DISABILITY: DEALING WITH THE STATE + THE FEDS

DEALING WITH THE STATE + THE FEDS

August 9, 2018

By:  Charles W. Forsythe, Huntsville, AL

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With a Social Security disability claim, you have to contend with both the state government and federal government.  It's enough to make you pull out your hair!

 

Your state will make the initial decision about whether you meet the requirements to receive a disability benefit.  In Alabama, this agency is called the Disability Determination Service or DDS.  It's manned by state employees working under contract with Social Security.  This will be your first experience when filing a claim.

 

DDS is looking for claims that obviously meet the criteria for disability, with no complications, gray areas or reservations.  If they see a rare case which meets one of the published Listings, they are likely to approve it.  Nearly all other cases, including any case that has questions, reservations, uncertanties or which is doubtful in any way--will be denied.

 

Next, you file an appeal and begin to deal with the federal government.  Your case is shipped over to the Office of Hearings Operation, which is the appeal unit within the Social Security Administration. You will be scheduled for a hearing before an Administrative Law Judge (ALJ). 

 

In the good old days, judges might take a claimant's word about his pain level or other symptoms that made it difficult to perform activities of daily living.  Today, however, the judge will look for solid and extensive medical evidence.  They will want to see MRIs, X-rays, CT scans or other diagnostic tests that graphically explain the cause of your impairment.  Without this evidence, most of them simply are not going to approve a claim.  Not only must you prove that you are disabled now (at the time of the hearing) but that you were disabled then (at your alleged onset date).  Failure to prove the DATE disability began will cost you thousands of dollars in back pay.  I recently went into a hearing with almost $100,000 in back pay on the table!   

 

I think it takes twice as much medical evidence today as it did ten years ago to win a claim.  Judges have become more skeptical, the media has sensationalized a few cases of fraud, and congressional lawmakers are belly-aching about too many people getting Social Security benefits.  If you don't have the medical evidence, it's very hard to get a judge to award you any money.  A qualified attorney or non-attorney advocate who specializes in Social Security claims is the best person to judge the quality and completeness of your medical evidence.  They have attended hundreds or thousands of hearings and know what the rules and regulations demand in terms of evidence.

 

One of the jobs of the disability advocate or attorney is get the medical evidence, explain the medical evidence, and show how the medical evidence proves disability according to the regulations.  It's a very technical process that must follow the federal regulations. There are always 5 steps of consideration as to whether a claimant qualifies for benefits.  Each step must be proven according to specific rules and regulations.  Fail just one step (1,2,3,4 or 5) and you are denied.

THE FORSYTHE FIRM
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
CALL US (256) 799-0297