For the forseeable future, it appears that ALJ allowance rates for disability claims will be lower than they were from 2005 through 2010. Time will tell where falling allowance rates stabilize. My prediction is that we will see the rate of favorable decisions level off at about 50% nationally.
What does this new environment mean for those applying for disability benefits?
1. Ongoing medical care is crucial. Current medical treatment notes are central to a successful disability claim. The easiest claims to deny are those that do not have adequate medical documentation, and lack of ongoing medical treatment is frequently cited by administrative law judges as a reason to deny a claim. To be blunt, no treatment usually means no benefits.
When there is a lack of treatment due to no medical insurance, or poor insurance that doesn't cover everything, or if the copays are too much to afford, you have to be sure to explain this to the judge. See Social Security Ruling 96-7p.
2. Representation is always important, but now more than ever. You need to do everything possible to improve your claim for disability benefits.
Unfortunately, finding a lawyer is going to be more difficult for some, because attorneys have responded to the changed environment by screening cases more rigorously. Cases that are winnable but problematic are getting screened out. I know this is happening by the calls I get from disability claimants who have been turned down by other lawyers.
3. I asked a few of my colleagues to provide their tips for claimants:
- Jonathan Ginsberg, a Georgia Social Security disability attorney, writes this post: Claim Approval Tip: Submit a Doctor Completed Functional Capacity Form
- Erin Schmidt, an East Ohio Social Security disability attorney, has several excellent tips in her post Social Security is approving a lower percentage of cases what can I do to help my case
- Aaron Rifkind, an Illinois Social Security attorney, says "be prepared for your hearing" in his post, Response to Lower ALJ Allowance Rates
- Stanley Denman, a Dallas Social Security disability attorney, wrote this post: The "Empire Strikes Back"?: How to Win Your Disability Case in a Time of Rising Denial Rates
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