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Byron Broun PA
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DEPRESSION AND BIPOLAR DISORDER
Depression is a form of mental illness that can often lead to a person becoming disabled depending on the length, intensity and severity of the condition. Depression affects more than 15 million American adults, or about 6.7 percent of the U.S. population age 18 and older in a given year. Persistent depressive disorder, or PDD, (formerly called dysthymia) is a form of depression that usually continues for at least two years.
Many people suffer with lifelong symptoms of depression before they are properly diagnosed by a mental health professional. Other people can develop what is called a "reactive depression" in response to an injury, illness, traumatic event or death of a loved one. Regardless of whether you suffer from depression standing alone or whether you suffer from depression as a result of a life altering event, a claimant must seek treatment. Psychiatrists and psychologists specialize in the treatment of depression, and other mental illnesses, and their input is essential to proving a Social Security disability claim for SSDI or SSI benefits under Social Security's impairment listing 12.04, Depressive, Bipolar and Related. ... To qualify for either Social Security disability (SSDI) or SSI disability benefits on the basis of depression, you must show you have severe depression by having at least five of the following symptoms: depressed mood.

12.04 Depressive, bipolar and related disorders (see 12.00B3), satisfied by A and B, or A and C:
A. Medical documentation of the requirements of paragraph 1 or 2:
1. Depressive disorder, characterized by five or more of the following:
a. Depressed mood;
b. Diminished interest in almost all activities;
c. Appetite disturbance with change in weight;
d. Sleep disturbance;
e. Observable psychomotor agitation or retardation;
f. Decreased energy;
g. Feelings of guilt or worthlessness;
h. Difficulty concentrating or thinking; or
i. Thoughts of death or suicide.
2. Bipolar disorder, characterized by three or more of the following:
a. Pressured speech;
b. Flight of ideas;
c. Inflated self-esteem;
d. Decreased need for sleep;
e. Distractibility;
f. Involvement in activities that have a high probability of painful consequences that are not recognized; or
g. Increase in goal-directed activity or psychomotor agitation.
AND
B. Extreme limitation of one, or marked limitation of two, of the following areas of mental functioning (see 12.00F):
1. Understand, remember, or apply information (see 12.00E1).
2. Interact with others (see 12.00E2).
3. Concentrate, persist, or maintain pace (see 12.00E3).
4. Adapt or manage oneself (see 12.00E4).
OR
C. Your mental disorder in this listing category is “serious and persistent;” that is, you have a medically documented history of the existence of the disorder over a period of at least 2 years, and there is evidence of both:
1. Medical treatment, mental health therapy, psychosocial support(s), or a highly structured setting(s) that is ongoing and that diminishes the symptoms and signs of your mental disorder (see 12.00G2b); and
2. Marginal adjustment, that is, you have minimal capacity to adapt to changes in your environment or to demands that are not already part of your daily life (see 12.00G2c).
Types of Depression
You can have a single bout of major depression or you can have recurring episodes. When depression lasts two years or more, it is called persistent depressive disorder. A less common type of depression is called bipolar disorder, or manic-depressive illness. Bipolar disorder involves cycles of depression alternating with extreme highs, or manias.
Specific circumstances can trigger other forms of depression. If you have seasonal affective disorder (SAD), your mood is affected by sunlight. You’re more likely to be depressed during winter, when there’s less sun.
Many new mothers go through something called the baby blues. It’s caused by hormonal changes following childbirth, lack of sleep, and everything that goes along with taking care of a new baby. Symptoms include mood swings, sadness, and fatigue. These feelings usually pass within a week or two. When they drag on longer and escalate, it may be a case of postpartum depression. Additional symptoms include withdrawal, lack of appetite, and a negative train of thought. According to the National Institute of Mental Health (NIMH), about 10 to 15 percent of women develop postpartum depression. Untreated, it can be dangerous for mother and baby.
When major depression or bipolar disorder are accompanied by hallucinations, delusions, or paranoia, it’s called psychotic depression. About 20 percent of people with major depressive disorder develop psychotic symptoms, according to the National Alliance on Mental Illness (NAMI).
Many people still believe there is a stigma associated with mental illness. It is important that we, as a society, work together to eliminate the stigma of associated with mental illness as it exists in all socio-economic segments of our society, and can often lead to unwarranted and harmful discrimination in the workplace and other walks of life. People experiencing mental distress in the form of depression or bipolar related disorders deserve our help and compassion. Life certainly has a way of kicking all of us in the gut, and bringing us to our knees, at some point in time.
If you are suffering from depression or bipolar disorder and need legal representation, please do not hesitate to contact the Law Office of Byron Broun, P.A.


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How Do Social Security Disability Lawyers Get Paid Their Attorney Fee?

99% of Social Security disability claims whether they be SSDI (Title II - Social Security Disability Insurance) or SSI (Title XVI - Supplemental Security Income are handled on a contingency basis. The Social Security Administration will pay your attorney 25% of your past due benefits with a $6,000.00 cap. For example, assume you applied for benefits on June 1, 2017 claiming that you became disabled on January 1, 2017, and that you are entitled to an SSDI benefit of $1,200.00 per month. Now, further assume that you are before an administrative law judge (ALJ) on June 1, 2019, and he or she agrees with you that you were indeed disabled on January 1, 2017. If that were the case, you do not get back benefits for the first 5 months of disability, and the Social Security Administration would thus owe you 24 months of back benefits or $28,800.00. The Social Security Administration would withhold $6,000.00 from your past due benefits to pay your attorney, and then release the remaining $22,800 to you before beginning regular monthly payments of $1,200 per month. Separate from the attorney fee, you may owe your attorney a few hundred dollars to cover the costs associated with the pursuit of your claim. The costs in a Social Security disability claim rarely exceed $500.00 and are usually around $250.00 or less.
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Obesity - Its Killing Us
I keep a copy of the 1999 Social Security statute in my library because it is the last year that the Social Security Administration listed disability as a disabling condition in and of itself. Over the years, the Social Security Administration has done away with the Listings for obesity because of the number of Americans battling this condition.
Sixty-seven percent of American adults are overweight (BMI of 25 or higher). Thirty percent are obese. Five percent of American adults are morbidly obese—a 400 percent increase since 1986. The obesity epidemic in America is unquestionably tied to hidden sugars, saturated and hydrogenated fats in processed foods, high caloric intake and genetics.
Prior to 1999 a man or woman who was morbidly obese could rely on obesity tables set forth by the government to prove that they were disabled based on their height and weight. For example, a man who was six feet tall and weighed 336 pounds or a woman who was five foot five inches tall and weighed 266 pounds would be automatically deemed disabled provided they also had issues with one of the following: musculoskeletal pain and limitation; diastolic blood pressure over 100 mm; history of congestive heart failure; venous insufficiency or respiratory distress.
As the obesity epidemic became greater and greater, the government realized it had a problem with the cost of obesity-related disability claims, and decided to make the criteria for disability benefits somewhat more stringent. However, the reality is that obesity remains the determinative factor in many claims. Accordingly, in 2002 the Social Security Administration indicated that administrative law judges must take the additional and cumulative effects of obesity into account when assessing orthopedic claims. The interaction between obesity and the inability to walk effectively is also taken into account. Obviously, there is also a link between obesity and sleep apnea, high blood pressure, diabetes, kidney and heart disease. Often, the obese individual is also suffering from what is known as metabolic syndrome, i.e., a combination of these symptoms that adversely impact one another and lead to even greater disability.
"Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.
The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.
In this article, "heart disease" refers to coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque builds up inside the coronary (heart) arteries.
Plaque hardens and narrows the arteries, reducing blood flow to your heart muscle. This can lead to chest pain, a heart attack, heart damage, or even death.
Metabolic Risk Factors
The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.
• A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
• A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.
• A low HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease.
• High blood pressure (or you're on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.
• High fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.
Overview
Your risk for heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. The risk of having metabolic syndrome is closely linked to overweight and obesity and a lack of physical activity.
Insulin resistance also may increase your risk for metabolic syndrome. Insulin resistance is a condition in which the body can’t use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it’s used for energy. Insulin resistance can lead to high blood sugar levels, and it’s closely linked to overweight and obesity. Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome.
Outlook
Metabolic syndrome is becoming more common due to a rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease."
Doctors, judges and members of the public at large are not immune from harboring widespread prejudice toward the morbidly obese. However, based on the increasing numbers of obese people throughout the developed world, it is quite clear that obesity is not a moral failing. Americans must individually and collectively tackle the problem of obesity in our society. The health and human costs are staggering. However, we must also have compassion for individuals whose obesity has led to the development of other disabling health conditions. Thankfully, the Social Security Administration still acknowledges the causal connection between morbid obesity and disability.
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"My doctor says I am disabled!"

Proving that someone is disabled under Social Security's guidelines generally pivots around one's age, education, past work history, prior relevant work experience and the physical and mental limitations under consideration.  Often, clients come to me saying "my doctor says I am disabled!"  However, disability claims are predicated upon medical and vocational factors.   As such, in order to prevail in a disability claim, we must be able to establish that your physical and mental limitations not only prevent you from performing your past relevant work (work that you have performed for the 15 years preceding your disability)  but that there are also no significant numbers of jobs available in the national economy that you are capable of performing.  Hence, it is imperative that your doctors not only keep good records of your treatment, but any opinion that they render be supported by their treatment notes.  Doctors generally want to help their patients and will often erroneously exaggerate the nature and extent of a disability claimant's medical problems.   Unfortunately, in their zeal to help, a doctor's opinion that is not supported by his or her own medical records will usually end up hurting the claimant more than it helps as the doctor's credibility with the judge will be closely scrutinized.    As such, in assessing a patient's physical and mental limitations as they pertain to potential future  employment for purposes of establishing disability, doctors should be instructed to be able to point to objective tests (MRI's, CT scans, blood work, neuropsychiatric exams) and clinical signs observed upon examination that exist in their record in formulating their opinions.  Attached please find the relevant rule utilized by the Social Security Administration administrative law judges in weighing the opinion of a treating physician.   
https://www.ssa.gov/OP_Home/cfr20/404/404-1527.htm
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http://www.dailykos.com/story/2015/01/07/1356086/-Republicans-Move-To-Gut-Social-Security-Benefits-on-Their-First-Day-in-Power#
Unfortunately, a concerted effort is underway in Congress to defund Title II (SSDI) and Title XVI (SSI) of the Social Security Act.  We, as citizens, must let our elected representatives know that we will not stand idle and allow them to gut the one social program that serves as a social safety net for all Americans.  Like most of you, I have paid my hard earned money in Social Security taxes my entire working life.  Our disability or retirement benefits do not constitute "entitlements"!  We worked for them and we have paid for them.  It is not our fault that we have a dysfunctional government that continuously borrows money against the Social Security Trust Fund in order to cover other budgetary shortfalls they deem more important than the people's welfare.    
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Social Security disability claimants (SSDI and SSI) often complain about the length of time it takes to get a hearing before an administrative law judge (ALJ).  Rightfully so.  Unfortunately, due to funding cutbacks the problem is getting worse.
As of July, 2015 there were over one million claims pending, and the average hearing office processing time has increased to 511 days.    Moreover, more claims are being denied than ever.  There has been a documented 29% decrease in the ALJ allowance rate since 2009. 
Clearly, the more conservative voices in our country are hell bent on reducing the Social Security Admini
stration's funding.  This is leading to slower processing times, and more conservative judges being appointed, who either inject their personal political beliefs into the adjudication process or cannot understand the physical toll of long-term manual labor on the human body.  
The backlog of claims coupled with the lower approval rates, serve as evidence of a further betrayal of the social contract with the working and middle class.  We, the people, must make sure that we elect representatives who do more than pay lip service to preserving continued viability of the Social Security system in its entirety by adequately funding the program for all citizens.     
     
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Your Social Security retirement and disability benefits are under attack.  This Congress has engaged in repeated efforts to create the impression that the system is rife with fraud.  In reality, fraud constitutes less than 1% of the money allocated to the Social Security disability budget. 
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