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Your Doctor isn’t Necessarily an expert in your ailments

5 Reasons Social Security Denied Your Disability Claim When Your Doctor Said You Were Disabled

 

If you’re wondering why Social Security denied your disability when your doctor soundly believed that your ailments were disabled…you’re not alone!  That may offer some relief, but now that you’ve been denied (or were denied some time ago), you need to get ready to take another look at your application for social security disability.  

Whether you’re re-applying for disability or filing an appeal with a disability appeal lawyer, you probably want to know what led to the miscommunication or outright disconnect between your doctor and the Social Security Administration.  

To help you with this, we compiled the most common reasons we have noticed that Social Security denied claims against doctors’ opinions – for our social security disability appeal clients in Spokane, WA.  

 

Your Doctor Didn’t know How to Communicate your Disability to Social Security

 

This reason is so common that we should write a whole article for the purpose of talking to doctors about how to communicate with Social Security (and the VA).  The point here is that in almost every case doctors practice medicine, not law.  And while your disability is a medical condition, the benefit – and process of obtaining it – is a very legal process.

Imagine you’re taking your car into a shop because it is misfiring.

You have someone that’s willing to pay for the repairs, but they need to know how it’s misfiring so they give you a form that says, “please describe what’s wrong with the car.”

You show up to the shop and ask the mechanic to fill out the form, and without context, the mechanic looks at the form and examines the car.  On the form the mechanic accurately describes what’s wrong with the car:

“The car’s tires are 40% worn, they need to be rotated. The car needs an oil change.  Windshield wipers need to be replaced.  Rear window is cracked.  Electrical issues – radio doesn’t work.  Transmission needs service.  Car Idles rough.”  

Technically the mechanic answered the questions.  But when you turn the form back in to get the repair $, your benefactor says, “I looked at the mechanics response, the problems with the car are generally superficial and are what you can expect from a 20 year old car, there’s no mention of a misfire, I’m denying your repair”

“Why,” you wonder?  The reason, without context the mechanic had no idea what to focus their report on.  They didn’t necessarily know that you needed to have that one item assessed.  They didn’t know how their report would play into the overall discussion.  Had they known they might have written something to the effect of:

“vehicle has wear and tear in a number of places, however, there is a critical misfiring causing a rough idle and imminent breakdown.”

Both statements are true – but in one the mechanic didn’t have context, and in the second one the mechanic knew the context.

This happens more often than you can believe!  And it’s not only Social Security disability that this occurs in, VA claim denials are famous for this situation. A doctor will describe a constellation of issues, but not focus on the issue that is material to your disability claim.  As such, it can create predictably poor results.

 

Your Doctor (or you) Didn’t Get Your records to Social Security Fast Enough

 

At every step of the Disability Application and Disability Appeal process you are under a ticking clock.  You have timelines you have to hit, and the system will not wait for you.  From the SSA’s (Social Security Administration) perspective, they have tens of thousands of cases to assess and to keep the process moving forward they have to decide or decline by a standard deadline date.

A side note to this reason is that if you missed timelines as a result of a disability of yours, that would be something you’d want to be documented in your reconsideration/appeal.  You might also want to get help in filing those, as you don’t want to have the same problems at that point.  If your doctor missed timelines, that’s going to be something that needs to be addressed too.  A great advocate or local disability lawyer is great for this.

 

Your Doctor Never Even Met You

 

Be honest.. did you show up to your doctor appointment(s)?  Did you know you had doctor appointments?  Were you aware that the SSA might try to get ahold of medical records for the care you received (or sought to receive) on your conditions?  In some cases, applicants have a pattern of not showing up to doctor appointments, even critical doctors appointments set by SSA for the purpose of evaluating your disability.

This is common enough of a problem that we had to cover it.  It also means that you probably need some additional help when you file your new application or appeal.  If you need someone to remind you, provide you transportation, give you motivation and a helping hand – reach out to them and ask for help.   We don’t mind providing reminders either!

 

You Gave Your Doctor Confusing Information

This is in the same arena as the mechanic story above.  If you’re not clear about why you are seeing your doctor, they may not be clear about what you are needing.

Also, confusing statements that appear to contradict your claims occur very often in medical records.  Consider the simple question, “how are you today?”

Do you even think before answering this question?  Most people don’t – it’s become a salutation like, “hi” and “hey.”  You probably get asked some variation of this question at least 4-5 times a day without giving it a second thought.  Here’s the issue…

If you’re filing a claim for Social Security Disability, there is likely some aspect of your health that is not “fine” – “good” – or “grand.”  And you need to be deliberate, honest, and accurate in answering that question and others like it when speaking to a doctor, or a judge.

 

Your Doctor Isn’t Necessarily an Expert in Your Ailments

We use terms like “doctor” or “lawyer” in generic ways.  However, like lawyers, most doctors have specialties.  For instance, a dermatologist has a different specialty than a neurologist. There’s a lot the two will have in common, including a great understanding of medicine.  However, one is far more prepared to give testimony on skin issues whereas another is better for brain issues.

A general practice physician may not be able to provide enough information to declare the limits of your abilities or disabilities if they’re very specific.  Ideally, a specialist can provide a more thorough diagnosis and prognosis.  If your only medical testimony is from a doctor who doesn’t specialize in your challenges, you may be reliant upon the judgment of an adjudicator at the SSA.

 

On That Note…

You probably want to work with someone who knows disability and disability law if you’re in a situation where you have already been denied benefits.  A social security lawyer is different than a family law lawyer, or a tax lawyer, etc.  In this manner, a social security lawyer in Spokane is different than one halfway across the country!  If you’re going to consult a lawyer, make sure they have experience in Social Security Law, and that they are actually located nearby.

 

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    Randi L. Johnson, Lilac City Law, Estate Planning, Social Security Disability, VA Disability

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      I highly recommend everyone at Lilac City Law. They helped me through every step of the SSDI process. Thank you so much!!
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      I don’t know really where to start in order to cover the magnitude of professionalism, understanding, persistence and compassion Lilac City law showed me. From Randi to each one of her staff-they worked very hard on my case and pushed me to keep fighting in the midst of several set backs from disability. They were always atop of communicating with me and all others involved. I highly recommend them and not just because I received a favorable decision but because of the plan they executed; so even if the results were unfavorable-I would still not hesitate knowing I chose the right practice. Thank you for you compassion and patience😊
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      I had my hearing yesterday for Social Security Disability. I was very nervous , but we won my case. Randy and the whole team at Lilac Law was very supportive and understanding! They truly want to help people win the benefits they deserve and I highly recommend them!
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      Don't remember exactly when I first met with them, but they were absolutely amazing to work with and only took a few months for my disability claim to be approved.I highly recommend Lilac City Law.
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      Randi and her Team helped me through my disability claim and they were there through every question I had. Great Customer Service! Timely returned calls and emails, very knowledgeable and helpful the entire time and even afterwards! Will definitely be working with Randi and her Team in the future!
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      Wow, these guys were so nice and easy to work with. It ended up that they couldn’t help us with what we needed, but the gentleman we worked with went above and beyond my expectations, and more. I could tell that they really care about people there, not just cases. He was super patient in explaining things to me when I didn’t understand, it wasn’t a stressful experience as I thought it would be. Thanks for everything guys!
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      06:09 21 Aug 19
      Lilac City Law is an incredible firm! I had the pleasure of working with the amazing team at Lilac City Law for nearly 2 years. Their team is absolutely remarkable! They are extremely knowledgeable, helpful, and overall compassionate when it comes to working with their clients. I sought their assistance nearly 2 years ago and have continued to work with them. I had a great deal of interaction with more than just one member of the Lilac City Law team and therefore can attest to the fact that this group of individuals is absolutely unparalleled. Attorney, Randi Johnson, is an exceptionally skilled lawyer as well as an overall remarkable woman! Her support staff is incredible as well, including Cassandra, Pam, Marissa, David, etc. with all of them by your side you have been blessed and are going to receive the best results possible. I would absolutely recommend seeking assistance from this law firm, as they have the ability to change lives; they definitely did mine. Thank you all so, so much!
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      Randi and team are amazing! We previously had our will and other documents prepared by another firm in the Seattle area where we are from. I met with Randi to update areas of my trust and was soooooo impressed with how much more she provides than the firm who first helped me. I love the short term care directive that she provides and think it is amazingly thoughtful!! Thank you so much Randi Johnson!!
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      I had a great experience with Randi and her team this past year when we worked with them to create our first-ever wills and trust. Planning for your untimely death and discussing personal finances aren't always fun topics, but we were appreciative of Randi's approach to these potentially uncomfortable conversations and especially liked the recorded legacy interview she conducted with us. Total 5-star experience!
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      23:52 29 Jan 19
      Parents are so intentional about so many aspects of their children's lives. Few will forgo putting together a will. But, what if you don't die? What if you are just incapacitated? Are you prepared for the unexpected? Are you leaving your children at risk? If someone else does raise them, do you know that they will be raised according to your wishes? Have you even thought through what your wishes are? All these questions and more will be covered in the process of completing a Family Protection Plan with Randi Johnson at Lilac City Law. Having our Family Protection Plan in place gives me an incredible sense of comfort and peace of mind. I highly recommend Randi and the staff at Lilac City Law. Hopefully you never need her services, but isn't it better to be prepared than to leave things to chance?
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      20:05 12 Jan 19
      I became ill over two years ago now,at the age of 29.. I experienced seizure like movements that lasted for hours or even days at a time. The doctors were at a loss for a diagnosis so they called it a mental disorder. As I was unable to care for myself most days or work, I applied for social security and was denied. I sought the help of Lilac City Law, and was immediately greeted with compassion and action. My case was a hard one to win or prove. Amy Santa helped me and explained everything to me step by step.. She ALWAYS answered my questions and showed immense sympathy for all I was going through. My case went to trial and Amy was amazing in court and won me the benefits I so desperately needed. This process was so difficult and overwhelming on my own.. I couldn’t have done it without these amazing people and thanks to them I can focus on improving my health,and not worry about my family struggling. I’m thankful and very blessed to have had them on my side! Sincerely, Ashley Schauble
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      This has been an awesome experience from beginning to end. Randi and her team were super helpful in helping us wrestle through all the aspects of our estate plan. Randi’s knowledge of estate and wills were very obvious from the beginning and we are thankful for her and her staffs expertise. Thank you so much!
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      I needed to get my husband's advanced health directive for a procedure he was having and it was so easy to find in our perfectly tabbed out legal binder. I found it right away, made a copy and stored it right back in the binder. Thanks for making us get it, and for making it easy to find and understand.
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      Jessica Gruver Koefod
      19:40 12 Oct 18
      I highly recommend this law firm. They have the experience and skills to help people with their plans and their future. From their work with others, they take a pragmatic approach to law and don't over complicate things unnecessarily. With that said, if a matter is complex they are very capable of handling it.
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      09:29 05 Sep 18
      Randi demonstrates a beautiful balance of expertise and compassion while dealing with difficult circumstances. I'm very thankful we had her in our corner! I can't reccomend her strongly enough.
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      16:47 25 Jul 18
      Randi and her staff are the best! They help you with your case and are there if you have any questions.I highly recommend them!
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      21:56 18 Jul 18
      Randi did a wonderful job of asking simple questions to help us determine exactly what type of trust we needed to match our goals. Thank you so much, Randi, for taking time out of your busy schedule to get us were we need to be!
      Michelle Darnell
      Michelle Darnell
      02:52 17 Jun 18
      Such a great meeting today with Randi. Tell me who wants to talk about wills and final arrangements, right? Well, my husband and I did this today and Randi, you made it easier than we expected. What a blessing to work with such talent and know you have our backs. Between you and Cary Wong. We will be sitting pretty, no matter what life brings us. THANK YOU!
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      01:20 31 Mar 18
      Vincent Adolph
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      13:30 26 Feb 18
      Randi and her staff are great to work with - no surprises, and she made it all so easy. Now we have a will and health directives, so our children won't be burdened when the time comes. I highly recommend!
      Sharon Robertson
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      18:04 05 Feb 18
      Randi and her team do amazing work. Thank you very much for what you do.
      Erin Whitney-Neher
      Erin Whitney-Neher
      20:18 23 Jan 18
      Randi are her staff are amazing! They are all very knowledgable, helpful and passionate about serving others. Every step of services are explained clearly and follow-up exceeded expectations. In addition, Randi is active in the community and regularly volunteers her time and talents putting on presentations focusing on educating others on specific topics. She has a passion for assisting those with special needs or situations. For legal assistance with heart, Lilac City Law is highly recommended!
      Nadine Burgess
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      18:14 25 Apr 17
      Excellent staff. Very knowledgeable and go out of their way to get the job done! Would recommend to anyone looking for services they offer!
      Jason Spade
      Jason Spade
      02:17 19 Oct 16
      Randi was an excellent attorney. Her staff was excellent as well. I was treated with kindness, compassion and dedication towards winning my complex and difficult case, which ultimately happened. I am very happy that I chose Lilac City Law to represent me. I would highly recommend them!!!
      Richard D. Seibert
      Richard D. Seibert
      15:56 03 Oct 16
      Melanie Jason Carter
      Melanie Jason Carter
      06:46 01 Sep 16
      Mia Martinez-Bermudez
      Mia Martinez-Bermudez
      04:22 30 Jul 16

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