Ten Common Social Security Misconceptions & Facts Medical records review is an important process in the disability determination process. Here are 10 common SS misconceptions and the real facts.
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Social security disability benefits are provided for Americans with disabilities, and act as a great financial support. As providers of medical record review for attorneys handling social security disability cases, we understand the SSA (Social Security Administration) estimates that nearly 3 out of every 10 of today’s twenty-year-olds will become disabled before they reach age 67, their Social Security Normal Retirement Age. Census data shows that at present around 50 million people in the United States have some form of physical or mental disability. Americans who are already disabled, but too young to qualify for retirement benefits, and have earned sufficient work credits under the social security system while working for an employer or self-employed, may be eligible for Social Security Disability Insurance (SSDI) benefits. It is important though, to clearly understand the SSDI system and also, how to apply for the benefits. Misconceptions and Facts about Social Security Benefits Social security has a set of rules that are complex, and also exceptions to those rules – all of which make it difficult to understand the program and also lead to the formation of myths and misconceptions regarding it. Let us consider some of these myths and the actual facts. ➢ Myth 1: All applicants get their benefits denied at least once – This is not true because around 26% of applicants are approved for benefits in the initial stage itself. The acceptance rate is low because the SSA approves only people who have severe impairments that totally prevent them from working. Applicants must ensure that they have produced all proper medical documentation from their providers about their disabling condition. Legal representation increases a person’s chances for getting approved by 15 to 20%. ➢ Myth 2: People die before their appeal is heard – Though such unfortunate things may happen, if a physician certifies that a person is going to die from a medical condition, the court will speed up the case and allow an emergency hearing. This can be arranged by an attorney. ➢ Myth 3: Most people who complete the appeals process will eventually receive benefits – This is not correct because in central Pennsylvania for instance, the SSA court in Harrisburg awards benefits to 40% of cases and denies benefits in 36% of cases. The remaining 24% cases get dismissed, typically because •
The claimant fails to attend the hearing
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The case is withdrawn for lack of treatment
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The claimant has returned to work after recovery.
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➢ Myth 4: You have to be disabled for at least a year before you can apply for disability benefits – This is a myth. If a person’s condition has lasted only a few months and prevents him/her from working but their physician expects that it will last more than a year must apply for disability benefits as soon as possible. ➢ Myth 5: The system disqualifies as many people as possible from collecting benefits in order to save money – This is untrue. Though the government is trying to find ways to keep social security funded, it does not affect how claims are processed. People who are really disabled according to SSA’s rules will be approved if their cases are clearly presented. Some people could be denied either by mistake and get approved on appeal. Some others are denied because they do not meet the disability requirements. ➢ Myth 6: SSI (Supplemental Security Income) is the same as SSDI (Social Security Disability Insurance) – You need to be disabled to apply for SSI, but it is a financial need-based program for individuals who don’t have any work history in the past 10 years, and are unable to work. SSDI on the other hand, is a disability program for workers who have paid into payroll tax deductions while working for at least 5 out of the past 10 years and are no longer able to work because of a disabling condition. ➢ Myth 7: You cannot receive SSDI and workers’ compensation benefits at the same time – You can receive both these benefits at the same time. If you are approved for SSDI after receiving workers’ comp or vice versa, the SSA will reduce your disability benefits using the workers’ compensation offset rule to create a counterbalance. So it is possible to receive both these benefits simultaneously. ➢ Myth 8: People who were addicted to drugs or alcohol earlier will not be given benefits – This is not true because the SSA will give benefits to those who used to be drug/alcohol addicts but have been sober for at least one year and are seeking therapy or treatment. If a condition arose from drug/alcohol abuse such as alcoholic hepatitis, they can still qualify for benefits provided that they have been clean for at least a year. ➢ Myth 9: The SSA requires people to go for a consultative medical exam to provide treatment for their conditions – This is not correct. In most cases, the SSA sends a claimant to consultative exams for two reasons.
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(800) 670 2809
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The Disability Determination Services (DDS) believes the applicant is not disabled but needs documentation to close (deny) the case
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The DDS does not have enough medical documentation to approve the applicant’s case, and needs more evidence to further prove the applicant’s condition is disabling.
➢ Myth 10: It is easier to win children’s SSI cases than adult’s cases – This is incorrect. Children’s disability claims are harder to win because most cases involve one of the following four conditions: •
ADHD
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Asthma
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Learning disability
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Seizure disorder
The above conditions are difficult to determine as disabling unless they are very severe. The SSA has set tough restrictions and tests in place for each of these conditions to be approved for benefits. ADHD and learning disabilities need recommendation from a doctor as well as documentation from teachers. These conditions often get better as the child gets older, and can create problems during appeal hearings with administrative law judges typically 2 years after the initial application was made. By then, the child’s condition could have potentially improved. A number of misconceptions exist about Social Security Disability and Supplemental Security Income. No one can receive disability just because their physician says they are disabled. Medical records review is an important process in the disability determination process. Cases are not easy to win and many Americans depend on disability advocates or attorneys because legal representation could help increase their chance of acceptance by 20% or more.
www.mosmedicalrecordreview.com
(800) 670 2809