Social Security Disability: Advice From a Disability Examiner
Here's some advice from a former examiner on applying for and winning your SSDI or SSI disability case.
Here are a few helpful things I learned during my years as a disability examiner at the Social Security Administration (SSA).
1. Don't wait to file for disability.
If you are disabled and unable to work, it's good advice to pursue a claim for Social Security disability and get it filed immediately.
Reason: Disability claims can take a very long time to process. This isn't true in all cases, but it is in most. Unfortunately, many claimants for disability benefits (applicants) experience financial hardship simply because they had no idea how long the process would be, and only realized when it was too late that they should have filed an application much, much sooner.
In addition, for SSDI, this is important because you don't want your disability insurance to expire. (See our article on the date last insured.) For SSI, this is important because you can't collect retroactive disability benefits before your application date.
2. Hire an attorney to appeal a denial.
If you are denied on your initial disability claim, it's good advice to get an attorney, or even a non-attorney representative, to represent you and help you with your claim for continuing and retroactive benefits (disability backpay).
Reason: The way the disability system works, a disability claimant will either be approved on an initial application or will be forced to follow the appeals route. Most claimants will have to go to an appeal hearing if they hope to be approved, and going to a hearing before an administrative law judge without a lawyer can hurt your chances at winning. (See our section on disability lawyers to learn how much they can help a case.)
3. Get help with the disability application if you need it.
If you think you may have problems doing the paperwork for your Social Security disability claim, get assistance filling out the paperwork.
Reason: An extraordinary number of people who apply for disability benefits, or file an appeal following a denial, fail to properly complete their paperwork, or fail to submit their paperwork on time (appeals for disability must be filed within 60 days of the date of the last denial). Incomplete paperwork or missed deadlines will result in a denial. Get help to fill out the forms, either from a family member, a disability lawyer, or a Social Security field representative at a local Social Security office.
4. Visit the doctor regularly.
Since your Social Security disability claim will be evaluated on the basis of your medical records, the best advice is to get regular, ongoing medical treatment in the months (even years) before you apply.
Reason: If you attempt to get a supporting statement from your doctor, you may have difficulty getting your physician to cooperate if you haven't had a doctor's appointment recently. In addition, the SSA may not believe that your medical condition is severe if you are not visiting a doctor often. Remember this advice: As a general rule, you cannot be approved for Social Security disability if you are not seen by a medical provider at least once every two months.
If you lose your medical coverage before your claim for benefits is approved, as is usually the case, try to be seen at a free clinic, county health department, or emergency room. While these "treatment sources" (what Social Security calls doctors) are not the best, they are, simply put, better than nothing. (If you haven't seen a doctor regularly, read our article on applying for disability without a doctor.
5. Take your prescribed medications.
Reason: Whether you take your prescribed medicine or not may affect how Social Security views your impairments. In fact, judges will often deny claims in which claimants did not take what was prescribed. The fact that the claimant had no means by which to obtain their needed meds is not always of interest to an administrative law judge (ALJ) at a disability hearing. For more information, read our article on how failing to follow prescribed treatment affects a disability case.
6. Be cordial with the people working on your case.
Reason: Even if your case has been mishandled (for example, long waits, misplaced paperwork, etc.), it never pays to be rude or lose your temper with people at the Social Security Administration (SSA) or Disability Determination Services (DDS), or anyone who might represent you. The disability process can be anxiety-provoking and frustrating at times, but maintaining good relations with the individuals working on your case is good advice to practice. The truth is: These individuals usually have very many cases to work on and literally hundreds of phone calls each week to deal with. How you last communicated with one of these individuals can make the difference as to whether or not your case gets more attention, or less.
7. Have your treating physician complete an RFC form.
Reason: RFC stands for "residual functional capacity." RFC forms are used by DDS examiners to determine how much functional ability you have despite your medical condition. Each claims examiner must have a DDS unit physician or psychologist complete a physical or mental RFC form before a claimant's case can be closed. If your treating doctor submits an RFC form, the claims examiner may rely on it to create your internal RFC. For more information, see our article on the DDS and doctor's RFC forms.
8. Don't call the SSA's toll-free number to get updates on a disability claim.
Reason: The information supplied by Social Security call center reps is routinely and consistently incorrect. Speaking from experience, in the last couple of years, I have spoken with no less than forty or fifty disability claimants who were given blatantly wrong information regarding the disposition of their claims, causing them great anxiety as a result.
To get updates on a disability case, call either the Social Security office where you filed your claim or the disability examiner at Disability Determination Services. If a hearing has been requested, call the Office of Disability Adjudication and Review (formerly known as the Office of Hearings and Appeals) since, at that point, the Social Security office will know very little about the pending status of a disability claim and hearing. Here's how to contact a disability examiner to check the status of your case.
By: Tim Moore, former Social Security disability claims examiner