Author name: patrick@greemantoomey.com

So you have waited anywhere between 2 and 6 months to hear something from the Social Security Administration after filing your initial application. You got all that paperwork that Disability Determination Services sent you about your work and day to day life, and sent it back, filled out (and taking a lot of time and effort to do that). You finally have that letter in the mail you have been waiting for deciding your claim… and it’s a denial. You read through, and it makes seemingly wild claims saying that your condition simply isn’t severe enough to warrant being considered disabled. It’s time for: Dealing with the initial application denial 101. Step 1: Don’t panic. You are in good company. Getting an initial application approved is a lot like getting into a highly ranked university when you’re not a legacy…expect a 70% denial rate. Step 2: If you have a case manager, call him/her immediately, with the letter in front of you. This is a major development they will want to know about. This person will then schedule you in for an appeal of your claim to the next level. Be prepared to answer questions about the date of the letter, and maybe to read portions of it (just in case you got the letter before your case manager did). Step 2a: If you don’t have a case manager, still don’t panic, and look at the date of the letter and remember it. You have 60 days from this date to file the next step in the process. Step 3: Make a list of everywhere you have sought medical treatment at since filing your initial application, and write down when your first outpatient visit was, your most recent visit was, and if there is any scheduled upcoming visits. Note the conditions treated and doctor’s seen. Also note any in-patient stays, any ER visits, and any medical tests. Next, make a list of your current medications, noting who prescribed them, or if they are OTC, what they are for, and what side effects you have. Finally, note any new conditions, any changes in your conditions or daily activities, and new things you are finding you can no longer do, since you filed your most recent initial application or request for reconsideration (if your denial was on that level). Remember, you can always file your appeal online at www.ssa.gov. If you are represented, your case manager can file for you, after he or she has had a chance to talk with you about everything in step three. Denials are infuriating, there is no question about it. Appeals are a necessary step for a great many claimant’s in the process, and a lot of claimant’s find the most success on the hearing level. Just like an Adult Disability Report, preparation can make for a timely and smooth appeal sendout. It’s not something to wait to do, but not something to panic about.

“Why don’t they just quit complaining and look for work like the rest of us?” As an attorney practicing exclusively in Social Security disability law, I hear these kind of misguided and misinformed assumptions about my clients all the time: “people on SSDI are lazy whiners trying to milk the system,” “drug-addicts,” “scam artists” … and so on, and so forth. This couldn’t be further from the truth. The vast majority of the people I represent have decades-long work histories, each year of which they’ve been making mandatory contributions into the Social Security system. When my clients apply for SSDI, they aren’t trying to “scam” the system – they are asking to access the insurance policy they’ve been paying into since the first day they started working, just like every other tax-paying employee working in America. Essentially, my clients are asking to claim money that they’ve earned, and that they’re entitled to based upon their work history and earnings record. Even still, most of my clients would much rather be working than seeking support from SSDI, and would return to work in a heartbeat if their medical conditions would allow it. I’m reminded of a woman I met last week who’d worked as a receptionist for over 40 years and who had finally landed her dream job when a series of medical tragedies – cancer, followed by more cancer, followed by complications including near total hearing loss – created barriers that made it impossible for her to do the work she’d done for her entire life. I’m reminded, too, of my younger clients who started strenuous, demanding, physical careers in construction or manufacturing right out of high school, who suffered from devastating work injuries that cost them not only their physical health but their jobs, their health insurance, their pride, and their sense of self-worth. SSDI payments, for these younger workers, will often only be temporary – once they have recovered from their physical trauma and are able to return to work, the SSDI payments will stop. These are not “lazy” people. If you have a medical impairment that interferes with your ability to work, we want to hear your story. Contact Greeman Toomey at (612) 332-3252 or (877) 332-3253 for a free consultation with a Social Security Disability attorney.  

The Social Security Administration’s (SSA) rules require approved disability claims to be supported by evidence obtained by the SSA and provided by you, the claimant. Medical opinions are a common form of evidence and often form the basis of an approval or denial of a claim. Although the SSA might be able to determine whether you are disabled by your medical records alone, it can be very advantageous for your regular doctor to provide a medical opinion regarding your condition. Medical opinions provided by your regular medical provider, known as a “treating source,” are typically given more weight than the “consultative examiners” used by the SSA. Treating sources include doctors or other professionals you have seen in the past, including family doctors, specialists, psychologists and therapists. Per 20 C.F.R. 404.1527(d)(2), opinions regarding your conditions provided by a treating source that are well-supported and are not inconsistent with the rest of the available records are given what is called “controlling weight” – that means the SSA must treat the opinion is true, particularly in cases where the opinion states that you are unable to do certain tasks. Even if the treating source’s opinion is not found to be well-supported or is inconsistent with the available evidence, the opinion can be given more weight than other doctors or consultative examiners used by the SSA. Treating sources with whom you have an established and long-term treatment relationship are given more weight under 404.1527(d)(2)(i) and (d)(2)(ii). Also, the SSA considers how much an opinion by any source (not just a treating source) is supported by the medical evidence, how consistent the opinion is with the available record, whether the opinion is written by a specialist in the appropriate field (such as a psychiatrist, rheumatologist, etcetera), and any other factors raised by you, the claimant. This means opinions by doctors who see you frequently for illnesses or conditions in which they specialize are usually considered “better” than opinions by consultative examiners that have only seen you for an hour during a single examination. Sometimes an opinion from a claimant’s regular family doctor can mean the difference between getting approved for benefits on an initial application and having to wait over a year and a half for an Administrative Law Judge to finally approve your claim. Attorneys and case managers at Greeman Toomey regularly encourage our clients to speak with their regular doctors about providing medical opinions and we work with those doctors to ensure opinions from treating sources get to the SSA as soon as possible.  

Medical records play a crucial part in showing whether someone is eligible for Disability Insurance Benefits and Supplemental Security Income. Your records are the primary source used by the Social Security Administration, the state-level Disability Determination Services (DDS), and the SSA Administrative Law Judges to determine whether you are disabled under the SSA’s rules. The SSA does ask claimants to provide any records the claimant may already possess, but claimants do not have the primary responsibility to gather medical records.  The SSA has the duty to gather a claimant’s relevant medical records both under the United States Code and SSA’s own regulations. Once a claimant has given the SSA permission to request medical records, the SSA and DDS will request medical records from the medical providers named by the claimant (such as hospitals, clinics, and mental health professionals). The regulations also require ALJs to work toward clarifying a claimant’s medical records if the records already gathered are too incomplete or deficient to provide a basis for a determination of disability. Unfortunately, the SSA and DDS are not always able to fully update a claimant’s medical records for a variety of reasons. In those situations, a claimant can gather his or her own medical records and submit them to the SSA and DDS. A claimant who is represented by an attorney does have an easier option: the claimant can have his or her attorney gather and submit the medical records on his or her behalf. Gathering medical records is only one of the many tasks our attorneys perform for our clients; we also provide legal advice to our clients regarding Social Security benefits and we use our experience and education to make compelling legal arguments for our clients to help ensure they receive benefits.

No one needs an attorney or a representative to apply for Social Security disability benefits. The process is described as “non adversarial,” which means that the Social Security Administration (SSA) tries to be accessible, and to help you through the process of applying and gathering medical evidence. However, most people find communications from the government hard to understand, deadlines hard to meet, and legal standards hard to prove on their own. Hiring an experienced attorney is risk-free: Because payment is on a contingency basis, your attorney only gets paid if you win. If you lose your case or decide not to pursue Social Security benefits, your attorney’s work is free. This encourages attorneys to only take cases they believe have merit, and it should encourage you to consider hiring an attorney to help you with this complicated process from the very beginning. If you win your case, and the Social Security Administration decides you are or have been disabled at any point in time, an attorney will typically receive 25% of back pay owed to you by the SSA. This amount is limited to $6000. The SSA considers and approves the fee agreement between you and your representative before any attorney fees are paid. So, why hire an attorney? Because hiring an experienced attorney is risk free, and makes the long and often frustrating process of applying for Social Security benefits much more navigable. Having an attorney cannot make this process any quicker, but it can help ensure you do not miss key steps or evidence, which gives you the best chance of winning your claim. Attorneys will contact your doctors and therapists, gather all the evidence you need for your case, and request opinions from your doctors and caretakers in ways designed to highlight the strongest parts of your claim. They will take time to answer your questions about your case and about the Social Security disability process. Most importantly, they will make legal arguments at your hearing and have a detailed understanding of the current case law, which makes it much more likely you will be successful in your claim. It’s one of the only legal fields where you can get an attorney’s advice without any out-of-pocket costs. Really, the question is – why not hire an attorney to represent you in your Social Security disability case?