Common Mistakes Made When Filing a SS Disability Claim

When you apply it is important to follow these rules:

Dealing with the Social Security Administration (SSA) can be an extremely frustrating and time-consuming task. If you are unfamiliar with the process of applying for Social Security Disability (SSD) or Supplemental Security Income (SSI), this task can be very difficult and you may have a number of questions. Employees of the SSA will not necessarily help in alleviating your confusion; often they will add to it!

Answers from the SSA are occasionally incorrect, but most often vague or confusing. Most SSA employees do not have the qualifications or incentive necessary to assist you. For this reason, you should not rely on any answers given to you by an SSA employee that assess your disabling condition, interpret Social Security law, or evaluate statements you intend to make on your SSD or SSI application. The simple fact of the matter is, with only 1 in 10 applicants receiving approval after the initial evaluation, a high level of experience and legal expertise is required to overcome the many obstacles denying you the compensation that is rightfully yours as a result of your disability. Many Social Security experts agree that a consultation with an SSD/SSI attorney or advocate is highly recommended before your initial application. Many advocates attorneys offer this service for free.

Exaggerating or Understating Your Disability
Many applicants spend a considerable amount of time on their initial application only to be denied. This is only the beginning of a long process, but all too often applicants accept this denial in frustration and do not pursue the matter further. Application evaluators examine your medical records thoroughly and highly value the opinion of your doctor. They will compare what you have written in your application against the opinions of your doctor expressed in your medical records. Consequently, if you exaggerate your condition, your application may be denied. At the same time, if you downplay your condition and the evaluators believe you may be able to perform some type of work, this may also result in a denial. A qualified SSD/SSI attorney or advocate is familiar with the type of language necessary for an application that will result in the award of Social Security Benefits.

§404.1527 Evaluating opinion evidence. Explaining the Effects of Your Disability
Your application must convince the SSA that you are disabled. If you understate your condition and the SSA believes that you are capable of performing work or work-like tasks your application will be denied. It is important to accurately describe the physical limitations of your disability as well as the emotional and psychological effects that accompany your condition. You must describe how your disability impacts your daily routine and common activities such as household chores, dressing yourself, or even sleeping. In addition, you must assess the mental and physical tasks involved in your work history as well as basic job responsibilities and determine how your condition has disabled you from fulfilling these duties. You can only be found disabled if you are unable to do any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months. See §404.1505. Your impairment must result from anatomical, physiological, or psychological abnormalities which are demonstrable by medically acceptable clinical and laboratory diagnostic techniques. Many applicants are unfamiliar with the extent to which they must explain their disability to the Social Security Administration. As a result, their application is denied. Consulting a SSD/SSI attorney that understands the complexities of documenting an applicant’s disability is highly recommended.

Your Doctor’s Diagnosis
The opinion of your physician will factor greatly into the success of your application. Many claims are denied on the basis of the doctor’s statement. This is not because your doctor believes you are not disabled, but because the language used by your doctor is intended for the medical field and does not meet the criteria demanded by the SSA’s application evaluators. It is often necessary for applicants to discuss their intention to apply for disability with their doctor. Generally, the ALJ is required to give more weight to opinions from your treating sources, since these sources are likely to be the medical professionals most able to provide a detailed, longitudinal picture of your medical impairment(s) and may bring a unique perspective to the medical evidence that cannot be obtained from the objective medical findings alone or from reports of individual examinations, such as consultative examinations or brief hospitalizations. If we find that a treating source’s opinion on the issue(s) of the nature and severity of your impairment(s) is well-supported by medically acceptable clinical and laboratory diagnostic techniques and is not inconsistent with the other substantial evidence in your case record, we will give it controlling weight.  20 CFR §404.1527 (d)(2).   Blakely v. Comm’r of Soc. Sec., 581 F.3d 399 (6th Cir. 2009) Furthermore, an applicant must also educate their doctor on the necessary specifics to be included with the medical record to ensure approval of the application. It is this part of the process where legal expertise and experience is most often required to successfully secure your SSD/SSI award. An experienced attorney or advocate can discuss the application process with your doctor to avoid or appeal a denial.

Appealing a Denial
Clearly the SSA has made the laws regarding disability extremely complex. Attorneys who do not specialize in disability law typically do not understand it. If you have never worked with an attorney or advocacy service before, you may be concerned that the cost is simply too high given that you are not in a situation to work! However, it is common practice for advocates and attorneys to work on a contingency basis. This means that they do not charge a fee unless you win. Typically this fee is no more than 25% of your award. Applicants who retain an advocate or attorney typically receive a larger award than those who do not. If you have questions or concerns regarding your initial application or an appeal for your denial, I can provide you with a free consultation to determine what the best course of action is for your case.

If you would like to contact me concerning representation in your case, I can be reached by e-mail at prj@prjoneslaw.com