Advice on Beginning Disability Claims
April 26, 2016
Applying for disability benefits under the Social Security Administration is a process that can be difficult to navigate if you are unfamiliar with the process. There are deadlines to be met, specific information that you must submit and lengthy questionnaires that require detailed responses. The Social Security Administration’s website does not offer much in the way of answers to specific questions and calls to the branch offices often result in long periods of time spent on hold. The following advice is meant to help provide some understanding to people trying to decide how to file for Disability benefits.
Do not delay in filing.
The thing most people underestimate when considering applying for Disability is the length of time the process will take. Once an Application for Disability benefits is filed, it is processed at the local Social Security Administration office and then sent to Disability Determination Services (DDS) for review. The current average processing time at DDS is 80 days, though that is expected to increase by 9-19 days in 2016.
If an Application is denied by DDS the next step is to file a Request for Hearing before an Administrative Law Judge. This is a process to appeal the denial of the application and to have a judge make a determination based on the rules and regulations. The Request for Hearing goes to the local Social Security office and is then transferred to the Office of Disability Adjudication and Review (ODAR). The average processing time for a case at ODAR in 2015 was 411 days, and that is expected to increase to 456 days in 2016.
The total amount of time on average for a case to be processed through the hearing stage can be up to 555 days. If you are disabled and without income, you do not want to delay that process any further by putting off filing an Application.
Provide detailed information in the Application.
Filing an Application appears to be a straightforward process, but you can help your case immediately by providing the most information possible. Providing full and detailed information on places you have received medical and mental health treatment allows DDS to obtain the most complete record possible, and the most information favorable to you, when making the decision. This information includes addresses, phone numbers, treatment dates, tests, medications and other details on your treatment. If you do not provide correct treatment dates, DDS may not request your entire medical record. Indicating specific tests and medications in the Application also helps direct the attention of the person examining your file to medical evidence favorable to your claim.
Providing detailed diagnoses and symptoms is also very important. There is a dramatic difference between listing a diagnosis as depression when you have been diagnosed with major depressive disorder. There is a difference between listing back pain and spinal stenosis of the L4-5 vertebrae. If mental health diagnoses are not listed, DDS might not give them adequate consideration when reviewing the record.
Fill out the DDS questionnaires as completely as possible.
DDS will send an applicant several questionnaires prior to making the decision. These questionnaires typically include a Function Report, Work History Report, Personal Pain Questionnaire and other questionnaires that may involve particular disabilities listed on the Application.
These questionnaires ask for detailed information, and the Function Report and Work History Report are lengthy. Many people become overwhelmed when attempting to answer the questions and answers can be incomplete or inconsistent. Other people believe that the questionnaires are straightforward, and do not provide detail in answers that would be beneficial to their claim.
The importance of these Questionnaires cannot be stressed enough. The Work History Report provides information that will be used to help determine an applicant’s past relevant work. Subtle differences in job classifications based on this information may make all the difference in deciding an Application. The Function Report provides information that DDS uses to determine whether an applicant can complete activities of daily living, and also to help determine what restrictions an applicant has when determining the person’s Residual Functional Capacity (RFC). Answers to these questions are very important and will follow an applicant throughout the entire case.
Obtain Medical and Psychological Treatment and be honest and direct with treatment providers.
DDS and Administrative Law Judges use a variety of resources to determine a case, but the most important resources are an applicant’s medical records from treating physicians or psychiatrists. Many people delay going to a doctor or psychiatrist. Others have difficulty communicating their symptoms and problems to a treatment provider. Patients can be intimidated by doctors who have busy schedules and may dismiss problems that the patient does not emphasize during the examination. An applicant who has not, and is not, seeking care and treatment for their symptoms and disabilities will have a harder time getting a favorable decision.
Consult a lawyer.
Many people do not seek a lawyer until after the initial denial. This is a mistake. It is a mistake made for a variety of reasons. Many people believe that they have such a strong case that they cannot possibly be denied. While a case might be strong, if it is not presented correctly it can often be denied by DDS. Other people believe that they can forego the cost of an attorney by trying it themselves at the Application stage. While this approach is understandable, any mistakes made in completing the Application and answering the questionnaires will follow an applicant all the way to the hearing before the Administrative Law Judge.
Inconsistencies or answers that do not fully describe an applicant’s limitations can be used to question the extent of their disabilities at the hearing. In addition, attorney fees in Disability cases are contingent upon a favorable decision and award of benefits and do not require a retainer or upfront payment. The reward for avoiding attorney fees is typically not worth the risk.
Applying for Disability is a lengthy process with a great deal on the line. A person can lose access to SSDI benefits by not understanding the rules regarding onset dates. Missing deadlines can result in denials and having to restart the entire process. It is worthwhile to at least consult a lawyer before deciding to proceed by yourself.