Sunday, April 27, 2014

Are Social Security Benefits Available to An Alien?

A potential client comes into the office and inquires about obtaining disability benefits under the social security system. He tells you he is an alien. Does he have the ability to obtains benefits?
The Social Security Administration (SSA) provides 2 types of benefits for disabled individuals. To determine whether you qualify for Title II benefits (SSDI) rather than Title XVI of benefits (SSI) depends upon your employment history. The test to see if you qualify based upon your disability is the same for both type of benefits.

The first issue to determine is the workers status. If he is neither a citizen nor a permanent resident, the worker may be entitled to receive SSDI if he can show that he is lawfully present in the United States and meets certain other criteria. (8 U.S.C. § 1611(b)(2)).1

Most foreign workers in the United States who work and pay taxes on their wages are covered under the U.S. Social Security program and therefore potentially qualify for disability benefits. This is true even if they are not citizens or permanent residents..

The next consideration is the worker's earnings or lack of earnings. In order to be eligible for SSDI there is a basic concept – you must have worked and paid Social Security taxes. Payment of such taxes earns the worker social security “credits”. A worker can earn a maximum of up to 4 “credits” in a year. As a thumbnail, a worker needs to have worked 5 of the past 10 years to obtain the right to apply for SSDI benefits, in other words having worked and earned sufficient credits within the requisite number of years, the worker has earned an “insured status”. ( 20 CFR § 404 contains the regulations for SSDI benefits.)

What if the worker has not achieved an insured status? Then consideration turns to SSI benefits. The first issue is the worker's status. To be eligible for SSI benefits a worker needs to be a resident of the United States (§ 416.1603), and—
(1) A citizen or a national of the United States (§ 416.1610);
(2) An alien lawfully admitted for permanent residence in the United States (§ 416.1615);
(3) An alien permanently residing in the United States under color of law (§ 416.1618)2; or
(4) A child of armed forces personnel living overseas as described in § 416.216.

In addition the worker must qualify under 20 CFR § 404.202 , i.e. he is (1) Aged 65 or older;
(2) Blind; or (3) Disabled.

Lastly, since SSI is a safety net program there be income and property limitations that need be considered because they may reduce or eliminate the right to receive a full payment or any payment.

This is a complicated area of the law, especially when SSI benefits are involved.  It is a necessity to have the assistance of an attorney.










1 8 U.S. Code § 1611 - Aliens who are not qualified aliens ineligible for Federal public benefits

(a) In general
Notwithstanding any other provision of law and except as provided in subsection (b) of this section, an alien who is not a qualified alien (as defined in section 1641 of this title) is not eligible for any Federal public benefit (as defined in subsection (c) of this section)....

(b) Exceptions
(1) Subsection (a) of this section shall not apply with respect to the following Federal public benefits:
(A) Medical assistance under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] (or any successor program to such title) for care and services that are necessary for the treatment of an emergency medical condition (as defined in section 1903(v)(3) of such Act [42 U.S.C. 1396b (v)(3)]) of the alien involved and are not related to an organ transplant procedure, if the alien involved otherwise meets the eligibility requirements for medical assistance under the State plan approved under such title (other than the requirement of the receipt of aid or assistance under title IV of such Act [42 U.S.C. 601 et seq.], supplemental security income benefits under title XVI of such Act [42 U.S.C. 1381 et seq.], or a State supplementary payment). …...
(2) Subsection (a) of this section shall not apply to any benefit payable under title II of the Social Security Act [42 U.S.C. 401 et seq.] to an alien who is lawfully present in the United States as determined by the Attorney General, to any benefit if nonpayment of such benefit would contravene an international agreement described in section 233 of the Social Security Act [42 U.S.C. 433], to any benefit if nonpayment would be contrary to section 202(t) of the Social Security Act [42 U.S.C. 402 (t)], or to any benefit payable under title II of the Social Security Act to which entitlement is based on an application filed in or before August 1996.
(3) Subsection (a) of this section shall not apply to any benefit payable under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] (relating to the medicare program) to an alien who is lawfully present in the United States as determined by the Attorney General and, with respect to benefits payable under part A of such title [42 U.S.C. 1395c et seq.], who was authorized to be employed with respect to any wages attributable to employment which are counted for purposes of eligibility for such benefits....


2  § 416.1618. When you are considered permanently residing in the United States under color of law.

(a) General. We will consider you to be permanently residing in the United States under color of law and you may be eligible for SSI benefits if you are an alien residing in the United States with the knowledge and permission of the Immigration and Naturalization Service and that agency does not contemplate enforcing your departure. The Immigration and Naturalization Service does not contemplate enforcing your departure if it is the policy or practice of that agency not to enforce the departure of aliens in the same category or if from all the facts and circumstances in your case it appears that the Immigration and Naturalization Service is otherwise permitting you to reside in the United States indefinitely. We make these decisions by verifying your status with the Immigration and Naturalization Service following the rules contained in paragraphs (b) through (e) of this section....


Sunday, April 6, 2014

Migraine Headache—It Isn’t Easy But You Can Get Benefits


A migraine is a neurological condition associated with intense headaches sometimes accompanied by nausea, vomiting, and perceptual disturbances known as aura1
 
The Listing of Impairments contains hundreds of medical conditions that will automatically qualify a person for disability benefits, if his/her condition meets all the requirements of a listed impairment. There is no specific listing for migraines in the Listing of Impairments, so a person who suffers only from migraines will not meet a listing. However, migraine headache sufferers may "equal" a listing if it can be shown that their symptoms are of equal severity to a listing for a similar condition.
There is medical research that would arguably place migraines on the seizure spectrum; as such it's possible that someone with chronic migraines could equal the listings for epilepsy.  Merely having occasional migraines won't equal the listing. To equal a listing, migraines must occur at least twice a week, despite treatment, and impair mental functioning for several hours at a time. Equaling a listing is difficult in any case. You will need support in the medical records and from witnesses.
Usually a migraine diagnosis is primarily based upon reported symptoms and medical history. Migraines do not appear on x-rays or MRIs but objective testing may be done to rule out other possible causes of headache. 
 
What the Administrative Law Judge will be searching in the record and questioning the claimant about is a credible medical history, treatment etc. to support the claimant’s allegations of disability.
Consider Kirby v. Callahan, 975 F.Supp. 1290 (D.Kan.1997) – Complaints of disabling migraine headaches were discounted where the claimant failed to seek any treatment for headaches.  Many times I have had people in this situation because they lacked medical insurance.  Emergency room records may show incidents, but are lacking on treatment records.
VERSUS- Orr v. Chater, 956 F.Supp 861 (N.D. Iowa 1997) Here the claimant submitted evidence relating to duration, frequency and intensity of pain to support her allegations of subjective pain from recurring headaches and seizures and tended to make her subjective complaints that pain was disabling more credible then less.

It is important to a case in which migraine headaches are alleged to be the impairment that the claimant keeps a headache diary and recording detailed information about headaches, including the following:
  • date of migraine
  • length of migraine
  • intensity of pain
  • description of aura, if any
  • preceding symptoms
  • possible triggers
  • medication and dosage, and level of relief.
It is important that the claimant be consistent in attending treatment, consistent in his/her complaints to the doctor, and shares his diary with the doctor (for purposes of treatment, not “because my attorney told me to tell you these things”). Such a diary will assist the doctor in making an accurate diagnosis. It will also improve the Social Security disability case by documenting the frequency and intensity of the migraine headaches.

If a claimant’s condition does not meet or equal the Listing of Impairments (probably the Neurological schedule 11.00, 11.02, 11.03) the determination moves to steps 4 and 5 of the sequential evaluation.

At steps 4 and 5, Social Security is to take into account claimant’s age, educational level, employment history, and Residual Functional Capacity (RFC) to decide whether there are jobs in the U.S. that claimant can perform.  One or more of the following limitations might be found in the RFC of a claimant with persistent migraines.
  • Missing more than two days of work per month due to pain.
  • Require unscheduled breaks throughout the day because of nausea, pain, or the  
  • Be off-task for at least 15% of the workday due to pain.
  • Would be unable to maintain focus and concentration throughout the workday.
An impairment of this type presents unique difficulty because it is an impairment based upon a subjective evaluation to identify the impairment and establish its severity.  With this impairment, the more documentation you can put before the Administrative Law Judge (ALJ) the better.
Difficult or not, if sufficient evidence is presented the ALJ cannot ignore it. Consider: Baker v. Apfel, 159 F.3d 1140 (8th Cir. 1998) The hypothetical question posed by the ALJ to the vocational expert was inadequate and did not fairly reflect impairments and capabilities of claimant, and therefore did not establish claimant was qualified for any jobs existing in the national economy where the questions did not consider limited time claimant was able to work, absences from the workplace, treatment etc.

Disclaimer: Blogs posted herein are intended neither as legal advice, nor do they create nor attempt to create an attorney-client relationship. The person viewing my blogs is admonished that an attorney-client relationship may only be created with the express consent to the parties to it. This blog is only the opinion of the author and are not expressed authority on any of the subjects discussed




1An aura is a perceptual disturbance experienced by some with migraine or seizures before either the headache or seizure begins. It often manifests as the perception of a strange light, an unpleasant smell or confusing thoughts or experiences. Some people experience aura without a subsequent migraine or seizure. From Wikipedia, the free encyclopedia