Monthly Archives: September 2010

Social Security Notice of Denial and What this Means for You

Social Security Disability benefits are denied for a variety of reasons. If you have been denied either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits it could mean you may have failed to meet the nonmedical conditions and you have insufficient work credits for SSDI or you have too many resources or income to qualify for Supplemental Security Income. Social Security Disability benefits are also denied for medical reasons which means the Social Security Administration has determined either your condition or illness does not meet the Social Security Administration’s definition of “disabled”, or you did not have sufficient medical evidence to prove you were disabled.

Countless Social Security Disability claims are denied each year and many of those claims are legitimate. Some claimants have had success winning Social Security Disability Insurance or Supplemental Security Income by contacting a Social Security Disability attorney to review their SSDI or SSI claim and file a Social Security Disability appeal.

What a Denial Means For You?

So you have filled out the Social Security Disability application, sent it to the Social Security Administration and patiently waited months for the decision. Now you are staring at a denial. You may be frustrated, sick and angry. What does this denial mean for you? Does it mean you will never get Social Security Disability benefits? What is the next step?

The good and bad news is you are not alone. Over 75% of first time SSD applications are denied. As mentioned before, many of these claims are legitimate, and the claimants will eventually be awarded benefits. If you are staring at a denial letter, if you are disabled with a mental or physical health condition that keeps you from employment and is expected to last for at least 12 months, it is time to file your Social Security Disability appeal.

Many claimants never file a Social Security Disability appeal and simply keep refilling for benefits over and over again. This may seem like a simpler solution but unfortunately this decision generally renders the same decision. New Social Security Disability applications are reviewed by the Disability Determination Services office (DDS). DDS examiners are responsible for analyzing each Social Security Disability application and making a medical determination about each claimant’s case. The DDS examiners have very strict, formalized criteria which they use for this review, and although your second application probably will not be reviewed by the same examiner, in most cases, the second examiner will make the same decision.

Filing a Social Security Disability Appeal

Filing a Social Security Disability appeal is often the best course of action for most claimants because it allows the claimant an opportunity to eventually present their SSD case to an Administrative Law Judge. Administrative Hearings are generally the third step in the Social Security Appeals process, and they allow claimants a chance to meet the decision maker face to face, offer medical evidence and present witnesses for their case. Judges are not bogged down by strict guidelines and oversight, and statistically, claimants have a forty-percent chance of winning their Social Security Disability benefits in an Administrative hearing even if they choose to fight for benefits without the help of a Social Security Disability Attorney. Claimants who choose to hire a Social Security Disability attorney have an even higher chance of winning Social Security Disability benefits.

How can a SSD lawyer help? Lawyers can gather recent medical evidence, present information about your residual functional capacity for working and question the vocational and medical experts.

Don’t keep applying over and over again for Social Security Disability benefits, remaining in an endless cycle of repetitive denials. Talk to a Social Security Disability lawyer about what type of evidence you need to win your Social Security Disability claim.

Social Security Disability Application Interview Process

If you have a disabling health condition and are unable to work you may apply for Social Security Disability benefits. The Social Security Administration administers two disability programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). To qualify for either disability program the applicant must meet certain medical standards, SSI applicants must meet certain resource and income levels and SSDI applicants must have contributed enough payroll taxes to the Social Security Trust Fund and earned enough “work credits” qualify for benefits.

Unless the Social Security Disability applicant decides to fill out the Social Security Disability application online, the first step in the Social Security Disability process is to contact the Social Security Administration (SSA) and set up an interview time. The application can be done over the phone or in person. Regardless of whether or not the applicant is completing the application online or in person, the SSA encourages each person to complete the Social Security Disability checklist prior to their Social Security Disability interview. Visit www.socialsecurity.gov/applyfordisability to find the Social Security Disability checklist.

Before the Social Security Disability Interview:

  1. Download the Social Security Disability Checklist and the Social Security Disability Starter Kit to prepare for the Social Security Disability interview. The Starter Kit includes a Social Security Disability Checklist and general information about the Social Security Disability process and all the necessary forms which the applicant will need to complete for the Social Security Disability application process.
  2. Gather all the medical records you have in your possession. The Social Security Administration is responsible for gathering any records that you do not have which are determined to be relevant to your Social Security Disability claim. Sending them the records or bringing copies of them to the SSD interview can expedite the SSI or SSDI claims process.
  3. If you have been injured on the job and have filed a workers’ compensation claim it is important to bring information about the case such as the settlement dates, the compensation amounts, the date of the injury, the workers’ compensation claim number and information about all workers’ compensation disability payments which you have been awarded.
  4. Provide information about the names and ages of your children and spouses.
  5. Provide dates of marriages and divorces.
  6. Gather all financial records including bank account information, routing numbers and direct deposit information.
  7. Complete the medical form SSA-827 which will give the Social Security Administration authorization to request medical information from hospitals, doctors, clinics and any other type of medical facility.
  8. The Medical and Job worksheet – Adult should be filled out and brought with you to your Social Security Disability interview.

Completing the Social Security Disability Starter Kit and the checklist will help you prepare for your Social Security Disability interview. It is important to keep the appointment even if you do not have all of the information you need. The Social Security Administration may be able to help gather certain pieces of medical data for you.

For the Social Security Disability Interview

It is the day of your Social Security Disability interview and you want to be prepared. What should you bring? Many of the items you will need you have already gathered while completing the Social Security Disability Checklist. In addition to those items it is a good idea to bring the following:

  • Birth certificate
  • Social Security card
  • Investment information
  • A list of your current prescribed medications
  • Doctor’s information (names, addresses and phone numbers)
  • Any medical records you have in your possession. Copy the relevant medical records prior to the interview and give the copies to the Social Security examiner. Do not ask them to make copies for you.
  • A list of any physical or mental impairment which you have and any functional limitations caused by your mental or physical health conditions.

The best way to expedite the Social Security Disability process is to be prepared. Have the information the Social Security Administration requests with you for the interview and be ready to answer questions about your work history, medical condition and current limitations which are caused by your disabling health conditions.

Providing medical records for your conditions can eliminate the need for the Social Security Administration to gather the data themselves which is the most time consuming part of the Social Security Disability decision making process. Medical records should be complete for each medical source and should contain your previous and current medical data. Older records may be needed to establish your eligible onset date (EOD) and current medical records are needed to prove you are still disabled.

Many Social Security Disability claimants want to know why the Social Security Disability process takes so long. It takes a long time because there are so many applicants. With a few simple steps and a willingness to provide the right information, the claimant may be able to save a great deal of time.

Social Security Disability and your Work History

The Social Security Administration will determine a claimant is disabled if they have a severe impairment and are unable to work at least 12 continuous months. They may qualify for Social Security Disability Insurance if they have worked and earned enough “work credits”. If they do not have sufficient work history, but they are limited in resources and income, they may qualify for Supplemental Security Income.

Evaluating Work History

It is difficult to understand how your work history affects your ability to win Social Security Disability benefits without understanding the disability determination process. The main objective of the SSA is to determine whether or not the claimant’s condition is so severe they are unable to work. To do this the Social Security Administration analyzes your residual functional capacity and work history to decide if you can work your current job or any other job you have performed in the last 15 years given your mental of physical limitations.

The Disability examiner will analyze your work history, only considering jobs which lasted for 3 months or longer and which were performed at SGA level. The examiner will match past jobs to jobs listed in the SSA’s Dictionary of Occupational Titles and rate the physical and mental requirement of each job. If the disability examiner determines that you do not have enough RFC or residual functional capacity to perform any of your past work they will decide if you are able to be retrained for a new job.

For example, if you are a 24 year-old construction worker who has a college degree and has worked several other types of skilled office positions and the DDS determines you are not able to return your construction job due to a leg injury or some other physical impairment they may decide, based on residual functional information from your doctors, you are able to perform work at a light exertion level. Next they will decide if given your age, educational level and work skills if you could retrain for another type of job. If they decide you could, you will be denied Social Security Disability Insurance or Supplemental Security Income benefits.

In some cases your work history or age may be benefit your case. For instance, if you are a fifty-five year old construction worker who did not graduate from high school, has always worked heavy labor, and is now required to do sedentary work the DDS may determine given your work history, education level and your age you it may be impossible for you to retrain for a desk job and will therefore be awarded disability benefits.

The Social Security Administration not only considers a claimant’s mental or physical health condition, they also analyze a claimant’s residual functional capacity, age and other factors to determine a claimant’s ability to maintain employment. The evaluation process can be complicated, and disability examiners can use a variety of tools created by the SSA such as vocational guidelines and GRID rules to help make their disability decisions. If you are unsure of whether or not you meet the definition of disabled according to the Social Security Administration, contact a Social Security Disability lawyer for more information.

Disability Decision

If you have applied for Social Security Disability Insurance or Supplemental Security Income, chances are you have been sick for several months, unable to work and may be facing financial hardships. You may have expected to receive your benefits immediately and did not realize most claimants wait months or even years to receive their Social Security Disability benefits. Claimants who file their Social Security Disability applications and receive SSD benefits immediately are, unfortunately, the exception.

All dates for disability decisions provided by the Social Security Administration are simply estimates. The Social Security Administration does have a legal obligation to meet any of their outlined decision dates. Why the delay in decision making? This is a great question, and there are several legitimate reasons:

·         Disability examiners who are reviewing Social Security Disability applications may have to wait months to receive all of your medical records which they must have to make a determination of disability for your Social Security Disability claim. Claimants who have not seen a doctor recently will likely have to be examined by a consultative examiner to prove they are still disabled. Getting consultative examinations scheduled, getting the results back to the examiner and having the examiner review the results all takes time. Why do the disability examiners care about the consultative examinations? These exams are frequently needed to provide the DDS examiner with more definitive information about a claimant’s disabling health condition and allow them to finalize their disability decision and close a claimant’s SSD case.

·         The number of Social Security Disability applications filed each year has substantially grown, and there are simply not enough disability examiners to review the claims quickly.

·         Claimants fail to provide complete information about their medical history, work history or other relevant personal data, and the Social Security Administration must spend valuable time researching and requesting any missing information.

·         Claimants who are denied Social Security Disability benefits and delay requesting any of their Social Security Disability appeals can also substantially add to their wait time. Claimants have 60 days to request, not only the reconsideration, but also the administrative hearing. Waiting the full 60 days to make the appeals can delay the claimant from receiving benefits for up to 4 months.

·         Most claimants who have appealed their Social Security Disability decision will wait the most time for their hearing to be scheduled with an Administrative Law Judge. The amount of time can vary greatly depending on where the claimant lives. Some claimant’s Social Security Disability hearings are scheduled immediately; others wait up to two years to have their hearings scheduled.

Expediting the Disability Decision

Can the claimant do anything to expedite their Social Security Disability decision? Yes, claimants can gather medical records for the disability examiner and their Social Security Disability lawyer, or at the very least, make sure the examiner gets all of the medical records they have in their possession. Claimants can provide accurate and detailed information on their Social Security Disability application. Claimants can return phone calls and answer letters as quickly as possible and finally, claimants can file all Social Security Disability appeals as soon as the denial letters are received.

Hiring a Social Security Disability lawyer may also help claimants get approved for Social Security Disability. Evidence has shown that hiring a Social Security Disability lawyer can increase a claimant’s chances for approval at every stage of the Social Security Disability process.