Answering your SSDI Questions (Part 1) | The Disability Benefits Podcast #39

In this episode, we answer your questions about the disability process. Social Security institutes a lot of rules for you to follow and forms to fill out. We're here to guide you through any step of the process!

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Disability Consulting, LLC
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Disclaimer: We are a non-attorney firm. Our company specializes in representation for Social Security disability claims and is not a law office. The information provided in this video is for general informational purposes only and does not constitute legal advice. For legal guidance specific to your situation, please consult a licensed attorney.

Transcript

SPEAKER_02 0:00

Okay. Well, it's been a month or two, so we'll do kind of a part one episode and then also part two and just responding to people's comments. Sure. Some of them are question comments and some of them are just comment comments or just statements. Some did comments. So we'll uh we'll hop right into it. So Paul asks, how far back do you need medical records? And I a lot of these I know that we've talked about them in the past, so some of them were will be pretty short, and some of them will be you know spiral into a whole conversation. But yeah, how far back do we need the medical records?

SPEAKER_01 0:33

Great question. Um and there is an absolute answer. Social Security wants medical records one year prior to your onset date. So if you're on, you say you became disabled in January of 2025, they want records back to January of 2024. Um, the only um caveat to that would be mental health records. Sometimes they want to go back um a little bit further, especially if you've had an inpatient stay, mental health inpatient stay, they might want those records. But as a general rule, 90 plus percent of the time, one year prior to the date you became disabled is what they're looking for.

SPEAKER_02 1:11

Cool. And if you've been diagnosed with any kind of psychosis, for example, and you've had an inpatient stay and it was three years before your onset date, then you should probably go ahead and include that as well.

SPEAKER_01 1:20

Absolutely, yeah. And that and they'd want that. Yeah. You know, because that that gives them some kind of uh history. And it's interesting, but you know, physical conditions, they they seem to, you know, especially if there's a trauma, they seem to just appear. Yeah. Um, or they appear more quickly. Whereas mental health conditions, they seem to kind of just creep up on you. And that's why they they're sometimes wanting older medical records.

SPEAKER_02 1:45

Cool. And then I'll I'll add this. I know the answer to this, but what does Social Security do if you give them way more medical records than uh than they need? So instead of one year, you give them past 20 years of medical records while you're still working full-time.

SPEAKER_01 2:02

Um they will soundly ignore it. Yeah. Um just a waste of time. They don't they don't really trash things anymore because everything's electronic, but they would virtually trash that. Because it's just yeah. They're not gonna they're not gonna go through it because that with Social Security and with disability consulting, the number one thing that takes our time is to read medical records. And people ask me, you know, wait a minute, you know, my medical file's 700 pages. Are you telling me that you read every single page? Yes. I read every single page. Social Security is supposed to read every single page. Um, so it's it's a really um intense, involved, and time-consuming endeavor. So, yeah, if you you know, and not to be mean, but if you gave me 20 years of your medical records and I say, well, when did you become disabled? You know, well, last April. But you'll but you'll see how bad things have been for 20 years. You've been working for the past 20 years. Well, yeah, but you'll see how bad they are. And I don't want to hurt your feelings, but I one, I'm not going to read the medical records. And, you know, from a business and logical standpoint, I don't have time to read those kinds of records. You know, I'm going to read what pertains to the disability, what I can use to prove your disability to the Social Security Administration, and anything else is just kind of a waste of time.

SPEAKER_02 3:27

Yeah. And that that's important for clients to know. It's it's not just that we would prefer to only have one year prior to their onset date. If you're a client and or you're a claimant and you think that, well, I'll give Social Security instead of one year, like they're asking, the last five years or 10 years, and that'll give me a better chance of approval because they'll have more to go off of, it's just a waste of time. It's not gonna Okay, yeah.

SPEAKER_01 3:49

Yeah, it's a waste of time. Absolutely.

SPEAKER_02 3:51

Cool. Okay. Um, next one, this is also from Paul. Um, so the context is when a representative fails to properly represent their clients. Um, Paul also says, uh, happened to me with my last one I tried back in September. Thank goodness I found your company and never had a problem like I did. Your company's on top of things and easy to ask questions about my case. That's one of those comments, but same same person.

SPEAKER_01 4:17

So I've said it before. Um I would love to be able to say that there's only us, and you only need to come to us because we're the best in the whole wide world and nobody else is any good. I wish I could say that, but that's not the truth. There are very, very capable representatives doing it as long as I've been in it, or even longer. Not very many of them, but but you know, there are some really good ones out there. And there are some really bad ones, and you can normally tell the bad ones with these telltale signs. Paul is exactly right. I couldn't get in touch with them, they didn't seem to be on top of things. Um, you know, it it's always a to me a red flag. If I hear my uh a client who was with somebody else said, yeah, I would call them and I would tell them about this and this and this. The next time I talked to them, which took a long time for them to respond to me, they asked me about the same thing that we talked about. Obviously, they hadn't documented it. And, you know, we are we are crazy about that. I tell my I tell everybody in my company, whether they're a case manager or a rep or not, everybody in my company has to document with the five W's of German journalism. Who, what, when, where, why. They have to. Every single phone call. What do you mean, every single phone call? It lasted five minutes. Every single phone call. And that way when they call back next week or they call back next month, oh yeah, yeah, okay. I see what you yeah, you know, Dr. Jones, we're getting with Dr. Jones. We did request those records. We we know what we're doing because we've documented that, and we can open the file and see immediately what's gone what's gone down in the last, you know, however long it's been.

SPEAKER_02 5:53

Yeah. I yeah, I completely get where the client's coming from. I mean, that's just the worst client experience in social security disability, but also just any kind of client um, you know, relationship is you tell someone all your problems or what you need, and then okay, and then the next call, you go over the same thing, and then the third person's like, so what can I help you with today? And it's like, yeah, just forget it, you know. It's yeah, yeah. That's and that's unfortunate, or unfortunately, that's very common.

SPEAKER_01 6:18

But there are good ones out there, you know. I I I don't want to be one of those reps that uh there's nobody else but me out there. There, there's some good ones out there. Um, but you'll know it. I mean, telltale signs, you'll know it. If they don't answer the phone, telltale sign. If they answer the phone every time and they remember a conversation that you've had, they're they're they're on top of things usually.

SPEAKER_02 6:39

All right. Next question from the viewer. They say, What does one do if you have to pay for the electric bill, phone bill, and food? I work 18 hours a week and make $14 an hour. Why would you refuse me? And so I'll I'll kind of break down that last part of why would you refuse me? Because I know they don't mean it to be super hostile, but we need to be really clear. It's like it's not our company and social security versus this claimant applying for disability. It is the claimant and our company, or you know, our representation versus social security. And so if they denied the claimant, they denied us. That's right. We're not gonna refuse them, we're not gonna deny them. Um, but yeah, so that's with that being said, yeah, person works 18 hours a week, being $14 an hour, um, so they're still working. What can you say about that?

SPEAKER_01 7:31

Yeah, I mean, that is it's one of those catch-22 questions um or situations. And you're exactly right. And if nothing else our answer to this question, it needs to be stated like you just stated. It is never disability consulting us or partnering with Social Security to help you win your way through the claim. Social Security, they respect me, they interact with me, and on some occasions they hate my guts because I'm arguing not only that somebody's disabled, but that they were idiots to deny them in the first place. I had a hearing this morning, 61-year-old, denied twice. Then okay, well, denied twice. And you read the read the medical records. They literally said in the medical records that, well, yeah, she wouldn't be able to do things as quickly as other employees, but she could probably do a desk job. So you basically said that she's disabled. Yeah, she's not able to do things as quickly as other employees. That is a telltale sign of disability. Um, and of course, the judge, it was 12 minute 12-minute hearing. The judge was like, Can you do this? Could you do that? Can you do this? And medical records don't show that you could do that. I mean, it was, you know, 12 minutes. Um and so the lower levels probably didn't like my brief about how there was no reason for them to deny her. Um we partner with our client. I don't have any kind of affiliation with Social Security Administration. I used to work for them, I haven't worked for them in 22 years. Um, nobody in my company works for Social Security or has any kind of affiliation with Social Security. Um most of the times they are the avenue by which we have to travel to do the case, and sometimes they're the enemy. And that's just the way it is. Um, and I would I would think some of them would see the same thing with me. Well, okay, well, you're trying to get Mr. Jones' benefits, you know, and we don't believe he's disabled, you know, you're the enemy. That's the way that the claimant needs to understand. We are not on Social Security side. We're arguing against them almost from the get-go. We're arguing against them. Um, definitely arguing against them after they denied you. Denied you the first time, denied you the second time, you know, we just keep puffing out our chest and getting a little bit more aggressive. But back to his question or his scenario, it's a catch-22, which is I I can't make ends meet. What am I supposed to do if Social Security doesn't believe I'm disabled? And it's an unanswerable question. Um we are very sensitive about taking cases where earnings are involved. There has been in the last, well, probably since COVID, when um and social media advertising, um they they want to shock shock you so you'll click, you know. Have you heard that you can't work um and draw social security disability benefits? That's not true. Click, I want to hear about that. You know, I'm still working, yeah. I'm going to work and I, you know, you're at work while you're my knees killing me, and I, you know, uh, well, okay, it was clickbait, and you clicked on it, and you know, they want you to put in some information and they might contact you. And you're under the impression because they they declared it right out of the gate. Have you sh heard that you can't work and draw Social Security? That's not true. Well, it's not true, but then again, it is. Because if you're working at a certain level, and it doesn't matter if it's 18 hours if you're making decent money, and uh, you know, it's just there are limits, there are thresholds. And if you're above the threshold, you're above the limit, they'll never get to looking at you in a medical way. Yeah, it'll never get there. So we are very sensitive when somebody says, you know, well, I'm working, you know, at like this guy, you know, 18 to 20 hours a week. Okay, that might be below the limit. But before I expend a tremendous amount of time with my company, tremendous amount of time for me, tremendous amount of money to pay all the people in my company, I want to make sure that you're not telling me sometimes I only work 18 hours. Well, last week I worked 28. And next week I'm scheduled to work 30. But, you know, 18 hours, and and I'll need pay stubs, and people just really bristle at that. What do you mean you need my pay stub? I need to be able to tell Social Security what your earnings record is gonna show down the road anyway. Social Security, in every single case, every single case, they run an earn earnings query on you. If you filed your taxes, even if you were self-employed and you filed taxes, it is going to be showing up on your earnings record, and social security is gonna ask you about it. Um, the amounts that you write in there, that just becomes like sworn testimony. You know, I made sixteen thousand dollars that year. Okay, and you go in and tell Social Security, oh, I only made about ten thousand that year. Well, your earnings record shows that you made sixteen thousand. That that's a difference, it's a big difference. So I don't have a great answer for that um scenario. Um and a lot of people ask me, you know, what am what am I supposed to do in the meantime if I do take the case and they're not able to make ends meet, you know? Well, Mr. Groves, what what do I what am I supposed to do in the meantime? I've got to eat, I've got to pay rent. Yeah. And it is a horribly, horribly hard question because I don't have a good answer. I can't really, you know, I I can tell you, you know, there's these kinds of programs, there's these kinds of programs. You might already be, you know, taking advantage of of some of the stuff that's out there for you. And if you're not, I might be able to refer you. You know, we do have some some knowledge of some resources like that, but it'll it'll almost always be unsatisfactory to you. I I won't be able to fix the problem because the only thing that really fixes the problem is if I win your case. When I get to the end, I win your case. You're gonna usually get a chunk of change, which is gonna help you, you know, pay some old bills. You're gonna get a monthly benefit that you can count on, um monthly uh amount of money you can count on. Yep. And um eventually you're gonna get medical coverage too. It might not be immediate, but you'll get medical coverage, and I mean those things are big. But in the meantime, it's always the question that you know we kind of hang our heads, you know. I don't have a great answer for that. And so I don't have a great answer um for him.

SPEAKER_02 14:25

Yeah, and I'll just say, you know, the threshold that you're talking about is called SGA substantial gainful activity. And we have done uh several videos on if you know, can you still work and receive benefits? Can you work part-time? What is SGA? So for any viewers or listeners, if you want like an actual deep dive on how that works, working and still qualifying, um, just go to our page and and look at those.

SPEAKER_01 14:49

Yeah, just but just be aware, you know, it it's going to be something that you know we cock our head at when you tell us, you know, yeah, well, I'm still working, but I'm disabled. Okay, and that that could very well be the absolute truth that you you you're not above the threshold and you are disabled, and I can win your case. And I win them all the time. It happens all the time. I can do that. But don't be surprised if I want to see your pay stubs for the last you know several months, or I want to see you know 2025's tax return. Yeah, don't be surprised if if I want that because I need to know that what I'm telling Social Security is the truth. Yep. Um it it it it impacts my credibility if I'm like, well, this guy hasn't worked but you know, 10 hours a week for the last three years, and he made 30 grand last year, and he made 30 grand the year before that, and I'm like, oh, oops. So yeah. You can't do anything with that. No, yeah, we we we want to avoid that.

SPEAKER_02 15:45

And a lot of times that happens when the case is to the point where it's too late. Yeah, you're you're stuck with a case. Maybe you're in the middle of a hearing and you're like, Well, I just lost the case and there's nothing I can do about it because of these earnings.

SPEAKER_01 15:56

I've I've had many hearings where we get through the beginning of the hearing, you know, they swear the claimant in, you know, this is what we're here for, and blah, blah, blah, blah, blah, blah, blah, blah. And before I ask you some questions, Mr. Jones, I'd like to ask something from Mr. Groves. And I'm yes, Your Honor. And Mr. Groves, what about these earnings in the second and third and fourth quarter of 2025? You know, because a lot of times we don't get access to that until the very last minute. And uh, and if we've missed it, um, we normally don't. But if we've missed it, it's like, uh, you know. So yeah, and you don't you as a claimant, you don't want that to happen. I certainly, as the rep, don't want that to happen, but as a claimant, you don't want it to happen either. Yep.

SPEAKER_02 16:41

Okay, good. Next question. Kathy asks, on your RFC, how does the judge determine what your limitations are? Um I guess a a better better way to get into that is just if you could explain RFC and how that when someone fills out any kind of forms or any kind of verbal test clause testimony that they give, how does that actually like what is the whole RFC thing? How does a judge make a decision based on that?

SPEAKER_01 17:08

Sure. They have to. I mean, the you as a claimant, you have to have an RFC, which stands for residual functional capacity. Basically, after your impairments, what are you still able to do? What's your residual functional capacity? What can you do, you know, even though you've got these limitations? And are the limitations high enough to where you're disabled? And that's basically what the RFC does. But the way that they come about to an RFC is um really there's only two ways they they go about it, and that is what are the medical records show? And that's the most important thing. What are your medical records show? Yeah. Okay, I've got severe degenerative dysdise in my lumbar sacral spine at L4, L5, and S1. And those are just just your vertebrae. Yeah. Um, okay, well, that's medical records. It's objective. Nobody can disagree with that. I mean, it there it is. Okay, well, then I fell out of form. You know, I can't be on my feet for more than 10 minutes at a time and sitting in a work position like I'm sitting right now, my feet flat on the floor and bent at the waist, like I'm at a desk, or I'm typing on a keyboard. Um, I can't do that for more than a few minutes at a time. That's gonna impact your RFC, your residual functional capacity. So you got this low back problem, and it impacts your ability to stand and walk, and it impacts your ability to sit. Well, guess what? There are only two bodily positions that you can work in, and that is on your feet or on your butt sitting down. So that's gonna impact you, and what's gonna happen is an adjudicator, sometimes a d doctor, but not always, but an adjudicator is going to say, okay, well, this degenerative dys disease that's severe at the those lower levels, yeah, there's no way that they could be on their feet. So I'm gonna say that, you know, a few minutes at a time throughout a workday, two hours. You know, eight-hour workday, if you add it all up, not at one time, but all add it all up, it's two hours. And um sitting down, you know, if they took breaks and they worked it out and they were able to squirm and do that, we're gonna say they could probably do that for four hours. Okay, well, a residual fact functional capacity evaluation also has how much can you lift or carry? You know, well, with that problem, that low back problem, they should not be lifting anything heavy. I would say maximum ten pounds. So now you have an RFC. What is lifting carrying 10 pounds? Standing and walking, two hours, sitting four hours. Well, sitting, standing, and walking have to equal eight hours, or else you're disabled within the meaning of the law. If you're a certain age, and let's say that you could sit for two hours or sit for for six hours basically, but you could only be on your feet for two hours, well, that would probably limit you to a desk job. You know, that's called a sedentary RFC. And that's what they have. They have strength levels. So a sedentary RFC, a light RFC, which is a little bit higher, like a cashier, uh sewing machine operator, um, uh medium RFC, uh over-the-road truck driver, forklift operator, and then heavy RFC, construction worker.

SPEAKER_02 20:10

Um heavy's like you're doing a lot of stuff.

SPEAKER_01 20:12

Yeah, heavy, heavy is you're lifting up to hundred pounds. Yeah. And then there's very heavy, and that can be like like a concrete worker or a professional wrestler. Yeah, yeah. It's you know, if you've got a very heavy pass job, it's you know, you you've done some serious, serious manual labor. But the RFC basically they marry that with what you say on your forms. You know, well, I can only be on my feet for a few minutes at a time. I can only lift about, you know, five or ten pounds. Um, there are other things they're called non-exertional limitations, but lifting, carrying, standing, walking, and sitting, those are all what are exertional limitations. Non-exertional limitations would be your posturals. Can you bend you? Can you stoop? Can you balance? Can you crouch? Can you kneel? Can you crawl? Manipulative restrictions. Um, can you find uh manipulation is buttoning, you know, using a pen. Uh gross manipulation would be lifting a box, you know, and all these things have limitations on it, and it comes from your medical records, yeah, and comes from what you tell Social Security you can or cannot do. Um, mental health limitations are all non-exertional limitations. But how long can you concentrate, stay on tasks, finish things through to the end, get along with others, others get along with you. Can you respond to changes in uh in the workplace? There are always changes in the workplace. Um, some of them are very mild and gradual, and some of them are your boss peeks his head over the the cubicle wall and he says, I need you to do this and I need to do it now. We've got a customer that's I rate. Okay, it's a quick change, and you know, can you handle that kind of stuff? Um so that will be in your medical records and the things that you say in the forms that you complete. So that is an RFC, residual functional capacity, and um Social Security. They use it at every single Single level. The initial level, recon level, hearing level with the judge. Judge is the one who usually comes up with the RFC. Medical doctors or psychologists or psychiatrists at the lower levels. And then the appeals counsel, they can do it too if they want to. They can come up with one. And then the federal, federal courts, I don't think they they mess with that, but they'll differ. Yeah, it's a little bit different, but they still use them. Yeah, yeah. They may not come up with them, but they still use them. Yep.

SPEAKER_02 22:30

Okay. Well, last one for us to end it on. It's not a question, it's a comment. Um, and I'll kind of respond to it, and I know you'll agree with me. And this is just it's a client that says, I have severe stenosis, carpal tunnel syndrome, peripheral neuropathy, was denied at initial on the reconsideration step. That's all they say. And um you you can't say, like, I can't look at this and say, well, if you have carpal tunnel syndrome, we can definitely win your case, or you're definitely disabled. But at the same time, stenosis, uh, neuropathy, carpal tunnel syndrome, especially if it's affecting your, you know, your hands and your wrists, um, that's intense. That's really severe. And unfortunately, it's not surprising for us to see someone like that get denied. So this person, I think they're kind of just saying, I have all this stuff and I was denied and I had to appeal it. Yeah. That is outrageous. Um, we I would have to talk to this person, but it's it's not surprising. Yeah, it's common.

SPEAKER_01 23:27

Unfortunately, you know, that it's job security for the representative community. You know, there's there are thousands of us out there, and I don't think there's still enough of us with the number of people who get a no from their government when it's just obvious, you know. Absolutely. I mean, and it's not a question, but I'm gonna give you some unsolicited advice. Take my attitude when Social Security says no, that it's not a no. It's just that you haven't convinced them yet. Yep. What's the secret to a disability claim? You know, all my friends, since I started doing this 35 years ago, what's the secret? What how do you win? What's the secret? There is a secret. Persistence. Keep going. I mean persistence. Um give me a better secret. There's no better secret. You know, they say no to you, you appeal. They say no again to you, you appeal. Persistence is the name of the game.

SPEAKER_02 24:29

Yeah. Makes a lot of sense. Um, and at the reconsideration phase, you know, I'll I'll be cutthroat and I'll just say it. There's a high likelihood this person gets denied a second time. Sure. And then our whole sentiment about persistence is even more important because appealing at a second time, going to the hearing level and having uh uh the opportunity to actually talk about your condition, it's the highest chance of approval at the hearing level.

SPEAKER_01 24:51

And it's no accident, you know. When you get to actually communicate with somebody in real time, and it's the only time you get to do that in the whole process at the hearing level, you get to communicate with an adjudicator who has the power to allow your case, and he gets to hear or she gets to hear you speak and tell your story, and they can tell, uh, okay, this person's telling the truth. Yeah, that it's no accident that the overwhelming number of cases that are allowed in the US are allowed at the hearing level.

SPEAKER_02 25:22

Yep. No accident. Yeah. Keep going. If you want our help with representation, definitely give us a call. Sounds like a a case we could help you with. Okay. We'll leave it there. Cool. If you have a question about your disability case, drop it in the comment section below, and we will do our best to answer it in the next episode.