Social Security Disability Archives

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SSA and Fibromyalgia

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

SSA and Fibromyalgia is an interesting topic. 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. One reason is  due to the lack of objective medical findings inherent in these conditions. Let’s learn and discuss 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. Moreover, this is 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 limits the person’s functional abilities. Furthermore, it must also  precludes him or her from performing any substantial gainful activity”.

However. in cases involving fibromyalgia and chronic  fatigue syndrome there is an exception. Once fibromyalgia and chronic  fatigue syndrome have been established, SSA will consider all of the  evidence in the case record. Furthermore, SSA will evaluate the intensity and persistence  of the claimant’s pain or other symptoms. Finally, this is 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: www.niams.nih.gov/Health_Info/Fibromyalgia; www.mayoclinic.com/health/fibromylagia; or www.rheumatology.org.

Excuses for Late Disability Appeals

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

Social Security Hearings

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.

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