Social Security Disability benefits are predicated on whether or not you can perform Substantially Gainful Activity (SGA), so it makes sense that a disability blog should define that a bit better and provide examples.
Defining Substantially Gainful Activity (SGA)
Social Security bases their definition of disability on your ability to work (or perform tasks like working) that do or could, earn you more than the current monthly income threshold. If you make more than that threshold, you are not seen as warranting disability compensation benefits by the Social Security Administration. You can appeal these determinations.
This can be a bit of a tricky calculation, but here are the basics. If a wage or earnings are not made, the work is not gainful. However, if you do perform some form of activity for pay, then it is considered gainful as long as the expense of doing so is less than the income you receive.
Social Security Administration Definition of Gainful Activity
Work performed for pay or profit; or
Work of a nature generally performed for pay or profit; or
Work intended for profit, whether or not a profit is realized
It is possible you can perform activities that you might do on a regular basis that would require significant physical or mental abilities. These activities could be the basis for employment, as such the value of the activities could potentially factor into the income calculations of an SSI claim.
Example: HR Professional in Spokane
Jane has been an HR professional in Spokane for 20 years. Over the last 5 years, she’s had to reduce her hours significantly due to complications from diabetes. She’s now working about 10 hours per week, earning $15 per hour.
Wage Earnings: $150/week ($600/month)
Jane is unable to work more than this due to increasingly impactful complications. Her employer has made accommodations, including flexible scheduling, work from home, and other allowances. But due to her disabling condition(s) Jane is unable to increase her gainful activity.
The value of Jane’s gainful activity is $600 / month (minus certain expenses). Jane would be eligible for disability due to her inability to meet the SGA monthly income threshold, and her inability to perform supplementary and/or alternatives tasks that would otherwise be substantially gainful.
Example: Car Sales Professional in Spokane Valley
Alan is a car salesman in Spokane Valley. He had a heart attack 3 years ago and has only been able to work part-time since then. He makes about $500 per month working part-time sales.
Wage Earnings: $500/month
When Alan is not working at the car lot, he helps his sister with her home business by answering phones, filing papers, and responding to emails. He does this about 2 hours a day or so.
Non Earning Activity (2 hrs/day) = 40hrs/month
Although the activity Alan performs for his sister’s business is not paid, it is substantial activity that could potentially fetch a wage in the economy.
The Social Security Administration determined that in addition to the $500/month Alan was earning at the car lot, the value of his work demonstrated substantially gainful activity and thus he was not entitled to the disability benefits he sought.
Here’s an excerpt that will help frame the answer to the question above:
Supplemental Security Income (SSI) is a program through the Social Security Administration (SSA) designed to provide a monetary benefit to Americans who are older than 65, blind, or disabled. SSI is needs-based, meaning that the beneficiaries must be below a certain asset threshold. And they must have limited income, and/or income earning potential.
SSI is often paired with Medicaid, administered by individual states. Recipients of SSI often also qualify for food stamps.
Social Security Disability Insurance (SSDI) is similar to an insurance program you might buy into for the contingency that you might become unable to work due to an injury in the future. In actual fact, it is essentially just that – an insurance program. Though, it’s not really opt-in if you’re employed; you pay (or paid) into it through payroll taxes.
The payout for SSDI istypically higher than SSI, but it requires that you have a relatively recent work history, to base the amount of your benefits on. Beneficiaries become eligible for Medicare after two years of being on SSDI.
Are You Eligible for SSDI?
The first question to help you understand whether or not your claim for SSDI is likely to be denied (assuming your application for SSI was denied) is, do you meet the eligibility requirements for SSDI?
We’re keeping it simple here, but here are the two basic qualification criteria for SSDI
Notice that none of these requirements are related to your previous income? Alternatively, to your assets? Unlike SSI, SSDI is not a means-tested/related benefit.
If you were denied SSI due to an asset issue (too much $ or property), you would not be denied from SSDI for that same reason. However, you might be denied for other reasons, including not meeting the criteria listed above.
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Find Out Why You Were Denied SSI or SSDI!
Is There a Reason Why Your SSI Was Denied?
In addition to assessing your basic eligibility criteria for SSDI, you might want to determine why you were denied for SSI in the first place.
If it is a lack of basic eligibility, that is pretty straightforward. We covered eligibility for SSDI above, and because there are a lot of “if/else” caveats to SSI eligibility, we will link to the full eligibility criteria for SSI, here,so that you can review them in-depth.
If your reason for being denied SSI is not due to eligibility deficiencies, then we should look elsewhere to assess why you were denied. Moreover, why you would be looking to SSDI as an alternative to SSI.
It is possible, for instance, that you should have filed for SSDI the whole time and only filed for SSI because of a knowledge gap of the differences between the two programs. This gaffe does happen, and it is easy to see why! SSI & SSDI have a similar name, similar function, and provide support for similar groups of people.
You’ve filed for Social Security Disability (or SSI) because you’re unable to work due to an injury or illness. Great job! But now what can you do to set yourself up of the best possible chance of success?
Here are four things to do for anyone who has filed a social security disability claim.
Keep Going to the Doctor
It’s incredibly important that you continue to go to all scheduled medical appointments. If the Social Security Administration determines that you aren’t going to regularly scheduled appointments, while they’re evaluating your disability claim, they may decide against your claim on the basis that IF you did go to the doctor your impairments would be manageable. And thus, you would be able to seek, obtain, and maintain employment (or other substantially gainful activity).
Going to appointments can be difficult, depending on your conditions. If you find it difficult to maintain a schedule of medical appointments you should make sure to note this. Better, even than keeping personal records on this though, is retaining an advocate and making sure they know how difficult it is for you to attend your medical appointments. They may be able to secure some accommodations and/or they may be able to communicate your challenges effectively to the Social Security Administration.
Maintain Good Records of Any and All Hospital Visits
In a perfect world, everyone who needs access (and has permission to access) your medical records, would do so prior to making a decision that impacts you. However, it’s not a perfect world, and one of the most common goofs on disability claim decisions occurs when the adjudicator makes a decision without all the evidence they should have. Sometimes, a big piece of the pie is tracking down what SSA knew, and what they should have known.
Of course, this isn’t the only reason to keep records of visits. It’s good practice to do so even if everyone is on the same page because you never know when someone might lose a record, claim to have never received it, or claim that you didn’t go to that medical appointment in the first place.
Keeping good records can be as easy as making sure everything goes into a specific folder or box. Just don’t throw them away!
Keep Track of Challenges you Have During the Day
At some point, someone is going to want to know what kind of impact your impairments have on your everyday life. You can sit there across from a judge, or in front of a doctor and try to recall ALL the ways in which you’re affected, or you can rely on the notes you’ve taken in preparation for that question.
This means, take notes. Keep a journal. Take pictures, if that’s easier. Keep a video diary. Just document your challenges in some way.
This one action helps eliminate the ambiguous understanding (on the part of the SSA) that Social Security Disability claims denials often spring forth from.
Consider Discussing your Claim with an Excellent & Local Social Security Disability Lawyer
It’s never really too early to start a discussion with an excellent local Social Security Disability Lawyer. There are several reasons you’d want to do this.
#1) An experienced Social Security Disability Lawyer can give you advice from having gone through this process >1000 times. This is probably your first time through the process. If you can get any direct advice or even support, it’s worth your time to reach out for it!
#2) If your claim is denied (it happens far too often) – you have a short turn-around to file an appeal. Being able to bring in a disability attorney that has already heard the merits of your claim, provided input on them, and that you have a pre-existing relationship with – will help to reduce your stress at a very difficult point.
If you’re wondering why Social Security denied your disability when your doctor soundly believed that your ailments were disabled…you’re not alone! That may offer some relief, but now that you’ve been denied (or were denied some time ago), you need to get ready to take another look at your application for social security disability.
Whether you’re re-applying for disability or filing an appeal with a disability appeal lawyer, you probably want to know what led to the miscommunication or outright disconnect between your doctor and the Social Security Administration.
To help you with this, we compiled the most common reasons we have noticed that Social Security denied claims against doctors’ opinions – for our social security disability appeal clients in Spokane, WA.
Your Doctor Didn’t know How to Communicate your Disability to Social Security
This reason is so common that we should write a whole article for the purpose of talking to doctors about how to communicate with Social Security (and the VA). The point here is that in almost every case doctors practice medicine, not law. And while your disability is a medical condition, the benefit – and process of obtaining it – is a very legal process.
Imagine you’re taking your car into a shop because it is misfiring.
You have someone that’s willing to pay for the repairs, but they need to know how it’s misfiring so they give you a form that says, “please describe what’s wrong with the car.”
You show up to the shop and ask the mechanic to fill out the form, and without context, the mechanic looks at the form and examines the car. On the form the mechanic accurately describes what’s wrong with the car:
“The car’s tires are 40% worn, they need to be rotated. The car needs an oil change. Windshield wipers need to be replaced. Rear window is cracked. Electrical issues – radio doesn’t work. Transmission needs service. Car Idles rough.”
Technically the mechanic answered the questions. But when you turn the form back in to get the repair $, your benefactor says, “I looked at the mechanics response, the problems with the car are generally superficial and are what you can expect from a 20 year old car, there’s no mention of a misfire, I’m denying your repair”
“Why,” you wonder? The reason, without context the mechanic had no idea what to focus their report on. They didn’t necessarily know that you needed to have that one item assessed. They didn’t know how their report would play into the overall discussion. Had they known they might have written something to the effect of:
“vehicle has wear and tear in a number of places, however, there is a critical misfiring causing a rough idle and imminent breakdown.”
Both statements are true – but in one the mechanic didn’t have context, and in the second one the mechanic knew the context.
This happens more often than you can believe! And it’s not only Social Security disability that this occurs in, VA claim denials are famous for this situation. A doctor will describe a constellation of issues, but not focus on the issue that is material to your disability claim. As such, it can create predictably poor results.
Your Doctor (or you) Didn’t Get Your records to Social Security Fast Enough
At every step of the Disability Application and Disability Appeal process you are under a ticking clock. You have timelines you have to hit, and the system will not wait for you. From the SSA’s (Social Security Administration) perspective, they have tens of thousands of cases to assess and to keep the process moving forward they have to decide or decline by a standard deadline date.
A side note to this reason is that if you missed timelines as a result of a disability of yours, that would be something you’d want to be documented in your reconsideration/appeal. You might also want to get help in filing those, as you don’t want to have the same problems at that point. If your doctor missed timelines, that’s going to be something that needs to be addressed too. A great advocate or local disability lawyer is great for this.
Your Doctor Never Even Met You
Be honest.. did you show up to your doctor appointment(s)? Did you know you had doctor appointments? Were you aware that the SSA might try to get ahold of medical records for the care you received (or sought to receive) on your conditions? In some cases, applicants have a pattern of not showing up to doctor appointments, even critical doctors appointments set by SSA for the purpose of evaluating your disability.
This is common enough of a problem that we had to cover it. It also means that you probably need some additional help when you file your new application or appeal. If you need someone to remind you, provide you transportation, give you motivation and a helping hand – reach out to them and ask for help. We don’t mind providing reminders either!
You Gave Your Doctor Confusing Information
This is in the same arena as the mechanic story above. If you’re not clear about why you are seeing your doctor, they may not be clear about what you are needing.
Also, confusing statements that appear to contradict your claims occur very often in medical records. Consider the simple question, “how are you today?”
Do you even think before answering this question? Most people don’t – it’s become a salutation like, “hi” and “hey.” You probably get asked some variation of this question at least 4-5 times a day without giving it a second thought. Here’s the issue…
If you’re filing a claim for Social Security Disability, there is likely some aspect of your health that is not “fine” – “good” – or “grand.” And you need to be deliberate, honest, and accurate in answering that question and others like it when speaking to a doctor, or a judge.
Your Doctor Isn’t Necessarily an Expert in Your Ailments
We use terms like “doctor” or “lawyer” in generic ways. However, like lawyers, most doctors have specialties. For instance, a dermatologist has a different specialty than a neurologist. There’s a lot the two will have in common, including a great understanding of medicine. However, one is far more prepared to give testimony on skin issues whereas another is better for brain issues.
A general practice physician may not be able to provide enough information to declare the limits of your abilities or disabilities if they’re very specific. Ideally, a specialist can provide a more thorough diagnosis and prognosis. If your only medical testimony is from a doctor who doesn’t specialize in your challenges, you may be reliant upon the judgment of an adjudicator at the SSA.
On That Note…
You probably want to work with someone who knows disability and disability law if you’re in a situation where you have already been denied benefits. A social security lawyer is different than a family law lawyer, or a tax lawyer, etc. In this manner, a social security lawyer in Spokane is different than one halfway across the country! If you’re going to consult a lawyer, make sure they have experience in Social Security Law, and that they are actuallylocated nearby.
Here are 9 of the most common reasons you might find your SSI Denied
(in no particular order)
SSI Denied Because…Your Income Is Too High for SSI
Sometimes applicants don’t necessarily know or understand the application requirements for SSI. If you’re earning more than the benefit you would receive from SSI, generally you aren’t eligible. Most years the income threshold changes, but a great place to keep up to date on the earned income caps is, here.
In addition to earned income limits, there are personal and family asset caps. To qualify, you must have less than $2000 in personal assets, or $3000 if you have a significant other.
You Missed Paperwork Deadlines
Throughout your claim the Social Security Administration is going to be asking you for various pieces of documentation. It’s imperative that you return forms, files, records, and anything else they ask for in a timely manner. Failing to return a critical piece of information quickly could (often does) result in a decision being made prematurely.
Think about this from the adjudicators perspective. They have to try to understand your situation on paper, and they’re under a time crunch to make decisions in doing this. If they’ve asked for information, and don’t get it, they don’t have the ability, or even necessarily discretion to delay making a decision.
Your Medical Records Show Conflicting Information
How do you feel today? You’re going to be asked that everywhere you go. Perhaps one of the hardest things for us to do is to be honest in answering that question. Now imagine you’re Dr. is writing down your answer – and later on someone is evaluating your claims based off what they wrote down.
A simple note stating: “Ms Smith reports feeling in good health and has no apparent pain…” is going to create confusion in your claim for SSI, especially if the crux of your disability is in regards to what that doctors appointment was about.
On that same note, one of your medical records could very easily conflict with another one for reasons as simple as two or more doctors seeing or understanding your condition(s) in different ways. Most claimants don’t even know this is an issue until they see a denial. It can be avoided, and it can definitely be overcome on appeal.
You Aren’t Following the Doctor’s Orders
The crux of your claim is that your condition as it is today is a barrier to you being able to engage in substantially gainful activity (work). This means that if there is a medical treatment that would/could/will get you to the point where you can work, and you are not following your doctors prescriptions (or directions) for care, you are the barrier to your own improved condition. The SSA needs to see your condition, under treatment, to make a determination on your ability to work. If you’re refusing treatment, you’re rising having your SSI denied.
Your Case Lacks Evidence
Do you have treatment records? Do you have other records or statements to support your claim? Is the only medical opinion going to be the exam the Social Security Administration makes you go to prior to making a determination? The problem with presenting only the one piece of evidence that the SSA collects is that if the evidence presents your claim in an unfavorable way, the adjudicator will have no counter opinion to assess. Presented with one side (or even no sides) of the story, their SSI determinations will be limited to their understanding.
You Are Already Better
It’s going to take a couple months to get the SSI worked out, even if your claim is successful. Is your disabling condition permanent or will it be mended by the time your claim is decided? A broken arm is likely to be more temporary than a broken back or neck, for instance.
In addition to this, the severity of the impairment is often assessed. Consider, at what point does a behavioral health challenge turn into a complete barrier to social interaction? For each person the answer to this is different. If there’s one thing that a system like SSI has a hard time with, it’s individual assessment of an ambiguous impairment.
This is taking the failure to respond to another level. Have you gone to ground; complete radio silence? One of the biggest challenges for lawyers and advocates helping people to get an SSI claim processed is losing contact with claimants. If the SSA can’t get ahold of you, they can’t get information from you. They certainly can’t let you know when appointments will be. If you move, change mailing addresses, or even if you haven’t heard from the SSA in a long time – it’s worth checking in to make sure everything is still moving along.
SSI Denied Due to Incarceration
Have you been in jail or prison recently? You cannot receive SSI benefits while incarcerated, but you can often apply for them under pre-release programs.
You Never Showed Up
Skipping doctor appointments and skipping hearings are big no-no’s for this process. Your claim will almost assuredly be denied if you fail to show up for appointments scheduled for you. This can be a very frustrating situation for many claimants simply due to inconvenient, or sometimes unknown appointment times and dates. Do your best to stay on top of appointments when they’re made and to be flexible or make yourself flexible enough to make appointments even if you learn about them at the last minute.
If any of these apply to your SSI claim, don’t miss our comprehensive guide…
How Do I Appoint a Guardian for My Child If I Die?
Honestly, no one wants to think about this question. It’s a tacit reminder that we are indeed mortal and, in some cases, we may leave this world before we are ready. What are our plans if this were to happen? Putting your assets in a trust, or last desires into a Will – helps to make sure your financial holdings are passed on to whomever you want them to go. However, if you don’t create a care plan, or declare a guardian for your children the courts may decide who cares for your children if you die.
Are you comfortable with a stranger making this decision?
A Stranger Might Raise Your Children
“My greatest fear, someone I don’t know raising my child… What if something happens to me, who is going to take care of my child?”
This sentiment is a visceral fear that most parents have at some point. And for a good reason; when we raise our children, we are trying to put the best of ourselves into them. That means our world view, and our lessons learned, even our religion or philosophy for life. In short, we are trying to instill our values and love. But not everyone has those same values, do they?
Before we get into how to go about setting up a Guardianship Plan, this is something to consider…Who should you appoint as a guardian for your children in the event of untimely death?
Who Should Raise Your Children if You Die?
Establishing the Guardianship Plan (Kids Protection Plan) is the last step in the process of protecting your kiddos. Before you even get that far, you should first be thinking very seriously about who can provide a lifestyle for your family that you’d be ok with raising your family.
Often this is a sibling, parent, or maybe even an adult child. However, it’s not uncommon to consider someone who isn’t directly related. Your internal family dynamics aren’t on trial; it’s a very personal consideration and decision you are making in the best interest of your family. Don’t unduly narrow the scope of consideration; this is a choice you are preparing for everyone’s best interest.
Here are some basic requirements and some other things to think about:
Your children’s guardian must be:
At least 18 (in most cases)
Able to fulfill their duties as a guardian
Able to financially provide for your children
Your children’s guardian should be:
Of similar outlook to you and your partner
Knowledgeable of your goals as a family and parent(s)
Capable of providing emotional support for your children
Stable (family wise, financially, etc.)
Someone that you’re comfortable having around your children.
Aware that they are being asked to be appointed as a guardian
How to Appoint a Guardian For Your Children
If you know who you want to take care of your children, the process for establishing a guardian involves declaring your desires in such a way that it will stand up to scrutiny by a judge if necessary. That’s a wordy way to say that just because you have a wish for a guardian, it doesn’t mean your preferences cannot, or will not, get challenged. This potential hurdle is why so much consideration should go into your decision of who to appoint as a guardian.
A verbal agreement, for instance, is quickly challenged and will not instruct a judge what your wishes are. They may consider it, but without proof, your children will be relying on a judge’s discretion. In this case, a judge well-meaning meaning but does not know you and will only know you through what information you leave behind if any. Frankly, there are too many unknowns here for me or most moms to feel comfortable knowing things will, “turn out ok!”
Better than a verbal agreement, a quickly drafted written agreement provides at least some potential protection. In this sense, an informal written agreement certainly is better than a verbal agreement, but it can still be easily challenged. When looking for how to prepare documents to stand up to future challenges, we always advise putting them together in such a way that it answers all the questions a judge would have about your wishes. That’s why when we prepare guardianship plans, we put all these wishes, desires, values, and more into a well prepared, and notarized, Last Will and Testament.
Placing your guardianship plan in your Last Will means a couple of things. First, because you probably had an attorney’s input on the structuring of the guardianship plan, it will be structured to be clear enough to avoid being challenged. Second, it automatically becomes part of the probate process, for which your family will likely have an attorney helping them through. If the plan is part of your Will, the attorney will be working to make sure your wishes are carried out according to what you have drafted.
Alternatives to Placing Your Guardianship Plan in a Will or Estate Plan?
It is possible to create a Guardianship Plan and not have it be part of your Will. Here’s a free and easy way for you to do it right now.<- This will get you set up with the basics of a Kids Protection (and Guardianship) Plan. You’ll still want to consider having an attorney involved in this process, even if you can use that link to start laying out your desires without one. The benefits, as described before, are that with an attorney’s assistance you’ll be creating a plan that will stand up to the scrutiny the law requires a judge to pay to your desires and the well-being of your children.
What Happens to My Family If I Die?
Strictly speaking, death isn’t the only way a Guardianship Plan might become necessary. A Guardianship Plan might be essential if you (and your partner) become incapacitated in some manner too. This potentiality in and of itself describes why you might want to make this more of a protection plan than something you place in your Will and forget. If you haven’t died, but need to appoint a guardian, you likely still want the plan to support your desires!
Back to the point, what happens if you die? The processes are determined by the state you live within, but generally speaking, a guardian will be required to establish the ability to provide for your children. This procedure occurs in a court setting. Here’s a great list of requirements and resources for more information, by state. Of course, if you have questions about this, you can always respond in the comments below too, or send us a question/messagehere.
Have you Been Through this Process as a Child or as a Guardian?
We’d love to put together a list of tips or lessons learned from the perspective of a child having gone through this, or from the perspective of a guardian having adopted the children of deceased parents. Please feel free to reach out to us so we can help parents better understand how this process works. You can contact ushereor connect with us on Facebook.
I’m Ready to Protect My Family if I Die, What Do I Need to Do?
Reach out to us via the contact form below, or simply call our office. Our team will reach out to you and send you all the information you need. We are here to help you protect your family. It’s our mission and our passion to support you and your family.
Everyone needs to take care of their estate and make sure their family is well taken care of. Randi and her team will take very good care of you and protect you and your family’s future. You cannot go wrong using their services. Client service is their top priority!
Wow, these guys were so nice and easy to work with. It ended up that they couldn’t help us with what we needed, but the gentleman we worked with went above and beyond my expectations, and more. I could tell that they really care about people there, not just cases. He was super patient in explaining things to me when I didn’t understand, it wasn’t a stressful experience as I thought it would be. Thanks for everything guys!
Lilac City Law is an incredible firm! I had the pleasure of working with the amazing team at Lilac City Law for nearly 2 years. Their team is absolutely remarkable! They are extremely knowledgeable, helpful, and overall compassionate when it comes to working with their clients. I sought their assistance nearly 2 years ago and have continued to work with them. I had a great deal of interaction with more than just one member of the Lilac City Law team and therefore can attest to the fact that this group of individuals is absolutely unparalleled. Attorney, Randi Johnson, is an exceptionally skilled lawyer as well as an overall remarkable woman! Her support staff is incredible as well, including Cassandra, Pam, Marissa, David, etc. with all of them by your side you have been blessed and are going to receive the best results possible. I would absolutely recommend seeking assistance from this law firm, as they have the ability to change lives; they definitely did mine. Thank you all so, so much!
I had a great experience with Randi and her team this past year when we worked with them to create our first-ever wills and trust. Planning for your untimely death and discussing personal finances aren't always fun topics, but we were appreciative of Randi's approach to these potentially uncomfortable conversations and especially liked the recorded legacy interview she conducted with us. Total 5-star experience!
My husband and I worked with Randi and her team to complete our last will and testament, advanced directive, and health care proxy in the summer of 2018. Randi, and her team, as well as David Morris, were exceptionally kind, very professional, and thorough. We had several meetings to go through the important stuff - the financial info, heirlooms, and disposition of my husband's motorcycle. At each meeting, Randi and her team listened to our intentions and concerns. At the signing ceremony, we got a huge binder with our info and a data stick for safekeeping. Included in our will is a review which will take place every other year. We also got a document which states who can take our children to give our babysitter in case something bad happens to us when we were out. I'm very satisfied with Lilac City Law, and their work. I would recommend them without qualification to anyone.
Parents are so intentional about so many aspects of their children's lives. Few will forgo putting together a will. But, what if you don't die? What if you are just incapacitated? Are you prepared for the unexpected? Are you leaving your children at risk? If someone else does raise them, do you know that they will be raised according to your wishes? Have you even thought through what your wishes are? All these questions and more will be covered in the process of completing a Family Protection Plan with Randi Johnson at Lilac City Law. Having our Family Protection Plan in place gives me an incredible sense of comfort and peace of mind. I highly recommend Randi and the staff at Lilac City Law. Hopefully you never need her services, but isn't it better to be prepared than to leave things to chance?
Lilac City Law did an amazing job with my estate plan, which was something I had 'thought' about doing for a long time, but avoided... Fortunately, Randi and her team made the process very easy and approachable. I now feel relief knowing everything is in order for my two daughters in the (hopefully unlikely!) event something were to happen to me. Thank you Lilac City Law for helping me sleep better at night! 🙂
This has been an awesome experience from beginning to end. Randi and her team were super helpful in helping us wrestle through all the aspects of our estate plan. Randi’s knowledge of estate and wills were very obvious from the beginning and we are thankful for her and her staffs expertise. Thank you so much!
If you’re looking for a Social Security Lawyer in Spokane, WA or northern Idaho here’s a checklist of five things to consider.
Are they actually located in Spokane?
Are they Connected to the Community of Spokane?
Do they Help You to Understand Your Social Security Claim?
Are they an Expert
Are they Approachable?
Are they actually located in Spokane?
These are perfectly legitimate question to ask any lawyer your considering working with. Where are you located? Can I visit you if I have questions? Can we schedule a time to discuss my case?
It may surprise you to discover that some law firms that advertise in the Spokane area are not from Spokane at all. In fact, they only rent an office space, just to have a local address. Shocking, but we covered these types of misdirection in another article, here.
Are they Connected to the Community of Spokane?
One of the biggest benefits to working with a local Social Security lawyer is that you benefit from the connections they’ve made in their work. It’s very common that someone seeking the help of a Social Security lawyer has other support needs that are a natural handoff to someone who has a robust local network. An excellent local law firm will have a list of, or at least referrals to, other excellent firms and resources available at request.
Do they Help You to Understand Your Social Security Claim?
It’s very important that you consider the commitment a local law firm places in helping you to understand your Social Security claim. The process of appealing SSI & SSDI denials can be confusing, and it can be frustrating. A great blog & newsletter might seem small when you’re first looking into representation, but these will be the first places you look when you want to know more about something like a reconsideration denial.
In a not so subtle way, a firm that commits to educating their clients is a firm that will be committed to bringing them along every step of the way. So…take a look at that blog & newsletter. See if it helps you understand your situation? Does the firm demonstrate awareness, understanding and expertise in the way they break down the things you don’t know?
Are they an Expert & Are they Approachable?
Ok, this is a two-part criteria, but you’re aiming to find someone that is both of these at once. An expert that is unapproachable is not going to help you understand your claim. And an approachable novice is a novice nonetheless.
They say there’s no substitute for experience, and it takes time, commitment, and success to gain that experience.
As for approachability, take a look at the videos on the lawyer’s website. Look at their social media pages, and check out the reviews. You’ll get a “gut” sense pretty quickly about whether that lawyer is someone you can relate to, trust, and share your story with.
How Lilac City Law Stacks Up to this Criteria
Now that you’ve seen our list, take a deeper look at our firm.
If you’re in the process of applying for Social Security Disability, or if you’ve already applied and are looking to get a bit more help for an appeal – then the following criteria can help you select the best Social Security lawyer for your case.
Work With Someone That Makes You Comfortable
The first and maybe most important factor in picking a Social Security Lawyer is overcoming the initial fear factor of reaching out for help.
Let’s be honest, most of the time the first person called is the attorney with the commercial on TV or that website that shows up on the top of Google. However, as we’ve learned in our firm, a lot of clients gravitate towards representatives that can understand them. For instance, if you’re seeking to claim PTSD and already apprehensive about reaching out for help, getting someone on the other end of the phone that has an imposing persona very easily could lead to trouble at many points during the claims process.
A Social Security claim or appeal can be complex, it’s very important that you have confidence in your lawyer, but also that you have the impression that you can communicate with them or their office without worrying about how they might view, judge, or aggravate your impairments.
Be careful to choose a lawyer that doesn’t intimidate you in any way. You’re going through a tough enough process, keep the barriers to your relationship low and the trust factor high.
Trust w/ Your Social Security Lawyer
The things that generate trust vary widely from one person to the next. However, there are some basic principals that everyone can rely upon when determining if a given Social Security Lawyer is trustworthy.
Ratings & Reviews
Avvo is a great tool for getting straight-forward ratings and reviews of attorneys. They have a proprietary ratings system and review system that they claim can’t be gamed. This is very important, and as you can imagine, review and rating stuffing is common and sadly something that erodes confidence in any rating system.
In addition to Avvo, Google provides a great system for getting reviews of all sorts of lawyers, including disability lawyers. If you do a search for disability lawyers near you, or for a specific disability lawyer, you will likely see their Google ratings & reviews pop-up next to their listing. This is a bit more crowd-sourced than Avvo but is a very valuable tool for both selecting a great disability lawyer, and for reviewing them after you’ve worked with them. Here is an example of ratings and reviews using Google.
The internet has been around for a while at this point. As have digital cameras. The old saying “a picture is worth a thousand words” is just as true today as when it was coined. In fact, it might even be truer today than ever. Consider how a picture helps to establish rapport and trust.
You want a disability lawyer that shows you they know what they’re doing. They are respectable and respected. And they will be the best champion for your fight, right? That’s why every attorney, doctor, consultant, author, etc. has a professional picture of themselves somewhere on their website. But one of the biggest problems is that pictures can (and are) staged. However, an authentic video is much harder to fake.
Check out the prospective disability attorney’s Facebook and YouTube channels. First off, do they even have social media at all? And on those channels, see if they have videos sharing insights, talking to clients, answering questions. Sometimes these videos will also be on the lawyer’s website or blog as well.
Watching how the lawyer answers questions will give you a lot more than a picture – at least in helping you to build an idea of who they are and how they communicate.
Ask yourself, “is this someone that can communicate my challenges, is this someone I can communicate my challenges to?”
A short video will usually give you an enormous amount of insight into answering those questions.
When seeking insight into a disability lawyer’s persona don’t forget to look at the extras on their website. Blogs, especially, will tell you how committed they are to sharing information with you.
Is their website a bunch of short questions with hooks at the end of each one? If so, how does that help you, as a potential client, to understand the processes involved in your claim? Alternatively, do they have a wealth of information about all aspects of your claim, and questions you hadn’t even thought to ask yet in their blog or newsletter? Six months from now when you’re wondering what your chances are of succeeding, this might be exactly what you need to keep your spirits high.
A blog may not be what you initially thought of when thinking, “how do I pick a Social Security lawyer,” but now that you’re in the search, take a look around and see who’s keeping their clients and future clients informed and who’s just fishing for the next client.
Would you rather be a big fish in a small pond or a small fish in a big pond? Think about this for a moment.. this is something that can help you to identify what type of disability lawyer or disability law firm to work with.
One might argue that a huge firm with many thousands of cases is big because they are good. They certainly have the advertising budget to portray that success. However, the continued existence of many hundreds, or even thousands, of community disability lawyers fly in the face of that sentiment. At the end of the day, you can deal with one bureaucracy (huge firm) to fight another one (SSA), or you can work with a personalized firm who remembers your name when you call.
It comes back to that question, big fish or small fish? The small fish sometimes has a hard time being heard.
In response to the big fish/small fish question, you do, at some, point want to consider how responsive your disability lawyer will be to your unique needs. Hint, they have to recognize that you indeed do have unique needs in the first place.
Like a Dr. Office, it’s probably not reasonable that the attorney can stop immediately talking to one patient (client) to take a call from another. That’s why staff and client liaisons exist. However, it is reasonable and should be necessary, to have an attorney that is available to talk, within a reasonable amount of time.
Can you call the firm and get a response from the attorney in a reasonable amount of time? Can you schedule a time to actually come into the firm and talk to the lawyer that’s representing you? Not everyone can…
Being able to communicate, even briefly, is something you’re going to want to do as a disability hearing approaches.
During the course of your claim (or appeal), there will be curveballs thrown your way. Whether those curveballs originate from within the claim itself or they happen to come from directions yet unseen, you want someone on your side that “knows someone.”
One of the best things about working with an experienced and established disability lawyer is that you’re also working with their network. A good lawyer doesn’t gain experience by being an island unto themselves. They often work with partners in similar fiends to increase the effectiveness of their own services.
To you, the client or future client, this means – that when that curveball arrives you can ask for referrals, assistance, resource information, and things like this. Or rather, you should be able to. Unfortunately, this also relies on the idea that your disability lawyer is local, which as we know from previous discussions, is just not always the case.
You bet it does! Though it comes down to the severity and how PTSD presents on a daily basis. We’ve covered the chances of you getting a successful claim through the initial filing process before, and I suspect that some of the reason this question gets asked is that it seems mental health challenges are often mischaracterized in disability reports. To assess the situation from a wholistic perspective consider the following five questions.
How are you sleeping?
If the answer is anything other than, “I get a decent amount of sleep” .. then, you, me, and everyone (SSI/SSDI) needs to know why?
Are you having nightmares, insomnia, lack of consistency, where are you sleeping? Do you need special equipment to sleep? A fan for white noise, the TV turned on, a CPAP machine.
Bottom line, if PTSD is causing trouble sleeping or being made worse by lack of sleep, it has an impact on your health and employability in many different areas.
What motivates you?
It seems a basic question, but this is something that cuts straight to the heart of PTSD and other mental health challenges.
Are you distant, non connected, ambivalent towards goals? Are you hyper focused on a certain subject?
Any of these could be “normal” in the right circumstances, but experiencing PTSD can change the balance of “normal” for anyone.
What do you do for recreation?
This doesn’t necessarily mean, “what do you do for fun,” but you can think about it like that.
If you can’t really answer this question then ask yourself what did you do in the past for recreation? Did you find it enjoyable or fun then? Do you do it now, and if you do, do you get enjoyment from it?
Many times with PTSD a fear of social engagement, or triggers, will cause people to stop doing activities they once found enjoyable. If you can’t engage in recreation, or other enjoyable activity, there’s almost certainly an impact to your ability to work. Clearly, a lot to your story needs to be told.
How do you cope?
Let’s start by dismissing coping as good or bad. Everyone copes with challenges everyday. Being able to identify and put into perspective the level of coping is key in making a compelling description of how PTSD impacts your life.
Coping can almost be anything, some people cope through working out, for instance. But if you’re working out 12 hours a day and your marriage fell apart, and your finances are a mess – it’s obviously become more of a hinderance to your overall state of being than it has a help. The same can be true for alcohol, drugs, excessive sleep, risk taking behaviors, isolation, aggression, social media, eating, the list is endless.
So how are you coping with challenges brought on by PTSD?
Do you have a diagnosis?
Do you believe you have PTSD but you haven’t received a diagnosis? Do you believe you were misdiagnosed? In your opinion did an examiner not ask the right questions to be able to adequately determine if you experience PTSD, and perhaps the level of impairment you might have?
Sometimes this can all be placed in the fact that you might not have PTSD…per a clinical definition. That doesn’t mean though, that you aren’t experiencing clinical anxiety, depression, intrusive memory or hallucinations, ADD, or any number of other symptoms that in themselves are diagnosable mental health conditions.
Sometimes, we focus on labeling too much and not enough on the challenges presented by what we’re experiencing. If we expand the label outwards a little, there may be similar diagnosis that would better match the conditions you might be experiencing.
The Last Question: How Can you Best Tell this Story?
The surprising thing most people don’t know about “ local ” Social Security disability law firms.
Imagine you want to go to school. You go online, and see there’s a local campus in your city. After some searching you can’t find the hours the campus is open, so you give them a call. They answer quickly and are very friendly. They get your info and send you all your application papers. You fill them out and return them in the pre-stamped envelope provided to you. All is great.
Well it seems great, but now you have a question. You want to know if you can meet with your instructor before class starts. You aren’t sure about the class you’re going to be taking. So you call.
The nice person on the other side of the phone says they’ll have the instructor call you back. But you don’t want a call back, you want to meet with them. You’d like the ability to sit down face to face with them, if possible, before class starts.
It’s only at this point, after much insistence on your part, that you find out from the school that the instructor doesn’t actually live in the area. In fact, the school itself is in another state. All of your work is going to be done remotely, and you might never even talk to the instructor until your final test date. They (the instructor) will fly in a couple hours before your test, answer any questions you have, then give you the test. Don’t worry though, you can always talk to the someone from the school – over the phone, of course..
Maybe this scenario is a little silly, there’s almost no industry where this actually happens. Well “almost” is the key word. Let’s take this story and change a few things around. And in so doing, reveal the secret implied in the title of this article.
The Big Secret..
Instead of a school, let’s say you’re looking for a disability attorney. And instead of an education, let’s say you want to successfully appeal a denial of your disability claim.
In this revised story, you have a disability denial and you called a disability lawyer in Spokane. You signed up to work with them, and when you had a question about your disability claim you called the local office. Only through your insistence to meet with your social security lawyer did you find out they didn’t actually have an office in Spokane. Nor in Idaho, or anywhere in the Inland Empire.
The Spokane Disability Lawyer you found online actually only has a rented space, with a rented receptionist. Guess what? The boss will never be in.
With the exception of an occasional phone call, you’ll have a completely virtual experience with your disability attorney.
At this point you should know that all disability lawyers charge the same amount. It’s set by law. So if cost is thrown out of your decision tree, what would be the big reason for going with an out of state attorney vs one close to home.
We take a lot of pride in being part of this community. As your actual “local” disability attorney we have all the knowledge and experience of the out of town firms with the added benefit of being here for you anytime you have a question.
Give us a call, or stop by and find out why when you work with us, there’s no surprises.
You might have seen the Shared article we placed on Facebook earlier this month regarding the upcoming changes to the Social Security Administration medical Listings for neurological, respiratory and mental health impairments. The new Neurological Impairment listing updates became effective 9/29/16 and new Respiratory Impairment listings on October 7, 2016. The new Mental Health updates won’t become effective until January 2017. That said, really important changes have already occurred under the Neurological and Respiratory updates.
How these new Medical Listings Apply to You
For example, SSA has really broken down neurological conditions and diseases. Whereas certain disorders, like seizure related disorders, were all more generally lumped together, now different types of seizure activity are spelled out. The Disabled Individual claiming eligibility for SSA benefits has the burden to prove that their impairments preclude all substantial work. One of the ways to do this is by providing medical evidence demonstrating that the condition, like epilepsy, meets or equals these medical Listings. A keen eye to detail must be used when analyzing neurology and radiology records. A person with significant limitations due to their neurological disorder may be denied if the decision-maker is not paying close attention to these records in light of the new medical Listings.