Social Security

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Why is it so hard to win Social Security disability benefits? The most obvious answer of course is that Social Security is struggling for cash.

While trying to assist a family member with her request for approval for Social Security disability benefits, we were dismayed to find the process so cumbersome. After completing the initial application and providing what we believed was all the necessary documentation requested, we found we were highly disappointed with the system.

We foolishly believed she would be approved to receive benefits since she met the criteria and had paid into Social Security for most of her life, only to be disappointed in her hour of need.

She received letter after letter requesting additional documentation and in response located, faxed and mailed all requested documents. She began feeling frustrated, like she was never getting anywhere.

Finally, she received an answer: DENIED!

I was surprised to find that it is not uncommon for a person with a long work history and a genuinely disabling medical condition to get wrongly denied on their first application. While exploring this issue to help her, I found that at the initial application level, more than 60 percent of claims are denied.

Once the initial application was denied, she had to quickly submit an appeal called a Request for Reconsideration. I also found that, on average, about 80-90 percent of all Requests for Reconsideration are also denied by Social Security.

My family member is about to give up. Her health continues to deteriorate, her medical bills are piling up and her health coverage ended. She feels like she is losing everything while awaiting a Social Security hearing. I told her not to give up. It is at the hearing level that she has the best chance at winning her Social Security benefits.

Although we are still awaiting the hearing portion of her application, we believe it is unfortunate that the only way left for her to improve her chances of winning her disability benefits is by retaining an attorney to present her case to an administrative judge at the hearing.

While researching this I learned that statistics show that disability cases in which an applicant is represented by an attorney have a much greater chance of being approved. So she hired an attorney.

Here’s what we found while applying for her benefits that might help to improve your chances for approval:

  • Provide a complete and detailed medical and work history. Provide documentation for all medical providers listed on your application.
  • Provide a written statement from your doctor(s) describing your condition in detail, telling exactly how your ability to perform work is limited or how you are prevented from returning to the work force.
  • If filing an appeal, make a follow-up call sometime within 10-14 days to verify that the appeal was actually received and continue to check the status of your case.

You may also be able to help your case simply by calling the examiner who has been assigned to your case and ask if there’s anything you can do to help speed up the process.

We went to my family member’s doctor’s office and other necessary agencies and picked up the required documents. We then faxed and hand-delivered them to the local office and mailed a copy to the state Disability Determinations Office.

Additionally, the Disability Determination Services (DDS) has a program for people with terminal illnesses called TERI through which applications are expedited. Keep in mind that the Social Security Administration defined a terminal illness as “a medical condition that is untreatable and expected to result in death.”

Be prepared and don’t give up. This is a lengthy process.

Diane Link is a Consumer Directed Services (CDS) Specialist at Paraquad. She can be reached at dlink@paraquad.org.

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