When I speak of "medical evidence," I'm speaking of records from doctors, hospitals and other treating sources.
Social Security cannot take a claimant's word for the existence of an impairment or the severity of symptoms. This evidence must be supplied by licensed physicians, psychologists or acceptable medical sources.
Medical evidence not only must exist, it must be submitted to Social Security. Of all the denials that I review, Social Security did not obtain all the medical evidence in about one-third of cases.
If a claimant has no health insurance and can't afford to see doctors, it is especially difficult to get a claim approved. True, Social Security may send you to see one of their consulting doctors--but these doctors rarely help your case.
I often see the following justifications for denial of benefits. I will give the Social Security language followed by plain-speak:
1) You are not disabled according to our rules. Plain-speak: You may be sick but our rules are very strict and you haven't proven that you're sick enough to meet our rules.
2) You cannot perform any of your past work as you described it; however, you can perform your past work as it is generally performed in the national economy. Plain-speak: You describe your past work as very difficult, more difficult than average. You would be able to do this work for another employer where the work is not quite so demanding.
3) We agree that you cannot perform any of your past work. However, there is other work in the national economy it that you are able to perform. Plain-speak: We agree that you are not able to perform your past work. However, there are lots of other types of jobs in the national economy that you can do. Since you can do some other type of work, you do not qualify for a benefit.
The decision hinges on the definition of "disability." And on Social Security's interpretation of whether your impairments are severe enough to prevent you from working some type of full-time job.
What should you do? You should file an appeal immediately and ask for a hearing. This is your best chance of getting a benefit. Filing a new claim probably won't do any good. They will deny it, too. An appeal leading to a hearing before an administrative law judge (ALJ) is the best option.
Going before a judge gives you a second chance to prove your case. The judge will ask you to prove that you really are unable to work. He/she will want objective medical evidence (from doctors) to prove it. If your original claim wasn't supported by hard medical evidence, here's your second chance to provide the evidence.
An experienced advocate or attorney can be of great help to you, because.....
- He/she knows what evidence is required.
- He/she knows how to get and use this evidence.
- He/she knows what each judge prefers.
- He/she knows how to make a legal argument that you meet the regulations and should be paid.
- He/she understands the thousands of rules and regulations that Social Security uses.
The Forsythe Firm
7027 Old Madison Pike - Suite 108
Huntsville, AL 35806
PHONE (256) 799-0297
WEBSITE: SOCIAL SECURITY JUSTICE
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