Social Security Disability Archives

Tag Archive for: Social Security Disability

Because the Social Security Disability application and appeals process can be difficult, especially when a claimant may be suffering from multiple medical impairments, it is crucial to hire an attorney that specializes in Social Security Disability Income (SSDI) and Supplemental Security Insurance (SSI) claims.

Aline Gaba, attorney and founding partner of the San Diego Disability Law Group (SDDLG) recently participated in a webinar for the San Diego County Bar Association. In this webinar, she discussed the role of Social Security Disability Attorneys in helping their clients, along with the differences between SSDI and SSI claims. One particularly valuable focus included how medical evidence helps in achieving successful SSDI and SSI claim outcomes.

You can watch the discussion touching on the points above through the recorded 23-minute webinar published here:

Below, we will review some of the main points from the webinar. If you still have questions, please feel free to call the San Diego Disability Law Group at (619) 338-9000 or contact us via email and we will do our best to get your questions answered as quickly as possible.

SSI Claims vs SSDI Claims

It is important to know the difference between a Supplemental Security Income (SSI) claim and a Social Security Disability Insurance (SSDI) claim. 

SSI is a needs based program for individuals who have a severe impairment that prevents them from being able to sustain gainful employment.  There are different financial requirements depending on your marital status; however, SSI does not require any work history or qualifying quarters. As such, an individual may qualify for SSI if they have never worked a day in their life so long as they meet the financial and medical requirements for SSI.  For this reason, SSI benefits are usually much lower than SSDI benefits.

SSDI also requires a severe impairment that prevents substantial gainful employment; however, you must also have sufficient qualifying quarters.  In other words, you must have sufficient work history as well as a medically determinable impairment in order to be eligible for SSDI.  Because SSDI is based on your earnings, these benefits are usually much higher than SSI benefits.

Why Hire an SSDI/SSI Attorney?

What does an SSDI attorney really do, and is hiring one actually necessary? A Social Security Disability attorney, like Ms. Gaba, has many years of knowledge and experience in dealing with the processes and procedures of the Social Security Administration (SSA).  You could say that we are fluent in the language that the SSA speaks, which makes us uniquely qualified to address the many problems and pitfalls that may arise during the application and appeals process. 

Attorneys who specialize in Social Security Disability, like Ms. Gaba, are well versed in the SSDI and SSI application and appeals process.  We analyze each case from start to finish, including status of the claim, pending appeals, and hundreds to thousands of pages of medical records.  Over the course of this long process, we work closely with and get to know our clients so that we can develop a comprehensive strategy to give them the best chance of winning their claim. 

The Use of Medical Evidence in an SSDI/SSI Claim

It is important to note that the role of medical evidence is critical to the successful outcome of the SSDI/SSI claims process.  An experienced Social Security Disability attorney, like Ms. Gaba, will review your entire medical file and ensure that the SSA has all of the necessary and relevant information.  Your SSDI attorney will identify and request any missing records, ask your doctors for opinion letters, and work with you to gather any additional evidence that would support your claim. 

In the webinar, Ms. Gaba also discusses the impact of the current Coronavirus pandemic situation on the processing of disability claims. Due to COVID-19 related business closures, the backlog of cases waiting to be processed by SSA quickly increased early on. However, the SSA has recently pushed though cases at a more rapid pace, which helped in reducing the claim processing delay. In addition, all of the San Diego Social Security hearings are currently being held telephonically instead of in person to comply with the related health requirements and to prevent further delays in processing claims.

SDDLG Can Help With Social Security Disability Claims

Many claimants find the Social Security Disability process daunting and discouraging due to the high rate of denials and the obscure nature of dealing with a large bureaucracy such as the SSA. However, you don’t have to go through the process alone.  Please contact the San Diego Social Security Disability lawyers for a free consultation.

RELATED: Excuses for Late Disability Appeals

You can reach the offices of The San Diego Disability Law Group by calling 619-338-9000, or contact us here.

Social Security Disability and Reflex Sympathetic Dystrophy

Is RSD a Disability?

We presently have a client who has been diagnosed with Reflex Sympathetic Dystrophy (RSD) also known as Complex Regional Pain Syndrome (CRPS).  RSD is a unique clinical syndrome that may develop following trauma, severe or minor. Claimants with RSD typically report burning, aching, or searing pain that starts out at the site of the trauma and can then spread to other limbs or parts of the body. In our case, our claimant is a 30-year-old woman who fractured her finger playing football. She had surgery on the finger but it never healed properly. She can’t bend it or make a fist. After the surgery, her hand started to swell and tingle. She also had a burning, searing pain first in the injured hand and then in her other, non-injured hand. Thereafter she developed symptoms all over her body including both her lower extremities. The pain and spasms are so bad that both her feet contract inward during an episode making it extremely difficult for her to walk. She certainly can no longer do her job as a certified nurse’s assistant.

The Disability Lawyers with the  San Diego Disability Law Group analyze each case according to the sequential evaluation process applied to all initial Social Security insurance claims and all adult SSI claims i.e. 1) Is the claimant presently engaged in substantial gainful activity; 2) Does the claimant have a severe impairment; 3) Does the impairment meet or equal a listed impairment; 4) Does the impairment prevent the claimant from performing past relevant work and 5) Does the impairment prevent the performance of other work considering the claimant’s age, education and prior work experience.

The Social Security  Administration publishes a Listing of Impairments with medical evidence requirements which, if met, are conclusive of social security disability. Sometimes, however, a severe condition like RSD is not listed in the Listing of Impairments but is addressed in a Social Security Policy Interpretation Ruling.  In preparing this case,  the Disability Lawyers at the San Diego Disability  Law Group referenced SSR 03-02P ” EVALUATING REFLEX SYMPATHETIC DYSTROPHY SYNDROME/COMPLEX REGIONAL PAIN SYNDROME”.

SSR 03-02P acknowledges that RSD/CRPS is a chronic pain syndrome most often resulting from trauma to a single extremity and that patients typically report persistent, burning, aching or searing pain that is initially localized to the site of the injury. The degree of pain is often out of proportion to the severity of the precipitating injury and cases have been reported to progress and spread to other limbs, or to remote parts of the body (Like in our case).

The Social Security Act defines “disability” as the inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. The act also requires that the impairment result from anatomical, physiological, or psychological abnormalities that can be shown by medically acceptable clinical and laboratory diagnostic techniques.

SSR 03-02P states that, for purposes of Social Security disability evaluation, RSD/CRPS can be established in the presence of persistent complaints of pain that are typically out of proportion to the severity of any documented precipitant and one or more of the following clinically documented signs in the affected region at any time following the documented precipitant: 1) Swelling; 2) Autonomic instability i.e. changes in skin color or texture, changes in sweating(decreased or excessive sweating); 3) changes is skin temperature; 4)Abnormal hair or nail growth;  5) Osteoporosis; or 6) involuntary movements of the affected region of the initial injury.

The Disability Attorneys with the San Diego Disability  Law Group know that it is important in RSD/CRPS cases to present longitudinal treatment records that document the above-referenced criteria in order to make the strongest case possible for RSD/CRPS claimants.

As a claimant with  RSD/CRPS it is extremely important for you to continually tell you treating doctors about your symptoms and the effect that your symptoms have on your activities of daily living and your ability to function. Develop a longitudinal medical record that clearly documents your RSD/CRPS symptoms. Documenting your symptoms will enable your Disability Lawyer to present the best claim possible.

If you or any friend or family member has a Social Security Disability claim or question, contact the Disability Attorneys at the San Diego Disability Law Group for a free consultation, or call us at 619-338-9000.

San Diego Social Security disability lawyers regularly help applicants apply to receive benefits if they are unable to perform any easy work they have done in the past. This may seem like a simple process, but San Diego Social Security disability attorneys frequently need to guide clients through the often complicated yet necessary procedures.

Defining the Term “Disabled”

San Diego Social Security disability attorneys are aware that the Social Security Administration defines the term “disabled” in a particular way. “Disabled” applicants are those who can no longer complete any “past relevant work,” and must meet the following criteria:

  1. The applicant must have been employed in the occupation within the last 15 years or 15 years prior to the most recent disability requirement check (whichever was earlier).
  2. He or she must have performed the work for a significant period of time. (Any applicants unsure about whether their work qualifies should consult their San Diego Social Security disability lawyers.)
  3. The applicant must have earned a certain amount of money throughout the working period.

Qualifying for Disability Benefits

San Diego Social Security disability lawyers may test whether an applicant may qualify for disability benefits by following a two-step process:

  • The San Diego Social Security disability lawyers will first conclude which occupation fits the “past relevant work” criteria and is the least strenuous.
  • Then, they may investigate why the applicant can no longer perform the occupation.

Level of Exertion Required to Perform Job Duties

An applicant will not qualify for benefits if his or her San Diego Social Security disability lawyers cannot show that he or she is unable to complete a former job of average difficulty. In addition, the Social Security Administration will ask the San Diego Social Security disability attorneys whether the applicant’s past performance corresponded to the difficulty level of each position.

Medical-Vocational Guidelines

The Social Security Administration will utilize the Medical-Vocational Guidelines to determine a candidate’s degree of disability. San Diego Social Security disability lawyers will need to prove that the applicant cannot perform any commonly available job.

Contact San Diego Disability Law Group

Many candidates find the application process confusing. If you are disabled and would like to apply for benefits, consult with San Diego Social Security disability lawyers at the San Diego Disability Law Group by calling 619-338-9000, or contact us here.

The Social Security Disability Attorneys at the San Diego Disability Law Group recently represented a 47 year old woman with Breast Cancer. When she first contacted our office her claim for disability benefits had already been denied by the  Social Security Administration and the time limit to file a Request For Reconsideration had already passed.

San Diego Social Security Disability Attorneys Comment on Obesity and SSDI/SSI Benefits

The attorneys at San Diego Disability Law Group recently  had a case involving a young claimant who was five  feet six inches tall and weighed over 350 pounds. She had a BMI over 50. In addition, she had  been diagnosed with scoliosis (a sideways curvature of  the spine associated with pain but  not neurological impairment),lumbar spondylosis (stiffening or fixation of the vertebrae) and hypo joint mobility. She had a high school diploma but no work experience. She took daily pain medication but still woke up  several times per night due to the pain. This caused her to be groggy and not mentally focused during the  day.

One of the issues in the claim involved what effect her obesity was having on her underlying orthopaedic  conditions. In order to properly present her claim we had to research to  what extent obesity  is  considered by the Social Security  Administration. According to the Social Security Administration, obesity is a complex, chronic disease characterized by excessive  accumulation of body fat caused by a combination of factors i.e. genetic, environmental and  behavioral. Obesity is a risk factor that  increases an individual’s chances of developing impairments in  most body systems.

The National Institutes of Health established medical criteria for  the diagnosis of obesity. These guidelines classify overweight and  obesity in adults according to Body Mass Index (BMI). BMI is the  ratio of an individual’s weight in kilograms to the square of his or height in meters.  For adults, both men and women, the guidelines describe a BMI of 25-29.9 as overweight and a  BMI of 30.0 or above as obesity. The guidelines further recognize three levels of obesity. Level I includes BMIs of 30.0 – 34.9. Level II includes BMIs of 35.0 – 39.9. Level III, termed extreme obesity includes BMIs greater than 40.

Prior to October 25, 1999, there was an actual SSA listing  for obesity (9.09). The  listing was deleted because the Social Security  Administration believed that the criteria in the listing were not  appropriate indicators of listing-level severity in that they did not represent  a degree of functional limitation that would prevent an individual from engaging in  any gainful activity.

Although the listing was  deleted, the Social Security  Administration still recognizes obesity as a medically determinable impairment. On September 12, 2002 they  issued a Policy Interpretation Ruling (SSR 02-1p) regarding the  evaluation of obesity.

In the  ruling SSA reminds adjudicators that “obesity  is a medically  determinable impairment and that adjudicators should consider its effects when evaluating disability”. The  ruling also reminds adjudicators that the combined effects of obesity  with other impairments can be greater than the effects of each of the  impairments considered separately. They also instructed adjudicators to consider the  effects of obesity when assessing an individual’s residual functional capacity.

The ruling provides that the Social Security Administration will find that “obesity  is a severe impairment when, alone or in combination with another medically determinable physical or mental impairment(s), it significantly limits an individual’s physical or mental ability to do  basic work activities.” They  will also consider the  effects of any symptoms  (i.e. pain or fatigue)that could limit  functioning.

In our case we believe that we were able to show that the claimant’s obesity combined with her underlying orthopaedic conditions significantly limited her physical and mental ability to do  basic work activities.

SDDLG Specializes in Obesity and SSDI/SSI Benefits

The San Diego Social Security Disability Attorneys with  the San Diego Disability  Law Group will help you present the strongest claim possible for Social Security Disability  based  on obesity  and other limiting conditions.

If you or a friend or family member has a Social Security Disability claim or question, contact the Social Security Disability Attorneys at the  San Diego  Disability Law  Group for a free consultation at 619-338-900.

Under the Social Security Act, a claimant is considered “disabled” if (1) she is unable to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less that twelve months and (2) the impairment is of such severity that she is not only unable to do her previous work but cannot, considering her age, education, and work experience, engage in any other kind of substantial gainful work which exists in the national economy.

On October 26, 2012, the 9th Circuit Court of Appeals issued its ruling in the case of  Hill v. Astrue, 2012 DJDAR 14911. In this case, the ALJ found that Ms. Hill had not engaged in substantial gainful activity and that she had severe medical impairments but, when considering her residual functional capacity, he ignored the evaluation of Hill’s treating psychologist who found that Hill’s combination of “mental and medical problems makes the likelihood of sustained full time competitive employment unlikely”.  

The 9th Circuit Court of Appeal found this to be an error. It ruled that, in order to reject a treating physician’s opinion, the ALJ has to give clear and convincing reasons because the opinion of a treating doctor can be rejected only for specific and legitimate reasons that are supported by substantial evidence. The court found that the ALJ failed to give any reasons for rejecting the treating doctor’s opinion let alone clear and convincing reasons. The case was reversed and remanded for further hearing.

This case points out how important it is for claimant’s to establish and maintain a relationship with their treating doctor’s since the ALJ must consider and give greater weight to the treating doctor’s opinion. The disability attorneys, Aline Gaba and Geroge Heppner with the San Diego Disability Law Group find that treating physician’s are more likely to complete a Residual Functional Capacity Questionnaire when they have seen the patient regularly. Additionally, the information needed to complete the questionnaire will generally be in their medical records. In the questionnaire, the physician  states what the patient can still functionally do; i.e. how long can she stand, sit or walk; can she kneel, stoop, bend or climb stairs; how many pounds can she carry or lift; does she need to take frequent breaks. It’s an important piece of evidence and might make the difference between receiving your benefits and having your claim denied.

If you or a family member need a San Diego Disability Attorney or have a question regarding Social Security Disability please contact the San Diego Disability Law Group at 619-338-9000 or contact us through our website. 

SSA and Fibromyalgia: Is it Difficult to Obtain Social Security Benefits?

A recent issue of the NOSSCR (National Organization of Social Security Claimants’ Representatives) Social Security Forum had a interesting article on why claimants with Fibromyalgia and Chronic Fatigue Syndrome(CFS) oftentimes have a difficult time obtaining social security benefits due to the lack of objective medical findings inherent in these  conditions and how a new Social Security Ruling could help overcome this obstacle.

On July 25, 2012 Social Security Ruling (SSR) 12-2p was issued. SSR-12p states that fibromyalgia may  be a “medically determinable impairment” when it is established by appropriate medical evidence and can be the  basis for a finding of disability. Once fibromyalgia is established as a “medically determinable impairment” it will be considered in the  sequential evaluation process to determine whether the person is disabled. It is still the  claimant’s burden to provide “sufficient objective evidence to support a finding that the person’s impairment so limits the person’s functional abilities that it  precludes him or her from performing any substantial gainful activity”.

Now in cases involving fibromyalgia and chronic  fatigue syndrome, once fibromyalgia and chronic  fatigue syndrome have been established, SSA will consider all of the  evidence in the case record to evaluate the intensity and persistence  of the claimant’s pain or other symptoms to determine the extent to which the symptom’s limit the person’s capacity for work.

In addition to the physicians diagnoses based on objective criteria, Attorneys  with the San Diego  Disability Law Group  make sure that their clients provide  the administrative law judge with as much longitudinal evidence of symptoms and treatment as possible, as well as reports from family and friends of how the claimant’s impairments affect his/her activities of daily living or ability to work.

If you or a family member has  a question regarding Social Security Disability please contact the San Diego Disability Law Group at (619) 338-9000.

For more information regarding Fibromyalgia visit:;; or

All is not necessarily lost if you don’t get your Social Security Disability appeal filed on time. The Social Security Administration (SSA) regulations recognize several excuses as “good cause” for missing the appeal deadline. An experienced San Diego Social Security attorney can help you establish good cause, or, even better, help you meet the time requirement in the first place.

Procedure for Raising Excuse

The first thing you need to do with a late disability appeal is getting it filed. If it has clearly missed the deadline, you’ll need to include a detailed letter telling the SSA exactly why you are filing late.

If the SSA finds that your explanation amounts to “good cause,” it extends the deadline, magically making your late disability appeal a timely appeal.

Who Determines “Good Cause”

The SSA’s lengthy Program Operations Manual System gives the authority to decide if there is “good cause” to the “individual from the component that has the authority to adjudicate the appeal being filed.” In practical terms, this means that the official who determines good cause depends on which filing is late:

  • If the Request for Hearing is late an administrative law judge (ALJ) determines good cause
  • If the Request for Review of Hearing Decision is late, the Appeals Council determines good cause
  • If the deadline to file in federal court was missed, the Appeals Council again determines good cause

What Excuses Amount to “Good Cause”

There are SSA regulations describing, at general level, what amount to “good cause”:

  • The specific circumstances which led to the untimely filing
  • Whether the claimant was misled by any action of the SSA
  • Whether the claimant understood the time requirement

A more specific regulation provides that SSA will consider whether the claimant had any physical, mental, educational, or linguistic limitations—including any lack of facility with the English language–which prevented a timely filing, or which prevented the claimant from understanding or knowing about the need to file a timely request for review.

SSA has issued a Ruling on the lack of mental capacity, which states that tardiness will be excused when claimants lack the capacity to understand the procedures for requesting review, and had no one legally responsible for prosecuting the claim, such as “a parent of a claimant who is a minor, legal guardian, attorney, or other legal representative.” In applying this standard of mental incapacity, it doesn’t matter how much time has passed since the decision the claimant wants to appeal.

Reasonable doubt about the claimant’s capacity is resolved in favor of the claimant.

Get Social Security Disability Help

Establishing good cause is something best left to an experienced disability attorney in San Diego. Get the help you need to protect your right to benefits; if you need a lawyer for ssi appeals, call George Heppner and Aline Gaba at (619) 338-9000.

RELATED: Why Applying for Disability isn’t always easy

If you have to appeal your denial for Social Security disability benefits in a hearing before an administrative law judge, you may be anxious about your hearing and curious as to what you should expect. Social security hearings are complicated. Here’s an explanation of the process from a high level, and an overview of what you can do to make it run smoothly.