Prior
to the pandemic, I would give presentations at hospitals, to support groups, to
caregivers, and to a variety of other service organizations interesting in learning
how to navigate the Social Security Disability and Supplemental Security Income
systems. With the exception of some Zoom presentations that I gave in 2020 and
2021, most in-person presentations have faltered due to our new infectious reality
of living life during a pandemic. Thus, I have decided to provide 11 general tips
in blog form. While these written tips may not be as dynamic as an in-person
discussion we could have about navigating the Social Security system, I hope
the information will prove to at least be helpful to those of you who are applying
for benefits during this difficult time.
1. If you are
unrepresented, keep a copy and get a receipt of any application or appeal you
file.
All
too often, we hear a familiar story. A claimant has applied for benefits, but Social
Security has no recollection of this application. The claimant has been forced
to refile the application and the resolution of the claim has been
significantly delayed.
This
scenario can easily be avoided if you get a receipt of your appeal from the
Administration. If you file in person with the Administration, they can stamp
your appeal and provide you with a copy. If you apply online, print out the
confirmation document. If you apply by mail, follow up with the Administration
and ask them to forward you a receipt. Thus, if the Administration later claims
that you have never applied for benefits, you have concrete proof that you did.
2. See a
doctor regularly and seek out a county facility or free clinic for treatment if
you have lost your medical insurance.
In
order to be entitled to benefits, your impairments must be medically
documented. This means there must be legible medical documentation supporting
your claim. The judge may believe that you do have severe pain, but if there is
no concrete proof, the judge must deny you benefits.
Treating
regularly with a physician is necessary to establish your impairment. Treating
with a specialist who specifically treats your condition can add even greater
weight to your claim.
We
understand that treatment is expensive and can be difficult with the rising
costs of healthcare. If you are no longer insured or in danger of losing your
insurance, seek out county facilities and free clinics in your area so there
will not be a significant lapse in treatment.
3. Keep track
of all the medical providers or facilities you treat with and let your
representative know when this information needs to be updated.
The
foundation of every disability claim is medical evidence. If your attorney is
not aware of all the providers or medical facilities you treat with, your
attorney cannot get the materials to prove your claim. Every time you treat
with a new provider or facility, let your attorney know. Make sure you get all
the pertinent contact information for the provider, including: name, address,
phone number, and fax number. If possible, get a copy of the medical record of
each visit following your appointment. You never know what valuable piece of
information could result in a favorable determination.
4. Treat with a medical provider you trust and
who is aware of your disability.
If
your doctors do not support your claim for disability, you may need to ask
yourself whether you legitimately fit the Social Security Administrations’
definition of disability. It is important that you have supportive providers
throughout this process. Often the Administration or your attorney will contact
your providers for support in your claim. If your provider is not aware of your
disability, or does not support your claim, it is very unlikely that you will
be able to obtain benefits.
5. If you
return to work, let your representative or the Administration know.
A
return to work can drastically change your claim. While there are some
regulations that permit you to work at certain levels, your attorney needs to be
aware of your work status. Not only is it important for your attorney to
explain to you how work affects your case, the attorney needs this information
to help formulate a legitimate theory to win your claim. Additionally, if you
return to work without notifying the Administration, your claim may result in
an overpayment. In an overpayment situation, the Administration will ask you to
pay back the surplus amount that you were paid. If the Social Security
Administration finds that you intentionally misled them to receive additional
benefits, they may impose additional civil penalties.
6. Pay
attention to the time frame you have to appeal a denial.
The
Social Security Administration has strict deadlines for entering an appeal.
Generally, it is 60 days from receipt of the denial, but this can vary. The
Administration is not very understanding when a deadline is missed and may make
you refile your application. This is easily avoidable if you read each denial
letter carefully. Often the appeal timeframe is not on the first page, so read
every page of the denial. As soon as you receive a denial, let your attorney
know. Though the Administration is supposed to copy your representative on all
correspondences, this does not always happen. Notifying your attorney can
ensure that a deadline is not missed.
7. Get a copy of your medical record following
each visit so the Administration has accurate information regarding your
medical condition.
Getting
a copy of your medical records following each visit can save you a lot of
administrative costs that your doctor may charge. To prove your claim, we will
request a copy of your medical records from each treating provider and
facility. While West Coast Disability Legal Center does not charge a fee for
representation unless we win your case, your doctors may require that you pay
nominal copy fees for release of your medical records. While you are
responsible for these charges, you may be able to avoid them. Ask for a copy of
your visit record following your appointment with your doctor. This could
result in drastically reduced copy fees.
8. Let your
representative know if your doctor is not supportive.
If
your doctor is not supportive, you may be wasting your time applying for
benefits. Make your representative aware of any providers who do not support
your claim. If we legitimately do not think we can prove your case, we will let
you know. The Social Security claims process is lengthy and we will honestly
approach you if we think your case is unwinnable.
9. Fill out
all paperwork your representative or the Administration gives you honestly and
accurately.
To
effectively represent you, we must have accurate details in regards to your
claim. While we recognize that you may not recall every detail of your treatment
or work histories, try to fill out all required paperwork as accurately as
possible. Never intentionally change information to make your case look
stronger. The Administration may impose civil penalties for such fraudulent
behavior.
10. If the
Social Security Administration schedules you for a consultative examination,
please attend.
The
Social Security Administration may send you to one or more of their doctors for
a consultative evaluation at no cost to you. We understand that you are
probably more comfortable with your own provider for regular treatment, but you
must attend this evaluation. Failure to attend may result in a denial due to
your lack of cooperation with the Administration’s requests.
11. Ask
questions to your representative if you do not understand something.
We
understand how complicated the Social Security claims process is. However, we
are experienced attorneys who handle these matters every day of the week. Do
not be intimidated to ask your attorney questions. No question is silly,
stupid, or embarrassing. As attorneys, we are expected to know the law. You are
not. You hired us for our expertise, please allow us to address your questions
and concerns.
Got
a question about SSDI or SSI that you need us to answer? Please check out our
website at www.westcoastdisability.com . We try to provide you with
helpful information on our website that will allow you to successfully navigate
the Social Security Disability process. Also, feel free to email me your
questions at megan@westcoastdisability.com or call me at (800) 459-3017 x 101.
