Sunday, December 02, 2007

Filing for Disability Benefits and Preparing for the Worst

I came across a blog post written by a woman whose husband had extensive neck surgery, a fusion. Much like a typical American family, they have a couple of children, a mortgage, car payments, and, probably, other bills as well. Due to his surgery, they knew their financial situation would be affected. However, they made the assumption that he could file for disability and receive disability checks while he recovered at home. As she said herself in her post, she couldn't have been more wrong.

What exactly was she and her spouse wrong about, though? Well, they actually made a couple of incorrect assumptions that many or most applicants for disability benefits make.

1. They assumed that the decision on a social security disability case would be made in a reasonable amount of time.

2. They assumed that the system worked well enough to accurately determine whether or not a person should be awarded disability benefits.

"Reasonable", of course, is a subjective matter. What is reasonable when it comes to how long a disability claim should take? One month, two months, three months? It's probably easier to decide what, instead, is "unreasonable". And having to spend three years waiting to be approved for SSD or SSI benefits surely fits the definition of unreasonable, as many applicants for disability discover after a case has been denied and the disability apeals process has been initiated.

Regarding accurate decisions, unforunately the social security administration falls very short in this area as well. The great majority of all claims for disability are denied at the application and reconsideration (a request for reconsideration is the first appeal) levels. Yet, a high percentage of appeals that are brought to the hearing level (before an administrative law judge) are won. This, of course, makes for a fairly compelling argument that decision-making within the SSD and SSI disability system is highly flawed at best.

With all this mind (that disability claims take a very long time to decide and that most claims will be denied), a claimant who files for disability should probably prepare for the worst. By that, I mean they should assume that their case will take a minimum of several months at each step of the process (disability application, request for reconsideration, request for hearing) and, with that thought in mind, plan accordingly, in terms of finances. A claimant should also strive to avoid unnecessary roadblocks in the disability adjudication process, by:

1. Supplying detailed information regarding one's work history and medical treatment sources at the time of application and on appeals.

2. Updating the social security administration (by contacting the claims rep who took the application at the social security office or by contacting the disability examiner who is actually processing the claim) when new medical treatment sources have been obtained and when recent visits to medical treatment sources have been made.

3. Responding promptly to correspondence sent from SSA, including letters requesting that a claimant contact the social security office or the disability examiner.

4. Quickly returning requested forms, such as work history forms, medical releases, and "activities of daily living" questionaires.

5. Attending any type of exam that has been scheduled by the social security administration, which can include a physical exam, mental exam, or an appointment for xray imaging or to have spirometry (pulmonary function testing) done.

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