The Social Security Administration (SSA) denies a whopping 72% of the initial disability benefit applications and denies about 90% of reconsiderations (the first level of appeal). (Annual Statistical Report, 2011). Though these numbers might make you think poorly of SSA, in most of these cases the evidence in SSA’s record just does not support a claim for disability. You may, in fact, be disabled but theevidence in SSA’s possessiondoes not support disability. If you are applying for disability benefits or at an appeal stage, below are three suggestions to increase your chance of success.
1. Make sure medical provider information is accurate and current
Your application for disability benefits requests the dates, names and addresses of your medical providers. This is because SSA will contact the providers and request your medical records. This is a blessing and a curse. It’s great that SSA takes on the headache of getting copies of your medical records and even pays the medical records copy fees. But it’s a curse because SSA may not have all of the medical records to support your claim for disability in the record.
An incomplete medical record at SSA is typically because of one of two reasons. First, the medical provider may not have responded to the record request. Unfortunately, this is fairly common. SSA does not have the personnel to pester medical providers who fail to respond to medical records requests. Second, you may have failed to provide accurate and/or current medical provider information. If you do not provide the SSA with accurate addresses or current information about your treatment, they obviously will not be able to obtain those medical records.
So my advice is to be diligent about providing the correct names and address of all of your medical providers to SSA. And for those truly motivated individuals, you might request a complete set of your own medical records and provide copies to SSA. In this way you can be the one to pester your doctors for not providing copies of medical records.
2. Obtain specific work restrictions from your treating doctor
Even if SSA does get all of your doctor’s reports, the reports they receive may not be enough to prove you are disabled. The doctor’s diagnosis of failed back syndrome, bipolar disorder, or muscular dystrophy is often not enough to prove that you are unable to work. Standard medical records contain four basic sections: complaints, examination findings, diagnosis, and treatment. There is no section of a standard medical report for the doctor to provide information regarding your ability to work. Thus, try to get your treating physician to indicate in writing your restrictions as a result of your medical condition and submit this information to the SSA. By restrictions I mean how much you can lift, how long you can sit or stand, etc. A doctor’s note that simply states you are unable to work is rarely persuasive to the SSA.
3. Hire an attorney
I know it sounds self-serving, but consider hiring an attorney. A competent attorney who practices before SSA can be an invaluable resource in making sure the evidence that SSA uses to make its decision is sufficient and complete. An attorney is also a good idea if you are heading to a hearing before a federal administrative law judge.
The numbers seem to support the idea that hiring an attorney might be a good idea. The Social Security Advisory Board found that people who had an attorney at the initial application stage were more likely to be awarded benefits. (SSAB, 2012). And the Government Accounting Office found that people who had an attorney at their hearing were more likely to win their case. (GAO, 2003).
By David Galinis