2004/05 Winter GBS Newsletter…

Sean,

I tried to bring up the weblink for this but couldn’t.

Winter 2004/05 GBSFI Newsletter, [I]The Communicator,[/I] [B]Understanding Social Security and Disability Rules,[/B] By Owen Katzman, Administrative Law Judge, Philadelphia Office of Hearings and Appeals

The concept of disability as used in the Social Security Act is really quite elementary, but it differs from more well known concepts of disability as used in Workers Compensation cases. In workers comp cases, the worker has to prove that he/she cannot perform his/her past job. Under the Social Security Act, the claimant must prove that he/she cannot perform any job that exists in substantial numbers in the national economy.

A “disability” can be physical or psychological in nature, or a combination of both. Your disability must be established by medical evidence. You cannot just walk into the agency and pronounce yourself disabled; you must establish your disability by medical evidence (in the form of treatment notes from doctors or psychologists, along with appropriate testing, like x-rays, MRIs, cardiograms, EEGs). Once you show that you have a medical condition, the agency will accord greater weight to your complaints about what you can and cannot do, so long as your complaints are reasonably consistent with the medical evidence.

Procedurally, there are multiple levels of appeal available to an unsuccessful claimant. Don’t just assume that a denial at the first step is the end for you. Agency statistics show that more than half of all appeals filed at every appellate level are successful.

Initially, your claim will be evaluated by a State agency formally designated by the Social Security Administration. That State agency employs doctors whose job it is to evaluate the medical documents and other materials that a claimant submits. In most states, a person who is denied can seek reconsideration, and a different doctor employed by the State agency will take another look at the case. If the case is denied at the reconsideration level, you can appeal and ask for a hearing before an Administrative Law Judge (ALJ). (The reconsideration process has been eliminated in some states and may be eliminated in all states in the near future.) Your hearing before the ALJ is usually the only time a claimant can appear in person and explain the facts of the case.

After the ALJ issues a decision, there is one appeal left within the agency and several levels of appeal within the Federal court system. [B]END[/B]

Hope this helps in some way.

Best regards.

Jethro