Tough love and tough facts about applying for Social Security Disability benefits
Let me be the first to tell you that representing Social Security Disability clients can be tough. My heart goes out to all people who are in the position of having to apply for Social Security disability benefits. Unfortunately, some times I have to be in the unenviable position of having to give some ‘tough love’ or ‘tough facts’ about the Social Security disability process:
1) Just because you got it quick BEFORE doesn’t mean you’ll get it quick again!
Remember this phrase “CASE BY CASE basis”. I can’t tell you the number of times people who have received disability benefits before who keep relying on their previous experiences when they are reapplying for disability benefits. Just because you got it QUICK the last time, that’s no guarantee that it will happen quickly again.
2) Just because you GOT it BEFORE doesn’t mean you’ll get it again!
The regulations do NOT provide an automatic favorable outcome to you merely because you had received disability benefits in the past. That MEANS NOTHING! Especially if you worked after the period of time that you were receiving disability benefits.
3) Just because your FRIEND gets it, doesn’t mean YOU will!
I know you don’t want to hear this but the simple fact is that YOU haven’t seen every MRI your friend has, every doctors’ notes your friend has, every medical appointment your friend has, or every medication your friend has had to take. With that being said, you have absolutely NO WAY of knowing if your friend’s situation is EXACTLY the same as yours. So stop racking your brain trying to understand why THEY got it and you are still waiting.
4) YOU are NOT the doctor!
I can’t tell you how many times I’ve had people who have DECIDED what they feel is best for them DESPITE what their doctors tell them. I’ve seen people who have refused to go to a doctor their primary has referred them. I’ve seen people refuse to take medication. I’ve seen people refuse to come back to their doctors for follow ups. What these people realize is that every one of these scenarios HURTS your case! Remember, you have to prove that you are medically disabled. Unfortunately, refusing to do what the doctor tells you DOESN’T help!
5) You can’t have it BOTH WAYS!!
Let me break it down as simply as I can. You can’t complain about breathing problems yet still be smoking a pack of cigarettes a day. You can’t complain about your diabetes but you don’t take your insulin pills or shots. You can’t complain about being depressed but you still use illegal drugs and drink alcohol. These types of things DON’T go together in proving you’re disabled.
6) If you don’t go to the doctor, then there is nothing a representative can do
Here is the BOTTOM LINE SIMPLE FACT: YOU bare the burden of proving you are disabled. It’s not your Representative’s responsibility. It’s not Social Security’s Responsibility. It’s YOURS! I understand if you are in an area that doesn’t have medical treatment available. However, if you can go to a free clinic or get county health insurance BUT you DON’T AND you don’t go to the doctor, there’s not much else anyone can do.
7) In some parts of the Social Security Disability process, you HAVE to wait!
This part is the most painful part of the process with my clients. Unfortunately, when you are going through the initial development and/or the reconsideration development, you HAVE to wait for Social Security to get all of the information they need to determine your status. If you get to the hearing level, you HAVE to wait until it’s your turn for a hearing date. So many times, people don’t realize that there is really nothing that can be done except WAIT!
Everybody is in a critical situation!
Let’s face it. A lot of people are in eviction proceedings or foreclosure proceedings or bankruptcy proceedings. A lot of people can’t pay their bills. Alot of people are broke. Unfortunately, a great DEAL of these people are applying for Social Security disability. Social Security is in a tough spot because if you got 1000 people applying and 900 of them are screaming that they want their case expedited and each of them are in foreclosure or evictions or bankruptcy, WHO moves to the front of the line??? See the dilemma.
9) TERI cases are the rare cases that move to the front!
TERI stands for Terminally Ill. If you are terminally ill, your case is going to be processed QUICKLY. So I hate to tell you, if it’s a choice between working your case (and you just have a bad back) and a cancer case, your case will be moved back.
10) Blowing up Social Security’s phones does NOT help!
Let me tell you that you get NO WHERE when you call Social Security 100 times a day! For every time you call them about your case, this STOPS them from working on your case. Just let them work.
11) No representative or Social Security wants you to wait.
The simple fact is that anyone involved in this process WANTS you to get your determination quickly. No one wants you to have to wait a 2 months, 6 months or a year for a determination.
12) If you go to the doctor, do what the doctor says, do what Social Security says, stay clean, & wait, the process runs a smoother!
‘Nuff said!
As always, I am super sympathetic to the struggles of people who are trying to get disability benefits. However, you must realize that some things CAN be helped and some things CAN’T!
Should I apply for Social Security Disability if I am still working?
This question actually comes to me alot and it is a tricky question that really doesn’t warrant a “YES” or “NO” response. Since I’m an attorney, I gotta give you the text book response of “IT DEPENDS”.
Here’s how the scenario usually plays out. You find yourself in a position where you are working a job but you are struggling because of your medical condition. So you start to consider what would happen if you apply for Social Security benefits. You go and talk to your doctor and your doctor encourages you to apply for benefits. Here’s where the story begins. What do you do now? You are still struggling with your job but you need the money. You want to apply but you don’t know if you can wait. So what do you do and how should you proceed?:
1) Question 1, Are you still working? This question is usually the FIRST thing Social Security will asking because the First inquiry into the Social Security process is ‘Are you performing Substantial Gainful Activity?’. Now, Substantial Gainful Activity (or SGA) is normally based on the amount of money you earn. Social Security using a variety of different to determine SGA but let’s say that you (as a non blind individual) was making about $1100 a month. Now, I know you are saying “No one can live on that” but that’s not relevant to the disability process. In accordance with the Social Security guidelines, for 2009, anything over $980 is considered SGA. In other words, you may make too much money unless you can show that you are working under special circumstances.
2) Question 2, Are you working under special circumstances? You now have to ask yourself the question “how are you coping to your working situation?”. How many days are you missing from work? Is your boss cutting you some slack or some leeway? Do you have someone helping you? Are you getting paid even if you’re not working?
3) Question 3, are you out of work for 12 months or more? Part of the regulations requires you to determine if your condition keeps you out of work for 12 months or more OR can reasonably expect to keep you out of work for 12 months or more. Remember, your medical condition has to be the basis for your inability to work at SGA level.
4) Question 4, is your MEDICAL CONDITION keeping you from working? Sometimes, I have had people tell me “Oh, I’ll just quick or reduce my hours in order to get under the SGA level”. AAAAAAAAAA!! WRONG ANSWER!! If you are merely lowering your hours to get under the level BUT you can still WORK at the level you were before, SSA is probably going to assume that you can work at that level. The question is “Has your medical condition caused you to reduce your work load”.
The toughest part of this analysis is when people ask if they should stop working. I can’t tell you that but you do need to be aware of a few things:
1) If you decide to stop working, be prepared to wait. The Social Security process is long and tends to take a while so please don’t think that once you apply, you will see results right away.
2) Be prepared to explain your work. If you stop working and apply right away, SSA is going to want to know what happened that caused you to stop working.
3) IF you decide to go back to work while the case is pending, it MAY have an effect on your case. How much of an effect? You can’t really tell. It depends on the circumstances of the work. If you go back and try for a few days or weeks, the work may be considered an Unsuccessful Work Attempt. However, without more information, it is difficult to tell.
The Social Security Disability process is not easy and alot of good people find themselves trying to decide what steps to take when they are unable to work at they normally do. Evaluate all of your circumstances and, if you have any questions, ask.
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