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How to Win a Social Security Disability Case –That’s the Challenge

Jeff Freedom Disability Advocate

 

I am an attorney at Freedom Disability. I know from my experience that every case I work on has a different set of unique circumstances influencing its outcome.  This is true of a new or an appealed case waiting for a hearing. Here are a few examples:

Case One – Presumptive Disability Case Forced to Wait for a Decision

I had an initial case that I knew would be approved for Social Security disability insurance (SSDI).  So did SSA. And yet, my claimant had to wait longer than I ever would have expected for a final decision. 

He qualified for Supplemental Security Income (SSI) because of his low income and resources and he was deemed presumptively disabled because he has a severe condition of the eyes that causes temporary blindness. (A presumptive disability is one that clearly meets SSA’s strict definition of disability.) My claimant had to undergo a series of laser treatments over several months.

After each of his treatments I would fax his updated medical documents to his state’s Disability Determination Services (DDS) office and then try to convince them that history showed no improvement. There was no need to hold off on the decision.  

However, SSA policy required that all medical procedures had to be completed. After that, they had to wait a mandatory three months before assessing the outcome. Then they could render a formal approval on the SSDI portion of his claim. DDS would not make an exception. It was very frustrating.  There was nothing I could do to push his claim through faster.

Outcome:  Case One Takes Twice as Long to Get Approved

The state DDS office remained strict with their bureaucratic rules even though they knew that this claimant would be approved. I am happy to say that he finally did get his SSDI award.  It just took twice as long.

Case Two – State Hearing Office Considers Late Filing and Financial Hardship

I had another case for a woman who had applied on her own but was denied at the initial level and at the reconsideration level of her appeal. She had already been trying to get disability benefits for a year. She wanted to take her case to the hearing level but she had filed her request several days past the 60-day mark and missed her right to continue her appeal. (SSA allows 60 days to appeal a denied decision.) That’s when she came to Freedom Disability for help.

She was also getting evicted from where she lived because she couldn’t pay her rent or utilities. Unfortunately, financial hardship is a common story, as well as waiting a year or more for a hearing. Sometimes a state hearing office will move a case up because of severe financial circumstances. However, SSA is very selective. They need real proof.  And I had to convince them to excuse her late filing to avoid starting over with a new claim.

Outcome: Hearing Office Excuses Late Filing and Moves the Case Up

 The judge I spoke with at my claimant’s state hearing office agreed to excuse my claimant’s mistake in filing past the 60-day grace period.  He also had the hearing office move the case up from 12 months to three months. This was because I was able to work with the claimant to get legal documentation that sufficiently proved her financial hardship. Again, the final decision will be up to the hearing judge assigned to her case.

Case Three – Doctor’s Answers Support Claimant’s Disability

A key component to every disability case is getting strong supportive evidence from the claimant’s doctors. I want to be sure that I get good information back about my claimant’s functionality because I must prove how the disability limits daily activities and the ability to work. I always put together a series of questions for the doctors to answer that are specific to my claimant’s medical condition. Some doctors can be less cooperative than others. For this particular case, my claimant’s doctor took the time to provide very detailed answers to my questions.

Outcome:  Claimant Gets a Hearing Bench Decision

A well-documented hearing brief that included detailed answers from the claimant’s doctor convinced the judge. She had no further questions to ask the claimant. A bench decision was rendered within five minutes.

No Case is Like Another

As these examples show, no one case is like another.  Case One’s DDS office was very strict about following SSA rules which delayed the decision. Case Two’s state hearing office had a more lenient attitude that worked in Case Two’s favor. If we didn’t get strong medical support from Case Three’s doctor, the judge may have taken a longer time to decide the case.

There are all sorts of factors that can influence the outcome of a disability case. That’s the challenge.


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How to Win a Social Security Disability Case –That’s the Challenge

 

I am an attorney at Freedom Disability. I know from my experience that every case I work on has a different set of unique circumstances influencing its outcome.  This is true of a new or an appealed case waiting for a hearing. Here are a few examples:

Case One – Presumptive Disability Case Forced to Wait for a Decision

I had an initial case that I knew would be approved for Social Security disability insurance (SSDI).  So did SSA. And yet, my claimant had to wait longer than I ever would have expected for a final decision. 

He qualified for Supplemental Security Income (SSI) because of his low income and resources and he was deemed presumptively disabled because he has a severe condition of the eyes that causes temporary blindness. (A presumptive disability is one that clearly meets SSA’s strict definition of disability.) My claimant had to undergo a series of laser treatments over several months.

After each of his treatments I would fax his updated medical documents to his state’s Disability Determination Services (DDS) office and then try to convince them that history showed no improvement. There was no need to hold off on the decision.  

However, SSA policy required that all medical procedures had to be completed. After that, they had to wait a mandatory three months before assessing the outcome. Then they could render a formal approval on the SSDI portion of his claim. DDS would not make an exception. It was very frustrating.  There was nothing I could do to push his claim through faster.

Outcome:  Case One Takes Twice as Long to Get Approved

The state DDS office remained strict with their bureaucratic rules even though they knew that this claimant would be approved. I am happy to say that he finally did get his SSDI award.  It just took twice as long.

Case Two – State Hearing Office Considers Late Filing and Financial Hardship

I had another case for a woman who had applied on her own but was denied at the initial level and at the reconsideration level of her appeal. She had already been trying to get disability benefits for a year. She wanted to take her case to the hearing level but she had filed her request several days past the 60-day mark and missed her right to continue her appeal. (SSA allows 60 days to appeal a denied decision.) That’s when she came to Freedom Disability for help.

She was also getting evicted from where she lived because she couldn’t pay her rent or utilities. Unfortunately, financial hardship is a common story, as well as waiting a year or more for a hearing. Sometimes a state hearing office will move a case up because of severe financial circumstances. However, SSA is very selective. They need real proof.  And I had to convince them to excuse her late filing to avoid starting over with a new claim.

Outcome: Hearing Office Excuses Late Filing and Moves the Case Up

 The judge I spoke with at my claimant’s state hearing office agreed to excuse my claimant’s mistake in filing past the 60-day grace period.  He also had the hearing office move the case up from 12 months to three months. This was because I was able to work with the claimant to get legal documentation that sufficiently proved her financial hardship. Again, the final decision will be up to the hearing judge assigned to her case.

Case Three – Doctor’s Answers Support Claimant’s Disability

A key component to every disability case is getting strong supportive evidence from the claimant’s doctors. I want to be sure that I get good information back about my claimant’s functionality because I must prove how the disability limits daily activities and the ability to work. I always put together a series of questions for the doctors to answer that are specific to my claimant’s medical condition. Some doctors can be less cooperative than others. For this particular case, my claimant’s doctor took the time to provide very detailed answers to my questions.

Outcome:  Claimant Gets a Hearing Bench Decision

A well-documented hearing brief that included detailed answers from the claimant’s doctor convinced the judge. She had no further questions to ask the claimant. A bench decision was rendered within five minutes.

No Case is Like Another

As these examples show, no one case is like another.  Case One’s DDS office was very strict about following SSA rules which delayed the decision. Case Two’s state hearing office had a more lenient attitude that worked in Case Two’s favor. If we didn’t get strong medical support from Case Three’s doctor, the judge may have taken a longer time to decide the case.

There are all sorts of factors that can influence the outcome of a disability case. That’s the challenge.