How Returning to Work Affects your Disability Determination

Posted October 13, 2022 by Premier Disability Services, LLC®

Disability determinations are tied to one’s ability to do work, so returning to work could naturally impact one’s disability claim. However, that impact could range from none to total preclusion of that claim. Determining how a return to work could affect your claim requires understanding an important term: “substantial gainful activity”.

What is substantial gainful activity and why is it important?

When employment results in income over a particular limit, it is considered substantial gainful activity. That limit is $1,350 per month as of 2022, though it is subject to change every year. Why does this matter?

Disability claims are evaluated using a five-step process. The first step requires determining if, using the income limit described above, the claimant had engaged in substantial gainful activity after their alleged onset date. If they had not, their claim proceeds to the next step in the evaluation. This is true even if the claimant had returned to work, so long as their income was not high enough to be considered substantial gainful activity.

What if I have substantial gainful activity?

If a claimant returns to work, and that work is considered substantial gainful activity due to the income limit described above, it often precludes their disability claim. This means they will be found “not disabled”. However, there are two exceptions to this: unsuccessful work attempts and sheltered working environments.

Exact definitions of those terms are outside the scope of this writing. Generally, however, if a claimant was employed for six months or less and that employment was terminated due to their impairment, that employment will be considered an unsuccessful work attempt and will not impact their disability determination. If the claimant can show that their employer altered their job environment and/or responsibilities to accommodate their impairment, their employment may be considered a “sheltered working environment” and will not impact their disability determination.

What if my employment was not an unsuccessful work attempt or in a sheltered work environment?

Before addressing this topic, notice that this scenario assumes that: (1) you have returned to work after your alleged onset date; (2) your income is higher than the substantial gainful activity level described above; and (3) you have worked, or intend to work, longer than six months and do not work in a sheltered work environment. If all of these conditions apply, you must adjust your alleged onset date to a date following termination of your employment. If you do not, or if you cannot due to continued employment, you will be found not disabled at the first step of the claim evaluation process.

If you would like to complete a free, no-obligation evaluation, contact our office today!

By: Devon Brady of Premier Disability Services, LLC®

5 Ways to Improve your Social Security Disability Claim

Posted September 30, 2022 by Premier Disability Services, LLC®

One of the biggest complaints we hear from our clients is how long the process of receiving Social Security Disability benefits can take.  A harsh reality of filing for Social Security Disability is that it is a long and tedious process.  The most important thing to remember is, whether your claim takes two months or two years, you want the final decision to be an award of benefits.  Below are five methods of improving your claim so that you have a better chance at being awarded.

 

  1. Go to the Doctor

When you file a claim for Social Security Disability, you are alleging that you are unable to work due to a severe medical impairment.  Social Security (SSA) uses your treatment records to determine the severity of your condition.  It is very important to maintain regular treatment for two main reasons: 1) SSA may view your lack of treatment as evidence that your condition is not as severe as you allege and 2) treating on a frequent basis means there will be more objective evidence supporting your claim.

Remember, if SSA does not feel they have enough medical evidence to make a decision, they may schedule you for an examination with a doctor they hire.  These examinations can be very brief and unsupportive to your claim.  Your likelihood of being awarded is much greater if you have supportive findings from a treating physician.

 

  1. Obtain a Supportive Doctor’s Statement

To be found disabled, you have to prove both that you have a severe medical condition and that condition prevents you from performing the functional requirements of competitive employment.  Medical records alone may be insufficient in establishing the functional limitations resulting from your condition(s).

A medical source statement (MSS) is a form that details the specific functional limitations resulting from your impairments.  A supportive MSS from your treating physician is a crucial piece of evidence because it helps Social Security translate your medical records from that provider into functional limitations.  This is key in supporting your claim.

 

  1. Promptly Return Paperwork

After you file an application for Social Security Disability, you will receive a series of forms to complete and return to SSA.  These forms may include an Adult Function Report, Work History Report, and/or Third Party Function Report.  These forms may seem repetitive and unimportant.  In fact, these forms are extremely important to your claim.

A failure to complete these forms could result in delaying your claim or even being denied.  Once you receive these forms, take the time you need to complete them accurately.   However, it is important to understand that these forms are integral to the processing of your claim.  The longer it takes you to return them, the longer you will have to wait for a decision.

 

  1. Submit an Accurate Application

The initial application for Social Security Disability includes a section where a claimant is required to provide treatment/doctor information.  Inaccurate or incomplete information in this section is one of the most common mistakes unrepresented claimants make.  This is also one of the most common reasons unrepresented claimants are denied.

SSA requires medical records supporting your disability.  They request your medical records based on the information you provide on your initial application (or your reconsideration appeal).  If you fail to provide them with enough information, they simply will not obtain your records and you will be denied.

If you are considering filing an application for Social Security Disability benefits, we strongly encourage you to have your treatment information readily available; including doctor’s name, facility name, address, phone number, and when you started treating there.

 

  1. Hire a Representative

Hiring a representative to assist with your Social Security Disability claim has many benefits.  Most notably, an experienced representative will be able to work with you to complete items 1-4 of this list.  Our firm has an entire department of experienced Application Technicians whose sole responsibility is filing accurate applications for our clients.

In addition, our Case Management Department is always available to assist you with completing forms.  We also attempt to obtain a supportive medical source statement for every client to improve their chances of being awarded.  Finally, should your claim reach the hearing level, our hearing department will work with your treating facilities to obtain updated medical records.  Hiring a company experienced in navigating the Social Security process greatly improves your chances of winning.

If you would like to complete a free, no-obligation evaluation contact our office today!

By: Devon Brady, Premier Disability Services, LLC®

How Many Months of Back Pay Will You Get?

Posted September 23, 2022 by Premier Disability Services, LLC®

Almost every applicant who is awarded Social Security disability insurance (SSDI) benefits also gets past-due disability benefits, often called “disability back pay.” These past-due monthly payments go back to the date the applicant filed their disability application, and sometimes even earlier.

The amount of your Social Security disability back pay depends on three factors:

  • the date you apply
  • the date you became disabled, and
  • the date you’re approved for benefits.

Your Application Date

The first factor that determines how much disability back pay you’ll get from Social Security is the date you apply for disability benefits.

Payment for the months following your application date. If you became disabled at least five months before your application date, you can get back payments for the months going back to your application date. You’ll receive back pay for the months between your application date and your approval date at your monthly benefit rate.

But, for SSDI, not everyone receives benefits going back to the date they apply. You’ll receive past-due benefits going back to your application date only if you were disabled before that date. That might sound strange, but it’s because most SSDI recipients have a five-month waiting period before they can receive benefits (we’ll talk more about this waiting period below).

Payment for the months before your application date. In addition to back payments, you might be able to get “retroactive benefits” going back to the date you first became disabled, which is often many months before the application date. Most people don’t stop working due to a disability and file for disability benefits on the same day. On average, it takes about 8 months for people to finally apply for disability benefits (6 months for those age 60 and older, 11 months for those under 48).

An SSDI claimant (applicant) can get up to 12 months of retroactive benefits (back to one year before the application date), but not everyone gets this full amount. You can get retroactive pay for a year before the application date, but only if you became disabled long before your application date. How many months of retroactive benefits you can get depends on the date you became disabled.

Your Date of Disability

The onset date of your disability—that is, when your disability began—is also when your SSDI waiting period begins.

When an SSDI claimant files an application for disability benefits, they indicate (on the application) when they think their disability began. This date is known as their “alleged onset date.” 

Whether benefits will be payable back to the beginning of the 12-month retroactive period depends on how long ago your onset date was. Here’s where the other twist in calculating the SSDI benefit start date comes in: the waiting period.

Your Waiting Period

The third factor that affects when SSDI benefits begin (and how much back pay you’ll get) is the five-month waiting period. Essentially, after Social Security establishes an onset date for an SSDI applicant, the agency pauses the start of benefits for five months. (This rule doesn’t apply to applicants with ALS, or Lou Gehrig’s disease—they get paid starting on their onset date.)

So if you apply for benefits soon after you become disabled and Social Security decides your claim right away, you might not get any back pay—you’d still be within the five-month waiting period when you get your approval letter. In that case, your monthly payments would just start at the end of your waiting period.

But most people do get some retroactive pay because they waited many months to apply for benefits. For these applicants, the waiting period doesn’t start after they apply, but earlier, right after the date their disability began. This date could be just a couple of months or several months or years before the application date. But Social Security has a rule that the five-month waiting period can’t start any earlier than 17 months before the application date (that’s why you can only get up to 12 months of retroactive benefits).

Combining all the rules and timelines here can actually get pretty complicated for SSDI recipients. It might help to look at an example to understand how the five-month waiting period affects back pay. 

If you became disabled one year ago today and you apply today, Social Security will owe you some retroactive benefits. Your date of entitlement—the date Social Security starts owing you benefits—will be seven months ago (12 months minus the five-month waiting period). In your lump sum of back payments, you would get seven months of retroactive payments, plus benefits for the number of months following your application date that it takes for Social Security to approve your case.

Please contact us today to complete a free disability evaluation!

By: Premier Disability Services, LLC®