|This is a guest post by Tim Moore on the mistakes to avoid when filing an ADHD Social Security Disability claim. Tim's bio and contact information are available at the end of this post. Please visit his web page and contact Tim with any questions that you may have regarding ADHD disability. Thanks Tim for this valuable information.|
Are there mistakes to avoid in the Social Security Disability claim system?
Very often, individuals who are filing for disability benefits with the social security administration (under either the title II social security disability program or the title 16 SSI disability program) will search for answers to a number of questions, such as "Can I speed up my claim?" or "How long will the disability process take?". These are logical questions, to be sure. After all, knowing how long the process may potentially take and whether or not the processing time for a claim can be mediated can allow an individual to better plan for the months ahead. However, one question that should probably get asked just as often is this: Are there mistakes that I can avoid when I apply for disability. And the simple answer to the question is, yes, there are.
As a former disability examiner working on social security disability claims, one of the biggest mistakes I routinely witnessed was the failure of claimants to utilize the appeals process. Let me explain. When a disability claim is denied, a claimant is sent a notice of denial. The notice purports to explain why the claim has been denied, but, in truth, it is mostly a form letter, an electronically canned one at that. In most cases, the individual who has been denied can safely ignore everything the denial letter has to say. With the exception, however, of one thing which is the date stamped in the upper right hand corner of the notice. This is the official date of denial and its true significance is that the claimant has sixty days from this date in which to file an appeal.
Appeals in the social security disability and SSI disability system (in actuality, SSD and SSI are two separate programs, but they are indistinguishable and are processed in identically the same way) are what typically make the difference between ultimately receiving disability benefits and not receiving disability benefits. To elaborate, initial claims, or disability applications, are denied at the rate of seventy percent on average. The first appeal in the system, the request for reconsideration, is denied at an even higher rate, roughly eighty-five percent. Only when a claimant's case gets to the level at which a hearing before an administrative law judge is held will the odds shift substantially in the claimant's favor.
At the hearing level, those individuals who have been previously denied at the initial claim level and reconsideration appeal level will be more likely than not to be approved for benefits, presuming that the judge hearing their case has been supplied with updated medical records and a detailed and objective supporting statement from their treating physician. In other words, cases that are appealed to the level of an ALJ (administrative law judge) disability hearing will typically result in an awarding of monthly benefits and an awarding of substantial back pay for those claimants who often been forced to wait for many months or even years while their case is pending in the system.
Statistically speaking, more than sixty-two percent of represented claimants who have been previously denied will win their case if they appeal as least as far as the disability hearing level. Yet, despite this fact, a significant percentage of individuals who receive notices of denial will not utilize the appeal process. What do they do instead? In some cases they simply give up. In other cases, however, they do what I witnessed many times as a disability examiner working on claims. After being denied, they start over with a brand new claim.
Why is filing a new claim versus filing an appeal a huge mistake? Because, overwhelmingly, if a claim has been denied at the disability application level then simply filing a new disability application will just result in another denial and probaby for the same reasons. Following the appeals process, on the other hand, will eventually get a case heard by a federally appointed administrative law judge.
At an ALJ hearing, the claimant will have the chance to do several things that were not permitted at other steps in the process. They will be able to meet the decision-maker in their case (the ALJ). They will be able to introduce evidence and statements they have collected themselves--through their attorney if they are represented--versus relying on the social security administration to collect evidence (and, by the way, it should be stated that, at the hearing level, the social security administration no longer attempts to procure evidence, making the burden fall entirely upon the claimant). Thirdly, the claimant, who will be given access to their aggregate file, will also be able to challenge the basis of their prior denials.
Perhaps more importantly, though, at a hearing the claimant becomes more than just a file with evidence, but, instead, a person who can be both seen and heard by the person deciding the outcome of their case, and, to a great extent, their life.
Claimants who do not utilize their right to appeal after being denied will never have the benefit of having their case heard by an administrative law judge. And that makes eschewing one's appeal rights probably the biggest mistake that can ever be made on a disability claim, and definitely one to be avoided.
The author of this article is Tim Moore, a former medicaid-disability caseworker and a former disability claims examiner for the social security administration's DDS, or disability determination services. Tim Moore is the publisher of The Social Security and Disability Resource Center.