SOCIAL SECURITY OBSTACLE COURSE
Social Security
disability was set up under the Social Security Act to provide income
for workers who became disabled before reaching retirement age. The
program, for many claimants, simply doesn't work. There are too many obstacles
placed in the way. Here are a few of them.
Obstacle: The Application for Benefits. A typical Social Security benefit application package contains at least 38 pages of forms, questionnaires and documents. Many people simply cannot complete all these forms in a way that allows benefits to be paid. Social Security will use some of these forms, such as the Function Report, to deny claims.
Obstacle: The Consultative Examination. In some cases, Social Security will order you to attend a "consultative examination" with the doctor of their choice. This doctor typically spends about 15 minutes with you and performs no lab tests, X-rays or other diagnostic procedures. In 90 percent of cases, the doctor will find no significant abnormality and will, in effect, pronounce you fit to work. He will report that you are able to get on and off the exam table without assistance, have limbs that appear normal, have breath sounds that seem OK and that you are "in no apparent distress." Good to go. Here comes your denial.
Obstacle: The Single Decision Maker. A single decision maker at the Disability Determination Service, who is not a doctor, will review your medical records and make a decision that you may not be able to perform any of your past work but that there is some other work that you could do.
Obstacle: The Burden of Proof. You are assumed to be able to work until you can prove otherwise. If you are under the age of 50, it isn't enough to prove that you cannot perform any of your past work (called 'past relevant work'). You must also prove that there does not exist any other job in the United States economy that you are able to perform. This is a very high burden of proof. Social Security will often argue, for example, that you could do the work of an inspector, garment tagger, ticket taker, egg washer, assembler, hand packager, or sack mender... They will even argue that you can perform these jobs sitting down and that you can change from sitting to standing any time you need to.
Obstacle: Interpretation. Social Security will interpret medical and vocational evidence as it suits them. If you look out the window and say it's raining, they will say, "Where do you find that in the medical evidence?" If your doctor gives you a letter stating, "Mr. So-and-So is not able to work," Social Security will say, "The doctor is not allowed to make that decision." (There are things the doctor can say, but that is not one of them).
This is why a huge industry has grown up around Social Security disability. At least 70 percent of all claims get denied before they are approved. The appeal process is long, complicated and technical. Unless you understand Social Security regulations, it can be a maize of terms, processes, interpretations and requirements that you have no hope of understanding.
Obstacle: The Application for Benefits. A typical Social Security benefit application package contains at least 38 pages of forms, questionnaires and documents. Many people simply cannot complete all these forms in a way that allows benefits to be paid. Social Security will use some of these forms, such as the Function Report, to deny claims.
Obstacle: The Consultative Examination. In some cases, Social Security will order you to attend a "consultative examination" with the doctor of their choice. This doctor typically spends about 15 minutes with you and performs no lab tests, X-rays or other diagnostic procedures. In 90 percent of cases, the doctor will find no significant abnormality and will, in effect, pronounce you fit to work. He will report that you are able to get on and off the exam table without assistance, have limbs that appear normal, have breath sounds that seem OK and that you are "in no apparent distress." Good to go. Here comes your denial.
Obstacle: The Single Decision Maker. A single decision maker at the Disability Determination Service, who is not a doctor, will review your medical records and make a decision that you may not be able to perform any of your past work but that there is some other work that you could do.
Obstacle: The Burden of Proof. You are assumed to be able to work until you can prove otherwise. If you are under the age of 50, it isn't enough to prove that you cannot perform any of your past work (called 'past relevant work'). You must also prove that there does not exist any other job in the United States economy that you are able to perform. This is a very high burden of proof. Social Security will often argue, for example, that you could do the work of an inspector, garment tagger, ticket taker, egg washer, assembler, hand packager, or sack mender... They will even argue that you can perform these jobs sitting down and that you can change from sitting to standing any time you need to.
Obstacle: Interpretation. Social Security will interpret medical and vocational evidence as it suits them. If you look out the window and say it's raining, they will say, "Where do you find that in the medical evidence?" If your doctor gives you a letter stating, "Mr. So-and-So is not able to work," Social Security will say, "The doctor is not allowed to make that decision." (There are things the doctor can say, but that is not one of them).
This is why a huge industry has grown up around Social Security disability. At least 70 percent of all claims get denied before they are approved. The appeal process is long, complicated and technical. Unless you understand Social Security regulations, it can be a maize of terms, processes, interpretations and requirements that you have no hope of understanding.
An experienced attorney or skilled non-attorney advocate may help you get over or around these obstacles. Even then, there is no guarantee of success.
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