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In the eyes of the Social Security Disability and ssi programs, a person is considered disabled when:

• They have a severe impairment that has lasted, or will last, twelve months.
  
• They are unable to perform work (work they have done in the past) while earning in excess of $900.00 per month.
  
• They are unable to perform other types of work, typically work related to their past work (for example, a car mechanic might be expected to switch to motorcycle engine repair if the job duties are similar enough).

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For a Social Security disability (or ssi) case, medical evidence takes many forms, including physician treatment notes, mental health records, bloodwork panels, and reports of imaging studies (MRI, CAT scan, and XRAY).

The records that carry the most weight, however, are those from a personal doctor, or Treating Physician. This is because a Treating Physician will generally know a Claimant's medical condition better than any other source.

Consequently, evidence statements from a Treating Physician can be very helpful to a Social Security Disability or ssi benefit claim and are considered by SSA to be authoritative in nature.

However, it should be noted that statements from a personal doctor similar to "patient is completely disabled and unable to work" possess little practical value at any step in the evaluation process. In fact, such evidence is typically disregarded by a disability Examiner and hardly helps when presented to an Administrative Law Judge at the hearing level.

To provide assistance and help on a Social Security Disability or ssi benefit case, a doctor's evidence statement should:
Be detailed regarding a patient's symptomology, restriction in range of motion, muscular strength, and the ability to sit, stand, walk, crouch, bend, and reach.


Should specify the medical reasons as to why a Claimant is unable to work; that is, the physician should indicate the diagnosis, prognosis, and the functional restrictions that result from a patient's impairment(s), i.e. why the patient is unable to return to work.

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As with Initial ssd and ssi claims for benefits, there is simply no way to know how long a disability appeal with the Social Security administration will take. This is due to several facts.

First, disability cases do not have deadlines (despite the fact that the social security office will often represent "90-120" days as the expected time frame for processing a decision).

Second, all cases are different as far as a claimant's impairments and medical evidence is concerned.

And, third, sometimes a case is assigned to a DDS claims Examiner who has three hundred cases to work on, and sometimes to an Examiner who has ninety cases.

In other words, the luck of the draw may apply.

On average, though, Reconsiderations (the first appeal after the Initial claim denial) are completed in four months or less, and Hearings before judges are granted six months after a Hearing is requested.

Unfortunately, however, there are many examples of Reconsiderations taking considerably longer than six months, and Hearings taking a year or more to be scheduled.

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If you have a mental impairment of some kind, or even if you don't allege a mental illness on an application for disability but your records make mention of "depression", "anxiety", or "memory loss", there is always the possibility that you may be sent for a mental consultative examination.

Mental Consultative exams serve the same purpose as physical consultative exams. They are A) scheduled by adjudicators (either a disability examiner or disability judge, depending on the level your claim is at in the system) for the purpose of gaining additional information about your condition and B) are conducted by independent professionals who do not work for the social security admininstration.

Most often, an exam of this type is requested if a claimant has either A) never been treated for a specific condition or B) has not been treated in quite some time for the condition (more than three months).

Claimants who are sent to mental exams may be sent to either a psychiatric examination, a mental status exam, or a full psychological exam (basically, an IQ test). Regardless of the type of exam conducted, though, a claimant should give their best effort during the examination.

The reason for this is simple. Any indication expressed by a consultative examiner (in this case, that would be a psychiatrist or a psychologist) that a claimant who has been tested has "given less than their best effort" could potentially invalidate the results of the exam. This is particularly true in the case of IQ testing. In situations such as this, an applicant for social security disability or SSI disability benefits may be asked to go to a second exam if sufficient doubt is cast on the results of the first exam.

However, in addition to invalidating one's testing results, giving less than one's best effort during testing can throw doubt upon an entire case in the eyes of a DDS (disability determination services, the agency that makes decisions on claims for the social security administration) claims examiner, or a federal administative law judge at a disability hearing.

What does "giving less than one's best effort" actually mean? It simply means not exerting effort to answer questions correctly, or worse, giving deliberately incorrect answers for the purpose of influencing the outcome of a claim.

Do some claimants actually engage in this type of behavior? Yes, as a disability examiner I recall one case in which an individual tried to lower his tested IQ score by giving nonsensical answers to questions. The result? After three separate testings, his case was denied.

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This is certainly one of the most common mistakes made by disability claimants. They file for disability, get denied for disability, and then, instead of filing a disability appeal, file a brand new application.

As a disability examiner, I was able to view a special code on the cases I received. This code was referred to as a unique number and it meant the number of times that an individual had filed a new application for disability. It was not uncommon at all to see a case arrive on my desk with a unique number as high as sixteen. What did a unique number of 16 mean? Simply that a person had been denied up to 15 times and had filed up to 16 separate disability applications.

As a disability examiner, I found it puzzling that someone would file 16 times, particularly when all they really had to do was the following:

1. After learning that their disability claim was denied, a request for reconsideration should have been filed. A reconsideration is the first appeal in the disability appeal process. It is handled exactly the same way that an initial claim is handled, only by a different disability examiner. Typically, depending on the state a person resides in, about 80-85 percent of all reconsiderations will be denied. The success rate at this first appeal level is very low; however, in a realistic sense, it should only be viewed as a gateway to the second, and much more successful, appeal step.

2. After learning that a reconsideration appeal has been denied (as we said, most reconsiderations are turned down), a claimant should submit their second appeal, which is a request for a hearing before an administrative law judge. Hearings are held by federal disability judges and claimants can attend unrepresented or represented by either a disability attorney or a non-attorney representative.

The success rate at the disability hearing level is substantially higher and claimants who are represented achieve a better than 60 percent win rate. Sixty percent may not sound like a particularly favorable rate of approval, but when children's claims are filtered out of the statistics (children's claims have a higher rate of denial), the actual win rate for adult claims is higher, probably 70 percent or more.

Claimants who decide to file a disability appeal after being denied on an initial claim actually improve their chances of winning. The goal, of course, is to get a case heard by a judge at a hearing. Claimants, on the other hand, who do not file appeals, but instead file new applications, will simply get denied all over again (as we pointed out earlier, up to 16 times or more). Their cases will never be evaluated by a judge and they will never have the opportunity to have their case argued in person, either by themselves or by an experienced representative.

By applying again, instead of filing a disability appeal, a claimant will effectively give up their appeal rights and, in most cases, almost certainly guarantee continued denials of their claim.

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These are just some of the basics, go to www.disabilitysecrets.com for more info.

JT said:

mental illness disability...ahaha. give me a break.

"oh i'm so depressed, i can't work. give me free money"

right.

i'm a psych major and this still makes me

*not necessarily talking about you poid, just in general.

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JackthaTripper said:

Go for it Poid, you won't even need any tips.
Be strong, you can do this!

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I'm not necessarily going to admit to having made an SSI claim.

KetamineKatalyst said:

My mother is trying to get some disability benefits (she has diabetes, arthritis, and chronic bronchitis among other things), and someone told her that if they deny you, don't give up. He said they deny almost everybody and this you have to be really persistent. Good luck!

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They are unable to perform work (work they have done in the past) while earning in excess of $900.00 per month.

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A disabled individual may be working when they apply for Social Security Disability, and may continue to work even after they have been approved---as long as they do not earn more than the SGA amount. The SGA amount changes periodically, but currently it is $900.00 per month. It is important to remember this is a gross income amount, i.e. before taxes have been deducted.

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I think they're trying to say that one is considered disabled when they're not able to continue working in their usual field, but are making over $900 a month in a different field.

I'm not too sure, though.