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Winning your Social Security Disability - the odds are in your favor

Social Security Disability and SSI disability claims seem daunting to anyone who knows a person who has had to go through the long process of filing for disability disability, getting denied for disability, and filing a social security disability appeal. And for good reason. The process can seem confusing (social security does not do an adequate job of explaining how the process works to claimants), decisions can seem arbitrary as well as incorrect, and the process can last years.

Having said all that, however, the odds are in a claimant's favor...as long as they do not give up on their claim and continue forward. What do I mean by this? Simply that if your claim gets denied by SSA, you should appeal and if your first appeal gets denied (the request for reconsideration) you should appeal again to request a hearing.

Here are some interesting statistics that are hardly new:

1. Seven out of ten applications for disability are denied.

2. Eight and a half first appeals (reconsiderations) are also denied.

3. A little better than half of all second appeals (the hearing before a judge) are approved.

Obviously, claimants who give up after they are denied on a reconsideration are doing themselves a grave disservice. How many people give up? This is even more interesting, mainly because the statistic is very sad to hear. Reportedly, two thirds of all individuals who have been denied on a social security disability claim do, in fact, decide to give up.

As I've said many times on this site, the worst thing a claimant can do is to give up on a claim. However, there are a couple of other things a claimant should do and should avoid doing.

1. Do not file a new application after you have been denied. Instead, file an appeal. Why? So you can eventually get your case heard by a judge.

2. If you have to go to a hearing in front of a judge, get a disability lawyer. You can increase your chances of winning your hearing by fifty percent if you do this.

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Social Security Disability Tips

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Qualifying for disability on the first application

Is qualifying for disability on the first application possible? Yes, it is. In fact, about three out of every ten applicants for SSDI (social security disability insurance) or SSI (supplemental security income) are approved for disability on their first application.

Obviously, a claimant who files has a statistically significant chance of winning benefits. However, what about the other seventy percent of individuals who are not so lucky and get denied for disability? Many of them decide to give up on their claims. As I mentioned in an earlier post, federal tracking indicates that 66% percent of all claimants who get denied on their claim decide to give up. Which, of course, is a mistake since, at a disability hearing, a claimant who is represented by a disability lawyer has approximately a better-than-half chance of being awarded disability benefits.

How do claims qualify for disability on the first application? It all comes down to what a claimant's medical records have to say about their condition. Specifically, a claimant's medical records need to prove that the claimant satisfies the social security definition of disability. Essentially, this means that the records need to demonstrate the following:

1. The claimant has a severe condition.

2. This condition has the effect of preventing the claimant from doing their past work and from doing other forms of work.

3. The claimant's severe and disabling condition must last for at least 12 months.

Qualifying for disability really boils down to a claimant's records showing that the claimant cannot work. And this, of course, means that the records must reveal the claimant's functional limitations. For example, does the claimant have difficulty walking, sitting, or standing for certain periods of time, or have difficulty lifting more than a certain amount of weight, or difficulty reaching overhead? Limitations such as these can rule out the ability to perform types of work.

How do you know what your medical records have to say about you and whether or not they support your case? There's really only one way to know, which is to view them yourself, or have a disability attorney do it for you in order to determine where you really stand with regard to your chances of winning.

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Tuesday, February 12, 2008

Budget shortfalls for Social Security still in budget

Although budget figures for Social Security are generally favorable for 2009, it still falls short of the 10.4 billion requested by Michael Astrue. Mr. Astrue stated in his recent fiscal budget message that Social Security was at a crossroads due to the projected avalanche of baby boomer disability and retirement claims.

Although Social Security faired well in the overall Bush budget plan, Social Security is an agency that requires proper staffing to effectively processes retirement and disability claims. Studies indicate that Social Security has lost many experienced personnel in recent year; consequently waiting times have risen and phones have not been answered as timely as they have been in years past. Mr. Astrue went on to say that without proper reliable funding the situation at Social Security would only get worse.

Many organizations, including employee groups, support an 11 billion dollar budget because the Bush Budget did not address the finances needed to work the large backlog of disability claims currently at Social Security.

Mr. Astrue stated (in his message to Social Security employees) that the 2009 budget would help get Social Security ready for the onslaught of work that is expected for 2009. Although he seemed reassuring, the facts send a different message.

For instance, even with Congress providing an additional 148 million over the proposed Bush budget last year, there is still a need for more personnel. Even though the fiscal year 2009 employee level would increase by 351 over the 2008 employee level, the proposed increase in employees would still leave the agency with 1033 fewer employees than the year 2007.

Does it make sense that, when Social Security is facing such large backlogs and increases in retirement and disability claims, that the President would suggest a budget that would not even provide enough funding to maintain 2007 staffing levels?

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Social Security Disability - Mental Impairment Qualifications

The social security administration lists a number of mental impairments in its impairment listing manual, also known as the "blue book". The book contains the following listed impairments for which it includes the disability criteria needed for approval: 1. Autism and other developmental disorders, 2. Disorders involving substance addiction, 3. Personality disorders, 4. Psychosomatic conditions (somatoform), 5. Conditions involving anxiety, such as panic attacks and generalized anxiety disorder, 6. Mental Retardation, 7. Depression and Bipolar Disorder, 8. Psychotic conditions, including schizophrenia, and 9. Organic conditions, including traumatic brain injury.

Obviously, not every mental condition is listed in the impairment listing manual. Can you get approved for either SSDI (social security disability insurance) benefits or SSI disability benefits if your particular condition is not listed? Yes, you can be approved for benefits the way most claims are approved, which is through a medical vocational allowance. This is a system by which a claimant's medical records are analyzed to A) determine what their physical and mental limitations are and B) determine whether or not they can return to their past work or do some form of other work.

What are the problems with getting approved for disability based on mental conditions? There are several. One is the fact that many mental health treatment treatment specialists keep relatively poor notes. In fact, many will opt to send in a synopsis of their notes to social security (either to the disability examiner or the disability judge) because the notes themselves provide scant detail and, in essence, are not helpful to a case.

Other problems involving mental disability cases include the following:

1. The claimant having no record of treatment for the condition listed on the disability application. This tends to happen with cases involving depression. Often, it involves a claimant whose family doctor has prescribed an anti-depressant but who has never been seen by a psychiatrist. This, of course, means that the claimant will have no substantial mental treatment records to present for their claim.

2. Non-compliance with prescribed medications. In some instances, the medical records will show that a claimant has been diagnosed with a specific mental impairment and has been prescribed medication, but has not taken the medication. This is a huge problem for mental disability cases because the social security administration focuses on what a claimant is able to do (i.e. ability to work) despite the limitations of their condition. However, a claimant's limitations cannot be accurately measured if they are not taking the medications they have been prescribed.

Why is medication compliance an issue for some claimants? Sometimes, this is due to the cost of medication. Unfortunately, the social security administration is not concerned with whether or not a claimant can afford their medication, but, simply, whether or not they take their medication.

3. Duration. Some social security disability and SSI disability claims are denied on the basis of duration, meaning that a disability examiner or disability judge has concluded that the condition has not lasted for a year, or cannot be projected to last for a year. However, this is problematic for a claim based on a mental condition (and physical conditions such as lupus, as well) that has a tendency to exacerbate and remiss (get better and worse with regularity). Bipolar disorder is a good example of this phenomenon.

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Disability denial

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Monday, February 11, 2008

Social Security Disability Attorney Fee - it is not paid upfront

I've spoken to more people than I can count who have labored under a terrible false assumption: that they could not afford to get an attorney for a social security disability or SSI claim. In many instances, this type of assumption has simply delayed them from getting assistance on a case, and in other instances this has caused individuals to actually appear at a hearing without the benefit of representation.

Can you afford a social security disability attorney fee? In actuality, anyone can because the fee is only paid under very specific circumstances. The first is that you only pay if your case has been won. And the second is that you only pay after the case has been concluded.

However, there are a couple of other factors that you should keep in mind, such as the fact that, when it comes to disability representation provided by an attorney, you will not have to pay the fee yourself. This is because the social security administration will actually cut the fee payment check to your disability lawyer. SSA can do this because they have the appointment of representative form (a form you signed when you obtained representation, known as form SSA-1696, titled appointment of representative) that you signed when you established your relationship with your disability lawyer.

So, its fairly obvious that cost should never be a barrier to getting assistance on a social security disability or SSI claim. The social security disability attorney fee is only paid if you win your case and nothing is paid if you lose. And, making matters very convenient, the social security administration will take care of the actual fee payment.

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