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MISTAKES THAT GET YOU DENIED FOR SOCIAL SECURITY DISABILITY

Here are some of the mistakes people make that get their Social Security disability denied:

 1.  You don't have enough work credits or "quarters of coverage."  These credits are obtained by working job s which deduct FICA tax from your ages and match your contributions.  Self-employed individuals can also pay their FICA at the time they file their federal income tax returns.  These payments support  disability claims.  Without them, you are not an "insured person" under the Social Security Act.

2.  Your medical impairment will not last for at least 12 straight months.  There is no short-term disability with the Social Security Administration (SSA).  Any condition that has lasted fewer than 12 straight months, is expected to last fewer than 12 months, OR to end in death cannot be approved.  This is called the "duration requirement."

3.  Filing a disability claim while you are still working.  This results in an automatic Step 1 denial.  You simply cannot be found eligible for SSDI benefits while you are working at "substantial gainful activity" or SGA.  In 2023, you engage in SGA if your work produces gross income of at least $1,470 per month.  You must wait until you stop working or until your gross wages fall below $1,470 per month.  (This number changes each year).  It does not matter why you are working.

4. You depend on Social Security's doctors.  Social Security may indeed send you to one of their consulting doctors.  However, these exams seldom result in awarding of benefits. You will need to depend on exams and records from your doctor(s).

5.  Failing to get current medical treatment.  I often ask a potential claimant, "Are you seeing a doctor for your illness?"  To which they may reply, "Yes."  Then, I ask, when's the last time you saw your doctor?"  The reply is often "2 or 3 years ago."  This is not current treatment and it won't support an award from the SSA.  Without recent treatment, the SSA will not award  benefits.  I think of "current" treatment as something which has occurred within 6 months--but certainly no longer than 12 months ago.

6.  Not asking your doctor to support your claim.  While doctors cannot "sign you up" for disability, they can give important evidence that helps the SSA to give a favorable decision.  We always recommend getting a Residual Functional Capacity report.

7.   Using a general practitioner or family physician rather than a specialist.  With Social Security, doctors have "pecking order."  SSA decision makers pay more attention to specialists than to family practitioners.  A cardiologist carries more weight than your family doctor.  That's true with orthopedic specialists, oncologists, etc.

8.  Getting all your treatment from someone who is not a doctor at all.  There's a trend for medical practices to use nurse practitioners to see more patients.  It's always better if you can see a Doctor of Medicine (MD), Doctor of Osteopath (DO) for treatment and diagnosis. Chiropractors, while often helpful, will not help you with Social Security.

Mental health counselors or therapists are also not considered "acceptable medical sources" at Social Security.   It's better to see a psychiatrist, who is an MD--or a licensed psychologist (Psy.D or Ph.D).  Seeing a counselor or therapist in addition to the psychiatrist or psychologist is quite acceptable.

9.  Failure to appeal a denial within 60 days.   Only about 27 percent of disability claims are won in the application stage.  Most will be denied and require an appeal to be approved.  Most claims must go before a federal appeals judge to be approved.  Giving up after the first denial is a tragic and monumental mistake.  So is filing a new claim, in most cases.  Appeal your original claim and keep appealing until it reaches an administrative law judge.  Persistence is the key to success!

10.  Trying to perform this complex and highly skilled work by yourself.  Representing yourself is usually a formula for defeat and it definitely reduces your chance of success by a large margin. A recent study by the US Government Accountability Office (GAO) found that claimants using an attorney or advocate win almost 3 times more disability claims than claimants without professional help.  If disability benefits are important to you (and they are), then find someone who knows the law, the procedures and the evidence required. Going it alone is really "trial and error" but you may only get one good chance to win your case.

___________

Charles W. Forsythe at The Forsythe Firm in Huntsville helps qualified applicants at every step of the Social Security process.  No fee unless you win. (256) 799-0297.

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