must have the ability do substantially all of those activities. If someone can do light work, we determine that he or she can also do sedentary work, unless there are additional limiting factors such as loss of fine dexterity or inability to sit for long periods of time. Medium work. Medium work involves lifting no more than 50 pounds at a time with frequent lifting or carrying of objects weighing up to 25 pounds. If someone can do medium work, we determine that he or she can also do sedentary and light work.

Q: How does Social Security decide whether someone is disabled?

A: There is a complicated process that the Administration follows for determining whether someone is disabled under Social Security rules. There are basically five steps which are followed. If it is determined that the Claimant is or is not “disabled” at a step of evaluation process, the evaluation will NOT go on to the next step. When we present our evidence to the Judge, we make sure that all of the steps have been covered.

STEP ONE
SSA must determine whether the claimant is engaging in substantial gainful activity. Substantial gainful activity (SGA) is defined as work activity that is both substantial and gainful. “Substantial work activity” is work activity that involves doing significant physical or mental activities. “Gainful work activity” is work that is usually done for pay or profit, whether or not a profit is realized. Ssa link – http://www.ssa.gov/oact/cola/sga.html

Generally, if an individual has earnings from employment or self employment above a specified level set out in the Social Security Regulations, it is presumed that the Claimant has demonstrated the ability to engage in SGA. If an individual engages in SGA, s/he is NOT “disabled” regardless of how severe his/her physical or mental impairments are and regardless of her age, education, and work experience. If the individual is NOT currently engaging in SGA, the analysis proceeds to the second step.

SGA is a determination made by SSA and is generally dependent upon the earnings a claimant is able to make. Generally, if the claimant is earning more than the SGA threshold the claimant would be considered capable of substantial gainful activity and would therefore be found “not disabled.” It is possible to argue a finding of substantial gainful activity. As advocates for our clients we will analyze the work and present many different arguments to persuade the Administration to allow benefits.

STEP TWO
SSA must determine whether the claimant has a medically determinable impairment that is “severe” or a combination of impairments that is “severe.” An impairment or combination of impairments is “severe” within the meaning of the Regulations if it significantly limits an individual’s ability to perform basic work activities.

If the claimant does NOT have a severe medically determinable impairment or combination of impairments, s/he is NOT DISABLED. If the claimant has a severe impairment or combination of impairments, the analysis proceeds to the third step.

STEP THREE
SSA must be determined whether the claimant’s impairment or combination of impairments meets or medically equals the criteria of an impairment. SS website If the impairment or combination of impairments meets or medically equals the criteria of a listing and meets the duration requirement (20 C.F.R. §4041509 and §416.909), the claimant is “disabled.” If it is not, the analysis proceeds to the next step.

STEP FOUR
Does the claimant have the residual functional capacity to perform the requirements of his/her past relevant at work (20 C.F.R §40431520(f) and §416.920(f)). IT IS AT THIS STEP WHERE TREATMENT NOTES AND MEDICAL OPINIONS OF THE CLAIMANTS’ TREATING SOURCES IS CRITICAL! The Social Security Administration uses the Dictionary of Occupation titles which has classified jobs as SEDENTARY, LIGHT, MEDIUM, HEAVY, AND VERY HEAVY when determining the physical exertional requirements of the Claimant’s past relevant work.

STEP FIVE
The ALJ must determine whether the claimant is able to do any other work considering his/her residual functional capacity, age, education, and work experience. If the claimant is able to do other work, s/he is “not disabled.” If the claimant is not able to do other work and her impairments meets the duration requirements, s/he is “disabled.” Although the claimant generally continues to have the burden of proving disability at this step, a limited burden of going forward with evidence shifts to the SSA. In order to support a finding that an individual is not disabled after this step, SSA is responsible for providing evidence that demonstrates that other work exists in significant numbers in the national economy that the Claimant can do, given the residual functional capacity, age, education, and work experience.

Q: How can I speed up the process?

A: The best way to expedite a claim is to ensure that your medical records support your disability and the statements you made about your disability to the Administration. Often we will send questionnaires to your physicians to determine your functional limitations. We frequently will request an “On the Record Decision” where possible, in an attempt to have the claim approved prior to a hearing. Also, there are circumstances where your claim may be expedited due to either dire financial or dire medical need. This is on a case by case basis and there are certain criteria used to determine whether your claim will meet these criteria.

Q: How long does the Social Security Disability process take?

A: On average, it can take from eighteen months to two years from the time an application is made until a hearing is actually scheduled. This can vary depending on where your claim will be heard.

Q: What is Supplemental Security Income?

A: In order to qualify for SSI benefits, you must not only prove that you are disabled, but you must also have limited income and resources. SSI provides payments to individuals (including children under age 18) who are disabled and have limited income and resources. It is the amount of income available to the household and the number of individuals in the household that are the major factors in deciding eligibility for such benefits. It is important to note that changes in household income, including the receipt of various disability benefits, public assistance, etc, may have an affect on needs based benefits such as Medicaid and SSI. If other household members receive benefits of this type, it is important to know that any change in household income may affect their benefits as well. The local office Social Security office normally makes the determination of financial eligibility under this system. If you have questions regarding your eligibility you should contact your local Social Security Administration. To Read More Click Here

Q: What is Retirement, Survivor and Disability Insurance Benefits (DIB)?

A: To be eligible for disability Title II benefits, you must be insured under the Social Security program as of the date you became disabled.  The date last insured is based upon the number of years during which you worked and Social Security contributions were deducted from your wages. A claimant must have earned at least 20 quarters of coverage in the preceding 40 quarter period. This means that the person has worked under Social Security for at least five of the 10 years (20-out-of-40 quarters) just before becoming disabled. If you find that you have no earnings for years that you clearly worked and have proof (via a W-2), then you should contact Social Security Administration at (800)772-1213.  If your date last insured is AFTER the date you became disabled, you will not be eligible for Title II benefits

Q: What if I can’t afford to pay for a doctor?

A: You can get treatment at the local health department. It may require you calling l0-15 times before you get through. Calling may be frustrating. Failure to document your condition and see a doctor may be more than frustrating. It may destroy your claim.
You may also qualify for psychiatric care at the Centers.
Marion County:
Marion County Health Department 352-629-0137
Heart of Florida 352-732-6599
The Centers – 352-291-5500

Alachua County:
Alachua County Health Department – 352-334-7910
Meridian Behavioral Health Care 352-374-5600

Q: What can I do to increase my chances of winning my case?

A:
1. Make sure you see a doctor. Failure to have medical documentation is one of the most common reasons for a denial. Judges believe if you are really disabled then you will see a doctor.
2. Document your symptoms. We have a diary under “resources” and a form to complete if you are diabetic. Being able to explain to a judge the types and frequency of symptoms is very helpful.
3. Follow your doctor’s advice. Judges may deny your claim if you refuse to comply with medical treatment unless you have a good reason.
4. Don’t misuse your medications. If you run out of medications too soon you may be discharged by your doctor and the judge may find you are abusing your medications. Keep in mind the new laws regarding prescription narcotics may result in your being given a random drug screen. Having drugs in your system for which you are not prescribed or not having drugs in your system for which you have been given prescriptions may cause serious problems.
5. Don’t misrepresent your condition on your application. Exaggeration can only hurt, not help your claim.
6. Be honest about employment. The government has information about your earnings and if you attempted to work during a period of disability you must be up front about this if asked.
7. Don’t give up. There are important deadlines that must be met. When we represent claimants we provide documentation for appeals. If you are handling your case on your own and miss a deadline it could mean the end of your case.

Q: How do I get a copy of my file?

A: At the conclusion of your case we will provide you with a CD of all of the medical records obtained on your behalf. Keep them in the event your case is disallowed in the future.

Q: What Do Social Security Representatives Do?

A: That depends on who you retain. For example, our firm may:

a. Obtain, or assist you in obtaining, your medical records to support your claims.
b. Speak with your doctor and send forms which clarify the “hows” and “whys” of your disability.
c. Research your condition and, in some cases, provide articles or references to substantiate your claim.
d. Obtain other evidence such as testimony from family, friends, employers or submit diaries and photographs, etc.
e. Attend a hearing with you and argue your case before an Administrative Law Judge.
f. Explain the synergistic effects of your medications and how they may be more disabling than the condition itself.
g. Assist in your communications with the Administration.
h. Assist you in completing forms and explain the process to you.

Our firm maintains a data base of research on hundreds of conditions we have researched. This includes:
§ Fibromyalgia
§ RSD/CRPS type I and II
§ Chronic Fatigue Syndrome
§ Bipolar Disorder
§ Depression
§ PTSD
§ Anxiety
§ Carpal Tunnel
§ Herniated disc
§ Congestive heart failure
§ Chronic obstructive pulmonary disease
§ Emphysema
§ Multiple sclerosis
§ Schizophrenia
§ Diabetic neuropathy
§ Dystonia
§ Hepatitis
§ HIV/AIDS
§ Chronic Liver Disease
§ Spinal diseases and disorders
§ Crohn’s disease
§ Meniere’s disease
§ Lupus
§ Arthritis
§ Cardiac conditions
§ Cancer
§ Pulmonary conditions
§ Dementia
§ Traumatic Brain Damage
§ Knee, ankle and feet injuries
§ ADD/ADHD and Autism
§ Side effects of chronic pain
§ Auto-immune diseases

We also have a data base of background information on over 1,000 doctors we have researched. Depending upon the facts in the case, this information may be used in the event the Social Security Administration retains a doctor and the testimony may not be favorable to your case.

Be Careful. There are many ways in which you can unknowingly hurt your case. If you’d like to contact us for a free consultation please call us at 352.629.0480 or info@ocalaw.com

Q: Does it matter who I retain to represent me?

A: It can.  The Social Security Administration has no special requirements in order to represent you in your social security case.  A family member can act as your representative.  You want to know who will be working on your claim and what experience that person has.  Has your representative had any training with regard to Social Security issues?  Do you have a representative who knows how to cross-examine the government’s expert?  Does your representative have legal malpractice insurance? Are they able to take your claim into federal court?  Remember, no matter who you hire, the fee is the same, regardless of experience and training.