Wednesday, February 24, 2016

Appealing Partially Favorable SSD Decisions

When you apply for Social Security Disability (“SSD”) benefits, the State agency  can approve your application, but based on a date after you claimed you became disabled. The result of that partially favorable decision (“PFD”) is that you may lose benefits, and it may take longer for you to receive Medicare

To decide whether or not to appeal, you must review the entire file. However, frequently the reason why a particular later date was selected for the disability onset cannot be discerned. Regardless, the issue boils down to what changed between the time you claimed you became disabled, and the date you were found to become disabled. 

I just received two ALJ decisions that rejected the State agency PFDs. One was a 56 year old former bread machine operator with upper left arm impairments, and the other was a 52 year old former stock clerk with progressive orthopedic injuries from car accidents. The State agency claimed there was no contemporary medical records for either. At their hearings, I showed that there were in fact contemporary medical records for the former, and a valid retrospective medical opinion for the latter. 

The ALJ agreed with my arguments, which essentially demonstrated that each claimant’s medical restrictions and limitations had existed since the date that each claimed they had become unable to work. Consequently, the ALJ issued a fully favorable decision for each claimant. The result was that each claimant received in excess of another year of SSD benefits.

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