What You Should Know About Social Security Disability

To the people who make the decision in your Social Security disability claim, you are just another number on a claim form. The sympathetic people you see at the Social Security Office are not the same people who decide your claim.

The decision makers at the first two levels only read the papers in the file. They don’t meet you one on one, or see your pain. All they will see is another piece of paperwork to be approved or denied.

It is only after you have been denied twice, and request a hearing, that you will even actually meet the person who will decide your claim. This person is called an Administrative Law Judge. He or she is a lawyer who is much more interested in what your doctors have to say about you than with how much you hurt.

Our attorneys know the best way to help you is to understand you and your case. We’ll spend time with you, learning about your disability and how it has burdened your life. We know how to help your doctors clearly communicate to Social Security the severity of your condition. We’ll work hard to effectively present your disability claim to Social Security.

At E.S. Gallon & Associates, we have been helping people just like you for years with their Social Security Disability claims. We understand how the system works. Disability claims are complicated because few medical conditions are black or white, but are really matters of degrees -- shades of gray.

We know how to piece together the many facets of your case to make the strongest claim possible. If you are about to file a claim or have filed a claim which has been denied, it could be worth your time to talk to one of our attorneys. The initial visit is free of charge and can give you valuable insight into your disability claim.

At E.S. Gallon, you’ll never be a number on a claim form.

The Process

Filing a claim for Social Security disability is a long and complicated process. Filing a winning disability claim takes a thorough understanding of the process to know what Social Security is looking for. If you are about to file a claim, or if you have filed a claim which has been denied, here are some things you should know:

• Social Security is much more interested in what your doctors have to say about your condition than what you or anyone else says. If you don’t have a doctor who thinks your are disabled, you probably don’t have a case.
• There is no such thing as a "partial" disability with Social Security. You must show that you cannot do any work for your claim to be approved -- and requires detailed information from your doctor about why you cannot work.

If your application has already been denied twice, the next step is to request a hearing. If your claim is denied at the hearing, it may be impossible after that to win the claim.

How can an attorney help you?

The Social Security disability claims process is very complicated. Social Security weighs many factors to make a decision of "disabled" or "not disabled." An attorney experienced in Social Security disability claims can help you put together all the pieces of your case to make the strongest case possible for a finding of "disabled."

• If you don’t paint a complete picture of your disability, Social Security might not do it for you. Social Security may not know about all your disabling factors unless you tell them clearly. An experienced attorney can help you bring out information that you may not know is important to tell your whole story.
• If you have already been turned down for Social Security disability benefits twice, you next step is a hearing. This is when most people get the help of an attorney. Hearings are often won or lost based on how well prepared you are to explain your disability, and how well your doctor’s report proves your case. At a hearing, the Administrative Law Judge wants much more than just a conclusion from your doctors stating you cannot work. The Administrative Law Judge wants to know in detail why you cannot work. Getting an unfavorable hearing decision reversed is extremely difficult, so do not take chances with your hearing.

Remember, your case can continue to evolve. Sometimes important tests are not run, or surgery performed for months or even years after you stop work. A decline in your medical condition can improve your chance of qualifying for Social Security disability benefits.

How do you select an attorney for your Social Security Disability claim?

You need someone who knows what kinds of information Social Security is looking for from both you and your doctor. You know how you feel but do not have the medical knowledge to describe your condition medically.

Your doctor has the medical knowledge to describe your condition, but your doctor cannot actually feel your pain. Social Security wants to know both what your doctor thinks and how you feel. A Social Security attorney knows what Social Security is looking for from both you and your doctor.

A Social Security attorney can help you get the kinds of medical reports from your doctor that Social Security needs to find you "disabled" and pay you benefits.

The 10 Most Important Questions About Social Security Disability

1. What does Social Security need to find me "disabled"?

"Disabled" means unable to work due to your medical conditions. The period of disability must last for 12 consecutive months, or be expected to result in death. Where you are actually working, even part-time or "off and on," with gross earnings that average $500 per month or more, Social Security will not find you disabled no matter how severe your medical conditions or how severe your pain.

2. What does Social Security consider to decide whether I am "disabled"?

Social Security considers four things in determining if you are disabled:

• Age. Under age 50, you are considered a "younger worker" and age is not generally significant unless you are illiterate in English. As you get older, it gets easier for Social Security to find you disabled. The important ages at which disability becomes easier are ages 50, 55, and 60.
• Education. Most people are able to read and write a simple message in English. If you are not, you are not nearly so able to work as someone who can. If you are at least able to read and write a simple message in English, your education is usually not an important disability consideration.
• Work Experience. All the jobs you performed in the last 15 years are considered the jobs you already know how to perform. You must first show your medical conditions keep you from performing these jobs. Social Security can then show that even though you may be disabled from these jobs, you cans till do other work. As a result, Social Security may agree that you cannot do your past work, but still find you are "not disabled."
• Impairments (Physical and/or Mental) Your impairments are the physical and/or mental conditions that keep you from working. Even more important than the conditions themselves are their severity. Most conditions are not so severe by themselves that everyone with that condition is unable to work. The severity of your condition is by far the most important factor in determining disability. Severity is determined by the medical evidence from your doctors.

3. What impairments will Social Security consider in determining my "disability"?

Social Security considers your physical an/or mental impairments together in determining whether you are disabled. The severity of an impairment is one of the most difficult questions a doctor is asked. Sometimes doctors disagree on severity, and Social Security must decide which doctor to believe.

4. How does Social Security know whether my doctor thinks I am "disabled"?

Social Security will request written reports and records from the doctors, hospitals, clinics, etc. that have treated you. Where you are not under treatment, there is no one Social Security can contact about the kind of impairment you suffer, or its severity, and the condition usually will not be considered a significant impairment. Generally a medical disability opinion must come from an M.D. or a D.O. physician; in cases of mental impairments, the disability may come from a psychologist.

5. What is the most common mistake I am likely to make in my Social Security claim?

The most common mistake you can make is not having enough medical information about the kind and severity of your impairments. It is not enough for you to just tell how you feel. You must have medical reports from your doctors stating why you are disabled. It is extremely important for you to talk with your doctors to make sure they will support your disability claim. Without your doctor’s support, it is not likely you will be found disabled.

6. How can I work when I am in constant pain?

You may not be disabled by your impairments themselves, but from the pain or other discomfort caused by your impairments. Pain is not an impairment, but is the result of an impairment. You doctor must state what impairment caused your pain or other discomfort (diagnosis), and also state how it keeps you from work.

Your doctor may not conclude you are disabled by your pain if you are not getting regular medical treatment, not following medical advice, or taking prescribed medications. Even when your doctor states you are disabled, it must be more than "My patient John Jones is disabled from work due to low back pain." The doctor must explain what it is about the frequency, duration and severity of the pain that keeps you from working.

7. Will Social Security find me disabled where my doctor says I am "disabled"?

Your doctor’s opinion that you are disabled is extremely important to your claim, but it does not mean that you will automatically be found disabled. Social Security rarely finds someone disabled based on the opinion of just one doctor. Usually there are several doctors who have treated or examined you, or reviewed your medical file. Just having a disability opinion from your doctor does not guarantee you will be found disabled.

8. Why did Social Security find me "not disabled" when others (Workers’ Compensation, my employer, the Veteran’s Administration, and insurance company, etc.) have found me "disabled"?

There are several definitions of "disability" and some require only that you be disabled from your last job. Social Security requires that you be disabled from that job and from all other jobs. As a result, Social Security may agree you cannot perform your last job, but still find you "not disabled" because you can perform other work.

9. What should my doctor do to help my case?

First, your doctor must provide enough information about your impairments to show that you are disabled from all work. Where the doctor says only you can’t do you past work but doesn’t talk about less strenuous work, or where your doctor states you could a less strenuous job, the doctors opinion will not usually help you.

Secondly, your doctor’s opinion must be reasonable in light of the impairment -- a knee injury may keep you from long periods of standing or walking, but usually does not interfere with sitting. Where the doctor also restricts sitting from a knee problem, without some explanation, Social Security will not believe that limitation, and may also not believe the doctor’s limitations on standing and walking.

Where your doctor’s opinion doesn’t conclude you are disabled from all work, or doesn’t explain how the limitations are caused by your impairments, Social Security may not believe your doctor, and will rely on one of its doctors.

10. How can a Social Security attorney help me be found "disabled"?

You know how you feel, but do not have the medical knowledge to describe your condition medically. Your doctor has the knowledge to describe your condition in medical terms, and while you may tell your doctor how badly you feel, the doctor cannot actually feel the pain.

Social Security wants to know both how badly you feel, and why you feel that way. A Social Security attorney knows better than you or your doctor what Social Security is looking for to find you disabled. There are no partial Social Security disability benefits. You either win or lose. Where you lose, you do not get paid disability benefits. The Social Security attorney helps you get from your doctor the kinds of evidence that Social Security needs to find you disabled and pay you benefits.