Are you unable to work because of a disability? Get the answers you need on Social Security Disability to protect your rights
Keefe Disability Law has compiled a list of the most frequently asked questions in response to the overwhelming number of people who need help with the Social Security Disability process in Massachusetts, New Hampshire and Rhode Island. If you are disabled and need help with disability benefits, read on to learn how to protect your legal rights.
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Is it hard to receive Social Security disability for fibromyalgia?
Yes, it can be challenging to qualify for the Social Security disability benefits you deserve if you have fibromyalgia.
Fibromyalgia is the second most common musculoskeletal condition after osteoarthritis. People with fibromyalgia suffer significant muscle and joint pain, fatigue, and other symptoms that interfere with a person’s ability to work. Yet, fibromyalgia isn’t always well understood and it can be hard to get the benefits you deserve.
The Social Security Administration Used to Deny Benefits for Many Fibromyalgia Sufferers
In the past, the Social Security Administration (SSA) denied most disability applications for fibromyalgia. In part, this was because of conflicts within the medical community. While fibromyalgia certainly can be debilitating, the label “fibromyalgia” refers to a list of symptoms that can vary from person to person. Many family doctors used fibromyalgia as a catch-all diagnosis when no cause for symptoms could be found.
Accordingly, disability examiners were not sure how to classify the disorder. Applications were more likely to be approved if the applicant had a second diagnosis, especially a musculoskeletal disability such as rheumatoid arthritis or degenerative disc disease.
Now, fibromyalgia is better understood, and more people are able to get the Social Security disability benefits they need.
Social Security Disability Eligibility for Fibromyalgia
In 2012, the Social Security Administration issued a ruling allowing fibromyalgia to be a medically determinable impairment (MDI) if the applicant meets certain conditions. Specifically:
- There must be medical documentation of widespread chronic pain, including back, neck, or chest pain.
- The doctor must rule out other diseases that may cause the same symptoms.
Additionally, one of the following must be true and well-documented. The applicant must experience:
- Pain in at least 11 of 18 possible tender point areas of the body. The tender points must occur on both sides of the body. There must be tender points both above and below the waist.
- A minimum of six fibromyalgia symptoms, including repeated occurrences of fatigue, non-restorative sleep, cognitive or memory problems, depression, anxiety, irritable bowel syndrome (IBS), headaches, muscle weakness, seizures, dizziness, Raynaud’s phenomenon, or other symptoms.
Tips for a Successful Social Security Disability Application
Every Social Security disability applicant, including those applying with fibromyalgia, must submit a convincing application to get the benefits they deserve. If you apply for benefits, you can improve your chances of success by submitting:
- Accurate medical reports. Your Social Security disability determination will be based primarily on your medical records. You should know what those records say. Make sure your records list your symptoms, your treatment plan, and your diagnosis.
- Documentation of severity. Merely claiming that you have the disorder isn’t enough. You must have documented proof showing how badly the disorder affects your everyday life and how it keeps you from working.
- Signed documentation from a rheumatologist (specialized doctor in joint and tissue pain). The SSA is more inclined to consider a fibromyalgia claim if a specialist has verified the disorder.
- A straightforward explanation of how your case qualifies for disability. Personal accounts of pain and inabilities can help shed light on why you need disability benefits as a result of being unable to work.
You may also seek legal representation. An experienced disability attorney can increase your chances of approval by gathering the necessary documentation, clearly stating your case to the SSA, and appealing any disability denials.
Speak to a Social Security Disability Lawyer Today
Social Security disability can provide you with monthly benefits if fibromyalgia prevents you from working. You’ve paid into the Social Security system and you deserve to receive these benefits if you can’t work because of a disability that is expected to last 12 months or longer.
We encourage you to contact our experienced Massachusetts disability lawyers before you file your initial disability claim. We will ensure that your application is accurate, complete, honest, and easy to understand. We know how to argue your case, and we won’t rest until you get the Social Security disability benefits you deserve. Contact Keefe Disability Law now for a free consultation and review of your claim. We’re waiting to help you!
I have more than one disability. Do I have to pick one to include on my Social Security disability application?
No, you should not limit your Social Security disability application to just one condition if you suffer from multiple disabilities.
Your situation is common. You may have one, or more than one, primary medical condition. That condition may be significant but may not keep you from working. However, when you add in your other medical diagnoses, you are unable to engage in substantial gainful activity, and you may qualify for Social Security disability benefits.
How to Apply for Social Security Disability With Multiple Medical Conditions
Whether you have one disability or multiple disabilities, your goal is the same. You want your disability application approved as quickly and efficiently as possible. To this end, it is essential to make sure that:
- Your application is complete and easy to understand. If you don’t submit a complete and easy to understand application, the Social Security Administration may deny your benefits application.
- You include all relevant evidence. Medical records that clearly show all of your physical symptoms, pain, emotional symptoms, diagnoses, and treatments will be critical to your application’s approval.
- All of your symptoms, including your pain, are documented. You may do this through your medical records and by keeping detailed logs of how you feel and how your symptoms impact your life.
- You list all of your physical and mental conditions. Do not leave anything out because you think it is less important than something else. All of your medical conditions should be considered, including things like depression and anxiety.
- You provide enough information about your education and work history. The Social Security Administration is trying to determine what, if any, work you can do. Accordingly, you need to provide accurate information about your education and work history.
- You are honest. While you want to include all of your conditions, you don’t want to exaggerate your symptoms or be untruthful about any part of your application.
Don’t Apply for Disability Benefits Alone—Let an Experienced Social Security Disability Lawyer Help
Your medical conditions make everyday things hard, and you experience enough daily stress. It can be intimidating to go through the bureaucracy of applying for Social Security disability alone, even if you know that you qualify for benefits.
Our Massachusetts Social Security disability lawyers are here to complete your application on your behalf, to communicate with the Social Security Administration, and to represent you through any necessary appeals.
Our legal team understands the frustration of government bureaucracy and how critical Social Security disability benefits are for you and your family. Accordingly, we strive to:
- Answer our client’s calls and questions when they call us. You won’t have to wait a long time to get your answer.
- Provide you with realistic expectations. We want you to know how the Social Security disability application process works and what to expect at each step of the process.
- Help our community. Our Boston-area Social Security disability lawyers only represent clients in Massachusetts, Rhode Island, New Hampshire, and Vermont. We are not a national disability firm. Instead, we’ve chosen to help our neighbors.
- Make things as easy as possible for you. We know that getting to a lawyer’s office can be painful. Accordingly, we are set up to handle most cases by phone, internet, and mail.
We know that money may be tight, but you don’t have to worry about the cost of hiring a Keefe Disability attorney. Our lawyers won’t charge you anything up front. Instead, we will be paid a percentage of any back benefits you receive after you apply for disability benefits.
Contact us today to schedule a free, no-obligation consultation about your rights. We would be happy to schedule a meeting with you to discuss your specific situation and whether Social Security disability may be an option given your multiple disabilities. You can reach us any time by phone, live chat, or completing our online contact form to learn more.
I don't want surgery. Can I get Social Security disability benefits if I refuse to have surgery?
You may have excellent reasons for refusing surgery. Ultimately, you get to choose your own healthcare. No one can force you to consent to surgery. However, there may be consequences to refusing surgery.
Social Security Disability Eligibility May Be One of Those Consequences
In some cases, the Social Security Administration may deny your benefit application if you refuse surgery that would have likely allowed you to return to work after treatment.
The official reason for denying your application may be "failure to follow prescribed treatment" if the Social Security Administration finds that:
- You have a disabling condition. A disabling condition is defined as a medical condition that prevents you from working for at least 12 months or is expected to result in death.
- Your treating physician prescribed surgery. The "failure to follow prescribed treatment" denial only applies if the doctor you typically see prescribed the treatment. The Social Security Administration should not deny surgery if another doctor, such as a medical consultant who performed a consultative exam on behalf of the Social Security Administration, recommended surgery.
- The treating physician expects the surgery to allow you to return to work. Your doctor may have suggested surgery, but not all surgeries are expected to cure medical conditions. Instead, the surgery may have been recommended to help you manage pain, keep your condition from getting worse, or help you improve, but not to the extent that you would be able to work.
- Your medical records include documentation of your treating physician's recommendation for surgery and that you refused surgery.
The examiner assigned to your case should review your medical records. Additionally, if the examiner has any questions about your ability to work after surgery, then the Social Security representative should speak with your treating physician.
Social Security Disability Eligibility Even If You Refuse Surgery
In some cases, you remain eligible for Social Security disability benefits even if you refuse surgery. For example, your Social Security disability application should be approved if you satisfy eligibility criteria and:
- The Social Security Administration can't establish a failure to follow prescribed treatment according to the requirements described above.
- You are so afraid of having surgery that your treating physician considers your fear a contraindication to surgery. It's normal to be nervous about surgery, but if your fear is so intense that your doctor feels surgery will do more harm than good, you may refuse surgery and still get Social Security disability benefits.
- You suffer another mental health condition that prevents you from having surgery. These conditions may be considered on a case-by-case basis.
- It would be against your religion to get the surgery. You will need to provide evidence that you are affiliated with a religious organization and documentation of the religion's official teachings as they relate to the surgery.
- You can't afford the surgery. If you can't pay for surgery and can't find any affordable way to get the surgery, then you may be eligible for Social Security disability even if you don't get surgery.
- You've received conflicting advice about surgery. If you have more than one treating physician and one of the doctors does not recommend the surgery, you may be able to refuse surgery and receive disability benefits.
- The proposed surgery is a high-risk procedure. You may refuse the surgery if the potential harm associated with the surgery puts you at significant risk of further injury.
- The proposed surgery is to amputate an extremity.
- The proposed surgery is to fix cataracts in one eye, surgery carries a high risk of complications, and you already have significant vision loss in the other eye.
The Social Security Administration also has the right to approve your application if you deny surgery for other reasons, as it deems appropriate.
Protect Your Rights With the Help of an Experienced Social Security Disability Lawyer
Our metro-Boston Social Security disability lawyers want to help you stay in control of your life and get the disability benefits you deserve. Contact us today for a free, no-obligation consultation about your Social Security disability eligibility and how we may be able to help you get fair benefits.
Can I get Social Security disability benefits if I work from home?
Yes, if you are eligible for Social Security disability, you may still receive disability benefits even if you work from home. Below, we will address common questions people who work from home ask about Social Security disability eligibility so that you know what to expect and how to protect your rights.
Are You Disabled?
Social Security disability helps people who can’t work for at least 12 months or who are likely to die because of their disability. If you can continue engaging in substantial gainful activity from home, then you are ineligible for Social Security disability benefits. However, if you can’t work or if you can only earn a modest amount—in 2021, that amount is less than $1,310 a month for people who are disabled but not blind—then you may be eligible for benefits if you can prove that you are disabled.
The Social Security Administration may find you disabled if one of the following is true:
- You meet the disability requirements included in one of the Blue Book Listing of Impairments sections.
- Your condition is equal in severity to a listing in the Blue Book Listing of Impairments.
- Your condition prevents you from working your job or adjusting to new work and is expected to last for at least one year or cause your death.
Social Security disability is not an option if you suffer from a partial or temporary disability.
Did You Pay Into the Social Security System While You Worked From Home?
The Social Security Administration only pays Social Security disability benefits if you are disabled and you have paid enough into the Social Security system to qualify for benefits.
Most people need 40 work credits to qualify for Social Security disability and 20 of those credits must have been earned in the 10 years immediately preceding your disability. Younger people may qualify with fewer credits.
The criteria for earning a work credit change annually. In 2021, you earn one work credit for every $1,470 earned in wages or self-employment income. You can earn a maximum of four credits per year.
In order for income to count as a work credit, it must have been reported to the government and subject to federal taxes. Any work that you did from home and did not report would not count as a work credit. For example, if you babysit in your home, sold art you created, tutored, or did other “under the table” work that was not reported to the government, then that work would not count toward your Social Security disability eligibility.
Can You Still Do Your Work From Home Job?
Some people with disabilities may continue to work from their home even if they wouldn’t be able to work in an office. You may be able to make more accommodations, including a more comfortable work setting, frequent breaks, and other modifications that allow you to continue to work.
If you can still fulfill your job responsibilities, then the Social Security Administration may find that you are not disabled for purposes of Social Security disability benefits. However, if you cannot do your job, you should be found eligible for benefits regardless of where you work.
Do I Need a Social Security Disability Attorney?
You don’t have to suffer without an income just because you worked from home before becoming disabled. Many people applying for Social Security disability benefit from hiring an experienced Social Security lawyer. Whether you work for an employer from your own home or are self-employed and work at home, our lawyers will protect your right to disability benefits.
Our Social Security disability attorneys help people with initial claims and appeals in Massachusetts, Rhode Island, and New Hampshire. We invite you to call us or to complete our contact form to have us contact you to schedule a free consultation in our conveniently located Natick office or by phone.
Are Covid-19 long-haulers eligible for Social Security disability benefits?
The immediate medical crisis has passed. You survived the initial COVID-19 infection and you’ve tested negative for the virus. Yet, you continue to have symptoms that significantly impact your life. Your doctor has identified you as a COVID long-hauler, and you may be eligible for Social Security disability benefits.
Who Is a COVID-19 Long-Hauler?
Approximately 10% of COVID-19 patients become long-haulers.
So far, researchers don’t know why some people suffer from long COVID and other people make full recoveries. Everyone who contracts COVID-19 is at risk of becoming a long-hauler. It doesn’t matter how old you are, whether you had a mild coronavirus infection or you were hospitalized with severe illness, or whether you have underlying conditions.
Some of the ongoing symptoms experienced by COVID long-haulers include:
- Brain fog. Many COVID long-haulers experience brain fog. Brain fog can be debilitating and make a person confused, forgetful, or unable to concentrate.
- Coughing and shortness of breath. Some people with long COVID continue to suffer respiratory complications.
- Joint and muscle aches. This type of pain may make it challenging to sit in one position, lift anything heavy, perform repetitive movements, or even sleep comfortably.
- Debilitating fatigue. Extreme tiredness is one of the most common symptoms of long COVID. This type of fatigue can interfere with a person’s regular activities and ability to work.
- Headaches. Frequent or intense headaches may be debilitating. People with these types of headaches may be unable to do their work or go about their daily activities.
- Sleep difficulties. Sleep disruptions may make everything in your life more difficult. You may not be able to drive or operate heavy machinery safely, and you may be unable to concentrate on your work.
- Temperature dysregulation. Some long COVID sufferers may have trouble regulating their own body temperature. Temperature dysregulation may interfere with a person’s ability to work.
Medical experts don’t yet know whether long-haulers suffer permanent medical conditions from the novel coronavirus, but research is ongoing. Additionally, there isn’t much known about how to treat ongoing and persistent coronavirus symptoms. Long-haulers often go through neurological, cardiovascular, pulmonary, and respiratory tests, and they are often advised to rest, eat well, manage stress, and stay hydrated.
COVID-19 Long-Haulers May Qualify for Social Security Disability Benefits
Currently, the Social Security Administration is flagging electronically-submitted disability applications when an applicant alleges COVID-19 as a disability or the application gives the agency reason to believe the applicant has a medically determinable impairment of COVID-19. These flags exist to identify, track, and collect data on COVID-19 Social Security disability applications.
Despite these flags, the Social Security Administration is handling long COVID claims the same way as all other Social Security disability claims. Social Security disability applicants must convince the Social Security Administration that they have disabilities that make them unable to work for at least 12 months or are likely to result in death.
You may strengthen your disability application by:
- Presenting objective medical evidence. Your medical records, including the results of any medical testing, are essential parts of your disability application.
- Completing an honest and accurate Social Security disability application. Many initial disability applications are denied on technicalities. You may avoid a denial by submitting a complete and accurate application the first time you apply.
- Talking to a Social Security disability lawyer. The Social Security disability application process can be overwhelming, but an experienced attorney can help you get the benefits you’ve earned.
- Not giving up. If your initial application is denied, you may need to appeal your disability denial to get the Social Security disability benefits you deserve.
Our New England Social Security disability lawyers are committed to helping all long COVID sufferers get fair disability benefits. If you live in Massachusetts, Rhode Island, or New Hampshire, we encourage you to contact us today, by phone or through this website, to schedule a free, no-obligation consultation with an experienced Social Security disability attorney.
Can a person who is homeless and disabled get Social Security disability benefits?
Yes, people without a permanent address may still qualify for Social Security disability benefits. Individuals with disabilities must meet Social Security disability eligibility criteria and may work with an experienced Social Security disability lawyer to make sure their rights and benefits are protected.
Social Security Eligibility
An applicant is eligible for Social Security disability benefits if:
- The applicant worked long enough to qualify for Social Security disability insurance
- The applicant is disabled according to the Social Security Administration’s disability definition
Disability is defined as a condition:
- That is expected to last for at least 12 months or cause death
- Limits your ability to work enough to engage in what the Social Security Administration calls “substantial gainful employment”
The Social Security Administration will consider the following things to determine if a medical condition limits an applicant’s ability to work:
- Whether the Blue Book Listing of Impairments includes the applicant’s condition
- The severity of the applicant’s condition
- If the applicant currently works or has recently worked
- Whether the applicant is physically able to continue doing the work they used to do
- If there are any other jobs that the applicant can do given their disability
Complete, current, and accurate medical records are essential for strong Social Security disability applications. Unfortunately, many people who experience homelessness do not have health insurance and may not have recent medical records. Free medical clinics or medical providers that accept payment on a sliding scale may be critical to both the applicant’s healthcare needs and Social Security disability application.
Special Considerations for People Who are Homeless
While the Social Security eligibility criteria are the same for people with permanent addresses and people with housing insecurity, there are a few things you should keep in mind when you apply for Social Security disability benefits.
First, let the Social Security Administration know that the applicant is homeless. The Disability Determination Services (DDS) has examiners experienced in issues facing homeless applicants. These DDS examiners can review the application.
Next, you will need to identify a place for the Social Security Administration to send monthly disability payments. Without a stable home address, you may choose to have payments made by direct deposit if you have a bank account, sent to a P.O. Box, or sent to a trusted friend or relative’s home. Applicants who move between different shelters and homes should keep the Social Security Administration updated on their location so that they can be found easily.
Contact a Social Security Disability Lawyer for a Free Consultation
People experiencing homelessness have the same right to Social Security disability benefits as people with permanent residences, and disability benefits may be especially useful to help with living expenses and other costs. Additionally, Social Security disability recipients may be eligible for Medicare coverage after a qualifying period. Medicare may be as important as monthly payments and allow people with disabilities to get much-needed medical care.
Unfortunately, the majority of initial Social Security disability applications are denied on technicalities. Our experienced Boston-area Social Security disability lawyers make sure that each application we submit is thoroughly completed and has strong medical evidence to help prevent any unnecessary denials or delays.
You do not need any up-front money to hire us. We offer free consultations to Social Security disability applicants throughout Massachusetts, New Hampshire, and Rhode Island. If you hire us and the Social Security Administration refuses to find you eligible for benefits, you won’t owe us any money. If your claim is successful, then you still won’t have to worry about hourly legal fees. Instead, we are paid a percentage of your Social Security disability back benefits.
We invite you to learn more about how our Social Security disability law firm can help any applicant through the disability eligibility process. Call us or start a live chat with us at your convenience to find out more about how we may be able to help you.
How do I send medical records to the Social Security Administration?
There are various ways to submit health records to the Social Security Administration. However, you should not provide anything to the Social Security Administration or a Disability Determination Services (DDS) office on your own.
Your health records are essential parts of your Social Security disability application. The information in your medical records may establish your diagnosis, treatment plan, and compliance with your treatment plan. All of these things are critical to a disability finding.
Once you submit your health records, they become part of your application and they may affect the outcome of your claim. Accordingly, we encourage you to contact an experienced disability lawyer before providing any information to the Social Security Administration or DDS.
How to Submit Health Records
Your medical records help the Social Security Administration understand your disability. Without this information, your Social Security disability application may be denied or unnecessarily delayed. While health records are essential, you do not want to provide unnecessary or confusing information to the Social Security Administration because that could also result in a denial or unnecessarily delay.
Fortunately, you don’t need to make these decisions alone if you hire a Social Security disability attorney to represent you. Our experienced Boston area Social Security disability lawyers have been helping people in Massachusetts, Rhode Island, and New Hampshire get the disability benefits they deserve since 1994.
When the time comes to submit records in support of your Social Security disability application, our lawyers may submit the information:
- Electronically or by fax. The Social Security Administration encourages attorneys and other representatives to submit health records electronically because it is more convenient, saves time, and saves postage, copying, ink, and paper costs. The agency maintains that follow-up communication may happen more quickly and that the Social Security Administration’s website is secure, so there is no need to worry about your health records falling into the wrong hands. Once you sign SSA Form 827, submitting your health information electronically will satisfy HIPAA requirements. Currently, health records may be submitted in .wpd, .doc, .docx, .mdi, .txt, .rtf, .xls, .xlsx, .pdf, .tiff, .tif, or .zip formats.
- By U.S. mail. The Social Security Administration continues to accept medical records, applications, and other supporting materials by regular mail.
Either way, we will ensure that the necessary medical information gets to the Social Security Administration so that DDS considers your claim fairly and avoidable delays are prevented. Additionally, we will provide other information, such as information about your work history and education, in an easy to understand way so that the Social Security Administration has all of the data it needs to make a fair determination about your eligibility.
There Is No Financial Risk in Contacting a Social Security Disability Attorney
Keefe Disability Law provides free Social Security disability claim evaluations. During your disability claim evaluation, we will review how we are paid. However, we want you to know now that we are only paid if we successfully secure disability benefits for you. Federal law regulates how we are paid. In many cases, we are paid a percentage of your back Social Security disability payments up to a maximum amount set up law. The Social Security Administration will pay our legal fees directly.
The Social Security disability eligibility process is complicated. Many deserving applications are frustrated by unnecessary delays and unfair denials due to technical errors on their initial applications. Our disability lawyers will work hard to prevent these delays and denials or help you appeal if your initial application has already been denied.
However, we can’t help you unless you take the first step and contact us to schedule your free consultation. Please call us, start a live chat, or complete our contact form to have us contact you as soon as possible. Together, we can work toward getting you the disability benefits you’ve earned with as little frustration and delay as possible.
Is a chiropractor an acceptable medical source?
No. A chiropractor may be an essential part of your medical team if you suffer back pain, neck pain, or other injuries. However, a chiropractor is not considered an acceptable medical source for purposes of Social Security disability eligibility.
Will Information From Your Chiropractor Be Considered for Social Security Disability Eligibility?
Since the Social Security Administration does not consider chiropractors acceptable medical sources, the disability examiner assigned to your case is unlikely to request your chiropractic records or to consider any chiropractic records you provide.
However, if your chiropractor ordered any diagnostic tests, such as x-rays, the disability examiner may consider those test results. Since the chiropractor’s records won’t be part of your Social Security disability file, you will need to provide the results of the diagnostic tests for consideration.
Who Is an Acceptable Medical Source?
Federal regulations maintain a clear list of who is considered an acceptable medical source. As of January 2021, acceptable medical sources for adult Social Security disability applicants include:
- Doctors, including licensed medical doctors and osteopathic doctors
- Licensed or certified psychologists
- Licensed optometrists (for visual disorders only)
- Licensed podiatrists (for foot and ankle impairments only)
- Qualified speech and language pathologists (for speech and language impairments only)
- Licensed audiologists (for hearing loss, auditory processing disorders, and balance disorders only)
- Licensed physician assistants (PAs)
- Licensed Advanced Practice Registered Nurses (APRNs), including certified nurse midwives, nurse practitioners, certified registered nurse anesthetists, and clinic nursing specialists
The disability examiner may consider objective medical evidence (such as diagnostic test results), medical opinions, and other medical evidence from acceptable medical sources when determining your Social Security disability eligibility.
You Can See a Chiropractor and Get Social Security Disability Benefits
You should not stop seeing a chiropractor just because the Social Security Administration doesn’t consider a chiropractor an acceptable medical source. If a chiropractor provides you with pain relief or prevents a disability from worsening, you may continue care.
However, you should also make sure that you are under the treatment of at least one person who is considered an acceptable medical source. That acceptable medical source may be your primary care doctor, orthopedist, or another type of medical professional described above. These acceptable medical sources may provide you with additional information about your condition that helps you and provides essential information to the Social Security Administration so that your eligibility determination is made fairly. Additionally, you should let your doctor (or another acceptable medical source) know that you are seeing a chiropractor so that any relevant medical information can be documented in your record and shared with the Social Security Administration.
How to Submit a Strong Social Security Disability Application
Medical evidence is a critical component of your Social Security disability application. In addition to any chiropractor appointments you keep, it is essential to:
- Attend regular appointments with your doctor or other acceptable medical sources
- Get all of the tests recommended by your doctor or other acceptable medical sources
- Comply with all treatment recommendations
- Be honest with all of your medical providers and ask that all of your concerns and symptoms be documented in your medical record
- Seek second opinions from other acceptable medical sources if you are uncertain about your diagnosis or treatment plan
Additionally, if you are unable to work and your condition is expected to last for 12 months or longer, then now is also the right time to contact an experienced Social Security disability lawyer.
You have paid into the Social Security system, and you deserve to get disability benefits if you qualify. Our experienced lawyers can evaluate your claim, advise you of your chances of success, prepare your initial Social Security disability application, and represent you in any necessary appeals. Over the last 25+ years, we have helped thousands of people in Massachusetts, New Hampshire, and Rhode Island get the Social Security disability benefits they’ve earned. Contact us today for a free consultation to discuss how we may help you.
What is a Social Security disability TERI case?
The Social Security Administration handles medical conditions that are untreatable and likely to result in death differently than other permanent disabilities. Terminal illness cases, known as TERI cases for Social Security disability purposes, are processed faster so that the applicant may receive a disability determination sooner.
Types of TERI Cases
Any terminal illness may qualify for TERI processing. TERI cases include, but are not limited to:
- ALS (also known as amyotrophic lateral sclerosis or Lou Gehrig’s disease)
- AIDS (also known as acquired immune deficiency syndrome)
- Waiting for a heart, heart and lung, lung, liver, or bone marrow transplant
- Chronic pulmonary or heart failure that requires continuous home oxygen and prevents a person from caring for their personal needs
- Dependence on a cardiopulmonary life-sustaining device
- Metastatic cancer
- Stage IV cancer
- Cancer that is persistent or recurrent following initial therapy
- Inoperable or unresectable cancer
- Esophageal cancer (cancer of the esophagus)
- Liver cancer
- Pancreatic cancer (cancer of the pancreas)
- Gallbladder cancer
- Small cell or oat cell lung cancer
- Brain cancer
- Acute myelogenous leukemia (AML)
- Acute lymphocytic leukemia (ALL)
- Being in a coma for 30 days or more
Additionally, Social Security disability applicants who receive hospice care may have their disability applications expedited through the TERI program.
How TERI Cases Work
Disability applicants with terminal illnesses have the same eligibility requirements as applicants with other medical conditions. While eligibility remains the same, the processing of cases for terminally ill applicants is different than it is for other disability applicants.
Social Security disability applicants cannot designate their own cases for expedited TERI processing, but they should make sure their application clearly states that they suffer from a terminal illness.
The Social Security Administration does not inform applicants that their applicants are being processed through the TERI program. However, applicants with terminal illnesses may benefit from TERI processing, which begins when:
- A field office identifies and flags an application as a TERI case. Review of the case should be expedited for no later than the following business day. The claim should be hand-carried to the disability examiner assigned to the case.
- DDS identifies and flags an application as a TERI case. DDS controls must show the name of the examiner and DDS must notify the field office by telephone or electronic means so that the case may be expedited.
The disability examiner assigned to the case must use telephone, fax, or electronic means to handle any follow up on the case so that a determination can be made as quickly as possible.
Once a TERI designation is attached to a case, the designation remains unless a mistake has been made and specific procedures are followed to remove the TERI designation. The Social Security Administration cannot remove a TERI designation because of a failure to cooperate or for any other non-medical reason. Instead, all cases where an applicant has “a medical condition that is untreatable and expected to result in death” must retain the TERI designation.
How to Keep Your Social Security Disability Case Moving
Expedited and fast often mean different things. While the Social Security Administration may expedite the processing of cases for terminally ill applicants, delays and application denials still occur for people with terminal medical conditions.
Experienced Social Security disability attorneys can help prevent application delays and denials by submitting complete and accurate disability applications that include a medical source statement, medical testing results, and progress notes that clearly establish your medical condition.
Please contact our experienced Boston area Social Security disability lawyers today if you or a loved one are diagnosed with a terminal illness and you are seeking Social Security disability benefits. We represent clients in Massachusetts, New Hampshire, and Rhode Island, and we will fight to get you the Social Security disability benefits you’ve earned while you spend time with family and friends and on the things that are most important to you. Call us or reach out to us through this website today to schedule your free, no-obligation legal consultation.
I’m not a United States citizen. Am I eligible for Social Security disability benefits?
You may be eligible for Social Security benefits even if you are not a United States citizen.
Social Security Disability Eligibility
Before you consider whether your citizenship impacts your disability eligibility, you need to determine whether you meet the basic qualifications for Social Security disability benefits. Social Security disability benefits are only an option for people who:
- Have paid enough into the Social Security system. The Social Security Administration will consider the number of work credits you’ve earned and your age to determine whether you qualify for disability benefits. Generally, you earn one work credit for every three months that you work. Most people need at least 40 work credits, with at least 20 of those earned in the 10 years immediately before becoming disabled. However, this number is adjusted for younger workers since it takes at least ten years to earn 40 work credits.
- Have a disability that will last at least 12 months or likely cause death within a year. Only people with permanent disabilities are eligible for Social Security disability.
- Have a disability that limits functionality so much that you cannot work. Social Security disability benefits are only issued for complete disabilities. That means that you cannot engage in what the Social Security Administration calls substantial gainful activity. The amount of money that is considered substantial gainful activity changes annually. In 2020, substantial gainful activity was defined as $1,260 for most people with disabilities and $2,110 for people who are blind.
If these three things apply to you, then you may consider applying for Social Security disability benefits.
Special Social Security Disability Considerations for Non-U.S. Citizens
Generally, non-U.S. citizens who work in the United States may be eligible for Social Security disability benefits if they’ve paid into the Social Security system for the required amount of time. For example, you may receive Social Security disability benefits if you are:
- A permanent resident of the United States
- In the United States military or a Veteran of the United States military
As a non-citizen who is authorized to work in the U.S., you should have a Social Security number to include on your Social Security disability application. However, you may need to provide additional information to the Social Security Administration. For example, you may need to provide certain Department of Homeland Security documents, such as your:
- I-551 permanent resident card, or green card, which will verify your nine-digit alien registration number, or A number
- I-94 form, or Admission-Departure record to verify your 11-digit admission number
Even if you’ve worked in the United States, you may not be eligible for Social Security disability benefits if you are a:
- Foreign student or exchange visitor who worked in the United States but was exempt from paying Social Security taxes
- Citizen of Cuba, Vietnam, or North Korea
Talk to a Social Security Disability Before You Apply for Benefits
An experienced Social Security disability lawyer will:
- Review your eligibility
- Advise you of your rights
- Make sure that you have all of the right documentation based on your specific situation so that your Social Security disability application isn’t denied because of missing information
Additionally, a Social Security disability attorney will advise you about what happens to your Social Security disability benefits if you travel or reside outside of the United States. Your right to continue receiving Social Security disability benefits depends on the specific country you reside in, how long you are out of the country, and other factors.
Applying for Social Security disability is usually tricky but can be even more complicated by your citizenship status. Our disability attorneys are here to help you through the process.
Contact our experienced Massachusetts, New Hampshire, and Rhode Island Social Security disability law firm today for a free consultation about your rights and for more information about how to get the Social Security disability benefits you’ve earned.
Am I eligible for Social Security disability if I was hurt in a car crash?
Some people who are hurt in a car accident are eligible for Social Security disability benefits, but many people who suffer significant injuries in car crashes do not qualify for Social Security disability benefits.
If you are injured in a car wreck, your Social Security disability eligibility will depend on whether:
- You have paid enough into the Social Security system to be eligible for benefits
- You are disabled according to Social Security disability rules
Car Crash Injuries That May Result in Social Security Disability Eligibility
Car accident injuries are often painful and last for many months. You may be out of work during this time, but you won’t qualify for Social Security disability unless your injuries are permanent and expected to last more than 12 months or cause your death.
Some of the car crash injuries that can be severe enough to qualify for Social Security disability, according to the Listing of Impairments, include:
- Broken bones. If you suffer a fracture of the femur, tibia, pelvis, or a tarsal bone that keeps you from walking effectively for more than 12 months, then you may qualify for benefits pursuant to Section 1.06 of the Listing of Impairments. Likewise, if you suffer a fracture of an upper extremity, including the humerus, radius, or ulna, and you do not have functional use of your upper extremity for more than 12 months, you may qualify for benefits pursuant to Section 1.07 of the Listing of Impairments.
- Soft tissue injuries. Soft tissue injuries of an upper or lower extremity, trunk, or face under continuing surgical management to save or restore a major bodily function may qualify for Social Security disability benefits if the major function is not restored or expected to be restored within 12 months. Burns are included in soft tissue injuries. More information about eligibility for soft tissue injuries is included in Section 1.08 of the Listing of Impairments.
- Traumatic brain injuries. Section 11.18 in the Listing of Impairments describes two ways that someone with a traumatic brain injury may qualify for disability benefits. First, you may qualify if you have disorganization of motor function in two extremities resulting in an extreme limitation in the ability to stand up from a seated position, balance while standing or walking, or use of the upper extremities and the condition persists for at least three months after you are hurt. Alternatively, you may qualify for benefits if you have a marked limitation in physical function and at least one of the following areas of mental functioning: (1) understanding, remembering, or applying information; (2) interacting with others; (3) concentrating, persisting, or maintaining pace; or (4) adapting or managing yourself.
- Spinal cord injuries. Two sections of the Listing of Impairments deal with spinal cord injuries. Section 1.04 allows people to recover if the spinal cord is damaged and causing nerve root compression that results in pain, weakness, or an inability to walk effectively. Section 11.08 also considers spinal cord disorders and may apply if you are paralyzed because of your injury.
- Anxiety. If you have a severe and persistent anxiety disorder that affects you in three or more of the following ways: restlessness, getting easily fatigued, difficulty concentrating, irritability, muscle tension, or sleep disturbance, then you may have an anxiety disorder that qualifies for Social Security disability. To qualify pursuant to Listing 12.06, you must also have an extreme limitation of one or a marked limitation of two of the following: (1) understanding, remembering, or applying information; (2) interacting with others; (3) concentrating, persisting, or maintaining pace; or (4) adapting or managing yourself.
You may suffer multiple car accident injuries. Any one of these injuries may not be enough to qualify for Social Security disability benefits on its own, but when all of your injuries are considered together, they may be equal in severity to a Blue Book Listing.
Alternatively, if your injuries do not qualify according to an individual listing or are not equal in severity to a Blue Book listing, then the Social Security Administration may consider your residual functional capacity. If the agency determines that your medical condition, age, education, and work experience prevent you from engaging in substantial gainful activity, then you may be eligible for Social Security disability benefits.
Contact a Social Security Disability Lawyer Before Applying for Benefits
Whether you suffer a back injury, neck injury, broken bone, or another type of severe injury that is expected to last 12 months or longer, the action you take should be the same. Contact an experienced Boston area Social Security disability lawyer to discuss your potential eligibility.
We help clients throughout New Hampshire, Rhode Island, and Massachusetts get the disability benefits they deserve, and we welcome you to call us or contact us through this website today to learn more.
What is included in a consultative examination report?
Disability Determination Services (DDS) requested that you get a consultative exam. You complied with the request because you knew that the consultative exam was essential to your Social Security disability determination. Now, however, you may wonder what will be included in the consultative exam report.
Required Consultative Exam Report Content
The Social Security Administration’s Consultative Examination Guide, also known as the Green Book, requires consultative exam reports to include at least the following content:
- The applicant’s Social Security number (or other case identifier)
- Whether the applicant provided a photo ID
- A physical description of the applicant
- The applicant’s current medical history including symptoms, history of the start of the condition and its progression, treatment, and impact on daily living activities
- The applicant’s past medical history, including things such as significant illnesses, injuries, and treatments
- A list of the applicant’s current medications
- A review of the applicant’s body systems and how the condition has or has not impacted them
- The applicant’s social history, including alcohol use, tobacco use, and drug use
- The applicant’s family history
- A description of the physical examination conducted by the doctor
- An interpretation of lab results for any tests conducted
- The results of imaging tests, if authorized by DDS
- Medical source statement that assesses the applicant’s abilities and limitations based on the applicant’s medical condition. In this section, the doctor should explain the medical condition that prevents the applicant from working. Some of the specific things the doctor should include are the applicant’s ability to lift, stand, sit, stand, walk, carry, push, pull, and other factors that would impact the applicant’s ability to work.
Once the report is complete, the doctor who performed the exam should review and sign it. The doctor is responsible for the report’s contents. DDS will reject any report that is unsigned, signed with a disclaimer such as “dictated but not read,” rubber-stamped but not signed, or signed by someone other than the doctor.
Additional Consultative Exam Report Content for Specific Disabilities
Specific types of disabilities require additional information. For example, consultative exam reports require specific details about things such as diagnostic procedures, physical exams, symptoms, and more for the following types of conditions:
- Musculoskeletal injuries
- Visual impairments
- Hearing impairments
- Respiratory system conditions
- Cardiovascular system conditions
- Digestive system disorders
- Genitourinary impairments
- Hematological disorders
- Skin disorders
- Endocrine disorders
- Neurological disorders
- Mental disorders
- Malignant neoplastic diseases
- Immune system disorders
The goal of all of this information is to help DDS decide whether you are disabled and whether you qualify for Social Security disability benefits. Overall, the consultative report should explain your disability in enough detail for DDS to thoroughly understand how it impacts your life, how it affects your ability to work, and how long it is expected to last.
You can help the doctor complete a full consultative exam report by being honest and cooperative. If you need an interpreter with you during the exam, then an interpreter should be provided to you at no cost so that the exam and resulting report are thoroughly and accurately completed.
Incomplete consultative exam reports may be sent back to the doctor, and a determination on your Social Security disability application may be delayed until all the required information is provided to DDS.
What Happens After You Receive a Consultative Exam Report
Once a complete and signed consultative exam report is provided to DDS, the report should be considered by DDS and DDS should make a determination about your Social Security disability eligibility.
While your consultative exam report is important to your disability determination, it is not the only factor that will be considered.
Contact an experienced Social Security disability lawyer today to discuss your application and the necessary steps to getting your disability application approved. Our Massachusetts Social Security disability lawyers would be pleased to provide you with a phone consultation. You don’t have to travel to our Natick office to get the disability benefits that you deserve. Call us today to learn more.
Can I qualify for Veterans disability benefits and Social Security disability benefits?
The good news is that, yes, you may qualify for Social Security disability and Veterans disability benefits at the same time, and you may receive benefits from both programs.
However, each program has its own definition of disability and its own eligibility requirements. Therefore, qualifying for one program does not automatically qualify you for the other program, even if you are a Veteran.
Instead, you need to have your application approved by the Social Security Administration for Social Security disability benefits and the Department of Veterans Affairs for Veterans disability benefits.
Definition of Disability
The U.S. Department of Veterans Affairs considers someone disabled if the person:
- Served on active duty, active duty training, or inactive duty training.
- Has a disability rating because of an illness or injury that impacts the body or mind. The disability does not need to be a complete disability.
- Got sick or injured, or had an illness or injury worsen while serving in the military.
However, a Veteran who receives an other than honorable, dishonorable, or bad conduct discharge from the military will not qualify for Veterans disability benefits even if the Veteran meets the disability definition described above.
The U.S. Social Security Administration has completely different criteria for determining if someone is disabled. The Social Security Administration doesn’t care where or when you were disabled or if you served in the military, and the Social Security Administration will not accept a partial disability. Instead, a person is disabled if:
- You are totally disabled. If your condition prevents you from earning more than a minimum amount defined as substantial gainful activity, then you may be totally disabled. Partial disabilities are not considered by the Social Security Administration, even if they impact your income.
- You are permanently disabled. Medical professionals must expect your condition to last for at least one year or to result in your death.
- You have paid enough in Social Security disability taxes to qualify for benefits. You must have earned enough work credits to qualify for benefits. The number of work credits that you need depends on your age. However, most adult workers need to have earned 40 work credits with 20 of those credits earned in the ten years immediately before filing for disability.
The Department of Veterans Affairs and the Social Security Administration are both agencies of the United States government. However, they do not share a common application process. Instead, you need to convince each agency of your eligibility based on that agency’s specific eligibility criteria. That said, if you have a 100% disability rating from the Department of Veterans Affairs, then your Social Security disability application may be expedited, although your eligibility is not guaranteed.
If you think that you meet the disability definition for either program, then your next step is to complete an application for one or both programs.
You Don’t Have to Apply for Disability Benefits on Your Own
Whether you apply for Social Security disability benefits or Veterans disability benefits, you have the right to work with an experienced lawyer who may reduce the frustration and stress that comes with applying for either program.
While there are significant eligibility differences and different application procedures for Veterans disability and Social Security disability, both application processes can be frustrating and stressful. Both government agencies require precise information and may delay or deny applications based on unclear or missing information.
Accordingly, it is essential to work with an experienced disability lawyer to file your application, or your appeal if your initial application is denied. Our experienced Social Security disability lawyers are here to help Veterans and non-Veterans in Massachusetts, Rhode Island, and New Hampshire get the Social Security disability benefits that they deserve. We can also direct you to a Veterans disability lawyer if you need one.
To learn more, please read our free book, Unlocking the Mystery: The Essential Guide for Navigating the Social Security Disability Claims Process, and call us today for a free, no-obligation consultation.
What happens if you apply for Social Security disability and your job no longer exists?
The Social Security Administration will find that you are disabled if your medical condition prevents you from doing the work you’ve done in the past or another type of work.
However, what happens if the work that you did no longer exists and you aren’t qualified to do any other type of work for which there is currently a demand?
Jobs Change Over Time
The jobs available in the workforce change over time. For example, some jobs from the 20th century, such as switchboard operators, elevator operators, and film projectionists are no longer necessary because of technological advancements. Other jobs, such as milk delivery, have fallen out of fashion. Some of the skills used in some of these jobs are easily transferred to other occupations, but others are not as easy to apply in different situations.
Jobs in the National Economy
When deciding whether you can do the work that you used to do or another type of work, the Social Security Administration must consider whether you can do work that currently exists in the national economy. Your physical ability, mental ability, and vocational qualifications are considered when determining what kind of work you can do.
Generally, work exists in the national economy if the jobs exist in significant numbers in the region where you live or in several other regions in the United States. There must be a significant number of jobs in one or more occupations that have requirements that you can meet. While the federal regulations do not establish a specific number as “significant,” the regulations are clear that a few “isolated” jobs that exist in “very limited numbers in relatively few locations outside of the region where you live are not considered work which exists in the national economy.”
When the Social Security Administration determines whether jobs exist in the national economy, it considers information from the:
- Dictionary of Occupational Titles, published by the U.S. Department of Labor
- County Business Patterns, published by the U.S. Bureau of the Census
- Census Reports, from the U.S. Bureau of the Census
- Occupational Analysis prepared for the Social Security Administration by State employment agencies
- Occupational Outlook Handbook, from the U.S. Bureau of Labor Statistics
- Vocational experts or other experts if there is a complex issue, such as whether your work skills can be used in other work or occupations.
If jobs that you can do exist in the national economy, then you are not disabled even if you are unemployed because:
- You can’t get work
- There isn’t enough work in your local area
- The hiring practices of employers prevent you from working
- Technology has changed in the industry
- Cyclical economic conditions temporarily make work unavailable
- There are no job openings
- You don’t want to do a particular kind of work.
Additionally, the Social Security Administration will not consider the following in determining whether work exists in the national economy:
- If there is work in your immediate geographic area
- Whether a specific job vacancy exists
- If you would be hired if you applied for a specific job
The Social Security Administration must follow the specific regulations for determining if work exists in the national economy, as described above. However, the information that you provide or that your Social Security disability attorney presents in your application or appeal may influence the outcome of your Social Security disability case.
What Else You Need to Know About Social Security Disability Eligibility
A determination of your eligibility may be made without the Social Security Administration ever considering whether your job still exists in the national economy. For example, if your disability is included in the Listing of Impairments, then it is presumed that you cannot work.
Learn more about your Social Security disability rights and how to protect them by browsing our free library of articles or contacting our Boston area Social Security disability application lawyers today to schedule a free consultation.
I had a heart transplant a year ago or longer, and I still can’t work. Do I qualify for Social Security disability benefits?
Getting a heart transplant is a significant procedure. The Social Security Administration (SSA) recognizes how important it is that you make a full recovery, which is why it automatically approves heart transplant recipients to receive Social Security Disability Insurance (SSDI) for the first year.
If you still can’t work after one-year post-surgery, then you may reapply for Social Security disability benefits. This time, however, there is not a specific heart transplant listing in the Listing of Impairments that applies to you. Instead, you will need to prove that you qualify for benefits pursuant to a different section of the Listing of Impairments or that you can’t work because of the severity of your disability.
Heart Transplant Complications
Complications may occur if your body rejects the new heart, if the new heart fails, or if you experience significant side effects from transplant medications. While some of these complications are acute and happen soon after heart transplant surgery, other complications occur over time. Even at one-year post-transplant, you are still at risk.
Some of these complications are so severe and common that they are included in the Listing of Impairments. For example, you could experience:
- Coronary artery disease (Listing 4.04). Coronary artery disease, also known as ischemic heart disease, occurs when blood flow to the heart is reduced because of narrowed arteries. Not everyone with coronary artery disease qualifies for benefits, but if you meet the qualifications of Listing 4.04, then you will qualify for benefits.
- Heart failure (Listing 4.02). If you are diagnosed with chronic heart failure, you are on medication, and you meet the severity requirements included in the listing, then you qualify for Social Security disability benefits.
- Heart Arrhythmia (Listing 4.05). You may be eligible for Social Security disability if you have recurrent arrhythmias that occur despite treatment and meet the severity requirement of the listing.
- Kidney Damage (Listing 6.00). Heart transplant medications can damage your kidneys. If you experience a kidney condition that falls under Section 6.00 of the Listing of Impairments because of your heart transplant medication, then you may qualify for Social Security disability benefits.
- Thin bones, which may cause bone fractures (Listings 1.06 and 1.07). Heart transplant medication may cause your bones to thin. If you suffer a significant fracture of your femur, tibia, pelvis, a tarsal bone, or an upper extremity bone, then you may qualify for Social Security disability if you meet the requirements of Listing 1.06 or 1.07.
- Diabetes (Listing 9.00). The medications that you are on to keep your body from rejecting your heart transplant may cause diabetes. If this happens to you and you meet the requirements of Listing 9.00(5), then you should qualify for Social Security disability benefits.
- Cancer, especially skin cancer or non-Hodgkin’s lymphoma (listing 13.03 or 13.05). Anti-rejection medications can make you more susceptible to some kinds of cancer. If you suffer skin cancer or lymphoma from your medication, or for any other reason, and you meet the Listing of Impairments requirements, then your Social Security disability benefits should continue beyond one-year post-transplant or begin again once you are eligible for benefits.
Other conditions such as high blood pressure or an infection may also result in a permanent disability.
Even if your condition is not listed above, you may still qualify for benefits if you can prove that you can’t work because of your physical condition.
Are You Eligible for Social Security Disability Benefits?
Our experienced Social Security disability lawyers will thoroughly review your claim and consider all of your legal options.
If, at any point during your first year of Social Security disability eligibility, you think that you might be unable to go back to work, then we encourage you to contact us right away so that we can minimize any disruption in your benefits. Likewise, if you develop any complications after your first year of benefits expires, then you may still have a successful Social Security disability complication.
To learn more, contact Keefe Disability Law today for a free, no-obligation consultation about your rights. Additionally, if you know someone on the heart transplant list or who is recovering from a heart transplant, please share this article with them as a way to show your support.
Will I qualify for Social Security disability benefits if I have atrial fibrillation?
You may or may not qualify for Social Security disability depending on your unique medical condition.
Any time something prevents your heart from functioning normally, you risk side effects and complications. Atrial fibrillation, called “AFib” for short, impacts your heart rhythm. If your doctor has diagnosed you with AFib, the upper chambers of your heart might not be pumping blood normally, and you could suffer serious health complications such a stroke or heart failure.
Symptoms of AFib
You may have AFib without any symptoms, or you may experience one or more of the following symptoms:
- Chest pain
- Difficulty with heavy manual labor
If you experience any of these symptoms, your doctor should give you medication to help. If that still does not work, you might need a pacemaker to keep your heart rhythm regulated.
Getting SSDI With AFib
If your treatment works to control the symptoms of AFib, you will not qualify for Social Security Disability Insurance (SSDI). However, if you have other symptoms that go beyond what the medication or a pacemaker can treat, then you might qualify to receive SSDI.
Since AFib is a type of heart arrhythmia, it may be evaluated pursuant to Section 4.05 of the Social Security Administration’s Blue Book Listing of Impairments. To qualify for benefits pursuant to this section of the Blue Book, your AFib must:
- Be irreversible, uncontrolled, and recurrent. In other words, your condition is not controlled by medication, a pacemaker, or other medical interventions.
- Cause episodes of fainting or near fainting despite treatment. A near-fainting episode, also known as a near syncope, is not just a feeling of lightheadedness or dizziness. Instead, it is a period of altered consciousness.
- Be documented by resulting or ambulatory electrocardiography or another appropriate medically acceptable testing that occurs at the time of fainting or near fainting to establish the medical connection between AFib and fainting or near fainting episodes.
Section 4.05 Isn’t the Only Way to Qualify for Benefits
Section 4.05’s requirements are precise, but they aren’t the only way you can qualify for Social Security disability benefits. You may also qualify for benefits if your Social Security disability application proves that:
- Your AFib is equal in severity to another Blue Book listing. If you can prove that your AFib impacts your life to the same degree as another listing, then you are eligible for Social Security disability benefits.
- Your AFib is expected to prevent you from working for at least 12 months or result in your death. To make this determination, the Social Security Administration will consider whether you can do any work, not just the work that you did before your AFib diagnosis.
If you qualify for Social Security disability benefits in any of these two ways, then two things must happen before you receive benefits. First, you must fully complete an honest and accurate Social Security disability application. Second, you must provide appropriate documentation, which includes, but is not always limited to, information about your diagnosis, treatment plan, prognosis, work history, and education.
Some of the medical documentation that you will need may include:
- Chest x-rays, MRIs, ultrasounds, or CT scan results
- Electrocardiogram results
- Holter monitoring results
- Echocardiogram results
- Electrophysiological testing and mapping results
- Blood test results
- Exercise tolerance test or stress test results
- Tilt table test results which show your blood pressure and heart rate respond to gravity
- Detailed information about how your fainting episodes are connected to your AFib
- A detailed list of every treatment you’ve treated and its effect on your body
- Reports about any AFib related operations or hospitalizations you have had
Additionally, you will need a detailed report from your doctor that describes how AFib impacts your life.
Find Out If You Qualify for SSDI With the Help of an Experienced Disability Lawyer
Remember, not everyone with AFib will qualify for Social Security disability. When applying for disability benefits with a complicated condition like AFib, it is especially important to work with a Social Security disability attorney on your application. Fill out our online contact form or call us directly, and we will be in touch soon with more information for you.
Will psychotherapy notes be considered if I apply for Social Security disability?
You know what’s going on with your health. You know that your physical or mental condition prevents you from working. However, before you receive Social Security disability benefits, you have to convince the Social Security Administration that you are disabled.
You Will Need Medical Evidence
The Social Security Administration is not going to find you eligible for Social Security disability benefits just because you say that you are disabled. Instead, you must provide evidence to convince the Social Security Administration that you meet the requirements of a disability described in the Listing of Impairments, your disability is just as bad as one of the conditions in the Listing of Impairments, or you can’t work because of your disability.
Some of the most important pieces of evidence that you must provide are medical evidence. The specific medical evidence depends on the nature of your disability. For example:
- If you have cancer, then medical records from your oncologist may be crucial
- If you have a heart condition, then medical records from your cardiologist may be essential
- If you have a mental health condition, then medical records from your psychologist or psychiatrist may be critical to your disability determination
While you may be willing to share the details of your diagnosis, treatment plan, and prognosis with the Social Security Administration, you may be reluctant to share your psychotherapy treatment notes with anyone.
What Are Psychotherapy Notes?
According to the federal Health Insurance Portability and Accountability Act (HIPAA), psychotherapy notes include notes recorded in any way by a mental health professional that document or analyze the contents of conversation during a private counseling session or a group, joint, or family counseling session. These notes must be separate from the rest of an individual’s medical record.
However, psychotherapy notes do not include medication prescription and monitoring, the start and stop times of counseling sessions, the modalities and frequencies of treatment, clinical test results, or summaries of diagnosis, functional status, treatment plan, symptoms, prognosis, or progress. Instead, psychotherapy notes are limited to the therapist’s documentation or analysis of private conversations.
Psychotherapy Notes Are Not Medical Evidence
The Social Security Administration’s guidance to healthcare professionals about psychotherapy notes is clear. The agency states explicitly, “Social Security recognizes the sensitivity and extra legal protections that concern psychotherapy notes (also called “process” or “session” notes) and does not need the notes.”
The Social Security Administration goes on to provide three options for mental health professionals. Mental health professionals who keep psychotherapy notes may:
- Send medical records without psychotherapy notes, if psychotherapy notes are kept separate from medical records.
- Disclose all records, including psychotherapy notes, if psychotherapy notes are not kept separate from other parts of the medical record. Alternatively, the medical provider may choose to blackout or remove parts of the record that would be considered psychotherapy notes and could be kept separately by the mental health provider.
- Prepare a special report describing in detail the critical current and longitudinal aspects of the patient’s treatment and functional status.
Your Social Security disability will advise you about the evidence needed to establish eligibility.
Protect Your Privacy and Your Social Security Disability Eligibility
You shouldn’t have to choose between protecting the privacy of your therapy notes and receiving Social Security disability benefits. Instead, we invite you to contact our experienced Social Security disability lawyers today for a free phone screening about your Social Security disability eligibility.
If you qualify for Social Security disability, then our lawyers will gather all of the relevant evidence, complete your application, and advocate on your behalf throughout the eligibility process. The majority of initial Social Security disability applications are denied, and we can help you avoid preventable errors that prevent you from getting the benefits you’ve earned. Call us or complete our online contact form if you are applying for Social Security disability in New Hampshire, Rhode Island, or Massachusetts and let’s talk about your rights and how we can help you.
Can I get Social Security disability benefits if I’ve been diagnosed with an affective disorder?
Yes, if you suffer from an affective disorder and you can prove that you meet the eligibility criteria for Social Security disability then you may be able to recover monthly benefits.
The First Question Is Whether You Have an Affective Disorder
An affective disorder is not one specific disease. Instead, it is a term used to describe a set of psychiatric diseases that can range from mild to severe, with symptoms varying between individuals. Affective disorders are also sometimes referred to as mood disorders. There are three main types of affective disorders, including the following:
- Depression. Also known as major depressive disorder, this condition typically causes people to feel extreme sadness and hopelessness. Episodes can last for several days or can continue for weeks or months.
- Bipolar disorder. This condition results in people experiencing periods of depression followed by periods of mania. Mania occurs when you feel extremely positive and active. Unfortunately, mania is not always good. Instead, it can make you feel irritable, aggressive, impulsive, and even delusional. Bipolar disorders can be further broken down into different classes of the disease according to the severity of the depression and mania, as well as how often the swing between the two moods occurs.
- Anxiety disorders. Like bipolar disorder, anxiety disorders come in many different forms. These include social anxiety caused by social situations, post-traumatic stress disorder caused by a traumatic event, generalized anxiety disorder which does not have one particular cause, panic disorder, and obsessive-compulsive disorder.
While anxiety is a type of affective disorder, the Social Security Administration categorizes anxiety disorders differently than depression and bipolar disorders. If you are applying for benefits then it is important to know which Social Security disability listing of impairment may be relevant to your claim.
The Next Question Is Whether You Qualify for Social Security Disability Benefits Because of Your Affective Disorder
Unfortunately, when affective disorders are severe enough, it can become difficult or impossible for a person to carry out activities of daily living and to work. Social Security disability benefits may be available to provide some relief from this financial burden—if you qualify.
Just as there are different types of affective disorders, there are different ways to qualify for Social Security disability if you are diagnosed with an affective disorder. For example, you may qualify for disability benefits if:
You Meet the Requirements in the Blue Book Listing of Impairments
Affective disorders are included in Section 12.00 of the Social Security Administration’s Blue Book Listing of Impairments which covers mental disorders. You may satisfy the requirements for an affective disorder pursuant to a specific listing if one of the following is true:
- You have depressive disorder and you meet the requirements in Section 12.04A(1). To do this, you must have medical documentation that shows that you experience five or more of the following symptoms: depressed mood, diminished interest in almost all activities, appetite disturbance with a change in your weight, sleep disturbance, observable psychomotor agitation or retardation, decreased energy, feelings of guilt or worthlessness, difficulty concentrating or thinking, and thoughts of suicide or death.
- You have bipolar disorder and you meet the requirements in Section 12.04A(2). To meet this requirement, you must have medical documentation that proves that you experience three or more of the following symptoms: pressured speech, flight of ideas, inflated self-esteem, decreased need for sleep, distractibility, involvement in activities that have a high probability of painful consequences that are not recognized, or an increase in goal-directed activity or psychomotor agitation.
- You have anxiety disorder and you meet the requirements in Section 12.06A(1). To qualify pursuant to this listing, you must have medical documentation that proves that you have at least three of the following symptoms: restlessness, tiring easily, having difficulty concentrating, irritability, muscle tension, or sleep disturbance.
- You have panic disorder and you meet the requirements in Section 12.06A(2). To qualify for benefits under this listing, you must have medical documentation that one of the following is true: you have panic attacks followed by a persistent concern or worry about having more panic attacks or the consequences of panic attacks, or you have a disproportionate fear or anxiety about at least two different situations.
- You have obsessive-compulsive disorder and you meet the requirements in Section 12.06A(3). You will qualify for benefits under this listing if you have medical documentation to prove that one of the following is true: you have an involuntary, time-consuming preoccupation with intrusive, unwanted thoughts or you have repetitive behaviors aimed at reducing anxiety.
In order to qualify for benefits pursuant to any of these listings, you must also prove that one of the following is true:
- You have an extreme limitation in one, or a marked limitation in two, of the following four areas of mental functioning: (1) understanding, remembering, or applying information; (2) interacting with others; (3) concentrating, persisting, or maintaining pace; and (4) adapting or managing yourself.
- Your affective disorder is serious and persistent. That means that you have a medically documented history of the disorder for a period of at least two years and there is evidence—that despite ongoing medical treatment, mental health therapy, psychosocial support, and a highly structured setting that diminishes your symptoms—you still have a minimal capacity to adapt to changes in your environment or demands that are not part of your daily life.
These are tough requirements to meet and you may be unable to work because of your disability—even if you do not meet the technical requirements in the Listing of Impairments.
You May Qualify for Benefits Because of the Severity of Your Affective Disorder
Even if you do not meet the requirements in one of the listings described above, you may still qualify for benefits if your symptoms are equal in severity to another listing or if you are unable to work because of the significant way that your condition impacts your ability to work.
Get the Help You Need Before You Apply for Benefits
Obtaining Social Security disability benefits is important for many people suffering from affective disorders. You may need these benefits if you are unable to earn a living. Our experienced Social Security disability lawyers are here to help you through this process. We encourage you to contact us today for a free consultation and to download our free report, Unlocking the Mystery: The Essential Guide for Navigating the Social Security Disability Claims Process, to learn more.
I got a call from Texas Disability Determination Services asking me to see a doctor before a decision is made on my Social Security disability application. Do I have to attend this appointment?
Generally, yes, if you want your application for Social Security disability benefits to be approved then you need to comply with the Disability Determination Services (DDS) request that you attend a consultative medical exam. This exam will not cost you any money, but before you see any doctor for any reason, it is important to understand the purpose of the appointment and your rights.
Who Performs a Consultative Exam?
The doctor who you usually see may be the one who performs your consultative exam. It is the Social Security Administration’s policy that the treating source (or your regular doctor) perform the consultative exam if the doctor is:
- Qualified and able to perform the exam or tests requested.
- Willing to do the exam or tests for the fee schedule payment provided by the Social Security Administration.
- One who generally furnishes complete and timely reports.
However, in some cases DDS may request that an independent medical provider conduct the consultative exam or test. This may occur if one of the following things is true:
- Your regular doctor does not want to perform the exam.
- There are conflicts or inconsistencies in your file that can’t be resolved by your regular doctor.
- You prefer to have someone else perform the exam and you have a good reason for having this preference.
- Prior experience indicates that your regular doctor may not be a productive source for getting the information sought in the consultative exam.
If a doctor other than your own is selected to perform your consultative exam, then that selection should be based on the doctor’s ability to perform the requested tests or specific exam, the doctor’s appointment availability, and the distance you must travel to get to the doctor.
What Happens at a Consultative Exam
DDS must be clear about the additional medical evidence that it needs to make a determination about your eligibility. In some cases a full exam may be needed. However, in other cases one test (such as an X-ray or EKG) may be all that is needed. You should understand the scope of the consultative exam before you attend your scheduled appointment.
Even though the scope of the consultative exam may be limited, the consultative exam report must contain specific information. Specifically, the Social Security Administration requires the report to include:
- Your claim number and a physical description of you.
- Your medical history.
- The results of your physical examination and laboratory findings.
- The examiner’s medical conclusions.
The report must be complete enough to allow a reviewer to determine what your disability is, how severe it is, how long it is expected to last, and how it impacts your ability to work. Additionally, it must be consistent. However, it should not include an opinion as to whether you are disabled as that term is defined by Social Security disability law. If the report is found to be incomplete or inconsistent then it will be sent back to the doctor and a determination about your Social Security disability claim may be delayed.
What to Know Before You Go to a Consultative Exam
The failure to attend a consultative exam may result in your Social Security disability claim being denied. While you need to attend the appointment, you also deserve to understand what is happening with your claim before, during, and after a consultative exam.
During the exam, all of your questions should be answered. The doctor treating you should explain what he is doing and why. If you do not speak English then an interpreter will be provided to you during your exam. You will not have to pay for the interpreter’s services.
Before you attend the consultative exam, and afterward, your Social Security disability lawyer will be available to help you with your application for benefits. The consultative exam is just one part of the application process. We will use the information from your exam, and all other applicable information, to help you get the benefits that you deserve. Please contact us today via this website or by phone to learn more about protecting your rights.
What is the Activities of Daily Living questionnaire?
The Social Security Administration wants to know if your disability prevents you from working. In order to make this critical assessment that will significantly impact your Social Security disability eligibility, the Social Security Administration (SSA) may ask that you fill out an Activities of Daily Living Questionnaire.
The purpose of the questionnaire is to better assess how your physical and mental impairments impact your daily life. While your medical records allow the SSA to evaluate your medical diagnoses, this questionnaire allows them to assess how the diagnoses impact your life on a day-to-day basis. Your answers will help determine whether you have functional limitations that impact your ability to engage in substantial gainful activity. Learn more about substantial gainful activity in our other article.
What Is Included in the Activities of Daily Living Questionnaire?
The Activities of Daily Living Questionnaire is more formally known as Function Report – Adult – Form SSA-3373-BK. This form asks about your abilities and limitations in performing tasks such as caring for yourself and your household.
Some of the questions that you can expect on the form include:
- Do you live alone or with other people?
- How does your disability limit your ability to work?
- What do you do on a typical day, starting from the time you wake up until the time you go to bed?
- Do you take care of other people—such as children, a spouse, parents, other relatives, or pets? What do you do for them? Do you have any help from anyone else?
- What were you able to do before you became disabled that you cannot do now?
- Does your disability affect your sleep?
- Does your disability affect your ability to get dressed, bathe yourself, shave, use the toilet, or otherwise take care of yourself?
- Do you need help or reminders to take medication?
- Do you prepare your own meals?
- Are you able to do household chores? Are there any household chores that you need help with?
- How often do you go outside?
- Do you drive?
- Can you go out alone?
- Can you shop? Can you do it independently?
- Are you able to pay your own bills and manage your own money?
- Do you have hobbies, interests, and activities that you enjoy on a regular basis?
- Do you spend time with others? In what situations? Do you have trouble getting along with people?
- What abilities does your disability impact? Examples include lifting, walking, concentrating, using hands, talking, sitting, and other important abilities.
- How far can you walk before you need to rest?
- How long can you pay attention?
- Do you finish what you start?
- Can you follow verbal or written instructions?
- Do you get along with authority figures?
- Have you ever been fired because you had trouble getting along with others?
- How well do you handle stress and changes in routine?
- Do you use any assistive devices (such as hearing aids or crutches, for example)?
- Do you take any medications? What are the side effects of those medications?
If you answer yes, or in such a way as to indicate that you are disabled, then you will be asked to further explain your limitations or condition in a short answer format. Additionally, there is space at the bottom of the questionnaire for you to add in information that was not included in the routine questions.
Tips for Completing the Activities of Daily Living Questionnaire
The good news is that you are the person in the best position to answer questions about what you do on a typical day. When you complete the form it is important to:
- Be honest. You do not want to exaggerate or understate your limitations and abilities.
- Give as many details as you can so that the person reading the questionnaire gets an accurate idea of what your life is like on a daily basis.
Technically, this form is voluntary. However, if you fail to fill it out, then the SSA may not be able to find you eligible for Social Security disability benefits. While you are the one who must fill out the form, it should be done in consultation with your Social Security disability lawyer who can help you complete your entire Social Security disability application.
For more information, or to get started with your own Social Security disability claim, please contact us today via this website or by phone to schedule your initial consultation. Additionally, we encourage you to download a FREE copy of our book, Unlocking the Mystery: The Essential Guide for Navigating the Social Security Disability Claims Process, to learn more today.