Have you submitted a disability benefits claim and are waiting to hear whether or not it’s been approved? Unfortunately, the odds are stacked against you. Only 23% of Social Security Disability Insurance (SSDI) claims are approved at the initial application stage. Sometimes, even less if you did not use a disability lawyer.
Of course, you can always appeal a denial of disability, but even then, you’re facing an uphill battle. The total number of approvals, whether initially or upon appeal, is only about 34% of all claims filed.
Is there a way to improve your chances of receiving disability benefits? Luckily, the answer is yes. You can hire a disability lawyer to help you navigate this complex process.
A Successful Disability Lawyer Has Medical Knowledge
Social Security Disability Insurance (SSDI) cases are particularly tricky because they require an in-depth understanding of medical conditions that can interfere with a person’s ability to perform their job duties. Therefore, the lawyer that you choose must be experienced in the specialty of disability law.
You are most likely not going to get the results you are looking for if you hire your tax lawyer to tackle your disability case. Look for a law firm whose lawyers have experience litigating medical-related cases. Ask them how many disability cases they have handled and if they have dealt with your particular disability before.
A Successful Disability Lawyer Understands the Law
This statement should go without saying, but the complexity of disability cases means that a lawyer must know the Social Security system’s requirements inside and out.
In all disability situations, your lawyer will be seeking to demonstrate one, or all, of the following:
your medical condition meets the criteria of a condition that is among those described by the Social Security Administration (aka a “disability listing“)
you cannot perform your previous work in accordance with Social Security’s “grid” system, which classifies exertion associated with job duties
you cannot work even a sedentary position
you have limitations that aren’t covered by the grid but impact your ability to perform a job
An Experienced Disability Lawyer Will Be Choosy About Cases
Lawyers who specialize in disability claim appeals cannot charge clients an upfront fee or retainer.
Instead, they receive compensation on contingency. Once your appeal has been approved, and you have been awarded a sum of back pay from the Social Security Administration, your lawyer’s feeswill be deducted.
Not having to pay any amount upfront is a massive bonus for clients who may already be struggling financially due to their disability. It means you can afford excellent representation – and you can be awarded your disability benefits even within our challenging disability system!
It also means that if a lawyer takes on your case, they are also taking on the risk of not achieving a favorable outcome. It is in everyone’s interest to work hard for you.
A Great Disability Advocate in Lilac City Law
Our disability team has the know-how and expertise to help you fight and win your disability appeal. For a free, no-obligation consultation, contact us today.
In order to win your appeal for Social Security disability, you must prove that your limitations from injury or illness prevent you from not only doing your recent job but any job that is also less demanding but within your ability to do.
This is difficult, especially for younger people. Social Security believes that younger claimants can adjust to sit down jobs even if they have an impairment.
However, if you can prove that you can do less than sedentary work, you will have a great shot at winning your appeal for Social Security disability.
Sedentary Work As an Alternative to Social Security Disability
Generally speaking, the following are going to be strong indicators that you can perform sedentary work:
You can lift more than ten pounds
You can stand or walk for more than a total of 2 hours combined
You can sit for 6 hours out of an 8 hour work day
If you can do a minimum of these three tasks on a daily basis, the Social Security Administration is going to be seeking to understand why you are unable to work, even at a reduced rate. You should start making note of your specific limitations and how they might help you counter these questions.
Limitations That Might Prevent you to Perform Sedentary Work
Physical exertional limitations
Inability to do any of the above mentioned skills
Need the use of medical devices to help walk
Need to have leg elevated
Unable to use an arm due to amputation above the elbow
Needing to alternate sitting and standing
Need to rest or lie down
Cannot stoop or bend
Reduced ability to use hands and fingers
Need to take frequent sick days
Cannot balance (even on smooth surfaces)
Cannot work in noise
Cognitive or Behavioral Health limitations that can affect the ability to do Sedentary work
Inability to focus and concentrate due to a prescribed pain medication
Cannot get along with others or cannot respond appropriately to authority
In your disability appeal, the SSA will consult with a vocational expert (VE). A vocational expert knows about job availability and the skills need to perform those jobs. The VE will most likely be able to find jobs that you can still do, regardless of your condition; however, a seasoned and effective Social Security Disability Attorney will be able to push back and give you a stronger chance for overcoming the appeal than if you decide to do it yourself.
Talk To An Experienced Social Security Disability Attorney Today!
Four Examples of Sedentary Work
You are a 36-year-old who was a machinist for the past fifteen years. You were in a car accident that caused a severe back injury, and you are unable to perform your job. You can no longer lift more than 10 pounds. When you applied for Social Security, you were denied because they said that you could perform sedentary work. The vocational expert says that you can work as an administrative assistant. However, this does not apply to you because you need to change sitting and standing positions every hour or you are in excruciating pain.
You are a 52-year-old who was a teacher for the past 30 years. You fell down the stairs and broke your leg in multiple places. You had to have surgery and now need to take pain medication on a regular basis to function. You can no longer stand long enough to teach, so you are unable to work anymore. When you applied to Social Security for disability, you were denied due to your ability to perform sedentary work. Your pain medications, however, cause you to be unable to focus or concentrate and complete a task in a timely manner.
You are a 62-year-old woodworker. You have been building cabinets since you were in your early twenties. You have no formal education, only a high school diploma. You broke your back in an ATV accident when you were in your forties. This caused lymphatic damage which turned into lymphodema causing your legs to swell and have poor circulation. If you bump your leg, it breaks open easily and gets infected, so you can no longer work around wood and tools that can cause injury. You also have a very difficult standing and lifting. You applied for Social Security disability but were denied. You were deemed able to perform sedentary work. However, the medication that you are taking causes you to become dizzy and at times almost pass out. You cannot bend without almost falling because you cannot balance.
You are a 45-year-old, and you were a concrete worker. You hurt your back and can’t work anymore. You help out your wife at your home business by filing documents, answering calls, and responding to emails. You apply for Social Security and get denied. Even though you do not get paid, Social Security determines that if you were getting paid you would make SGA and you are capable of performing sedentary work. However, you use a script when answering the phone because your head is fuzzy from medications. You also only work about two hours during the day because you need to lie down and take a break because your back hurts so much.
In all four examples, you were told that you were able to perform sedentary work, but again in all four examples, sedentary work did not necessarily apply to you. In these cases, and similar situations, you want to contact a disability attorney asap to help you prove that you are unable to perform sedentary work.
Social Security Disability benefits are predicated on whether or not you can perform Substantially Gainful Activity (SGA), so it makes sense that a disability blog should define that a bit better and provide examples.
Defining Substantially Gainful Activity (SGA)
Social Security bases their definition of disability on your ability to work (or perform tasks like working) that do or could, earn you more than the current monthly income threshold. If you make more than that threshold, you are not seen as warranting disability compensation benefits by the Social Security Administration. You can appeal these determinations.
This can be a bit of a tricky calculation, but here are the basics. If a wage or earnings are not made, the work is not gainful. However, if you do perform some form of activity for pay, then it is considered gainful as long as the expense of doing so is less than the income you receive.
Social Security Administration Definition of Gainful Activity
Work performed for pay or profit; or
Work of a nature generally performed for pay or profit; or
Work intended for profit, whether or not a profit is realized
It is possible you can perform activities that you might do on a regular basis that would require significant physical or mental abilities. These activities could be the basis for employment, as such the value of the activities could potentially factor into the income calculations of an SSI claim.
Example: HR Professional in Spokane
Jane has been an HR professional in Spokane for 20 years. Over the last 5 years, she’s had to reduce her hours significantly due to complications from diabetes. She’s now working about 10 hours per week, earning $15 per hour.
Wage Earnings: $150/week ($600/month)
Jane is unable to work more than this due to increasingly impactful complications. Her employer has made accommodations, including flexible scheduling, work from home, and other allowances. But due to her disabling condition(s) Jane is unable to increase her gainful activity.
The value of Jane’s gainful activity is $600 / month (minus certain expenses). Jane would be eligible for disability due to her inability to meet the SGA monthly income threshold, and her inability to perform supplementary and/or alternatives tasks that would otherwise be substantially gainful.
Example: Car Sales Professional in Spokane Valley
Alan is a car salesman in Spokane Valley. He had a heart attack 3 years ago and has only been able to work part-time since then. He makes about $500 per month working part-time sales.
Wage Earnings: $500/month
When Alan is not working at the car lot, he helps his sister with her home business by answering phones, filing papers, and responding to emails. He does this about 2 hours a day or so.
Non Earning Activity (2 hrs/day) = 40hrs/month
Although the activity Alan performs for his sister’s business is not paid, it is substantial activity that could potentially fetch a wage in the economy.
The Social Security Administration determined that in addition to the $500/month Alan was earning at the car lot, the value of his work demonstrated substantially gainful activity and thus he was not entitled to the disability benefits he sought.
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.
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 actuallylocated nearby.
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.
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.
Trust w/ Your Social Security Lawyer
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.
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.
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.
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.
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.
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.
If you have applied for SSI or SSDI, you probably know that for many, getting approved on your first shot is a challenge.
Getting approved is not an impossible challenge, but the odds can be against you if you did not sufficiently prove your disability, or if you did not demonstrate how you rate social security benefits.
If you now have, or fear that you will have a denial letter in hand, here’s a step-by-step approach to help you in appealing an SSI or SSDI denial.
Step 1: Create a Plan to Appeal Your SSI or SSDI Denial
In a previous article, we covered, briefly, what you can do if you do receive the dreaded denial letter. The first thing you should do is not panic, take a few breaths, and accept that this is not the end of the process. Like most initial applicants, you have been denied. However, the evidence shows that if you stick with the claim, you have a strong chance of eventually overturning the denial in appeal.
Of course, your chances of success at this point are directly related to the quality of your plan and your ability to execute it. Or for many, to find someone who can build a plan for you and carry it out as well. We are talking about a professional advocate or attorney.
Step 2: Retain an Attorney (Optional but Encouraged)
Technically, this step is optional. Also, you can retain an attorney at almost any point during the claim or appeal process. However, a strong case can be made that hiring an attorney early on is the more prudent approach. Regardless, you are reading this article from a post on a law firm’s website, so…
There are some reasons, a lot of reasons actually, that you would want to consider this as an option. First being that this is one form of law that is based entirely on contingency. If a lawyer does not win your case for you, they will not be getting paid. Everyone then, you and the law firm, has a financial incentive, and hopefully a personal one too, to get you the benefits you need.
The second reason, and from a coldly logical perspective, a very powerful reason is that you might go through this process only once in your life. Many of the things that will gum-up the process are avoidable. And the un-avoidable issues can be addressed quickly and efficiently if you know they are likely to arise. Only going through this process once, you have to learn all of this the hard way, or be extremely lucky. Alternatively, a disability attorney goes through these processes a couple of hundred times a year (thousands of times in a career).
You can get pretty good at handling these things throughout several thousand claims. Still, for the die-hard do-it-yourself type, we will go back to the step-by-step. Remember though; you can retain an attorney at almost any point in the process.
Step 3: File for Reconsideration
You can file for reconsideration a couple of ways. One way is to file a Form SSA-561 (Request for Reconsideration). The other is to file online at www.socialsecurity.gov/disability/appeal. The basic instructions for this process will also likely accompany your disability denial letter.
So what is a reconsideration, you ask? It’s an independent review of the original claim by someone who has not been a part of the original decision. Their job is to take a look at the initial evidence submitted (by you or others) and to take into account any new evidence you might have. This last point is something that you want to start investigating at this point too.
Step 4: Get Your Records Together
Whatever the case may be, getting a copy of your records is going to be essential to re-stating, re-phrasing, and correcting your appeal claim. Write down a list of all the doctors, therapists, support groups, or even friends who’ve helped you during the last five years. If you can’t remember the last five years, write down what you can remember.
Sometimes remembering when a meeting or appointment occurred can be hard. Using holidays or key dates as markers to your memory can be very helpful.
For example, if you remember you had a Dr. appointment a couple of years ago but not when thinking about what else you had to adjust to make it happen.
“I remember I had to schedule that Dr. appointment around Thanksgiving because my sister was visiting..” <- The appointment happened sometime before or after Thanksgiving.
It can be hard to remember all this stuff, but if we use something we’re better at remembering to act as a memory anchor, it can help.
Step 5: Start Working on Understanding Why you Were Denied
If it was a lack of understanding, you can start approaching the problem from the perspective that Social Security has all the evidence, they didn’t have the understanding to put it together. Naturally, you’re the one living your life, so in many respects, you’re the only one who knows how your challenges affect your ability to work. Not even your doctor may understand why you can’t pursue gainful activity.
This brings up a very common situation. Although we are all the expert on what we experience, we can’t always describe it or convey it very well. Sometimes, we lack the speaking or writing ability to describe adequately the level of impairment we are facing. Consider trying to convey the level of your disability in various ways (recorded conversation, writing it down, pictures, etc.).
The whole point of understanding, in this step, is to put yourself in the place where you can see why your claim was denied. If it was as we just described a lack of understanding on the part of Social Security, you can focus on making it more clear to everyone the challenges you face. If however, your problem was lack of evidence, you can attack that problem in a relatively straightforward approach. Get the evidence, everywhere you can.
Step 6: Request an SSI Appeal Hearing (If Your Reconsideration is Denied)
Let’s assume for the sake of this step-by-step approach that your reconsideration failed to overturn the initial disability denial. At this point, you can (should) request a hearing.
A hearing is your chance to present to an administrative law judge (ALJ) your claim. You can provide witnesses and there may also be professional witnesses present (medical or vocational experts) as well.
After the hearing, you’ll receive a determination from the judge, usually received via US Mail.
Step 7: Study! Find Info to Help You Through this Process
Here are some resources to help you with the process:
The Appeals Process: This is a PDF from Social Security that helps you understand the process of appealing.
MDJunction Forum: This is a forum for general advice and support relating to Social Security Disability and claims advice
Disability Answers WA State: This is a Facebook page built for the community and to facilitate sharing information for those experiencing disabilities.
Lilac City Law Blog: Shameless plug here, but we’re genuinely trying to provide as much information as possible for those working through the disability claims process. And for those that need the help, we ensure that too.
Social Security Disability Resource Center: An incredible, free resource, compiled by a former disability claims examiner. The goal is to inform applicants about the Social Security Disability and SSI claims & appeals process.
Consider, joining a support group on Facebook (you can even join our Facebook page and share your questions & frustrations there). Other things to consider is making sure your close family or friends know what that you’re pursuing this. While this might be something you want to keep to yourself, you very easily could end up needing some moral support during the appeal process. It’s not usually easy.
And, the last point on this, don’t discount the value of a good therapist — someone who can help you to stay confident and centered during the appeal.
Step 9: After the SSI Appeal Hearing
You can keep going; you have the option of asking for a review by the Social Security Appeals Council. At this point, though, some requests are denied. Meaning, you may not be given a review by the Appeals Council. If the Appeals Council denies the review, you’ll receive a letter as to why you remain denied. You can either re-file for disability at this point (yes back to the beginning, sorry) or you can file
If the Appeals Council grants a review, they may review themselves or send it to back to an ALJ (judge) for review.
At this point, if you disagree with an Appeals Council decision, or if they decided not to review the claim, you can file a lawsuit in a federal district court.
This will all be laid out in the decision letters you receive at each stage of the process.
Step 10: Keep At It! Never Give Up on Your SSI or SSDI Appeal
If you have questions about any part of this process or any support during the appeal – let us know. And if you have great tips for others going through an appeal, we want to hear them too!
The surprising thing most people don’t know about “ local ” Social Security disability law firms.
Imagine you want to go to school. You go online, and see there’s a local campus in your city. After some searching you can’t find the hours the campus is open, so you give them a call. They answer quickly and are very friendly. They get your info and send you all your application papers. You fill them out and return them in the pre-stamped envelope provided to you. All is great.
Well it seems great, but now you have a question. You want to know if you can meet with your instructor before class starts. You aren’t sure about the class you’re going to be taking. So you call.
The nice person on the other side of the phone says they’ll have the instructor call you back. But you don’t want a call back, you want to meet with them. You’d like the ability to sit down face to face with them, if possible, before class starts.
It’s only at this point, after much insistence on your part, that you find out from the school that the instructor doesn’t actually live in the area. In fact, the school itself is in another state. All of your work is going to be done remotely, and you might never even talk to the instructor until your final test date. They (the instructor) will fly in a couple hours before your test, answer any questions you have, then give you the test. Don’t worry though, you can always talk to the someone from the school – over the phone, of course..
Maybe this scenario is a little silly, there’s almost no industry where this actually happens. Well “almost” is the key word. Let’s take this story and change a few things around. And in so doing, reveal the secret implied in the title of this article.
The Big Secret..
Instead of a school, let’s say you’re looking for a disability attorney. And instead of an education, let’s say you want to successfully appeal a denial of your disability claim.
In this revised story, you have a disability denial and you called a disability lawyer in Spokane. You signed up to work with them, and when you had a question about your disability claim you called the local office. Only through your insistence to meet with your social security lawyer did you find out they didn’t actually have an office in Spokane. Nor in Idaho, or anywhere in the Inland Empire.
The Spokane Disability Lawyer you found online actually only has a rented space, with a rented receptionist. Guess what? The boss will never be in.
With the exception of an occasional phone call, you’ll have a completely virtual experience with your disability attorney.
At this point you should know that all disability lawyers charge the same amount. It’s set by law. So if cost is thrown out of your decision tree, what would be the big reason for going with an out of state attorney vs one close to home.
We take a lot of pride in being part of this community. As your actual “local” disability attorney we have all the knowledge and experience of the out of town firms with the added benefit of being here for you anytime you have a question.
Give us a call, or stop by and find out why when you work with us, there’s no surprises.
Most people look at military discharges as a two way street. Either your career went one way and you received and Honorable Discharge, or it went another way and you received a Dishonorable Discharge. In reality, there are many different discharge characterizations and each of them entitles you to a slightly different mix of benefits or resources.
It would help to first cover the types of discharges and the reasons you might have received these discharge characterizations. To begin, discharges are broken up into Administrative and Punitive.
An administrative discharge is “run of the mill.” It is a standard discharge that didn’t require any additional actions, other than your fulfillment of your initial service contract requirements. Within the scope of Administrative Discharges are…
An honorable discharge is the most common type of discharge among Veterans. Simply put, a Veteran with an Honorable discharge fulfilled all the terms of their contract in an honorable manner. They showed up, met their physical and mental requirements, and their service record isn’t populated by a lot of misconduct. Service members with an Honorable Discharge are eligible for most/all Veterans benefits through the VA and shouldn’t have restrictions in receiving service connected disability compensation and Social Security disability if they rate either or both.
A General discharge is also known as General Under Honorable Conditions. This is what you would receive if for some reason you were not able to complete the terms of your original service contract. Having to leave service for a hardship, family reasons (pregnancy), inability to serve (but not misconduct or medical), and other similar reasons are the usual backgrounds of those who received this type of discharge. A General discharge qualifies Veterans for most benefits; however, some education benefits can be a challenge with this type of discharge. Most important to what we do at Lilac City Law, you can receive full service connected compensation and Social Security, if you qualify, with a General discharge.
Other than Honorable
Other than Honorable Discharges are also known as OTH’s and General under Other than Honorable Conditions discharges. They may also be referred to as Undesirable discharges. These are tricky in that it can be very dependent upon when someone served as to whether their conduct would have rated an OTH vs a Bad Conduct Discharge. We’ll cover Bad Conduct Discharges in a moment. The reasons a Veteran may have received an OTH always come down to some sort of misconduct. Most often the misconduct was not so severe that it warranted a Court Martial – and thus a punitive discharge. However, it’s common that Veterans will take a ‘plea’ deal in a Court Martial in exchange for an OTH. OTH’s are common for service members with patterns of misconduct: minor assault, substance abuse, domestic violence, attendance, failure to adapt, etc.
If you are a Veteran with an OTH, you might be able to receive service connected compensation for a disabling injury or illness. However, the VA determines that on a case by case basis. And YES you do get a right to appeal their decision if they determine the facts of your situation incorrectly. If you are not entitled to compensation, and your injury is service related, you are still entitled to limited health care for those service connected conditions through the Veterans Health Administration. You may also be entitled to Social Security and disability benefits.
Lilac City Law advocates on behalf of the disabled in their claims for for Social Security Disability and SSI
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Punitive discharges differ from administrative in that the only way to have received a punitive discharge is to have been convicted in a special or general court martial. We won’t go into the weeds on different types of courts martial; however, it is important to remember that a court martial was part of the process for receiving these discharges. As such, they can be understood and viewed as analogous to and through the lens of their civilian counterpart convictions
(misdemeanor = BCD / felony = Dishonorable).
Bad Conduct Discharge
Bad conduct discharges are also known as BCD’s and by various slang terms, e.g. “Big Chicken Dinner.” To receive a BCD a service member must have committed misconduct warranting either a Special or General Court martial.
BCD’s are usually received for misdemeanor type misconduct. Assault, theft, desertion/dereliction, etc.
If a former service member has a BCD from a Special Court Martial they still may receive health care support for a service connected medical condition as long as that medical condition was not the result of the action that warranted the BCD in the first place. Also, the condition can not be the result of something that occurred while being held for the Court Martial or while being AWOL (absent without leave). A former service member with a BCD may still receive Social Security and disability compensation from the SSA if they are eligible for these benefits.
A Dishonorable Discharge is by far the least common type of discharge from military service (less than 1%). It can only be the result of a general court martial, which you can equate to the civilian equivalent of a jury trial. Dishonorable discharges are the result of misconduct that goes beyond the scope of OTH and BCD. Generally speaking, we’re talking about felony type misconduct. Conspiracy, Fraud, Murder, Rape, Espionage, Drug Trafficking, etc.
A former service member with a Dishonorable Discharge is not going to be able to access benefits from the VA or most Veterans benefits programs. However, they may still be eligible for Social Security benefits if they meet certain requirements.
Uncharacterized and other Discharges
There are a number of discharges that don’t fit the scope described here. For instance there are a whole classification of discharges known as uncharacterized because they don’t fit the molds above. These would be fraudulent enlistment, entry level separation, and similar situations. Generally speaking these are case-by-case basis situations and are best covered in consultation with Lilac City Law (contact us here).
Also missed in this discussion are Reserve and National Guard discharges. This will be a distinction we’ll cover in a future article. For now, what you need to remember is that it is also a case by case situation; however, the basics are.. If an injury occurred the Reservist or National Guardsman were on duty, or on their way to or from duty, they may be eligible for service connected benefits.
Hopefully this has been helpful. If you’ve found it to be, please consider sharing this article with someone who could benefit from it.
Lilac City Law advocates on behalf Veterans in appeals for Service Connected Disability Benefits