August, 2017: Richard’s NH Social Security Fully Favorable Decision out of Manchester, NH ODAR

Richard’s favorable decision at the hearing level in Manchester, NH (and involving the Concord, NH Social Security District Office) is yet another case resolved short of going to hearing. It is another example of how a zealous NH Social Security lawyer adept at dealing with this very specialized type of case can, in many circumstances, help you avoid the need to go to a hearing altogether.

Richard’s story is that of a gentleman in his late 50’s who developed a terrible infection in his buttocks and groin area following a tick bite. Treatment required a significant period of hospitalization (for what was more than a month’s period of time), during which time Richard underwent a series of surgical procedures at Massachusetts General Hospital. To make matters worse, Richard had longstanding knee issues which already made walking and being on his feet difficult although he had been managing to push through the pain and work very physically demanding work. Both issues required extensive follow-up and treatment during the course of the following year.

Unfortunately, Richard was faced with the difficult decision as to how to make ends meet. It is important to remember that there are two types of Social Security to consider should you become disabled from working. The benefit you pay for through your Social Security taxed earnings is called Title II or Social Security disability (SSDI) benefits. This benefit does not pay for the first 5 full months following a finding that one became disabled from working and will remain so disabled for what will be a year or longer. Thus, filing a claim soon after going out of work will in many cases promoted a denial and the need to appeal. If you are out of Maine and Massachusetts, a Social Security disability denial would result in the need to proceed to a reconsideration process (which is presently taking 4-6 months on average) and would likely result in yet a second denial (and the need to request a hearing before an Administrative Law Judge (ALJ).

In Richard’s circumstances, however, his filing of an application rather immediately resulted in a prompt denial and the need to proceed with a request for a hearing before an Administrative Law Judge (ALJ). Because NH is a pilot project state wherein the reconsideration process was abolished, one would have to proceed directly to hearing.

The other type of benefit that one needs to consider is called Title XVI benefits or Supplemental Security Income (SSI). This type of a benefit is a welfare benefit and pays the month after one applies (assuming, again, one is likely to remain out of work for what has been, or is expected to be, a year or longer). To qualify for this benefit, one needs to show that during the time period in question one does not have income or assets that bring them above the Federal poverty guidelines. Ultimately, an approval for SSI allows for payment of a welfare benefit the month after one applies, up until such time as SSDI is deemed received monthly, and allows for automatic entitlement to New Hampshire Medicaid benefits (which is especially important for those who otherwise do not have health insurance in place to pay their medical bills). Once again, filing too early will likely prompt a denial but if interim welfare benefits may ultimately be awarded (and if automatic Medicaid entitlement may be awarded), one may have no choice but to file early (such as in Richard’s case).

Richard contacted our office following his initial denial. During our preparation for hearing, we were able to see that at the initial level, DDS (Disability Determination Services) out of Concord, NH, had concluded that while his condition remained severe at the time of application, it was not anticipated to remain so.

Unfortunately, Richard’s treatment providers were not helpful with providing medical questionnaires to support his claim. Instead, it became necessary to cobble together the bits and pieces of information the treatment providers were willing to provide in order to show the presiding ALJ that his condition had remained severe and disabling such that he remained disabled from performing the vast majority of sedentary (or sit down) types of work. Likewise, we argued successfully to the ALJ in our brief that given Richard’s age, education, past work experience which involved very heavy work that the Social Security grid rules would direct a finding of disabled even if he retained the ability to perform the full range of sedentary exertional level employment. The ALJ saw fit to agree with the arguments contained in the brief and provide benefits to Richard without his need to attend a hearing and testify.

Thus, if you or someone you love finds themselves in a quandary as to whether or when to apply for benefits, contact the Law Offices of Russell J. Goldsmith at (800) 773-8622 so we can provide you with the guidance you need during this rough time.