Social Security Disability: Advice From a Disability Examiner

Here's some advice from a former claims examiner on applying for and winning your SSDI or SSI disability case.

Updated by , J.D., University of Missouri School of Law
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When you file a claim for Social Security disability benefits, a disability examiner will review your file, gather necessary medical and vocational evidence, and issue an initial approval or denial within a matter of months.

Below is some advice from Tim Moore, a former disability claims examiner, on how to increase your chances of being approved for Social Security disability benefits.

1. Don't wait to file for disability.

If you're disabled and unable to work, file a claim for Social Security disability as soon as you can.

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 applicants for disability benefits experience financial hardship simply because they had no idea how long the process would be. In many cases, they realized too late that they should have filed an application much sooner.

If you're filing for SSDI benefits, this is especially important, because you don't want your disability insurance to expire. (See our article on the date last insured for SSDI.) For SSI, it's important to file soon because you can't collect retroactive disability benefits before your application date. (Read more about the difference between SSDI and SSI.)

2. Hire a legal representative to appeal a denial.

If you're denied on your initial disability claim, you should strongly consider hiring a disability law firm or attorney to handle your claim.

Reason: A disability applicant will either be approved on an initial application or (more likely) will have to appeal. An appeal involves getting together medical and vocational evidence and attending a hearing before an administrative law judge.

When should you hire a legal professional? As soon as you receive an initial denial, or even before you file your claim. Trying to represent yourself on appeal is almost never a good idea. That's because Social Security disability law is a complex and highly specialized field. Most disability applicants and even most general practice lawyers don't understand it. (Read more about how hiring a disability lawyer can help your 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, an SSDI expert, 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, Social Security may not believe that your medical condition is severe if you are not visiting a doctor often. As a general rule, you won't be approved for Social Security disability if you aren't 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 often 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. Understand the Social Security forms you need your doctor to fill out.

Ask your doctor to provide Social Security with a form that lists your limitations. Most doctors provide their written opinions to Social Security by either writing a letter or completing an "RFC" form. RFC stands for "residual functional capacity." DDS examiners use RFC forms to determine how much functional ability you have despite your medical condition.

Each disability examiner must have a DDS unit physician or psychologist complete a physical or mental RFC form before an applicant's case can be approved or denied. 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.)

One of the jobs of your legal representative (if you've hired one) is to try to get a supporting opinion from your doctor. That usually means sending a physical or mental RFC form to your doctor along with a statement explaining why it's important for your case.

Reason: Social Security's rules give special weight to the opinion of your treating doctors. That means if your doctor isn't willing to support your application for disability, you should consider finding one who is.

If you're receiving regular treatment from someone who isn't a doctor—for example, a nurse, medical social worker, or counselor—you can also ask him or her to complete an RFC form or write a letter. But their opinions will generally carry more weight with Social Security if they're supported by a statement or signature from a doctor.

6. Take your prescribed medications.

Do whatever you can do to make sure you follow your doctor's advice, including taking your medicine as prescribed.

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 applicants haven't taken what was prescribed. The fact that the applicant 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.

7. Be cordial with the people working on your case.

The disability process can be anxiety-provoking and frustrating at times, but maintaining good relations with the people working on your case is good advice to practice.

Reason: Even if your case has been mishandled or you've had to endure a long wait for a hearing, 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 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.

8. Don't call the SSA's toll-free number to get updates on a disability claim.

Not only are there long wait times when you call Social Security, but you might get less-than-reliable information.

Reason: The details supplied by Social Security call center reps are routinely and consistently incorrect. Speaking from experience, in the last couple of years, I have spoken with at least 50 disability applicants 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 you've requested a hearing, call the Office of Hearings Operations for a status update. At that point, the Social Security office will know very little about the pending status of the disability claim and hearing.

Updated October 19, 2021

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