MOST DISABILITY CLAIMS DENIED ON FIRST TRY: WHAT YOU CAN DO

In Alabama there are 3 stages in the life of a Social Security disability claim:

Stage 1:  You File an Application.  The denial rate here is nearly 70 percent.   Most people will receive a rather mechanical denial.

Stage 2:  You file an appeal and attend a hearing with an Administrative Law Judge (ALJ).  The odds here are much better, depending on a variety of factors, including which judge holds your hearing.

Stage 3:  An appeal to the Appeals Council (AC) - only if the ALJ denied your case in Step 2.  The odds here are also rather poor.

Why are most claims denied at the Application level?  There are several reasons, in general:
(1)  Nobody ever sees you at the application level.  It is a paper only review of your claim.  No one lays eyes on you.
(2)  The process is mechanical.  If all the boxes don't check, the easiest thing is to deny the claim.
(3) Incomplete applications:  Most claimants do not complete all their forms correctly.  Sometimes, all the medical evidence is not obtained.  
(4)  Mistakes are made by your case handler.  They nearly always assign you are higher Residual Functional Capacity than you can actually perform.  For example, Social Security finds that you can work at the Light exertion level when in reality you are limited to sedentary or below sedentary. 

DENIED?  WHAT CAN YOU DO?  The legal process for fixing denied claims is the appeal.  File an appeal within 60 days of the denial letter.  Your case will not be settled within 60 days but you cannot file an appeal after 60 days pass.

WHAT WILL HAPPEN WHEN YOU APPEAL?  You will get in line for a hearing before an Administrative Law Judge, who will listen to your testimony, review all the medical and vocational evidence and render a totally new decision.  If your benefits are ever going to be approved, the odds are they will be approved at the hearing, not before.

MUST I HAVE REPRESENTATION FOR MY HEARING?  Representation is not required but it is very important if you want to win.  I do not recommend risking your financial future on a hearing where everyone present is a professional except yourself.  Very bad odds.

A representative will not charge you a fee unless the appeal decision is in your favor and you are paid back pay.  Otherwise, representation is absolutely free according to Social Security law.

SOCIAL SECURITY JUSTICE: OUR WEBSITE 

 
 PH (256) 799-0297
 

DESCRIBING YOUR ACTIVITIES OF DAILY LIVING

When you apply for disability, Social Security will send you a "Function Report" in the mail to complete and return.  This form will ask about your activities of daily living (ADL):  cooking, shopping, housework, hobbies, bathing, dressing, caring for pets, etc.

Since you aren't working, and probably have not worked in a year or two, Social Security needs to know what you can and can't do.  It make sense to ask about things you do around your house every day.

If your daily activities seem very normal and unrestricted, Social Security may determine that you could perform some simple repetitive job.  If so, they would deny benefits.

When filling out the Function Report, try to be as specific as you can.  Avoid very general terms like "once in a while, not very often, or just a little bit."  Try to use more specific terms like minutes, hours, feet, yard, pounds, etc.

For example:  How often do you shop and what do you shop for?  A poor answer would be, "Not very often. I just shop for things I need."  A better answer:  "I go to the grocery store and pharmacy once a week and buy food and medicines that I need for the next week."

Leaving answers blank on the form is not a good idea.  Try to answer every question.

Do decision makers really read these forms?  I think so. Certainly, forms aren't the only piece of evidence used to make a decision but they should not be ignored or taken lightly.
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THE FORSYTHE FIRM
Social Security Disability Counselors
PHONE (256) 799-0297