Can you avoid a Social Security Disability Denial in Texas?

Unfortunately, there are not a lot of things you can do to prevent being denied by Social Security. Currently, on a national average basis, only thirty-five to forty percent of all initial disability claims are approved for disability benefits. Meaning, conversely, that basically sixty to sixty-five percent of all individuals who apply for disability are denied.

With regard to Texas, the state statistics are in close alignment. A disability application typically stands just a 33 percent chance of approval, making it necessary for the majority of claimants to enter into the appeals process.

The inevitable question becomes "Can you avoid being denied for disability?"

If you want to improve you chances of being approved for disability, you should try to provide Social Security with the necessary medical and work information at your disability interview in detail. This is important because after the claim is taken at a field office, it is transferred to DDS (disability determination services) where it will be assigned to a disability examiner who will process the case and render a decision.

The examiner reviews all the medical evidence and vocational information (meaning work information related for adults; for children, school information generally replaces this) that he or she has at their disposable. But the examiner is completely dependent on the claimant to supply this information, typically at the time of initially filing the claim.

For this reason, claimants should be prepared to give complete information with regard to all medical treatment sources. This means you need to know names, addresses, phone numbers, treatment dates, medications prescribed, and what kinds of tests each provider has performed. The list that is supplied to Social Security should obviously include all current sources of treatment.

However, it should also include older sources of treatment so that the claimant's onset date (when their disability began) can be proven, which has a direct impact on how much back pay the claimant may be found eligible for.

To reduce the chance of important information being left out during the application interview, it is good advice for claimants to write down both their medical and work histories prior to the appointment.

With regard to work activity, you should be able to list what types of work you have performed in the fifteen years prior to becoming disabled (i.e. cashier, salesman, teacher, etc) and the approximate dates that you performed each type of job.

Even more important concerning the work history, however, will be the descriptions you provide regarding the work that was performed for each job.

Why is this so important? The majority of decisions that are made on SSD and SSI disability claims are "medical-vocational". This means that the examiner will review the claimant's work history to determine what types of activities were done on prior jobs, as well as the skill levels involved with each job.

This will allow the examiner to determine if the claimant has the ability to go back to a past job, has the ability switch to some form of other work, or lacks the ability, based on their current physical and/or mental limitations, to work at all.

The claimant's capacity to work is actually part of how SSA defines "disability". Social Security defines a disability as any physical or mental condition that has prevented a person from working for twelve months, or is expected to prevent work for twelve months.

Social Security Disability is based more on functional capacity rather than having specific medical conditions, so disability examiners are required to evaluate the possibility of an individual returning to their past work, or their ability to do other types of work considering their functional limitations.

Therefore, if you provide detailed information about your jobs and their requirements it may result in a more accurate decision, and, thus, may help you avoid being denied for disability

Other reasons for denials

Some disability applicants are denied because of their own failure to cooperate in the development of their disability claims. For example, disability examiners routinely send out questionnaires for disability applicants to complete and return. These questionnaires are used to gain a perspective into how the applicant's condition or conditions limit their ability to perform routine daily activities (i.e. shopping, driving, cleaning, working with others, dealing with social situations, and a variety of other activities involved in daily life). If these are not returned, the disability examiner may be more likely to deny the claim.

Disability applicants sometimes also fail to attend scheduled consultative examinations needed for their disability claim. If this happens, disability examiners are likely to deny the claim for failure to attend the consultative examination.

Consultative examinations are usually scheduled because the examiner has no current medical evidence to base their disability decision on; therefore a failure to attend the examination leaves the disability examiner no choice but to deny the claim because they do not have enough information to make their decision.

You may be able to avoid having your disability claim denied by just returning all needed information and attending any scheduled consultative examinations.

As I mentioned earlier, there are very few things in your control as a disability applicant to avoid being denied for disability. However, you can help your chances of being approved by avoiding unnecessary pitfalls and providing quality information about your treatment and work activity.

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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