Initial Disability Claims

Initial Disability Claims

Initial disability claims can be overwhelming. The decision to apply for disability benefits forces a person to acknowledge an inability to continue working because of a disabling medical condition.

Once you decide to apply for Social Security disability, the initial disability claims process can be overwhelming and intimidating. Federal laws, regulations, and complicated procedures make it difficult to achieve a successful result.

The Social Security Administration denies 62% of the initial disability claims it receives each year. That also means that 38% of claims are approved. Of those initial disability claims denied benefits, an appeals process provides an opportunity to be approved.

James Mitchell Brown, an Ohio disability claims lawyer, has devoted more than 50 years to helping people with disabilities overcome the challenges of the Social Security disability claim system. You get to concentrate on your health and well-being while James Mitchell Brown skillfully handles your Social Security disability claim.

What is an Initial Disability Claim?

The first formal application submitted to the SSA for Social Security Disability Insurance or Supplemental Security Income becomes your initial disability claim. The claim includes information about you, including:

• Your medical condition or conditions.
• Work history to establish that you meet the requirements for SSDI benefits.
• Limitations caused by the medical condition that impair your ability to work.

The information required for initial disability claims extends well beyond contact information and a brief statement of a medical condition. Taking it lightly and omitting details, not checking for errors, or providing conflicting information could, at best, result in processing delays. It also could lead to a denial of the claim.

You want to get it right the first time you apply for disability benefits. The best way to do that is by gathering the documentation and information needed before beginning to fill out the application. Seeking disability lawyer help early in the process gives you an experienced representative with experience who can anticipate what the SSA looks for when processing initial disability claims.

Required Documents & Medical Evidence

It’s a mistake to attempt to complete a disability benefits application without first gathering medical records and other documents that contain the necessary information. For instance, here are documents to gather to provide the information required to complete a disability application:

• Personal data: Social Security card, birth certificate, marriage certificate, judgment of divorce or annulment, and driver’s license or other form of government-issued photo identification.
• Employment: Tax returns, W-2 forms from employers, and 1099 forms for contract or self-employed workers.
• Medical information: Medical records containing physicians’ examination notes and findings, blood and other laboratory test results, diagnostic test results, diagnostic imaging reports, hospital records, and a list of prescribed medications and treatments.
• Healthcare providers: Contact information for all healthcare providers, including primary care and specialists.

The importance of current, detailed, and complete medical records to support an SSDI application cannot be stressed enough. A diagnosis by a doctor with a statement that the patient is disabled does prove that an applicant for disability benefits has a disability that meets the SSA standard.

Federal regulations define a disability as the inability to do substantial gainful work activity because of a medically diagnosable physical or mental impairment, or a combination of impairments. The impairments must be expected to result in death or must have lasted or be expected to last for at least 12 consecutive months.

Detailed medical documentation is required to provide proof of a person’s inability to work. A disability claims lawyer, such as James Mitchell Brown, understands what the SSA looks for when evaluating applications and the documentation supporting them.

How The SSA Reviews Initial Claims

The application review process begins at one of the many SSA field offices nationwide. A Social Security representative reviews the application to verify that it meets the non-medical requirements, such as the duration of an SSDI applicant’s work history or the income and resources of an applicant seeking SSI benefits.

Once it completes its review, the SSA field office sends the claim to a Disability Determination Services office. DDS offices are state agencies funded by the federal government to review the medical documentation and determine whether the person meets the federal disability or blindness standards.

A DDS disability examiner primarily relies on the medical records of the applicant’s healthcare professionals. However, the examiner may request a consultative examination by one of the applicant’s medical providers or by an independent source.

DDS examiners rely on a five-step sequential evaluation process when reviewing initial disability claims. The steps include:

• Work Activity: Does the claimant work and make more than the monthly earnings threshold for substantial gainful activity? If they do not, then the review continues.
• Severe Medical Condition: Is the applicant’s medical condition severe enough to result in death or last for at least 12 consecutive months? If it is, the process continues.
• Listed Impairment: Does the person have a physical or mental impairment that meets or is functionally equivalent to a condition in the SSA’s listing of impairments? If they do not, then the review continues.
• Past Relevant Work: Does the claimant’s residual functional capacity (RFC) allow them to do work they did in the past? If it does not, the review continues.
• Doing Other Available Work: Does the person’s RFC, age, education, and experience give them the ability to adjust to doing other types of work available in the national economy? If it does not, then the person may meet the disability standard.

The case file returns to the SSA field office where a representative makes a final decision and sends a written notification to the claimant.

Why Many First Claims Are Denied

The two-thirds rate of denials of initial disability claims is not without reason. Some individuals who apply for SSDI or SSI do not have a disability that meets the strict federal standard. Other common reasons include:

• Failing to meet the work requirements for SSDI or the income and resource limitations for SSI.
• Working when applying for benefits and earning more than the threshold for substantial gainful activity.
• Not providing medical documentation to prove a severe medical condition.
• Not taking prescription medications or following the treatment plan recommended by your doctor.
• Submitting an application containing errors, inconsistent information, or leaving out essential information.

Relying on disability lawyer help from James Mitchell Brown from the start of the initial disability claim process provides you with a skilled representative who knows from experience what it takes to present a strong, well-documented claim.

Benefits of Hiring an Attorney from the Start

Relying on the assistance of an accomplished disability claims lawyer instead of trying to take on the Social Security disability system alone has several advantages, including:

• You get a skilled representative who knows and understands the initial disability claims process.
• An attorney can spot errors, omissions, and other application deficiencies.
• A lawyer knows the medical and other evidence to gather and present for a strong, well-documented claim.
• A missed deadline could defeat a claim, so a lawyer ensures that appeals and other paperwork get submitted on time.
• Attorneys know the appeals process, including how to prepare you for the disability hearing.

Learn how 50 years of disability claims experience can make a difference for you.
Contact James Mitchell Brown for a free consultation.