Manipulative Limitations in a Disability Claim

Nearly every job requires a full and complete use of the hands. Anyone who has “manipulative limitations” caused by injury or pain needs to be aware that this can be an important component of a disability claim. While more obvious in situations involving a condition such as carpal tunnel syndrome or a specific hand injury, this limitation can also be important even when it is not the major disabling condition.

Social Security law says that in order to do even unskilled, sedentary work a person must have good use of both hands and the fingers – this is called “bilateral manual dexterity” in the regulations. Any significant limitation in a person’s ability to handle, pick up and finger small objects is important in the disability decision. Many claimants have conditions that restrict the amount of lifting they can do. Anyone person who can lift and carry even 10 pounds for most of the day may still be found capable of sedentary work, under Social Security regulations. The addition of a manipulative limitation, particularly of the dominant hand, can be enough to tip the scale in favor of the claimant.

More general medical conditions such as arthritic impairments, fibromyalgia, and chronic fatigue may also include hand, arm, and/or shoulder pain. Often when Social Security is collecting information on these illnesses from a claimant, the entire focus is on lifting, standing and sitting limitations. Careful medical record development of limitations on use of the hands is very helpful in the decision-making process. Soliciting this information from treating medical sources can be extremely important. These limitations may sometimes be viewed as a minor problem in the context of some larger disease process. As such, medical case records often do not specifically mention them.

When the right questions are asked of the medical provider, however, a clearer picture may emerge. Does the person have pain in the dominant hand? Does stiffness prevent full use of the hand, particularly for small motor tasks such as writing? Is the pain increased by repetitive use? Although someone may be able to lift five pounds, or use the painful hand for a task once or even five times, can this be done on a continuous, repetitive basis for an 8-hour work day, five days per week? What is the effect of such an activity level on the person’s ongoing condition?

Think of a manipulative limitation in combination with all other impairments. Often it can be overlooked, for example, when the presenting problem is psychiatric. When a condition such as anxiety or depression is not severe enough on its own to qualify a person for benefits, the claim can be strengthened by considering this and other physical limitations.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

By: Thomas A. Klint of Premier Disability Services, LLC®

Disability Determination Services’ Review Process

To determine whether you are disabled, and thus qualify for benefits, the Social Security Administration (SSA) will send your claim to a state agency of disability examiners. In many states, the agency is called “Disability Determination Services,” or DDS, but the agency goes by various names. For instance, Florida calls its agency the Division of Disability Determinations, California calls it the Disability Determination Service Division, and Pennsylvania calls it the Bureau of Disability Determination. Claims are reviewed by DDS at the initial and reconsideration stages of the application process.

This is what happens at DDS: A disability claimant’s file arrives from a Social Security office and is assigned to a disability claims examiner. The examiner begins to order medical records from all the treatment sources indicated by the claimant on their application. Once those medical records begin to arrive, the examiner can begin to go about the task of deciding whether or not a person will qualify for disability. These are the questions the claims examiner will ask:

1) Are you currently working?

The first test the examiner will apply to your file has nothing to do with your condition, but whether you are working, and, if so, how much you are working. For both the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program, a disability claimant cannot work and earn more than an amount equal to or greater than what is known as SGA, or substantial gainful activity. If you are currently working and are making this amount or more, DDS assumes you are not disabled.

2) Is your condition severe?

As the second step of the evaluation process, the DDS will assess the severity of your condition and how it limits you. For instance, if you have moderate hearing loss, but with hearing aids you are able to hear 95% of what people are saying, the DDS is not likely to consider your condition severe, and your claim will not move on to the next level of the evaluation process.

3) Does your condition meet a disability listing?

If your medical records indicate that you have a severe medical condition that matches the requirements of an official Social Security disability (“blue book”) listing, you qualify for disability and the claims examiner will immediately put you on “benefit receipt” status. The examiner will forward your file back to the SSA for further processing.

4) Are you able to work full time?

This test has to do with how your medical and/or psychiatric conditions limit your ability to work. If you have a medical impairment or disability that makes to impossible for you to work your prior job full time, or another type of work full time, you can get benefits. Typically, the vast majority of disability claims evaluated by DDS are denied, requiring disability claimants to have their cases heard by an administrative law judge at a disability hearing before they can be approved for benefits.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your case!

By: Joyce Trudeau of Premier Disability Services, LLC®

How is my Monthly Benefit Calculated?

Last week, we wrote about the Social Security Administration’s 2018 cost-of-living adjustments, which begs the question – how much will I be paid? Once you are found disabled, your monthly benefit amount is calculated in accordance with your claim type:

• For disability insurance benefits (SSDI), the amount depends on how much you have worked and earned, and thus paid in FICA taxes, in the past;
• For disabled widow’s and widower’s benefits, the amount depends upon how much your deceased husband or wife worked and earned;
• For disabled adult child benefits, the amount depends upon how much the parent worked and earned.

In general, all Social Security Disability benefits are very modest. The average SSDI benefit for a disabled worker in 2018 will be about $1,197 per month. For a family, the average benefit will be approximately $2,051 per month. Family members are eligible for an additional benefit, up to 50% of the disabled worker’s benefit.

Once the Social Security Administration (SSA) determines that a worker has sufficient credits to permit entitlement, SSA calculates the “Primary Insurance Amount” based on wages or self-employment income on which taxes were paid. There are many different calculations, and the appropriate one is chosen based on the worker’s date of birth, and either the date the disability began, or the date the worker died or became entitled to a retirement benefit. The benefit calculation is very complex, and it is performed by SSA’s computer system when an individual applies for benefits. Re-computations occur automatically when an individual has additional earnings that positively affect the potential benefit.

The Supplemental Security Income (SSI) program uses different rules entirely. SSI is an income-based program designed to help aged, blind, and disabled people who have little or no income and do not have a strong working history to qualify for SSDI benefits. Because of this, any other income a SSI recipient receives will generally reduce his or her monthly SSI benefit amount.

In 2018, the Federal maximum for monthly SSI benefits will be $750 for an eligible individual. But, since a recipient’s monthly benefit amount is reduced by subtracting countable income, the average SSI monthly benefit may be less. Some States and local areas also supplement SSI benefits, meaning the State pays additional money to increase the recipient’s monthly Federal SSI payment to bring the payments up to a minimum cost of living.

If you or someone you know is unable to work due to a medical condition, please contact us for a free evaluation of your claim!

By: Joyce Trudeau of Premier Disability Services, LLC®