Tag Archives: SSA
SSA disability medical listing for Crohn’s disease
Crohn’s Disease and disability
Crohn’s disease affects about 600,000 men and women in the United States and Canada alone. Currently, there is no pharmaceutical or surgical cure for Crohn’s disease. Instead, all existing treatment is geared toward controlling symptoms, maintaining remission and preventing relapses.
Crohn’s disease is a type of inflammatory bowel disease (IBD). Crohn’s is also known as granulomatous enteritis or colitis or regional enteritis. Crohn’s primarily causes breaks in the lining of the small and large intestine, but it can affect the digestive system at any point from the mouth to the anus. In severe cases, bowel obstructions and perforations may occur.
Symptoms of Crohn’s include abdominal pain, diarrhea, fever, loss of appetite, and weight loss. These symptoms tend to fluctuate between periods of rest and activity so they may not always be present or as severe. It can be difficult to diagnose the disorder as symptoms are similar to other intestinal disorders such as irritable bowel syndrome.
Flare-ups of Crohn’s disease are treated with drugs such as antibiotics for infections and anti-inflammatory drugs to control inflammation. Severe Crohn’s cases may require multiple surgeries to control or maintain remission of the disease.
Social Security does consider Crohn’s disease to be a significant impairment that may prevent an individual from performing substantial gainful activity. Given this, it is possible for a person to receive disability benefits on the basis of Crohn’s disease alone.
Social Security evaluates Crohn’s disease using the disability guidebook impairment listing 5.06 Inflammatory bowel disease (IBD). To qualify under the IBD listing, you need to have a diagnosis of IBD, plus a listed complication, such as untreatable anemia, a bowel obstruction, an abscess or fistula, significant, unintentional weight loss (of more than 10% of your body weight), or a tender abdominal mass with pain and cramping.
As is almost always the case, if you do not have one of the requisite complications, you can also qualify if you can show that your symptoms make it impossible to work your prior job, and that with your job skills and education, there are no other types of jobs you could learn to do that you would be capable of doing.
If you think you may be entitled to Social Security Disability benefits and have questions, call The Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation today.
SSA policy is that drug dealing can be considered “substantial gainful activity”
SSR 94-1c – Substantial gainful activity rules
The case that this SSA policy ruling is based involves a claimant that applied for disability benefits under the Supplemental Security Income (SSI) program, claiming that he was disabled due to asthma, multiple allergies, and previous drug addiction. His application was initially denied and he later requested a hearing before an administrative law judge (ALJ).
At the hearing before the ALJ, the claimant testified that he was then using between $200 and $300 worth of drugs each day and that he supported his drug habit through stealing and panhandling. Based on his own testimony, the ALJ concluded that the claimant’s stealing constituted substantial gainful activity (SGA) worth an average of approximately $5,600 per month.
The ALJ went on to say that due to the poor area in which the claimant panhandled, stealing this much required a substantial amount of physical and mental activity. The ALJ concluded that because the claimant was engaging in such SGA, he was not disabled and, therefore, not eligible for any disability benefits. The Appeals Council declined to review the ALJ’s decision which led the claimant to appeal the decision to federal district court which upheld the previous decision. Finally, the case made its way to the Court of Appeals for the Seventh Circuit.
The claimant argued that his stealing and panhandling, illegal activities, should not be considered SGA. Assuming that such actions are not SGA, the claimant said that the decision was therefore inappropriate. Using a very novel approach, the claimant further said that if his “work” was to be considered SGA, then the cost of the drugs he uses should be deducted from his income as an impairment-related work expense.
The Court of Appeals found no reason why his stealing and panhandling could not be considered SGA given that no provision in the Social Security Act requires SGA to be lawful. The Court said that the rules say work activity is “substantial” if it “involves doing significant physical or mental activity” and is “gainful” if it is “the kind of work usually done for pay or profit, whether or not a profit is realized.”
The Court ultimately found that given that neither the Act nor the regulations recognizes a distinction between lawful and unlawful activity for purposes of determining SGA, illegal activity can constitute SGA.
The Court rejected the claimant’s argument that the cost of narcotics must be deducted from his income as an impairment-related work expense. The court noted that to be considered an impairment-related work expense under the rules, a drug must “reduce or eliminate” the symptoms of a claimant’s impairment, or “slow down its progression.” Here, it was clear that the use of drugs was the basis of the disability, and the continued use of the drugs only exacerbated the claimant’s medical condition. As a result, the Court of Appeals affirmed the decision of the district court denying the claimant’s application for disability benefits.
If you think you may be entitled to Social Security Disability benefits and have questions, call The Nationwide Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation today.
Source: SSR 94-1c: SECTIONS 1611 AND 1614(a) OF THE SOCIAL SECURITY ACT (42 U.S.C. 1382 and 1382c(a)) SUPPLEMENTAL SECURITY INCOME — DISABILITY — ILLEGAL ACTIVITY AS SUBSTANTIAL GAINFUL ACTIVITY
How do I show the SSA that I qualify for disability benefits?
If you have an illness that you think should qualify you for Social Security benefits there’s one thing you and every other claimant must do regardless of your disability – provide sufficient proof that you actually are disabled. The Social Security Administration defines disability as “the inability to engage in any ‘substantial gainful activity’ (SGA) by reason of any medically determinable physical or mental impairment(s) 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.” In other words, the claimant must both prove both that he has a disability and that it is severe enough to qualify for federal benefits.
First and most important, the claimant must provide documentation from “acceptable medical sources” of his condition. Licensed physicians are prime examples of acceptable medical sources and are capable of establishing all disabilities. Other medical professionals are permitted to act as acceptable sources but only in limited situations specific to their areas of expertise. For instance, a psychologist is competent to provide evidence for mental disabilities and a podiatrist is competent to provide evidence for foot issues, but not the other way around. Medical professionals who are “treating sources” i.e. professionals who’ve tended to the claimant over a long period of time, are deemed the most important sources of information.
Once the claimant has chosen an appropriate medical source to assist in making a disability claim, that medical professional must then hand over reports to the SSA. Such reports include medical histories, lab tests, and reports describing the claimant’s ability to perform “work-related” tasks.
Sometimes, the claimant is not able to get all the information he needs from his own doctors or medical sources that are available to him. The claimant is then permitted to schedule a Consultative Examination with either his usual treating source or another medical professional to obtain the specific medical information needed by the SSA. A complete Consultative Examination Report would include the following information:
• the claimant’s major complaint;
• a detailed description, within the area of specialty of the examination, of the history of the major complaint;
• a description, and disposition, of pertinent “positive” and “negative” detailed findings based on the history, examination, and laboratory tests related to the major complaint, and any other abnormalities or lack thereof reported or found during examination or laboratory testing;
• results of lab and other tests (for example, X-rays);
• the diagnosis and prognosis for the claimant’s impairment;
• a statement about what the claimant can still do despite his or her impairment; and
• the consultant’s consideration, and some explanation or comment on, the claimant’s major complaint and any other abnormalities found during the history and examination or reported from the laboratory tests.
If you think you may be entitled to Social Security Disability benefits and have questions, call The Law Offices of John T. Nicholson at 1-800-596-1533 for a free consultation today.
How much does SSI pay per month?
How much will your Supplemental Security Income (SSI) checks pay each month? Well, it varies as some states award additional income to the base amounts listed below. That being said, here are the amounts for 2012. Keep in mind that these amounts change each year in conjunction with the cost of living adjustment (COLA).
Social Security Administration SSI payout amounts for 2012:
| Recipient | Unrounded annual amounts for— | Monthly amounts for 2012 | |
|---|---|---|---|
| 2011 | 2012 a | ||
| Eligible individual | $8,095.32 | $8,386.75 | $698 |
| Eligible couple | 12,141.61 | 12,578.71 | 1,048 |
| Essential person | 4,056.93 | 4,202.98 | 350 |
| a The unrounded amounts for 2012 equal the unrounded amounts for 2011 increased by 3.6 percent. | |||
Payment reduction
Remember, these payouts are lowered depending on your countable income each year. If you are thinking of applying for disability benefits click for a free consultation or call 1-800-596-1533.
Does my income affect my child’s ability to qualify for Social Security Benefits?
How much income can parents have before their children no longer qualify for Supplemental Security Income benefits?
Disabled children can qualify for benefits under the Supplemental Security Income (“SSI”) program, which is administered by the Social Security Administration, depending: (1) on the nature of their disabilities; (2) on how much income they have (if any); and (3) on their available resources. Children’s “available resources” include the income (and assets) of their parents and guardians. Therefore, many parents and guardians of disabled children wonder how much income they can have before their children no longer qualify for SSI benefits.
The Social Security Administration (“SSA”) defines a child as someone who is not married; is not head of a household; and is under age 18, or is under age 22 and regularly attending school. This discussion only applies to SSI benefits for disabled children, as the SSA defines the terms “disabled” and “children.”
1. Nature of disability. According to the definition established by the applicable laws and regulations, a child is “disabled” if the child “has a medically determinable physical or mental impairment, which results in marked and severe functional limitations, and 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.” In other words, a child is disabled for purposes of SSI benefits if the child has a very serious medical condition that will last (or has lasted) for at least one year. For example, a child who suffers from cystic fibrosis could qualify for SSI benefits. A child with a minor broken leg, but who did not otherwise have a serious medical condition, would probably not qualify.
2. Child’s income (if any). In terms of a child’s income, a child may not earn more than $1,000.00 per month from employment and still qualify to receive SSI benefits (in 2011; the limit on a child’s total monthly income changes every year). On the other hand, a child who is unemployed, or who is employed but earns less than $1,000.00 per month (in 2011), would meet the income limit.
3. Income and resources (i.e. assets) of parents or guardians. The determination of a child’s eligibility to receive SSI benefits also takes into account
Income, in this context, comes in two varieties: “earned income” and “unearned income.” Earned income consists of “wages from employment, net earnings from self-employment, certain royalties and honoraria, and sheltered workshop payments.” Unearned income consists of money received from other sources, “such as Social Security benefits, pensions, state disability payments, unemployment benefits, interest income, and cash from friends and relatives.” Some income is exempt and does not count toward the applicable limits. The following chart illustrates the income limits currently applicable in many (but not all) circumstances.
|
Number of Ineligible Children in Household |
All Income is Earned |
All Income is Unearned |
||
|
One Parent in Household |
Two Parents in Household |
One Parent in Household |
Two Parents in Household |
|
|
0 |
$2,821 |
$3,495 |
$1,388 |
$1,725 |
|
1 |
$3,158 |
$3,832 |
$1,725 |
$2,062 |
|
2 |
$3,495 |
$4,169 |
$2,062 |
$2,399 |
|
3 |
$3,832 |
$4,506 |
$2,399 |
$2,736 |
|
4 |
$4,169 |
$4,843 |
$2,736 |
$3,073 |
|
5 |
$4,506 |
$5,180 |
$3,073 |
$3,410 |
|
6 |
$4,843 |
%5,517 |
$3,410 |
$3,747 |
By “resources,” the SSA essentially means property. For instance, resources include bank accounts, cash, life insurance, real estate, stocks, U.S. savings bonds, vehicles and other property belonging to a child’s parents or guardians that could be exchanged for cash and used for food or shelter. Some resources, such as a home, household goods and personal effects, and money in pension funds, are exempt and do not count toward the applicable limits. Currently, the applicable resource limit (for non-exempt resources) is $2,000 for a single parent or guardian, and $3,000.00 for a couple.
To summarize: A disabled child’s eligibility for SSI benefits depends upon the nature of the child’s disability, the amount of income that the child earns (if any), and the income and resources available to the child—including resources available through parents and guardians. Regarding the resources of parents and guardians, the limits vary from case to case depending on the circumstances. The income limits listed in the foregoing chart, and the resource limits discussed above, might or might not apply in a specific situation because of the many rules and regulations, as well as exemptions, that govern SSI eligibility for disabled children. If you are the parent or guardian of a disabled child and would like to learn more about SSI eligibility, then talk with a lawyer with experience dealing with Social Security issues.
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