“My doctor will not sign off on my disability so I have no chance of getting disability”
A treating doctor’s opinion of a patient’s illness and the extent of functional limitations is important. Social security disability regulations require social security to given the opinion of a treating doctor “controlling weight” unless it is not supported by the medical findings and evidence. This does not mean, however, that social security requires a treating doctor to provide a letter of support for a social security disability applicant.
“I need to get social security disability so I can see a doctor”
Medicare is available to a social security disability recipient after 24 months of entitlement to social security disability benefits. SSI recipients are entitled to Medicaid. Since in most cases medical insurance coverage continues to be tied to employment in the United States, and disability applicants are not working, it is understandable that many would see social security disability as the solution to their lack of medical coverage. The problem is, however, that ongoing medical treatment is necessary in order to qualify for social security disability. Moreover, the typical wait for disability approval is around 18 months. Social security disability benefits cannot be the solution to the immediate problem of medical coverage and treatment.
“The Administrative Law Judge was so nice to me at the hearing so I know I won”
“The Administrative Law Judge asked some hard questions and wasn’t real friendly so I am sure I lost”
The inverse of the above is also true: don’t assume a generally unsympathetic ALJ who tries to poke holes in your story will turn you down. ALJs uniformly take their role very seriously, and will fully develop the evidence, facts and credibility of the claimant even in cases they were inclined to grant all along.
“Social security sent me to a doctor so I do not need to get medical treatment to get my disability”
Social security often arranges for a medical consultative examination at government expense. Physicians find the pay rates for the examinations to be very low, and the exam is usually brief and cursory. A social security consultative examination is no substitute for ongoing and regular medical treatment.
“I am getting (Long-Term Disability, VA Disability) so Social Security must find me disabled”
Long term disability benefits are a typical employer benefit in major corporations or institutions. Usually LTD insurance policies pay 60% of one’s salary and require proof of inability to do prior work for the first 24 months. Thereafter, the long-term disability recipient must prove inability to do any work. Social security disability requires inability to do any work. So, for the first 2 years of long-term disability, the standard applied by the insurance company is different than that of social security.
Veteran’s disability benefits are awarded on a percent basis. Veteran’s with a 100% disability rating are correct that this award will be helpful in securing social security disability benefits: ALJ’s are required to address and properly assess the impact of a VA disability decision on eligibility for social security disability benefits. It is not, however, a foregone conclusion that VA disability will mean social security disability is also approved.
“I have a hearing with a judge who has a very low approval rate so I have no chance of winning”
Statistics on the award ratings for administrative law judges are now available. These numbers are revealing, but can be misleading. Keep in mind that all social security disability applicants have the right to an administrative hearing. It is important to remember that there remain a fair number of claimants who take their case to ALJ hearing that are simply not disabled. If you have a judge that pays only 17% of cases, does that mean you have a 83% of being turned down? No, it just means the ALJ only pays 17% of the cases that come before her. If you have a strong case, your chances with the 17% ALJ are still much higher than 17%.
“I am drawing unemployment benefits so I cannot get social security disability”
Drawing unemployment benefits and seeking social security disability benefits is not prohibited, nor does it automatically disqualify for either benefit. ALJs do however, routinely question claimants drawing unemployment benefits very carefully because in order to qualify for unemployment benefits in Texas you must tell the government that you are looking for work and that you are able to work. Drawing unemployment benefits and also seeking disability benefits is not a good idea, and overall is a negative in the eyes of ALJs, but it is not an automatic disqualifier
“I am getting workers compensation now so I should wait to file for social security disability until my worker’s compensation ends”
Social Security disability benefits are reduced in most states,(including Texas), by the amount of workers compensation received. In prior years I routinely heard reports from claimants that social security workers discouraged workers compensation recipients from filing a claim for social security disability since they were likely to be entitled to no social security disability benefits while getting worker’s compensation. This was terrible advice that I do not hear being given by social secuirty now. There are several reasons why waiting for the worker’s compensation to end is a bad idea:
- since it takes so long to move through the social security disability assessment process, you will be in a world of financial hurt if you wait to file when the checks stop;and
- you may run out of coverage for social security disability benefits if you wait too long to file.
“I need a junk yard lawyer who will kick some “A” to win my case”
Many seem to think that being a brash and belligerent lawyer is the same as being an effective one. It is, however, often true in adverse litigation matters than a combative style is helpful. But social security disability is not an adversarial process. There is no lawyer present at the ALJ hearing for the attorney to lock horns with. Effective representation in social security disability is the art of persuasion.