Waiting for Disability or SSI decisions is a lengthy and frustrating process during a desperate time. Most initial applicants are denied, which results in an appeals process that results in waiting for disability for two years. This time period should not simply be treated as a wait. If denied at the initial filing, Claimants should seriously consider retaining a competent local attorney to assist. If you are in Georgia and need a disability attorney, O’Brien & Feiler would like to help. Regardless of whether counsel is hired or not, these 10 things can be done during while waiting for disability to help a Claimant’s chances of being approved.
- See the doctor and journal your Dr. visits – Treatment records from the physicians, PAs, NPs, and other professionals are the currency of the disability kingdom. The records that are created during a treatment relationship will often lend insight in to the nature of a disabling illness, and also provide insight into the limitations that an illness may cause a person. Seeking regular care from any physicians that will offer treatment is vital, as is subsequently ensuring that Social Security is either informed about (or supplied with) those records. In many cases Social Security will send a Claimant to one or more of their physicians, and those records are rarely helpful and are frequently damaging. Without clear, convincing evidence that is created over the course of the period of disability, a Claimant stands little chance of seeing their case approved.
- Tell your Dr. the full story and comply with their orders – Many Claimants who suffer from a longstanding illness are often diligent about maintaining a positive attitude. This is helpful not only from a mental health perspective, but also the mental health of those around them. Unfortunately, this mode of thinking often results in Claimants under-reporting symptoms to their physicians. It is extremely important that Claimants accurately represent their symptoms and limitations to their doctors not only for the purpose of receiving appropriate treatment, but also to ensure that their limitations are properly reflected in their medical records. When discussing health with a physician, the best policy is to tell the “warts and all” truth. Subsequently, it is important to make all efforts to comply with physician orders including pharmacy, therapy, and other orders. Non-compliance with physician orders may not only cause a less favorable health outcome, but also may allow Social Security to deny a claim due to non compliance.
- Apply for TANF or Food Stamps (links are for Georgia) – TANF and Food Stamps are often vital lifelines for families whose lives are on hold while waiting for disability. When income drops significantly due to disability of the wage earner, these programs may help. Many states have programs identical to those administered by the Georgia Department of Family and Children Services. Temporary Assistance for Needy Families (TANF) is a monthly cash assistance program for low-income families with children under age 18, and children age 18 and attending school full-time. The Georgia Food Stamp Program (Supplemental Nutrition Assistance Program (SNAP), is a federally-funded program that provides monthly benefits to low-income households to help pay for the cost of food. Apply for TANF at your local DFCS office, and SNAP can be applied for online, but requires a phone interview with DFCS.
- Investigate free or sliding scale clinics / apply for charity care (see OBF’s list by clicking here) – One of the most challenging issues that individuals who are waiting for disability face is continuing their care without insurance or earnings. Oftentimes COBRA monthly payments are prohibitive, and with the repeal of the individual mandate, one might expect health premiums on individual plans to continue to rise. One of the most straightforward ways to continue care is to contact the health department in the Claimant’s county of residence. Though this care typically only includes general practitioners and women’s health, receiving some regular care is far superior to the alternative. Additionally, some hospitals offer needs-based assistance which will allow patients to seek care from a specialist. This will require proof of financial need, but most facilities are adept at working with patients to secure this information. Finally, in the event of a medical crisis, Claimants should seek care from their local emergency room. The Emergency Medical Treatment and Labor Act (EMTALA) requires Medicare-participating hospitals with ERs to provide an examination or treatment for an emergency medical condition regardless of an individual’s ability to pay. Those hospitals are then required to provide stabilizing treatment for patients with emergency medical conditions, and some hospitals upon successful completion of charity care paperwork will allow specialist follow-up after discharge.
- Ensure your case file is being properly built at the SSA – During the initial and reconsideration levels of application for Social Security Disability or SSI, DDS will make attempts to secure medical records from a Claimant’s providers. Failure by DDS to secure records from all dates of service due to faulty Claimant reporting, faulty Provider reporting, or simple omissions may lead to the denial of a claim and additional waiting for disability. For this reason, it is important to not only fully report all physician and hospital care, but to follow up to ensure that proper inclusion of those care records in the disability case file. When a case is denied at the reconsideration level of appeal, a claim is all but guaranteed to take at least another year (usually more) to come before a judge, and for the period between the reconsideration denial and the ALJ hearing, the Claimant may be expected to bear more of the burden of assembling and submitting all medical evidence.
- Write your Congressperson or Senator – There are very few tried and true ways of actually reducing the amount of time spent waiting for disability faced by Claimants. Some ways to speed up a disability case are discussed in item 7 below. At the ALJ level of appeal, the SSA often recommends accepting a video hearing. While this may allow a case to be heard more quickly, some National Hearing Centers have approval percentages that are dramatically below the national average. One tactic that some Claimants have employed is involving their Senators or Congresspeople while waiting for disability. Whether this results in faster adjudications is up for debate, but at a bare minimum a Claimant’s representatives will hear about the time delays and challenges that the disabled face as they seek medical benefits. In a perfect world this would inform their decisions regarding funding the Social Security Administration properly so that future Claimants do not experience the same difficult wait.
- Seek critical status if appropriate – There are six types of cases that may cause the SSA to provide special processing thus reducing the amount of time spent waiting for disability. These case types are: Terminal Illness (TERI), Veteran 100 Percent Permanent and Total, Military Casualty/Wounded Warrior (MC/WW), Compassionate Allowances (CAL), Dire Need (DRND), and Potentially Violent Cases. In many cases, especially dire need, it is important for Claimants to be proactive with regard to seeking this status, though it is important to note this special handling is not granted in every case. Claimants who are seeking this status should immediately provide supportive evidence to the SSA such as eviction notices, notices of foreclosure, utility shut-off notices, copies of medical bills, or other information that supports special handling under these categories.
- Update your contact information – A fast way to lose a disability case it to ignore time-sensitive communications from the SSA. Make sure that all Claimant contact information is kept up to date with the SSA to ensure timely and accurate communications, and ensure that appeal periods do not expire without a response.
- Be careful with work – Working during the disability application process will not necessarily result in a denial of a claim, but Claimants should be very aware of what the SSA considers Substantial Gainful Activity (SGA). In 2018, the SGA limit is $1,180 for non-blind people. This means that earnings need to be below this monthly value in order to be considered to not be engaging in work. This is not necessarily the only thing that the SSA looks at though. If a Claimant earns less than this amount but is working 35-40 hours per week, they will likely not be considered disabled during this time period, unless the work is considered accommodated, which can change the analysis somewhat. As such, it is recommended to not only observe the SGA limit, but also to work fewer than 20 hours per week.
- Avoid illegal substances and alcohol abuse – The SSA will examine the impact of drug and alcohol use on a Claimant’s disabling conditions. If drug or alcohol use is noted to be a contributing factor material to the determination of disability, the SSA will then examine whether or not they would still find a Claimant disabled if drug or alcohol use was stopped. If the limitations that remain after drug or alcohol use was stopped could still be considered disabling, then a Claimant can be ruled disabled, but if the remaining limitations are not considered disabling, then no benefits will be paid to a Claimant.
If you would like to consult with a disability attorney about your case for free, please contact The Law Firm of O’Brien & Feiler. If you have questions about any of the terms used in this article, please consult our online glossary.