When you apply for disability, your claim is sent to a state agency that SSA hires to made the medical determination of  whether you are disabled. In many states this is called the Disability Determination Service,  DDS, while in Indiana the current name is the Disability Determination Bureau, DDB. It is these State workers that decide your claim.

The National Association of Disability Examiners, NADE, describes itself as:

a professional association whose purpose is to promote the art and science of disability evaluation. The majority of our members work in the state Disability Determination Service (DDS) agencies where 15,000+ employees adjudicate claims for Social Security and/or Supplemental Security Income (SSI) disability benefits. As such, our members constitute the “front lines” of disability evaluation.

A recent issue of The NADE Advocate, Volume 26, Number 1,  provides insight into why SSA may make the wrong decision in your case.

The growing complexity of the Social Security and SSI Disability Programs, coupled with the need to produce a huge volume of work, justifies even more the need for adequate resources in order to provide the service that the American public has come to expect and deserve from SSA. It takes an average of two years for a newly hired disability examiner to become fully trained and proficient to the point they can function independently and contribute to the process of making timely and accurate disability decisions. Thus, decisions not to replace productive personnel when they leave can take two or more years to correct even after new hires are made. NADE has long maintained that it is critical for SSA to be provided with the resources needed to hire and train new staff that can perform these duties. Low salaries, hiring restrictions and the stress of the job have contributed to high attrition (12.3%) in the DDSs. (Emphasis added)

Constantly having to replace 12.3% of the workforce and it taking two years before they can function independently, plus the stress of the job to get the work out fast, combined with low pay, may be a reason that DDB makes the wrong decision so many times.

The important point for you is that you should not be discouraged when your claim is turned down at the initial or reconsideration stages. With approximately 65% turned down on initial application and approximately  93%  turned down at Reconsideration,  you should take the steps necessary to increase your odds of winning. You will need an experienced attorney in Social Security claims to help you increase your odds in what NADE calls a “growing complexity of the Social Security and SSI Disability Programs.”

Unlike many attorneys, I will begin to help you with your case before your file your claim.  Read When Should I Hire An Attorney For My Disability Case? for my reasons why. What are you doing to increase your odds of winning?

I try to warn clients that most claims are denied at these levels because everyone thinks the ‘other guy who really does not deserve it will be denied, but I will not.’ These statistics prove that most people should be prepared to be turned down and should be prepared to go to hearing. They should not go it alone thinking they have a good change to win without someone who knows the rules . They need to know when to hire an attorney to represent them.

Social Security asks a lot of questions about what you do during the day. These types of questions are about your activities of daily living. The idea is that if Social Security asks you what you do day in and day out and learns what you do, they can then figure out if your medical impairment would prevent you from working.

So, what does Social Security conclude if you state that you go out to eat several times a month? This depends upon what your medical impairments are.  Assume you cannot work due to back pain. You cannot stand for more than 15 minutes at a time before you have to sit down for 15 minutes. You cannot sit for more than 30 minutes before you have to stand or lie down. Can you guess what conclusions Social Security is likely to jump to about your ability to work because you go out to eat?

When I go over these types of issues with my clients, they have no idea what the real question is that they are answering. Due to not knowing the real question, they do not tell all that they know that is relevant to the real question. Since they do not tell everything they know that is relevant to the real question, they actually end up in effect lying.  They are not telling the whole truth, only part of the truth. Do not misunderstand me, they are trying to tell the truth, but they do not understand the real question.  They are not telling all that they know which is critical to answering the real question. This partial truth-only part of the facts-is used by Social Security to reach conclusions about whether or not they are disabled. When they do not have all of the facts, how can Social Security make the right decision?

Some Administrative Law Judges will compare what the claimants says at the hearing with what they told SSA at the beginning of the process before the claimant understood what was really being asked.  If there is any variation, they conclude that the claimant is not being truthful.  Our clients want to tell the truth. We help them to tell the whole truth at the beginning of the process. We help them understand the question – the real issues in the questions that Social Security is going to ask them. Do you have someone with the experience needed to help you tell the whole truth?

I hope you have a fun and safe Fourth of July. It is a great time to celebrate our liberty and rights. The holiday is known as Independence Day because our forefathers had to fight for our liberty and rights. The government of that time (British) did not want to recognize the rights that we were claiming. It was only by our forefathers fighting hard and not giving up that we have our rights today.

No one man could do it by himself. It took a team effort. Farmers and villagers who did not know military strategy depended upon the generals of the Continental Army to figure out what needed to be done, to make the plans, and then to lead everyone in executing the plan. By working smart and hard and not giving up, we have our rights today.

If you are not able to work due to your physical and/or mental impairment, and you meet certain non-medical requirements, you have a right to a disability payment from Social Security. Most people are turned down on their initial application for benefits and are also turned down at the reconsideration stage. They are told they do not have a right to a disability payment.  Are you willing to work smart and hard and not give up to obtain what you are entitled to receive? Do you have someone that knows the strategies to figure out what needs to be done in your case?

Have a safe and fun Fourth of July!

3D Animated Flags–By 3DFlags.com>

When I first started representing claimants in 1994, I also would not take a client until they had been turned down at least once. I reasoned that if someone could be approved on their initial application without an attorney, why not let them go ahead on their own and find out if their claim could be approved. They could save an attorney fee and it would not hurt their case if they did lose, so why not wait to see who really needed an attorney to help them?

But then I started to notice something. When people applied by themselves, they were making it harder to win their case by not having an attorney at the beginning to explain to them the rules of Social Security. They were unknowingly lowering the odds for success at that stage and at the appeal stages. They were not realizing that they were making strategic decisions that might ruin their claim before some administrative law judges. They did not have someone to help them figure out what was the relevant evidence that they needed to be sure they presented to Social Security. I figured out that I was wrong-people were hurting their case by not having an attorney at the beginning of their case.

Several years ago I decided that I had to start taking claimants as clients as soon as possible. Claimants needed to be represented before they filed their claim. If I made a claimant wait until they were turned down before I would represent them, their not knowing the rules put them at a disadvantage: bad evidence was created, good evidence was not brought forward, other strategic choices were being made that could not be undone, and good claims were being unnecessarily tainted with misinformation.

Do not wait to hire an attorney. Get competent help before you file so that the job will be done correctly from the beginning. Do not hope that the attorney can tear out the bad and re-do it. Do it right the first time. It can shorten the whole disability process. Get an attorney that will represent you from the beginning of your claim. Have someone on your side that knows the rules of Social Security and can explain them to you.