INFO - Winning your social security disability claim: 15 mistakes you can't afford to make

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WINNING YOUR SOCIAL SECURITY DISABILITY CLAIM:

15 Mistakes You Can't Afford to Make!

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by , Esq.

Mistake #1: Assuming that what SSA tells you is true. Unfortunately, some

of the advice Social Security Administration (SSA) employees provides to the

public is incorrect. So if you aren't happy with what SSA told you over the

telephone, you'll be glad to know it may not be correct. The problem 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.

Advice: Don't give up on your claim until after you have reviewed your case

with a disability lawyer. Disability lawyers know more about the law than

SSA employees and give you correct information.

Mistake #2: Assuming the SSA Administration will approve your claim. Not

true. Many people believe that because they have paid into SSA, their claim

should easily be approved when they apply for disability benefits. Many

people believe it's just a matter of filling out the forms and going through

the process. But this 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.

Advice: (1) Appeal every denial within 60 (sixty) days of receipt, (2)

build a strong case by understanding what information Security Security

requires, and (3) make sure to present it properly.

Mistake #3: Assuming the disability forms you fill out will win your case.

Usually they will not. Claimants hurt their case by overstating what they

can do. In most cases, SSA and judges rely heavily on medical records as

well as your doctor, psychiatrist and/or psychologist's opinion 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

the forms. 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.

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. Also, it is important

to assume you are back working full time on a sustained basis (8 hours per

day, 5 days per week) when answering questions about what you are capable of

doing.

Mistake #4: Assuming 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 document 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!

Advice: It is critical you receive continuous and consistent medical

treatment and care so you can provide SSA and a judge with current and

complete medical records which support your doctors' opinions.

Mistake #5: Assuming your diagnosis will win your claim. It won't. It's

true that SSA needs a diagnosis. But SSA also needs medical proof that your

diagnosis causes limitations that are so significant and severe that they

preclude your ability to work full time on a sustained basis.

Advice: Disability cases are won based on your limitations, not your

symptoms. Make sure you provide detailed medical records from your doctor

that reflect your symptoms, his diagnosis, and your limitations.

Mistake #6: Assuming SSA will be persuaded by any type of medical treatment

you choose. It will not. You can choose any alternative therapies and

holistic treatments you desire. After all, you should do whatever it takes

to try to get better. However, be aware that SSA and judges are most

persuaded by mainstream doctors (M.D., D.O., psychologists) 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.

Advice: To win your claim, try to exhaust every medical treatment your

mainstream doctors recommend, so you can prove that in spite of doing so,

you continue to be unable to work full time on a sustained basis.

Mistake #7: Assuming your family doctor's opinion is the only one you need.

This may not be a good choice depending upon your diagnosis. If your

diagnosis is usually made and treated by a specialist (M.D., D.O., Ph.D),

you should treat with both 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 have a stronger case when your doctor is a specialist who is

skilled and experienced at treating people who have your condition. 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.

Advice: Get your medical treatment from a specialist because the more skill

and experience your doctor has, the more likely you are to win your claim.

Note: If you are a member of an HMO and they will not allow you to go to a

specialist, consult with your disability lawyer, who can help you get

appropriate treatment.

Mistake #8: Assuming 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 bed ridden to qualify. In general, doctors

are very conservative in their opinion about a patient's ability to work.

Because SSA and a 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 if they will support

your claim - if they will not, you should consider finding another doctor

because their opinion is not likely to change! It is critical your doctor

supports your inability to work full time on a sustained basis!

Advice: As soon as practicable, you should learn whether your doctor

supports your disability claim. If not, consider finding a more

compassionate doctor who will. One place to find a referral is to attend a

local support group for individuals who share your diagnosis.

Mistake #9: Assuming you have to go to SSA's doctor for a medical

examination. Often, SSA wants to a claimant to go a disability examination

with a doctor/psychiatrist/psychologist it chooses. Unfortunately, the

doctor is not really " independent " and probably performs many of these

examinations for SSA each month. In my experience, the majority of the time

the doctor will conclude you are not disabled and can return to work. Once

this opinion is included in your file SSA and a 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 precludes your ability to work. Once your doctor's exam report is

in your file with a conclusion that you are disabled, SSA and a judge may

have sufficient medical information to approve your claim.

Advice: This strategy is only possible if you are certain your doctor

supports your 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.

Mistake #10: Assuming 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!

Advice: Apply for disability benefits as soon as you or your doctors

believe your medical and/or psychological condition will 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.

Mistake #11: Assuming that if you lose before a judge at a 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. True, you can

file a second application if you lose at a hearing; however, the second time

you go through the process, SSA and a 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.

Advice: Make sure your case is properly prepared so you can present your

strongest case at the first hearing.

Mistake #12: Assuming you can handle your case without a disability lawyer.

Most people can't. SSA disability laws are complex, 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 before SSA or 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.

Advice: Retain only an experienced disability lawyer. They will help build

your case, develop a case strategy, obtain a complete set of your medical

records and critical opinions from your doctor that will maximize your

chances of success. More often than not, your doctor will not be familiar

with the stringent criteria that SSA and a judge will utilize in determining

whether you meet their definition of disability.

Mistake #13: Assuming 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, attorneys generally specialize in a certain area of the

law. You wouldn't go to a dentist for a physical examination, so do not

pick just " any " attorney to represent you in your disability claim.

Advice: Choose a disability lawyer who's practice is dedicated to

representing clients because your odds of winning will increase. A seasoned

disability attorney will understand the strategy and tactics that are

crucial to helping you win your claim.

Mistake #14: Assuming you should not hire a lawyer until your case has

initially been denied. Not true. You can hire a lawyer any time you wish.

Unfortunately, many employees at SSA will tell you that it is not necessary

to hire an attorney until 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 day you file your application!

Advice: You should consult with and/or hire a disability attorney as soon

as possible after you file your application. The attorney can explain how

the process really works and lay the proper foundation for your case by

developing a case strategy. The attorney can also guide your case through

the myriad of rules and regulations that are certain to have an effect on

your entitlement to benefits.

Mistake #15: Assuming that you cannot afford a lawyer. Not true. In

almost every case, you will only pay the attorney 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 is capped at $4,000. In other

words, if your back benefits total $1,000.00, the attorney's fee would be

$250.00. The law does not allow your lawyer to charge a fee on your future

benefits.

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, their disability benefits would total

$240,000.00! This amount does not include the value of the lifetime health

insurance they would also receive through Medicare or Medicaid.

Advice: Because the amount of the benefits can be staggering, the truth is,

you can't afford not to hire an experienced disability attorney!

The above article and others are found here:

http://www.scottdavispc.com/articles.html

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org