PSA: Overpayments

We have recently experienced a significant increase in phone inquiries from individuals receiving Social Security Disability ("SSD") benefits who have received an “overpayment” notice from Social Security. In essence, Social Security is indicating that they have paid more money than the claimants were entitled to receive.

Many SSD recipients find it challenging to subsist on the limited monthly benefit provided. If one’s health permits, it is possible to engage in limited part-time employment while receiving SSD benefits; however, it is essential to understand the earning limits stipulated by Social Security to avoid an overpayment.

Any form of compensated work constitutes employment, regardless of the nature or perceived difficulty of the job. The critical factor is the gross monthly income earned, not the type of work performed.

Recently, we consulted with a former client who is unable to meet her financial needs solely through SSD benefits. She supplements her income by babysitting, which involves collecting children from school and supervising them until their parents return home. Although she believed this activity would not impact her SSD benefits due to its simplicity, we advised her that Social Security considers only the total monthly earnings, irrespective of job complexity.

Social Security regulations are unequivocal. If your gross income exceeds the Substantial Gainful Activity ("SGA") threshold for more than a nine months trial work period within a 60-month period (regardless of whether these months are consecutive), you must notify Social Security to suspend your benefits temporarily. Should you become unable to continue working within five years, you may file for "expedited reinstatement" of your disability benefits without having to file a new application.  Failure to report excess earnings can result in substantial repayment obligations once Social Security identifies the discrepancy. It is crucial to familiarize yourself with these regulations to prevent such situations from occurring.

Lifelong Disability Approved

Our client is a 30-year-old woman born with Cerebral Palsy, a lifelong condition affecting her mobility, muscle control, and overall functional capacity. Despite significant limitations, she had attempted to navigate the disability process twice on her own but was denied both times. By the time she retained our office, she was understandably frustrated.

We elected to file a new application and developed the case thoroughly from the outset. Updated medical records were obtained, and we worked to ensure the evidence clearly documented not only her diagnosis, but also her limitations in standing, walking, balance, coordination, and endurance over the course of a workday. Unfortunately, the State agency denied the application at the initial and reconsideration levels. While disappointing, these denials, are not uncommon, even in cases involving longstanding impairments.

We requested a hearing before an Administrative Law Judge ("ALJ"). Prior to the hearing date, the attorney at the hearing office assigned to review the file explored the possibility of resolving the matter without a formal appearance before the ALJ. Although those discussions were constructive, the case ultimately proceeded to a hearing. As part of our pre-hearing preparation, we amended the alleged disability onset to a much earlier date. At the hearing, the ALJ observed our client directly and heard her testimony regarding her daily functioning and work-related limitations. Following the hearing, the ALJ issued a fully favorable decision.

Every disability case is unique, but this one reinforces why careful case development, strategic advocacy, and preparation for hearing can change the outcome entirely. If you are considering filing for SSD, please reach out to our office for a free consultation.

 

 

Vocational Evidence

Obtaining Social Security Disability (“SSD”) benefits requires proving the inability to perform any full-time job for at least twelve months.  The process requires submitting substantial medical support from treating providers. Many claimants are unaware that there is also a vocational component involved in the evaluation process.

In addition to submitting medical evidence, claimants must provide detailed information about their work history for the past five years. Social Security not only reviews medical documentation but also employs Vocational Experts ("VEs") to examine claimants' work histories. A VE considers the claimant’s job experience, age, and any restrictions or limitations when determining what work, if any, is possible. A VE may also assess whether the claimant possesses transferable skills that would allow them to work full-time in another occupation.

VEs frequently rely on the Dictionary of Occupational Titles ("DOT") an outdated resource.  Each occupation listed in the DOT is classified into categories such as sedentary, light, medium, heavy or heavy work.

We represent a 52-year-old Peace Officer from Baldwin, New York, who recently received a Fully Favorable Decision regarding their SSD application. Several months prior to the scheduled hearing, we requested an On the Record (“OTR”) decision; the administrative law judge ("ALJ"), however, declined to grant it at that time.

Shortly before the hearing, we submitted an in-depth description of the claimant’s past occupation as a Peace Officer from his employer, New York City, including the requirements necessary for the position. Upon reviewing this information, the ALJ recognized that the claimant did not possess transferable skills applicable to other occupations. As a result, the ALJ approved the OTR the day before the hearing was scheduled.