If Your SSI Was Denied Will Your SSDI be Denied Too?

SSI Vs SSDI if SSI was Denied

SSI and SSDI are both programs for supporting people who have disabilities that stop them from being able to work. 

However, the program that works best for you will be dependent upon a couple of different factors. 

If we break this down a little further, we can fully address the main question: 

If your SSI was denied will your SSDI be denied too?  

SSI Vs SSDI

We broke down the differences between SSI & SSDI in a previous article titled: Is Social Security the Same As Disability?

Here’s an excerpt that will help frame the answer to the question above:

Supplemental Security Income (SSI) is a program through the Social Security Administration (SSA) designed to provide a monetary benefit to Americans who are older than 65, blind, or disabled.  SSI is needs-based, meaning that the beneficiaries must be below a certain asset threshold.  And they must have limited income, and/or income earning potential.

SSI is often paired with Medicaid, administered by individual states.  Recipients of SSI often also qualify for food stamps.

Social Security Disability Insurance (SSDI) is similar to an insurance program you might buy into for the contingency that you might become unable to work due to an injury in the future.  In actual fact, it is essentially just that – an insurance program.  Though, it’s not really opt-in if you’re employed; you pay (or paid) into it through payroll taxes.

The payout for SSDI is typically higher than SSI, but it requires that you have a relatively recent work history, to base the amount of your benefits on.  Beneficiaries become eligible for Medicare after two years of being on SSDI.

Infographic: SSI Vs SSDI

Are You Eligible for SSDI?

The first question to help you understand whether or not your claim for SSDI is likely to be denied (assuming your application for SSI was denied) is, do you meet the eligibility requirements for SSDI?

We’re keeping it simple here, but here are the two basic qualification criteria for SSDI

Have a work history of jobs covered by Social Security (another great article on who is and is not included here as well)

Have a medical condition acknowledged by Social Security as a disability

Notice that none of these requirements are related to your previous income?  Alternatively, to your assets?  Unlike SSI, SSDI is not a means-tested/related benefit.

If you were denied SSI due to an asset issue (too much $ or property), you would not be denied from SSDI for that same reason.  However, you might be denied for other reasons, including not meeting the criteria listed above.

Is There a Reason Why Your SSI Was Denied?

In addition to assessing your basic eligibility criteria for SSDI, you might want to determine why you were denied for SSI in the first place.

If it is a lack of basic eligibility, that is pretty straightforward.  We covered eligibility for SSDI above, and because there are a lot of “if/else” caveats to SSI eligibility, we will link to the full eligibility criteria for SSI, here, so that you can review them in-depth.

If your reason for being denied SSI is not due to eligibility deficiencies, then we should look elsewhere to assess why you were denied.  Moreover, why you would be looking to SSDI as an alternative to SSI.

It is possible, for instance, that you should have filed for SSDI the whole time and only filed for SSI because of a knowledge gap of the differences between the two programs.  This gaffe does happen, and it is easy to see why! SSI & SSDI have a similar name, similar function, and provide support for similar groups of people.

However, bear in mind you may have been completely correct in filing for SSI in the first place, and were denied for other reasons.

Should you Re-File for SSI? 

Having a better understanding of why your SSI was denied will help you to get perspective on whether you should seek SSDI, re-file for SSI, or file an appeal on SSI.

In reality, if continuing to pursue SSI is the right decision for you, you should file an appeal vs. refile.  Unless, of course, you have missed your deadline to file your appeal.

Lastly, while you are assessing your options, you should re-consider all potential benefits you might be able to obtain.

Consulting with a local advocate or attorney is a good step in the right direction.  They will be able to advise you on likely reasons why your original SSI claim was denied, what to do now, and other benefits you may find value in seeking.

Here’s What You Should Do Now That You’ve Filed Your Social Security Disability Claim

Keep Track of Challenges you Have During the Day

You’ve filed for Social Security Disability (or SSI) because you’re unable to work due to an injury or illness.  Great job!  But now what can you do to set yourself up of the best possible chance of success?  

Here are four things to do for anyone who has filed a social security disability claim.


Keep Going to the Doctor

 

It’s incredibly important that you continue to go to all scheduled medical appointments.  If the Social Security Administration determines that you aren’t going to regularly scheduled appointments, while they’re evaluating your disability claim, they may decide against your claim on the basis that IF you did go to the doctor your impairments would be manageable.  And thus, you would be able to seek, obtain, and maintain employment (or other substantially gainful activity).

Going to appointments can be difficult, depending on your conditions.  If you find it difficult to maintain a schedule of medical appointments you should make sure to note this.  Better, even than keeping personal records on this though, is retaining an advocate and making sure they know how difficult it is for you to attend your medical appointments.   They may be able to secure some accommodations and/or they may be able to communicate your challenges effectively to the Social Security Administration.

 

Maintain Good Records of Any and All Hospital Visits

 

In a perfect world, everyone who needs access (and has permission to access) your medical records, would do so prior to making a decision that impacts you.  However, it’s not a perfect world, and one of the most common goofs on disability claim decisions occurs when the adjudicator makes a decision without all the evidence they should have.   Sometimes, a big piece of the pie is tracking down what SSA knew, and what they should have known.

Of course, this isn’t the only reason to keep records of visits.  It’s good practice to do so even if everyone is on the same page because you never know when someone might lose a record, claim to have never received it, or claim that you didn’t go to that medical appointment in the first place.

Keeping good records can be as easy as making sure everything goes into a specific folder or box.  Just don’t throw them away!

 

Keep Track of Challenges you Have During the Day

 

At some point, someone is going to want to know what kind of impact your impairments have on your everyday life.  You can sit there across from a judge, or in front of a doctor and try to recall ALL the ways in which you’re affected, or you can rely on the notes you’ve taken in preparation for that question.

This means, take notes.  Keep a journal.  Take pictures, if that’s easier.  Keep a video diary.  Just document your challenges in some way.

This one action helps eliminate the ambiguous understanding (on the part of the SSA) that Social Security Disability claims denials often spring forth from.

 

Consider Discussing your Claim with an Excellent & Local Social Security Disability Lawyer

 

It’s never really too early to start a discussion with an excellent local Social Security Disability Lawyer.  There are several reasons you’d want to do this.

#1) An experienced Social Security Disability Lawyer can give you advice from having gone through this process >1000 times.  This is probably your first time through the process.  If you can get any direct advice or even support, it’s worth your time to reach out for it!

#2) If your claim is denied (it happens far too often) – you have a short turn-around to file an appeal.  Being able to bring in a disability attorney that has already heard the merits of your claim, provided input on them, and that you have a pre-existing relationship with – will help to reduce your stress at a very difficult point.

#3) It’s free.

 

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

Your Doctor isn’t Necessarily an expert in your ailments

 

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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How to Choose a Social Security Lawyer in Spokane

How to Choose a Social Security Lawyer in Spokane

 

If you’re looking for a Social Security Lawyer in Spokane, WA or northern Idaho here’s a checklist of five things to consider.

    • Are they actually located in Spokane?
    • Are they Connected to the Community of Spokane? 
    • Do they Help You to Understand Your Social Security Claim?
    • Are they an Expert 
    • Are they Approachable?

 

Are they actually located in Spokane?

 

These are perfectly legitimate question to ask any lawyer your considering working with.  Where are you located?  Can I visit you if I have questions?  Can we schedule a time to discuss my case?

It may surprise you to discover that some law firms that advertise in the Spokane area are not from Spokane at all.  In fact, they only rent an office space, just to have a local address.  Shocking, but we covered these types of misdirection in another article, here.

 

Are they Connected to the Community of Spokane? 

 

One of the biggest benefits to working with a local Social Security lawyer is that you benefit from the connections they’ve made in their work.  It’s very common that someone seeking the help of a Social Security lawyer has other support needs that are a natural handoff to someone who has a robust local network.  An excellent local law firm will have a list of, or at least referrals to, other excellent firms and resources available at request.

 

Do they Help You to Understand Your Social Security Claim?

 

It’s very important that you consider the commitment a local law firm places in helping you to understand your Social Security claim.  The process of appealing SSI & SSDI denials can be confusing, and it can be frustrating.  A great blog & newsletter might seem small when you’re first looking into representation, but these will be the first places you look when you want to know more about something like a reconsideration denial.

In a not so subtle way, a firm that commits to educating their clients is a firm that will be committed to bringing them along every step of the way.  So…take a look at that blog & newsletter.  See if it helps you understand your situation?  Does the firm demonstrate awareness, understanding and expertise in the way they break down the things you don’t know?

 

Are they an Expert & Are they Approachable?

 

Ok, this is a two-part criteria, but you’re aiming to find someone that is both of these at once.  An expert that is unapproachable is not going to help you understand your claim.  And an approachable novice is a novice nonetheless.

They say there’s no substitute for experience, and it takes time, commitment, and success to gain that experience.

As for approachability, take a look at the videos on the lawyer’s website.  Look at their social media pages, and check out the reviews.  You’ll get a “gut” sense pretty quickly about whether that lawyer is someone you can relate to, trust, and share your story with.

 

How Lilac City Law Stacks Up to this Criteria

Now that you’ve seen our list, take a deeper look at our firm.

 

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How to Choose a Social Security Lawyer

How to Pick a Social Security Lawyer

If you’re in the process of applying for Social Security Disability, or if you’ve already applied and are looking to get a bit more help for an appeal – then the following criteria can help you select the best Social Security lawyer for your case.  

Work With Someone That Makes You Comfortable

The first and maybe most important factor in picking a Social Security Lawyer is overcoming the initial fear factor of reaching out for help.

Let’s be honest, most of the time the first person called is the attorney with the commercial on TV or that website that shows up on the top of Google.  However, as we’ve learned in our firm, a lot of clients gravitate towards representatives that can understand them.  For instance, if you’re seeking to claim PTSD and already apprehensive about reaching out for help, getting someone on the other end of the phone that has an imposing persona very easily could lead to trouble at many points during the claims process.

A Social Security claim or appeal can be complex, it’s very important that you have confidence in your lawyer, but also that you have the impression that you can communicate with them or their office without worrying about how they might view, judge, or aggravate your impairments.

Be careful to choose a lawyer that doesn’t intimidate you in any way.  You’re going through a tough enough process, keep the barriers to your relationship low, and the trust factor high.

How Much Can You Trust Your Disability Attorney?

The things that generate trust vary widely from one person to the next.  However, there are some basic principals that everyone can rely upon when determining if a given Social Security Lawyer is trustworthy.

Ratings & Reviews

Avvo is a great tool for getting straight-forward ratings and reviews of attorneys.  They have a proprietary ratings system and review system that they claim can’t be gamed.  This is very important, and as you can imagine, review and rating stuffing is common and sadly something that erodes confidence in any rating system.  

In addition to Avvo, Google provides a great system for getting reviews of all sorts of lawyers, including disability lawyers.  If you do a search for disability lawyers near you, or for a specific disability lawyer, you will likely see their Google ratings & reviews pop-up next to their listing.  This is a bit more crowd-sourced than Avvo but is a very valuable tool for both selecting a great disability lawyer, and for reviewing them after you’ve worked with them.  Here is an example of ratings and reviews using Google.

Videos

The internet has been around for a while at this point.  As have digital cameras.  The old saying “a picture is worth a thousand words” is just as true today as when it was coined.  In fact, it might even be truer today than ever.  Consider how a picture helps to establish rapport and trust.

You want a disability lawyer that shows you they know what they’re doing.   They are respectable and respected.  And they will be the best champion for your fight, right?  That’s why every attorney, doctor, consultant, author, etc. has a professional picture of themselves somewhere on their website.  But one of the biggest problems is that pictures can (and are) staged.  However, an authentic video is much harder to fake.

Check out the prospective disability attorney’s Facebook and YouTube channels.  First off, do they even have social media at all?  And on those channels, see if they have videos sharing insights, talking to clients, answering questions.  Sometimes these videos will also be on the lawyer’s website or blog as well.

Watching how the lawyer answers questions will give you a lot more than a picture – at least in helping you to build an idea of who they are and how they communicate.

Ask yourself, “is this someone that can communicate my challenges, is this someone I can communicate my challenges to?”

A short video will usually give you an enormous amount of insight into answering those questions.

Blogs

When seeking insight into a disability lawyer’s persona don’t forget to look at the extras on their website.  Blogs, especially, will tell you how committed they are to sharing information with you.

Is their website a bunch of short questions with hooks at the end of each one?  If so, how does that help you, as a potential client, to understand the processes involved in your claim?  Alternatively, do they have a wealth of information about all aspects of your claim, and questions you hadn’t even thought to ask yet in their blog or newsletter?  Six months from now when you’re wondering what your chances are of succeeding, this might be exactly what you need to keep your spirits high.

A blog may not be what you initially thought of when thinking, “how do I pick a Social Security lawyer,” but now that you’re in the search, take a look around and see who’s keeping their clients and future clients informed and who’s just fishing for the next client.

Capacity: Can Your Disability Attorney Make Time For You? 

Would you rather be a big fish in a small pond or a small fish in a big pond?  Think about this for a moment.. this is something that can help you to identify what type of disability lawyer or disability law firm to work with.

One might argue that a huge firm with many thousands of cases is big because they are good.  They certainly have the advertising budget to portray that success. However, the continued existence of many hundreds, or even thousands, of community disability lawyers fly in the face of that sentiment.  At the end of the day, you can deal with one bureaucracy (huge firm) to fight another one (SSA), or you can work with a personalized firm who remembers your name when you call.

It comes back to that question, big fish or small fish?  The small fish sometimes has a hard time being heard.

Is Your Disability Firm Responsive to Your Questions?

In response to the big fish/small fish question, you do, at some, point want to consider how responsive your disability lawyer will be to your unique needs.  Hint, they have to recognize that you indeed do have unique needs in the first place.

Like a Dr. Office, it’s probably not reasonable that the attorney can stop immediately talking to one patient (client) to take a call from another.  That’s why staff and client liaisons exist.  However, it is reasonable and should be necessary, to have an attorney that is available to talk, within a reasonable amount of time.

Can you call the firm and get a response from the attorney in a reasonable amount of time?  Can you schedule a time to actually come into the firm and talk to the lawyer that’s representing you?  Not everyone can…

Being able to communicate, even briefly, is something you’re going to want to do as a disability hearing approaches.

You Should Seek Out Someone That Will Help You During The Challenge of Your Disability Claim

During the course of your claim (or appeal), there will be curveballs thrown your way.  Whether those curveballs originate from within the claim itself or they happen to come from directions yet unseen, you want someone on your side that “knows someone.”

One of the best things about working with an experienced and established disability lawyer is that you’re also working with their network.  A good lawyer doesn’t gain experience by being an island unto themselves.  They often work with partners in similar fiends to increase the effectiveness of their own services.

To you, the client or future client, this means – that when that curveball arrives you can ask for referrals, assistance, resource information, and things like this.  Or rather, you should be able to.  Unfortunately, this also relies on the idea that your disability lawyer is local, which as we know from previous discussions, is just not always the case.

Highlighting our Ultimate Disability Guide

Lilac City Law is a different kind of law firm.  We are focused on great service and support for you if you are disabled.  And more recently we started focusing on making sure your family is taken care of.   Whether your needs are disability advice, family wealth planning, or something else, you need information.

This last point is why we are thrilled to be able to write this blog.  It is our way of highlighting important information about all our services.  We get to share with you what we know, and what we feel you should too.  One of the tools we created to help you in navigating disability services is The Ultimate Disability Guide.  What’s that?  The Ultimate Disability Guide is 10 insider tips, shared with you for free, to help you maximize your Social Security Disability or SSI Application.

Our Ultimate Disability Guide covers 10 very important topics that you might surprise you.  And yet it is designed to be quick to understand.  In five minutes, you can begin putting into place your plan for applying for SSI or SSDI.  And if you need help, you can know when is the best time to start looking for disability lawyer representation.

Whether you want to know about the biggest pitfalls to avoid or the best ways to keep your disability claim moving, The Ultimate Disability Guide is a great first step.

We’d like to highlight other great resources in the Lilac City Law blog.  Please send us any thoughts you have in the comments below.  In the meantime, here’s a great video about The Ultimate Disability Guide.


Preview the Ultimate Disability Guide

 


 

Lilac City Law advocates on behalf of the disabled in their claims for Social Security Disability and SSI

Take advantage of our FREE 30-minute consultation! 

 

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