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Social Security Disability

First Steps

Before applying for social security disability benefits, ask yourself whether you are able to work. The Administration applies a 5-Step analysis for determining whether you are disabled. The first step is determining whether you are currently working and whether your work activity is substantial enough to bar your from collecting benefits. The social security program is intended as a way to help people whose physical or mental conditions really limit their ability to work. If you are physically, mentally, and emotionally able to continue working, then you should, because it is very likely that the amount you will earn working will be more than your monthly benefits. 

 

If you are unable to work full-time because of your condition, then you should consider filing an application with the Social Security Administration. There are several ways to file an application. Contact your local Social Security Administration Field Office for ways that they can help you start an application. Visit the Field Office Locator to find the office closest to you. Online, the application takes from 45-60 minutes and you will need to provide basic information about yourself, your family, your medical conditions, and your treatment. 

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When filing an application, it is important to be as detailed as possible. The Administration will help gather medical records from the doctors and treatment facilities that you provide. BUT if you forget, or fail, to include a doctor, clinic, or hospital that you've been to, the Administration will have no way of gathering those records. In other words, it’s up to you to provide a complete list of the providers you've been to. 

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Make sure to include all of your conditions that limit your ability to work. Many people applying for social security disability benefits are suffering from severe symptoms including, pain, fatigue, memory loss, and inability concentrate in varying levels of intensity. Someone in severe pain may not be thinking about their mental health conditions and conversely, someone suffering from severe depression, may not be prioritizing their physical conditions. When applying for benefits, make sure to include any conditions that limit your ability to perform basic work activities, even if on their own they may not prevent you from working completely. 

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While the statistics vary from year to year, unfortunately, most people who apply for disability benefits are denied at the initial stage. Many people who are initially denied don't understand that this is just the beginning of the process. In fact the process includes several stages, with important differences at each stage. If your initial application has been denied you should contact a disability attorney. 

Your Application Was Denied

First, don't panic. Unfortunately, the reality is that most people applying for disability benefits are denied at the initial stage. The process for applying for and ultimately winning disability benefits often requires advancing the case to different levels of review.

 

First your application will be reviewed by medical staff and other social security personnel at the initial level. After that, if you appeal this determination, your claim will be sent to reconsideration, where other medical staff and social security personnel review your claim.

 

If you are denied at the reconsideration level it is your right to request a hearing before an Administrative Law Judge. If you are denied by the Administrative Law Judge at hearing, it is also your right to appeal that decision to the Appeals Council and finally to Federal Court.

 

While it is your right to pursue your claim using this process, unlike criminal cases, you are not entitled to free legal counsel. As the process progresses from reconsideration to the hearing level and then to the Appeals Council and beyond, it becomes increasingly more complex and the arguments that your attorney will make frequently shift away from your conditions and towards the law.  

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Fortunately, most social security attorneys, including ours, do not charge you a fee unless you win. If you do win, then your attorney will get a percentage of the back-due benefits that the Administration owes you. That way, people applying for disability benefits are free to hire legal representation even if they can't pay legal fees directly out of their pocket and if you don't win, you will not have to pay anything.   

The Hearing

While a disability lawyer can help navigate your claim through the process from the application forward, if you are appealing your claim to the hearing level it is especially important to seek an experienced disability attorney. There are several reasons for this. At this stage, your attorney will help you gather additional medical evidence. While the Administration will help you gather medical evidence at the initial levels, there are frequently records missing that are germane to your case. Your attorney will also help you gather statements from your doctors and vocational experts that the Administration may never request. There are many reasons why this evidence wasn't added to the record before. For example, you may have received additional treatment between your last denial and the hearing or the Administration just failed to follow up with records that they requested and so they never made it into the file. It is crucial at this stage to complete the record because barring certain circumstances this will be the record that all future appeals will be based on. In other words, while you can add evidence to the record after the hearing decision, it may not always be considered. 

 

In addition to gathering evidence your attorney will also provide an argument that explains why your case meets the standards to be found disabled. Many people think that just because they have a certain condition and receive treatment that they meet the standard to be found disabled but this is not the case. The 5-Step Sequential Analysis that the Administration applies is as follows:

 

  1. Is the individual performing substantial gainful activity?

  2. Is the individual’s physical and/or mental condition severe?

  3. Does the individual's medical condition meet or equal the severity of a listed impairment?

  4. Can the individual do any of their past relevant work?

  5. Can the individual make an adjustment to other work?

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While these steps explain the broad contours associated with the decision process, there are pitfalls and opportunities at each stage that an experienced disability attorney can help you with. For example, addressing work activity that occurred after you became disabled, understanding the complex requirements of listed impairments and which listing you may meet, what defines past relevant work, and understanding medical-vocational guidelines and other policies that explain whether someone can or cannot adjust to other work. 

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Your attorney should also be prepared to present your case at the hearing. Frequently Administrative Law Judges rely on vocational and medical experts to testify regarding your case. It is important for your lawyer to not only understand the facts of your case but also be ready to cross-examine these witnesses.

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