Five Traps That May Disable Your SSDI Claim

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The Social Security disability benefits process is frustrating for most people.  You have to fill out numerous forms, talk to numerous people about your disability, remember small details, and track down numerous medical records.  On top of that are the many laws and regulations that must be followed.  Plus, you have to do all of this while fighting your disability.  

To help your chances, don't fall into these five traps that can prevent you from getting your disability benefits.

Trap No. 1: Believing in the system or that everyone at Social Security tells you the whole truth.

You need to be on top of your claim.  If you send something to Social Security that must be in before a deadline, send it certified/return receipt requested.  Don't just believe that the mail will get there, or that Social Security will properly document its arrival.  You may need proof. Also, you should call to check the status of your claim to make sure it doesn't fall through the cracks.

Also, some of the advice Social Security Administration (SSA) employees provide to the public is wrong. These SSA employees probably do not set out to give you bad information about SSDI, but it does happen. Here is a motto that will serve you well: "Trust, but verify."

Trap No. 2: Believing that YOUR claim is different than all the others that have been denied.

Over 70% of SSDI claims are denied initially.  Another 30-40% are denied at hearing.  To Social Security and its examiners, your claim is just a claim.  These examiners do not have the emotional investment in your claim that you do.  How do you change that?  Well, you really cannot, because to the examiner your claim is just one of many they review every day.  But you can make your claim stand out.  How? By making your medical records accurately reflect your diagnosis, prognosis, AND (this is important) your functional limitations.  Denials are just part of the process when you file for SSDI, so you need to prepare your claim to overcome the expected outcome. 

Trap No. 3: Believing that all you need to get disability benefits is a medical opinion that you are disabled.

I have seen it a few times and have been asked about it a bunch.  The question usually goes something like this:  "My doctor said I am disabled, but I was denied disability benefits.  How is that possible?"  A doctor's opinion that you are disabled can be extremely helpful in obtaining Social Security disability benefits.  But such an opinion needs to be supported by medical evidence and/or other evidence. How much value is there to you if your child comes home and says that he is passing all of his classes, but does not show you a test or progress report?  I guess it depends on your child, but you know your child.  The claims adjusters who work for Social Security do not know you or your doctor, nor will they ever meet you.  They need to see evidence for statements like "You are disabled." Learn about how your doctor should submit information to the SSA.

Trap No. 4: Believing that you cannot apply until you have waited at least 12 months after becoming disabled.

You can apply for Social Security disability benefits when you become disabled, even on the day you become disabled.  What is important, and where the 12 months comes from, is that your disability must be expected to last at least 12 months (or result in death).  The logic here is simple: Congress does not want disability benefits to be paid to people who have a disability that will heal in short order, something like a broken arm, the flu, or something similar. 

This rule causes a lot of confusion.  Waiting to apply may cost you significant benefits, because the SSA is only allowed to pay you for up to one year prior to your application date for SSDI or, for SSI, the month after your application date.  If you believe your medical condition may prevent you from working for one year, you should let Social Security know you'll be filing (this will get you a protective filing date) or call a Social Security disability attorney to help you get your application started right away.

Trap No. 5: Believing that you cannot afford legal help with your SSDI claim

Most, if not all, SSDI attorneys work on a contingency basis.  This means that they only get paid if they are successful at getting you disability benefits.  If you do not win, the attorney does not get paid.  The same is generally true for non-attorney disability representatives. 

Additionally, an SSDI attorney can only charge you a fee that is approved by the Social Security Administration.  The Social Security laws and regulations state that an attorney's fee can only be 25% of your disability back pay benefits, up to a maximum of $6,000 in most cases (there are a few exceptions, but the fee cannot be more than 25% of your back benefits). (Learn about disability back benefits.) What's more is that SSA will pay your attorney directly if benefits are obtained from your back benefits. 

Some disability attorneys do require that their clients pay for some of the costs associated with bringing the claim either upfront or if successful.  Costs include things like medical records, or obtaining a medical report from your doctor.  You should ask disability attorneys you interview whether or not they require such costs up front or not.

Simply avoiding these traps will not guarantee your disability claim will be successful. However, knowing where the traps are allows you to better navigate the minefield.  Good luck.

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