Indiana Social Security Disability Lawyer Blog

One of the most rewarding parts of my job as a disability lawyer is helping disabled children and their families get the benefits they deserve.  After hearing about the daily struggles  families face when they have disabled children, it is hard not to take a personal interest in their cases.  I believe a larger percentage of my practice is made up of Supplemental Security Insurance (SSI) claims involving children than in the practices of many of my fellow Social Security disability attorneys.  In fact, sometimes other attorneys refer children's cases to me because they simply do not handle children's disability claims.  I have noticed that more and more of my child clients have been diagnosed on the autism spectrum, and I have found that many of these cases have unique issues that must be addressed in order to enhance the chances of a favorable outcome.

The Social Security Administration (SSA) uses six "domains" of functioning to determine how a child's daily living is affected by the child's disability.  These domains are:

• Acquiring and using information
• Attending and completing tasks
• Interacting and relating with others
• Moving about and manipulating objects
• Caring for yourself
• Health and physical well-being.

A child is considered disabled if the child either has "marked" limitations in two of these domains, or "extreme" limitations in one of them. 

I have found that many autistic children have extreme limitations in interacting and relating with others.  Individuals with autism may have difficulty holding simple conversations with others, suffer from language difficulties, or repeat words or phrases (echolalia).  I have noticed many of these children do not have the ability to recognize the simple social cues most of us take for granted.  In my experience, most of these kids are smart, and I mean really smart, but their inability to interact and relate with others can interfere with their ability to function in a regular classroom setting.  Some of these children have Individual Education Programs (IEPs) to help structure classroom subjects in a more suitable way for them to learn.

Do I have a magic wand for helping all of these families win their Social Security disability claim?  No, but I do have experience in preparing cases to ensure that the Administrative Law Judge (ALJ) has all the information needed to understand how autism affects a child's functioning.  This information includes:

• Complete school records showing the kinds of accommodations and assistance the child receives during the school day, as well as grade reports, teacher comments, and progress reports.
• Good medical records from doctors, therapists, and any other treating provider stating a clear diagnosis, including progress notes that reveal the provider's professional observations and opinions.
• Medical records related to any physical impairments for which the child receives treatment.
• Medical source statements.  I strive to contact the medical professionals treating the child to obtain their written opinions, based on professional training and personal interaction with the child, about how the autistic child's symptoms and behaviors fit under Social Security's standards for disability. 

Please keep in mind that even if your child suffers from severe autism, you may not qualify for SSI if your household income and resources rise above a certain level because SSI is a needs-based program.  To find out if you qualify for Supplemental Security Income (SSI) for your autistic child, you should contact the SSA and file an initial application. 

In my practice I often represent individuals with bowel and urinary problems, and Irritable Bowel Syndrome (IBS) is no exception.  The symptoms my clients describe make me a real believer that they are unable to function in a work environment without accommodations that most employers are unwilling to make.  Some of my clients find it embarrassing to discuss their symptoms, so they do not provide the best testimony at their disability hearing.  I remind them that their hearings are confidential, and that no one outside of the hearing room will know what has been said.  Nonetheless, I understand their hesitancy to discuss these personal issues.

One key to winning at your Social Security disability hearing is to make sure that the administrative law judge (ALJ) understands the nature of your Irritable Bowel Syndrome symptoms.  The Social Security Administration (SSA) publishes a book called the "Listing of Impairments"  that attempts to clearly define the conditions the SSA recognizes as disabling. Although IBS is not specifically addressed in these listings, some of its symptoms are included under Listing 5.06 for Inflammatory Bowel Disease and under other listings in Section 5: Digestive System Impairments.  Even if your Irritable Bowel Syndrome does not meet or equal a listing under Section 5, your symptoms may be severe enough to interfere with your ability to do work-related activities.  These symptoms can include, but are not limited to:

• Diarrhea that can be frequent and chronic
• Constipation that can be frequent and chronic
• Abdominal pain
• Feeling of fullness or bloating
• Gas

Many of my clients with this disabling condition complain of having to make countless trips to the bathroom each day and of having uncontrollable bowel movements or "accidents" on many occasions.  If you have frequent bowel accidents, it is important to inform your medical treating source about them and about any other symptoms you regularly experience so they can be documented in your medical records.  In my experience, it is also important to see an appropriate medical specialist, such as a gastroenterologist.  Medical records showing consistent care from a doctor who specializes in treating your disabling condition can be crucial to prove that your impairment is severe enough to be disabling.

If an Administrative Law Judge (ALJ) can be convinced that your IBS symptoms, such as needing frequent restroom breaks or having bowel accidents, require you to leave your workstation too often during a work day, the judge may conclude you simply cannot perform a full day of work and would be terminated from employment for being off task too often.  I have seen Vocational Experts (VE) testify at hearings that excessive bathroom breaks are not tolerated by employers.  Through my law practice I have come to understand how frustrating disabling conditions such as IBS can be to my clients, and I work hard to make sure the SSA knows the severe limitations my clients experience. 

Yes, the Social Security Administration is supposed to consider your pain when deciding if you are disabled.  The pain you experience from standing, walking, pushing, pulling, lifting, and sitting may make it difficult, if not impossible, to perform substantial gainful activity.  Many of my clients are not able to focus or concentrate long enough to work because the pain is so severe.  If you do experience pain, it is important to regularly report the frequency and intensity of your pain to your physician.  The Administrative Law Judge (ALJ) may be skeptical about your complaints of pain if your medical records do not show that you have talked to your doctors about them.

Some of my clients suffering from physical disabilities tell me the pain they experience is simply too much to bear. They often enter an Indiana Social Security disability hearing prepared to let the ALJ know exactly what the pain is like on a day to day basis. As an attorney, I give my clients guidelines to help them explain their pain to the judge, and I urge them to be as truthful and straightforward as possible. Most of my clients listen to my advice, but sometimes, clients go into the courtroom and exaggerate their pain symptoms to an unbelievable degree.

Being honest about everything at your disability appeal hearing is very important, from explaining what you are physically able to do to describing the pain you experience. In most hearings, the judge or I ask the claimant to rate his pain on a scale from zero to ten, where a rating of zero is no pain, and a rating of ten is pain so severe that you have to go to the hospital. To my surprise, some individuals testify that their pain is at level ten on a daily basis. They usually say this after they have talked about the activities they do at home each day, and none of them talk about going to the hospital on a daily basis.  I do believe that some people may experience pain at a level ten and not be able to go to the hospital every time they do, but a judge is going to find it hard to believe that a person can experience pain that severe on a daily basis without being hospitalized regularly.

In my practice, I find that one of the best things I can provide to the ALJ to show that you are unable to work is a written statement from your doctor giving her professional opinion about the restrictions caused by your disabilities.  If your doctor says that you are restricted in sitting, standing, walking, or lifting, it can help show that you are unable to perform a full day of work activities.  Your doctor can also give his opinion about problems you may have pushing, pulling, and manipulating objects.  If your treating physician states that you would miss too many days of work each month due to your symptoms or your treatments, or that you are unable to work an eight hour day, or that you simply cannot work due to your disabling condition(s),  it may enhance your chances of winning your claim.

In summary, while good medical records can be the key to a successful outcome, I believe that your truthful testimony matters as well.  Be realistic about the pain you experience, and attempt to let the judge know the specific ways it impacts your life.  While the judge and I can look at MRI results and doctors' diagnoses, those records cannot adequately describe the pain you experience every day.  Your solid, credible testimony is the only way to let the judge know how your pain is disabling to you. 

I represent many families with children who have disabilities at the hearings level in Indiana.  I believe I handle more children's cases than many of my counterparts.  In fact, some attorneys tell me they simply will not take children's disability claims at all. Children's disabilities can vary greatly, and the mental and physical problems caused by these health condition(s) can be devastating.  I often sit at the hearing and wonder, "When my client is awarded benefits, who is going to manage the money, and how will the money be used?"

In children's Supplemental Security Income (SSI) cases it is important to first understand Social Security's income and resource restrictions.  If a family makes too much money, or if the family's assets such as its vehicles, house, or bank accounts are worth too much, that family probably will not qualify for SSI benefits.  A family that does qualify for SSI is most likely struggling quite a bit to pay for for medical expenses, rent, food, and clothing.  Once a child is awarded SSI benefits, the family is eager to find out what types of expenses can be paid with SSI benefits, and who will be responsible for spending the money.  The Social Security Administration (SSA) has guidelines as to how those monies should be spent and who will do the spending. 

First, most minor children are required to have a representative payee who will manage their SSI payments.  The representative payee is required to:

• Use the payments to meet the needs of the beneficiary (i.e., the child)
  
• Save any money left over
• Report any changes
  
• Keep good records
• Help the beneficiary get medical treatment
• Notify SSA of changes in payee's circumstances
• Complete accounting reports regarding the use of funds
• Return any monies beneficiary is not entitled to

Now the big question - what can SSI payments be used for?  The Social Security Administration states that the uses for these payments should be:

• Food
• Clothing
• Shelter
• Utilities
• Dental and medical care
• Personal comfort items
• Reasonably foreseeable needs

The representative payee is required to use the funds in the best interest of the beneficiary.  I have heard from some parents of the children I have represented that the SSA has been keeping a closer eye on how the child's benefits are being spent.  Although representative payees have some discretion in managing a child's payments, I always hope the representative payees are dong the right thing and spending the money on the needs of the child in a responsible way.