I assume that you have a legitimate long-term disability that basically meets the rules and regulations for a Social Security check. You are not working now at a job which plays at least $1,180 per month. Your impairment is expected to last at least 12 straight months. Those are the starting points.
What do you have to do?
First, file an application with the Social Security Administration: go online to www.socialsecurity.gov and file, call or visit a Social Security office and file, or find an attorney or disability advocate who is willing to help you file an application. You will wait 4 to 6 months to get a decision, which is often a denial.
Why Most Benefits Are Initially Denied
The denial letter will disguise the reason they denied your claim. However, it usually boils down to one of two reasons:
1. They find that you can perform at least one of your past jobs (called a Step 4 denial) OR
2. They find that if you can't perform any past jobs, there is other work in the national economy that you could perform (called a Step 5 denial).
Neither of these assumptions by Social Security may be true. The truth is, they probably rated your ability to work much higher than it really is. (The technical term for the ability to work is residual functional capacity). So, the denial isn't fact-based, it's error-based.
What Do You Have to Do If Denied?
File an appeal within 60 days of the date on the denial letter. This is the second step and the most important step.
Gather additional medical evidence from your doctors and medical providers that prove how severe your symptoms are and how your impairment makes it impossible for you to work a full-time job. Be prepared to make an impregnable argument before the administrative law judge who will preside at your hearing.
Will You Need an Attorney or Legal Representative?
Well, you are headed to a judge who will decide your case based on complicated rules and regulations of the federal government, specifically based on 20 Code of Federal Regulations, Part 404. If you aren't familiar with the Code or the burden of proof required to be awarded federal benefits in an appeal case, you may want help.
Also, keep in mind that preparing an appeal is a time consuming affair. Not only must you order and then read all your medical records, you must annotate them with notes that you use at your hearing to tell the judge where the medical records indicate that you are unable to work. Some cases that I work on have 4,000 pages of medical records (or more), which can takes weeks just to read.
Then, there is the problem of the hearing itself. You will be confronted by a vocational expert, or jobs expert, who is likely to testify that there are indeed thousands of jobs available which you could still perform. You will need to refute this idea with pointed questions to the VE if you want to win. And the regulations will let you ask some questions, not others. Some questions are helpful, while others can hurt your case. So, you must prepare to ask the right questions.
Finally, there are the technical issues of the case: alleged onset date, date last insured, listings, medical-vocational rules, acceptable medical sources, etc. Should you amend your alleged onset date if the judge suggests it, or should you hold firm?
All things considered, I think legal representation is a good idea and worth what it costs (which is nothing unless you win).
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