FACTORS AFFECTING SOCIAL SECURITY DISABILITY DECISIONS

Have you been denied Social Security disability benefits?  Are you headed for an appeal or hearing?  Here are some of the factors that will influence whether you are approved at the hearing or denied again.

1)  The strength of medical evidence:  Is there strong objective medical evidence of a severe impairment that has lasted, or is expected to last, at least 12 consecutive months?

     "Your representative will purchase and submit medical records for you, saving you potentially hundreds of dollars in upfront costs...."

2)  Vocational Evidence:  Do you have a medical source statement from one of your doctors describing how your medical condition limits your specific ability to perform work related activities such as sitting, standing, walking, lifting, bending, concentrating, remembering or staying on task during an 8-hour workday?  This can help you win.

3)  Are You Now Working?  If you are currently working and earning at least $1,170 per month before withholding, you are not currently eligible for SSDI benefits.  If you are working and earning less than $1,170 per month, you may be eligible for disability benefits; however, the judge could consider that part-time work is de facto evidence of your ability to work and this might hurt your chance of being approved.  This is a gray area, very subjective.

4)  Job History:  If you have a long history of steady employment with good earnings it will help your chances.  Judges like to see a claimant who will take a substantial pay cut by getting on disability.  They do not like to put unemployed or under-employed individuals on disability.

5)  Which judge will hear your case?  Judge's award rates vary tremendously.  Some judges pay 70 percent of claimants appearing before them, while other judges may make awards in only 15 or 20 percent of cases they decide.  A judge with an higher award rate is obviously better.  (No, you don't get to choose your judge; neither does your representative).

6)  Completeness of your case file:  Many claimants who represent themselves walk into a hearing to find that their medical files have not been updated in the last 18 months and important medical records are missing.  This is because Social Security stops ordering or updating medical records when the appeal is filed.  From that point on, it is up to the claimant to purchase and submit his own medical records.  Without a representative to order the latest doctor's records (or hospital reports), nothing gets updated and the record is woefully incomplete.  This will usually result in the hearing being postponed--months of additional waiting while the claimant tries to obtain and submit all the more recent medical reports which are vital to a decision.  If the claimant is represented, the attorney or representative is responsible for obtaining these records and making sure the file is complete.

ONCE SOCIAL SECURITY HAS MADE AN INITIAL DENIAL OF A CLAIM, IT STOPS ORDERING MEDICAL RECORDS.  SOCIAL SECURITY WILL NOT ORDER ANY MEDICAL RECORDS WHILE YOU WAIT ON A HEARING TO BE SCHEDULED.  THIS MUST BE DONE BY YOU OR YOUR REPRESENTATIVE.  YOU OR YOUR REPRESENTATIVE MUST PAY FOR THESE RECORDS.

One of the vital services provided by your representative is ordering (purchasing) and submitting your medical records, especially records of treatment you have after the appeal.  has been filed.  Since the average wait time to get a hearing is around 15 months, there is usually quite a lot of medical records to be obtained.  Your representative will usually pay for these records, saving you potentially hundreds of dollars in out-of-pocket costs.  (The representative may bill you for the actual cost of these records AFTER you start receiving disability benefits--but only if you win your case).  If you do not win, the representative will bear all the cost involved in preparing the appeal or claim, including the cost of medical records--another advantage of being represented.

Charles W. Forsythe, Partner
The Forsythe Firm
7027 Old Madison Pike NW, Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297

Free Consultations    Pay a Fee Only If you Receive Benefits

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