What this Book Includes: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15.
16. 17. 18.
Page
Top Ten Tips to Help You Win Your Case 7 Attorney Practice Tips (throughout book) How to complete an application 20 How to review medical evidence 29 How to prepare a legal argument and for a hearing 27 How to prepare a medical expert and vocational expert examination 43 Sample hypothetical – Vocational Expert 48 Sample Medical Expert questioning 54,55 Seven step testimony process 40-42 Two step vocational expert process 47-49 Medical expert 3 step harvest process 52,53 Seven step argument approach 27-32 Three step equivalency argument process 35,36 Three step med-voc argument process 17-19 Hyperlinks to the Social Security Disability (Addendums A,B,F,G,K) regulations, rules, rulings, listings and other informative links 66 - 103 How to interpret the multi-axial system for mental health impairments and create an axes argument 50,51 Ten hearing day tips 58-60 How to close your hearing in the most advantageous way 59
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T A B L E
TABLE OF CONTENTS INTRODUCTION
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5
1.
CHAPTER ONE -
Top Ten Tips to Win Your Case
7
2.
CHAPTER TWO -
SSA Listings and Medical Vocational Rules . . . .. 13
3.
CHAPTER THREE -
How to complete an application . . . . . . . . . . . . . ..
4.
CHAPTER FOUR -
Appeal rights and Timelines . . . . . . . . . . . . . . . . .. 25
5.
CHAPTER FIVE -
Create Your Disability Argument . . . . . . . . . . . . . 27
6.
CHAPTER SIX -
Hearing at ODAR . . . . . . . . . . . . . . . . . . . . . . . . . . 38
7.
CHAPTER SEVEN -
How to prepare your testimony . . . . . . . . . . . . . .. 40
8.
CHAPTER EIGHT -
How to prepare for a medical expert and vocational expert examination . . . . . . . . . . . . .. 43
9.
CHAPTER NINE -
How to handle your return to work and the impact on your case . . . . . . . . . . . . . . . . . . . . . . .. 56
10.
CHAPTER TEN -
10 hearing day tips and how to conclude your Hearing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 58
11.
CHAPTER ELEVEN - Summary of all chapters . . . . . . . . . . . . . . . . . . . . 61
12.
ADDENDUM MATERIALS A – K (hyperlinks and sample: attorney arguments, letters, and forms) . . . . . . 65 - 103
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C O N T E N T S
I N T R O D U C T I O N
ULTIMATE GUIDE FOR OBTAINING SOCIAL SECURITY DISABILITY BENEFITS The Social Security Disability (SSD) program became law in July 1956. Between 1956 through 1960, the Social Security Administration paid SSD benefits only to those workers who were disabled and at least 50 years old. During 1975, to address the disabled who did not qualify for SSD benefits due to a lack of work history, the Social Security Administration (SSA) enacted Supplemental Security Income benefits (SSI) with a resource and income stipulation. In order to reach a larger portion of the disabled without creating an additional entitlement program, SSA added additional listings and medical vocational guidelines. However, the additional qualification criteria did not necessarily increase your opportunity to be granted benefits. Indeed, according to the Social Security Administration, 64% of 2010 filed applications (excluding child and disabled widower applications) received a denial based on Social Security Administration guidelines. See www.socialsecurity.gov/OACT/STATS What does this mean to you? You can hire an attorney or you can take on the Social Security Administration yourself. An attorney using a fee agreement (contingency fee) will generally charge 25% or $6,000.00 (the lesser of the two) of your retroactive payment as an attorney fee. An attorney that submits a fee petition may possibly charge more. However, you can represent yourself and save the $6,000.00 with proper preparation. Prepare, Prepare, Prepare and you will win your case! My ultimate guide will help you frame your case in the best light and increase your chances. My guide takes you step-by-step to build a successful Social Security Disability case from start to finish. With more than 15 years experience advocating for Social Security Disability benefits, I share my secrets of success with you. I include helpful attorney practice tips, hyperlinks to applicable Social Security
regulations, vocational rules, and other relative information useful for preparing your case. For example, in order to help you gather evidence to support your case, I provided samples of medical record request letters, follow-up letters, evidence submission letters to the Court, Motions for On-The-Record Decisions (formal and informal), Post-Hearing brief, a Court evidence response letter, and other helpful samples. The Social Security disability process does not have to be as difficult as the Administration makes it. Knowledge is power. You are about to learn the “ins and outs� of the Social Security disability process. You will be provided tools and materials which will enable you to win your case!
I N T R O D U C T I O N
C H A P T E R 8
Chapter 8
HOW TO PREPARE FOR A MEDICAL EXPERT AND VOCATION EXPERT EXAMINATION (examination of adverse witnesses) To begin, read your hearing notice. Verify the date, time, and whether a medical or vocational expert was requested to testify during your case. Under HALLEX I-2-6-74 and HALLEX I-2-6-70, the Social Security Administration must give you notice that an expert shall testify at your hearing by placing a statement of the request in the “REMARKS” section of the Notice of Hearing. www.ssa.gov/OP_Home/hallex/I-02/I-2-6-74.html and www.ssa.gov/OP_Home/hallex/I-02/I-2-6-70.html Practice Tip: If your notice does not contain an expert name, than chances are the Administration did not request an expert to appear. However, sometimes an expert just appears at the hearing without legal notice. Beware: The Judge might state at the beginning of the hearing that he or she plans to have an expert testify during your hearing. If your hearing notice lacked a statement that an expert shall appear at the hearing, OBJECT! You must object to the expert testifying due to lack of notice. Request an adjournment to prepare for the expert’s testimony. You are entitled to an adjournment. On the other hand, if your hearing notice contains an expert to attend your hearing, the hearing will begin with your testimony and then the vocational or medical expert will be questioned by the Judge. I will provide information about each expert individually and provide how to handle the individual expert. Practice Tip: The Judge may schedule both experts to testify at your hearing. Thoroughly read your hearing notice. VOCATIONAL EXPERT A vocation expert is summoned by the Court to provide further information about your past relevant work (PRW) history, job duties you performed, job duties traditionally performed for these job titles, and what work a person with your impairments can perform. PRW is work you performed within the past 15 years. The Judge will ask the vocational expert at least one hypothetical question. The vocational expert
ADDENDUM MATERIALS Page A)
Procedural SSA hyperlinks (1) Sequential evaluation (2) RFC (3) PRW B) Functional Equivalency Regulation hyperlinks C) Request for an On-The-Record decision samples (1) Motion for OTR on unmarked exhibit evidence (2) Attorney vocational rule and listing argument (3) Attorney post-hearing equivalency argument (4) Listing and vocational rule argument (5) Vocational argument (6) Mental health listing analysis argument D) Social Security Disability Chart E) Disability Questionnaire F) Top 11 Most Useful Social Security Rulings Hyperlinks G) Mental Residual Functional Capacity Assessment H) Sample physician medical form I) Sample medical request letters (1) Physician request letter (2) Mental health counselor letter (3) Hospital letter J) SSA/ODAR sample follow-up letter (1) SSA application/appeal letter (2) Status inquiry to SSA or ODAR (3) SSA payment request letter K) Sample NYS OCA approved HIPPA medical release hyperlink
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A D D E N D U M S