Victor Malca Law A Trusted Name In Florida
Victor Malca P.A. has over 25 years of litigation experience in Workers Compensation and Social Security Disability lawsuits. His experience and continued success in fighting for his clients puts among the most trusted workers compensation lawyers in Florida. Our area of expertise is in representing injured workers on compensation benefit cases and disabled individuals claim social security disability benefits.
Our unwavering advocacy for employee rights and privileges are recognized by our past clients across South Florida. Book a free consultation today.
ABOUT THE AUTHOR
Judy Ponio is a writer for Victor Malca Law P.A. and enjoys helping people with questions about social security, workers compensation, and other serious matters involving peoples livelihood. She is not an attorney and her writing should not be considered legal advice.
What If The Social Security Administration Finds That My Disability Has Ceased But Im Still Not Able To Work
The notice, which you will receive from the Social Security Administration following a continuing disability review, will explain your appeal rights. Read this notice carefully. If you appeal within ten days of the date you receive the notice your benefits will continue during your appeal. So be sure to act quickly.
Do You Want To File A Disability Claim
If you are applying for benefits or have been denied benefits, we can help. Our practice is social security disability law and nothing else. We have offices throughout Arkansas, Missouri, Kansas, Oklahoma, and Illinois. We offer free consultations and we do not get paid unless you win your case. Contact us online today for more information. We can also be reached at .
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Medical Improvement Not Expected
You may be set to a seven-year diary if you have a condition that is not expected to improve, such as some cancers, blindness, deafness, autism, Parkinson’s disease, multiple sclerosis, cerebral palsy, Down syndrome, or other chronic conditions. These cases are categorized as medical improvement not expected . In addition, those over the age of 55 are often assigned seven-year increments, simply because older individuals are less likely to improve than younger persons.
Even disability recipients who have undoubtedly permanent conditions, such as amputations or mental retardation, may be subject to continuing disability reviews.
Social Security Rule Changes Will Harm Disabled Workers
Two new rules from the Trump administration will make it harder for workers and other disabled individuals to collect Social Security disability insurance and supplemental security income benefits.
The first rule, which took effect Dec. 16, changes the disability appeals process by allowing internal agency lawyers who work for the Social Security Administration, or SSA, to conduct disability hearings that have traditionally been conducted by impartial, independent administrative law judges.
The second proposed rule changes the frequency at which certain individuals who collect benefits will be forced to prove their continuing disability to the agency, and will result in the wrongful termination of benefits for countless disabled individuals. Its likely to go into effect prior to the 2021 change in administration.
Agency Attorneys to Conduct Impartial Hearings
In most cases, disability claims before the SSA are evaluated under a four-level review process: initial determination reconsideration hearing before an administrative law judge and review before the Appeals Council. The first two levels of review are conducted by federal and state decision makers. If a claimant is not approved at one of the first two levels, they are provided the opportunity to present their case to an impartial, independent ALJ.
Increasing the Frequency of Disability Reviews
The second rule change proposes and increase in the frequency of continuing disability reviews, or CDRs.
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Is There Anything I Can Do To Make Dealing With The Social Security Administration Easier
You shouldnt expect as many problems dealing with the Social Security Administration while receiving benefits as you had trying to get benefits in the first place. Sometimes, though, some people have problems. Here are some things you can do to try to minimize the hassle:
- Keep all decisions, letters, and notices you receive from SSA in a safe place.
- Read everything you get from the Social Security Administration. The booklets that come with award letters and notices are well written and informative.
- When reading the booklets you receive from the Social Security Administration, pay special attention to the kind of information you are required to report to the Social Security Administration. Report promptly and in writing and keep a copy with your Social Security papers.
- Dont necessarily believe everything they tell you at the Social Security Administration 800 number. If you have an important issue to take up with the Social Security Administration, sometimes it is better to go to your local Social Security Office.
Grid Rules For Social Security Disability Reviews After Age 50
Generally, at step five you would need to prove your condition prevents you from performing any other work in the national economy. However, the medical-vocational guidelines, or GRID rules, may apply to social security disability reviews after age 50. These rules are quite complicated, with multiple exceptions. The general concept is that if you are age 50 to 54 and found to have a sedentary RFC, with an inability to perform the work you have done in the past fifteen years, you will be found disabled. This effectively means you can be found eligible for disability benefits, even though there are jobs available to you at the sit-down level. As mentioned in the beginning, this is because the SSA has determined that once you hit the age of 50 it is too difficult to retrain you to perform a sit-down type of position. Keep in mind that if your past work was performed at the sit-down level, and you are found to be able to perform your past work, you will NOT be found disabled using the GRID rules.
As you continue to age, the rules continue to become even more relaxed. If you are age 55 to 59, you can be found disabled if your RFC is limited to the light level. A light RFC means you are capable of lifting 20 lbs occasionally, 10 lbs frequently, and standing and walking six hours out of an eight-hour day. Similar to the age group 50 to 54, for these rules to apply, your past work must first be ruled out.
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Is There Anything That Can Trigger A Cdr
While CDRs are carried out on a periodic basis, certain things can trigger an otherwise unscheduled CDR. These can include:
- You report to the SSA that you have recovered or have returned to work
- Your state vocational agency reports to the SSA that you are working or are able to work
- Someone in a position to know your physical condition tells the SSA that you are not disabled, you are not following your prescribed treatments, or that you have returned to work
- The SSA receives any other evidence that raises questions about your continuing eligibility
Keep in mind, however, that there are exceptions to these rules. For example, entering a trial work period to determine whether you are ready to return to the workforce while you are receiving benefits will not be taken as evidence that your disability has ended .
Returning To Work Substantial Gainful Activity Work Incentives
Certain circumstances may affect your eligibility to collect Social Security Disability benefits.
Benefits typically discontinue if you return to work, or in Social Security terms, engage in substantial gainful activity. The SSA defines substantial gainful activity as work involving significant and productive duties paying more than the current monthly income limit set by the SSA $1,090 for 2015 and including part-time work that pays less and/or involves less responsibility than your regular employment.
When reviewing your eligibility for continuing benefits, the SSA will employ the same process for determining whether you are involved in substantial gainful activity as when you originally applied for benefits.
Click here to read the about the 5-Step Social Security Disability Claims Qualification Review Process.
If you are determined to be working, that is, engaged in substantial gainful activity, then your eligibility for benefits will likely be terminated, even if your medical condition has not improved.
There are special rules that may allow you to continue receiving Social Security Disability benefits for a while after you return to work. The special rules, called Work Incentives, seek to encourage you to return to work to test your ability to return to substantial gainful activity.
Work incentives include:
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Do I Have To Do Anything Such As Visit The Social Security Office Or Complete Some Forms In Order To Get Paid My Social Security Disability Benefits
No. The Social Security Administration will process your claim and send you your benefits automatically. But if you have children who were under age 18 at any time after your date of entitlement, it will be necessary to put in an application for them to receive benefits but your own benefits will still be processed automatically.
Will You Get To Keep Your Benefits After A Cdr
The good news is that, of all the adult disability recipients who received either a mailer or the long-form disability review report in 2017, SSA statistics shows only 4.5% had their benefits ceased. For those who undergo the full CDR, and for children, however, the chances of losing benefits are quite a bit higher.
Those who go through a full medical review will have their benefits terminated if the claims examiner finds that their condition has improved since they were approved for benefits. This happens in relatively few adult cases, although the percentage of adults whose benefits are terminated has been increasing over the last few years. In 2013, 13% of adults were terminated after a full medical review, while in 2017, over 16% of adults had their benefits ceased after a full medical review. But the good news for this 16% whose benefits were ceased is that about half of CDR benefit denials are reversed on appeal.
SSI recipients are slightly more likely to have their benefits terminated after a full medical review than SSDI recipients . For more details, read our articles on your chances of SSDI termination after a CDR and your chances of SSI termination after a CDR.
CDR Review vs. Initial Review
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Will I Have To Pay Taxes On The Social Security Disability Benefits I Receive
Probably not, but this depends on the amount of your total income. Most people wont have to pay taxes on their Social Security disability benefits. Couples whose combined incomes exceed $32,000 and individuals with income exceeding $25,000 will pay income tax on a portion of their Social Security disability benefits. The IRS has an odd way of figuring out total income for this rule. The IRS uses adjusted gross income as reported on Form 1040, plus one-half of the total Social Security benefits received for the year, plus non-taxable interest.
Single people with incomes over $34,000 and married people with incomes over $44,000 pay tax on a higher percentage of their Social Security disability benefits.
Heres an odd thing: People whose Social Security benefits are reduced because of the workers compensation offset or offsets for other public disability benefits must count the amount of Social Security benefits not paid when determining taxability of their benefits. But if a child receives benefits on a parents account, those benefits count only for determining if the child must pay taxes on Social Security benefits received.
Tax law is very complex. Please talk to a tax specialist if you have any questions about taxes on your Social Security benefits.
Social Security Disability Faqs
Anyone who has tried navigating the Social Security Disability system can tell you that it is complicatedâto put it lightly. Though SSI and SSDI payments can be a godsend to those who need them, the system that provides them can be very difficult to navigate, with rules, regulations, and unknown factors that can confuse the average person.
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Should I Have Someone Represent Me At The Alj Hearing
You may have someone like a lawyer or an experienced paralegal represent you. You can also represent yourself. Represented people generally do better. If you want a lawyer with experience in Social Security claims, ask your local bar association or the National Organization for Social Security Claimant Representatives for a referral.
If you will represent yourself, get a copy of your file as soon as possible. Call the hearing office to arrange to copy your file. Social Security will send you a notice that your file is ready for your review. Call the 1-800 number in the top right of the notice to make an appointment.
The papers in your file are the only info the judge has about you. You must present your whole case at the hearing.
Frequency Of Social Security Case Reviews
When your application for Social Security disability benefits is approved, the disability determination representative who handled your claim will set the dates for your continuing disability reviews . The Certificate of Award you received when your claim was approved should indicate when you can expect your first review. Generally speaking, CDRs are set at every three years or every seven years.
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If You Receive The Mailer Only
About 72% of all disabled adults receive the short-form mailer only. This form, called the Disability Update Report, asks you about whether your health has improved, whether you and your doctor have discussed your ability to work, whether you’ve visited a doctor, clinic, or hospital, and whether you’ve done any recent work, school or training.
Most people who fill out the mailer and send it in will get a letter from Social Security after one to three months saying that Social Security does not need to do a medical review at this time. This means you do not have to go through a CDR at this point and your CDR is deferred until your next periodic review.
Social Security will reset your periodic review interval, which it calls your “medical reexamination diary,” at the same interval it was before you received the mailer. For instance, if Social Security designated you as “medical improvement possible” and gave you a three-year diary when you were approved for benefits, you’ll be sent another mailer or long-form report in three years.
How To Pass A Continuing Disability Review
In order to maintain your disability program, here are some suggestions on how to pass a continuing disability review:
- Follow Your Treatment Recommendations
- Learn More About Your Condition.
- Be Honest and Answer Questions Directly.
- Keep Copies of Your Medical Records.
- Inform the SSA of Any Change in Your Address.
Again, it is important to talk with an experienced disability attorney to review your personal facts and to provide you with an individual analysis of how to maintain your disability and answer any questions you may have.
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How Often Will Social Security Review My Disability Claim
You can collect Social Security disability benefits for as long as you are unable to work due to illness or injury. However, once your condition has improved to the point that work is possible, you are supposed to inform the Social Security Administration and return to work. To ensure that people are not taking advantage of the system, the SSA will periodically review cases to confirm that recipients continue to be disabled. How often that review occurs depends on the possibility of your medical improvement.
What Does The Ssa Look For In A Cdr
During a CDR, the SSA evaluates whether a recipient remains eligible to receive Social Security disability benefits. There are two key things the SSA is looking for when it conducts a CDR:
- Work review, wherein the SSA looks at whether you are engaging or capable of engaging in substantial gainful activity
- Medical review, wherein the SSA evaluates whether your condition continues to meet the SSAs definition of disabled .
During the CDR process, the SSA will review your original case file with the supporting evidence you previously submitted to evaluate whether you are entitled to continued benefits. You must also submit any additional evidence that will help the SSA make its determination. In some cases, the SSA will order a consultative examination.
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What Should I Say At My Hearing
You and your witnesses should explain how your disability keeps you from working and affects your daily activities. Your witnesses can either answer your questions or speak directly to the judge about you. The ALJ will ask questions of you and your witnesses.
The judge will make a written decision and mail it to you within a few months. If it is not favorable, it will tell you how to appeal to the Appeals Council.
What Methods Of Observing You Does The Ssa Use
If the SSA has reason to look into your eligibility for continuing to receive disability benefits for any reason, they will probably use one of the following methods for doing so:
- Direct Observation. This is exactly what it sounds like. The SSA could have someone follow you to try to catch you doing things that prove your medical condition has improved and you are no longer disabled.
- Video Surveillance. This is where the SSA would try to catch you on video doing something that shows you are no longer disabled.
- Social Media Monitoring. You could put your disability benefits at risk by making remarks or posting pictures or videos of yourself that prove or imply that you are no longer disabled. Social media is easy and accessible, and the SSAs fraud investigators are adept at using it. So, think before you post.
Applying for Social Security disability benefits is serious. To file a disability claim, contact a disability law firm for advice.
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