Can You Avoid Being Denied on a Social Security Disability or SSI Claim?

Unfortunately, there is no guarantee that you will be approved for Social Security Disability (SSD) or SSI. The fact is that only about 30% of all initial disability claims are approved by DDS (the state agency that decides claims for Social Security), and the number of reconsideration appeals that are denied is even higher.

There are some simple things you can do to improve your chances of being approved by a disability examiner, however. Submitting a complete medical history with your disability application--that includes up-to-date contact information for physician(s) and medical treatment facilities--helps disability examiners get the information they need to decide a claim.

If you have already been turned down once and have filed a reconsideration appeal, be sure to include along with it any new medical information that can help your case, or any medical information that you did not include with your initial application.

Submitting a complete work history, again with current contact information for past employers and specific details such as job titles, work skills, and past tasks you were required to perform in your positions, helps a disability examiner decide if your medical condition prevents you from performing past work, or any other type of work that an individual with your employment history could reasonably be expected to do.

If, despite your best efforts you are not approved for disability by DDS on a disability application or on a request for reconsideration (the first appeal), you can appeal again, this time at a hearing before a federal administrative law judge (ALJ). Statistics show that over 60% of all disability claims denied by DDS are later approved by an ALJ (when a claimant is represented; unrepresented claimants win approximately forty percent of their cases at the hearing level).

This is why it is so important for those who file for disability to appeal a denial rather than starting all over again with a new claim. Appealing a decision keeps your claim moving through the disability system, and if you are getting no relief from DDS you want your case to be reviewed by an ALJ as soon as possible.

To avoid being denied at the hearing level of consideration, the most important thing a claimant can do is to spend time preparing for the hearing. Request your most recent medical records from your physician, and submit them to the judge assigned to hear your case.

Also, if you can get your physician to fill out a residual functional capacity (RFC) statement (or RFC form--if you have representation for your hearing, your disability lawyer will generally try to obtain a completed RFC form from one of your treating physicians), it will improve your chance of approval. Residual functional capacity statements and forms list activities that the claimant can (or cannot) do given the limitations of their medical condition.

Before your hearing, you should call social security and ask to review your case file (you would not do this, of course, if you are represented since your disability attorney would obtain a copy of your file as part of their preparation for the hearing). The file should include a record of all prior denials, the medical information the examiner considered in issuing these denials, as well as how the examiner classified your past work.

If you find that there is anything in the disability examiner's decision-making process that you do not agree with or feel was unfair, gather the information needed to present a coherent argument refuting the examiner's logic before a judge.

If you have not obtained legal counsel prior to this point, it is strongly advised that you do so. Most individuals are not nearly as capable of advocating for themselves as an attorney who specializes in Social Security Disability law and regulation.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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