While there are many different aspects involved in
investigating a long-term disability claimant or
individual disability insured, including IME’s,
surveillances, database searches, etc., one of the most valuable
tools at our disposal while working for a disability
insurance company was the personal contact interview.
Conducting a disability interview is both art and
science, and takes a lot of training and experience to perfect. In
the end it can make the difference between a claim for
disability benefits being approved or denied. To
our surprise, after jumping ship to the other side and representing
SSDI applicants at Social Security
disability hearings, we learned that the exact same
questions asked during our previous disability interviews were, and
continue to be, used by Administrative Law Judges. Thus, winning at
the disability hearing level requires more than
simply submitting medical documentation and arguing the law, but
also in-depth knowledge of the correlation between
activities of daily living and stated
restrictions and limitations (residual functional
capacity). If your disability attorney is not
fully prepping you for a hearing by questioning you in great detail
(for hours) about the same, taking into consideration your physical
and mental impairments, you need to find a competent
disability advocate fast. There are plenty of general
practitioners out there who believe, as lawyers, they can take on
virtually any case, but that is not reality. Think about it. If you
have a sinus problem you go to an ENT, not a podiatrist who treats
feet. The legal profession is no different folks. Find a
disability specialist.
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Truth be told, through experience in representing clients before
the Social Security Administration in disability
appeals, we have learned how to successfully leverage certain
aspects of the disability benefits hearing to a
client’s advantage. However, that being said, prior preparation is
paramount to winning Social Security disability
benefits by way of an Administrative Law Judge (ALJ)
decision. A few vital things to consider are noted hereinafter.
Request to attend the hearing. Don’t go overboard though and
consider this an acting job. Exaggerating your stated restrictions
and limitations is fatal to a disability claim.
Your testimony must be credible and reliable. However, consistently
conveying relevant information alone is not enough. Your appearance
also must serve to humanize your case and have the ALJ associate an
actual face with your file, preferably a sympathetic one. Thus, it
is imperative that you retain a disability lawyer
well in advance of the hearing who knows how to prep a witness
properly. And not just any disability attorney,
but one who handles the majority of his or her cases in this area
of specialization, and regularly appears before Social Security
judges in your jurisdiction. Remember, a good attorney knows the
law, but an excellent one knows the judge, meaning he or she
understands the type of proof expected to win before the ALJ
assigned to your case. Updated medicals from supporting physicians,
to include questionnaires tailored for specific impairments and
narratives are a must. Although a treating physician who has a
longitudinal relationship with a patient carries the most
evidentiary weight, if necessary, seek out a physician for an
independent medical examination (IME) as well.
When a claim is borderline a solid IME may help win you
Social Security disability benefits. Favorable
medical proof should be forwarded to the assigned ALJ and/or
hearing office in advance of your disability
hearing date, with a well-written summary by your
disability advocate. Waiting until the date of
your hearing and attempting to submit updated medicals to an
already stressed out ALJ is not best practice.
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admin on December 2nd 2007 in Social Security Disability
If you have filed an initial application for disability
benefits with the Social Security
Administration along with medical records and other
supporting documentation, and received an unfavorable written
decision, the next step is the reconsideration level. Keep in mind
the Social Security Administration will deem you to have received
the notice denying you disability benefits, within
five days after the date on it, unless you can prove that you
didn’t receive it within that period. There are similar time
constraints during every step of a disability
appeal, so it is important that you are aware of them and
act accordingly. Don’t take chances. Check out SSA.gov, visit your
local Social Security office, or contact a
disability lawyer. For reconsideration you must
complete a Appeal Disability Report and Request for
Reconsideration and send them in to your local Social
Security office. They will then forward them to the State
Disability Determination Services office that originally
reviewed your disability benefits case. Although it won’t be the
same team that reviews your records the second time around, be
realistic folks, because they usually just back up the original
disability examiners’ decision. If you receive an unfavorable
decision at the reconsideration level, the next step is to go to a
hearing. Complete the Appeal Disability Report and
Request for Hearing by Administrative Law Judge
(ALJ) and send them into your local office. Meeting face-to-face
with a judge takes a long time - in many cases years, before you
actually appear at a hearing with your
disability attorney. Although the ALJ is required
to be neutral and detached, fair and impartial, and the hearing is
supposed to be non-adversarial, many of these judges fathom
themselves advocates for their agency rather than finders of fact,
and are predisposed to denying you benefits (more on this in future
posts). If you lose at the hearing level, the next step is the
Appeals Council Review. Complete the Request for
Review of Decision/Order of Administrative Law Judge and send it in
to your local office. It will be forwarded to the Office Of
Hearings and Appeals in Falls Church, VA. This review is
on the papers. A well-reasoned brief citing statutory and case
authority is essential (more later). The Appeals Council rarely
grants disability benefits on it’s own. However,
they will determine whether your hearing was fair, and if not, send
your case back for a second hearing. Once again, this can take
years, but at the very least, gives you another bite at the apple.
If the Appeals Council either refuses to review your case or denies
your disability appeal, the next and last step is
to take your case to federal district court.
There, a federal judge has the power to award you
disability benefits, deny you benefits, or send the case
back for another hearing.
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admin on November 23rd 2007 in Social Security Disability
The Social Security Disability Income
(SSDI) program is the largest involuntary insurance policy
in the world. As soon as you are old enough to start working, FICA
taxes are taken out of your paycheck, to provide benefits to you
upon reaching retirement age, or if you become disabled. That’s in
theory anyway. The truth of the matter is, if you become disabled
and are unable to keep working, the very program you had no choice
but to pay into for all those years will do just about everything
in their power to deny you benefits. Had you been given the option
of investing those FICA taxes yourself in an individual
disability policy you might have been better off. That’s
not to say that insurance companies issuing individual and group
long-term disability benefit
plans won’t give you a run for your money either. However,
the big difference is, that with private disability
insurance, depending on the policy, you may very well be
covered for benefits if you are unable to work and perform your own
occupation at the time you became disabled. With
SSDI, in many instances, after considering your
age, education, experience, residual functional capacity, and other
factors, you can’t collect Social Security disability
benefits if you could move across the country and work as
a surveillance system monitor (a favorite of Social Security
Administrative Law Judges and the medical and vocational “experts”
that they consult), looking at a security screen all day. It really
doesn’t matter that you used to be a mid-level manager in a Fortune
500 company either. The end result is, like most applicants, you
will likely be denied disability benefits and have
to fight for what your deserve every step of the way. That means
understanding, navigating, and winning the Social Security
Administration Disability Appeal Process. Here at
DisabilityAppeal.com we think the way the system operates is
despicable. So we are going to share a few things with you that we
have learned over the years. It won’t be legal advice, but should
give you a better understanding of how the disability appeals
process works and help you win Social Security disability
benefits.
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A new site dedicated to helping you understand the
Social Security Administration Disability Appeal
Process.
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admin on November 18th 2007 in Social Security Disability