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Here is Your Formula to Increase Chances of Winning Disability Claims

Here is Your Formula to Increase Chances of Winning Disability Claims

Let's be honest, in an ideal world, all individuals having any kind of disability deserve the spiritual, financial, physical and moral support to help them get through the disabled life and assist them to survive. The Social Security Disability Insurance was developed by the federal government to help these individuals get through these difficult times. The SSDI program offers income support to disabled individuals who are unable to earn under substantial gainful activity (SGA) on their own.

In 2019, 5.5 million people were provided social security benefits among which 2.3 million were SSDI benefits. However, of these 2.3 million SSDI benefits, this made only 35% of what the total number of claimants was for the SSDI claims.

In 2020, the situation is even dire with the rising unemployment and loss of jobs and uncertainty due to the Coronavirus pandemic. Although hundreds of benefits are denied because they fail to meet the eligibility requirements, many are also denied due to inadequate attitude of the claimants in presenting their case to the SSA properly.

But do not worry, we have compiled a list of actions you can make to ensure that your disability case is presented in the best possible way. In addition to improving the odds of approval, these actions may also expedite the process of winning your disability claims quicker than before.

Please remember that this list is only a guideline and there is no sure fire way to 'win' disability benefits. If you have presented your case properly by following these guidelines then rest assured – and leave the rest of work to the SSA staff. However, this does not mean in any way to manipulate your judge or disability examiner (DE).

  • I. A Complete and Fair Diagnosis of Your Disability

Although common sense might say that having some medical records may be enough, they are not. You disability examiner has to evaluate hundreds of applications in hundreds of ways to complete the consultative evaluation for your SSDI application. The disability examiner or judge will appreciate if your SSDI application has clear and firm proofs and records of your medical diagnosis. Remember beating around the bush or hiding facts about your disability that you are embarrassed about might actually jeopardize your chances of winning your disability claims in the long process.

For instance, your physician might be having difficulty in putting a name to the cause of your disability by having possibilities, such as possibility A, possibility B and possibility C – if the doctor thinks that you could not put a name to your disease that is fine as long as you have clear medical records of what symptoms and limitations those impairments are causing. For example, your doctor might be unable to pinpoint whether your back pain is caused by a childhood injury, a compressed nerve or a slightly dismantled joint on your pelvic bone. Hence, you must have medical records that prove that your back pain is actually hindering your functionality and ability to perform substantial gainful activity. You must also have medical proofs and doctors/caretakers statements if your disability also hinders you day-to-day activities such as standing up, sitting down, bathing etc.

  • II. You Must See a Specialist For Your Disability

Statistics have shown that a judge is more likely to take your disability seriously if you have medical records and proofs from a specialist for your disease. Many claimants who visit only a family doctor for all kinds of physical problems are less likely to be taken seriously by the disability examiner.

For instance, you might be having arthritis as an underlying cause of your knee pain but your general physician is unable to treat it. Hence, you must first see a Rheumatologist who will surely be able to make difficult diagnoses and treat your disease better than your family doctor.

Similarly, if you have back pain or herniated disk or pelvic bone fracture, the judge might appreciate if you have actually seen an orthopedist or if you have diabetes perhaps they would want you to have seen an endocrinologist.

This is not to say that getting treatment from a family doctor is not enough or prohibited, but, generally speaking if your disability is serious enough or disabling enough, then it's more probable that you should have seen a specialist that could perhaps do something to treat it or reduce its effects on your functionality. Hence, your case would be a lot stronger if you get treatment and statements from your specialist.

  • III. Missing Records in Your Medical History

Although you may or may not be seeing a specialist, having gaps in your disability application would not seem good to your disability judge or examiner. You might be seeing your specialist or doctor only 3 or 4 times a year and it would be enough if all that is recorded – yet, if you make 18 visits a year to a general physician without getting a proper treatment for your disability – or if you are seeing a specialist but visit once every two years and have broken medical records, then it may seriously damage your case.

Remember, you might be avoiding visiting a specialist due to insufficient funds or not having an insurance policy, this is not what the judge will take into account when carrying out consultative evaluation. However, if you do consult a specialist and get treatment and proper medical records – and then, if you win your disability benefits – then the SSA will reimburse all of your medical expenditure that you had to make in order to get that treatment from the specialist.

  • IV. You Should Not Miss Out on Your Doctor's Treatment

This point speaks for itself – you must make sure that you take your specialist's advice carefully and take full responsibility to reduce the limitations due to your conditions as much as possible by following your prescribed treatment. For instance, you must try to avoid things that trigger your angina or take certain medications for your migraine or avoid lifting heavy objects if you have chronic back pain, or take regular insulin treatment if your doctor has prescribed it to you.

  • V. You Must Keep Your Onset Date Genuine

Remember, keeping your medical records true whether your symptoms were milder than today. It might not impact your case if your symptoms at the time of onset were not serious enough or limiting enough than they are today – however, if you try to hide the facts this may affect your case.

A true onset date with no-break medical records will give out the impression to your examiner that your case has no loopholes in it. It will also lessen their burden to find out the missing records.

Also, you should not avoid mentioning even the little details such as, you might need to go to the bathroom every one hour or you need a caretaker to help you bathing or you need crotches to walk or you might need a wheelchair to travel. Hence, it will become obvious that a lot of jobs are out of question for you which will make your case even stronger.

Lastly, we suggest you consult with a disability attorney to do a rough evaluation of your application and prepare you thoroughly for what you might be expected from by your ALJ or disability examiner.

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Sunday, 13 June 2021