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Social Security Disability
How to Win Your Claim

On March 1, 2000 special guest speaker Stanley Denman, an attorney who specializes in assisting Social Security Disability claimants, spoke to our room. We would like to thank him for graciously volunteering to perform this service for us. We hope to have him back again in the future for those who missed this session. If anyone wishes to contact Mr. Denman directly, he is available by telephone at: 214-219-7288. The transcript has been edited somewhat for clarity.

[StanD] Thanks Nancy. It’s a pleasure to be here. Let me give you a bit of background on me.  I'm an attorney in Dallas Texas. I have limited my practice to social security disability for the past 8 years.

[StanD] I have noted through the years that many social security disability applicants come to our office very uninformed about social security disability, particularly the process.  Sometimes claimants make mistakes that can never be undone. Unfortunately many along the social security disability road present information that is not always accurate or helpful.

[StanD] That why I am excited see Nancy’s thoroughly impressive information about social security disability and other issues related to depression, and to be a part of this forum. So with that in mind, I thought I would discuss a few of these mistakes I have seen folks make

[StanD]  One big mistake I see claimants with mental disability make is to be unaware of their Date Last Insured. Any one know what this is?

[StanD] Audience participation time

[Annie]  private insurance, you mean, Stan?

[StanD]  No. I mean social security disability insurance.

[StanD]  Let me give you an example. Date Last Insured (DLI) is quite important.

[Annie]  I'm not sure about the last date. I haven't worked out in the world since 1993.

[StanD]  DLI is the last day on which you have coverage for purposes of social security disability. In my experience, it is an issue of particular import for those with a mental impairment.

[StanD]  Let’s say you have a DLI of 12/31/99. If you prove disability on or before this date, you win Disability Insurance Benefits (DIB).

[StanD]  What if you prove disability on 1/1/2000. No DIB. Period. (Now you could be eligible for SSI – but that is another story

[StanD]  Many of you have probably heard that to qualify for DIB you must have worked at least 5 of the last 10 years. The DLI is what that is referring to.

[StanD]  So for you Annie, not having worked since 1993 (and paid social security taxes) you may have a DLI problem.

[Annie]  right

[StanD]  Why do I think this is so important for those with mental impairments? In my experience many with mental impairments have a broken work record. We can use euphemisms if you like, but the sad truth is that mentally impaired folks get fired a lot. But most of them keep trying.

[StanD]  A typical 10 year period for such a person could have only a total of 3 years of work, scattered through the time period. Now here’s the problem: lets say you have the DLI of 12/31/99, but you work for the first three months of 2000. When you march into SSA in April 2000 to file, you’ve got real problems.

[StanD]  A period of work is now between you and you DLI. SSA could find this work was not “substantial gainful activity”, but lets not get bogged down in details. My point is this: if you knew your DLI was 12/31/99, you may have thought twice about taking that job in 2000. I’m not trying to encourage folks not to work, I just want them to understand the stakes. In my view, it would be better to qualify for DIB, then consider work attempts

[Buffy]  Aren't mental impairments reviewed more often than with physical disability, once approved for SSDI?

[StanD]  I'll table that one Buffy until we get to Q&A. Its a good question.

[StanD]  I see this DLI problem a lot. Have I explained it adequately?

[Annie]  yes

[Pumba]  yes

[StanD]  In a nutshell, be aware of how spotty your work has been, and don't risk important benefits for a three job.

[StanD]  Another big area of mistakes I see is the failure of individuals to take control of who represents them. This is easy to understand – after all, those with a disability are struggling just to cope with their illness.

[StanD]  But too many disabled let big insurance companies and hospital collection services dictate who will be their representative in their social security disability case

[StanD]  If you are receiving long-term disability from an insurance company, or you have an unpaid medical bill at a major treatment center, one day someone will suggest (sometimes quite forcefully) that you use a specific lawyer or service to represent you. I need to be clear here: there is nothing wrong with these representatives

[StanD]  But I know from experience that many disabled think that they have to use the service or lawyer that their insurance company suggests. Some of these lawyers or services office thousands of miles from you.

[StanD]  In my view, people need a representative that is near their home. Our office is like most good social security disability firms: we have a long, face-to-face meeting to prepare for the ALJ hearing. I believe good representation requires this.

[StanD]  I advise claimants to interview potential attorneys for the job!

[StanD]  Well I see we've worked up to a nice group. I'll take Buffy's question first.

[Buffy]  Once approved, SSA does reviews more often with mental impairments. Why don't they contact your treating psychiarist before doing the CDR's?

[StanD]  Buffy I know of no statistics to support the view that those with mental impairments undergone a Continuing Disability Reivew (CDR) more often. SSA is gearing up big time on the CDRs, so we'll see what develops.

[StanD]  Great question Buffy. SSA has always preferred to use consultative examiners rather than treating physicians.

[StanD]  Buffy, you should however take it upon yourself to contact your own doctor.

[hiding]  may i ask something?

[hiding]  i have a phone appt. with SSA on friday... to apply, - my husband is leaving me and my kids, how can i best be prepared, and what do i need to say and know?

[StanD]  I am so sorry to hear this about your family. Many people worry about saying the wrong thing with SSA. In my experience, folks worry (understandably) too much about this.

[hiding]  thank you.... i believe they are going to look at SSI benifits, as; i haven't really worked in over 17 yrs..what will they need to know/

[StanD]  SSA will take basic information from you. Where you have worked in the last 15 years, when you became disabled, and why you believe you cannot work. They will also ask about your doctors.

[hiding]  is there any particular area i should be ready about?

[hiding]  how about proving income because of husband leaving, i don't know what i will be getting yet?

[StanD]  Just be honest with SSA. Tell them why you cannot work. The interview is not an ambush.

[hiding]  :) ok

[StanD]  Hiding: This is one of the parts of my job I do not like. Clearly from your situation as you described, you need the SSDI help. Many attorneys will not get involved early, but you may want to find one now.

[hiding]  i should find a lawyer before my interview?

[StanD]  This is not because I think you will "mess it up". But in my view a big part of this practice is to help reassure the client.

[hiding]  is there a good way to find one in my area that is good?

[StanD]  No, Hiding, I think that is overkill. Please take my reassurance on this: I think you are fully capable of handling the interview.

[hiding]  thank you so much :)

[hiding]  done

[Annie]  I am in the same situation as hiding. Been a housewife for many years, and now divorcing. Any entitlement for me?

[Annie]  as a dependent?

[StanD]  Annie: there may be. Call me at 214-219-7288 and we can discuss the facts of your situation.

[Annie]  ok ty stan

[Kev]  Stan does it really take 3to6 to six months to get an answer from soc sec admins.

[StanD]  Kev, I believe you had a "time" question. The waits vary throughout the country. On average it takes about 4 months to get a decision from SSA.

[Kev]  Thanks Stan I applied in NY they told me 3 - 6 months

[aemjem]  I have had depressiion for the last 4 years, the last year I have worked but last week I was put on medical leave from my doctor, what is the best thing for me to do or go about?

[StanD]  Aemjem: the backlogs in the social security disability assessment system mean that in general it is better to file early.

[aemjem] and my date would be last week?

[StanD]  Here's an interesting thing. In order to qualify for SSDI, you must be disabled for 12 months. But with the backlogs, if you wait 12 months to file for SSDI, you are that much further behind.

[StanD]  Talk with your doctor. If you both think you may be unable to work for that long due to your mental condition, I would recommend that you file for SSDI. Call 1-800-772-1213 and apply by phone.

[aemjem]  You must be disabled for the last 12 months or the next 12 months

[StanD]  Amejem: the date you claim as your "onset date" for your disability would in all likelihood be the day you left that job and did not return.

[Pumba]  I worked full time up until 1997 I think....I got a job 2 weeks ago and worked 3 days..the 3rd night I worked alone and got scared and had panic attacks and quit.What would you suggest for me? I am not familiar with SSI or SSDI at all.

[StanD]  Pumba: If you worked steady through 1997, you are probably not in that DLI danger zone that I alluded to.

[Pumba]  Do I just need to call the # you gave and apply?

[StanD]  I would take a hard look at your situation. For example, was the job you had a poor fit for someone with panic attacks.

[Pumba]  It was 3rd shift at a convience store LOL...pretty silly huh?

[Pumba]  I have 2 kids and have to work 3rds

[StanD]  IF so, maybe you could succeed in another job. But if you have gone through a lot of jobs, and this one had no extraordinary stresses, you may be at a point where you are unable to work due to your mental condition. In that case, file for SSDI thorugh the toll-free nubmer, or go to your local social security office.

[depressionADM]  could you repeat the number, Stan?

[Pumba]  Thank you very much Stan

[StanD]  1-800-772-1213

[depressionADM]  thank you

[Pumba]  done

[StanD]  Another comment for Pumba. If you are actually working, you would not be eligible for SSDI. Sadly, many disabled have to come to the point where they must leave all work due to their health.

[Pumba]  I quit work in 1997 when my baby was one..I have not been able to go back since

[StanD]  Oh sorry I misunderstood your reference to 3rd shifts: though that meant you were working others. Sounds like you would be wise to file.

[depressionADM]  Stan, are there any application requirements specific to mental disabilities that we should be aware of?  Ways in which it would vary from claims for physical disabilities. It seems easier to find information about physical disabilities.

[StanD]  Yes, a good question. Well certainly there are obvious differences between mental and physical impairments, but as an attorney I approach all cases similarly.

[StanD]  In general, you must be under the care of appropriate medical specialists. So in the case of the mental impairment, you need to be under the case of a psychologsist of psychiatrist.

[StanD]  It is not helpful if your doctor does not really think you are "disabled". I encourage clients to have a frank discussion with their doctor about this.

[depressionADM]  so your doctor's opinion counts for a great deal in your ability to win your claim?

[StanD]  With mental disability it has been my experience that SSA is more likely to send you to a consultative examiner.

[StanD]  Yes, in most cases your doctor's opinion under the regulations it to be accorded "great weight".

[depressionADM]   what is a consultative examiner? what do they do?

[StanD]  These are private doctors who are paid by SSA to perform specific examinations for SSA. For example, SSA might pay a psychiatrist to do an evaluation of a claimant who alleges disability due to depression.

[depressionADM]   This would be a one-time exam to confirm your own physician's findings?

[StanD]  Well I would not say it is to confirm the treating doctor's findings. In general (and it is a broad generalization) this physicians do not write reports that support the disability claim.

[StanD]  Typically they have no medical reports or records, and know only of the treating doctor's view through what the claimant tells them.

[depressionADM]   I'm a little confused what their purpose is...sorry, it's been a long day!

[StanD]  SSA does not take the view that what the doctor says in Gospel. This is based upon a perception (that I think is wrong) that treating physicians too easily support their patients in their disability case.

[StanD]  So it is routine for SSA to send folks to the CES. The "rationale" is that this doc will be unbiased, though the fact that her fee is paid by SSA seems to be ignored.

[depressionADM]   so things are weighted against your winning?

[StanD] In general, yes. But there are huge variations in the severity of mental impairments. I don't wnat to mislead. Our office wins mental impairment cases all the time.

[StanD]  Moreover, many do get paid at the initial and reconsideration stage. I'll let my bias show" given the limitations that mental impairments impose, I think that "going it alone" is unwise.

[StanD]  I believe those with mental impairments need skilled SSDI representation.

[depressionADM]  with conditions like depression, going it alone is very hard anyway. That's just the nature of the illness. You can't muddle your way through the day, let alone cut through red tape.

[Cynthia]  do they consider that depression is caused by several illnesses, and outside circumstances?

[Cynthia]  Stan, could you suggest where I may get that representation here in central florida?

[StanD]  Cynthia: I know of several in your area. I recommend interviewing several lawyers to find who is right to you. Call me at 214-219-7288 and I can give you some names.

[Cynthia]  i can barely walk, i've gained 20 lbs in past two years not being able to exercise as i used to.

[StanD]  Cynthia: on your "cause question" (very good question).

[Cynthia]  i have become very frightened, thinking of going into a treat center

[StanD]  Depression comes in a variety of gradiations from dysthemia to clinical depression. The ALJ (where you will likely end up) will focus on the "results" of your illness, not just how it started.

[Cynthia]  i am physically ill, every morning when i get up, it is awful, i need over an hour to be able to just sit.

[Cynthia]  what is clinical depression i kee hearing that term used

[depressionADM]  depression due to a chemical imbalance within your brain, Cyn.  Cyn, after Stan gets done I'll send you to some information resources.

[Cynthia]  how would anyone know i have a chemical imbalance in my brain

[depressionADM]  A doctor has to evaluate you based upon your symptoms and history, Cyn.

[StanD]  Cynthia: your illness certainly sounds severe. Currently more than half of those who have an ALJ hearing win. Stay with it, and you have a good chance.

[Annie]  Hi, Stan; this is bar and you have been very helpful. Does the SSA and their consultants rely on DSM-IV for diagnoses?

[Cynthia]  what does ALJ stand for?

[StanD]  Annie: Yes, they are qualified psychologists and psychiatrists. The rub comes generally not in the diagnosis, but the "severity" of the disease.

[StanD]  Cynthia: sorry - ALJ stands for Administrative Law Judge.

[Cynthia]  is that who decides the case? is it just one person?

[StanD]  Where are you, Cynthia, in your case?

[Cynthia]  Brevard County, FL

[StanD]  Sorry. Bad question: at what stage is your disability case (u.e., initial application, recon, etc)

[Cynthia]  i haven't filed application it is so long

[Cynthia]  i want them to know i used to be a good person, productive citizen, i just can't do it right now.

[StanD]  OK. Here are the stages: initial app, reconsideration, and ALJ hearing. Most people are denied at the first two steps. The decision is made by a disability examiners in conjunction with a state agency medical exaniner.

[Cynthia]  Stan, are there other benefits available during the process?

[StanD]  The ALJ hearing is where most folks win. It is one judge who will make the decision. But she may enlist the aid of experts she might choose to call to the hearing.

[Cynthia]  I am about to be evicted from my apartment, i don't know what to do.

[StanD]  Cynthia: Sorry, I know of none. did you have an long term disability benefits available through work?

[Cynthia]  no i am not working i am on cobra medical... paying for it through credit card

[StanD] I am so sorry Cynthia. Most of our clients must rely on friends and family while they wait for approval.

[StanD]  Yes, but did your former employer have long-term disability?

[Cynthia]  no

[StanD]  OK, Well call tomorrow, yes? You probably need a lawyer in your area.

[StanD]  Cynthia: you do need to get that application in. Try to pace yourself to get it done.

 [depressionADM]  I believe sofine has one more question if you have time, Stan?

[StanD]  Right. Am listening.

[sofine]  stan after turned down for ssi and filed appeal back in dec with lawer

[sofine]  i have a heart diease called hypertrophic obstructive cardiomopathy

[sofine]  with paressis in right arm where they put pacemaker and defebulator in me

[sofine]  ssi turned me down when they put 1st aicd in me

[sofine]  then got staff infection and had to take it out and out 2nd one in that when they messed up arm

[sofine]  says im high risk for sudden death

[sofine]  been off work since feb1/99

[sofine]  filed in april/99 turned down nov and file appeal with laywer in dec

[sofine]  still havent hear anything but va says im totaly and permently disable

[StanD]  Sofine: Did you say that you have a lawyer on your disability case?

[sofine]  yes

[sofine]  from time of appeal

[sofine]  va did all the medical work that messed up arm too

[sofine]  everything in medical records

[sofine]  oh and they treating me for depression too

[StanD]  Don't mean to seem fastidious, but you really should be getting your advise from him or her. We lawyers are supposed to refrain from advice when someone has a lawyer. Your lawyer is naturally in the best position to understand your case.

[sofine]  what i was wondering from you is typically how long does appeal take

[StanD]  If your lawyer concentrates in social security disability she should know what the waits are like in your area. About 4 months is the national norm.

[sofine]  ok thanks for all your help

[depressionADM]  Stan, thank you so much for coming. I hope we can do this again. It's been very informative.

[depressionADM]  I just hope I'm not being billed by the hour! ;-)

[StanD]  Thank you Nancy. Always open to another session.

[StanD]  Yes, the bill's in the mail bye for now.

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