All information and/or recommendations given here are from a Disability Determination Specialist for the state of Maryland. Please understand each state is different. Be sure to research your state guidelines on the process to apply for disability. Most information/tips given here are about the process in general and apply regardless of the state.
These tips are for adult applicants only.
It is NOT true that everyone gets denied the first time. That can’t be farther from the truth! Your claims adjuster works hard to try and APPROVE you NOT deny you.
1) Before starting the process of applying for disability, be sure to gather any and all medical records yourself and send a copy (Not the originals!) in to your claims adjuster. Do not send them to your local Social Security office. Keep a copy of your records for yourself.
2) Educate yourself on the process of applying for disability and don’t be afraid to ask any questions. You can find many helpful tips and Q&A at http://www.socialsecurity.gov/disability/
3) Understand and educate yourself on the definition of disability and the different listings/guidelines that can be met. Understand that your medical records must show that you unable to hold any active gainful employment for at least 12 months. You must meet Social Security’s definition of being disabled NOT yours.
Find out what listing your disability meets and send in records that document that. This site will help in understanding the definition of disability and give a list of the different listings that can be met http://www.socialsecurity.gov/disability/professionals/bluebook/AdultListings.htm
4) After you have received your introduction letter and you haven’t heard from your claims adjuster, be sure to call them! The name of your claims adjuster and phone number will be on the bottom of the letter.
5) A few days later you should be receiving the ADL (Adult Function Report) and a 15 year Work History Report. Fill them out completely and detailed as if it is your worst day BUT be honest. Get those in ASAP!
6) Don’t assume your claims adjuster will get everything needed for your claim. It’s up to you to make sure all records and forms are received on time. If your claims adjuster calls and leaves a message be sure to call them back ASAP. If your claims rep is unable to answer the phone, be sure to leave a detailed voicemail answering any question they had, or asking any questions you have. You do not need to call your claims adjuster multiple times a day. Leave a voicemail and they will get back to you.
7) Follow up with your doctors and make sure they are filling out all requested forms and sending them in on time. You have to make that happen, not your claims adjustor.
8) Be sure to communicate any change of address or phone number. You can be denied just because your claims adjuster can’t reach you. You can also be denied if you don’t call them back after a certain amount of time.
9) They do not deal with email because it is not a secure form of communication. If you have medical evidence to add to your case be sure to ask for a barcode and 800 number to the scanning facility from your claims adjuster. This way you cut the middle man out.
10) The claims adjuster will not talk to your doctors about your claim. That is your responsibility to get what is needed for your claim.
11) Make sure to go to all appointments made by your claims adjuster. If you miss these appointments your claim can be denied.
12) Usually Social Security themselves does not work your claim. It starts out at Social Security and then goes into a queue or is transferred out to the state employees at DDS (Disability Determination Services). It’s their job to gather records and make a determination. Then, your claim could go to a regional office for quality control (that could add 30 days), or it could go straight back to the field office where they contact the applicant to communicate approval or denial of their case. After quality control, it could go back to your DDS claims rep to handle anything found that may require extra steps.
13) This website gives approval/denial rates, facts and statistics about the process by state http://ssdfacts.com/
14) Remember, your claims adjuster is there to help you with your case. They are NOT there denying cases because they are in a bad mood that day. There is a complicated process they must go through to process your claim. The system is clogged up with a lot of frivolous claims but, all must be given equal treatment.
Unfortunately, the system is geared towards the disenfranchised. The more education you have the more jobs you are able to do, which makes it harder to get an approval…….sometimes.
15) After your approval, be sure to continue seeing doctors to document your disability because your claim will be reviewed in the future and you will need the documentation.
16) Lastly, hang in there…….be patient…….stay in contact with your claims adjuster!
If you are denied be sure to start your appeal right away! Do not re-apply again. You will be sent information on how to file an appeal. Some people hire attorneys to file for them. You will have to give up to $6,000 or more of your back pay to an attorney so keep that in mind. It may not be worth it if you follow these tips. Good luck!