Skip to main content

WHAT IS A "THEORY OF AWARD"?

If you listen to lawyers talk about Social Security disability you will hear the term "theory of award."  Judges often ask attorneys at the hearing, "What is your theory of award?"

A theory of award means:  What set of facts meets Social Security's rules to allow a payment of benefits?

It isn't sufficient to say, "The claimant can't work," or "the claimant is disabled."  The lawyer has to carefully examine Social Security's rules and explain which rule allows a payment or an award.

Here are some examples of a theory of award

 1.  The claimant's medical condition meets or equals Listing 12.05.

2.   Grid rule 202.06 will direct a finding of "disabled" based on the claimant's age, education, past work history and residual functional capacity.

3.  Based on the severe functional impairments, the claimant cannot perform past relevant work under 20 CFR §404.1520. 

4.  The claimant would be unable to perform any significant gainful activity which is available in the national economy using Medical-Vocational Guideline 201.04 as a guideline.  

5.  Pursuant to SSR 85-15, the claimant is unable to sustain any other employment available in significant numbers in the US economy.

Think of the Social Security disability process as a long, winding path. The path takes many turns and twists. The end of the path is the conclusion about how the regulations dictate a particular ruling.  Your lawyer always looks for a favorable decision at the end of your path--one which allows you to collect all the benefits you are entitled to get.

Only by explaining the legal reasoning can a lawyer expect to obtain a favorable ruling which pays his/her client.  That reasoning is the "legal theory of the case."  

Comments

Popular posts from this blog

MEETING SOCIAL SECURITY'S DURATION REQUIREMENT FOR DISABILITY

SSDI, or Social Security Disability Insurance, requires a severe impairment which has lasted for at least 12 straight months, is expected to last at least 12 straight months OR is expected to end in death. This 12 consecutive months requirement is called the "Duration Requirement."  Disabilities with a duration of less than 1 year are not covered under the Social Security Act. You do not have to wait 12 months to file a claim. There is no requirement to wait 12 months to file.  But if your disability has not already last for at least 12 months, the nature of the impairment must be such that is can reasonably be expected to last 12 months or longer OR to end in death.  Short term impairments are not covered. What you will need to document for your medical and/or mental impairment(s):   A claimant will require objective medical proof.  This comes in the form of official medical records from doctors, clinics, hospitals, counselors, therapists and other professiona...

SOCIAL SECURITY BENEFITS FOR DOWNS SYNDROME

Downs Syndrome may qualify for automatic SSI disability in children. A child with Translocation Syndrome or Trisomy 21 will usually be classified as disabled from birth. This type of syndrome affects about 98 percent of the Downs Syndrome population. Social Security will want a diagnosis from a medically acceptable source and they will want certain tests.Once the documentation is presented, an SSI award may be automatic.  Those with Mosaic Down syndrome may qualify, but your child would need more than a diagnosis to be approved. Because [according to SSA] people with Mosaic Down syndrome may not have as many intellectual or physical disabilities as those with other forms of Down syndrome, you’ll need to meet another listing in the Blue Book to qualify. Social Security will consider the complications or manifestations of Downs Syndrome in making a decision. If the claimant is a child (under 18), k eep in mind that SSI is a needs-based program for families with limited resources...

A DISABILITY DENIAL IS NOT THE END OF YOUR CASE

By Charles W. Forsythe The Forsythe Firm Social Security denies a lot of applications.  It's expected.  But it's not the end. The good news is:  You can probably win your case on appeal and get paid benefits.  It just takes a bit longer. About 8 out of 10 new disability claims will be routinely denied.  So, it's rather unusual to be approved just by filing an application. An appeal sounds like a last resort or tricky legal maneuver.  It's really quite common--almost  normal--in a Social Security disability case. 8 out 10 claims will be appealed at least once, often twice, before they are paid. The process that pays Social Security disability is not the application, it's the appeal process. Many claimants who don't understand the importance of appeals give up after the first denial.  A serious mistake.  You odds get better in appeals. TIME LIMIT ON APPEALS.  All unfavorable Social Security decisions must be appealed within 60 days.  ...