As a practicing Social Security disability lawyer in Maine, Massachusetts and New Hampshire for the past 27 years, I have had an opportunity to review thousands (1000’s) of disability claims during this time. I have found that there are a number of common themes that arise over and over again as to why claimants are denied their claims, whether it be at the initial level, on reconsideration, or at the hearing level. Understanding the pitfalls one may face with their claim can help you avoid these common mistakes.
One of the primary reasons a claimant is denied on their initial claim is that the claim is presented prematurely without the understanding that one needs to prove that they have been or are likely to remain totally disabled from all forms of gainful employment for a year or longer. This is not possible to prove in most cases just a month, two or three upon leaving work. In many cases, recovery from a surgery can be anticipated in a few months’ time and there is little reason to believe the disabling condition will cause the individual claimant to remain out of work for a year or longer. Thus, in many cases it is appropriate to wait and see how one will fare with treatment before presenting a claim for long term disability such as a claim for Social Security disability insurance (SSDI) and Supplemental Security Income (SSI) benefits.
Another common reason for a denial of a claim is that the claimant is not seeking sufficient treatment for their condition. Too many times we are approached by claimants who have been denied their disability claim with little or no treatment in place. Many claimants are of the mindset that if they are seeking treatment with their primary care physician and they continue to remain disabled from working, whether it be for their mental health treatment or their back condition, for example, then there should be a basis for a favorable decision before the Social Security Administration (SSA). We inform each of our clients that for any condition that remains severe they should be in treatment with a specialist for that condition, showing that they are doing everything they can to improve and return to some manner of gainful employment. Thus, for a back condition, it may be advisable to seek treatment with an orthopedic specialist such as a physiatrist or a neurosurgeon, for example, and for mental health conditions, it is always advisable to seek treatment with a counselor and a psychiatrist.
In keeping with the above reason for a denial, many disability claimants find that they are at a loss as to how to seek the treatment they need. With that in mind, we assist in providing ideas for free treatment in one’s area through one’s local hospitals and clinics, while at the same time ensuring our clients looking into all available insurance options that may be available to them through either the Affordable Care Act provisions or through their state administered Medicaid program (which in Maine is called the Mainecare system, in Massachusetts is called Mass Health and which, in New Hampshire, is referred to as Medicaid).
In section 2 of this blog, we’ll explore some additional, very common reasons for a denial of one’s Social Security disability claim and how to avoid such a denial. In the meantime, should you find that you face what you believe to be a wrongful denial of your Social Security disability claim, be sure to contact the Social Security disability experts at the Law Offices of Russell J. Goldsmith at 1-800-773-8622 so as to obtain the advice you need to see about turning this denial around.