Belleville, Ill. (Vocus) October 31, 2008
Getting a denial letter after hours of work and months of waiting for Social Security disability benefits leads some people to call it quits, according to Allsup, which represents people nationwide for Social Security Disability Insurance benefits (SSDI).
"People just want to know when they're going to be able to get their money, and getting that denial notice really frustrates and discourages them," said Cindy Ratermann, manager of disability claims specialists at Allsup. "They start to question themselves, and wonder -- if their doctor says they are disabled, why doesn't Social Security say they're disabled?"
SSDI is a federally mandated insurance program overseen by the Social Security Administration (SSA) that provides monthly benefits to individuals who are under full retirement age (65 or older) and who can no longer work because of a disability (injury, illness or condition) that is expected to last for 12 months or is terminal. Individuals must have paid FICA taxes to be eligible. More details are provided in the "SSDI Overview" on Allsup.com.
Ten Common Mistakes After SSDI Denial
There are many reasons why an SSDI application can be denied, but the following are some insights on common mistakes that can worsen the situation for someone who is dealing with the next steps after a denial of benefits.
1. Many applicants give up. Applying for SSDI benefits is not an easy process. It's not as simple as applying for Social Security retirement. In the retirement program, once someone reaches the appropriate age, he or she can file and begin receiving benefits. On the other hand, SSDI is administered under a review process that requires applicants meet certain guidelines.
In addition, more than two-thirds of the 1.5 million people who apply each year are denied at the initial level (first level) of application. But more than two-thirds of claimants who reach the hearing level (third level) are awarded their benefits. "There can be a significant value to having patience and hanging in for the long haul,'' said Ms. Ratermann. ''This means you'll need to appeal."
2. Applicants miss the appeal deadline and re-apply (sometimes several times) at the initial level. ''By doing this, you are literally spinning your wheels,'' Ms. Ratermann said. "If you were not awarded at the first level, it's highly unlikely you would be awarded when applying at the first level again."
3. Applicants decide not to appeal. There can be a couple of factors in this decision, including claimants' fear of pursuing the application after being told they weren't disabled. "If you are not capable of going back to work because of your disability, you really are entitled to this benefit," Ms. Ratermann said. "It's important to realize that this is not a simple application process, and appealing your case is the next required step."
4. Applicants didn't provide enough information and detail on their initial application and make the same mistake on appeal. One example is not providing enough detail about how your disability affects your ability to handle activities of daily living. "Someone might say, 'Yes, I can take a shower.' But they forget to mention that they've installed bars, and a seated chair and also get help from a family member to take that shower," Ms. Ratermann explained.
Another example is not providing enough information about your physicians, including their names, addresses, phone numbers and dates of treatment. ''Disability Determination Services staff do not have that information at their fingertips,'' Ms. Ratermann. "Claimants frequently will forget to tell the DDS examiner about all of their doctors, maybe leaving out a specialist or even their primary care physician. Then those records are not included in the case when it is considered."
5. Applicants waste time fighting the decision or trying to correct information that was provided in the initial application and denial. "Everything that you provided in your original application is there to stay, including the denial decision and letter from the Disability Determination Services," she said. "That decision stands; even if there was an error that nobody caught at the time of review. You've got to file your appeal and use that as the opportunity to clarify the information in your case."
6. Applicants do not provide continuous updates to the DDS about their case. While you are appealing, you should continue to provide information on doctors' visits, hospital visits and medical tests, such as CT scans and MRIs. "You need to make sure the DDS has this information. Don't wait for the next appeal to provide that," Ms. Ratermann said. "Keep in mind, it also can be a difficult and time-consuming process getting this information to DDS. In some cases, you must know who your examiner is, and you may be required to fax the information to the DDS office."
7. Applicants don't keep copies of their applications and records. ''These documents are useful when you make an appeal. And this can be one of the biggest mistakes because documents can get lost,'' Ms. Ratermann said. "After you've spent so much time compiling medical records, contacting doctors' offices and putting on the miles -- it's one of the worst feelings to hear that those documents have been lost."
8. Applicants underestimate the extent of their own disabilities. "A lot of people forget the modifications that they've made to their lives to cope with their disabilities,'' Ms. Ratermann said. ''And because of this, people make another mistake when they appeal -- they say that their condition hasn't changed. It's very unlikely that's true. Something has changed, whether you are experiencing more pain, or you've been in the hospital again or you've undergone additional tests."
9. Applicants don't know they can get representation services at any level of the process. About 90 percent of people whose cases reach the hearing level, or level 3, have a representative for their cases, according to the SSA. What many don't realize is that they could have had a representative even earlier in the application.
"Until they hear the word 'hearing,' they may not think about getting a representative, or realize they can have a representative to help them apply," Ms. Ratermann said. "It's hard to be an expert on Social Security disability when you don't deal with this every day. Many people may be able to avoid the stress of the denial and delay by getting a representative earlier in the process." Allsup provides representation services for claimants at all four levels of the process.
10. Applicants don't weigh the costs of going it alone. There is a fee for using the services of a representative only if your benefits are awarded. It's important to weigh this fee against the other costs for you and your family.
"There are the costs of your own time, the headache of the paperwork, the miles to doctors' offices and transmitting this information to DDS," Ms. Ratermann said. "Then there are the delays you're going to face if you are denied again and again because of your lack of knowledge about SSDI. I've dealt with people who wondered, 'Why did I try to do this by myself? It would have been so much easier and I might have gotten my benefits a long time ago."
Allsup, Belleville, Ill., is a leading nationwide provider of financial and healthcare related services to people with disabilities. Founded in 1984, Allsup has helped more than 100,000 people receive their entitled Social Security Disability Insurance and Medicare benefits. Allsup employs more than 500 professionals who deliver services directly to consumers and their families, or through their employers and long-term disability insurance carriers.
For more information, visit http://www.Allsup.com .