Every Tuesday, Social Security Attorney Taylor Potts will expose some of the more frequent myths surrounding Social Security Benefits. Be sure to “like” our Facebook page and stop back each week as Attorney Potts takes you through The Twilight Zone – Social Security Style. If you have questions about Social Security Disability or VA Disability benefits, contact Attorney Taylor Potts at (304) 845-9750.
Myth #1: No One Wins On Their Initial Application
You are about to enter a land beyond what many of us know. A land that could almost be considered a different dimension. A dimension of medical records, vocational classifications, administrative law judges, and functional limitations. Strap yourself in and get ready as we enter the twilight zone of Social Security Disability benefits.
WARNING! PROCEED WITH CAUTION
Social Security Disability can be a strange and confusing land, but allow me to be your guide as we (hopefully) shed some of this mystery and bring it back into the realm of reality. In this series, we will take some of the most common (12 to be exact) misunderstandings, or myths, about Social Security Disability Insurance and Supplemental Security Income and help explain why these myths are not necessarily true and why the myths became so pervasive.
SAY IT ISN’T TRUE…
One of the most pervasive myths surrounding Social Security Disability benefits is that it is impossible to obtain benefits on your initial application. It is true that the majority of initial applications are denied. While the rate varies year to year, decade to decade, benefit type to benefit type, and even State to State, overall, Social Security denies between 70-80% of initial applications consistently. Not a great percentage, but by no means impossible. So why does it seem so difficult to obtain benefits at this stage? The key lies in two things: 1) how the Social Security Administration handles initial applications and 2) the different ways the Social Security Administration finds individuals disabled.
INITIAL APPLICATION PROCESS…this can be tricky
At the initial level, Social Security obtains information from your application regarding your health issues and medical treatment. While Social Security will use this information to obtain medical records from your healthcare providers, it is ultimately the applicant’s (your) duty to provide proof of disability. That means if you forget to provide information regarding a medical provider to Social Security, or they are missing information they need, Social Security will not and are under no obligation to search for the information. If this is the case, SS will make their decision regarding your disability based solely on the incomplete information they have, which oftentimes leads to a denial of benefits. This is a big problem that I often see in initial applications, many are incomplete and missing vital information that should be included to help you with your disability claim.
It is also important to note that the consideration at the initial level is not as thorough as it may be later in the process. This is not to say the individuals making these considerations are not doing a good job. They are only working with the information that is available to them through the initial application. Initial reviewers do not have the benefit of certain types of evidence or information, such as a vocation expert’s opinions regarding past work or other available work. All of this leads to a decision based on more surface level considerations compared to other levels in the disability claims process.
HOW DISABILITY IS DETERMINED
While it simplifies things to a degree, there are three ways in which the Social Security Administration can and will find someone disabled.
The first is by finding the individual meets a listing criteria. There are numerous listing criteria that create a per se disability. If the individual has an accepted diagnosis, and medical records supporting the required issues stemming from that diagnosed condition, they are disabled regardless of any other factors. Essentially, if the reviewer can go down the list and place a check mark in all the boxes, you will be awarded benefits. The problem is, listing standards are difficult to meet and prove. Thus, most people filing for disability benefits, and even many who are later approved, are not approved based on listing criteria.
The second way individuals are found to be disabled is through Social Security’s gridding system. The Social Security Administration combines your age, your residual functional capacity to perform physical work, your education, and your skills to determine if you are disabled. It is a more complex consideration that requires decisions regarding availability of your past work, any transferable skills between types of work, and all the limitations that you may have given your medical condition(s). Thus, if you fall into the right “grid” you are found disabled as a matter of law.
Finally, an individual can be determined to be disabled by Social Security standards because they have other limitations that make them not acceptable for employment (such as needing too much time off, etc.).
PUTTING IT ALL TOGETHER
When you look at all of this together you see why initial applications often feel like they are impossible to win. It is difficult to provide all the necessary information to Social Security or to even know what information Social Security has available at the initial application stage. Further, the denial may not actually mean you are not disabled. It may simply mean that the reviewers did not delve deep enough into determinations about your limitations or have the evidence necessary to make certain types of decisions regarding your claim.
DON’T GIVE UP! WE CAN HELP
Don’t Give Up! The important thing to remember is that a denial on your initial application is not the end of the line for your disability benefits claim. It also does not mean your disability benefits claim is not a good one. What it does mean is that you may need assistance in pursuing your disability benefits claim. At Gold, Khourey & Turak, it is our business to assist you with all of these things and more. If you have been denied for Social Security Disability Insurance or Supplemental Security Income benefits, DO NOT WAIT, contact us now at (304) 845-9750 for a free consultation. We can provide the assistance you need and help you obtain the benefits you deserve.