Winning Your Social
E. Davis, Esq.
Disability laws are complex and often
overwhelming for the person
without a law degree. In this article, Scott Davis, a Social Security and long-term disability insurance
attorney in Phoenix, Ariz., shares his wisdom and relates the 15 most common mistakes people make when
applying for Social Security disability benefits.
assume that an entire year has to pass before you can file a disability claim. The Social
Security Administration (SSA) requires that before you can be approved for disability only one of the
following must be true: (1) you have already been disabled and out of work for one year, (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. Many people have had a SSA employee incorrectly
tell them they could not file a claim until one year had passed since they last worked.
Apply for disability benefits as soon as you believe your condition will preclude you from working for
at least one year.
2. Donít assume you
can handle your
own case. Even many attorneys donít understand SSA disability laws. It is crucial that
you understand what must be proven legally. If you do not know what you need to prove, you risk losing.
Advice: Retain only an experienced disability lawyer who can help build
your case, develop a case strategy, obtain a complete set
of your medical records and crucial opinions
from your doctors.
you cannot afford a lawyer. You usually only pay an attorney a fee if you have
won your case and received benefits. Further, SSA law limits the amount of money your lawyer can earn
from your claim.
Advice: You canít afford not to hire an experienced disability
attorney if you are to receive the benefits you are entitled to.
assume any lawyer can help you win your claim. Retain a disability lawyer who is familiar
with SSA laws and regulations.
Advice: Choose a lawyer
whose practice is dedicated to disability law and who understands the strategy to help you win.
Donít assume the disability forms you fill out will win
Claimants often hurt their cases by overstating what they can do. In most cases, the SSA and judges rely
heavily on medical records and opinions from doctors about your ability to work full-time. Inconsisten-cies
in answers you provided on the forms could make the judge question your credibility.
When completing the forms, be honest, accurate and brief. Also, when answering questions about what you
are capable of doing, answer as though you are working full-time on a sustained basis (eight hours per
day, five days per week).
6. Donít assume
that your symptoms
will be enough for the judge to approve your claim. You need detailed medical records
that document your symptoms and limitations and specific opinions from your doctors, whose opinions will
only be given weight by the judge if you have received continuous and consistent medical treatment.
It is crucial that you receive continuous and consistent medical treatment so that you can provide
the SSA and a judge with current and complete medical records that support your doctorsí opinions.
Donít assume that the SSA will be persuaded by any type of
you choose. You can choose any holistic or alternative therapies you desire, however,
the SSA and judges are most persuaded by mainstream doctors (MD, doctor of osteopathy, PhD) and how you
respond to their treatment. If you are not taking medications or are not receiving treatment by a mainstream
doctor, you may be jeopardizing your claim.
Advice: Exhaust the appropriate
medical treatments your mainstream doctors recommend. If your condition persists, you can then prove that,
in spite of treatment, you continue to be unable to work full-time on a sustained basis.
Donít assume that your family doctorís opinion is the only
one you need.
If your diagnosis is usually made and treated by a specialist, you should be treated by both a board-certified
specialist and your family practitioner. You want to show the judge that your diagnosis is correct and
that you are receiving the best possible medical care.
Advice: The more
experienced your doctors are, the more likely youíll win. Note: If your HMO will not allow you to go to
a specialist, consult with your lawyer, who can help you get appropriate treatment.
Donít assume that your doctor will support your claim for disability
Some doctors refuse to help patients with their disability claims, donít know the definition of disability,
or donít know how to complete the forms or write a supportive disability letter. [Editorís Note: The
Association publication, ďDisability
Evaluation in a Nutshell,Ē by Douglas Smith, shows doctors how to write disability reports for the
SSA.] Because SSA and a judge will want to know if your doctor supports your claim, it is crucial
you know the same.
Advice: Determine if your doctor supports your disability
claim. If not, consider finding one who will. One place to find a referral is to attend a local CFIDS
10. Donít assume you have
to go to a SSA
doctor. The SSA often wants you to go to a doctor it chooses, but they often conclude
that you are able to work whether or not you can. Once this is included in your file, your claim could
be denied. However, you are allowed to have your own doctor perform the disability exam and SSA must pay
for all or part of it. Once your doctorís report that you are disabled is in your file, SSA and a judge
may have sufficient information to approve your claim.
Advice: If you
do not have a doctor who supports your claim or who is willing to perform the exam, you must go to a SSA
doctor or risk having your claim denied or closed out.
Donít assume your diagnosis will win your claim.
that the SSA needs a diagnosis, but it 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 that reflect your symptoms, diagnosis and functional
12. Donít assume you should
not hire a lawyer
until your case has initially been denied. You can hire a lawyer any time you wish, but
many SSA employees will tell you that it is not necessary to hire an attorney until you have been initially
Advice: Consult with and/or hire a disability attorney as soon
as you file your application. If you need help finding an attorney, contact the National Organization
of Social Security Claimant Representatives at 800/431-2804 or visit their web
13. Donít assume that what SSA
tells you is
true. Many people do not file a disabil-ity
claim for years
simply because a SSA employee gave them bad information.
your case with a disability lawyer, who may know more about the law than some SSA employees.
Donít assume the SSA will approve your claim.
The SSA denies
70% to 75% of all first-time claims and 82% of claims that are appealed. However, when cases are heard
before judges, 53% are approved.
Advice: Appeal every denial within 60
days and build a strong case by understanding what information the SSA requires
and making sure it is presented properly.
that if you lose before a judge at a hearing, you can file another claim. Your best chance
at winning is at your first hearing. A loss is recorded in your file and could have a detrimental effect
on the judge at a second hearing.
Advice: Make sure your case is properly
prepared so that you can present your strongest case at the first hearing.
Davis represents clients seeking
disability benefits on a broad
spectrum of disorders. For inquiries, telephone 602/482-4300.