My Reality re: SSI Disability

[Wiley50]

Don't we have a Social Security employee who reads this thread? I NEED HELP!


I was a floorcovering installer for 27 years. To get any work from a carpet store, I had to work as contract labor, on a IRS Form 1099 and sign a waiver to absolve the store from any workman's comp liability.
I had to buy all of my own installation supplies and hire any helpers needed. After overhead, I cleared only about $15000 a year. I couldn't afford medical coverage. I always paid 13% SS self- employment taxes as well as IRS.
I first hurt my back in 1986 and it got progressively worse over the years. Without coverage and any way to pay for imaging (Xray, MRI, ect)
I couldn't get a doctor to do any more than tell me to lay on a heating pad and take aspirin.
The last 5 years I could no longer turn out enough work to really survive and was unable to file my taxes or pay into SS. I was too stubborn and too in debt to quit. I began drinking a lot as it was the only meds I had access to that worked at all for pain. I was also taking dangerous amounts of OTC pain meds.
I remarried in 1999 and got medical coverage through my wife. I got to an Ortopedic Surgeon who took one Xray, took one look and said," No wonder you hurt, your spine looks like a train wreck." He operated in early 2000 which only made it worse. Degenerative Disc Disease, 10 discs involved and Osteoarthritis in both knees.
I filed for disability in March 2001. I was told that I still qualified for regular ( Title 1 ) disability, although my coverage would end in a matter of weeks. I got in under the wire, I thought.
My claim was sent to the TN Dept of Disability Determination. Six months later, when they denied my claim, I was overmedicated with morphine and mismedicated with anti deppressants. I was a wreck who was not able to appeal the claim in the 60 days mandated.
Two months later, when they got my meds under control, I contracted a para legal, for help in filing a late appeal for good reason.
SS told her that I had to file a new claim and only was eligible for SSI now. We did that and the claim was denied because of my wife's income. That was the last straw for my marriage and my mortgage. I lost both house and wife.
I filed again in May 2002. DDS sat on the claim for one year and notified neither I or my attorney when they denied that claim. Two months later we asked and were informed. This time they let me file a late appeal as it was cleary their fault.
They then denied the appeal. Next step was a one and a half year wait for a hearing.
My attorney had always told me that we would try to get my original claim reinstated at that hearing.
My claim hit the ALJ's desk on Feb 25, 2005. He took one look and approved my claim as of 8/02. I never got a hearing.
Although I wanted to pursue the first claim, the ALJ and my attorney both said if it was sent to the SS appeals council that they could overule the ALJ's judgement and deny everything. It was best to settle for what I had.
I figured that since the owed me over $18000 back pay ( 25% to lawyer) that I could live with that since I had been living on little but foodstamps for 3 years.
My lawyer said to create debt for back rent from my Mom or they would pay the back pay in 3 installments 6 months apart. So I did so.
SS ignored the rent debt calling it a gift of " Food and shelter" and deducted that amount from all back pay months. But, I"M feeding both me AND MY MOM on my food stamps!
They also deducted the gross reciepts 1099 from my 2004 pay and used it to reduce my 2005 SSI payments too. I actually made $440 net from that buisness in 2004 but they charged me back for $2190.
They are charging me back per month over $200 for foodstamps and Tenncare premiums (I guess) and $187 for "food and Shelter".
Bottom line: They reduced my back pay to $1200 and are now paying me $204 a month instead of the $579 I'm supposed to get. They also left two years pay off of my judgement.
I filed appeal and they found the two years as it was on my judgement directly above the ALJ signature. Awarded me another $4100 but won't tell me when they'll pay it. It does not change my monthly benifit of $204
They say further appeal will have to await a hearing by an ALJ, 18 months from now.
If they had granted my original claim in 2001 I would still be married and wouldn't have lost $80,000 in equity when my home was foreclosed.

Tell me again how helpfull SS is.
Right.

[deek]

1. I hear you eom

.

[faithnotgreed]

2. wiley - i dont work for ss but just wanted to convey

my sorrow for what youve been through

[mike_c]

3. holy sh*t, that's one awful story....

It's easy to imagine rank upon rank of civil servants dedicated to saving pennies on the dollar by denying disability or other SS benefits. That's awful....

[KT2000]

4. This is happening to so many

it is getting to the point where workers comp is useless for injuries that are not witnessed by someone and especially for illnesses and injuries that do not "show."

In Washington state there was a manufacturer of aircraft that poisoned alot of their workers - working 7 days a week - 12 hour days with very toxic chemicals. Many became so brain damaged they were unable to do anything much less work. At first they put people on workers comp and then when they saw how much it would cost they denied everyone and demanded the money back - including putting liens on property and furniture for amounts already paid.

In order to fight the claim the people had to pay cash for medical care and evaluations. Anyway everyone turned to SSD and it took years for their claims to be approved. They were denied for years and lives were ruined.

Sorry to be so depressing, but you are not alone. People just don't realize how crooked the system is untill something happens and then its too late.

[ThomCat]

13. I tell everyone, if you get hurt on the job,

crawl outside and claim it happened on the sidewalk. Don't go through worker's comp. They'll screw you, and take their sweet time doing it for years.

[Sugarbleus]

5. OMG, Wiley... I am sooo sorry and pissed off for you...

That is an OUTRAGEOUS circumstance you got embroiled in.

I know that disability benefits and worker's comp are getting tougher to get ALL OVER THE COUNTRY. Fortunately or unfortunately, depending on where one lives, some states are much better at administering their disability programs.

In calif where I live, we still have to go through processes that can be time consuming and intrusive. Sometimes people will have to hire a SS disability lawyer to get their claims approved. But for the most part, people here don't go through as much as folks in other states.

In terms of getting any aid from them without a doctor's exam, we will be denied just like you were. It's a crime in that a person could be suffering untold misery but if they have no money nor insurance to get a thorough exam, we get denied just like that!

I don't know TN law but it sure seems like you got screwed over. When I applied the first time without a permanent doctors thorough exam, I was denied. I waited another year and finally got into the Medicaid program where I got that top to bottom exam. When I applied the second time I was granted my award without any hassle and no lawyer. In Calif today, we cannot get back pay for more than one year.

I applied to SS as a low income medically needy worker. I haven't had a permanent job since early 80's. I worked temp jobs over the years and continue as an in-home caregiver to my ex spouse. I have osteo arthritis in hips and spine,diabetes, sleep apnea, depressions, foot problems and more... I figured they just gave it to me because of my age--I'm closer to retirement age anyway. I had multiple medical complications. The weird part is that they gave me SSDI
PLUS SSI. They based my SSDI on my paltry work record..unlike your lifelong record..and based on my continuing in-home caregiving.

Still, the system has beefed up it's intrusive and rude and threatening scanning of each case with people. It wasn't always like that. They keep sending me stuff called "ticket to work"...yeah right! If I could work in gainful employment, I would go to work. I didn't want SSDI and didn't expect it. I wanted SSI, but got both. Go figure.

They subtract my current low income earnings from both my SSDI and SSI. I think that because we are a federal income tax paying state, we get more from disability than some states give. Be that as it may however, the cost of living out here is astronomical so that the benefits don't allow us to live large any more than if we lived in a cheaper state with smaller benefits.

What I do know, about applying in order to get your claim the attention it needs, (again, I don't know TN law) is to be very exact and thorough when you fill out the paperwork. You have to be very detailed about your every movement on a daily basis from morning til night. Every ache, every pain, how it affects your mood/demeanor, personal hygiene, all the difficulty in place to just get to the bathroom, and how your condition keeps you from working EXACTLY, etc.. You have to lay it on thick and be very revealing about your situation. Being a drug addict or alcoholic is NOT a positive thing to include. They stopped helping addictive persons a long time ago. Some might slip through the cracks but it's not a verifiable reason to give aid anymore, overall.

When I went through the process, if there was anything they asked or wrote down that was incorrect, I immediately corrected them. Once they get a wrong item written down, it's difficult to get it straightened out, if at all. Wrong data, wrong assumptions on their part are certain grounds for a denial. I keep a file cabinet for ALL the paperwork; sometimes THEY get the case all messed up so I like to have the original documents they send to prove where they went wrong.

ALL OF THIS HASSLE just for a few bucks so we can eat and hopefully pay rent. It's a criminal/indecent way to treat people!

I don't know your case first hand, but just by your telling of it, it seems you got screwed. If you have it in you, try to get it straightened out. If you worked all those years (even part time), you ought to be able to get SSDI.

Good luck to you Wiley... It's been a bitch, but you're in finally. Now we just have to keep the freaks in the White House from taking it away again!!

Best regards, SB

[dajoki]

6. GOD BLESS YOU

i thought i went through hell and back with worker's comp and ssd, but that is horribly sad what they did to you. you will be in my prayers and i wish you all the best.

[Wiley50]

7. Time for a kick n/t

[happyslug]

8. A couple of comments

First, you can petition SSA that you were disabled in 2001. What most people call SS Disability is in Title II of the Social Security Act, Title I just set up the Social Security System and ask the states to authorize the Federal government to act as their agent in setting up the SS System, a process required by the view on the proper Federal-State Relationship in the 1930s when SS was set up.

Now Title II benefits can be backdated to a date prior to your date of application. Now you will NOT get paid from 2001, SSA will only pay you for a year before your Application, but ongoing benefits of Title II can be based on someone being disabled years before he or she applied for benefits. Thus you can go down to your local SSA office and make an application for Title II benefits based on you being disabled in 2001 at any time, even decades after that date. The issue will remain where you disabled in 2001 and that can get hard to prove years after the date of disability but you indicate you have doctor's report from the time period. As my father use to say, what is the worse they can do say no? (Actually the SSA can do more than say no,see below but it all Depend on you age.)

The biggest problem you have is that you applied in 2001 and than left the claim expire. SSA and the Courts will tend to view that as a final decision but you can ask SSA for a hearing on the evidence available in 2001 that you were disabled. If you can get over the hurtle of the prior denial, you can have SSA rule you disabled in 2001 and thus eligible for Title II benefits. Now your benefits will only go back six months prior to your new application but it will be a change in benefits.

Now as to the risk involved in re-applying for Title II benefits. It is Possible for the ALJ or the Appeals Council will rule you NOT disabled and deny you your SSI, for more details see below.

The biggest problem in your case is that it is a back case. Back case are always a problem for SSA, it is hard to determine between someone who has a bad back and someone who is just claiming such a bad back. Furthermore the dispute is often not if you have a bad back but how bad is your back?

Now in your favor you have a long work history and your past work has been of the "Heavy" exertional level (You carried over 50 pounds in your job as a carpet installer). What "skills" you learned on the job are in the installing of Carpets. Given the weight requirements of a Carpet Installer and that your back has been operated on, I do not see any ALJ ruling that you can return to that work. Once a decision has been made that you can NOT return to past work the burden shifts to SSA to show there are other work you can do.

Now SSA also takes into consideration the Aging process. Thus different set of regulations set in when you turn age 50 and 55. Up to age 50 all SSA has to show is if you can do any type of job even a Sedentary type job (i.e. a job that requires you to lift no more than 10 pounds or be on your feet more than two hours in an eight hour day). If you can assemble small parts, bag small parts or watch Surveillance monitors you can do Sedentary work and thus NOT disabled under SSA regulations.

Now once you turn 50, SSA can no longer consider Sedentary work (Unless you did Sedentary work in the previous 15 years prior to 2001, something you indicate you did not do). Thus for people over age 50, the test is can you do light work, work that requires you to pick up weights up to 20 pounds occasionally, 10 pounds frequently OR a Sedentary job that requires you to be on your feet more than two hours in an eight hour day. Examples of these are light janitorial (Mostly daylight, you push a broom to keep the dust down), inserter in the printing industry, mail room sorter (Non-post office), Light Cashier (mostly in restaurants etc), light assembler and Security Guard.

If you are over 55 years of age, SSA can no longer consider Light work (unless you did it in the previous 15 years before 2001) SSA must show you can do medium Work (Work that requires you to pick up to 50 pounds occasionally, 25 pounds frequently). Examples of Medium work is Medium Janitorial (Mostly at night with the use of heavy cleaning equipment), Medium Cashier (Supermarket Cashier), Lenin Room worker and stock person.

I mention the age regulations for it is the framework SSA uses and any advice I give will be based on that Frame Work.

My advice is if you are today over age 55, you should reapply. The worse thing that can happen is SSA ruled you were NOT disabled in 2001, but you are disabled once you turn 55 (In all of the back cases I have been involved in, no physician considers a person whose back has been operated on capable of doing medium work activity). Thus in my opinion, will SSA consider you capable of medium work activity in your case IF YOU ARE OVER AGE 55 TODAY (What I mean by this is if you apply and fail, the worse that can happen is the case be dismissed and you stay on SSI). Now it is possible for SSA to rule you are NOT disabled, but if you are over Age 55, I just do NOT see that happening.

If you are above age 50 but not yet 55, the issue is tricker. Basically I have seen Doctor's reports that indicated a person with a back that has been operated on as being capable of Light work. Thus upon reconsidering the decision the ALJ may rule you are capable of Light Work today and you lose your SSI. Thus it is very possible for you to lose your SSI if you should apply for Title II benefits on the grounds that you are capable of doing light work. Now I doubt most ALJ will ruled against you if you are over 50, but you never know.

Please note under SSA regulations SSA is NOT suppose to re-litigate prior favorable decisions, but here you are asking them to review all of the decisions since 2001 and thus possible for them to re-open them all and make a new decision against you on the grounds you are today capable of doing light work. While such a negative ruling is unlikely, I have to warn you that it is a good possibility (It is even a possibility if you are over age 55, but I just do not see SSA ruling a person over age 55 with a back that has been operated on capable of doing Medium work, light work maybe but NOT medium work).

If you are below age 50, just hang it up. All SSA has to show is that you can do small parts bagging, small part assembling, Surveillance system Monitor type jobs. All of these has a sit/stand option i.e. you can sit till your back pain gets to much than you can stand and alternate between these two position while doing these types of jobs. Thus it is very possible that SSA can rule you capable of that type of work and thus not-disabled under the SSA Regulations. I would be to afraid that if try to re-open the 2001 case, all you will get is a ruling that you can do sedentary work today and lose what SSI benefits you are getting.

Now the longer you wait to claim disability for 2001 the less likely SSA will rule to re-open the decision and the less likely to rule you were disabled in 2001 (And you addiction to alcohol will be held against you in the claim since as you indicated it was a factor in you ability to work in 2001).

I hoped I helped you, but it is your life and you get to decide on how to live it. The above is a guideline to help you make that decision, but as I have told my clients, ongoing benefits are often more important than a huge lump sump sometime in the Future. In your case ongoing medical care may be more important than shifting to Title II from Title XVI of the Social Security Act.

[DemBones DemBones]

9. I think SSA always sends a notice of benefits with

the disclaimer that you can appeal if you don't think you got a fair award but if you appeal you could end up with nothing. Pretty much eliminates appeals, I should think.

[Wiley50]

10. GOOD NEWS!

Thanks to the advise of a poster on one of my other threads in this forum.
SS is putting $7000 in my checking acct tonight
and another $11000 in tommorrow night.
and I will get the maximum monthly on the first of every month from now on.

THANK YOU DU!

Wiley

[ThomCat]

14. Congratulations!

It's good to hear some good news.

[DanCa]

11. I can relate

I was diagnosed a year ago and have been on ssdi a little more than sixth months. I get paid about 514 a month and 60 dollars in food stamps because I live at home. My tremors are to bad for me to drive.
What really burns me is that my sister selene a prolifer throws it in my face all the time. Just yesterday she said I should really stop complaining about the president because he is a good christian that signs my welfare checks and i should be greatful for what he "gives" me.
I really want to go to work you see but would anyone hire me knowing that I will miss half the time due to tremors and stiffness.
Hang in there Wiley if i can ever help you let me know.

[VinnyB]

12. don't feel bad pal were in the same boat with no paddle

I've been on SSD since 1995 with Degenerative Disc Disease, 9 discs at last count, multi heart problems and so on...... Since November of '05 our government has Declared War on my sorry sick n broke as...er butt !! I was kicked off Medicade "with NO income change mind you" placed on a medically needy program where i would pay the 1st $465.00 of cost per month, but after i pay rent there's only 350.00 left to live on for the month. never mind med bills, But thats ok because they kicked me off this program last month! my RX costs have gone up with the great new medicare rx program and half of the meds i should take are not coverd so i cant take them. so I'm getting sicker by the day. my last trip to the E.R. i asked where can i get the care i need with the coverage i have ? they couldn't tell me. But thats ok because I got a letter this week to tell me they are going to kick me off food stamps as of the end of this month. So I think Bush and the Neocons have it all worked out, take the doctors away stop the RX drugs and don't feed the sick and disabled, in no time we will start droping dead and they will save another five dollars in tax. don't worry "W" iam doing my part!!! Job well done

[Pharaoh]

15. compassionate conservatives in action

:puke:

[hashibabba]

16. Yeah, yeah--compassionate, that's it.

Fortunately I got my SSDI about 10-12 years ago. I'm so sorry about these horror stories about how much people get and how they've been treated by the agencies. I had to jump through all kinds of hoops, but they accepted my first claim (no lawyer). And they paid me back about a year. I do get a decent amount, enough so that I don't qualify for food stamps. How can anyone possibly live on $500 a month? That's criminal. Fortunately, I get my meds for $2-5 each because I get a small amount of money. Once I hit the *doughnut hole* they'll be free! That will be this month. Good thing because I can't afford the $500 a month. I also finally got my housing assistance last year (every place had a three-year waiting list and I kept moving, so I finally got through after 9-10 years of trying). But then Bush wants congress to cut 50% of the housing program for this year's budget. Our county closed the program to new applicants last year because of his budget cuts.

So, hang in there and keep trying for your benefits. Sometimes it does work out.