With Social Security disability and SSI claims taking up to three years to process through the decision making system, you will want to do everything you can to speed up the process. Several years ago, I wrote a book called the Disability Answer Guide that helps claimants fill out Social Security’s forms using terms and concepts that make sense to Social Security personnel. Here is a selection adapted from my book that may be helpful to you as you begin the disability application or appeal process:
1. Understand what Social Security is looking for and write out a very clear statement of your case to be used in all of the forms you send into SSA. At its core, Social Security looks at your capacity for work in evaluating your disability claim – that is how they define the term “disability.” Your medical problem is important, but even more important is how that medical problem impacts your capacity for work. You will want to identify specific work limitations that arise from your medical problem.
Example: if you have a herniated disk in your lower back, the resulting work limitations may be:
- I can’t sit more than 10 minutes without having to move
- I can’t stand more than 5 minutes in place or total more than 15 minutes total
- I can’t walk more than 300 yards without having to stop
- I can’t lift more than a gallon of milk (8 lbs.)
Once you have identified the specific work limitations, ask your doctor to support your claim by including those limitations in a letter, narrative report or checklist form (functional capacity form).
2. Avoid general statements when you fill out the forms. Don’t say “I can’t walk very far” or “I can’t lift very much,” or “I am in pain all the time.” Instead offer specifics:
- “I can only walk for about 10 to 15 minutes at a time, then the pain in my back becomes so severe that I have to sit down and rest for at least 20 minutes.”
- “I can lift a gallon of milk with both hands and carry it from the refrigerator to the table. Even this small amount of weight causes my wrists to ache and I could only do this once or twice a day.”
- “I experience pain at a level 5 (on a 10 point scale) all day, every day. At least twice a week my pain will escalate to an 8 or 9, when it become so severe that I have to take prescription painkillers and go to bed. This escalation can result from overdoing housework or from a change in the weather.”
3. Review the Social Security listings and try to find one that fits your condition – listing level cases tend to get approved earliest in the process because a listing always describes a severe medical problem. If you can get your doctor to write a letter stating that you meet a listing, your chances for early approval go up dramatically.
4. Make sure that Social Security has up to date contact information for your doctors, therapists and any hospital where you have been treated. Social Security does not have the resources to follow up when a medical record request form comes back “moved, left no forwarding address.” Take the time to find the right address for medical record requests and get that to the adjudicator (claims adjuster). Also, encourage your doctor’s office to respond to SSA’s request. The law requires SSA to pay for medical records but the reimbursement rate is low – believe it or not, many doctors’ offices just ignore Social Security medical records requests. Don’t let this happen to you.
5. If you are denied, file your appeal as soon as you can. By law you have only 60 days to appeal – there is no need to wait until day 59 to file your appeal paperwork.
6. Enlist your doctor’s help – doctors generally think about your medical problems and appropriate treatments and not so much about any legal proceedings. By contrast, Social Security is concerned with work limitations. If you can get your doctor to “translate” your medical problems into specific work limitations, you will be giving Social Security what it wants. We often send treating doctors functional capacity evaluation forms that help judges by allowing your doctor to summarize your medical condition and treatment, and to identify specific work activity limitations. Without your doctor’s support, you are not likely to win early.
7. Remember that a confused mind always says “no.” Focus on the medical issues that create work activity problems. If you have been diagnosed with 10 medical conditions, focus on the one or two that would create the biggest negative impact on your capacity to work.