Does Social Security Always Make Correct Decisions on Disability?
NO. Never assume that Social Security's denial of your disability claim is correct. Many, many of their denials are wrong and error-ridden.
Social Security's denial rate is artificially high, meaning--they deny claims all the time that should have been paid. When your claim is on the scales, the scales are skewed toward denial.
Here's just one example from my case files.
The claimant in his fifties had active cancer that had spread (metastasized) to other parts of the body. Under the Social Security regulations, he qualified for both a Listing level impairment and a Compassionate Allowance, and should have been approved and paid quickly with no fuss.
Either of these guidelines would have dictated a finding of disability under Social Security rules. But instead of a quick approval, what happened?
The state agency that reviewed the initial claim denied benefits.
On appeal ("reconsideration") by my office, the state agency approved the claim (but did not pay it).
However, the claim was sent to "quality control," where it was held up for a month and reviewed again. QA overturned the award and denied the claim again, even after it had been approved.
I then filed an appeal with an Administrative Law Judge (ALJ) and asked for a hearing. I also requested an immediate on-the-record review of this claim because I felt the medical evidence made a favorable decision possible without waiting 6 months for a hearing. I asked for a quick review.
One week after filing this appeal, the judge approved the claim. The judge stated in his decision:
1. The claimant clearly meets a Social Security Listing, which automatically requires payment of the claim.
2. The claimant meets the requirements of a Compassionate Allowance, a rule which also should allow automatic and expedited payment. (The purpose of Compassionate Allowance is to permit obvious disability cases to be approved quickly without the red tape usually involved).
The claimant received retroactive pay (back pay) and a sizeable monthly benefit. Medicare will also become available to help pay burdensome medical expenses for treatment.
This is a prime example of how Social Security, at the lower levels, makes significant errors in their decisions.
The key to a Social Security denial is: APPEAL, APPEAL, APPEAL
If we had given up on the first 2 denials, it would have had devastating effects on the claimant. Because we stuck to the conviction that Social Security had made a series of outrageous mistakes on this claim, we recovered all the benefits.
Never, never, never assume that Social Security denials are correct. Most of the time, they are NOT. Most of the time, denials can be reversed on appeal (though you may have to appeal more than once). Your best chance is to kick your case up to an Administrative Law Judge (ALJ) for a hearing. At the hearing, your case will get looked at much more closely; someone will listen to you and your lawyer--and will apply the law correctly.
If you give up along the way, YOU LOSE.
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Charles W. Forsythe has been helping claimants all over Alabama and other states get the benefits they deserve through appeals and hearings. Never a fee unless we recover your benefits for you! Free consultations. Just call us. (256) 799-0297.
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