I thought this article about filing for SSDI was so important that I wanted to run a copy of it as my blog this week. It's from Allsup, a leading nationwide provider of financial and health care related services to people with disabilities; they help people receive their entitled Social Security Disability Insurance (SSDI) and Medicare benefits. I hope this article from them can help others navigate the confusing system of SSDI just a little bit.
Allsup tells us that two-thirds of all first-time SSDI applicants end up with their claim denied. To help educate people who are filing for their SSDI benefits, Allsup published this article:
"Seven Common Mistakes When Filing for SSDI"** 1.**** Going into the process uneducated**. Some people believe it's just a matter of filling out a few forms, sending them in and waiting for their checks. They would be surprised to find out just how complicated the SSDI process really is.
The Social Security Administration follows a five-step sequential evaluation process to determine if an individual qualifies for disability benefits ... including:
- You must not be gainfully employed, which is defined as earning $940 a month or more
- Your condition is severe, meaning it interferes with basic activities of work
- Your condition is on the Social Security Administration's list of disabling conditions, or medically equals one of the disabling conditions on the list, and you will be disabled for more than 12 months
- You are not able to do the work you had been doing before the impairment, and
- You can't perform any other type of work.
"You have to meet the first two criteria before the Social Security Administration will consider your claim," said [Allsup senior claimant representative Edward] Swierczek, who has more than 30 years of experience helping individuals through the complexities of the SSDI application process.
"If you're a 40-year-old ironworker who hurt your back, the Social Security Administration may find that you are not disabled if you can do desk work. You may not think you can, but if you don't provide compelling evidence why you can't, they will deny your claim," he said.
2. Going through the SSDI process alone. Individuals who apply for Social Security Disability Insurance benefits without representation are more likely to have their claim denied. "Working with government agencies and understanding the nuances of what's needed to comply with the regulation isn't something the average person is aware of," said Allsup senior claimant representative David Bueltemann, who has successfully represented thousands of SSDI applicants.
"Just as people hire accountants to complete their tax returns and represent them before the Internal Revenue Service if they're audited, individuals are recognizing they need for representation when they go into the Social Security Disability Insurance process," he added.
3. Underestimating the impact of your disability. Sometimes pride leads people to underplay the extent of their disabilities because they have endured a condition so long that they have learned how to cope with the stress of daily life. But many people underestimate how much their disability affects their day-to-day lives. A good example, Bueltemann explained, is a 50-year-old grandmother who tells the state Disability Determination Service (DDS) that she takes care of her grandchildren. If the woman doesn't explain that the children are teen-agers and self-sufficient, the DDS may deny her claim because it believes that she is capable of working in a day care center.
4. Exaggerating the impact of your disability. On the other end of the spectrum are people who want to make their condition appear worse than it is. For example, a man who uses a cane at a hearing before an administrative law judge but doesn't normally use a cane would be over-representing his condition. "If the judge asks to look at the cane and sees the tip is not worn, the claim is immediately suspect, even though the claimant may have had a legitimate case if he'd just stuck to the unexaggerated truth," Swierczek explained. "It is important to elaborate, but not exaggerate."
5. Being vague about your work history. Knowing what the expectations are for your work, and showing accurately from the outset why you can't perform this work any longer, is an essential part of qualifying for SSDI benefits.
For example, Swierczek said, a service technician might be required to drive for extended periods as part of the job. "If your impairment means you can only drive for 10 minutes without experiencing extreme pain, yet your job requires you drive in 60-minute stretches, you need to make it clear on your disability application what the work expectations are and what your limitations are," said Swierczek.
"Otherwise, you may end up in double jeopardy: Your disability claim is rejected because the Social Security Administration believes you can still perform your work," he said. "But you're out of work because you really can't meet the requirements of the job."
6. Missing the appeals deadline. The Social Security Administration denies more than 60 percent of all initial SSDI applications, but there is a formal appeals process with three levels. If you are rejected at any level, you have only 60 days to appeal to the next level. If you miss the deadline, you need to start the process from the beginning.
If you've applied on your own and received a denial, it's not too late to choose an SSDI representative ... to handle the appeal and continue with your case. Taking this step may make the difference in experiencing further delays to receiving your SSDI benefits.
7. Giving up. The process can be excruciatingly long and cumbersome. Nearly 750,000 people are waiting for a hearing before an administrative law judge, which is only one level of the SSDI appeals process. For individuals already facing significant physical or mental disabilities, this delay can add to the difficulty. Bueltemann, however, is quick to point out that receiving SSDI is a benefit that individuals with disabilities and their families have earned, if they meet the SSDI requirements. An SSDI award also is essential in securing other forms of financial support, including Medicare benefits and retirement protection.
"It may not be as easy as it should be to receive your payments, but don't give up," Bueltemann said. "Make sure you have good representation and don't lose hope that you can secure your benefits."
There's a quote I like from the ancient Roman poet, Ovid, that says, "What is harder than rock, or softer than water? Yet soft water hollows out hard rock. Persevere." That's as relevant today, in the 21st century, as it was in Ovid's time, over 2,000 years ago.
If you've you applied for SSDI benefits, what was your experience like, and what advice do you have for others?