Social Security Disability and SSI benefits: Before You File Your Claim
I promised that my next article in this series was going to be filing the claim, but I afterwards I realized I first needed to discuss the things you need to do before you file the claim.
The most important thing you can do before you file your claim is talk with your doctor and see if he or she supports your claim for benefits. Sometimes doctors don’t really understand the standard for Social Security benefits. Many doctors think that if you could work part time that you’re not disabled. That is not the standard. You have to be able to work full time without special accommodations in order to not be considered disabled. Tell your doctor that all you expect of him or her is the truth but that you hope he or she will put that truth into narrative form for SSA to read. If pain is an issue for you, your doctor needs to understand that pain that interferes with the ability to think, concentrate, or remember it is disabling. Fatigue is rated the same way.
Frequently doctors really want to help their patient, so they write a narrative report that says something like, “this individual is 100% totally disabled.” Now, the Social Security Administration should award this person benefits, right? WRONG! What SSA is looking for is proof of your limitations. Just because your doctor says you are disabled doesn’t mean you’re really are disabled because there is no proof that your doctor knows what it means to be disabled. What the Social Security Administration wants to see is how long can you sit and stand, how far can you walk, can you reach, bend, kneel, or squat, can you use foot controls, do you have problems with environmental hazards, are temperature changes a problem, do you have difficulty with fine motor skills, do you have a vision impairment, do you have any driving limitations, and so on. If you have any mental disabilities, what SSA is interested in are whether your problems affect your activities in daily living, affect your social functioning, affect your ability to think, concentrate, and remember, and have they caused you to have any decompensation or deterioration in a work or work like setting.
Pain and fatigue have already been discussed. Your physician can only discuss these problems to a certain level; then it will be up to you to convince SSA or the ALJ, that is, the Administrative Law Judge.
Frequently the Social Security Administration will send out a form for you to take to your doctor for completion. Do not merely drop this form off and just assume it was processed and sent out of the office. No, follow up with it. Sometimes the doctor’s office will require payment before they will complete the forms. The bigger the office, the more likely this will be the case. I always used to tell my clients to take the forms with them on their appointment and to ask the doctor if he’d mind filling them out then so they can take them back with them. Some of the larger officers have policies against doing this because they want the money they can get from charging the patient. On the other hand, some doctors will break the rules for you if that doctor knows you’re struggling financially.
So let’s say you’ve talked with your doctor and he or she knows SSA will be contacting him or her for information. It is okay if you already have your doctor’s opinion written down on paper and submit it when you file your claim. In fact, if you can get it from your doctor, do it! Submit everything you can get your hands on from a copy of your application for a handicap parking placard to your high school transcripts showing you didn’t go past the 10th grade because of a learning disability. Don’t expect SSA to hunt all of this stuff down for you. Yes, they’ll make a request for it, but if they don’t get it, well, it’s no skin off their nose. You’re the one who needs the benefits, not them.
On the other hand, what if you talk with your doctor and he says that he doesn’t think you’re disabled? Depending on your situation, you might really be in trouble. SSA may send you to one or more of their doctors for a consultative examination, but those doctors aren’t usually trying to help your case. Furthermore, it is the treating doctor who is considered to be the most important source of information.
Unless you haven’t been seeing this doctor very long or he is a physician you were sent to by Worker’s Comp, this can be extremely problematic for you. First, don’t panic. Remember, there is no proof that this doctor understands the standard for disability unless, of course, he is one of the doctors SSA uses for consultative exams and in that case the reason he man not want to support your case is because he knows what side his bread is buttered on. Do a little research to find out whether that is the case because, if so, you might need to start going to a new doctor. Otherwise, it is usually best to stay with the same doctor. SSA frowns on what they call “doctor shopping”, and your doctor will certainly put in the your records that you asked him about disability.
When I was working I used to frequently receive frantic calls from clients saying that their doctor said they weren’t disabled. Then, when SSA sent the doctor the form to fill out, the doctor filled it out in such a way as to prove the person was disabled. Again, the doctors don’t understand the disability standard.
It is also good to keep in mind that you are more than just an injured back, for example. People often approach Social Security Disability Benefits with the same mentality as Worker’s Compensation. With Worker’s Comp, you usually have one injury. But with Social Security, SSA is required to look at you as a whole person with everything that is right and wrong with you. SSA will be considering everything concerning your age, education, work experience, and what is wrong with you in their disability determination. They will be looking not merely at this last injury, but at everything medically and psychologically you have wrong. So this one doctor’s opinion may not mean as much as you think if you are being treated by other doctors who do support your claim.
If you do need to find a new doctor, you will need to delay filing your claim for a while Your new doctor needs to see you a couple of times before he or she can render any opinion as to whether or not you are disabled.
What if you don’t have a doctor or can’t afford one? This is a problem because you must prove that you are disabled. It’s not just that the ALJ takes your word for it. There are less free clinics than ever before, but no matter the incontinence, no matter how little the doctor actually helps you, it is very important that you start seeing whatever doctor is available at your local health department or other free clinic. The ALJ usually won’t punish you for not receiving proper medical care so long as you have made all reasonable attempts to obtain medical care.
One other place where you can obtain good evidence is from your former employer. If you were forced to quit your job because you could no longer keep up with the work, or because you needed frequently breaks, or for any reason that was obvious to your supervisor, then ask your supervisor if he or she would mind putting it down in writing so that you could give it to the Social Security Administration as proof of your disability. Your job in a Social Security claim is to first prove that you can’t do your past relevant work. There is no better way to prove that than to show how you weren’t able to do your last job.
Unfortunately, many employers are afraid to put this type of information down in writing for fear that they’ll be sued. For what I’m not quite sure. I believe they think they’ll be sued for not making special accommodations for you, but that is not the case. In any event, if your employer is willing to put down in writing that you used to, for example, require to lay down at work, or that you had frequent falls at work, or that your level of fatigue or pain was so great that you made numerous mistakes, or that the level of absences you had was unacceptable, then this information will go a long way with SSA.
These are the things you should be doing before you file your claim. You need to know where you stand with your doctor before you even file because you need to know whether you should find a new doctor and see that doctor several times before filing the claim. You should also be getting together your documents such as birth certificate. If possible, obtain a statement from your former employer. Good preparation prior to filing the claim will make things much easier for you later on.