How To Win Your Disability Claim!
(Lesson 4 - Speeding Up The Process!)

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    Today, let's discuss strategies that you can use to get your case decided early, so you won't have to wait two or three years.

    But first, to recap...Lesson One gave you an overview of the entire disability process. Lessons Two and Three gave you specific instructions about how to apply and what information you would need on hand.

   The purpose of this installment is to offer you practical tips about how to win your case as EARLY in the process as you can.

    Because Social Security is a large bureaucracy, it uses many checklists to evaluate your case in a specific order. Here is the main checklist:


1. Are you now working at some competitive level?

2. If you are not working, is your condition severe? Don't worry about this step. Almost every condition is severe.

3. If you condition is severe, does your condition meet a medical listing?

4. If your condition does not meet a listing, can you return to your past work?

5. If you cannot return to past work, can you do any other type of work?

     Today's let's focus on questions 3, 4, and 5. I will assume that you are not working and that your condition is severe (meaning it has some impact on your life).

     Does your condition meet a listing under Step 3 of the process?

     First of all, what is a listing? A listing is a specific description a medical problem published by Social Security.  There are 14 categories of impairments. If your condition meets the listing exactly, there is a good chance that you will be found disabled.

     Social Security publishes its Listings of Impairments in book form and on the Internet. Here is a link to the Adult Disability Listings:

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    You can use the listings to help win your case by asking your doctor to help you identify the specific category or categories where your particular medical problems fits. Then, ask your doctor to write a letter to Social Security describing your condition and how it meets or equals each element of the listing that applies to you. Your doctor's letter should also identify when you first met or equaled the listing.

     Attorneys often create checklists that track specific listings and contain check boxes for the doctor to fill out.

     As you read through the listings, you will note that most have two parts: a medical part focusing is on objective medical evidence, such as test results, lab results, and so forth; and a functional part where the doctor must describe how the medical problem impacts your ability to function.

     Here is an example: Listing 1.06 describes a fracture of the femur, tibia, pelvis or one or more tarsal bones with (A) solid union not evident on appropriate medically acceptable imaging and not clinically solid and (B) inability to ambulate effectively .. and return to effective ambulation did not occur or is not expected to occur within 12 months of onset.

     In plain English, this listing speaks about a badly broken leg or pelvis that has not healed properly and results in your inability to walk normally.

     The first part of this listing calls for proof of a fracture. Your doctor must diagnose a bad break and document it with an x-ray or MRI.

     Second, your doctor must offer an opinion as to how this badly broken leg will impact you. To meet the listing, he must conclude that the break will keep you from walking normally for a year or longer.

     If your condition meets a listing -- and if you can get written support from your doctor -- there is a decent chance that the Social Security decision maker will approve your case early in the process. Thus, the earlier you get started in speaking to your doctor about the listings, the better.

     Let me say this again - if you can enlist your doctor's help to say that you meet or equal a Social Security listing, you improve your chances at an early decision. Don't wait for or expect Social Security to ask your doctor if you meet a listing - you need to ask and you need to be aggressive in getting and submitting evidence of a listing level impairment!

     If your condition does not meet or equal a listing, then Social Security turns to Steps 4 and 5 of their checklist to evaluate your case. Step 4 asks whether you can return to past work, and Step 5 asks whether you can return to any type of work.

     At Steps 4 and 5, Social Security will focus less on the medical diagnosis and more on the impact your medical/emotional problem has on your ability to function in a work environment. In fact, most cases are decided under a functional capacity evaluation than on the medical listings.

     When evaluating functional capacity, the Social Security claims processor looks through your medical records to find any discussion of specific problems you have had performing various activities. Therefore, it is helpful if your medical record contains this type of evidence.

     When you meet with your doctor, describe for him specific problems you are having performing various tasks. For example, if you have problems lifting things and performing housework, describe that in detail for your doctor. If you are having mental health problems that impact your ability to concentrate, give examples to your doctor or therapist.

     Employees who make the initial and reconsideration level decisions are less likely to approve a case based on functional capacity. A functional capacity conclusion is a legal conclusion, and Social Security employees are not trained to decide matters of law.

     That does not mean that you should not try. Social Security employs medical doctors as consultants who help the claims adjustors. In some situations, a functional capacity evaluation will reach the desk of the medical consultant who may flag it for a favorable decision.

     In addition, having functional capacity evidence in your file early on will help you should your case come before a judge. Many judges consider the date of a doctor's reports and in general, the earlier the finding, the better.

     Another tool that attorneys use to help doctors describe activity limitations is a checklist form called a residual functional capacity evaluation (RFC) form. A good RFC form will help your doctor identify both the symptoms and the activity limitations caused by those symptoms.

     An RFC questionnaire should include check boxes for numerous symptoms that impact your ability to work. And here's a secret: Some symptoms are a much more important than others. In fact, when some attorneys are preparing a case for hearing, they will often send their client's doctor a marked up copy of the RFC form that identifies for the doctor which check boxes are the most important.

     You see, doctors often want to help, but don't know how. By showing the doctor how to answer certain important questions, the attorney can help both my client and the doctor.

     In attorney Jonathan Ginsberg's 
book, The Disability Answer Guide, he has included the physical and the mental health RFC forms he regularly uses with a great deal of success. Also, he has included examples of these forms filled out with answers that have won actual cases for him.

    Whether you use The Disabiltiy Answer Guide or not, remember to ask your doctor to comment in some form about specific functional limitations you experience because of your condition.

    The Disability Answer Guide is the comprehensive, step-by-step, plain English instruction manual you need to help you apply for and win your case.  You'll discover real-life examples of over 100 pages of Social Security forms you'll be dealing with before, during, and after being processed through the disability system. 

     Each form is filled out with sample answers for you to copy and modify. If you are in pain or have trouble concentrating, this will save you time and stress and eliminate a lot of frustration.

That's all for now.  Next, I am going to discuss problems to avoid.

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Brian Therrien

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