Only about
one-fourth of applications for Social Security disability benefits are
approved without a hearing. Below are some of the serious mistakes that
claimants make. If you are filing for Social Security disability, know
these mistakes and avoid them for the best chance of winning benefits:
1. Believing that the Social Security doctor will find that you are disabled. This
is very unlikely. The doctor Social Security sends you to will spend
no more than 15 -20 minutes with you and will perform a very limited
examination. He has no incentive to find you disabled, since he is paid
by Social Security. You may have better luck with your own doctor.
2. Don't fail to ask your own doctor to complete a Medical Source Statement. This
is a form which explains what specific limitations you have in
performing work related functions, such as sitting, standing, walking,
lifting, bending, concentrating, etc. This is in addition to routine
medical records and does not require a special examination.
3. Filing for disability while you are still working. You
cannot file for disability while you are working at "substantial
gainful activity" or SGA. In 2015, this amounts to work that pays you
at least $1,090 per month. In 2014, the SGA limit was $1,070 per
month. Work that pays less than the SGA amount may not disqualify you.
4. You have to prove that your disability will last at least 12 consecutive months (or that it has already lasted that long). There is no short term disability with Social Security. 12 months is the minimum duration for a qualifying disability.
5. Failing to get medical treatment. All
disability awards must be based on "medically determinable
impairments." You will need your doctor to examine you, diagnose your
problems and determine how severe your symptoms are. Medical doctors
and clinical psychologists are "accepted medical sources" with Social
Security. Chiropractors, counselors and nurse practitioners are not.
6. Failure to get psychological problems diagnosed and treated. Social
Security must consider psychiatric or emotional problems as well as
physical problems - but they must be diagnosed by a psychiatrist or
clinical psychologist, or at least by your family doctor.
7. You must apply while you have Social Security coverage. Not
everyone has Social Security disability coverage. You become covered
by working and paying a special tax called FICA tax, which is required
to be withheld on every worker. However, you must earn enough quarters
of work to be covered. Also, when you stop working, you eventually lose
your disability coverage with Social Security. This usually happens
after 4 years of no work. If there are gaps in your work, your coverage
may expire in less than 4 years. The date you stop being covered is
called your "date last insured" or DLI.
8. You have to appeal unfavorable decisions within 60 days. Being
denied is not the exception, it's the rule. Be prepared to file a
request for hearing within 60 days after you receive a denial letter
from Social Security. This 60 day rule is very strict. If you wait too
long you cannot appeal the claim and must start all over.
9. Avoid trying to represent yourself (pro se representation). Social
Security law is a highly technical and specialized field. The US
disability program is governed by thousands of pages of rules and
regulations. If you don't meet the rules or follow the correct
procedures you can be denied and this may cost you thousands--even
hundreds of thousands of dollars over the years. Consider getting a
specialist to represent you and arrange a "contingency fee" situation
where the representative gets paid only if you win.
10. Failure to prepare the vocational (work) aspects of your claim. There
are two important parts of a Social Security disability claim: the
medical aspect is the best known part. However, there is an equally
important vocational aspect to the claim. Past work will be classified
and a vocational expert will be asked to determine whether there are any jobs
in the US economy that you could still perform, in spite of your
physical and/or mental limitations. Failure to adequately prepare the
vocational aspect of your claim will result in a denial, just like
failure to prepare the medical part of the claim will get you denied.
11. Failing to get a Medical Source Statement from your doctor. This is not the same thing as routine medical records, which Social Security will obtain for you. Social Security will NOT ask for a medical source statement. Common forms used for this purpose are forms HA-1151 for physical impairments or HA-1152 for mental impairments. It is up to the claimant or his representative to get this form completed by the doctor. It can make the difference between approval or denial of your claim.
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