Insider Tips to Improve Your Chances of Success in Applying for SSDI or SSI, or in Appealing a Denial Letter
National numbers and statistics show approximately 70% of all initial applications for Social Security Disability benefits are denied by the Social Security Administration (SSA). This website is dedicated to educating you about the Social Security disability application and appeal process in order to try and increase your chance of winning your disability claim.
I encourage you to read this page in great detail, and to continue reading the remainder of the site to empower and educate yourself with information which may help you win your application or appeal after a denial. The tips here apply to both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) claims.
Although this website and this page provide tips and suggestions to win a disability claim, the information contained below is not legal advice, and should not be taken as such. Each claim is as unique as the claimant making the claim. The tips and suggestions on this site and this page may not be appropriate for your individual case.
Please do not take anything said here as legal advice unless and until you have hired me to represent you in your claim for benefits, and I have agreed – in writing – to represent you.
This page is an overly-simplified guide to building a winning claim for Social Security Disability (“SSDI” or “SSD”) or Supplemental Security Income (“SSI”) benefits. It details the key things you should do to win your SSDI or SSI claim. This page is not intended to be a substitute for hiring an attorney to represent you. Nor should your research end here. I will not be going into detail about Social Security’s rules and regulations, or case law that applies in your area. Instead, I’ll be providing tips that will assist you in maximizing your chances of winning your disability case.
These tips can be summarized as follows:
- Document your condition with medical records from a doctor;
- Explain all of your disabling conditions and symptoms to your doctor in detail;
- Obtain medical records of your disorders, and your resulting impairments, and submit them to SSA;
- If Social Security denies your initial application, appeal the denial letter within 60 days;
- Try to remember there are a large number of legitimate claims that are denied benefits at the initial application;
- Do not give up on your claim for benefits;
- If you are denied again, appeal again within 60 days;
- Follow your doctor’s treatment recommendations and take your medicines as they are prescribed to you;
- Keep a detailed notepad or diary of your impairments and keep an organized file of all your disability and medical records;
- Know the facts of your case and be prepared to discuss them with an adjudicator or an Administrative Law Judge;
- Have great patience – the process takes time even with an attorney;
- Retain an attorney to represent you and to handle your case.
If you’re applying for SSDI or SSI, or are appealing a denial, here are some tips that may improve your chances for success in your claim:
Tip 1: Make Sure Social Security Has All of Your Medical Records
The first thing you should do is make sure Social Security has a complete set of your medical records. As I explain to my own clients, medical records are the foundation of each and every disability claim. I often compare building a Social Claim to building a house. Like a concrete slab is the foundation to a new home, medical records are the foundation of a disability claim. Without medical records evidencing your severe impairments, you will likely lose your claim.
So, how do you make sure Social Security has all of your medical records? First, make sure you tell Social Security about all of your medical providers when you first apply for benefits. This list should include, and is not limited to, the following: your doctors, specialists, psychologists, hospitals (including ER and urgent care visits), clinics, chiropractors, health departments, therapists and counselors. Social Security will use the medical release you signed to obtain records from all of these medical providers. If you do not identify the provider the claims handler, Social Security will never request the records and the records will never become part of the decision in your claim.
Second, if Social Security does not receive the records from your providers, then you need to go out and get the records and submit them yourself. And let’s be clear what medical records are included. You do not need to go back decades and decades to when you were born. Generally speaking, the only relevant medical records will be those that relate to your to your disability, illness or injury, from one year prior to your disability onset date (the date you became disabled) to the present date.
The records may “objective” test results, including MRIs, X-Rays, blood work, EMGs, EKGs, EEGs, CT scans and more. The records should also include your doctor’s treatment notes, emergency room visits and hospitalizations (we typically restrict our record requests to “admit and discharge summaries”).
Tip 2: Impairment Opinions or Residual Functional Capacity (RFC) Forms From Your Doctors
Another Social Security disability tip is to have your doctors write a letter about your conditions or fill out a Residual Functional Capacity (RFC) form.
If you have a doctor who has indicated he or she supports your disability claim or who has offered to help in any way, you should ask him or her to put in writing any limitations or restrictions you may have. The doctor may write a “To Whom It May Concern” letter, or identify such restrictions right in your records. The doctor should not simply recite your diagnoses, and conclude “With all of these medical conditions, Patient X is disabled and should not be working.”
It would be much more beneficial if the doctor identified specific limitations and restrictions you will have due to your medical condition. For example, “Due to back pain, Patient X should avoid twisting, bending and stooping. Patient X should not lift and carry greater than 5 pounds at a time. And Patient X should not stand and walk for more than 3 hours total in an eight hour day.” This type of assessment could be one of the most important pieces of evidence in your entire claim.
If your doctor does not have the time to dictate a letter, then he or she should consider filling out a Residual Functional Capacity (RFC) form, also called an Ability to do Work-related Activities (Physical) form. These are forms that allow your doctor to identify what he or she believes are your limitations are from your illness or injury. Such an assessment identifies your impairments in a manner familiar to Social Security claims handlers and judges, and may be the critical difference between winning and losing your SSDI or SSI claim. Social Security will make sure they have some from their “independent” doctors so you should make sure you have yours to counterbalance those from the doctors hired by Social Security.
Note: Physical RFCs should go to your primary care doctor and specialists seeing you for your physical problems and Mental RFCs should go to your mental health providers, such as a psychiatrist, psychologist or counselor (if you have a psychiatric impairment).
You can obtain a general form from Social Security or by clicking this link: Free Medical Source Statement Form For Your Doctor or Physician
My firm has specifically tailored RFCs for particular disabling conditions, including the following:
- Bladder Problem Residual Functional Capacity Questionnaire
- Interstitial Cystitis Residual Functional Capacity Questionnaire
- Lupus (SLE) Residual Functional Capacity Questionnaire
- Chronic Fatigue Syndrome Residual Functional Capacity Questionnaire (Short and Long Versions)
- Spinal Nerve Root Compression
- Lumbar Spine Residual Functional Capacity Questionnaire
- Fibromyalgia Residual Functional Capacity Questionnaire
- Arthritis Residual Functional Capacity Questionnaire
- Cervical Spine Residual Functional Capacity Questionnaire
- Meniere’s Disease Residual Functional Capacity Questionnaire
- Vision Impairment Residual Functional Capacity Questionnaire
- Pulmonary Residual Functional Capacity Questionnaire
- Sleep Disorders Residual Functional Capacity Questionnaire
- Cardiac Residual Functional Capacity Questionnaire
- Crohn’s & Colitis Residual Functional Capacity Questionnaire
- Hepatitis C Residual Functional Capacity Questionnaire
- Skin Disorders Residual Functional Capacity and Listings Questionnaire
- Diabetes Mellitus Residual Functional Capacity Questionnaire
- Obesity Residual Functional Capacity Questionnaire
- Seizures Residual Functional Capacity Questionnaire
- Headaches Residual Functional Capacity Questionnaire
- Stroke Residual Functional Capacity Questionnaire
- Multiple Sclerosis Residual Functional Capacity Questionnaire
- Myasthenia Gravis Residual Functional Capacity Questionnaire
- Parkinson’s Disease Residual Functional Capacity Questionnaire
- Peripheral Neuropathy Residual Functional Capacity Questionnaire
- Postpolio Sequelae Residual Functional Capacity Questionnaire
- Reflex Sympathetic Dystrophy (RSD)/Complex Regional Pain Syndrome (CRPS), Type 1 Residual Functional Capacity Questionnaire
- Medical Source Statement of Ability to Do Work-Related Activities (Mental)
- Mental Residual Functional Capacity Assessment (SSA-4734-F4-Sup)
- Medical Opinion Re: Ability to Do Work-Related Activities (Mental)
- Mental Residual Functional Capacity Questionnaire (without Onset Question)
If you retain me to represent you, I will provide you with the appropriate RFC for your condition(s).
Tip 3: Submit Any Medical Evidence You Have At The Initial Application
The next tip to maximize your chance of winning disability is to submit any medical records you may have in your possession. For example, if you have x-ray reports, MRIs, CT scans, EKG reports, etc., you should submit these to the Social Security representative handling your application. You do not have to go out and gather your medical records. Social Security is supposed to do that. However, you may as well submit copies of any records you do have in your possession.
Tip 4: Identify All of Your Medical Conditions in Your Application
You should identify all of the medical conditions you have when you apply for Social Security disability, even conditions you believe are relatively minor. This is important because Social Security will look at all of your conditions in combination to determine your overall limitations or level of impairment.
For example, even if your neck or back is your biggest medical problem, you may have a number of other medical conditions that further limit you. Many people with a significant pain problem are depressed due to the amount of pain they are in all the time. The pain may also be so distracting that it limits your attention and concentration. Each of these other conditions (depression, memory and concentration) by themselves might not be that limiting. However, when combined with the neck or back problems may add up to total disability. Some conditions commonly left out by disability applicants include: obesity, high blood pressure, asthma, depression, anxiety, diabetes, migraine headaches, and sleep difficulties.
Tip 5: Keep Your Attorney Up to Date
If you have hired an attorney to represent you in your claim, you should stay in touch with him or her and check in on your case every couple of months. Some lawyers handle large case loads and your constant contact with your attorney will assure that your case is up to date. It is not necessary for you to call every day or even every week. As your representative should have explained to you, Social Security Disability cases can take a long time – up to two years in Florida – and, therefore, an update every couple of months or so should ensure your case is current and up to date. If you do not have a lawyer, then you should call Social Security with the same frequency.
Tip 6: You May Need to Obtain Your Own Medical Records
If your lawyer or Social Security itself is having trouble obtaining medical information from your doctors, then you should take it upon yourself to get whatever medical information is required. Doctors’ offices and their medical records departments are very busy. Providing records or filling out forms often takes a back seat to actually treating patients. That being said, when a doctor’s patient asks the doctor for a copy of the patient’s medical records, the doctor’s office will usually provide them pretty quickly. However, many doctors will want to conduct a complete examination before they fill out an RFC form for you.
Tip 7: Appeal A Denial Letter Immediately
One of the best tips to help with Social Security Disability is to appeal a denial immediately. This is important because there are set time limits to appeal. If you do not appeal in time you may have to start the whole process over and this could cost you both time and past due benefits (money)!
If you need help with an initial application for SSDI or SSI, or if you need help with the appeal of a denial letter, the Ortiz Law Firm can help. Located in Pensacola, Florida, our law firm represents clients statewide throughout Florida. Mr. Ortiz has successfully helped hundreds of clients receive Social Security Disability benefits. He has extensive experience in SSI and SSDI claims and has a proven record of success. In May 2013, Mr. Ortiz was designated as a Board Certified Social Security Disability Advocate By the National Board of Social Security Disability Advocacy.