ALJ Hearing Advice

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BCN59

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PEB Forum Veteran
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I recently received my second rejection for SSDI and my medical attorney told me I should request a hearing.

She said she herself doesn't understand why I was rejected again, and that I should hire someone to help me.

Does anyone have any advice? Is this pretty much a lost cause for now?
 
I applied twice, once while on active duty and once after active duty. My first attempt on AD was denied because I went on leave for 12 days and SS sent a medical questionnaire due in ten days. I was denied for the petty reason of being overdue on a form by 2 days.

After I was out I reapplied. I was approved because I met "the listing" (11.12) for myasthenia gravis. I recommend you research the SS listing for your conditions. Then try to meet that listing.
 
What are your disabling impairments? A Step 3 denial is pretty standard (i.e. Adult-level Listings). You were probably denied at Step 4, i.e. prior relevant work, or Step 5, other work in the national economy.
 
ssdlawyer said:
What are your disabling impairments? A Step 3 denial is pretty standard (i.e. Adult-level Listings). You were probably denied at Step 4, i.e. prior relevant work, or Step 5, other work in the national economy.
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100% for Major Depressive Disorder, Generalized Anxiety Disorder, Bulimia, and post-degenerative arthritis.
 
BCN59 said:
100% for Major Depressive Disorder, Generalized Anxiety Disorder, Bulimia, and post-degenerative arthritis.
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An admin hearing certainly isn't a "lost cause" before an ALJ, because the standard of review is de novo, and you have the chance to present your story. As someone who practices entirely in this area, I can say that MDD and your infantry (if that is what you are) or DJD of the joints are the two major issues for you to draw on, in describing the extent of your disabling impairments. If you have (the usual) ga-billion pages of VA and MTF treatment notes, go to the comp and pen sections for service-connection awards; those are probative, but not persuasive, in SSD/CFR 404 law. Another thing: Judges look a lot at credibility: If a veteran says that s/he has issues with crowds, anger, etc., as a symptom of his/her PTSD but is driving through traffic, spending time with a million friends, and last treated with a psych three years ago, then you have considerably hurt your case. I see that all the time, and with hundreds of veterans, it's a real issue, in my practice. Hope that helps. :)
 
BCN59 said:
I recently received my second rejection for SSDI and my medical attorney told me I should request a hearing.

She said she herself doesn't understand why I was rejected again, and that I should hire someone to help me.

Does anyone have any advice? Is this pretty much a lost cause for now?
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Totally normal to be denied prior to ALJ. Get a local Social Security attorney and have him review your medical records and prepare your case for the ALJ hearing. Trustworthiness is the cornerstone by which most judges render a decision, not to discard medical evidence but to adjudicate on your favor based on both.

Do not allow the case to be closed, if so, you'll have to re-apply and start from the very beginning.
 
You can help your SSDI case by having your MH doctors document the things in SS listing 12.04 which covers disability for depression.

12.04 Affective disorders: Characterized by a disturbance of mood, accompanied by a full or partial manic or depressive syndrome. Mood refers to a prolonged emotion that colors the whole psychic life; it generally involves either depression or elation.

The required level of severity for these disorders is met when the requirements in both A and B are satisfied, or when the requirements in C are satisfied.

A. Medically documented persistence, either continuous or intermittent, of one of the following:

1. Depressive syndrome characterized by at least four of the following:

a. Anhedonia or pervasive loss of interest in almost all activities; or

b. Appetite disturbance with change in weight; or

c. Sleep disturbance; or

d. Psychomotor agitation or retardation; or

e. Decreased energy; or

f. Feelings of guilt or worthlessness; or

g. Difficulty concentrating or thinking; or

h. Thoughts of suicide; or

i. Hallucinations, delusions, or paranoid thinking; or

2. Manic syndrome characterized by at least three of the following:

a. Hyperactivity; or

b. Pressure of speech; or

c. Flight of ideas; or

d. Inflated self-esteem; or

e. Decreased need for sleep; or

f. Easy distractibility; or

g. Involvement in activities that have a high probability of painful consequences which are not recognized; or

h. Hallucinations, delusions or paranoid thinking; or

3. Bipolar syndrome with a history of episodic periods manifested by the full symptomatic picture of both manic and depressive syndromes (and currently characterized by either or both syndromes);

AND

B. Resulting in at least two of the following:

1. Marked restriction of activities of daily living; or

2. Marked difficulties in maintaining social functioning; or

3. Marked difficulties in maintaining concentration, persistence, or pace; or

4. Repeated episodes of decompensation, each of extended duration;

OR

C. Medically documented history of a chronic affective disorder of at least 2 years' duration that has caused more than a minimal limitation of ability to do basic work activities, with symptoms or signs currently attenuated by medication or psychosocial support, and one of the following:

1. Repeated episodes of decompensation, each of extended duration; or

2. A residual disease process that has resulted in such marginal adjustment that even a minimal increase in mental demands or change in the environment would be predicted to cause the individual to decompensate; or

3. Current history of 1 or more years' inability to function outside a highly supportive living arrangement, with an indication of continued need for such an arrangement.

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http://ssaconnect.com/tfiles/SSA-4734-F4-SUP.pdf

Also helps if your current MH doc would fill this out for you and in the remarks give detailed information. If they just check the blocks on the form it won't hold any weight with SS. "Markedly" is the key here to being found disabled by SS
 
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