WORST MISTAKES IN SOCIAL SECURITY DISABILITY CASES - AVOID THEM
Only about one-fourth of applications for Social Security disability benefits are approved without a hearing. Below are some of the serious mistakes that claimants make. If you are filing for Social Security disability, know these mistakes and avoid them for the best chance of winning benefits:
1. Believing that the Social Security doctor will find that you are disabled. This is very unlikely. The doctor Social Security sends you to will spend no more than 15 -20 minutes with you and will perform a very limited examination. He has no incentive to find you disabled, since he is paid by Social Security. You may have better luck with your own doctor.
2. Don't fail to ask your own doctor to complete a Medical Source Statement. This is a form which explains what specific limitations you have in performing work related functions, such as sitting, standing, walking, lifting, bending, concentrating, etc. This is in addition to routine medical records and does not require a special examination.
3. Filing for disability while you are still working. You cannot file for disability while you are working at "substantial gainful activity" or SGA. In 2015, this amounts to work that pays you at least $1,090 per month. In 2014, the SGA limit was $1,070 per month. Work that pays less than the SGA amount may not disqualify you.
4. You have to prove that your disability will last at least 12 consecutive months (or that it has already lasted that long). There is no short term disability with Social Security. 12 months is the minimum duration for a qualifying disability.
5. Failing to get medical treatment. All disability awards must be based on "medically determinable impairments." You will need your doctor to examine you, diagnose your problems and determine how severe your symptoms are. Medical doctors and clinical psychologists are "accepted medical sources" with Social Security. Chiropractors, counselors and nurse practitioners are not.
6. Failure to get psychological problems diagnosed and treated. Social Security must consider psychiatric or emotional problems as well as physical problems - but they must be diagnosed by a psychiatrist or clinical psychologist, or at least by your family doctor.
7. You must apply while you have Social Security coverage. Not everyone has Social Security disability coverage. You become covered by working and paying a special tax called FICA tax, which is required to be withheld on every worker. However, you must earn enough quarters of work to be covered. Also, when you stop working, you eventually lose your disability coverage with Social Security. This usually happens after 4 years of no work. If there are gaps in your work, your coverage may expire in less than 4 years. The date you stop being covered is called your "date last insured" or DLI.
8. You have to appeal unfavorable decisions within 60 days. Being denied is not the exception, it's the rule. Be prepared to file a request for hearing within 60 days after you receive a denial letter from Social Security. This 60 day rule is very strict. If you wait too long you cannot appeal the claim and must start all over.
9. Avoid trying to represent yourself (pro se representation). Social Security law is a highly technical and specialized field. The US disability program is governed by thousands of pages of rules and regulations. If you don't meet the rules or follow the correct procedures you can be denied and this may cost you thousands--even hundreds of thousands of dollars over the years. Consider getting a specialist to represent you and arrange a "contingency fee" situation where the representative gets paid only if you win.
10. Failure to prepare the vocational (work) aspects of your claim. There are two important parts of a Social Security disability claim: the medical aspect is the best known part. However, there is an equally important vocational aspect to the claim. Past work will be classified and a vocational expert will be asked to determine whether there are any jobs in the US economy that you could still perform, in spite of your physical and/or mental limitations. Failure to adequately prepare the vocational aspect of your claim will result in a denial, just like failure to prepare the medical part of the claim will get you denied.
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1. Believing that the Social Security doctor will find that you are disabled. This is very unlikely. The doctor Social Security sends you to will spend no more than 15 -20 minutes with you and will perform a very limited examination. He has no incentive to find you disabled, since he is paid by Social Security. You may have better luck with your own doctor.
2. Don't fail to ask your own doctor to complete a Medical Source Statement. This is a form which explains what specific limitations you have in performing work related functions, such as sitting, standing, walking, lifting, bending, concentrating, etc. This is in addition to routine medical records and does not require a special examination.
3. Filing for disability while you are still working. You cannot file for disability while you are working at "substantial gainful activity" or SGA. In 2015, this amounts to work that pays you at least $1,090 per month. In 2014, the SGA limit was $1,070 per month. Work that pays less than the SGA amount may not disqualify you.
4. You have to prove that your disability will last at least 12 consecutive months (or that it has already lasted that long). There is no short term disability with Social Security. 12 months is the minimum duration for a qualifying disability.
5. Failing to get medical treatment. All disability awards must be based on "medically determinable impairments." You will need your doctor to examine you, diagnose your problems and determine how severe your symptoms are. Medical doctors and clinical psychologists are "accepted medical sources" with Social Security. Chiropractors, counselors and nurse practitioners are not.
6. Failure to get psychological problems diagnosed and treated. Social Security must consider psychiatric or emotional problems as well as physical problems - but they must be diagnosed by a psychiatrist or clinical psychologist, or at least by your family doctor.
7. You must apply while you have Social Security coverage. Not everyone has Social Security disability coverage. You become covered by working and paying a special tax called FICA tax, which is required to be withheld on every worker. However, you must earn enough quarters of work to be covered. Also, when you stop working, you eventually lose your disability coverage with Social Security. This usually happens after 4 years of no work. If there are gaps in your work, your coverage may expire in less than 4 years. The date you stop being covered is called your "date last insured" or DLI.
8. You have to appeal unfavorable decisions within 60 days. Being denied is not the exception, it's the rule. Be prepared to file a request for hearing within 60 days after you receive a denial letter from Social Security. This 60 day rule is very strict. If you wait too long you cannot appeal the claim and must start all over.
9. Avoid trying to represent yourself (pro se representation). Social Security law is a highly technical and specialized field. The US disability program is governed by thousands of pages of rules and regulations. If you don't meet the rules or follow the correct procedures you can be denied and this may cost you thousands--even hundreds of thousands of dollars over the years. Consider getting a specialist to represent you and arrange a "contingency fee" situation where the representative gets paid only if you win.
10. Failure to prepare the vocational (work) aspects of your claim. There are two important parts of a Social Security disability claim: the medical aspect is the best known part. However, there is an equally important vocational aspect to the claim. Past work will be classified and a vocational expert will be asked to determine whether there are any jobs in the US economy that you could still perform, in spite of your physical and/or mental limitations. Failure to adequately prepare the vocational aspect of your claim will result in a denial, just like failure to prepare the medical part of the claim will get you denied.
SEE OUR FREQUENT QUESTIONS AND ANSWERS SECTION - FREE
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