15 Secrets and Tips to Wining Your Social Security Disability Case
Never assume that what SSA tells you is accurate or correct.
Unfortunately, some of the advice Social Security Administration (SSA) employees provides to the public is incorrect. So if you aren’t happy what SSA told you over the telephone, you’ll be glad to know it may not be correct. The problems is, many people have told me they did not file a disability claim for years ( and went without benefits they deserve) simply because a SSA employee gave them bad information.
Don’t give up on your claim until after you have reviewed your case with a disability lawyer. Disability lawyer know more about the law than SSA employees and will give you correct information.
Never assume SSA will approve your claim. Not true. Many people believe that because they have paid into SSA, they claim should easily be approved when they apply for disability benefit. Many people believe it’s just a matter of filling out the forms and going through the process. But this just isn’t true. SSA denies 70 to 75% of first-time claims. SSA denies 82% of claims that are appealed for Reconsideration. However, the good news is that when cases are heard before judges, nationwide over half (53%) are approved.
And, when you hire an experienced disability advocate wil: (1) Appeal every denial within 60 (sixty) days of the receipt, (2) build a stronger case understanding what information SSA requires, (3) make sure to present it properly before the Court, and (4) argue the legal and factual aspects of your case to the judge.
Never assume the disability forms you fill out will win your case. Usually they will not. Many times Claimants can hurt their case by overstating what they can do. In other words, claimants frequently think they can physically do more than what they really can. In most cases, SSA and judges rely heavily on medical records as well as the medical opinions of your doctor, psychiatrist and/or psychologist’s about your ability to work full time. If the judge isn’t happy with you…if he doesn’t believe what you’re saying…or if he is looking for a reason to deny your claim, he may look for inconsistencies in answers you provided earlier on a SSA form. For example, if you answer one way on the form and testify at a hearing to something else, the judge may use the answer on the form to undermine your credibility and support a denial of your claim. You should never complete these forms without legal advice.
When completing the forms, be honest, accurate and brief. You should always answer the question in the space provided –do not attach additional sheets of paper or write in the margins. When answering questions about what you are capable of doing it is important to assume you are working full-time on a continued and sustained basis i.e., 8 hours per day, 5 days per week, 40 plus hours per week.
Never assume that your medical and/or psychological SYMPTOMS will be enough for the judge to approve your claim. Not true. You need detailed medical records which documents your symptoms and limitations and specific opinions from your doctor, psychiatrist and/or psychologist if you hope to win your case. Their opinions will only be given weight by the judge if you have received continuous and consistent medical treatment. If you are not treating regularly with your doctor you are jeopardizing your case!
It is critical you receive continuous and consistent medical treatment and care so you can provide SSA and the judge with current and complete medical records which support your doctor’s opinions.
Never assume your diagnosis will win your claim.
It won’t. It’s true that SSA needs a diagnosis. But SSA also needs a medical proof that your diagnosis causes limitations that are so significant and severe that they preclude your ability to work full- time on a continued and sustained basis.
Advice: Disability cases are won based on your limitations, not your symptoms. Make sure you provide detailed medical records from your doctors) that accurately reflect your symptoms, diagnosis, and limitations in a work setting.
Never assume SSA will be persuaded by any type of medical treatment you choose. Be aware that SSA and judges are most persuaded by mainstream doctors (M.D., D.O., psychologist) and how you respond or fail to respond to mainstream treatment. If you are not taking medications or are not receiving mainstream treatment by a mainstream doctor, you may be jeopardizing your claim. SSA Law and Judges will not give much evidentiary weight to treatment from such sources as: chiropractors, nurses, acupuncturists, et cetera.
To win your claim, be sure to exhaust every medical treatment your mainstream doctors recommend, so you can prove in a court of law that in spite of doing so, you remain unable to work full-time on a sustained basis.
Never assume your FAMILY DOCTOR’S medical opinion is the only one you need. This may not be a good choice depending upon your diagnosis. If your diagnosis is made and treated by a specialist (M.D., D.O., Ph.D), then you should be treated by a board certified specialist and your family practitioner. From a legal standpoint, you want to show the judge your diagnosis is correct and that you are receiving the best possible medical care. You will have a much stronger case when your doctor is a specialist who is trained, skilled and experienced at treating people with your specific, unique condition(s). Social Security law generally gives more weight to the opinions of a specialist than a general practitioner. As a result, SSA and the judge will look more closely at the credentials of the doctor who is providing the opinion.
Get your medical treatment from a specialist because the more skill and experience your doctor has then the more likely you are to win your claim.
Never assume your doctor will support your claim for disability benefits. He may not. Some doctors refuse to help patients with their disability claims. Many doctors do not know SSA’s definition of disability and believe that one has to be completely bedridden to qualify.
In general, doctors are very conservative in their opinion about a patient’s ability to work. Because SSA and the judge will want to know if your doctor supports your claim, it is critical you know the same information!
After you have established a relationship with your doctor you should discuss with them the fact that you have filed a claim for disability. Ask your doctor(s) if they will support your claim – if they will not, you should consider finding another doctor immediately because their opinion is not likely to change! It is critical your doctor supports your inability to work full-time on a sustained basis!
As soon as possible, you should learn whether your doctor supports your disability claim. If not, consider finding a more compassionate, sympathetic doctor who will. A great place to find a referral for such a doctor is to attend a local support group for individuals who share your diagnosis.
Never assume you have to go to SSA’s doctor for a medical examination.
In almost all cases, SSA will want to send for an “independent medical examination” or “consultative examination” with a doctor/psychiatrist/psychologist SSA chooses.
Unfortunately, these doctors are really not “independent.” Many of these SSA doctors only perform examinations for SSA each month and practice no other type of medicine for the public.
In my experience, the majority of the time, SSA doctors will conclude you are not disabled and can return to work. Once this opinion is included in your file SSA and the Judge will have sufficient evidence to deny your claim.
Here’s the good news: SSA rules allow your doctor perform the disability exam and SSA should pay for all or at least part of it. Naturally, if your doctor supports your disability claim he will probably conclude your condition(s) precludes your ability to work. Once your doctor’s exam report is in your file with a conclusion that you are disabled, SSA and the Judge may have sufficient medical information to approve your claim.
This strategy is only possible if you are certain your doctor supports you claim and is willing to do the examination. If you do not have a doctor or your doctor will not perform the examination you must go to SSA’s doctor or risk having your claim denied or closed out. This strategy really should only be employed by a disability lawyer because complex regulations are involved and must be complied with.
Never assume an entire year has to pass before you can file a disability claim.
Not true. SSA law requires that before you can be approved one of the following must be true: (1) you have already been disabled and out of work for one year, or (2) your doctors expect that you will be unable to work for a minimum of one year from the date you last worked, or (3) your medical condition is expected to result in death.
Too many people have told me that an SSA employee said they could not file a claim until one year had passed since they last worked. This information is totally incorrect and if followed, will almost certainly cost you disability benefits and medical insurance!
Apply for disability benefits as soon as you or your doctors believe your medical and/or psychological condition will be preclude you from working for at least one year. Waiting to file will only cost you benefits that you may not be able to recover.
Never assume that if you’re denied at an SSD Judge hearing, you can simply file another claim. When you have a hearing before a SSA judge, you do not want to lose. This is because, practically speaking, your best chance at winning is at your first hearing before a judge. Make sure your case is properly prepared so you can present your strongest case at the first hearing.
True, you can file a second application if you lose at the hearing; however, the second time you go through the process, SSA and the judge will know your first claim was denied. In my opinion, this may have a detrimental effect on your second claim as the second judge will know.
Additionally, if too much time has passed between the time you last worked and the time of your second filing, you’re Date Last Insured (“DLI date”) may have expired. The SSA laws and Regulations involving filing a second claim after a court denial and your DLI date are complex. Be sure to consult with an experienced Social Security Disability Advocate before proceeding.
Never assume you can handle your case without an experienced Social Security Disability Lawyer. Most people simply can’t navigate the mountains of paper work, forms, red- tape, et cetera. Social Security disability laws are complex. Indeed, even many lawyers do not understand them. To win your claim, you need to very carefully prepare your case from the very beginning.
In addition, it is critical to understand what you need to prove legally in order to win your case; if you do not know what you need to prove – why would you risk going against the SSA or before a Judge without knowing how to win your case? The fact that you and your doctor agree you are disabled is not enough to win your case.
Retain only an experienced disability lawyer. They will help build your case, develop a case strategy, a theory of your case and obtain a complete set of your medical records and critical opinions from your doctor that will maximize your chance of success. More often than not, your doctor will not be familiar with the strict criteria that SSA and a Judge will utilize in determining whether you meet the definition of “disability.”
Never assume any lawyer can help you win your claim. Not true. You want a disability lawyer who is familiar with SSA laws and regulations. Similar to doctors, advocate generally specialize in a certain area of law. You wouldn’t go to a dentist for back pain, so do not pick just “any” advocate to represent you in your disability claim.
Choose a disability lawyer whose practice is exclusively dedicated to representing disability claimants because your odds of winning will certainly increase. A seasoned disability advocate will understand the strategy and tactics that are crucial to helping you win the claim.
Never assume you should not hire a lawyer until your case has initially been denied. Not true. You can hire a lawyer anytime you wish. Unfortunately, many employees at SSA will tell the public that it is not necessary to hire an advocate until after you have been initially denied. Following this advice could be fatal to your claim! Why? Because in general, SSA will begin preparing a case against you from the first day you file your application!
You should consult with and/or hire a disability advocate as soon as possible after you file your application. The advocate can explain how the process really works and lay the proper foundation for your case by developing a case strategy. The advocate can also guide your case through the myriad of rules and regulations that are certain to have an effect on your entitlement to benefits.
Never assume that you cannot afford a lawyer. Not true. In almost every case, you will only pay the advocate a fee if and when you have won your case and received benefits. SSA law limits the amount of money your lawyer can earn from your disability claim. Generally, by the time you win your claim, you will have accrued back benefits. The law mandates the fee can only be 25% of your past benefits and oftentimes a fee cap will apply.
What may be at stake? By way of example, assume a claimant is 45 years old and their monthly disability benefit is $1,000.00. If the person never returns to work before age 65, due to a disability, their disability benefits would total $240,000.00!
This amount does not even include the value of the lifetime health insurance they would also receive through Medicare or Medicaid.
Because of the amount of the benefits can be staggering, the truth is, you simply can’t afford not to hire an experienced Social Security Disability Advocate!