How To Win Your Social Security Disability Claim

How to Win Your Social Security Disability Claim

This page will help show you how to win a Social Security Disability Insurance (SSDI).  It will also give you tips to win SSI, or Supplemental Security Income. The information contained on this page and throughout this site is extensive.  However, if you are committed to maximizing your chance of winning your SSDI and/or SSI claim, keep reading this site. Watch the videos.  Search for questions that have been answered before. I have helped over one thousand people win disability and hope this information helps you too. If you would like me to represent you too, fill out the form below or call me for a free case evaluation. My number is 850-308-7833

This page provides simple, straight-forward information on winning Social Security Disability (SSDI) or Supplemental Security Income (SSI) benefits. It summarizes the most important things you can do to win your SSDI or SSI claim. This page does not provide legal advice. It is not a substitute for hiring an attorney to represent you in your claim.  Nor is it a substitute for doing further research into the Social Security disability process.  I will attempt, however, to provide you some insider tips while pursuing disability. Again, I will not discuss the law or get into specific procedures here.  Instead, I will give five tips on things you can do to help your own disability case.

Guide to Winning Social Security Disability

I.  The FIRST TIP to help give yourself the absolute best chance of winning is to make sure you submit ALL relevant medical records to Social Security, or give them to your attorney to give to Social Security.

Medical Records

Relevant medical records include those that relate to your illness or injury from one year prior to the date you became disabled up to the present day.  This includes:

  • your doctor’s treatment notes;
  • the test results for all tests performed such as MRIs, X-Rays, blood work, EKGs, EEGs, EMGs, etc.
  • emergency room treatment records; and
  • records from any hospitalizations.

Residual Functional Capacity Forms / Physical Capacity Evaluation Forms

Residual Functional Capacity (RFC) forms, also called Ability to do Work Related Activity forms or Physical Capacity Evaluation (PCE) forms, can be the difference between winning and losing your SSDI or SSI claim. If your doctor supports your claim for disability, try to get him or her to give you a detailed written report of your condition(s) and how they limit you. This can be extremely persuasive evidence in helping you win your claim for Social Security disability benefits.

You can obtain an RFC or Ability to do Work Related Activity Form from Social Security or your attorney. The SSA’s Ability to do Work Related Activity Form (Physical) is a “one size fits all” form.  It is used for any type of physical disability.  Because different physical disabilities can impair you in different ways, my firm has customized RFCs for certain conditions.  For example, we have a Back RFC, a Fibromyalgia RFC, a Heart RFC, a Cancer RFC, a Crohn’s RFC,  a COPD RFC, a Seizure RFC, etc.  Contact us about your disability and I will send you the appropriate RFC for your condition.

Physical RFCs should be filled out by any doctor treating you for your physical conditions, and Mental RFC’s should be filled out by a mental health provider such as a your psychologist or psychiatrist.

II.  The SECOND TIP to help boost your chance of winning is to keep a journal of your activities of daily living.  Sit down and write down how your condition limits you on a daily basis.  Keep this journal handy at all times so that if you experience any mental or physical problems that limit your chores and other activities during the day you can make a note of it. Begin this journal now, even before you apply for Social Security Disability Insurance or SSI benefits. If you have already applied by the time you are reading this, then start keeping the diary now.

Now that you have this journal, what information do you put in it? You should start with a description of how your disability keeps you from performing work you have done in the past. List the duties you performed in your past jobs, and note why your conditions keeps you from performing those duties.  You should note other issues you are experiencing, such as how your disability disturbs your sleeping patterns, the amount of pain you have when performing chores and other tasks (or even at rest), and how you need to take breaks even when doing simple tasks. Think about other activities like shopping and social activities like going to church, and how they are now limited.  Perhaps you are unable to do certain things at all any more, such as hobbies like fishing and gardening. Note how your disability affects your ability to perform even simple, routine, repetitive tasks (SRRTs) such as driving a vehicle, grocery shopping, visiting family, taking care of family, sitting, standing, walking, remembering and attending appointments, cooking, dealing with stressful situations, dealing with other people, and more.  Think about things you used to be able to do and can no longer do due to your disabling conditions and make a note of those as well. Perhaps there are other things you can still do, but only do them for limited periods of time due to pain or fatigue. For example, you may have difficulty with your grip strength using your hands, a more limited ability to push and pull, and a more limited ability to lift and carry weight with your arms and hands. You may have memory and concentration problems, difficulty sitting very long, chronic pain, etc. You should also note any side effects you experience from your medication. Not side effects like cotton mouth, but side-effects that would affect your ability to work like extreme fatigue or tiredness, dizziness, and being foggy-headed. Please remember, these are just examples. Do not use them as examples in your journal unless you are actually experiencing these issues. Your journal is specific and unique to you. Thus, you should note your own personal issues, concerns, problems, limitations, and pain.

Many claims will be decided on whether you can do a sedentary (sit down) job or not, especially if you are under 50 years old. Thus, you should think about and write down why you could not even do a sit down job. Keep in mind that sedentary jobs are sit down jobs where you do not have to lift greater than 10 pounds on a regular basis. Sedentary Jobs are explained more in the GRID Rules section of this site.

After you have written and maintained this journal, give it to your attorney for review.

III. The THIRD TIP to help increase your chance of winning your SSDI and/or SSI claim is to continue to obtain medical treatment from your doctors and always take your medications as prescribed. When making a disability determination, Social Security will often make the wrongful assumption that your condition must not be that bad
if you are not getting medical treatment and/or you are not taking your prescribed medication like you are supposed to. Moreover, if you do not continue treatment with a doctor, or if you have long gaps of time between doctor visits (more than 90 days between visits), then you may not have enough evidence in the form of medical records to support your claim.

On a similar note, if you stop taking your medication, or you do not take it exactly as prescribed by your doctor, then Social Security may deny your claim because you are being “non-compliant” with your doctor’s orders. The SSA’s rules and regulations state that Social Security must consider why an individual is not following a prescribed medical treatment or medication regime in issuing its decision. For example, your excuse may be lack of money or health insurance to get medical care. However, my experience has shown that lack of treatment or failure to take your medication can tremendously hurt your chances of winning Social Security Disability Insurance or SSI benefits.

The reasons why many people do not take their medication vary. Often times it is simply a question of money or financial ability. It seems like simple logic – if you cannot work because of your disability, then you cannot afford to continue to get treatments or medications. However, regular medical care for your medical disabilities is important for your health as well for your claim. You must try your best to get treatment. There are numerous programs that can help you get the medical care you require. These groups include medicaid and charity care, if you qualify. When you do go to the  doctor’s office, you may make mention of the fact that you are pursuing Social Security benefits. Be sure not to go overboard. When I review medical records in a Social Security disability claim, it is frustrating to read in the doctor’s treatment notes that the patient is obsessed about getting disability.

Finally, when you do see your doctor make sure that you tell your doctor all of your medical problems (from head to toe) and how they are affecting your daily activities.

IV.  The FOURTH TIP to help improve your chances of winning your SSDI and/or SSI claim is to be sure that Social Security has as many of your medical records as possible before you go for a Consultative Exam (CE). Chances are Social Security will schedule you one or two Consultative Exams (CE). Before you go to the CE, make sure Social Security has as many of your records as possible before the actual examination. If you just started seeing a doctor, just recently received some of your records, or you just recently sent your records in to Social Security, take a copy of the records with you to the exam to make sure the SSA has them and give them to the examining doctor.

V. The FIFTH TIP is for the consultative exam. Tell the CE doctor all of your medical conditions, even if he or she does not ask you about them. If it is a CE for physical problems, the doctor will perform a physical exam. Keep in mind he or she is observing you the whole time you are there – from the time you are in the waiting room until you leave in your car. If it is a CE for a mental condition, the psychologist or psychiatrist will ask you a series of questions and he or she will be observing everything about you, including how you answer the questions, your mood, and your demeanor. The doctor will note your appearance such as how you are dressed, whether you are you showered, if your hair is done, whether your nails are trimmed and painted, etc. When answering these questions keep in mind that the doctor has seen hundreds (if not thousands) of claimants trying to get disability benefits. Do not try and fool the doctor by purposely giving ridiculous answers or intentionally missing the question. If you do, chances are that the doctor will note in his or her report that your answers were contrived. Not only is this dishonest but this could be destroy your disability claim.

VI. Other advice. Another piece of advice on how to win Social Security Disability Insurance (SSDI) or SSI is to remember that your non-exertional limitations become even more important if: (1) you do not meet a listing and (2) you are under 50 years old or you are 50 years old or older but had past relevant work that is considered sedentary. In this situation you will have to show that your conditions are so severe that you cannot even do a sedentary jobs. Some important examples of limitations that may prove this are: the inability to sit for long periods of time, mental limitations (such as difficulty with memory, concentration, getting along with others, dealing with stressful situations, etc.), limitations in reaching, pushing and pulling, and limitations in your posture (such as twisting, bending, stooping, etc.). But just telling the doctor that you have these limitations is not enough. The limitations must be supported by the medical evidence. This is where the RFC from your treating doctors becomes so important.

That brings us back to the Residual Functional Capacity Forms (RFC forms), also called Ability to Do Work Related Activity Forms or Physical Capacity Evaluations (PCEs). It is important to remember that medical evidence, especially RFCs/PCEs, is the key to winning an SSDI or SSI claim. It is the claimant’s responsibility as the one trying to get disability to show that he or she has an impairment and to prove the severity of the impairment. The Social Security Administration will request medical records from any doctors, hospitals and clinics you identify. However, do not leave everything to them. If the SSA requests medical records from your doctor’s office and the doctor’s office does not respond to the request, Social Security does not send follow-up requests. Social Security will simply issue a decision without those records. It is up to you to make sure Social Security has all of your records. Your medical records and other evidence should come from “acceptable medical sources”. Acceptable medical sources include: licensed physicians (medical or osteopathic doctors), licensed or certified psychologists, licensed optometrists, licensed podiatrists, and qualified speech language pathologists. Additional evidence from a provider who is not considered an acceptable medical source (such as a Chiropractor) will be considered but such evidence is given considerably less weight in the decision. Let’s say, for example, that you are applying for disability with a back problem. If you are seeing a chiropractor for such problem, you should make sure that you are also seeing a medical doctor (preferably a specialist such as an orthopedist). Medical record evidence from both the medical doctor and chiropractor will be considered. However, the orthopedist’s records will be given considerable more weight than the chiropractor’s records. Remember that Social Security will also want all of your records from any hospitals, clinics, urgent care facilities, and other health facilities where you have been. The most important medical evidence in your case will come from your treating sources. If you want to win your disability benefits, it is up to you to make sure Social Security has all the evidence from your treating providers. Social Security is supposed to place special emphasis on evidence from treating sources. A well written letter or narrative report detailing your condition, treatment and resulting impairments – along with your treating sources treatment notes and an RFC from him or her – will go a long way to improving your chances of winning your Social Security Disability or SSI claim.

If you want to win your disability benefits, continue to read this site and Social Security’s website to become as knowledgeable as possible about winning Social Security Disability benefits.