15 Tips To Winning Your SSDI Disability Claim

Never assume that what SSA tells you is correct. Unfortunately, some of the advice Social Security Administration (SSA) employees provides to the public is incorrect. So if you aren’t happy with what SSA told you over the telephone, you’ll be glad to know it may not be correct. The problem is, many people have told me they did not file a disability claim for years (and went without benefits they deserve) simply because a SSA employee gave them bad information. Don’t give up on your claim until after you have reviewed your case with a disability lawyer. Disability attorneys are often more well versed in the complexities, ins and outs of  the social Security |disability process than the average SSA employee.

Never assume SSA will approve your claim. Not true. Many people believe that because they have paid into SSA, their claim should easily be approved when they apply for disability benefits. Many people believe it’s just a matter of filling out the forms and going through the process. But this just isn’t true. SSA denies 70 to 75% of first-time claims. SSA denies 82% of claims that are appealed for Reconsideration. However, the good news is that when cases are heard before judges, nationwide over half (53%) are approved. And, when you hire an experienced disability attorney, your chances are greatly improved because a disability attorney will: (1) Appeal every denial within 60 (sixty) days of receipt, (2) build a strong case by understanding what information SSA requires, (3) make sure to present it properly before the Court, and (4) argue the legal and factual aspects of your case to the judge.

Never assume the disability forms you fill out will win your case. Usually they will not. Claimants hurt their case by overstating what they can do. In other words, claimants frequently think they can physically do more than what they really can. In most cases, SSA and judges rely heavily on medical records as well as your doctor, psychiatrist and/or psychologist’s opinion about your ability to work full time. If the judge isn’t happy with you…if he doesn’t believe what you’re saying…or if he is looking for a reason to deny your claim, he may look for inconsistencies in answers you provided earlier on the forms.

For example, if you answer one way on the form and testify at a hearing to something else, the judge may use the answer on the form to undermine your credibility and support a denial of your claim. You should never complete these forms without legal advice.

When completing the forms, be honest, accurate and brief! You should always answer the question in the space provided – do not attach additional sheets of paper or write in the margins. When answering questions about what you are capable of doing it is important to assume you are working full time on a sustained basis i.e., 8 hours per day, 5 days per week, 40 plus hours per week.

Never assume that your medical and/ or psychological symptoms will be enough for the judge to approve your claim. Not true. You need detailed medical records which document your symptoms and limitations and specific opinions from your doctor, psychiatrist and/or psychologist if you hope to win your case. Their opinions will only be given weight by the judge if you have received continuous and consistent medical treatment. If you are not treating regularly with your doctor you are jeopardizing your case!

It is critical you receive continuous and consistent medical treatment and care so you can provide SSA and a judge with current and complete medical records which support your doctors’ opinions.

Never assume your diagnosis will win your claim. It won’t. It’s true that SSA needs a diagnosis. But SSA also needs medical proof that your diagnosis causes limitations that are so significant and severe that they preclude your ability to work full time on a sustained basis.

Advice: Disability cases are won based on your limitations, not your symptoms. Make sure you provide detailed medical records from your doctor that reflects your symptoms, his diagnosis, and your limitations.

Never assume SSA will be persuaded by any type of medical treatment you choose. Be aware that SSA and judges are most persuaded by mainstream doctors (M.D., D.O., psychologists) and how you respond or fail to respond to mainstream treatment. If you are not taking medications or are not receiving mainstream treatment by a mainstream doctor, you may be jeopardizing your claim.

To win your claim, try to exhaust every medical treatment your mainstream doctors recommend, so you can prove that in spite of doing so, you continue to be unable to work full time on a sustained basis.

Never assume your family doctor’s opinion is the only one you need. This may not be a good choice depending upon your diagnosis. If your diagnosis is made and treated by a specialist (M.D., D.O., Ph.D), you should be treated by a board certified specialist and your family practitioner. From a legal standpoint, you want to show the judge your diagnosis is correct and that you are receiving the best possible medical care. You have a stronger case when your doctor is a specialist who is skilled and experienced at treating people who have your condition. Social Security law generally gives more weight to the opinions of a specialist than a general practitioner. As a result, SSA and the judge will look more closely at the credentials of the doctor who is providing the opinion. Get your medical treatment from a specialist because the more skill and experience your doctor has, the more likely you are to win your claim

Never assume your doctor will support your claim for disability benefits. Some doctors refuse to help patients with their disability claims. Many doctors do not know SSA’s definition of disability and believe that one has to be bed ridden to qualify. In general, doctors are very conservative in their opinion about a patient’s ability to work. Because the SSA and a judge will want to know if your doctor supports your claim, it is critical you know the same information! After you have established a relationship with your doctor you should discuss with them the fact that you have filed a claim for disability. Ask if they will support your claim.

Never assume you have to go to SSA’s doctor for a medical examination. Oftentimes, SSA wants a claimant to go to a disability examination with a doctor/psychiatrist/ psychologist it chooses. Unfortunately, the doctor is not really “independent” and performs many of these examinations for SSA each month. In my experience, the majority of the time the doctor will conclude you are not disabled and can return to work. Once this opinion is included in your file SSA and a judge will have sufficient evidence to deny your claim. Here’s the good news: SSA rules allow your doctor perform the disability exam and SSA should pay for all or at least part of it. Naturally, if your doctor supports your disability claim he will probably conclude your condition precludes your ability to work. Once your doctor’s exam report is in your file with a conclusion that you are disabled, SSA and a judge may have sufficient medical information to approve your claim.

Never assume an entire year has to pass before you can file a disability claim. Not true. SSA law requires that before you can be approved one of the following must be true: (1) you have already been disabled and out of work for one year, or (2) your doctors expect that you will be unable to work for a minimum of one year from the date you last worked, or (3) your medical condition is expected to result in death. Too many people have told us that an SSA employee said they could not file a claim until one year had passed since they last worked. This information is totally incorrect and if followed, will almost certainly cost you disability benefits and medical insurance! Apply for disability benefits as soon as you or your doctors believe your medical and/or psychological condition will preclude you from working for at least one year. Waiting to file will only cost you benefits that you may not be able to recover.

Never assume that if you lose before a judge at a hearing, you can simply file another claim. When you have a hearing before a SSA judge, you do not want to lose. This is because, practically speaking, your best chance at winning is at your first hearing before a judge. True, you can file a second application if you lose at a hearing; however, the second time you go through the process, SSA and a judge will know your first claim was denied. In my opinion, this may have a detrimental effect on your second claim as the second judge will know. Make sure your case is properly prepared so you can present your strongest case at the first hearing.

Never assume you can handle your case without a disability lawyer. Most people can’t. Social Security disability laws are complex, even many lawyers do not understand them. To win your claim, you need to very carefully prepare your case from the very beginning. In addition, it is critical to understand what you need to prove legally in order to win your case; if you do not know what you need to prove – why would you risk going before SSA or a judge without knowing how to win your case? The fact that you and your doctor agree you are disabled is not enough to win your case. Retain only an experienced disability lawyer. They will help build your case, develop a case strategy, and obtain a complete set of your medical records and critical opinions from your doctor that will maximize your chances of success. More often than not, your doctor will not be familiar with the stringent criteria that SSA and a judge will utilize in determining whether you meet their definition of disability

Never assume any lawyer can help you win your claim. Not true. You want a disability lawyer who is familiar with SSA laws and regulations. Similar to doctors, attorneys generally specialize in a certain area of the law. You wouldn’t go to a dentist for a physical examination, so do not pick just “any” attorney to represent you in your disability claim. Choose a disability lawyer whose practice is exclusively dedicated to representing disability claimants because your odds of winning will increase. A seasoned disability attorney will understand the strategy and tactics that are crucial to helping you win your claim.

Never assume you should not hire a lawyer until your case has initially been denied. Not true. You can hire a lawyer any time you wish. Unfortunately, many employees at SSA will tell you that it is not necessary to hire an attorney until you have been initially denied. Following this advice could be fatal to your claim! Why? Because in general, SSA may begin preparing a denial from the day you file your application!

You should consult with and/or hire a disability attorney as soon as possible after you file your application. The attorney can explain how the process really works and lay the proper foundation for your case by developing a case strategy. The attorney canalso guide your case through the myriad of rules and regulations that are certain to have an effect on your entitlement to benefits.