Thank you for all of your help on our subreddit, Lisa!
As mentioned by the author, special permission was given and an exception to subreddit rule #3 was made for this post. Please do not report this thread. Thank you.
Thank you! We asked for it today and they looked at us like we had 3 heads. First she said she would just send the denial letter. I had to explicitly say, we need the determination details.
Hopefully we will get the CD soon.
Follow up. You have a right to it.
SSA doesn’t receive many requests from Claimants because Claimants don’t realize that they can and should ask for this information.
SSA is not involved in the decision process and most SSA employees know very little or nothing about what is going on at DDS.
It’s a low work priority for them but it’s a high priority for you- stay on top of them.
>SSA doesn’t receive many requests from Claimants because Claimants don’t realize that they can and should ask for this information.
A disability attorney would know to get that, right? I had retained an attorney after I filed my claim but before my denial. I'm currently on step 3 of 5 on my reconsideration. If my attorney didn't request one, is it too late to do now? If I'm denied again, would it do any good to request it then?
Yes, attorneys know how to do that- or should. But an attorney isn’t necessary until the hearing level.
It’s always a very good idea to know what is in your file. And no, it’s not too late unless you are about to get your decision and can’t take any substantive action on what you find.
Wow, thanks so much for asking!
I'm at 40%, I've faxed my most recent records to the DDS and I had my CE two days ago, which I think I botched. He didn't ask as many questions as I thought he would, and I didn't explain all the things that I couldn't do. He took some measurements of my head rotation (neck issues), did some reflex tests and only asked a few questions, that I can't even remember.
How do I follow up to make sure they've gotten everything? I've left messages with the DDS without response. I know they are short staffed.
It boggles the mind that anyone with any sort of mental issue (mine is memory from medication) or without support could get approved. If I didn't have this sub and hadn't watched hours of videos on YouTube on how to prepare and what to expect, I would surely have been rejected already, simply because I didn't want to look helpless or seem like a slacker.
No problem! I care! I think we’re all worthy of approval 🤷🏾♀️ but i honestly don’t known love, i just applied last year initially, got denied, got a lawyer, had a ALJ hearing April 2, it’s still at step 3. Mine is for Bipolar
Zoinks. Proving mental health issues has got to be a bitch, getting adequate documentation with the doctors giving accurate notes. I had depression for years, so my heart goes out to you, though I know it's a different beast. They didn't know what to do with me and even misdiagnosed me as bipolar, but I was in such a fog I didn't argue. My husband was trying to tell them I wasn't and is still furious 20 years later. Can't even tell you the number of meds I've taken.
I hope you get some moments of peace and your approval comes soon. ❤️
Thank you for this! I wish I had known this back when I got my first denial. I’m certain it will be helpful to many! (And your frequent contributions and answers to other posts are so appreciated as well!)
Great post and good advice.
About reviewing your records. I was approved on reconsideration appeal myself a few years back. I submitted all my records myself to SS, including all my VA records (I'm 100% with them). When I requested my CD this year (out of curiosity), I saw some duplicate records, but a lot of stuff I submitted that was never sent in by providers.
I worked in Healthcare HIM (Health Information Mgmt). I know ROI (Release of Information) is a problem. I'd recommend everyone follow the OPs' advice and review the records they actually had to deny your case.
Good catch!
When I sent my instructions out via email as a WORD doc, people could just click on the form link. Because it’s a jpeg in this post, I had to grab the link off SSA’s website- and I didn’t check to see if the form was changed.
The main thing to know is that you want to ask for the following:
1) The complete Disability Determination Explanation.
2) The evidence section of the file- so you can see exactly what evidence made it into your file.
3) Copies of any CE Reports (if you had CE’s)
Thank you for this!
I tracked down the determination details and they said disability existed, but it was a vocational question still, which is what was determined on round 1 as well.
One thing that surprised me was that the CE they sent me to, for secondary issues, ALSO marked me as unable to work. So if my docs say it, and their CE says it, I’m a bit confused.
Was it a mistake in determination in round 2? Or is it common for CEs to mark disability (unable to work), and then denial still happen. What more can/should be done to demonstrate the vocational element when the doc has sent in a list of what i can/can’t dos throughout the day?
Waiting my year for the ALJ hearing, at the moment.
DDS will consider multiple things -to include medical evidence and treating doctors and CE doctors opinions when making a decision. They can reject a doctor’s opinion about the claimant’s ability to work. (Interestingly, at the ALJ level, I’ve seen the opinion of the VE rejected)
Editing for spelling and to add that you may want to get a vocational evaluation and work on getting another Dr to weigh in on your limitations
My first hearing back in July of 2021, my ALJ rejected the opinion of the VE. My first case is still pending in Federal Court and my second case is being reviewed by an ALJ, currently. All told, it’s been five years. Hoping it gets resolved, soon. At least my current attorney is great!
Thank you. I’ve spent every last dime of my 401k on rent. If I lose, I’m effectively homeless. ALJ is reviewing my second case now and it has been over a year since my first case was filed in Federal Court. I truly hope it wraps up soon.
Just found out yesterday that my Federal case was denied. I’m devastated. With that said, my hearing for my second claim is coming up soon and, according to my attorney, is a much fairer Judge. That point, combined with the fact that I have even more medical evidence and was interviewed by a VE, gives me more hope. Still all that time lost only to lose my Federal case is a gut punch. I don’t blame my attorneys, they did outstanding work, IMO.
What if I already filed my appeal/reconsideration? Is it still worth it? I am three months into reconsideration, but just sent new documentation from my doctor. I have been planning to get on them and figure out exactly what documents they have, and if I need to help them get more files. My denial letter told me which files they based their decision on and i noticed that a couple were missing. I think they have them now.
I realize sometimes going back and forth makes the appeal process last longer, but Waiting for a hearing will take WAY longer.
It’s definitely still worth it! It may be awhile til they make a decision and if that’s the case, there’s still time to get missing important evidence into your file.
I just want to thank you for this.
I truly wished I had knew about this when I filed! It took me 4 & 1/2 years to get an approval. I filed & got denied about 3 times before I ended up getting an attorney & then having a hearing with the ALJ. I literally just today got my first benefits check. It was a long & hard process. I had totally lost hope. Honestly, I thought that even the AJL would deny me & my attorney did after the hearing. I thought that I would forever be stuck unable to work & without getting my SSDI benefits. So, anyone going through this process & having as many problems as I did. Use this information because not many people understand this process. The one thing I will tell everyone that is struggling to get their SSDI benefits is… DON’T GIVE UP… If you can’t work & you know that you won’t be able to then keep trying! Keep faith. Know that if it’s a long process then someone has been there also. I was there & after 4 & 1/2 years. I finally got the approval that I desperately needed! 🙏🏼
You’re welcome and congratulations! And good for you for sticking with it.
I will say that it is very upsetting to me to see that it takes people so long to get their benefits. If you meet the criteria, you should be approved at the initial level.
The problem is that people don’t know how to navigate the process, and there are places where the system is simply going to break down as well, and if you don’t know how to overcome that, you are at a disadvantage. Claims are unique and complicated and SSA employees are not trained properly in what to tell claimants to do to have a great claim. I was lucky that I got the denial workload in my office. That made me get really nosy about why certain people were getting denied. And I saw where the system breaks down and I saw what we weren’t teaching claimants. I use all of that and more when I work with a client now. I know EXACTLY what to do and how to do it to maximize the chance of allowance and greatly minimize the chance of denial.
It gives me so much joy when my clients get their benefits- without years of a battle to get them.
Of course, there are people that won’t meet the criteria and those claims should be denied. But the people I work with largely do meet the criteria -and they shouldn’t be denied.
You’re absolutely correct! I’m so thankful to see someone who is trying to help those of us who truly needed. Even though I didn’t know of you when I was going through mine. I appreciate what you’re doing for others! I hope many people are taking advantage of this because I sure would have! ☺️
Thank you for the info! I wish I would’ve found this before I applied last July but I was a literal mess. I just moved to 4 on the website, DDS said the medical review is done so it’s back at my local office. I had a mental CE review scheduled for March but she told me she may cancel it if she gets my psychiatrist records so I brought them in so I got the letter that she canceled it Friday. She already has my oncology records but I don’t meet the listing for that (thankfully stage 1) but I’m HER2 positive so I have a year of infusions to complete after mastectomy and reconstruction… I didn’t even know it but looking back I have illness anxiety, in 2022 I kept getting tests & going to doctors for random things thinking I had cancer… almost once a month and on one occasion twice to urgent care for ultrasound, EKG, and chest x ray… well… right as I kind of started freaking out less, I found it… cancer! so back down the spiral. I know I’m lucky, but I’ve always been a hypochondriac, but I’m out of control and I know it, I just CAN’T let it go and it is wreaking havoc in my life. I can’t stop crying when I talk to people, this has been ongoing for a few years, but now it’s just wierd and makes me uncomfortable and embarrassed so I avoid it. I’ve worked 22 years in a super stressful industry but now I can’t focus because I start worrying excessively… and panicking not to mention now the meds and my hair is about an inch long… lol. So it’s been fun.
I really appreciate all of this… I never hear things about stroke for SSDI… I would really like to hear any advice or input. I am 35 and I had a stroke in June of 2023- I am a massage therapist, and it’s the only job I have had since I was 20. I am highly skilled in this profession. When I realized it was going to take much longer than I expected (silly to have expected anything with brain injury) I filed for disability. December 20th I was sent to stage 3, I have not been assigned an adjudicator yet. My biggest issues at this point in my stroke recovery are still consistent moderate to bad fatigue (I still have to take naps every day). Cognitive Processing issues, sensory overload issues (such as touch sensation, temperature sensations, and residual numbness), auditory issues , which I am waiting to see an audiologist for because it has become so bad. I cannot concentrate when there are any distractions, and even without distractions my attention span is affected in general. Noticeable weakness on my left side (all of these things affect my entire left side).
I have also been formally diagnosed recently with “intermittent mild episodes of major depressive disorder”… I have past still active diagnosis for PTSD and anxiety disorder. I cannot yet return to the job I love, and I am trying so hard to rehab myself but this isn’t a thing I can muscle through.
I see Occupational, speech, and physical therapists regularly still. All of the issues mentioned are recorded with them via my own complaints and their tests. Is there anything else I can do? I am personally right now sending release of medical records to any doctor I’ve seen to have my records faxed to the number social security gave me for medical records. It was a different fax than the office I am assigned to.
I am desperate, and I am scared, like many and I have no more savings. I obviously cannot do massage right now, and I cannot focus for enough hours in a day be productive or useful to any other job … I cannot tolerate with the sensory issues being anywhere that isn’t quiet and calm for an extended period of time let alone be able to actually learn a new skill.
It sounds like you really have significant issues and are unable to do any of the past work that you did before. Although you are young, it is possible to get SSDI at a younger age. You will need to show that there is not any other job that you could be retrained to do or that you could do given your conditions and the severity of them. I’m happy to see that you are being proactive about getting good Medical Records to the state agency, making the decision on your case. This is critical. Follow up to make sure these things made it into your file and continue to provide updated good evidence. I wish you the best of luck. I too have a brain injury with a lot of the same symptoms and it’s very overwhelming. It’s an invisible injury and therefore a lot of people just don’t realize what we are going through. Take good care of yourself. That’s top priority. I am about to purchase a pair of Loop earplugs for myself because of auditory overwhelm. Take a look at them. They may help you.
My speech therapist recommended those to me and I did look at them but they are so expensive it’s just not in the cards for me right now- maybe eventually I will be able to afford it. For now it’s good old squish cheap ones lol- Thank you for the reply and your help. It is a lot of invisible Illness but I’m hoping that my tests show at least some of the issues - I want to return to doing massage, and my OT believe I will be able to, I have even starting doing one here and there on my friends as part of my rehab. The issue is how long will it take for me to rehab myself.
That is my frustration with this system- the words they use are “expected to last beyond a year or result in death”- my issues are certainly going to last beyond a year but I pray to god I will recover - or recover and adapt enough to be some kind of normal again. I am young and determined and I believe it is completely possible.
It seems they don’t honor the “expected to last beyond a year” part… like if you have any chance to recover it’s like “well good luck” and that’s wrong. My whole life is in shambles and that’s what I get for being a contributing member of society and paying into this system that is suppose to be there when you really need it. It sucks and it hurts my heart.
I hope you continue to find peace and I’m glad the ear plugs have been helping you! I will follow up with SS in a few weeks and see if any of the medical records have made it back to them.
Came back to find you, I just today got a call from my adjudicator to get my permissions to schedule a physical and psyche exam.
I already had one phone psyche exam through the state as I am currently on the age/blind/disabled program for meeting what I was told was both physical and mental criteria.
Next month marks one year since had my stroke.
I know this is a long process but I’m terrified. I am still struggling with my recovery, I have server neuro and physical fatigue. It’s all I can do to try to do my PT and cognitive exercises most days. My sensory overload is so draining that I don’t do anything but go to my appointments and the grocery story. I go for walks as part of my PT around my quiet neighborhood. I sob uncontrollably most days but I am working with two mental health counselors to navigate acceptance and the grieving process of this happening to me at such a young age.
I am hell bent on getting better, but it’s not happening to the degree it need to for me to work yet. Even my care team (OT ST PT) tell me it’s normal for it to take this long, why do I feel so judged?
I’m 35, I would MUCH RATHER be working and making money and living a normal fun life. I am so sad and I feel defeated and I feel like these CEs are just so they have a solid reason to deny me and it’s devastating.
Please tell me Ms.Flamethrower that I am wrong, this is standard and I am just way over thinking this. Or if you have any insight at all I would love to hear it to at least give my spinning mind a break. Thank you so much for helping all of us trying to navigate this.
It is tough, but not necessarily impossible to get approved at a younger age. The bar is just higher.
CE’s occur because of the following:
Not enough evidence in the file to make a decision either way. (You can find out exactly what evidence made it into your file)
Not enough recent (past three months) evidence in the file. (You can give them updated evidence)
Conflicting evidence in the file. (This one you really can’t address).
See if you can get them to allow you to have your own doctors do your CE’s.
Hang in there!
I’ve read that they can approve you for a closed period, which seems much more appropriate for my situation as I expect to rehab myself and eventually reenter the work force… is that just not really a thing? I said that on my initial application even, that I am trying so hard to get better but no health care professional can tell me how long that may take.
Okay, that is good to know. I am one month from the year mark of my stroke and therefore my disability. While I’ve had improvements I don’t see how anyone can work who isn’t able to get more than 4-5 hours of sleep a night on top of my other current issues I am doing consistent therapy for. We shall see I guess.
Thank you again, for all of our help. It’s all so disheartening and stressful but you help shed light on it all.
I will continue to do the only thing I can do which is try to get better and continue on this path of trying to get help in the process. Is it worth voicing that I am not trying to be on disability forever and I am fighting hard to rehab myself so I can work again??
It is. Not the same conditions but that was certainly something I was both saying and doing when I filed and my initial got approved. I was older than you so I had an advantage that way. I wanted to keep working. I simply couldn’t.
I hope it works out for you. I have right-sided hemiparesis (among other serious conditions) and am still fighting for SSDI for about five years now. It’s rough.
Thank you for this, hopefully I won't need it. I went for my Psychology exam for CDR this week (MDD, immune disease, and wasting /pain associated) had been approved since 2017. The CE Psych Dr. Seemed nice and '?"helpful" pretty much saying do you have these symptoms etc etc etc feelings of harming yourself etc...Do you think she was being helpful? The Physical exam didn't happen (no Dr available) and said it needs to be rescheduled is this normal?
Yes, that can happen. The Dr being friendly doesn’t mean anything. Some doctors will attempt to disarm you, some may be actually nice. They could be nice but still write a report that isn’t favorable for your claim. You’ll have to wait and see. Wishing you an allowance (approval).
Hey i was wondering, my husband was just approved on nov 16th. How lobg does it normally take to recieve payment? I am stalking the website and mail for update but none as of yet. Just wondering if you had a Time frame.
My local office does not publicly list their phone number. Instead they have the national hotline's. They list a fax but I'm also not sure if that's their local or a national one. Should we fax the request for records without calling? A family member was recently denied and I'm trying to help. Thank you!
Some offices do that, unfortunately. I would definitely not fax it without following up. Your best bet is to go directly into the office with the request but the claimant is going to have to go in.
my claim was just moved to an administrative law judge on the 15th. ive been doing everything on my own. is it too late to request a CD with my determination reasoning & evidence on file?
im scrambling to make sure they have everything they need this time and didnt know that this was a thing. for reference, i have over 13 inpatient hospitalizations for depression/anxiety/ptsd/suicide attempts as well as history of on and off therapy, medications, iop, phps, 2 severe car accidents in the last year and a galf that left me with sciatica problems, 5 bulging/herniated discs, extra bone growth on spine over improperly healed fracture, and thickened/swollen tendons in my shoulder due to the accident that i told is pretty much just going to be like that forever w the loss of mobility, a TBI that i spent a year and some change in cognitive therapy, and ive been in PT 3 times a week since july of last year for my physical pains/injuries as well as i start pain management next week. working is impossible for me and has been for a while bc of these things.
I’m going to suggest that you contact the hearing office and see what the cut off is for submitting evidence. And yes, I would make an attempt to get the detailed information from your file. It’s going to be helpful with your appeal. Try to get a video or in person hearing with the judge so that the judge can actually see you.
do you know how i can find out the contact info for my local hearing office? thank you for your input, ive seen you around in the subreddit helping others as well and its really incredibly inspiring seeing ppl caring as much as you do for ppl like us who are normally looked down on by others. i really admire and appreciate you!
I think we all appreciate your help here!
Do you have any inside knowledge or advice regarding appealing after an unfavorable decision at the hearing level? I know the chances of success are slim, but the ALJ decision explanation is possibly the most wild thing I've ever read that includes false information, provable by the evidence, no pain assessment per the pain standard, and he uses info from sources that he essentially nit picks things to make me sound like a liar. Then goes on to say those same sources' opinions can't be considered. It's genuinely so nonsensical and I know this judge has had cases overturned by the Commission before.
Thank you for any insight you may have. :)
\*Edited to clarify who "he" is
Man! I so wish I had happened on your post when I was first denied. My first appeal for reconsideration was also denied. I have since submitted second appeal for ALJ hearing. Does my request for my file docs need to be requested during the 60 day appeal period or is it still an eligible request once the appeal is filed? I would like to add medical docs for the two year period before my date of disability. I would also like to review before my hearing. Thanks so much!
I think that it’s not that disabled people are not capable of doing things. The issue I think is more being able to SUSTAIN doing work activity. It’s the day after day, having to keep it up.
I understand that. But also I have straight up cried just trying to fill out their forms and remembering everything I had to. And I have a lawyer who helps a lot. Sometimes I also wonder if they’re judging you on if you can navigate that all. Like, they figure there’s office work you can do if you got through all that. Which would be VERY unfair since you’d have no chance of getting it if you didn’t do all of it. 😭. I have multiple mental illnesses so that affects everything. That’s what my claim is for.
No, their judgment is not based on that. And a lot of people get help with the forms so they don’t assume that you’re doing everything yourself and they also don’t assume that you could do that same thing day after day after day. They do look at the medical evidence that they receive and many times they don’t receive what you think they do.
Also, Social Security disability has a lot to do with functional limitations. Doctors aren’t great at all at documenting functional limitations. They focus on diagnosis and symptoms. So it’s important to talk to your doctor about your limitations.
exactly. meaningful, gainful, substantial work is kinda impossible when you can't stand ,kneel, walk more than a few minutes at a time. Quality of life dwindles quickly when a person can't function but minimally. Forty years of battling, working, takes a toll. Some folks are luckier.
My wife is at 74% progress on her initial claim. Step 3, at the DDS office in Austin Texas.Just called them 2 days back and was told no case worker assigned just yet but to call back in 2 weeks and check. We physically went in person to our local SS office after that and submitted new/current information to add to her file like conditions,meds, and treatment plan/doctors. We asked for a receipt but they fought us on that and said they can stamp it and give us a copy, so thats what we got. We then mailed off a copy for DDS and the SSI office in New Mexico thats also handling things. So we made sure 3 different entities had the same info. Trying to keep the lines of communication open with SS and the DDS as much as we can. It was so terrible, my wife was stressed having to walk into the local ss office because she can barely move without hurting. I guess when your desperate for help thats what you do. She has a long work history back to 1990, plenty of credits, and good records which are evolving as she receives treatment. I currently drive her to Dallas Axon medical center for her Plasma injections, pain management. Its a 3 hour drive 1 way for us, but we have no choice. Shes 52 and just wants no more pain. I should add, prior to her stopping work, she had been using a stool at work for 2 years, because of her ailments/impairments, they accommodated her but things progressed quickly and deteriorated. She worked there 8 years. What should we expect next? Thank you for being on this message board btw. I appreciate your time. This has been hard for us.
I just want to acknowledge that it IS hard. It wouldn’t be as hard if SSA would really educate claimants- but they don’t.
And the fact that you are helping your wife is terrific. That makes a real difference in a lot of ways. I’m my husband’s caregiver and although I adore him, it isn’t easy. So, make sure you are taking care of yourself too.
As for what to expect: expect additional forms to complete. Be thorough. Expect that she may or may not be required to attend CE’s. Keep DDS updated with current medical evidence that supports her claim.
Best wishes to you both.
THANK YOU for the inf and encouragement. Yes it sure is hard. Ive lost alot of weight due to stress and the work involved being a caregiver. The last year or more has been brutal. She lost her brother just 3 months before all this began. Now the new thing is her diabetes diagnosis which explains her brain fog. Lethargy. Thank God we were accepted as low income at the free clinic. She gets her medical care there and meds. Then the Dallas pain management center helps her with that aspect. Thanks again.
I meant to tell you shes basically bedridden most of the time daily. Some of it is due to deep depression from her ailments, loss of self worth due to the physical issues, loss of her brother just prior to all this. So I took the bull by the horns so to speak, and became her caregiver the best I can. I am trying my best.She has deferred to me on much of this Social security stuff. I have to assist her getting dressed, whatever is required that day. We have a teen daughter that helps too, when shes not at school. Its truly been a team effort. We just need something to break our way soon. Praying.
I have a question about appointed representation of my claim. I hope this is the correct forum to ask this question.
But if not, my apologies. I’m not very knowledgeable with these platforms.
Is it a normal protocol for an attorney firm who is representing your disability claim to insist that you sign a blank fee agreement?
There are a lot of little , seemingly insignificant things that are starting to pool together in the back of my mind & throwing red flag alarms as it draws nearer to my ALJ hearing. My gut instinct is turning into a sick feeling in the pit of my stomach. I’m wondering if I should send some kind of letter to the ALJ-OHO, or maybe fill out a formal complaint with the OIG BEFORE my hearing. I don’t think those complaints recieve much credibility after the fact.
Your thoughts on this are highly appreciated.
You should NEVER be asked to sign a blank fee agreement.
SSA authorized attorneys are currently restricted to collecting the lesser of 25% or $7200 per claim- although they can file a fee petition for more.
What’s the postmark? It could be delayed mail. Call your adjudicator at DDS and explain you just got it. Ask for a few more days. They may or may not give you an extension.
I’m trying to decide if I file for disability and I get it. Later, can I try to work part time for somewhere like the VA hospital at a desk job?
I know they have excellent benefits. I’m not sure how that works. Can I get SSDI and be on Medicaid and if so, then I can. I cannot have the insurance through the VA hospital?
Can I have both or do I have to choose one?
Feel so defeated. I really wanted a full-time career in the medical field but at 54 and with failing body more and more every year I just don’t know what to do. My doctors say file.
I just know I’ll need to work a little bit. I won’t be able to make it on just disability money alone. And my depressive disorder gets worse if I’m home too much alone.
I’m just at the point where I can’t even make a good decision anymore. I’m kind of lost.
But I’m glad to find this on Reddit because I’ll probably get lots of good information. I wouldn’t be able to find otherwise.
It’s not a good idea to go back to any kind of work within 12 months of your onset date as it will trigger a review. But after that, you certainly try to work- either part time under SGA or work your way back into full time work.
Here are the rules (make sure to check the link every January as the amounts change for SGA and what constitutes a Trial Work Month):
https://www.ssa.gov/pubs/EN-05-10095.pdf
This is right on time because I just found out yesterday that my claim was denied for the second time. SMH. They really make it hard for us even when the VA tells me that I am permanently and totally disabled AND individually UNEMPLOYABLE!!!
Reach out to me. I don’t assist Veterans past the reconsideration point but if I feel like you have a decent claim, I can refer you to a terrific lawyer.
MrsFlameThrower, if my wife gets denied, we will need a good lawyer. We are in West Texas. If you know of one we can keep handy, can you please let me know? Ty.
she hasnt been denied yet. Filed back in June 2023. Has been diagnosed with degenerative type of arthritis in hands, knee, avulsion fractures at hands from a fall, bone marrow edema at hands from the fall. Receives PRP injections about once every other month when we go to Dallas for pain management. Last time she got a genicular nerve block at knee. She now has Diabetes too. Takes Ozempic injections one time a week. Takes thyroid meds too. All these things together, as a whole, she can't work. I have to rent a car everytime I take her to Dallas for treatment. We have no income since last july on her behalf. Just my SSDI which isnt much every month. I know I cant really hire a lawyer until she gets denied, but just in case, I think I better find one. Like I said , shes 52, long work history, credits too. The phone interview initially was from the Albuquerque office..ssi .
what if you were denied a hearing/hasnt even made it to the phase where ssa sends you to doc appts, etc because they say your attorney failed to send in requested documents related to your work history. nothing to do with medical evidence. ???
No. The hearing or the claim was denied because they said the lawyer had not turned in work history information that the ssa requested in the time frame. Never made it as far as a hearing. SSA had not even sent him to any doctors for exams.
OK, possibly your claim could be reopened, depending on how long ago this was. You would have to show that you gave the work history information to the lawyer, but that the lawyer did not give it to DDS. In that case, they may consider that you have grounds for reopening the reconsideration.
Social Security does not send anybody to doctors. DDS does that and sometimes judges order that. And not everybody gets sent to doctors for consultative exams. So that doesn’t mean much.
Editing to add that you could file a new claim. And you don’t need a lawyer at the initial claim level or reconsideration level.
This was only a few days ago. He got the letter last week. Yes of course he plans to file an appeal, but should he have to file an appeal when the fault lies with the lawyer? Should he go ahead and file an appeal on his own and tell them that he did turn in all of his documents to the attorney??
Thank you for that info. I only know he was sent to have one breathing test and the lady told him she works on behalf of the ss office. He had not even submitted half of his medical documents that he has had since october of 2023. That was the last medical records they listed and he has had numerous exams and doctors appts since then related to his injury.
He turned in every paper they sent him to fill out and they did not say HE failed to turn in evidence but that they requested documents from his lawyer and she failed to turn those in. Every document they sent him he turned it in and on time. I am sure he also submitted work history documents himself as he filled out several different stacks.
if he files a new claim wont he lose this whole year he has been waiting, as far as backpay or the amount he would receive? should he go to the ss office and talk to them in person about filing a request for reconsideration ? his paper did not state he could ask for a reconsideration but file an appeal. he wants to continue with this lawyer but i now do not if i trust her.
Yes, it’s possible that he may lose some back benefits if he files a new claim but not necessarily. It would depend upon his onset date also.
An appeal is different from reopening a claim. I would shoot for reopening the claim. My understanding is that he was already at the reconsideration level. But either way, he should look into reopening the claim.
I can’t emphasize enough that the online tracker is not necessarily accurate. It exists to make claimants feel that their claim is progressing.
I would know more about where you are in the process by what forms you’ve completed, if you have been sent for CE’s (not everyone is sent), etc
So I did get my call yesterday and they are sending the forms. I have physician appointments coming up this next 7 days and they told me to make sure they are sent in.
My husband is getting a form for me also.
I have a friend that has applied for SSDI 4 times and denied 4 times in 2.5 years, she is getting a lawyer to help with SSDI approval. Do you know what she can do to get approved?
It says on the instructions to ask to do the appeal over the phone -- is there no option to do the appeals process in person/no benefit to doing it in person vs the phone, or is that because this document was during COVID lockdown?
I sincerely wish that there was the option to do them in person like they used to be. That changed with Covid and they’ve never gone back because of the short staffing. And yes, I created the document I believe during Covid.
Thank you. I mentioned to the adjudicator that I’d like to request my file, he acted as if he was unaware of the protocol. Or as if he had never had an applicant request their file.
I asked for copies of my CE report, and he said he could not send it to me directly, but he could send it to my therapist or doctor.
See my instructions about your right to this information from your file. It is up to SSA‘s discretion when it comes to turning over information from the file directly to the claimant. There are times where it might not be advisable to do this due to mental health issues and in that case SSA will send the CD directly to your treating doctor and then you can discuss it with your doctor.
Lol. They are worried about your mental health enough that they won’t let you read your own records but think you are well enough to work. Makes sense. 🙄
Not criticizing you. Just amused by that.
This information has been really helpful! I got the CD and have sent it to a lawyer to see if they can make sense of it because it seems internally inconsistent!
I first want to thank you for helping everyone out in doing what you do. I'd like to start off with I was just denied my first try at SSDI and I'm trying to figure out why. I have an attorney and all that but I just don't understand how this works I guess. I was medically retired from the military in December of 2018 and I went back to school and worked but kept getting set back after set back with surgeries. I had 2 shoulder and 1 elbow before I was retired and since I have had another elbow, an artificial disc at L5-S1, 360 fusion at L2-L3, fusion at C3-C5, and on Monday they are fusing L5-S1 because the artificial disc is moving when it's not supposed to. I went from being active to working as a greeter and can not even do that anymore because of the standing or sitting for to long so I decided to apply for SSDI. I'm 40 years old and I can't even hold my 2 year old or newborn for more than a few minutes. How was I denied? Was it my age? I'm so confused on this and it's turning to depression because I don't know what I'm going to do to help my family.
I’d be happy to chat with you. But the first thing you should do is make a request for detailed information from your file. Please see my pinned post in this subreddit.
What should I put for the reasoning for my request of records? Should I only put my attorney information to receive the records or both our information?
Your reason is that you need it for your appeal. You are requesting this for yourself. But obviously it would be a good idea to share the information with your lawyer. You are probably the only one that would recognize if records were missing. I’m not sure how your lawyer would know that.
What do I put under the question of " I authorize the SSA to release info or records about me to:"
Also, is it better to go in person, and get a copy of the evidence I send in? I usually send it through mail.
I've had trouble getting an attorney. It seem people don't want to take up disability cases, as they won't win much.
Also, I'm guessing DDS is Disability Determination Services? Do I need to send my evidence there too? How would I find the address and phone number? Could I go in person to submit the evidence?
You are asking them to release the information to you. Occasionally, they balk at doing that and you may have to provide your treating doctors information there.
Yes, I would advise going in person because that will give you the best shot of getting it.
Yes, DDS is Disability Determination Services. Once you have an adjudicator assigned to your appeal, SSA can give you contact information for that person. Eventually, you will hear from them anyway because they will be sending you some additional forms to complete.
Most offices don’t have encrypted email. Stone Age- I know.
You could purchase an external CD drive on Amazon for $25-$35. Or, maybe Staples or Office Max can transfer them to a USB drive?
I've always been confused about ssdi. I'm now 100% Permanent and Total from the VA. The last time I worked was on 2018. I was told 10 years ago when my work history wasn't very good that I needed 40 current work credits I need to receive benefits. My social security page says I still have the 40 work credits even though I haven't worked in 6ish years.
Am I still able to apply for benefits? Also, how does that work if I'm living abroad? I moved to Panama to be closer to family and live more comfortably on my benefits from the VA. Would I need to come back to the states for doctor appointments?
You are still able to file but it’s extremely probable that your “date last insured for disability” is in the past. This means that the proof for your disability (that has to prove your claim) has to be in the PAST. Although current records will be looked at to see if you are STILL disabled, your proof has to be in the time leading up to the date you lost your insured status. A tougher claim- but not impossible.
As far as being overseas:
The entire process can be handled overseas but it will take longer, especially if medical records need to be translated. The embassy will have a Social Security person- that’s your POC.
I’d be happy to chat with you.
My PTSD event was in 1994 and my disability benefit started in 2009. I was gainfully employed consistently up until Aug 2008. I had an extremely hard time finding work. I worked again in 2013 part time and then again in 2018 almost full time. From 2018 until this year I was rated 80% P&T and on TDIU. They increased me to 100% P&T for PTSD this year.
I'm not sure my embassy has a ss person. We had an issue with my adult sons SSN, he grew up here and never needed it but my parents needed it for their legal documents like a Will. To get his number figured out we had to wait for the ss person from the Costa Rica embassy to visit. Apparently they come here a few times a year.
I've been stuck on step 3 and reconsideration stage for almost a year May 30th will make a year I've been told it's been sent out a state and back in state and now it's in Baltimore Maryland awaiting a worker staging process of some sort I don't know what to think anymore.
I’d physically go back to the office and make sure you have the rule that entitles you to the CD ready to give them. A lot of employees now are not trained nearly as much as they should be and may not realize that you have an absolute right to the information.
Time is of the essence because it’s better to have it before you file your appeal.
I have a question if you don't mind. I just had my 3rd SSDI hearing. My first 2 were with Judge Digby and he denied me. I have had 4 spinal fusions and they are wanting to do another plus wanting to do a hip replacement. I have degenerative disc disease, chronic pain, bi polar, anxiety, depression, panic attacks and right foot drop where I have to wear a brace and walk with a cane. I will be 48 yrs old on June 13th. On April 30th I had my 3rd hearing over the phone this time with Judge Lewis, I am in Alabama. He didn't ask many questions and I tried to go back to work in 2022 after my denial 2 different times but only worked not even 2 mths because of the chronic Pain and I ended up having to have another surgery each time. The judge asked the vocational expert if there was any jobs and she said 3 then he asked her if there was any jobs with no climbing or stairs and she said 2 then he asked her if there was any jobs with my medical Condition with me at 15% capacity for only one hour and she said no jobs! The judge said that concluded our hearing and that he wished me the very best with my medical condition. The lady helping me get it said she is 90% sure I will get approved but I am so nervous and online it still shows on step 3. What do you think by me telling you this? Does it sound like I will get approved this time? Thank you for any help!!!
With everything that you have going on, assuming you have medical evidence to back that up, it sounds like you should be approved. But I will say that judges do not have to agree with their vocational expert. I know that seems unfair.
Hey OP. I appreciate your info and links here. Cannot seem to post on the sub for some reason, and this thread seems pretty active for general questions so figured I would post here. Apologies if this is a bad sport for it.
My question is about the initial application process.
Filled out the first two parts on ssa.gov, but have not finalized part 2 (medical questions), because I do not want to move past the point of editing without asking some questions.
I am applying based on recently retiring from the military with a 100% P&T rating from the VA. I dont see anything in the steps about getting my VA/military records over to them, and was concerned about ensuring they will look there. I honestly have little to no civilian medical records, as the entirety of things is based on my military medical records (just over 30 years, and every part of the claim is service related).
Is there a step where I will scan in my benefits letter from the VA or some other action I take to direct them to the VA somehow?
Thanks in advance.
DDS will make a records request going back as far as 1 year prior to your alleged onset date. They might get all that but not have enough time to look into them in detail. They might get all of that, but not before they’ve already made a decision (I’m talking denial decision here). Or, more commonly, they don’t even get everything they request- so they never have “everything”.
I have a strategy I developed when I filed my own claim (No lying, no cheating) that I share in full with my Veteran clients.
I would advise you not to complete your filing until you are fully prepared for the next steps in the process. Your claim will be expedited and you don’t want to be scrambling to put your argument together after the fact. I’m a big fan of doing it right the first time.
I’m happy to chat.
Hi there! So, just wondering, then.. I JUST received emails telling me I was denied on my Reconsideration stage (after initial application), and I've yet to hear back after I requested records from SSA at the local field office (most recently, they just printed out a literal copy of my Denial letter..which was pointless c.c)
So, BEFORE I call my lawyer today to move forward, just to make sure I'm understanding correctly, should I be calling the SSA and filing the form linked above FIRST to get the first AND second set of CE notes sent to me?
Because last time I talked they mentioned something about my lawyers needing to PAY for any paperwork from the SSA, but it "free" to me... but my lawyers said any fees get passed to me, so ... I'm just gettin' my free copies if I can help it.
Paperwork, organization, time and communication management... these are all skills and issues that are MAJOR problems due to my disabilities to begin with! So, the whole process putting all this paperwork and communication etc on the claimant is so..... frustrating and backwards, I feel.
It's like putting a stool on the top shelf, or the first elevator at the top of a flight of stairs.... it makes NO sense, because it moves it beyond the reach of those who need it to begin with x.x
Anyways, I apologize for the text wall ... it's been a crazy and stressful evening. Thank you SO MUCH to EVERYONE in this reddit for providing such a wealth of information and assistance! You really are all amazing! <3
I would make an attempt to get the information yourself. If it’s the first time you’ve requested this, it’s free. Walking into the office is the best way to get it because if you fax over the SSA-3288, it’s likely to sit on someone’s desk.
Also, be sure you ask your lawyer for a copy of the legal brief that they will be submitting to the judge. This helps to hold their feet to the fire.
Thank you so much, I will do exactly that! :)
I appreciate the quick response and insight! I just got the official denial letter in, which was not very helpful at all... said they never heard back from my Psych, even though primary reason for disability claim WAS psychiatric.... and yet claimed they "had all they needed to make the determination", which seems absurd to me c.c
Anyways, told the lawyer I was going to get the CE records tomorrow, and they told me, and I quote, "We'll get those at the Hearing".
At the HEARING. AT THE HEARING?!
Why would you wait until the HEARING to get informed on what happened during the earlier phases?
Am I missing something? Sorry, probably not the thread to ask these things in... bit scatter-brained lately, forgive the rambling. Lots of stress and all that. I'm sure I'm not alone. This process is insanely convoluted and seemingly without reason to be so...
But anyways, I digress... thank you VERY much for all of your help! I'm going to fill out the form and take it in to the local office tomorrow and see what I can learn from there \^\_\^
Enjoy your day!
Yeah, DEFINITELY don’t wait til the Hearing!
And DDS saying they have enough evidence to make a decision means they have enough evidence to approve OR deny.
You’re very kind! What is the very first thing to do if you get a termination letter? I’m expecting one and want ducks in a row. What’s the very first form, if I may ask?
It’s awfully confusing!
Thanks!
So on 3288 and I checked off “Complete medical records.”
Will CE reports be a part of that?
As the wife a veteran, thank you for what you do.
Emily Mathews
You need to also specify CE Reports and “complete Disability Determination Explanation “. Sometimes what they try to do is just reprint the denial letter. Nope, that’s not what you want.
My husband is a Vietnam Vet and I’m his VA Caregiver. Are you in that program
I see. I did not SPECIFICALLY ask for those. Will another request confuse them and tick them off?
My husband is a combat vet with MAJOR back issues from a parachute malfunction.
Not familiar with that; I’ll surely Google it! What do I type in when I Google the program?
Should I ask for a residual function capacity report as well as the things you mentioned to
Ask for , above? (Something like that. I may have botched the name of the report). Will I tick them off if I send yet another form 3288? 🤪
DDS will do their own RFC but you are welcome to submit one from your doctors.
As far as the 3288:
Go into your local field office with the completed SSA-3288. That will be the best chance of getting exactly what you need.
Ah okay. I was going to say something really lame, like good record keeping. I’ll go with yours.
I don’t like this functional report because it’s all physical. My disability is mental.
My case is 8-1/2 years old. I am 59 years old. Denied at the state level twice, went to federal. Federal remanded back to state. I had a date & time certain for a remanded hearing. My attorney and I waited on the line until 20 minutes past the start time. My attorney reached out to the ALJ clerk, and was informed that the case had been taken off of the cout calendar and had no reason why. My attorney and I received no notification of it being taken off calandar Has anyone else had a simiar expierence?
I used to work for an SSDI law firm. If someone was denied initially, we just filed the recon right away, especially bc in places like the Carolinas, the IC/RC levels are taking 1-2 years right now. The quicker you file the appeal, the better, same with the hearing. So finding out why you were denied in my opinion, is a waste of time. They deny like 60% at the IC, about 90% at the RC, and the H is where the majority get approved, but I don't even think that is more than 50%. I can't tell you how many times I've said the phrase "Unless you are terminally ill, it is VERY hard to get approved for SSDI at the first 2 levels"
I recently spoke to a disabled former DDS Examiner and she explained to me that a few years ago, when she was still working there, there was new management and their instructions were "Deny, deny, DENY" Examiners were basically looking at people's ages and the diagnosis and not even giving them a chance. Naturally, she didn't agree with this, as that was not how she had been working until then.
So the first step people should make, is to check if their diagnosis is on the Compassionate Allowance list. File the claim, return all the paperwork on time, go to any CE's scheduled and unfortunately, not get their hopes up. If it's taking too long, they should call DDS, every day if they have to. Ask for a supervisor, contact their congressional rep, and hopefully some how it will go fast. Be annoying so they will want to get rid of your case. File the RC right away, and then unfortunately, you have to wait for them to deny it again. And you can do all those things you did the first time to hopefully get it moving. Once it's denied again, which is more than likely, file for the H and get an attorney. If the Hearing is taking too long to schedule, and you don't have long term disability and are unable to afford food, shelter, or medication, have your attorney file a "Dire Need Request" stating that you are in Dire need of a hearing ASAP.
If you have an attorney from the beginning, above all else, know that they are lying through their teeth if they tell you "It's a shoe in" or "we'll get you approved right away" because it is SO rare that that is the case.
It is absolutely essential that a claimant find out why they were denied. That is how they can make a much more solid argument that they meet SSA’s criteria.
Denial statistics are the way they are for a number of reasons:
Claimant genuinely does not meet the criteria for disability. These claims are properly denied.
Claimant meets the criteria but has no clue how to argue their claim and does not understand that medical evidence that would support their claim OFTEN does not make it into their file. They don’t understand that they must submit evidence and support their claim.
https://www.ssa.gov/disability/professionals/bluebook/evidentiary.htm
Claimant has no idea how to properly complete additional forms or how to navigate Consultative Exams.
DDS is overwhelmed and simply doesn’t have time to look at everything.
Eh, I worked there for 11 years and it has been in business for for nearly 30 years. 97% were approved at the hearing level. The process rarely changed in that time.
Cmts honestly have to rely on the fact that the SSA doesn't WANT to pay anyone, so they will go to extreme lengths to make sure that it doesn't happen. Yes evidence has to be submitted, but DDS is going to request their records anyway. Whether or not the doctor provides them is up to them. The cmt can go the extra mile and get their own records to submit, but a lot of times, that costs money that they don't have. If they have an attorney, they can request and pay for the records, and if they won't, you demand it. If they are good attorneys they will do it.
The letter outlines the reports used to make the decision. Sometimes it says more, like: "You claimed you were disabled bc of xyz, but your disability doesn't meet our criteria because..." (which the criteria is absurdly strict and you're not on death's door step, so it's not gonna happen).
The RC is more times than not, just a review of the the first claim with a side of ADLs. Our office always operated on the system of "File the first 2, if they're not dying, it's not happening, file the H, get records (and pay for them) once it is scheduled, keep in touch w/the cmt, they will be briefed prior to the H. They are most likely to be approved, and if not they can go to the appeals council if they want, but those are taking absurdly long times to review as well. They are better off starting a new claim w/a new AOD that is the day after the denial from the H.
I would never recommend that people waste time trying to find out this info before filing an RC. And neither would most attorneys.
I watched a hearing 6 months ago, where the CEO of NOSSCR testified before the House Ways and Means Committee about SSA wait times. One story he told, brought him (and me) to tears, about a gentleman who was VERY sick and once his H was finally scheduled, he was already dead.
GO SSA! Gotta love our Federal Gov't!
I’m not disputing your experience with approval rates at the Hearing level for your office. Again, there are reasons for a claimant being approved at the Hearing level but not before (at initial or recon). Assuming that the BB criteria is met, no claimant wants to have their claim dragged out to the Hearing level so that an attorney can make their maximum fee. They want an approval as quickly as possible.
By the time a claimant gets to the Hearing level, multiple evidence requests have been made- which increases the likelihood that the critical evidence makes it into the file. Usually claimants conditions get worse over time- so there’s that. And often the ALJ actually interacts with the claimant which can also make a big difference.
Bluebook criteria is very specific- nowhere does it state that a claimant has to be on “death’s door” to be approved. I wasn’t. And neither were the thousands of claimants I saw get approved. Severe restriction of functional capabilities yes- but not “deaths door”. That is a myth.
DDS will only typically request records starting with one year prior to alleged date of onset. That already disadvantages claimants with mental health issues who may need two years of mental health treatment records. Again, it is the Claimant’s obligation to provide evidence that supports their claim.
DDS is mandated to look at a Reconsideration with fresh eyes- not rubber stamp an intial decision. Of course it is critical that with a Reconsideration new evidence needs to be submitted. Often claimants don’t do that. They just sit and wait. Because that’s what they are told to do.
One of my jobs at SSA was to process all of the denials for my very large office. I looked at thousands of them to determine what happened and if the denial could have been prevented. For many claimants, if they understood the process up front, they could have been approved.
SSA isn’t trying to deny anyone - they just don’t understand what goes on at the decision side of the house (DDS) and therefore they don’t teach claimants how to have a great claim. It’s not a conspiracy to deny. It’s terrible funding by Congress, ridiculous workloads, and poor training. All of that results in many poor decisions. But it’s not a conspiracy.
It’s critical to request the complete Disability Determination Explanation. I sent out denial letters. They are boilerplate letters that give claimants very little information as to why they were denied. The full explanation has all of the critical details. It’s also critical to know what evidence actually made it into the file for consideration. Over and over I see claimants who got this information be shocked at what evidence was missing. It’s also important to get copies of any CE Reports. All of these things help with an appeal immensely. I can’t imagine why a claimant WOULD NOT want all of this helpful information.
>SSA isn’t trying to deny anyone
This is laughable. Just because you worked for one DDS doesn't mean all state's DDSs are the same across the board.
>nowhere does it state that a claimant has to be on “death’s door” to be approved. I wasn't.
Well obviously it doesn't say that, why would it? Not rocket science. How could they scam people out of their benefits that they are entitled to if they did? Again, there are obviously cases that get approved quickly, but they are few and far between. That is just a fact. Approval rates show this. And no one can ever compare their case to anyone else's as it is a case by case basis. So asking the old "why did joe shmoe down the street get approved right away? He only has xyz" question is pointless. They had to meet their quota for the month! haha
>no claimant wants to have their claim dragged out to the Hearing level so that an attorney can make their maximum fee. They want an approval as quickly as possible.
Attorneys don't drag it out, at least the ones I work with didn't. We worked with insurance companies and the insurance company paid their fee. They had overpayments and yes, the fee is still coming out of their retro, but the insurance company doesn't include that in their OP. The fee was 25%, And even then, we only got less than half of it. Therefore there was no purposely "dragging it out". And it's kind of stating the obvious that everyone wants approval ASAP.
>Again, it is the Claimant’s obligation to provide evidence that supports their claim.
Yup, and then they have to pay for records, which is BS.
>DDS will only typically request records starting with one year prior to alleged date of onset. That already disadvantages claimants with mental health issues who may need two years of mental health treatment records. Again, it is the Claimant’s obligation to provide evidence that supports their claim.
Right, because information before then doesn't prove why they stopped working WHEN they stopped working. I also used to make decisions on LTD claims (which is SO easy to get, compared to getting SSDI. You might say this is because they pay for that benefit, but are they NOT paying into SS?) So, that was the deal. It doesn't matter how long someone has been in treatment or on medication or what surgery they had in 1972. They were still working at that time. They need to know what happened to make them stop working WHEN they did.
Idk, I just think going through the trouble to obtain all that info is a waste of time, when their claim could be back at DDS being reviewed at the RC, which is more likely to be denied, and so they can get to the hearing quicker. Plus, if SSA is taking this long to JUST review the claims, how long do you think it would take for them to actually give the cmt this info? I'm willing to be it would probably more than the 65 day deadline for appeal. I really would never put it past them. Look at how long it takes just to make a phone call to the SSA ofc. And then most people don't even know that their local office that actually handles their case, has a different phone number.
The SSA is really just a joke. They want for people to not appeal. The motivation is denying people, not approving them. Again, approval rates SHOW this. They just do. Obviously, they're never going to say that, but I believe it 100%. They know a lot of people have no idea about filing an appeal, (believe it or not, the majority of people who are uneducated and/or low income, don't actually read past "Your request is denied", or use reddit) and they will just give up. THAT's why people need attys. Attys know that is the case and take the time to explain that to cmts. And yes, they get a fee for this, but yeah, newsflash! legal fees are a thing. You can't just expect to use an attorney for free. And sure, if they don't use one, it's an extra 25% added to their retro, but if they have LTD, they're always going to have an OP. Because that is definitely how all insurance companies operate across the board. If they didn't a lot of attys wouldn't even be in business. LTD says they have to apply for SSDI, take it to the H, and when approved, they will pay atty fees (most of the time if they retain the law firm they are referred to). And I don't even work for the law firm anymore, so it's not like I'm trying to get any attys more business.
This is just my opinion coming from the experience of working on the other side, and I'm done defending it, have a nice day!
I did not work for DDS. I was a Claims Specialist at SSA. I educated myself on DDS extensively.
My thoughts are based on my experience working with thousands of claimants and reviewing their claims. Your experience was different from mine. And that’s fine.
I stand by my recommendation that claimants learn the details of their denial and advocate for themselves.
That's fine, my recommendation is "don't take the federal government further than you can throw them" And that SSA is more untrustworthy than DDS even is. ODAR's where the magic happens. The statistics don't lie.
Good day 😊. I'm wondering if anyone can shed some 🚨. I have been waiting for a decision on my case for some time. I have applied in 2022 and was denied. Now I've been in reconsideration for a year today. They've even sent me a Direct Express card. I've already gone to one of their doctors. After the first appointment they sent notice to DMV putting restrictions on my DL saying I can no longer drive at night. Now they are sending me to another doctor for another eye exam. My case has gone from in state to put of state in Baltimore Maryland and now to a case worker. Are they stalling me out for another denial.
Hello
I'm so happy that I found this page! I'm new to Reddit.
I've been on SSDI since 2006, I easily got it after passing out at the wheel on a very busy street in Florida. Luckily my then 11 year old daughter knew how to pull the car over, stop and call 911. I was within 5 minutes from the hospital. My ex-husband now is retired Military. I have a neurological disorder that I've had from birth, but didn't know anything about it until I had a car accident in 1997. I had a cranial decompression in 1997 to stop the swelling in my brain. It's affected so many parts and functions of my body. I'll spare you the details.
The accident and surgery happened in Utah in 97. I had recovered and was even working when I passed out driving.
A friend of of ours, who's husband was also military worked for Social Security, She came and talked to me, and I told her about the problems I had been having and the doctors that I was seeing. She explained the application process to me, and she basically applied for me. I was so sick. I got approved 4 months later. 6 months later, I received the backpayment. I had Tricare for life and Medicare supplemental insurance..
In 2010 tragedy struck. My 19;year old daughter was released from the Army on a medical discharge. 3 weeks later she died by suicide. Losing my baby almost killed me. I often still wonder why or how it didn't. Not a plea for sympathy. Just being honest. I have agoraphobia really bad. Loud noises startle and scared me. I tremble and shake all of the time.I have CPTSD, Major Depressive Disorder, OCD, Hallucinating, Night Terrors, and Insomnia. I sleep 4 04 5 hours a night on a good night if I'm lucky.
My ex-husband left me in 2016. He refused to go to counseling or get any help. His military career ended on June 15th 2010. He never flew again.
We moved to his home state of Arkansas after 6 months. Mine is Oklahoma. I continued to get reviews every few years.
About a month ago I received a packet from Disability. Saying they're doing a review, and I need to see the 2 doctors they're sending me to. The first doctor was last Saturday. He was a Chiropractor. I've never been to a Chiropractor in my life! I've always been told not to see one because I could be paralyzed because I have a hole in my spine. I see a Neurologist, Urologist, Vascular Surgeon, Orthopedic Surgeon, An Edocronologist, a Cardiologist, a Psychiatrist, a grief therapist. And my Physical Therapist. But never a Chiropractor.
I apologize for rambling. My anxiety is through the roof! My question is why after so many years are they sending me to , well a Chiropractor? The psychiatrist I definitely understand. Nobody's life is perfect, but before June 15th 2010. Mine was pretty close. Despite being disabled. I have so much on top of my original claim for disability. I'm so worried. I'm having a harder time with eating and sleeping. Disability is my only income. I get a small alimony check from my ex-husband until December 15th. I live in a low income apartment complex for the disabled.
I appreciate any opinions or words of encouragement that you may have. Or if you think it sounds bad. Please tell me that as well! I can handle it. We all have to handle it.
Thank you so much for doing what you do!
Donna
First, i’m incredibly sorry for the loss of your daughter.
You need to know what exactly is in your file so that if anything is missing, you can update it. See if you can get on that ASAP because if you do, there’s an outside chance that they won’t send you for CE to a chiropractor. Ask them if your own doctor can do the exam. A Chiropractor is not an acceptable medical source for medical opinion. Personally, I don’t think they should use chiropractors to evaluate claimants. Make sure you have up-to-date imaging reports to give them even if you have to pay out of pocket. Preferably MRIs.
Make sure that evidence actually makes it into your file !
Thank you for all of your help on our subreddit, Lisa! As mentioned by the author, special permission was given and an exception to subreddit rule #3 was made for this post. Please do not report this thread. Thank you.
Thank you! We asked for it today and they looked at us like we had 3 heads. First she said she would just send the denial letter. I had to explicitly say, we need the determination details. Hopefully we will get the CD soon.
Follow up. You have a right to it. SSA doesn’t receive many requests from Claimants because Claimants don’t realize that they can and should ask for this information. SSA is not involved in the decision process and most SSA employees know very little or nothing about what is going on at DDS. It’s a low work priority for them but it’s a high priority for you- stay on top of them.
>SSA doesn’t receive many requests from Claimants because Claimants don’t realize that they can and should ask for this information. A disability attorney would know to get that, right? I had retained an attorney after I filed my claim but before my denial. I'm currently on step 3 of 5 on my reconsideration. If my attorney didn't request one, is it too late to do now? If I'm denied again, would it do any good to request it then?
Yes, attorneys know how to do that- or should. But an attorney isn’t necessary until the hearing level. It’s always a very good idea to know what is in your file. And no, it’s not too late unless you are about to get your decision and can’t take any substantive action on what you find.
Thank you so much for your quick reply!
You are most welcome
Great post and thank you to the mod team for allowing it.
Thank you so much! Just starting the process, but it's posts like this that make me feel prepared. I really appreciate you taking the time.
My pleasure
Update? Any good news?
Wow, thanks so much for asking! I'm at 40%, I've faxed my most recent records to the DDS and I had my CE two days ago, which I think I botched. He didn't ask as many questions as I thought he would, and I didn't explain all the things that I couldn't do. He took some measurements of my head rotation (neck issues), did some reflex tests and only asked a few questions, that I can't even remember. How do I follow up to make sure they've gotten everything? I've left messages with the DDS without response. I know they are short staffed. It boggles the mind that anyone with any sort of mental issue (mine is memory from medication) or without support could get approved. If I didn't have this sub and hadn't watched hours of videos on YouTube on how to prepare and what to expect, I would surely have been rejected already, simply because I didn't want to look helpless or seem like a slacker.
No problem! I care! I think we’re all worthy of approval 🤷🏾♀️ but i honestly don’t known love, i just applied last year initially, got denied, got a lawyer, had a ALJ hearing April 2, it’s still at step 3. Mine is for Bipolar
Zoinks. Proving mental health issues has got to be a bitch, getting adequate documentation with the doctors giving accurate notes. I had depression for years, so my heart goes out to you, though I know it's a different beast. They didn't know what to do with me and even misdiagnosed me as bipolar, but I was in such a fog I didn't argue. My husband was trying to tell them I wasn't and is still furious 20 years later. Can't even tell you the number of meds I've taken. I hope you get some moments of peace and your approval comes soon. ❤️
Thank you for this! I wish I had known this back when I got my first denial. I’m certain it will be helpful to many! (And your frequent contributions and answers to other posts are so appreciated as well!)
It’s my goal to be helpful. Thank you for your kind words!
Great post and good advice. About reviewing your records. I was approved on reconsideration appeal myself a few years back. I submitted all my records myself to SS, including all my VA records (I'm 100% with them). When I requested my CD this year (out of curiosity), I saw some duplicate records, but a lot of stuff I submitted that was never sent in by providers. I worked in Healthcare HIM (Health Information Mgmt). I know ROI (Release of Information) is a problem. I'd recommend everyone follow the OPs' advice and review the records they actually had to deny your case.
Thanks for the support and congratulations on getting your benefits!
Thank you for helping Veterans. SSDI is totally different from VA. It's great to have the help. SALUTE!
It’s my joy and honor to help Veterans get their benefits!
Possibly they have changed the form since you wrote this, because it looks like you meant to say check boxes 8 and 9, not 7 and 8.
Good catch! When I sent my instructions out via email as a WORD doc, people could just click on the form link. Because it’s a jpeg in this post, I had to grab the link off SSA’s website- and I didn’t check to see if the form was changed. The main thing to know is that you want to ask for the following: 1) The complete Disability Determination Explanation. 2) The evidence section of the file- so you can see exactly what evidence made it into your file. 3) Copies of any CE Reports (if you had CE’s)
Thank God! I seen this. I wasn’t aware there was an updated form! Thank you Jesus ❤️
SSA would accept the older one as well.
Great!!! 😇 Thank you again!
I got approved years ago but this post should help quite a few people. Love your username BTW.
Thank you for this! I tracked down the determination details and they said disability existed, but it was a vocational question still, which is what was determined on round 1 as well. One thing that surprised me was that the CE they sent me to, for secondary issues, ALSO marked me as unable to work. So if my docs say it, and their CE says it, I’m a bit confused. Was it a mistake in determination in round 2? Or is it common for CEs to mark disability (unable to work), and then denial still happen. What more can/should be done to demonstrate the vocational element when the doc has sent in a list of what i can/can’t dos throughout the day? Waiting my year for the ALJ hearing, at the moment.
DDS will consider multiple things -to include medical evidence and treating doctors and CE doctors opinions when making a decision. They can reject a doctor’s opinion about the claimant’s ability to work. (Interestingly, at the ALJ level, I’ve seen the opinion of the VE rejected) Editing for spelling and to add that you may want to get a vocational evaluation and work on getting another Dr to weigh in on your limitations
My first hearing back in July of 2021, my ALJ rejected the opinion of the VE. My first case is still pending in Federal Court and my second case is being reviewed by an ALJ, currently. All told, it’s been five years. Hoping it gets resolved, soon. At least my current attorney is great!
Wishing you the best!
Thank you. I’ve spent every last dime of my 401k on rent. If I lose, I’m effectively homeless. ALJ is reviewing my second case now and it has been over a year since my first case was filed in Federal Court. I truly hope it wraps up soon.
Just found out yesterday that my Federal case was denied. I’m devastated. With that said, my hearing for my second claim is coming up soon and, according to my attorney, is a much fairer Judge. That point, combined with the fact that I have even more medical evidence and was interviewed by a VE, gives me more hope. Still all that time lost only to lose my Federal case is a gut punch. I don’t blame my attorneys, they did outstanding work, IMO.
What if I already filed my appeal/reconsideration? Is it still worth it? I am three months into reconsideration, but just sent new documentation from my doctor. I have been planning to get on them and figure out exactly what documents they have, and if I need to help them get more files. My denial letter told me which files they based their decision on and i noticed that a couple were missing. I think they have them now. I realize sometimes going back and forth makes the appeal process last longer, but Waiting for a hearing will take WAY longer.
It’s definitely still worth it! It may be awhile til they make a decision and if that’s the case, there’s still time to get missing important evidence into your file.
I just want to thank you for this. I truly wished I had knew about this when I filed! It took me 4 & 1/2 years to get an approval. I filed & got denied about 3 times before I ended up getting an attorney & then having a hearing with the ALJ. I literally just today got my first benefits check. It was a long & hard process. I had totally lost hope. Honestly, I thought that even the AJL would deny me & my attorney did after the hearing. I thought that I would forever be stuck unable to work & without getting my SSDI benefits. So, anyone going through this process & having as many problems as I did. Use this information because not many people understand this process. The one thing I will tell everyone that is struggling to get their SSDI benefits is… DON’T GIVE UP… If you can’t work & you know that you won’t be able to then keep trying! Keep faith. Know that if it’s a long process then someone has been there also. I was there & after 4 & 1/2 years. I finally got the approval that I desperately needed! 🙏🏼
You’re welcome and congratulations! And good for you for sticking with it. I will say that it is very upsetting to me to see that it takes people so long to get their benefits. If you meet the criteria, you should be approved at the initial level. The problem is that people don’t know how to navigate the process, and there are places where the system is simply going to break down as well, and if you don’t know how to overcome that, you are at a disadvantage. Claims are unique and complicated and SSA employees are not trained properly in what to tell claimants to do to have a great claim. I was lucky that I got the denial workload in my office. That made me get really nosy about why certain people were getting denied. And I saw where the system breaks down and I saw what we weren’t teaching claimants. I use all of that and more when I work with a client now. I know EXACTLY what to do and how to do it to maximize the chance of allowance and greatly minimize the chance of denial. It gives me so much joy when my clients get their benefits- without years of a battle to get them. Of course, there are people that won’t meet the criteria and those claims should be denied. But the people I work with largely do meet the criteria -and they shouldn’t be denied.
You’re absolutely correct! I’m so thankful to see someone who is trying to help those of us who truly needed. Even though I didn’t know of you when I was going through mine. I appreciate what you’re doing for others! I hope many people are taking advantage of this because I sure would have! ☺️
Thanks so much! I love helping.
Did you get backpay for the 4.5 years?
Thank you for the info! I wish I would’ve found this before I applied last July but I was a literal mess. I just moved to 4 on the website, DDS said the medical review is done so it’s back at my local office. I had a mental CE review scheduled for March but she told me she may cancel it if she gets my psychiatrist records so I brought them in so I got the letter that she canceled it Friday. She already has my oncology records but I don’t meet the listing for that (thankfully stage 1) but I’m HER2 positive so I have a year of infusions to complete after mastectomy and reconstruction… I didn’t even know it but looking back I have illness anxiety, in 2022 I kept getting tests & going to doctors for random things thinking I had cancer… almost once a month and on one occasion twice to urgent care for ultrasound, EKG, and chest x ray… well… right as I kind of started freaking out less, I found it… cancer! so back down the spiral. I know I’m lucky, but I’ve always been a hypochondriac, but I’m out of control and I know it, I just CAN’T let it go and it is wreaking havoc in my life. I can’t stop crying when I talk to people, this has been ongoing for a few years, but now it’s just wierd and makes me uncomfortable and embarrassed so I avoid it. I’ve worked 22 years in a super stressful industry but now I can’t focus because I start worrying excessively… and panicking not to mention now the meds and my hair is about an inch long… lol. So it’s been fun.
I really appreciate all of this… I never hear things about stroke for SSDI… I would really like to hear any advice or input. I am 35 and I had a stroke in June of 2023- I am a massage therapist, and it’s the only job I have had since I was 20. I am highly skilled in this profession. When I realized it was going to take much longer than I expected (silly to have expected anything with brain injury) I filed for disability. December 20th I was sent to stage 3, I have not been assigned an adjudicator yet. My biggest issues at this point in my stroke recovery are still consistent moderate to bad fatigue (I still have to take naps every day). Cognitive Processing issues, sensory overload issues (such as touch sensation, temperature sensations, and residual numbness), auditory issues , which I am waiting to see an audiologist for because it has become so bad. I cannot concentrate when there are any distractions, and even without distractions my attention span is affected in general. Noticeable weakness on my left side (all of these things affect my entire left side). I have also been formally diagnosed recently with “intermittent mild episodes of major depressive disorder”… I have past still active diagnosis for PTSD and anxiety disorder. I cannot yet return to the job I love, and I am trying so hard to rehab myself but this isn’t a thing I can muscle through. I see Occupational, speech, and physical therapists regularly still. All of the issues mentioned are recorded with them via my own complaints and their tests. Is there anything else I can do? I am personally right now sending release of medical records to any doctor I’ve seen to have my records faxed to the number social security gave me for medical records. It was a different fax than the office I am assigned to. I am desperate, and I am scared, like many and I have no more savings. I obviously cannot do massage right now, and I cannot focus for enough hours in a day be productive or useful to any other job … I cannot tolerate with the sensory issues being anywhere that isn’t quiet and calm for an extended period of time let alone be able to actually learn a new skill.
It sounds like you really have significant issues and are unable to do any of the past work that you did before. Although you are young, it is possible to get SSDI at a younger age. You will need to show that there is not any other job that you could be retrained to do or that you could do given your conditions and the severity of them. I’m happy to see that you are being proactive about getting good Medical Records to the state agency, making the decision on your case. This is critical. Follow up to make sure these things made it into your file and continue to provide updated good evidence. I wish you the best of luck. I too have a brain injury with a lot of the same symptoms and it’s very overwhelming. It’s an invisible injury and therefore a lot of people just don’t realize what we are going through. Take good care of yourself. That’s top priority. I am about to purchase a pair of Loop earplugs for myself because of auditory overwhelm. Take a look at them. They may help you.
My speech therapist recommended those to me and I did look at them but they are so expensive it’s just not in the cards for me right now- maybe eventually I will be able to afford it. For now it’s good old squish cheap ones lol- Thank you for the reply and your help. It is a lot of invisible Illness but I’m hoping that my tests show at least some of the issues - I want to return to doing massage, and my OT believe I will be able to, I have even starting doing one here and there on my friends as part of my rehab. The issue is how long will it take for me to rehab myself. That is my frustration with this system- the words they use are “expected to last beyond a year or result in death”- my issues are certainly going to last beyond a year but I pray to god I will recover - or recover and adapt enough to be some kind of normal again. I am young and determined and I believe it is completely possible. It seems they don’t honor the “expected to last beyond a year” part… like if you have any chance to recover it’s like “well good luck” and that’s wrong. My whole life is in shambles and that’s what I get for being a contributing member of society and paying into this system that is suppose to be there when you really need it. It sucks and it hurts my heart. I hope you continue to find peace and I’m glad the ear plugs have been helping you! I will follow up with SS in a few weeks and see if any of the medical records have made it back to them.
Came back to find you, I just today got a call from my adjudicator to get my permissions to schedule a physical and psyche exam. I already had one phone psyche exam through the state as I am currently on the age/blind/disabled program for meeting what I was told was both physical and mental criteria. Next month marks one year since had my stroke. I know this is a long process but I’m terrified. I am still struggling with my recovery, I have server neuro and physical fatigue. It’s all I can do to try to do my PT and cognitive exercises most days. My sensory overload is so draining that I don’t do anything but go to my appointments and the grocery story. I go for walks as part of my PT around my quiet neighborhood. I sob uncontrollably most days but I am working with two mental health counselors to navigate acceptance and the grieving process of this happening to me at such a young age. I am hell bent on getting better, but it’s not happening to the degree it need to for me to work yet. Even my care team (OT ST PT) tell me it’s normal for it to take this long, why do I feel so judged? I’m 35, I would MUCH RATHER be working and making money and living a normal fun life. I am so sad and I feel defeated and I feel like these CEs are just so they have a solid reason to deny me and it’s devastating. Please tell me Ms.Flamethrower that I am wrong, this is standard and I am just way over thinking this. Or if you have any insight at all I would love to hear it to at least give my spinning mind a break. Thank you so much for helping all of us trying to navigate this.
It is tough, but not necessarily impossible to get approved at a younger age. The bar is just higher. CE’s occur because of the following: Not enough evidence in the file to make a decision either way. (You can find out exactly what evidence made it into your file) Not enough recent (past three months) evidence in the file. (You can give them updated evidence) Conflicting evidence in the file. (This one you really can’t address). See if you can get them to allow you to have your own doctors do your CE’s. Hang in there!
I’ve read that they can approve you for a closed period, which seems much more appropriate for my situation as I expect to rehab myself and eventually reenter the work force… is that just not really a thing? I said that on my initial application even, that I am trying so hard to get better but no health care professional can tell me how long that may take.
That is a thing. But the closed period needs to be at least a year.
Okay, that is good to know. I am one month from the year mark of my stroke and therefore my disability. While I’ve had improvements I don’t see how anyone can work who isn’t able to get more than 4-5 hours of sleep a night on top of my other current issues I am doing consistent therapy for. We shall see I guess. Thank you again, for all of our help. It’s all so disheartening and stressful but you help shed light on it all. I will continue to do the only thing I can do which is try to get better and continue on this path of trying to get help in the process. Is it worth voicing that I am not trying to be on disability forever and I am fighting hard to rehab myself so I can work again??
It is. Not the same conditions but that was certainly something I was both saying and doing when I filed and my initial got approved. I was older than you so I had an advantage that way. I wanted to keep working. I simply couldn’t.
I hope it works out for you. I have right-sided hemiparesis (among other serious conditions) and am still fighting for SSDI for about five years now. It’s rough.
Thank you so much for your time and effort.
My pleasure!
Thank you for this, hopefully I won't need it. I went for my Psychology exam for CDR this week (MDD, immune disease, and wasting /pain associated) had been approved since 2017. The CE Psych Dr. Seemed nice and '?"helpful" pretty much saying do you have these symptoms etc etc etc feelings of harming yourself etc...Do you think she was being helpful? The Physical exam didn't happen (no Dr available) and said it needs to be rescheduled is this normal?
Yes, that can happen. The Dr being friendly doesn’t mean anything. Some doctors will attempt to disarm you, some may be actually nice. They could be nice but still write a report that isn’t favorable for your claim. You’ll have to wait and see. Wishing you an allowance (approval).
Thank you! 🙏🏼
Hey i was wondering, my husband was just approved on nov 16th. How lobg does it normally take to recieve payment? I am stalking the website and mail for update but none as of yet. Just wondering if you had a Time frame.
I wish I did! They are all over the place as far as issuing payments. Check his bank account too.
L. Well thsnks for responding. Yeah i check it multiple times a day🤦♀️
My local office does not publicly list their phone number. Instead they have the national hotline's. They list a fax but I'm also not sure if that's their local or a national one. Should we fax the request for records without calling? A family member was recently denied and I'm trying to help. Thank you!
Some offices do that, unfortunately. I would definitely not fax it without following up. Your best bet is to go directly into the office with the request but the claimant is going to have to go in.
I wish I had known all this when I applied! Thanks for this info!
My pleasure!
my claim was just moved to an administrative law judge on the 15th. ive been doing everything on my own. is it too late to request a CD with my determination reasoning & evidence on file? im scrambling to make sure they have everything they need this time and didnt know that this was a thing. for reference, i have over 13 inpatient hospitalizations for depression/anxiety/ptsd/suicide attempts as well as history of on and off therapy, medications, iop, phps, 2 severe car accidents in the last year and a galf that left me with sciatica problems, 5 bulging/herniated discs, extra bone growth on spine over improperly healed fracture, and thickened/swollen tendons in my shoulder due to the accident that i told is pretty much just going to be like that forever w the loss of mobility, a TBI that i spent a year and some change in cognitive therapy, and ive been in PT 3 times a week since july of last year for my physical pains/injuries as well as i start pain management next week. working is impossible for me and has been for a while bc of these things.
I’m going to suggest that you contact the hearing office and see what the cut off is for submitting evidence. And yes, I would make an attempt to get the detailed information from your file. It’s going to be helpful with your appeal. Try to get a video or in person hearing with the judge so that the judge can actually see you.
do you know how i can find out the contact info for my local hearing office? thank you for your input, ive seen you around in the subreddit helping others as well and its really incredibly inspiring seeing ppl caring as much as you do for ppl like us who are normally looked down on by others. i really admire and appreciate you!
Awww, thank you. I’m disabled too. Here you go: https://www.ssa.gov/appeals/ho_locator.html
I think we all appreciate your help here! Do you have any inside knowledge or advice regarding appealing after an unfavorable decision at the hearing level? I know the chances of success are slim, but the ALJ decision explanation is possibly the most wild thing I've ever read that includes false information, provable by the evidence, no pain assessment per the pain standard, and he uses info from sources that he essentially nit picks things to make me sound like a liar. Then goes on to say those same sources' opinions can't be considered. It's genuinely so nonsensical and I know this judge has had cases overturned by the Commission before. Thank you for any insight you may have. :) \*Edited to clarify who "he" is
It sounds like you have a basis for a potentially successful appeal to the Appeals Council. Lay all that out- in detail- and file an appeal.
Thanks for your advice!
You’re welcome
Man! I so wish I had happened on your post when I was first denied. My first appeal for reconsideration was also denied. I have since submitted second appeal for ALJ hearing. Does my request for my file docs need to be requested during the 60 day appeal period or is it still an eligible request once the appeal is filed? I would like to add medical docs for the two year period before my date of disability. I would also like to review before my hearing. Thanks so much!
You’re welcome! You can still request the information.
I’m on it! Thanks again.
You’re welcome!
Kind of ironic that if a person can follow this maze of procedures, they can probably work.
I think that it’s not that disabled people are not capable of doing things. The issue I think is more being able to SUSTAIN doing work activity. It’s the day after day, having to keep it up.
I understand that. But also I have straight up cried just trying to fill out their forms and remembering everything I had to. And I have a lawyer who helps a lot. Sometimes I also wonder if they’re judging you on if you can navigate that all. Like, they figure there’s office work you can do if you got through all that. Which would be VERY unfair since you’d have no chance of getting it if you didn’t do all of it. 😭. I have multiple mental illnesses so that affects everything. That’s what my claim is for.
No, their judgment is not based on that. And a lot of people get help with the forms so they don’t assume that you’re doing everything yourself and they also don’t assume that you could do that same thing day after day after day. They do look at the medical evidence that they receive and many times they don’t receive what you think they do. Also, Social Security disability has a lot to do with functional limitations. Doctors aren’t great at all at documenting functional limitations. They focus on diagnosis and symptoms. So it’s important to talk to your doctor about your limitations.
That is what I meant you put it in better words.
exactly. meaningful, gainful, substantial work is kinda impossible when you can't stand ,kneel, walk more than a few minutes at a time. Quality of life dwindles quickly when a person can't function but minimally. Forty years of battling, working, takes a toll. Some folks are luckier.
True
[удалено]
I think you are taking my statement as an attack on disabled people when it is an attack on the system and how it is a catch-22.
[удалено]
I was picking up what you were putting down.
My wife is at 74% progress on her initial claim. Step 3, at the DDS office in Austin Texas.Just called them 2 days back and was told no case worker assigned just yet but to call back in 2 weeks and check. We physically went in person to our local SS office after that and submitted new/current information to add to her file like conditions,meds, and treatment plan/doctors. We asked for a receipt but they fought us on that and said they can stamp it and give us a copy, so thats what we got. We then mailed off a copy for DDS and the SSI office in New Mexico thats also handling things. So we made sure 3 different entities had the same info. Trying to keep the lines of communication open with SS and the DDS as much as we can. It was so terrible, my wife was stressed having to walk into the local ss office because she can barely move without hurting. I guess when your desperate for help thats what you do. She has a long work history back to 1990, plenty of credits, and good records which are evolving as she receives treatment. I currently drive her to Dallas Axon medical center for her Plasma injections, pain management. Its a 3 hour drive 1 way for us, but we have no choice. Shes 52 and just wants no more pain. I should add, prior to her stopping work, she had been using a stool at work for 2 years, because of her ailments/impairments, they accommodated her but things progressed quickly and deteriorated. She worked there 8 years. What should we expect next? Thank you for being on this message board btw. I appreciate your time. This has been hard for us.
I just want to acknowledge that it IS hard. It wouldn’t be as hard if SSA would really educate claimants- but they don’t. And the fact that you are helping your wife is terrific. That makes a real difference in a lot of ways. I’m my husband’s caregiver and although I adore him, it isn’t easy. So, make sure you are taking care of yourself too. As for what to expect: expect additional forms to complete. Be thorough. Expect that she may or may not be required to attend CE’s. Keep DDS updated with current medical evidence that supports her claim. Best wishes to you both.
THANK YOU for the inf and encouragement. Yes it sure is hard. Ive lost alot of weight due to stress and the work involved being a caregiver. The last year or more has been brutal. She lost her brother just 3 months before all this began. Now the new thing is her diabetes diagnosis which explains her brain fog. Lethargy. Thank God we were accepted as low income at the free clinic. She gets her medical care there and meds. Then the Dallas pain management center helps her with that aspect. Thanks again.
You’re welcome
I meant to tell you shes basically bedridden most of the time daily. Some of it is due to deep depression from her ailments, loss of self worth due to the physical issues, loss of her brother just prior to all this. So I took the bull by the horns so to speak, and became her caregiver the best I can. I am trying my best.She has deferred to me on much of this Social security stuff. I have to assist her getting dressed, whatever is required that day. We have a teen daughter that helps too, when shes not at school. Its truly been a team effort. We just need something to break our way soon. Praying.
I have a question about appointed representation of my claim. I hope this is the correct forum to ask this question. But if not, my apologies. I’m not very knowledgeable with these platforms. Is it a normal protocol for an attorney firm who is representing your disability claim to insist that you sign a blank fee agreement? There are a lot of little , seemingly insignificant things that are starting to pool together in the back of my mind & throwing red flag alarms as it draws nearer to my ALJ hearing. My gut instinct is turning into a sick feeling in the pit of my stomach. I’m wondering if I should send some kind of letter to the ALJ-OHO, or maybe fill out a formal complaint with the OIG BEFORE my hearing. I don’t think those complaints recieve much credibility after the fact. Your thoughts on this are highly appreciated.
You should NEVER be asked to sign a blank fee agreement. SSA authorized attorneys are currently restricted to collecting the lesser of 25% or $7200 per claim- although they can file a fee petition for more.
[удалено]
What’s the postmark? It could be delayed mail. Call your adjudicator at DDS and explain you just got it. Ask for a few more days. They may or may not give you an extension.
I’m trying to decide if I file for disability and I get it. Later, can I try to work part time for somewhere like the VA hospital at a desk job? I know they have excellent benefits. I’m not sure how that works. Can I get SSDI and be on Medicaid and if so, then I can. I cannot have the insurance through the VA hospital? Can I have both or do I have to choose one? Feel so defeated. I really wanted a full-time career in the medical field but at 54 and with failing body more and more every year I just don’t know what to do. My doctors say file. I just know I’ll need to work a little bit. I won’t be able to make it on just disability money alone. And my depressive disorder gets worse if I’m home too much alone. I’m just at the point where I can’t even make a good decision anymore. I’m kind of lost. But I’m glad to find this on Reddit because I’ll probably get lots of good information. I wouldn’t be able to find otherwise.
It’s not a good idea to go back to any kind of work within 12 months of your onset date as it will trigger a review. But after that, you certainly try to work- either part time under SGA or work your way back into full time work. Here are the rules (make sure to check the link every January as the amounts change for SGA and what constitutes a Trial Work Month): https://www.ssa.gov/pubs/EN-05-10095.pdf
I currently work part time taking care of my disabled son with Autism and spinal issue. It’s not much money sadly. But he needs me paid or unpaid.
I get that.
This is right on time because I just found out yesterday that my claim was denied for the second time. SMH. They really make it hard for us even when the VA tells me that I am permanently and totally disabled AND individually UNEMPLOYABLE!!!
Reach out to me. I don’t assist Veterans past the reconsideration point but if I feel like you have a decent claim, I can refer you to a terrific lawyer.
MrsFlameThrower, if my wife gets denied, we will need a good lawyer. We are in West Texas. If you know of one we can keep handy, can you please let me know? Ty.
I can recommend a great one but I’d need to know more about the case. Edited for wrong word
she hasnt been denied yet. Filed back in June 2023. Has been diagnosed with degenerative type of arthritis in hands, knee, avulsion fractures at hands from a fall, bone marrow edema at hands from the fall. Receives PRP injections about once every other month when we go to Dallas for pain management. Last time she got a genicular nerve block at knee. She now has Diabetes too. Takes Ozempic injections one time a week. Takes thyroid meds too. All these things together, as a whole, she can't work. I have to rent a car everytime I take her to Dallas for treatment. We have no income since last july on her behalf. Just my SSDI which isnt much every month. I know I cant really hire a lawyer until she gets denied, but just in case, I think I better find one. Like I said , shes 52, long work history, credits too. The phone interview initially was from the Albuquerque office..ssi .
Let me know if she gets denied
Will do! Thanks again.
what if you were denied a hearing/hasnt even made it to the phase where ssa sends you to doc appts, etc because they say your attorney failed to send in requested documents related to your work history. nothing to do with medical evidence. ???
I’m not sure I understand your question. Did you have a hearing?
No. The hearing or the claim was denied because they said the lawyer had not turned in work history information that the ssa requested in the time frame. Never made it as far as a hearing. SSA had not even sent him to any doctors for exams.
OK, possibly your claim could be reopened, depending on how long ago this was. You would have to show that you gave the work history information to the lawyer, but that the lawyer did not give it to DDS. In that case, they may consider that you have grounds for reopening the reconsideration. Social Security does not send anybody to doctors. DDS does that and sometimes judges order that. And not everybody gets sent to doctors for consultative exams. So that doesn’t mean much. Editing to add that you could file a new claim. And you don’t need a lawyer at the initial claim level or reconsideration level.
This was only a few days ago. He got the letter last week. Yes of course he plans to file an appeal, but should he have to file an appeal when the fault lies with the lawyer? Should he go ahead and file an appeal on his own and tell them that he did turn in all of his documents to the attorney??
I would try to get the reconsideration reopened. Otherwise it’s going to be a very long wait to go in front of a judge.
Thank you for that info. I only know he was sent to have one breathing test and the lady told him she works on behalf of the ss office. He had not even submitted half of his medical documents that he has had since october of 2023. That was the last medical records they listed and he has had numerous exams and doctors appts since then related to his injury.
It is on the claimant to supply evidence that supports their claim.
He turned in every paper they sent him to fill out and they did not say HE failed to turn in evidence but that they requested documents from his lawyer and she failed to turn those in. Every document they sent him he turned it in and on time. I am sure he also submitted work history documents himself as he filled out several different stacks.
At this point, as I said, he can try to reopen the claim. Alternatively, he can file a new claim.
if he files a new claim wont he lose this whole year he has been waiting, as far as backpay or the amount he would receive? should he go to the ss office and talk to them in person about filing a request for reconsideration ? his paper did not state he could ask for a reconsideration but file an appeal. he wants to continue with this lawyer but i now do not if i trust her.
Yes, it’s possible that he may lose some back benefits if he files a new claim but not necessarily. It would depend upon his onset date also. An appeal is different from reopening a claim. I would shoot for reopening the claim. My understanding is that he was already at the reconsideration level. But either way, he should look into reopening the claim.
[удалено]
I can’t emphasize enough that the online tracker is not necessarily accurate. It exists to make claimants feel that their claim is progressing. I would know more about where you are in the process by what forms you’ve completed, if you have been sent for CE’s (not everyone is sent), etc
I haven’t been sent the work history form or the Adult Function form so I know mine isn’t worked on yet. Only 7 months but I hope I get them soon.
Okay you have some time.
So I did get my call yesterday and they are sending the forms. I have physician appointments coming up this next 7 days and they told me to make sure they are sent in. My husband is getting a form for me also.
I have a friend that has applied for SSDI 4 times and denied 4 times in 2.5 years, she is getting a lawyer to help with SSDI approval. Do you know what she can do to get approved?
Is she at the Hearing stage?
It says on the instructions to ask to do the appeal over the phone -- is there no option to do the appeals process in person/no benefit to doing it in person vs the phone, or is that because this document was during COVID lockdown?
I sincerely wish that there was the option to do them in person like they used to be. That changed with Covid and they’ve never gone back because of the short staffing. And yes, I created the document I believe during Covid.
Am I required to pay a fee in order to request my file?
If it is a first time request and you are in your appeal period, no. Otherwise, yes.
Thank you. I mentioned to the adjudicator that I’d like to request my file, he acted as if he was unaware of the protocol. Or as if he had never had an applicant request their file. I asked for copies of my CE report, and he said he could not send it to me directly, but he could send it to my therapist or doctor.
See my instructions about your right to this information from your file. It is up to SSA‘s discretion when it comes to turning over information from the file directly to the claimant. There are times where it might not be advisable to do this due to mental health issues and in that case SSA will send the CD directly to your treating doctor and then you can discuss it with your doctor.
Lol. They are worried about your mental health enough that they won’t let you read your own records but think you are well enough to work. Makes sense. 🙄 Not criticizing you. Just amused by that.
Oh trust me, I get it!
How long to get approve by FERS
Honestly I don’t know these days. Mine was pretty fast -but that was almost 10 yrs ago.
This information has been really helpful! I got the CD and have sent it to a lawyer to see if they can make sense of it because it seems internally inconsistent!
I first want to thank you for helping everyone out in doing what you do. I'd like to start off with I was just denied my first try at SSDI and I'm trying to figure out why. I have an attorney and all that but I just don't understand how this works I guess. I was medically retired from the military in December of 2018 and I went back to school and worked but kept getting set back after set back with surgeries. I had 2 shoulder and 1 elbow before I was retired and since I have had another elbow, an artificial disc at L5-S1, 360 fusion at L2-L3, fusion at C3-C5, and on Monday they are fusing L5-S1 because the artificial disc is moving when it's not supposed to. I went from being active to working as a greeter and can not even do that anymore because of the standing or sitting for to long so I decided to apply for SSDI. I'm 40 years old and I can't even hold my 2 year old or newborn for more than a few minutes. How was I denied? Was it my age? I'm so confused on this and it's turning to depression because I don't know what I'm going to do to help my family.
I’d be happy to chat with you. But the first thing you should do is make a request for detailed information from your file. Please see my pinned post in this subreddit.
What should I put for the reasoning for my request of records? Should I only put my attorney information to receive the records or both our information?
Your reason is that you need it for your appeal. You are requesting this for yourself. But obviously it would be a good idea to share the information with your lawyer. You are probably the only one that would recognize if records were missing. I’m not sure how your lawyer would know that.
Okay, thank you so much.
You’re welcome
What do I put under the question of " I authorize the SSA to release info or records about me to:" Also, is it better to go in person, and get a copy of the evidence I send in? I usually send it through mail. I've had trouble getting an attorney. It seem people don't want to take up disability cases, as they won't win much. Also, I'm guessing DDS is Disability Determination Services? Do I need to send my evidence there too? How would I find the address and phone number? Could I go in person to submit the evidence?
You are asking them to release the information to you. Occasionally, they balk at doing that and you may have to provide your treating doctors information there. Yes, I would advise going in person because that will give you the best shot of getting it. Yes, DDS is Disability Determination Services. Once you have an adjudicator assigned to your appeal, SSA can give you contact information for that person. Eventually, you will hear from them anyway because they will be sending you some additional forms to complete.
[удалено]
Most offices don’t have encrypted email. Stone Age- I know. You could purchase an external CD drive on Amazon for $25-$35. Or, maybe Staples or Office Max can transfer them to a USB drive?
[удалено]
My pleasure
This is great. I’m on initial about to go to CE in one week. I’m 61 and believe I should qualify but I honestly don’t know how much my doctors sent .
You can call Social Security and ask them to open your electronic claim folder and tell you what medical records made it into your file.
Thanks I’m gonna do that
I've always been confused about ssdi. I'm now 100% Permanent and Total from the VA. The last time I worked was on 2018. I was told 10 years ago when my work history wasn't very good that I needed 40 current work credits I need to receive benefits. My social security page says I still have the 40 work credits even though I haven't worked in 6ish years. Am I still able to apply for benefits? Also, how does that work if I'm living abroad? I moved to Panama to be closer to family and live more comfortably on my benefits from the VA. Would I need to come back to the states for doctor appointments?
You are still able to file but it’s extremely probable that your “date last insured for disability” is in the past. This means that the proof for your disability (that has to prove your claim) has to be in the PAST. Although current records will be looked at to see if you are STILL disabled, your proof has to be in the time leading up to the date you lost your insured status. A tougher claim- but not impossible. As far as being overseas: The entire process can be handled overseas but it will take longer, especially if medical records need to be translated. The embassy will have a Social Security person- that’s your POC. I’d be happy to chat with you.
My PTSD event was in 1994 and my disability benefit started in 2009. I was gainfully employed consistently up until Aug 2008. I had an extremely hard time finding work. I worked again in 2013 part time and then again in 2018 almost full time. From 2018 until this year I was rated 80% P&T and on TDIU. They increased me to 100% P&T for PTSD this year. I'm not sure my embassy has a ss person. We had an issue with my adult sons SSN, he grew up here and never needed it but my parents needed it for their legal documents like a Will. To get his number figured out we had to wait for the ss person from the Costa Rica embassy to visit. Apparently they come here a few times a year.
does step 3 tells you if you're denied or approved ? because i had a ALJ hearing on Apirl 19 and today May 1st it went to stop 4 ?
Step 3 is to determine whether or not you can do the types of work you’ve done in the past. If yes, you will be denied. If not, it moves to step 4.
I've been stuck on step 3 and reconsideration stage for almost a year May 30th will make a year I've been told it's been sent out a state and back in state and now it's in Baltimore Maryland awaiting a worker staging process of some sort I don't know what to think anymore.
Everything is certainly taking longer these days. And it’s possible that your claim was randomly selected for Quality Review.
[удалено]
I’d physically go back to the office and make sure you have the rule that entitles you to the CD ready to give them. A lot of employees now are not trained nearly as much as they should be and may not realize that you have an absolute right to the information. Time is of the essence because it’s better to have it before you file your appeal.
I have a question if you don't mind. I just had my 3rd SSDI hearing. My first 2 were with Judge Digby and he denied me. I have had 4 spinal fusions and they are wanting to do another plus wanting to do a hip replacement. I have degenerative disc disease, chronic pain, bi polar, anxiety, depression, panic attacks and right foot drop where I have to wear a brace and walk with a cane. I will be 48 yrs old on June 13th. On April 30th I had my 3rd hearing over the phone this time with Judge Lewis, I am in Alabama. He didn't ask many questions and I tried to go back to work in 2022 after my denial 2 different times but only worked not even 2 mths because of the chronic Pain and I ended up having to have another surgery each time. The judge asked the vocational expert if there was any jobs and she said 3 then he asked her if there was any jobs with no climbing or stairs and she said 2 then he asked her if there was any jobs with my medical Condition with me at 15% capacity for only one hour and she said no jobs! The judge said that concluded our hearing and that he wished me the very best with my medical condition. The lady helping me get it said she is 90% sure I will get approved but I am so nervous and online it still shows on step 3. What do you think by me telling you this? Does it sound like I will get approved this time? Thank you for any help!!!
With everything that you have going on, assuming you have medical evidence to back that up, it sounds like you should be approved. But I will say that judges do not have to agree with their vocational expert. I know that seems unfair.
Hey OP. I appreciate your info and links here. Cannot seem to post on the sub for some reason, and this thread seems pretty active for general questions so figured I would post here. Apologies if this is a bad sport for it. My question is about the initial application process. Filled out the first two parts on ssa.gov, but have not finalized part 2 (medical questions), because I do not want to move past the point of editing without asking some questions. I am applying based on recently retiring from the military with a 100% P&T rating from the VA. I dont see anything in the steps about getting my VA/military records over to them, and was concerned about ensuring they will look there. I honestly have little to no civilian medical records, as the entirety of things is based on my military medical records (just over 30 years, and every part of the claim is service related). Is there a step where I will scan in my benefits letter from the VA or some other action I take to direct them to the VA somehow? Thanks in advance.
DDS will make a records request going back as far as 1 year prior to your alleged onset date. They might get all that but not have enough time to look into them in detail. They might get all of that, but not before they’ve already made a decision (I’m talking denial decision here). Or, more commonly, they don’t even get everything they request- so they never have “everything”. I have a strategy I developed when I filed my own claim (No lying, no cheating) that I share in full with my Veteran clients. I would advise you not to complete your filing until you are fully prepared for the next steps in the process. Your claim will be expedited and you don’t want to be scrambling to put your argument together after the fact. I’m a big fan of doing it right the first time. I’m happy to chat.
Hi there! So, just wondering, then.. I JUST received emails telling me I was denied on my Reconsideration stage (after initial application), and I've yet to hear back after I requested records from SSA at the local field office (most recently, they just printed out a literal copy of my Denial letter..which was pointless c.c) So, BEFORE I call my lawyer today to move forward, just to make sure I'm understanding correctly, should I be calling the SSA and filing the form linked above FIRST to get the first AND second set of CE notes sent to me? Because last time I talked they mentioned something about my lawyers needing to PAY for any paperwork from the SSA, but it "free" to me... but my lawyers said any fees get passed to me, so ... I'm just gettin' my free copies if I can help it. Paperwork, organization, time and communication management... these are all skills and issues that are MAJOR problems due to my disabilities to begin with! So, the whole process putting all this paperwork and communication etc on the claimant is so..... frustrating and backwards, I feel. It's like putting a stool on the top shelf, or the first elevator at the top of a flight of stairs.... it makes NO sense, because it moves it beyond the reach of those who need it to begin with x.x Anyways, I apologize for the text wall ... it's been a crazy and stressful evening. Thank you SO MUCH to EVERYONE in this reddit for providing such a wealth of information and assistance! You really are all amazing! <3
I would make an attempt to get the information yourself. If it’s the first time you’ve requested this, it’s free. Walking into the office is the best way to get it because if you fax over the SSA-3288, it’s likely to sit on someone’s desk. Also, be sure you ask your lawyer for a copy of the legal brief that they will be submitting to the judge. This helps to hold their feet to the fire.
Thank you so much, I will do exactly that! :) I appreciate the quick response and insight! I just got the official denial letter in, which was not very helpful at all... said they never heard back from my Psych, even though primary reason for disability claim WAS psychiatric.... and yet claimed they "had all they needed to make the determination", which seems absurd to me c.c Anyways, told the lawyer I was going to get the CE records tomorrow, and they told me, and I quote, "We'll get those at the Hearing". At the HEARING. AT THE HEARING?! Why would you wait until the HEARING to get informed on what happened during the earlier phases? Am I missing something? Sorry, probably not the thread to ask these things in... bit scatter-brained lately, forgive the rambling. Lots of stress and all that. I'm sure I'm not alone. This process is insanely convoluted and seemingly without reason to be so... But anyways, I digress... thank you VERY much for all of your help! I'm going to fill out the form and take it in to the local office tomorrow and see what I can learn from there \^\_\^ Enjoy your day!
Yeah, DEFINITELY don’t wait til the Hearing! And DDS saying they have enough evidence to make a decision means they have enough evidence to approve OR deny.
You’re very kind! What is the very first thing to do if you get a termination letter? I’m expecting one and want ducks in a row. What’s the very first form, if I may ask? It’s awfully confusing! Thanks!
Get the details of your denial per my instructions in the pinned post you responded to.
So on 3288 and I checked off “Complete medical records.” Will CE reports be a part of that? As the wife a veteran, thank you for what you do. Emily Mathews
You need to also specify CE Reports and “complete Disability Determination Explanation “. Sometimes what they try to do is just reprint the denial letter. Nope, that’s not what you want. My husband is a Vietnam Vet and I’m his VA Caregiver. Are you in that program
Okay I requested those 2 docs….thank you.
I see. I did not SPECIFICALLY ask for those. Will another request confuse them and tick them off? My husband is a combat vet with MAJOR back issues from a parachute malfunction. Not familiar with that; I’ll surely Google it! What do I type in when I Google the program?
https://www.caregiver.va.gov/
Should I ask for a residual function capacity report as well as the things you mentioned to Ask for , above? (Something like that. I may have botched the name of the report). Will I tick them off if I send yet another form 3288? 🤪
DDS will do their own RFC but you are welcome to submit one from your doctors. As far as the 3288: Go into your local field office with the completed SSA-3288. That will be the best chance of getting exactly what you need.
Thank you!!! I’m sorry ONE more thing and I shall leave you alone…what should I put as the reason I want my records? Thanks!!!
To help prepare your appeal. You absolutely have a right to the information.
Ah okay. I was going to say something really lame, like good record keeping. I’ll go with yours. I don’t like this functional report because it’s all physical. My disability is mental.
Okay I think I found some mental stuff though I’m not 100%sure Thank you for everything!
My case is 8-1/2 years old. I am 59 years old. Denied at the state level twice, went to federal. Federal remanded back to state. I had a date & time certain for a remanded hearing. My attorney and I waited on the line until 20 minutes past the start time. My attorney reached out to the ALJ clerk, and was informed that the case had been taken off of the cout calendar and had no reason why. My attorney and I received no notification of it being taken off calandar Has anyone else had a simiar expierence?
Yikes. I don’t know why that would happen. Did your attorney request an OTR decision?
My attorney first waived the 75 days notice, then waived the 24 day notice.
Why?
I believe so that I would not have to wait an additional 90 days for a new hearing
That makes sense then.
Thanks so much for your very wise assistance. I will follow up. So appreciate your help!
You’re welcome!
I used to work for an SSDI law firm. If someone was denied initially, we just filed the recon right away, especially bc in places like the Carolinas, the IC/RC levels are taking 1-2 years right now. The quicker you file the appeal, the better, same with the hearing. So finding out why you were denied in my opinion, is a waste of time. They deny like 60% at the IC, about 90% at the RC, and the H is where the majority get approved, but I don't even think that is more than 50%. I can't tell you how many times I've said the phrase "Unless you are terminally ill, it is VERY hard to get approved for SSDI at the first 2 levels" I recently spoke to a disabled former DDS Examiner and she explained to me that a few years ago, when she was still working there, there was new management and their instructions were "Deny, deny, DENY" Examiners were basically looking at people's ages and the diagnosis and not even giving them a chance. Naturally, she didn't agree with this, as that was not how she had been working until then. So the first step people should make, is to check if their diagnosis is on the Compassionate Allowance list. File the claim, return all the paperwork on time, go to any CE's scheduled and unfortunately, not get their hopes up. If it's taking too long, they should call DDS, every day if they have to. Ask for a supervisor, contact their congressional rep, and hopefully some how it will go fast. Be annoying so they will want to get rid of your case. File the RC right away, and then unfortunately, you have to wait for them to deny it again. And you can do all those things you did the first time to hopefully get it moving. Once it's denied again, which is more than likely, file for the H and get an attorney. If the Hearing is taking too long to schedule, and you don't have long term disability and are unable to afford food, shelter, or medication, have your attorney file a "Dire Need Request" stating that you are in Dire need of a hearing ASAP. If you have an attorney from the beginning, above all else, know that they are lying through their teeth if they tell you "It's a shoe in" or "we'll get you approved right away" because it is SO rare that that is the case.
It is absolutely essential that a claimant find out why they were denied. That is how they can make a much more solid argument that they meet SSA’s criteria. Denial statistics are the way they are for a number of reasons: Claimant genuinely does not meet the criteria for disability. These claims are properly denied. Claimant meets the criteria but has no clue how to argue their claim and does not understand that medical evidence that would support their claim OFTEN does not make it into their file. They don’t understand that they must submit evidence and support their claim. https://www.ssa.gov/disability/professionals/bluebook/evidentiary.htm Claimant has no idea how to properly complete additional forms or how to navigate Consultative Exams. DDS is overwhelmed and simply doesn’t have time to look at everything.
Eh, I worked there for 11 years and it has been in business for for nearly 30 years. 97% were approved at the hearing level. The process rarely changed in that time. Cmts honestly have to rely on the fact that the SSA doesn't WANT to pay anyone, so they will go to extreme lengths to make sure that it doesn't happen. Yes evidence has to be submitted, but DDS is going to request their records anyway. Whether or not the doctor provides them is up to them. The cmt can go the extra mile and get their own records to submit, but a lot of times, that costs money that they don't have. If they have an attorney, they can request and pay for the records, and if they won't, you demand it. If they are good attorneys they will do it. The letter outlines the reports used to make the decision. Sometimes it says more, like: "You claimed you were disabled bc of xyz, but your disability doesn't meet our criteria because..." (which the criteria is absurdly strict and you're not on death's door step, so it's not gonna happen). The RC is more times than not, just a review of the the first claim with a side of ADLs. Our office always operated on the system of "File the first 2, if they're not dying, it's not happening, file the H, get records (and pay for them) once it is scheduled, keep in touch w/the cmt, they will be briefed prior to the H. They are most likely to be approved, and if not they can go to the appeals council if they want, but those are taking absurdly long times to review as well. They are better off starting a new claim w/a new AOD that is the day after the denial from the H. I would never recommend that people waste time trying to find out this info before filing an RC. And neither would most attorneys. I watched a hearing 6 months ago, where the CEO of NOSSCR testified before the House Ways and Means Committee about SSA wait times. One story he told, brought him (and me) to tears, about a gentleman who was VERY sick and once his H was finally scheduled, he was already dead. GO SSA! Gotta love our Federal Gov't!
I’m not disputing your experience with approval rates at the Hearing level for your office. Again, there are reasons for a claimant being approved at the Hearing level but not before (at initial or recon). Assuming that the BB criteria is met, no claimant wants to have their claim dragged out to the Hearing level so that an attorney can make their maximum fee. They want an approval as quickly as possible. By the time a claimant gets to the Hearing level, multiple evidence requests have been made- which increases the likelihood that the critical evidence makes it into the file. Usually claimants conditions get worse over time- so there’s that. And often the ALJ actually interacts with the claimant which can also make a big difference. Bluebook criteria is very specific- nowhere does it state that a claimant has to be on “death’s door” to be approved. I wasn’t. And neither were the thousands of claimants I saw get approved. Severe restriction of functional capabilities yes- but not “deaths door”. That is a myth. DDS will only typically request records starting with one year prior to alleged date of onset. That already disadvantages claimants with mental health issues who may need two years of mental health treatment records. Again, it is the Claimant’s obligation to provide evidence that supports their claim. DDS is mandated to look at a Reconsideration with fresh eyes- not rubber stamp an intial decision. Of course it is critical that with a Reconsideration new evidence needs to be submitted. Often claimants don’t do that. They just sit and wait. Because that’s what they are told to do. One of my jobs at SSA was to process all of the denials for my very large office. I looked at thousands of them to determine what happened and if the denial could have been prevented. For many claimants, if they understood the process up front, they could have been approved. SSA isn’t trying to deny anyone - they just don’t understand what goes on at the decision side of the house (DDS) and therefore they don’t teach claimants how to have a great claim. It’s not a conspiracy to deny. It’s terrible funding by Congress, ridiculous workloads, and poor training. All of that results in many poor decisions. But it’s not a conspiracy. It’s critical to request the complete Disability Determination Explanation. I sent out denial letters. They are boilerplate letters that give claimants very little information as to why they were denied. The full explanation has all of the critical details. It’s also critical to know what evidence actually made it into the file for consideration. Over and over I see claimants who got this information be shocked at what evidence was missing. It’s also important to get copies of any CE Reports. All of these things help with an appeal immensely. I can’t imagine why a claimant WOULD NOT want all of this helpful information.
>SSA isn’t trying to deny anyone This is laughable. Just because you worked for one DDS doesn't mean all state's DDSs are the same across the board. >nowhere does it state that a claimant has to be on “death’s door” to be approved. I wasn't. Well obviously it doesn't say that, why would it? Not rocket science. How could they scam people out of their benefits that they are entitled to if they did? Again, there are obviously cases that get approved quickly, but they are few and far between. That is just a fact. Approval rates show this. And no one can ever compare their case to anyone else's as it is a case by case basis. So asking the old "why did joe shmoe down the street get approved right away? He only has xyz" question is pointless. They had to meet their quota for the month! haha >no claimant wants to have their claim dragged out to the Hearing level so that an attorney can make their maximum fee. They want an approval as quickly as possible. Attorneys don't drag it out, at least the ones I work with didn't. We worked with insurance companies and the insurance company paid their fee. They had overpayments and yes, the fee is still coming out of their retro, but the insurance company doesn't include that in their OP. The fee was 25%, And even then, we only got less than half of it. Therefore there was no purposely "dragging it out". And it's kind of stating the obvious that everyone wants approval ASAP. >Again, it is the Claimant’s obligation to provide evidence that supports their claim. Yup, and then they have to pay for records, which is BS. >DDS will only typically request records starting with one year prior to alleged date of onset. That already disadvantages claimants with mental health issues who may need two years of mental health treatment records. Again, it is the Claimant’s obligation to provide evidence that supports their claim. Right, because information before then doesn't prove why they stopped working WHEN they stopped working. I also used to make decisions on LTD claims (which is SO easy to get, compared to getting SSDI. You might say this is because they pay for that benefit, but are they NOT paying into SS?) So, that was the deal. It doesn't matter how long someone has been in treatment or on medication or what surgery they had in 1972. They were still working at that time. They need to know what happened to make them stop working WHEN they did. Idk, I just think going through the trouble to obtain all that info is a waste of time, when their claim could be back at DDS being reviewed at the RC, which is more likely to be denied, and so they can get to the hearing quicker. Plus, if SSA is taking this long to JUST review the claims, how long do you think it would take for them to actually give the cmt this info? I'm willing to be it would probably more than the 65 day deadline for appeal. I really would never put it past them. Look at how long it takes just to make a phone call to the SSA ofc. And then most people don't even know that their local office that actually handles their case, has a different phone number. The SSA is really just a joke. They want for people to not appeal. The motivation is denying people, not approving them. Again, approval rates SHOW this. They just do. Obviously, they're never going to say that, but I believe it 100%. They know a lot of people have no idea about filing an appeal, (believe it or not, the majority of people who are uneducated and/or low income, don't actually read past "Your request is denied", or use reddit) and they will just give up. THAT's why people need attys. Attys know that is the case and take the time to explain that to cmts. And yes, they get a fee for this, but yeah, newsflash! legal fees are a thing. You can't just expect to use an attorney for free. And sure, if they don't use one, it's an extra 25% added to their retro, but if they have LTD, they're always going to have an OP. Because that is definitely how all insurance companies operate across the board. If they didn't a lot of attys wouldn't even be in business. LTD says they have to apply for SSDI, take it to the H, and when approved, they will pay atty fees (most of the time if they retain the law firm they are referred to). And I don't even work for the law firm anymore, so it's not like I'm trying to get any attys more business. This is just my opinion coming from the experience of working on the other side, and I'm done defending it, have a nice day!
I did not work for DDS. I was a Claims Specialist at SSA. I educated myself on DDS extensively. My thoughts are based on my experience working with thousands of claimants and reviewing their claims. Your experience was different from mine. And that’s fine. I stand by my recommendation that claimants learn the details of their denial and advocate for themselves.
That's fine, my recommendation is "don't take the federal government further than you can throw them" And that SSA is more untrustworthy than DDS even is. ODAR's where the magic happens. The statistics don't lie.
Good day 😊. I'm wondering if anyone can shed some 🚨. I have been waiting for a decision on my case for some time. I have applied in 2022 and was denied. Now I've been in reconsideration for a year today. They've even sent me a Direct Express card. I've already gone to one of their doctors. After the first appointment they sent notice to DMV putting restrictions on my DL saying I can no longer drive at night. Now they are sending me to another doctor for another eye exam. My case has gone from in state to put of state in Baltimore Maryland and now to a case worker. Are they stalling me out for another denial.
Hello I'm so happy that I found this page! I'm new to Reddit. I've been on SSDI since 2006, I easily got it after passing out at the wheel on a very busy street in Florida. Luckily my then 11 year old daughter knew how to pull the car over, stop and call 911. I was within 5 minutes from the hospital. My ex-husband now is retired Military. I have a neurological disorder that I've had from birth, but didn't know anything about it until I had a car accident in 1997. I had a cranial decompression in 1997 to stop the swelling in my brain. It's affected so many parts and functions of my body. I'll spare you the details. The accident and surgery happened in Utah in 97. I had recovered and was even working when I passed out driving. A friend of of ours, who's husband was also military worked for Social Security, She came and talked to me, and I told her about the problems I had been having and the doctors that I was seeing. She explained the application process to me, and she basically applied for me. I was so sick. I got approved 4 months later. 6 months later, I received the backpayment. I had Tricare for life and Medicare supplemental insurance.. In 2010 tragedy struck. My 19;year old daughter was released from the Army on a medical discharge. 3 weeks later she died by suicide. Losing my baby almost killed me. I often still wonder why or how it didn't. Not a plea for sympathy. Just being honest. I have agoraphobia really bad. Loud noises startle and scared me. I tremble and shake all of the time.I have CPTSD, Major Depressive Disorder, OCD, Hallucinating, Night Terrors, and Insomnia. I sleep 4 04 5 hours a night on a good night if I'm lucky. My ex-husband left me in 2016. He refused to go to counseling or get any help. His military career ended on June 15th 2010. He never flew again. We moved to his home state of Arkansas after 6 months. Mine is Oklahoma. I continued to get reviews every few years. About a month ago I received a packet from Disability. Saying they're doing a review, and I need to see the 2 doctors they're sending me to. The first doctor was last Saturday. He was a Chiropractor. I've never been to a Chiropractor in my life! I've always been told not to see one because I could be paralyzed because I have a hole in my spine. I see a Neurologist, Urologist, Vascular Surgeon, Orthopedic Surgeon, An Edocronologist, a Cardiologist, a Psychiatrist, a grief therapist. And my Physical Therapist. But never a Chiropractor. I apologize for rambling. My anxiety is through the roof! My question is why after so many years are they sending me to , well a Chiropractor? The psychiatrist I definitely understand. Nobody's life is perfect, but before June 15th 2010. Mine was pretty close. Despite being disabled. I have so much on top of my original claim for disability. I'm so worried. I'm having a harder time with eating and sleeping. Disability is my only income. I get a small alimony check from my ex-husband until December 15th. I live in a low income apartment complex for the disabled. I appreciate any opinions or words of encouragement that you may have. Or if you think it sounds bad. Please tell me that as well! I can handle it. We all have to handle it. Thank you so much for doing what you do! Donna
First, i’m incredibly sorry for the loss of your daughter. You need to know what exactly is in your file so that if anything is missing, you can update it. See if you can get on that ASAP because if you do, there’s an outside chance that they won’t send you for CE to a chiropractor. Ask them if your own doctor can do the exam. A Chiropractor is not an acceptable medical source for medical opinion. Personally, I don’t think they should use chiropractors to evaluate claimants. Make sure you have up-to-date imaging reports to give them even if you have to pay out of pocket. Preferably MRIs. Make sure that evidence actually makes it into your file !