Cingles Info

This is a good letter :-)
Winning Your Social Security Disability Claim:
15 Mistakes You Can Not Afford to Make!
by Scott E. Davis, Esq. and Scott M. Harris, Esq.
ImmuneSupport.com
02-03-2000
Mistake #1: Assuming that what SSA tells you is true. 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.
Advice: Don't give up on your claim until after you have reviewed your case
with a disability lawyer. Disability lawyers know more about the law than
SSA employees and give you correct information.
Mistake #2: Assuming the SSA Administration 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 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.
Advice: (1) Appeal every denial within 60 (sixty) days of receipt, (2) build
a strong case by understanding what information Security Security requires,
and (3) make sure to present it properly.
Mistake #3: Assuming 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 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.
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. Also, it is important to assume you
are back working full time on a sustained basis (8 hours per day, 5 days per
week) when answering questions about what you are capable of doing.
Mistake #4: Assuming 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!
Advice: 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.
Mistake #5: Assuming 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 reflect your symptoms, his diagnosis, and your limitations.
Mistake #6: Assuming SSA will be persuaded by any type of medical treatment
you choose. It will not. You can choose any alternative therapies and
holistic treatments you desire. After all, you should do whatever it takes
to try to get better. However, 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.
Advice: 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.
Mistake #7: Assuming 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 usually made and treated by a specialist (M.D., D.O., Ph.D),
you should treat with both 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.
Advice: 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.
Note: If you are a member of an HMO and they will not allow you to go to a
specialist, consult with your disability lawyer, who can help you get
appropriate treatment.
Mistake #8: Assuming your doctor will support your claim for disability
benefits. He may not. 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 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 - if they will not, you should consider finding another doctor
because their opinion is not likely to change! It is critical your doctor
supports your inability to work full time on a sustained basis!
Advice: As soon as practicable, you should learn whether your doctor
supports your disability claim. If not, consider finding a more
compassionate doctor who will. One place to find a referral is to attend a
local support group for individuals who share your diagnosis.
Mistake #9: Assuming you have to go to SSA's doctor for a medical
examination. Often, SSA wants to a claimant to go a disability examination
with a doctor/psychiatrist/psychologist it chooses. Unfortunately, the
doctor is not really "independent" and probably 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.
Advice: This strategy is only possible if you are certain your doctor
supports your claim and is willing to do the examination. If you do not have
a doctor or your doctor will not perform the examination you must go to
SSA's doctor or risk having your claim denied or closed out. This strategy
really should only be employed by a disability lawyer because complex
regulations are involved and must be complied with.
Mistake #10: Assuming 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
me 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!
Advice: 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.
Mistake #11: Assuming 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.
Advice: Make sure your case is properly prepared so you can present your
strongest case at the first hearing.
Mistake #12: Assuming you can handle your case without a disability lawyer.
Most people can't. SSA 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.
Advice: Retain only an experienced disability lawyer. They will help build
your case, develop a case strategy, 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.
Mistake #13: Assuming 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.
Advice: Choose a disability lawyer who's practice is dedicated to
representing clients 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.
Mistake #14: Assuming 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 will begin
preparing a case against you from the day you file your application!
Advice: 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 can also guide your case through
the myriad of rules and regulations that are certain to have an effect on
your entitlement to benefits.
Mistake #15: Assuming that you cannot afford a lawyer. Not true. In almost
every case, you will only pay the attorney a fee if and when you have won
your case and received benefits. SSA law limits the amount of money your
lawyer can earn from your disability claim. Generally, by the time you win
your claim you will have accrued back benefits. The law mandates the fee can
only be 25% of your past benefits and is capped at $4,000. In other words,
if your back benefits total $1,000.00, the attorney's fee would be $250.00.
The law does not allow your lawyer to charge a fee on your future benefits.
What may be at stake? By way of example, assume a claimant is 45 years old
and their monthly disability benefit is $1,000.00. If the person never
returns to work before age 65, their disability benefits would total
$240,000.00!
This amount does not include the value of the lifetime health insurance they
would also receive through Medicare or Medicaid.
Advice: Because the amount of the benefits can be staggering, the truth is,
you can't afford not to hire an experienced disability attorney! Scott E.
Davis and Scott M. Harris are social security and long-term disability
insurance attorneys in Scottsdale, Arizona. They are the founding partners
of Harris ? Davis, PLC. Although they have experience representing clients
with a broad spectrum of physical and/or psychological disorders, the
majority of their disability practice is devoted to representing individuals
with FMS and/or CFIDS. Mr. Davis and Mr. Harris represent clients throughout
the United States. In most cases a fee is charged only if their client
obtains benefits. They invite your questions and inquiries regarding
representation via email: harris.davis@... or facsimile (602)482-4300.