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Seven Mistakes to Avoid When Applying for Social Security Disability Benefits

Author: Medical Record
by Medical Record
Posted: Nov 23, 2015

For millions of Americans with disabilities and their families, social security disability payments are a major and sometimes the only source of income. Getting a disability claim sanctioned is difficult, and if done unprofessionally it is likely to be denied. Since claims are approved on the basis of a detailed review of medical records belonging to the applicant, it would be best to seek counsel from an experienced disability lawyer. Attorneys practicing in the area of social security disability will help in collecting and organizing all the relevant medical records, usually with the assistance of an efficient medical review company.

If mistakes are made when applying for SSDI benefits, it leads to delays and considerable stress for the applicant. It is estimated that at least two thirds of SSDI applicants have their initial claim denied. Even when they appeal and are successful in getting approval, there may be further additional steps to go through that cause delay again. So often there is a waiting period before applicants actually get the money in their hands.

Added to this, there are common mistakes that many disability claimants make that are responsible for denied and delayed claims. Disability lawyers would caution their clients against making the following mistakes.

#1: Applying for disability without complete knowledge of the process. Filing a disability application is not just filling up forms and sending them to the SSA. The SSDI process is quite complex and involves a detailed evaluation process to determine disability. The administration will consider the claim only if the applicant meets the first two requirements, namely:

  • The applicant must not be profitably employed.
  • The applicant has a severe condition that interferes with his/her basic activities of work.

Other requirements include:

  • The claimant’s condition must be listed among the SSA’s list of disabling conditions or medically equals one of those conditions and he/she will be disabled for more than 12 months.
  • The claimant is unable to do the work he/she had been engaged in before the disability.
  • The claimant cannot perform any other type of work.

Applicants must be fully prepared to provide a detailed account of their current condition and medical history, as well as a complete disclosure as regards the work activity they have/have not been able to fulfill. The outcome of the disability claim depends a great deal on how well the relevant paperwork has been completed.

  1. Claiming for disability without proper representation. It is always advisable to file the disability application with the support of a disability lawyer to avoid claim denial. The average person may not be knowledgeable regarding complying with applicable regulation, and this is a major reason why individuals going into the SSDI insurance process need proper representation.
  2. Not understanding the relevance of work history. The applicant’s work history is very relevant. The disability examiner will take into account the claimant’s work history, level of education, age and present disability. The applicant’s previous work history becomes very significant in this regard because the SSA is trying to determine whether you are no longer able to perform the work you did in the past. Therefore, being vague about work history can be quite damaging. To qualify for benefits applicants need to show right at the start why they cannot perform that work any longer.
  3. Overstating or understating the impact of the disability. Both these are serious mistakes that can lead to claim denial.
  4. Not quitting their work before filing the disability application. To qualify for disability benefits, the applicants must have either quit their job or start working fewer hours. The SSA must be convinced that the applicant has quit his/her job and does not earn more than the current SGA (substantial gainful activity) figure.
  5. Not taking the prescribed medications. The SSA has to be convinced the applicant is following the medical advice given, taking the prescribed treatments/using the assistive devices provided.
  6. Failing to appeal the denial before the appeals deadline. SSA allows a formal appeals process with three levels. If the claimant is rejected at any level, he/she has 60 days to appeal to the next level. If the deadline is missed, the process has to be started from the beginning. Here too, claimants have a better chance to win the case if they are properly represented by a good lawyer.
About the Author

Managed Outsource Solutions (Mos) has providing value-added medical record review services for the medico-legal industries.

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Author: Medical Record

Medical Record

Member since: Jun 17, 2015
Published articles: 31

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