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

Post a Comment

Popular posts from this blog

MUST YOU MEET A LISTING FOR SOCIAL SECURITY DISABILITY?

You hear talk of getting SSDI benefits by "meeting a Listing."  What are the Listings? The Blue Book listings are found in the regulations at 20 CFR 404, Subpart P, Appendix I. The Listings are divided into 12 body systems.  Each severe impairment is listed under its respective body system.  For example, Congestive Heart Failure is listed under Section 4.00 - Cardiovascular System. When you go there, there is a list of severe symptoms, and they are severe.   If you exactly meet or equal the list of very extreme symptoms you will be automatically approved for disability. Here's the problem:  Meeting one of the listings is about as likely as winning the Super Lotto.  It is very, very unlikely that you will do so. Thus, 99 percent of claimants do not and cannot get approved by meeting a listing.  The listings are only for catastrophic, extreme impairments that most claimants simply do not have--or do not have at the severity level demanded by the listings...
Post a Comment
Read more

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 ....
Post a Comment
Read more

CAN A LAWYER / ADVOCATE HELP YOU IN DISABILITY HEARINGS?

 HOW A LAWYER INCREASES YOU ODDS     There are many things a trained disability advocate or lawyer can do for you in a disability claim.  The biggest reason to have a lawyer or advocate is that you are 3 times as likely to be approved when using one. As with all levels of applying for SSI and SSDI , it is not required that you have attorney representation. However, the hearing before an Administrative Law Judge is your BEST chance of being approved for Social Security benefits. During this stage your chances of being approved are highly improved by having an attorney that is skilled with disability law . Only an experienced lawyer or advocate will understand the difficult and confusing concepts discussed at the hearing.  If you don't have a lawyer you will probably understand very little of what goes on at your hearing. Before your hearing your attorney can prepare you for the questions you will be asked at the hearing. A vocational expert will be a...
Post a Comment
Read more