The Two-Way Street of Updating Medical Evidence

A complete medical record is paramount in getting your Social Security disability claim approved. At the hearing level, the most common question I get from my clients is, “are all the records in?” The Social Security Administration recently enacted a new regulation that requires the Administrative Law Judge be provided, or informed of, all written evidence within five business days of the hearing. 20 CFR 404.935.

Attorney representatives typically request, pay for and submit medical records prior to a hearing. For the reasons explained below, timing is key in order to comply with the new 5-day rule.

First, it would be impractical for representatives to constantly hound all of their clients in case some new and material medical evidence has come into existence. Too much time would be wasted and the representation of SSD claimants would no longer be a viable practice. On the other end of the spectrum, representatives must exercise due diligence in pursuing relevant evidence in their clients’ claims.

Second, depending on the state, claimants can wait up to two years for a hearing after the previous denial. Social Security usually sends a Notice of Hearing about 90 days before the date of the hearing. This creates a dilemma. ALJs are very concerned with the claimant’s recent medical evidence, which shows whether ongoing benefits are warranted and whether any medical improvement has occurred or is likely to occur. So, if the file is updated too early, additional updates will be necessary to add new evidence. If the file is updated too late, the 5-day rule might be violated. Depending on the source, requests for records can be outstanding for 30 days or more, despite follow-ups and re-requests, before the records are produced. This results in a small window in which records requests will generate complete submissions just in time but not too late.

The best way to handle this situation is with a team effort. When this issues arises in hearings, I have had multiple judges describe to my clients a “two-way street,” where representatives and clients both have an obligation to communicate with each other. If you don’t notify your representative with your new address or phone number, your representative has no way to reach you and therefore no way to know where you have been going for treatment. They can update with sources they already know about but not with new sources. The longer you do not return their phone calls or respond to their letters, the more likely you will violate the 5-day rule and a strict judge will refuse to consider key evidence. If your representative is unable to reach you after several attempts, he or she is allowed to drop your case.

An ALJ can approve a case without a hearing if the evidence is strong enough, although this is very rare. However, as above, it is impractical for representatives to frequently contact their clients just in case there is new, significant medical information. A representative will always contact their clients to update the file before the hearing. Until then, clients must contact their representatives with new medical information so the representative can obtain the records and submit them to the ALJ. New medical information might be a new doctor, diagnosis, test or hospitalization.

Written by Charles Sagert

Charles A. Sagert is a Social Security Disability attorney in Roseville, MN.

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What documents will I need when I apply for Social Security Disability Benefits?

Certain documents will need to be provided to Social Security when you apply for benefits.  Providing original documents in a timely manner will expedite the process.  Some examples of documents you may need are:

  • Your Social Security card
  • Your birth certificate
  • Your children’s birth certificates and Social Security numbers (if applying for them)
  • Proof of U.S. citizenship or lawful immigration status
  • Your spouse’s birth certificate and Social Security number if he or she is applying for benefits based on your earnings
  • Your marriage certificate
  • Your military discharge papers
  • Your most recent W-2 or tax return

Once documents are gathered, benefits can be applied for in person or online at sss.socialsecurity.gov/applyforbenefits .  Applying for benefits is only the beginning of the process.  Knowing one’s rights along the way is very important to a favorable outcome and as such, you have a right to representation.  For questions related to how to apply for disability or any other issues related to your Social Security Disability claim, please contact us at Hoglund, Chwialkowski, and Mrozik.

by Lyndsey Sharpe

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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Burdens of Proof

When applying for Social Security Disability, the Administration must use a five-step analysis to determine if a claimant is disabled. Going through the steps, if at any point the claimant does not meet a step, the analysis ends and the Administration will find that the claimant is not disabled. The steps are:

 

  1. Is the claimant engaging in substantial gainful activity (making more than $1,170 per month before taxes in 2017)? If the claimant is making more than the limit, he or she is not disabled.
  2. Does the claimant have a severe impairment (An impairment that materially limits the ability to perform work activities)? If not, the claimant is not disabled.
  3. Does the claimant meet or equal a listing due to his or her impairments (Listings outline specific impairments and certain objective findings that, if documented, result in a finding of disability)? If not, the analysis goes to the next step.
  4. Can the claimant perform his or her past relevant work (work done at substantial gainful activity for a long enough period to learn the skills involved in performing the work, done in the last 15 years)? If yes, he or she is not disabled.
  5. Can the claimant perform any other work, as outlined by Social Security’s rules and regulations? If yes, the claimant is not disabled.

 

The burden of proof is on the claimant for the first four steps of the analysis. If the claimant proves that he or she cannot do any past relevant work, the burden shifts to the Social Security Administration to determine if there are other jobs available. This becomes important at a hearing, as an administrative law judge at hearing will have a vocational expert present to testify as to the availability of jobs for a person matching the claimant’s residual functional capacity. If it is established that he or she cannot do past relevant work, the onus is on the judge to establish that there is other work available. If the judge does not question the vocational expert about the existence of other jobs, by definition the Administration has not proven that there are jobs available for the claimant.
These issues can become very esoteric. Consult a Social Security Disability attorney if you have any questions about the disability adjudication process.

Written by Adam Kachelski

Adam Kachelski is a 2014 graduate of the University of Wisconsin School of Law. He lives and works in Cincinnati.

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Social Security approved me for disability benefits, now what?

Social Security Disability Insurance and Social Security Insurance are the two benefit programs that a disabled person can submit a claim for. While both benefit programs are for disabled individuals, they slightly differ in the requirements. Social Security Insurance(SSI) are for individuals who have not worked but are disabled and have little to no income or resources. Social Security Disability Insurance(SSDI) are for individuals that paid FICA taxes over many years. So for this program, you do not need to meet income limits in order to qualify. A finding of disability and the required work earnings are sufficient.

It may have been a long and frustrating road to get to this point but you are finally here. Your decision, may it be fully or partially favorable is now a reality. You are given back your independence and now know that you will have the ability to pay bills and buy the things that you need. Now, you’re wondering how long will it take to get your money. Unfortunately, you may have to wait another 1-3 months before you receive your first payment.

Social Security Supplemental Income(SSSI) will consider your resources such as spousal income, cash, bank accounts, stocks personal property, vehicles, life insurance, and anything that can be exchanged for cash. Social Security Disability Insurance(SSDI) will consider other employment or disability money received during the time your claim was pending such as, unemployment benefits, workers’ compensation, or long term or short term disability payments. Social Security will have to verify all sources of income before sending you your first check. However, being upfront and having these documents readily available could be of benefit in terms of speeding up this process.

 

For more information, please contact the attorneys at Hoglund, Chwialkowski, & Mrozik PLLC.

By Shana Knotts

Written by Shana Knotts

Shana joined Hoglund, Chwialkowski & Mrozik in October 2012 and works in the law firm’s social security department. As a senior paralegal, she works diligently to support our attorneys post-hearing. She also oversees our medical records department, ensuring records are submitted in a timely manner. Originally from Florida, Shana graduated from MSB with a B.A. in Paralegal. She then went on to work at a Social Security Advocacy Firm, gaining in-depth knowledge of the social security process. This experience allowed a smooth transition to Hoglund, Chwialkowski & Mrozik in 2012. In her free time, Shana enjoys traveling, reading, watching movies and spending time with her husband.

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Client Communication

When attorneys meet clients for social security disability cases, they usually have a lot of questions.  First question usually is, how long does the social security disability process take?

It is important for the social security disability attorney to explain each stage separately and that on average, a client will likely end up at hearing before being approved, if they are ever approved.  This will take over two years.

It is important that clients are aware this is normal and having low income or significant pain or difficulties will not speed their case up.  Getting an attorney in general does not speed the process up, but the proper attorney will make sure appeal deadlines are not missed, that all the medical records are ordered and received, and that the claimant is prepared when the hearing time comes.  This is primarily why it is prudent to hire an attorney.  Clients need to have realistic expectations of this long process.

Another frequently asked question is can I work?  Although attorney can quickly explain SGA limits, which is currently $1,130 before taxes, it is important to go beyond that, and discuss that this is an inquiry to be made with their doctor. Discuss working restrictions from a physical and mental aspect with their doctor beyond just the allowable dollar amount from social security is prudent.  Attorneys know that this is a long process and people need to get by, but these questions need to be discussed with counsel and a doctor to make the most informed decisions.

Client communication is an ethical obligation and an important aspect of effective representation in a social security disability case.  For example, an attorney cannot be effective if the claimant does not give the attorney all of their medical sources and symptoms of their conditions, and a client cannot be helpful if they are not made aware of how the process works and what the social security looks at.  Communication is key to obtaining benefits.

 

By Joshua Tripp

Written by Joshua Tripp

Joshua Tripp practices in the social security disability department of Hoglund law offices. Prior to focusing on social security disability alone, Mr. Tripp has practiced in several civil areas of the law including personal injury, probate and family law.

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The Importance of Choosing the Correct Onset Date

When applying for Social Security Benefits, you will need to fill out the initial application to get your claim started. On this initial application, you will put in the start date of your disability. This date is known as your Alleged Onset Date. It is a date that Social Security will use to build your case.  Sometimes it may not be as easy to pinpoint this date. However, it is strongly recommended that you try and choose as close of a date to when your condition(s) begin to worsen. There are many signs that lead up to figuring this date. One example would be a decrease in your work hours or having to end your employment. It is good to keep a journal of any major medical events that have affected your daily routine. Also, it is important that you speak to your doctor about any disruptions that you are experiencing in you daily routines due to ongoing symptoms. The more information you have in your medical records, the more of a benefit it will be to you when choosing you Alleged Onset Date.

Social Security does not always agree with the date that you have chosen. If Social Security chooses a different date, it will be a later date. Your medical records may support a different date of disability. The change in the Alleged Onset Date (AOD) by Social Security is known as the Established Onset Date (EOD). The newly Established Onset Date (EOD) chosen by Social Security may affect the amount of backpay that you receive. You can Appeal this decision if you do not agree with the date that Social Security has chosen. Having an expert to assist you through the process would help you avoid mistakes.

 

Please contact one of our attorneys at Hoglund, Chwialkowski, Mrozik, PLLC. today for more information.

Written by Hoglund Law

The attorneys of Hoglund law are licensed in Minnesota, Wisconsin and Ohio. Hoglund, Chwialkowski & Mrozik, PLLC is based in Roseville, Minnesota. In addition to handling cases involving bankruptcy & social security, Hoglund, Chwialkowski & Mrozik, PLLC handles faulty drugs and toxic exposure.

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