To: Kara DiCecco, M.S.N, L.N.C.C.
From: Chris Tremblay, R.N.
Re: LEI 233
Legal Nurse Consultant Mentorship
Place: Law Firm of Doroshow, Pasquale, Krawitz & Bhaya
Subject: Journal on Social Security Disability
The topic for discussion and review was that of Social Security and applying successfully for disability.
It came as a surprise to me how useful and valuable a nursing background was for participating and supplying the necessary key information to the disability process. By the end of the day I had to admit… a perfect fit.
Jean Marie McKinney and I met at the law firm where Kara DiCecco is the Legal Nurse Consultant. We spoke of the website that is very valuable as a reference source for any topic in regards to Social Security benefits, i.e. www.nosscr.org (National Organization of Social Security Claimant’s Representatives) and the homepage for social security, www.ssa.gov. Anything anyone would want to know about social security is on this site.
One of the pages on this website is www.ssa.gov/work. Known as the “Red Book” this is information concerning SSA’s “ticket to work” program. Anything anyone would want to know about social security is on this site.
The two basic programs for social security are Social Security Disability Insurance also known as SSDI and Supplemental Security Income, also known as SSI. It was very interesting to learn that if you become disabled and it is determined not totally disabled, the claimant can be placed down in skill level (requiring less than your current educational/work experience) in the workforce, but you cannot be placed up in skill level (harder than your current educational/work experience) in the work force.
A Five Step Process:
Step 1: A claimant must be unable to work one full year or a physician believes the individual’s condition will prevent them from working at least a year or longer (based on 2004 criteria). If you earn more than a set amount ($810.00 a month gross (in 2004), Social Security presumes you are not disabled. The individual cannot be working when they apply.
Step 2: There must be a physical and/or mental condition that prevents them from working. Social Security Administration gives a lot of weight to specialist opinions. The medical and/or emotional condition should be severe and be evaluated to meet a listing. This is a list of body systems and impairments that is the Gold Standard (eligibility requirement) for argument to the judge. Body systems are assigned certain numbers and if those the claimant’s impairment meets the criteria on the list, they qualify.
Step 3: If you don’t meet a listing, you go on to Step 3. This exact degree of severity of condition is step three in the analysis.
Step 4 is: Can you return to any of your former jobs going back 15 years?
All of these steps in the analysis are determined based on the medical information in front of the reviewer. They will make a decision without these records if they are not all gathered in front of the adjudicator.
Step 5: The burden of proof shifts to the Government and no longer the claimant’s as in Steps 1-4. It is the Government’s burden to prove you can work a full time job and show the jobs exist in competitive numbers in the workforce (good odds of getting the job).
The copy of the Dictionary of Occupational Titles (DOT) with the Copy of the Listings and Copy of Grids was reviewed and explained as the tool for determining the degree or severity of disability. It simply tells the reviewer yes or no for the applicant question: Do I qualify for Social Security disability?
This law firm has several attorney’s that specialize in representing Social Security claimants and knows the value of the Legal Nurse Consultant’s contributions.