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Does 2 marked functional limitations mean approval for child…

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Does 2 marked functional limitations...
Does 2 marked functional limitations mean approval for child ssi?
Submitted: 6 months ago.Category: Family Law
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3/20/2018
Family Lawyer: socrateaser, Lawyer replied 6 months ago
socrateaser
socrateaser, Lawyer
Category: Family Law
Satisfied Customers: 40,231
Experience: Retired
Verified

Hello,
Please allow me a few minutes to consider your question. If I can assist I will provide an answer. Otherwise, I will reopen the question for others to assist.
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Customer reply replied 6 months ago
Ok thanks
Family Lawyer: socrateaser, Lawyer replied 6 months ago

The rules for assessing a child's functional limitations are found at: Title 20 Code of Federal Regulations (C.F.R.) 416.926a.

By themselves, 2 functional limitations does not automatically operate as approval for SSI. A limitation must be severe/extreme, or the combination of limitations must create severe/extreme impairment.

Typically, a physician is required to make a report to the Social Security Administration (SSA) and provide sufficient expert opinion to show the required functional limitations.

I hope I've answered your question. Please let me know if you require further clarification. And, please provide a positive feedback rating for my answer (click 3, 4 or 5 stars) -- otherwise, Justanswer retains your entire payment, and I receive nothing for my efforts in your behalf. Note: If you cannot find the rating button on your webpage, please just type in your rating in a response to this note, and customer service will apply the rating for you.

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Customer reply replied 6 months ago
Okay I got a copy of the report from The Physician for SSI and he marked two functional limitations
Customer reply replied 6 months ago
He also put major impact on function and this was after our hearing...what do the physicians report findings mean for our case?
Family Lawyer: socrateaser, Lawyer replied 6 months ago

My comment was a suggestion of a report provided by the "child's" physician -- not a Social Security physician. However, based on what you're describing, "major" impact suggests that the physician is leaning towards finding a severe/extreme functional limitation. This is not the same thing as a finding as such. Which brings me back to my original answer. You may need your child's physician to assist you in an appeal if you are denied benefits.

I hope I've answered your question. Please let me know if you require further clarification. And, please provide a positive feedback rating for my answer (click 3, 4 or 5 stars) -- otherwise, Justanswer retains your entire payment, and I receive nothing for my efforts in your behalf. Note: If you cannot find the rating button on your webpage, please just type in your rating in a response to this note, and customer service will apply the rating for you.

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Customer reply replied 6 months ago
We had an appeal March 1, I had medical records suggesting exactly what the medical examiner put in his interrogatory report. I am just asking if we meet all other qualifications for ask ( his sister gets it so we qualify in all other areas) can I rest assure that the physician for the judge Marking 2 "marked" functional limitations in the domains of acquiring and using info. And interacting with others will turn a positive outcome?
Customer reply replied 6 months ago
His primary doctor and neurologist all medically documented his severity also.
Customer reply replied 6 months ago
Maybe I should ask if anything can keep us from being approved if the judges physician marked 2 functional limitations..
Family Lawyer: socrateaser, Lawyer replied 6 months ago

You're asking me to act as the judge. The issue is uncertain. Because, if it were certain, the judge would have ruled immediately in your favor. My observation from your stated facts is that you will be approved for SSI. But, I cannot say that as a certainty -- because I'm not the judge presiding over the case.

Edit: you're asking if anything can keep you from being approved. The answer is unequivocally, "yes." The judge gets to decide, and when it's a close call -- to be perfectly frank, anything can cause the judge to rule one way or the other. By anything, I mean a fight with a significant other, a flat tire on the way to the office, a strange look from a family member of the appellant. I'm being serious. Judges are human.

Most of the time, a judge wants a child to have every opportunity to receive necessary assistance. So, that weighs in your favor. However, sometimes, the judge is just a plain old jerk, and there's no other explanation for an unfavorable ruling.

I like your chances, but, I've not reviewed your case file in its entirety, and if I tell you that you're going to be approved, and you are later denied, you'll be an "unhappy camper." In my view, it's a close call, not because you don't deserve approval, but simply because the judge did not rule immediately in your favor at the hearing (or, at least give you a tentatively favorable opinion).

Please let me know if you require further clarification. And, please provide a positive feedback rating for my answer (click 3, 4 or 5 stars) -- otherwise, Justanswer retains your entire payment, and I receive nothing for my efforts in your behalf. Note: If you cannot find the rating button on your webpage, please just type in your rating in a response to this note, and customer service will apply the rating for you.

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Customer reply replied 6 months ago
Okay my final say would just be that the medical examiner was not at our hearing, so they did a medical interrogatory by mail. So this is why i feel the case wasn't decided that day, also I had to provide neurology notes which the judge gave me 5 days after the hearing to do ( I got them to her that day). Does this make anything different? Other than the judge having a bad day? ( I'm only asking because it was my understanding that legally if there were 2 marked functional limitations we functionally met the listing and from that point it was law)
Family Lawyer: socrateaser, Lawyer replied 6 months ago

20 C.F.R. Section 416.925(b)(2)(ii) reads as follows:

  • Although the severity criteria in part B of the listings are expressed in different ways for different impairments, “listing-level severity” generally means the level of severity described in §416.926a(a); that is, “marked” limitations in two domains of functioning or an “extreme” limitation in one domain. (See §416.926a(e) for the definitions of the terms marked and extreme as they apply to children.) Therefore, in general, a child's impairment(s) is of “listing-level severity” if it causes marked limitations in two domains of functioning or an extreme limitation in one. However, when we decide whether your impairment(s) meets the requirements of a listing, we will decide that your impairment is of “listing-level severity” even if it does not result in marked limitations in two domains of functioning, or an extreme limitation in one, if the listing that we apply does not require such limitations to establish that an impairment(s) is disabling.

In plain English, marked limitations in two domains generally satisfies the requirement for SSI approval. But, the key term here is "generally." This means that the judge can decide that the limitations for some reason are insufficient to qualify for approval. It's a close call. I like your chances, but the law is not as definite and certain as you seem to suggest (in my opinion).

Please let me know if you require further clarification. And, please provide a positive feedback rating for my answer (click 3, 4 or 5 stars) -- otherwise, Justanswer retains your entire payment, and I receive nothing for my efforts in your behalf. Note: If you cannot find the rating button on your webpage, please just type in your rating in a response to this note, and customer service will apply the rating for you.

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Family Lawyer: socrateaser, Lawyer replied 6 months ago

Hello again,

I see that you have reviewed my answer, but that you have not provided a rating. Do you need any further clarification concerning my answer, or is everything satisfactory?

If you need further clarification, concerning this matter, please feel free to ask. If not, I would greatly appreciate a positive feedback rating for my answer (click 3, 4 or 5 stars) – otherwise, Justanswer retains your entire payment, and I receive nothing for my efforts in your behalf. Note: If you cannot find the rating button on your webpage, please just type in your rating in a response to this note, and customer service will apply the rating for you.

Thanks again for using Justanswer!

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Customer reply replied 6 months ago
are u a disability attorney or a family attorney? Just the answer u provided me was so open ended in no way am I trying to ask u to "act as the judge", I just wanted some insight on the probability of our case. I do wish the 2 limitations automatically qualified my son however I know judges have bad days and I know things arise. I am just wanting to know the probability or maybe more often than not scenario...an example case, a percentage of approvals based on the 2 marked limitations rule...something to clarify my anxiety :) I appreciate your time and help so much.
Family Lawyer: socrateaser, Lawyer replied 6 months ago

Dear friend:

I hope that you take no offense at what I'm about to say.

1. The previous contributor with whom you corresponded, gave you the answer that you wanted to read. In return, you gave him a 5-star rating. That contributor, to my knowledge, is not a disability or Social Security lawyer -- but, his answer validated your own opinion, so you rated him highly. I'm not a disability or Social Security lawyer -- though, I was once asked to clerk for a Social Security administrative law judge, and I respectfully ***** ***** to the unreasonable driving distance between my home and the judge's office.

2. I gave you the Social Security regulations directly from the Code of Federal Regulations (not the informal definitions used by Social Security Administration). These regulations have the force of law, and they are as close as you can get to the truth, before a judge rules, because the regulations are what the judge must follow in deciding your case.

3. I could have easily told you, immediately, "Oh yeah, you have a great case! There's no chance that the judge will rule against you...etc." You would have been thrilled, and you would have provided me with a 5-Star rating, too. I know this for a practical certainty, because, I've been answering questions at Justanswer for just short of 10 years -- and if I wanted to get a 5-Star rating from every customer with whom I correspond, I could craft my answers to provide the customer with exactly what will validate their beliefs, the customer would rate me highly, and I would get paid.

4. But, you know what? Since my first day answering questions here, I have determined that nothing short of the unvarnished truth is sufficient for a customer, because that's the only way that I can look at myself in the mirror and know that I'm acting in accordance with the requirements of my profession. This is something that I, being a rather senior member of the legal profession (I'm retired and collecting Social Security, myself) know, from experience, is a rarity.

5. So, while you may want to clarify your anxiety about this issue, and while I would be willing to wager serious money that there are at least 25 lawyers online right now who would give you exactly the answer that you are seeking as a means of cutting the discussion short and getting paid -- you have (fortunately or unfortunately) encountered the one attorney who answers questions at Justanswer who will absolutely not take advantage of your anxiety and concern for your child's welfare as a means of collecting what amounts to the rough equivalent of a Starbuck's mocha and a brownie, in exchange for a positive rating. I like money as much as anyone -- but, I will not place my desire for compensation before my duty to provide candid and honest answers.

6. in sum, anyone who tells you that your case is a "slam dunk," or that you have a better than 50% chance of prevailing, is playing at your heartstrings as a means of earning a buck. The truth is that the case is difficult -- if it weren't, you wouldn't have had to appeal. If you want me to review your case file, I would have to charge you for several hours of my time -- and, I can't do that, because this is a Social Security matter, and attorneys can't collect advance fees. We have to get approval from Social Security for our fees after the fact.

7. Bot***** *****ne, while I would just love to tell you what you want to read, and let you sleep well at night, right up until the moment that you receive word that your case is denied -- and after which you will come back to Justanswer and scream that you want your money back and that the website is a scam, and that the attorney with whom you corresponded is a low-grade moron -- I just won't do it -- because I can't honestly tell you anything more than that I like your chances, based on the information you've provided. That may be insufficient to buy me a 5-star rating. But, one thing is for certain. If this were really all about money for me, I wouldn't have spent the last 10 minutes writing you this little monologue -- nor taken the time to research and provide the federal regulations concerning your case. I would have just told you whatever you wanted to read, and then moved on to the next sucker...ahem, I mean customer.

I've done my best, ***** ***** wish you the best with your legal dilemma and for your child's future health and welfare.

If you need further clarification, concerning this matter, please feel free to ask. If not, I would greatly appreciate a positive feedback rating for my answer (click 3, 4 or 5 stars) – otherwise, Justanswer retains your entire payment, and I receive nothing for my efforts in your behalf. Note: If you cannot find the rating button on your webpage, please just type in your rating in a response to this note, and customer service will apply the rating for you.

Thanks again for using Justanswer!

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Customer reply replied 6 months ago
That response was utterly useless
Customer reply replied 6 months ago
Sir u went to far, thank you for your time have a great day
Family Lawyer: socrateaser, Lawyer replied 6 months ago

Win or lose, six months from now, you will look in the mirror and think to yourself, "that attorney at Justanswer was the only person who told me the truth."

If you respond again, I will leave you with the last word.

Thanks again for using Justanswer!

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