Below is the video transcript
The Law Firm of Gonzalez & Goetz, including their phone number (954) 764-8989 and address (2300 NW Corporate Blvd. Suite #244, Boca Raton, Florida 33431).
Boca Raton disability claim law firm, Boca Raton attorney for Social Security disability, Fl law firm for Social Security disability claim, and South Fl SS disability law firm.
Video Transcript with Punctuation and Links:
“Everybody can hear me okay, right? Everybody’s awake? Okay. Why did I come up from Florida? I think a lot of people are thinking, um, Social Security Disability law is a federal law, and it’s nationwide. So, the same standards that apply in Florida apply in Guam, apply in Europe if you’re an employed person that got disabled, and apply anywhere in the 50 states. Um, so I’ve done a lot of programs with MS. It’s something near and dear to my heart, and I’d like to go through my slideshow and then try to tie it up to what the doctor was saying because I think he made some really great points. Um, just to get a clear picture of who’s here: how many people are currently on Social Security Disability, and how many people are applying for disability, and how many people have been reviewed? Those of you who are on disability, have you been reviewed through the years? Okay, so the reviews are being a little more aggressive, especially right now during the approach of an election year. So, my suggestion—question—is to make sure you continue getting treatment, continue to have your doctor documenting all your complaints, and make sure that, if they write the notes, they still document, um, the side effects of the medication: the fatigue, the lethargy, the tiredness. Because many times, doctors—once you’re on benefits and they’re just treating you—they just write, ‘Patient is stable,’ and the judges, more often than not, think that stable means cured. And as we know with MS, it’s not a cure. So, it’s really important to complain and to document that.
Uh, let’s see what we have here, and I will keep it very short since most of you are on Social Security Disability. We will have a Q&A session also, and I’ll be happy to answer any questions afterwards. But there’s basically two types. There’s one that’s Title II Disability Insurance Benefits, and those are for people that have worked and paid money into the system. And then there’s Title XVI, which is for SSI, um, benefits for people who may not have worked enough quarters to qualify for them to be covered under Title II benefits. So, that’s referred to and called Supplemental Security Income. And for that, you have to be able to show that you are unable to work—which is the same for both benefits—but that you’re also, um, you meet the financial eligibility criteria.
Social Security Administration—the definition of Social Security Disability—is that you’re not able to perform your past relevant work, um, that you’re not able to adjust to any other work activity because of your medical condition, and that the expected duration of your disability is for 12 months or more. Um, MS is a very difficult, uh, disease to kind of diagnose. And for my purposes—and many of you probably had experienced this when you were applying for disability—you have a lot of diffuse symptoms. So, they can be associated with a lot of other impairments and diagnoses, and many times you’re, um, diagnosed improperly. So, we’ll have people with symptoms of fatigue that they may say, ‘You know what? You’re just anxious, you’re tired, you’re overworked.’ Or you may have symptoms which show that you have rheumatoid arthritis, and you may actually have it and have very positive tests and not actually have the diagnosis of MS. You can have Lyme disease. A lot of people that have Lyme disease have a lot of, um, the same symptoms, uh, and they don’t get treated accordingly or properly. You can have HIV, lupus—so, it’s a terminology of the autoimmune, and it’s very hard to kind of put a finger on it.
So, the way that we win the cases before the federal government is to really show not just your impairment and your diagnosis, but how it’s affected you and how it’s prevented you from working. And working is defined as a 40-hour work week. So, the question becomes, if I work 38 hours, or if I work 35 hours, or 25 hours, can I still qualify for benefits? And then the question becomes income and how much money are you receiving. So, everything has a trap, and there are no easy explanations. Um, this is the definition per Social Security, but every single one is a term of art: every ‘unable to perform,’ and then the ‘past relevant work,’ and how much you are working—working on a substantial gainful work activity. So, these definitions have a lot of interpretation and vary as much as the particular judge that you have, um, in front of you.
So, um, one of the things that I really harp on when I prepare a case—and I know many, many attorneys that do the same thing that I do—um, we all prepare cases a little bit differently, and that has a direct correlation to your success rate as an attorney. And because it’s a nationwide practice, I’ve had the privilege of working with attorneys throughout the nation. Um, we just recently won our first case internationally, uh, in Israel, and we did not have to go into the embassy to prepare the case and go in, and it was thyroid cancer—a different kind of disability. But what was very interesting was that, throughout the world, anybody who’s applying for Social Security Disability has to meet the exact same criteria. So, as an attorney, when you go in front of these federal disability law judges, you have to make sure that you have the proper preparation for each case, and preparation could be the difference between getting denied or not getting denied.
So, many times, you may actually be applying for disability, not have a diagnosis for MS, have some of the signs and symptoms, some of the, um, labs, but not necessarily have done the spinal tap or have anything concrete, and you have not been diagnosed with MS—you could still qualify for disability, and you could still get a fully favorable decision. And likewise, you can actually have MS and be able to work and not qualify for Social Security Disability. So, it’s never really the diagnosis as much as the symptomatology, um, and the preparation that you have to do for the case begins when you apply or when you actually are not able to work anymore. Many times, we push through, and we try to work, and sometimes we wait too long to apply, and then it makes it more difficult for the process to go through because Social Security is so backlogged and so delayed in obtaining benefits.
So, by having the privilege of working with attorneys throughout the country, um, and some throughout the world, very few attorneys specialize in this area solely. And the reason is because we’re capped. So, we’re capped at $6,000 a win, basically. So, we take the cases, we win, we get paid; we don’t win, we don’t get paid. And right now, we have an all-time high of denials nationwide. Um, so a lot of attorneys—and everything’s becoming electronic—so I have four attorneys who I’ve known for the last 23 years who have put up their shingle and passed me cases. And now that they’re no longer my competitors, it’s very interesting to see how different attorneys prepare for the case.
So, for me, it’s all about, um, the complaints and the symptomatology. You can be depressed, and it doesn’t really matter if you don’t go to the doctor, and if you don’t complain, and if you don’t get medication prescribed to you, and if you don’t have it documented. So, whatever it is, and whoever, you know, that’s going through this, I have to emphasize that lack of treatment will never win your case—whether or not you have proper funding. And here in the state of Michigan, you have very good public funding. In the state of Florida, where we’re headquartered, we do not. And, um, the Affordable Care Act is not available to everybody, and people will say, ‘We don’t have enough to get the proper treatment.’ That’s never an excuse because it’s practically impossible to win the case, um, going through the sequential process, seeing what you need, and outlining the case.
So, few people do this really, and my advice to anybody who’s ever looking or needs an attorney—if anybody ever tells you, ‘You have the right to an attorney,’ they’re giving you that right because they have the ability to take something away from you. So, don’t take that in vain. The other thing is that if you ever hire an attorney for anything, um, my advice is to always ask, ‘What percentage of your practice does this particular kind of law?’ And the reason is because, just the same way that you wouldn’t go to a cardiologist necessarily for symptoms of MS, or to a psychiatrist if what you’re complaining about are lymph nodes, um, you wouldn’t go to a traffic attorney or criminal law attorney to do Social Security Disability.
So, many people dabble in it, but, um, having a great reputation in the area that you have is tantamount to having a better chance at winning your case. This is again how we prepare for a hearing. Uh, there’s only a few people in the crowd that are applying for benefits, so anybody who has applied has seen this before—should have seen this, really: opening statements in front of the judge, letting you know what to expect, referencing specific exhibits. And this is where I talk about, with respect to what you feel, um, going back to what the doctor was saying—if you have cognitive issues, fatigue, pain, depression—you document it. You tell the doctor because every time you go to the doctor, it’s almost like a blank page in a journal. You can write, you can document, and that is evidence in front of a judge. And that’s what we use as attorneys to be able to show that on this day, and this day, and this day, by referencing it back, you would not be able to work or hold a 40-hour week. Um, so those are really, very important things.
The other thing is, um, with regard to referencing specific exhibits, is also the drugs that you take and, um, how they may help is documented in your notes. And doctors love to write how the drug is helping, but also the side effects are very, very important to be able to prove a case on disability. We’ve been able to win cases on side effects alone of medication, but we cannot win that case unless it gets documented by your doctor. So, patient-doctor, um, relationship is really important. And if you’re with a doctor who is not going to write these detailed notes, then you need to find another doctor—at least for purposes of winning your Social Security Disability case.
Um, vitamin D deficiency—I know somebody mentioned that—that’s also a real hot topic, even in Florida where we have a lot of sun. And, um, that’s, uh—I would suggest getting a lot of blood work on that every three months because if you’re not reacting or responding to the vitamin D supplements that you’re taking, sometimes you need upwards of 1,500 a day, sometimes you need 5,000 a day. I am not a doctor, but I like to see those lab reports that show a continuum of labs and a continuum of complaints and where your levels are. Because that’s where you have control of your case: how you develop your case, how you are compliant with medication. Those are blood tests, and those show that you are compliant. So, those levels should be going up, and they really, really help meet specific criteria, um, with Social Security.
This is an example of quarters of earnings. Um, this individual had stopped working in 2009 and then went back to work. You could see the first quarter of 2009, they went to work, and then they stopped working, and then they went back in 2010 and worked an extra quarter. This is a fairly typical work history of somebody with, with regard to the frequencies of work and not work, with regard to a longstanding MS patient. Um, because they have been able to work, then they have periods of attacks, they don’t work, then they go back to work. And by the time they come to me, um, many times they’ve been out of work for several years, and then they have to wait another at least year or two to get their benefits.
Um, we have been much more successful in getting cases won at a sooner level, a faster level, but that’s really dependent on how much treatment you have had, how aggressive you are, how helpful your doctor is. The goal of compassionate allowance—okay, so MS was, um, put in the Social Security Federal Regulations as a compassionate allowance. Uh, does everybody know what that is, or no? Okay, so compassionate allowance is—it was an incentive done for people who were diagnosed with MS who met specific criteria, specific medical criteria, so that they could receive benefits at a quicker level. So, instead of waiting—what we just saw on here—instead of making you wait to go through the whole process of applying and waiting and appealing and going, they determined that they were going to put MS, and there’s certain other, um, impairments that are also on their compassionate allowance. The federal government decided they’re going to give you, as an MS patient, if you meet the criteria, a certain kind of—you’re going to cut the line, and you’re going to go, as they say, a little sooner. They’re going to pay your case and assume that you are severe.
So, um, it’s under the same program. You go to the top of the line, and it’s made so that if you are really failing and your impairment is going to be lasting 12 months or more, so that they can try to see if they can speed it up. The benefit is your benefits get sped up. The issue is, if they pay your case and they allow benefits under compassionate allowance, and they review it and they find that you did not meet the medical criteria, they can turn around and charge you an overpayment. The federal government can come back after you, knock on your door, and say, ‘Excuse me, we gave you these benefits, and you received all this money. It was erroneous. You now owe the government this money.’ So, it can create a lot of anxiety for people.
So, compassionate allowance is really for people that are very, very severe. And, um, I think the doctor was talking, like, uh, like a primary progressive MS, different types of MS that are more advanced—those may qualify in their compassionate allowance. And those, we need to go through the labs very carefully when we outline the case and talk to your doctor and see how we can get you to go in front of the line with MS. Um, this is a list—a comprehensive list—of compassionate allowances. Again, it’s not enough to be diagnosed with these. It’s really a question of how these affect your ability to work. But for compassionate allowance, they have specific criteria that are medical, and that doctors turn around and have to help you with, making sure that all of the answers are met.
So, even though you may have an attorney, you’re going to have to have your doctor’s assistance with a compassionate allowance. Again, this is more on compassionate allowance—it’s a way to expedite the processing of any Social Security Disability claim. It’s really for advanced MS, malignant MS, um, more aggressive types of MS. Uh, with regard to MS with Sjögren’s, it’s got another criteria; with lupus, it has another criteria; um, with HIV, another criteria; with malignant cancer is another one. So, it really is a combination—it’s very complicated, um, and very, very detail-oriented.
Um, some people apply for Social Security benefits and get their benefits right away. I would say that those people represent about 6 to 9% of the population that get their benefits at the initial level—at the initial level. Um, and then you have to appeal the case, and that takes 60 days—actually, it has to be appealed within 60 days. So, it’s a lot of paperwork going back and forth. And then, if you’re denied at the reconsideration, you appeal it again—another 60 days—so you can go in front of an Administrative Law Judge. Um, the cases are denied almost always at initial unless they’re compassionately allowed or unless your criteria is very high. Then, at the reconsideration level, which is the second-tier level, um, again, there’s a very, very high—alarmingly high—rate of denial, probably like 88 to 90%. And it depends on the state and where you’re at, and it’s as good as the person reviewing the case.
And then you go into a hearing in front of an Administrative Law Judge. When you go in front of an Administrative Law Judge, it’s as good as the judge that you get. So, that means that’s where you put your preparation together, where you put, um, your analysis together. But there are certain listings of criteria, which means—just like in compassionate allowance—there’s certain medical requirements that, if met, you should be entitled to receive your benefits at the initial level or at the reconsideration level. You should not have to wait 12 months. You should not go into a hearing in front of an Administrative Law Judge.
If that were the case, I wouldn’t be here today because, over and over again, I’m in front of a judge, and I have all the criteria, and they decide to say, ‘Autoimmune is in the mind; autoimmune could be anxiety; stress is created.’ And this is something that we go to federal court with very often—on a daily basis. So, if it were that simple, we wouldn’t have these discussions. The reason that we have them is because it’s open to interpretation. So, we all know that anxiety can exacerbate, but anxiety didn’t give you the diagnosis.
So, um, I can go on and on, but it’s getting late, and I think everybody can understand how frustrating it can be to go in front of judges when you have a really great, great record. Um, not everyone has the opportunity to have the treatment that’s consistent, continuous, or the neurologists and the doctors that are compassionate. It really has to do with the area that you live in and the socioeconomic, um, abilities that you have. The contacts that you have in support groups like this can inform—they’re a wealth of information.
And so many people—as many times as I talk in these groups, and as many times as I hear myself, and I think I’m ‘la la la la la la la la’—I’m always surprised to hear how many people have MS and didn’t know about a group like this. So, spreading the word is really important because those are the people that go in front of judges and get that comment, ‘It’s all in your head,’ or, ‘Oh, maybe you have MS, but it’s as of now when they diagnosed it—not two years ago when you weren’t able to work, and they didn’t know what was wrong with you.’ So, we try to go as far back as we can with the documentation that we have. I hope I’m making that really clear.
And that’s me—not the greatest picture. It may have been a selfie, or my kid may have taken it. But, um, I’m a graduate from the University of Florida. I went to Temple Law School, uh, member of the Pennsylvania Bar Association also because that’s where I was, an active member of the National Organization of Claims Representatives for Social Security, uh, trial member lawyer. Um, but really, all we do is Social Security Disability—100%. And it’s nationwide, and I’m happy to say it’s now worldwide. And I’m also happy to say that my hope is to take some cases into the Supreme Court because we have some great federal denials that are prime to go in. So, that’s what we do—we appeal the cases.
And I’d be happy to answer any questions you may have. Um, but for those of you that are currently on benefits, remember—remember—every time we go into an election year, we—the government tries to save money, and they do reviews, and they are actively pursuing reviews. As long as you are very wary every time Social Security phones, and you make sure you’re getting treatment, you make sure you’re consistent with your medication and compliant, you should have no problem. Because for a medical review, the standard is: has your condition improved? So, if Social Security can say that your condition improved in any way, um, they would be able to turn away and stop your benefits, which would mean that you would have to appeal it.
Oh, and if anybody gets reviewed, and anybody has to appeal it—if they cut your benefits off—they write it really tiny: you have 10 days in which to appeal and continue receiving your check. Only 10 days. You have 60 days to appeal the decision, but you only have 10 days to appeal to get your money, okay? The other side of the coin is that if you appeal within those 10 days, and you do receive your check, and two years later you lose your case, you have an overpayment.
So, I’ll be open to any questions, um, happy to answer any questions on or off the camera. Uh, I’d like to know, for those of us that are on benefits, if we just got that form that we filled out that you were talking about, and we marked ‘better’—’No? Yeah? No?’—it hit the mail. That’s ‘improved.’ ‘Better’ is ‘improved.’ ‘Better’ is another word for ‘better,’ okay? ‘I’m doing better.’ No. ‘Stable’ is a word. Don’t give—you—their choices: ‘better,’ ‘worse,’ or ‘the same.’ ‘The same’ or ‘worse’—never ‘better.’ Never ‘better.’ And the reason is because then you have to prove—or I would have to prove—that your condition is better, but you are still disabled. So, the tier mark for review is whether or not your condition has improved. If they can show that your condition improved, then they can deny you from benefits. If your condition is the same, they have to continue you on benefits. And if it has gotten better, then the question is: are you capable of working 40 hours a week on a sustained, gainful work activity basis? And you’re shaking your head, but that’s not your determination anymore—that’s up to Social Security because you marked ‘better.’
Next questions here? ‘If you have applied, and you were—you had an attorney, and then you got denied, and you want to switch over to another attorney, is it a long process, a lengthy process for that, or does it just change?’ Okay, um, no—that’s a good question because people always fear that, ‘If I let my attorney go, I’m going to have worse chances at Social Security.’ But all you need to do is really send a letter to the attorney and tell them that you no longer want them to represent you, um, and Social Security has to have a copy of that. So, I—I get ‘fired’ on a daily basis because people are so frustrated that the system takes so long, and by the time I’m done talking to them, they feel better, and they ‘unfire’ me or whatever. So, a lot of times, it’s not a verbal thing. When somebody needs to get rid of an attorney or wants to hire a new attorney, you have to put it in writing, and you have to document it with Social Security.
I don’t mean to say I get fired all the time, but it’s just a very frustrating practice. Everybody’s out of work, everybody’s got no funds, no healthcare—90% of the people have no healthcare—and they’re just—they think that we are delaying it. And, um, we work our cases as fast as we can. And I think I would say that of any attorney—it’s really out of our hands, except for—there’s two ways of rushing a case: one is if you’re dying, and one is if you’re about to become homeless. But if you’re dead, you can rush the case, and if you’re homeless, you can’t rush it—it’s only if you’re about to become. So, it’s—it’s very, very frustrating.
‘I actually have a company that’s helping me apply for my disability, and everything’s going smoothly. My initial application was denied, and now they said, you know, the status from SSDI is that I’m going for, um, waiting for the lawyer—or I’m sorry—waiting for it to go in front of the judge.’ Okay, so, ‘Did I not have that reconsideration?’ You did. You did. You may not have known it because it’s—you have to have it. It’s the initial, the reconsideration, and the request for hearing. And, um, what happens is, because it’s such a paperwork type of law, so many times you get papers and papers and papers, and an attorney or a company will fill it out and fill it out for you. So that whenever you call them and say, ‘I got this paper, I don’t know what to do,’ the answer is, ‘Don’t worry about it, we took care of it.’ And that’s good—that means they’re doing everything that they need to. Um, ‘Did you say that the company that’s helping you is, uh, a law firm or no?’ ‘It’s called Allsup.’ Okay, so they have some lawyers. Allsup is an insurance company, and it’s associated—sometimes when you get long- or short-term disability, they go ahead and they put an attorney for you or a person.
What I would tell you—because I would be remiss not to tell you—is if, and Detroit has great judges—great judges in Detroit—but if for any reason you were to get denied, there are other steps of appeal. And sometimes those kinds of companies will not exhaust all appeals—they’ll just keep you on the books. But the interesting thing is that it’s not only about money when you look at Title II benefits—it’s also about the Medicare. And it’s, um, it’s important for you because those quarters of coverage—the money that you earned and you paid into the system—expire. So, once—a rule of thumb is once you’ve been out of work five out of the last 10 years, you cannot collect benefits under your account. So, it’s important to exhaust every level of appeal—that would be my suggestion.
‘Hi, um, I have not applied for disability, but I’m considering it, and I was just wondering, um, does your possible pension affect your Social Security benefits? And if so, how? I imagine it would, but I don’t really know how it works.’ Depends on what pension. Is it from a school board? Is it—so, it depends on the state, and it’s based on the actual employer and that arrangement. Um, if you’ve paid FICA earnings—Social Security earnings—it should be in conjunction; it should not offset, okay? Um, and that’s pretty across the board. So, it really has to do with Social Security. There’s some pensions that you kind of deviate from paying FICA, and then you’re left only with your pension, okay? But if you paid Social Security Disability Benefits—I mean, Social Security FICA earnings—you’re fine. You should be able to qualify for both, okay?
Oh, and when you have an initial claim, some people ask me often, ‘When do I come to an attorney? Do I wait until I’m denied? Do I wait until I have, um, a hearing in front of a judge?’ And every attorney across the nation has different protocols. So, my experience—for me—would be to take the case as soon as you’re applying. I do the initial application, and the reason is ‘cause I like to have that case from the very beginning, and that way, any paper that ever gets sent to you, I get a copy of, okay? Some attorneys will say, ‘Don’t give it to me ‘til you’ve been denied.’
‘Yes, uh, do you, uh, practice in Michigan? Or if we have some friends that need to talk to you, can we call you at that number?’ Yes, um, I actually have a 1-800 number—it’s 1-877—um, doesn’t everybody have cell phones now? But I’ll give you the 877 number also. ‘Would you hold on a minute?’ Yep. And I do—I practice in Michigan. I practice nationwide. We have a great practice in a lot of different states, and Michigan is one of them, um, because you have great judges. ‘We do have good judges.’ You have very good judges, okay? It’s 877-899-8020—877-899-82528.
‘If you’re disabled, that doesn’t make any difference then, um—what do you mean?’ ‘If you’re collecting Social Security Disability right now, that doesn’t affect it at all for the higher amount?’ Well, that’s, um—it may make a difference. Uh, is this your—like, there’s a disabled widow’s benefits, for example. So, if you are over 50, and your spouse has died within seven years of you becoming disabled, then you collect their amount. So, that’s, you know—this slideshow was for two basic forms of disability, um, that would be as under disabled widows, right? ‘So, if I’m disabled right now, though, and my husband passed away, then I could collect his Social Security?’ Correct. ‘Have you been disabled for—within seven years?’ ‘Yeah, last three years.’ So, if it’s after seven years, then you can’t, right? Okay. And these are arbitrary numbers enacted by Congress years ago, so we just work with those numbers—seven years and 50, over 50.
Any other questions? ‘Oh, yes, we do.’ Any questions on that side? ‘No, we don’t.’ Um, ‘Hi, um, I’m considering myself, and my question is, how—if you can still work and want to work part-time—how much can you make? What’s the—what’s the cutoff line?’ Okay, so I will never give the cutoff line. They’re online—actually, like, online—um, every year they change. But I will say that Social Security and the judges and the personnel are trained to think and to know that if you’re working right under the cutoff line, you’re artificially keeping your hours and your pay lower so that you can double-dip and qualify for both.
So, my suggestion is twofold. One—one is, as long as you have proper documentation with your medical doctor as to how much work you’re doing, how it feels, how many absences you have, how many times you come in late, how many times your, um, task is off-task—you have that documented—and then you can show that your work is either accommodating you—it’s a whole other way of winning a case—or that your work is under the hours because you physically are not able to do 40 hours or more. And that becomes, um, a credibility issue—whether or not you are artificially keeping your hours low or not, and what documentation do we have for that.
Um, don’t wait until you’re very sick to apply for Social Security Disability benefits because the process is long and hard, and the criteria is tough to meet, and it’s almost like a job in and of itself to go through this. And it will take at least 12 to 18 months if you don’t have certain types of MS that qualify for an initial determination or reconsideration. So, it’s a delicate balance. Work as much as you can because it makes you feel well, but don’t work where it makes you feel exhausted. I hope that helps. ‘Thank you.’
Nice round of applause here for Lisa! ‘Yay! Thank you! Thank you!’
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