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Montclair Social Security Disability Law Blog

A denial of a New Jersey SSDI claim need not end the case

As our readers may know, New Jersey residents who have an inability to work due to a physical or mental disability may be eligible for benefits through the federal Social Security Administration. The most common form of these benefits is Social Security Disability Insurance, which is paid for out of funds deposited by people out of their wages during their working lives. However, as we have mentioned, not everyone who applies for SSDI is approved.

This is especially true when we consider the first stage of an application for SSDI benefits. Many times, people without much money and with physical or mental difficulties are trying to file somewhat complicated paperwork and gather sufficient evidence to allow the SSA to approve their claims. Unfortunately, on a regular basis, the SSA officer charged with reviewing the case will deny cases the first time around, either due to insufficient evidence or because the focus of the application may not have been on the most important aspects of the case as seen under the statutes and regulations governing the system.

What is the maximum SSI payment a New Jersey resident may get?

This blog has discussed quite a few of the basic differences between the two main federal disability benefits programs. New Jersey readers may remember that these two programs are Social Security Disability Insurance and Supplemental Security Income. Of the two, SSI is more restrictive and difficult to receive, and is meant generally for those with limited or no assets who have not paid enough into the social security system prior to becoming disabled. For people who have an inability to work due to some kind of physical or psychological disability, however, the SSI program may be the difference between being completely dependent upon others and being at least partially financially autonomous.

So, we’ve previously discussed some reasons one might be eligible to receive SSI, but perhaps what one really wants to know is: how much can a disabled person receive under the program? Well, the Social Security Administration puts out a publication which details the maximum amount of cash benefits that can be received by individuals in New Jersey from SSI. As with most benefits programs, these amounts will vary depending upon a person’s situation.

What is a 'somatoform' disorder in mental illness disability?

This blog has previously talked about the fact that, because of their tendency to have somewhat subjective symptoms and effects, mental and psychological disabilities may be more difficult to deal with for those who make determinations about Social Security Disability Insurance at the Social Security Administration. The frustration that some New Jersey applicants may feel when having to prove their mental illness can be multiplied when that illness is some form of 'somatoform disorder.'

A somatoform disorder is one in which some kind of physical symptom is manifested in a person for which no physiological or other organic cause can be found. That is, if someone goes blind and has a known physical disease such as macular degeneration, or some injury to the retina or optic nerve, it can be said with some certainty that that physical cause is the reason for the disability. However, in the case of what has been sometimes called 'hysterical blindness,' a person simply ceases to be able to see, but there is no obvious problem with the physical portions of the eye and those parts of the brain known to deal with vision. This may be considered a form of somatoform disorder.

What is the physical component of 'RFC' in New Jersey disability?

About a month ago, this space discussed the concept of 'Residual Functional Capacity' as it relates to the way the Social Security Administration evaluates applications for Social Security Disability Insurance or Supplemental Security Income. At that time, we presented a general overview of what RFC is and how the SSA utilizes it in the context of determining whether an applicant has an inability to work. This week we will take a closer look at one of the specific components that may affect RFC, and that is an applicant's ability to meet the physical requirements of work.

New Jersey residents who have suffered major injuries usually have some physical component to their inability to do the work they did previously. As you may remember, the SSA will analyze a claim for disability based on evidence that you provide, both from medical sources and others who may be aware of your limitations. Code of Federal Regulations Section 416.945 sets out the basics of what kind of limitations the SSA will look at to evaluate a claim. For many injured workers the most important category on this analysis will be his or her physical limitations.

What is the SSA's Appeals Council in an SSDI case?

This blog has discussed many aspects of New Jersey residents' potential Social Security Disability Insurance claims. From the various requirements to be considered disabled for certain disorders according to the Social Security Administration's "Blue Book," to the wait times for getting a hearing before an Administrative Law Judge if the SSA denies a claim, we've covered quite a bit of the process. About a year ago, the blog did a thumbnail sketch of the entire appeals process, and this week, we'll take a slightly closer look at one of the components of that process: The Appeals Council.

We've discussed the fact that New Jersey residents who feel an ALJ treated them unfairly can file a complaint with the SSA. However, an applicant can appeal an ALJ's decision whether or not the ALJ was unfair, or just made another kind of mistake and got the decision wrong. To do this, the applicant must request an appeal in writing with the Appeals Council, or call the SSA office to get a form to fill out. This must be done within 60 days of the receipt of the ALJ's decision. Unless there is proof otherwise, the SSA will assume that an applicant received notice of the ALJ decision five days after it was mailed. Failure to meet this deadline may result in loss of the ability to appeal.

SSA stops seeking repayment for 'Windsor' SSI overpayments

In general, recipients who qualify for Supplemental Security Income (SSI) have few financial resources. Due to the federal legal guidelines for the program, SSI recipients must show that they have very little income and almost no assets. Thus, for some New Jersey beneficiaries of the program, it may have been a surprise to learn that the government wanted them to repay money they received due to the government's own mistake.

When the U.S. Supreme Court handed down the decision in the U.S. v. Windsor case in 2013, it found a federal statute prohibiting the federal government from recognizing same-sex marriages as unconstitutional, which in turn, put those marriages on the same footing as heterosexual marriages throughout the country, instead of only in certain states as had been the case previously. This included for the purposes of federal governmental benefits. People who had been legally married in those jurisdictions that allowed it were suddenly recognized as spouses for a host of federal purposes, among them, SSI.

How many people in New Jersey get disability for mental illness?

When people in New Jersey discuss Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits, they often think of people with physical disabilities that make them unable to work. While these conditions certainly manifest in the population that receives SSDI and SSI benefits, there are also a number of people who receive the assistance based upon mental conditions. One question that may come to mind, however, is how large a population is it that receives disability for mental illness?

According to the Social Security Administration (SSA), in 2013, which is the last year for which complete numbers are available, over 3.5 million people received disability benefits based on some form of mental illness. By far, the largest category of mental disability was people who suffer from mood disorders, with almost 1.5 million people receiving benefits based upon these conditions. Mood disorders can include anxiety issues, depression and problems like bipolar disorders. The second-highest nationwide category was intellectual disorders, with over 800,000 individuals receiving benefits for those conditions.

What does 'RFC' stand for in New Jersey disability cases?

We've talked a fair amount about the basics of specific conditions that could cause one to be eligible for Social Security disability insurance benefits due to an injury. This blog has touched on lower and upper bodily injuries, as well as potential back problems that could lead to a disability. In this installment, let's look at a somewhat more general concept that still may have quite an impact on how the Social Security Administration might evaluate a New Jersey resident's SSDI application.

In the Code of Federal Regulations, Section 416.945 defines what is known as "Residual Functional Capacity" (RFC.) In layman's terms, RFC is that level of activity that you are capable of performing after the effects of your disabling condition are taken into account. In other words, what, if any, activities can you still perform? Keep in mind, the SSA isn't just going to take your word for what you can still do -- they are going to look at evidence. To do this, they will consider the evidence you present in the form of lab results, doctor's reports and other medical information, and also possibly statements by friends, neighbors and co-workers about your abilities. They may also attempt to get more information from your own physicians, or send you for a consultative examination.

Is there recourse if I feel my SSDI case was treated unfairly?

This blog has previously discussed the basics of appealing a denial of Social Security Disability Insurance benefits by the Social Security Administration. Most recently on this subject, we touched on the fact that it can take some time for a case in New Jersey to be scheduled for a hearing before an Administrative Law Judge (ALJ.) So, after waiting all this time, what happens when one appears at the hearing and feels he or she has not been treated fairly?

It should be remembered that most ALJs take their jobs very seriously, are handling many cases and are attempting to sift through the evidence they have to the best of their abilities. It is important to remember that just the fact that the decision has gone against one does not mean there has been unfair treatment. There should be some evidence that something was amiss, either through the words the ALJ used, the evidence he or she allowed to be presented or the weight he or she gave to certain evidence. If this indicates potential problems with the neutrality of the arbiter, what can an applicant do?

What is an 'emergency advance payment' for SSI?

Most people, at one time or another, will face unexpected events, be they natural, medical or familial, that will create a situation in which they are required to spend more money than they had budgeted during a certain time period. Many people use credit cards or savings to get through these tough times. However, those New Jersey residents who are on a restricted income due to disability and have few assets in their names, may find that their lack of finances can threaten their very well-being.

The Social Security Administration (SSA) has a program that may apply to certain individuals who find themselves in this dire situation. Called an "emergency advance payment," it allows the SSA to make a one-time payment to people who should be receiving Supplemental Security Income, but who haven't received their payments or have had their payments delayed. To be eligible, the person must be eligible for SSI , must be due a payment and they must be facing a financial emergency, in which is individual needs the funds immediately to avoid a threat to his or her health or safety, such as not being able to afford, clothing, shelter, food or medical care.

You won't know if you have a legitimate claim unless you talk to an experienced attorney. Get in touch with me today.

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