Persistence Pays Off

While employed as a mechanic, a client of Shivam Patel’s developed an autoimmune condition that attacked his soft tissue, muscles and organs, including his heart. On the transplant list for decades, he eventually became unable to work and relocated to the Carolinas to live with his daughters while awaiting the results of his Social Security Disability Insurance (SSDI) application. Unfortunately, the moves only complicated the process. 

After two denials, says Patel, a solo attorney in New York City, “Eventually we were able to get their decision changed, and he was approved. But it took him almost three years of having no income and dealing with these health problems.”

Although both SSDI (often referred to as just “Disability”) and the needs-based Supplemental Security Income (SSI) provide monthly payments for people under retirement age, only those with strong work histories are eligible for SSDI. It generally pays more and is calculated on the taxes the person has paid over the years on their earnings. 

According to the Social Security Administration (SSA), a whopping two-thirds of all SSDI claims are denied, most commonly because the applicant’s condition is determined to be not severe enough; they’re deemed able to return to work or find another job; or they don’t have the required recent work credits. Younger applicants generally encounter the most stumbling blocks, Patel says. 

Jenna Jonassen of Klee Woolf Goldman & Filpi blames the “impersonal” process, with assigned doctors making recommendations for claimants they never see in person and denial letters that are so short and standardized that “they always look the same,” she says. “A lot of times, they have copy-and-paste errors.”

The best way to raise the odds of approval is to see a medical specialist, Jonassen says. Most of the time, the SSA will send the applicant to an independent doctor—usually a regular internist—for an examination. “A big way that we could discredit those one-time doctors,” Jonassen says, “is by saying, ‘This orthopedic surgeon [my client] has been seeing for a long time, who knows more about his condition and way more about his functioning, is the one that you should rely on.’”

Patel often works with clients who’ve made one of two major mistakes: They failed to respond to SSA correspondence, or they tried to cram too many years of health conditions and injuries into the application when they’re simply not relevant. 

If you do receive that dreaded denial letter, Jonassen says, “Don’t get disheartened by it. Most of the time that people get denied, it’s not necessarily that they’re doing anything wrong.”

And you have recourse. If it happens once, you can file an appeal or a request for reconsideration. If you’re denied again, you can ask for a hearing in front of an administrative law judge and, if that doesn’t work, a review of the judge’s decision by the Appeals Council. As a last resort, you can file a case in federal court. The good news, says Jonassen, is that e-hearings, which began during the pandemic, are still the norm, drastically reducing wait time.

No matter which obstacles you face, they’re easier to surmount with help. From the outset, an experienced SSD attorney can help you verify your eligibility, deal with the stressful paperwork, and avoid mistakes. At the very least, says Patel, it’s smart to hire an attorney for the hearing stage. “There will be experts at that hearing, most likely, and they’ll be asking you questions, and you’re going to want to cross-examine them. Often, people might not know how to do that or what to ask.”

Adds Jonassen, “The process is very overwhelming. Social Security is very understaffed, and it’s a big-volume business. … People that are dealing with their health, whether it’s physical, mental or a combination of both, don’t need that on their plate. They’re worrying about getting better and maybe getting a job at some point. Attorneys take the load off all of that.”

To those going through the frustrating SSDI process, Patel urges, “Hang in there. If someone was denied the first time, they might think this is the end of it. But this isn’t uncommon. … Don’t just accept the denial at the early stages. Often, it’s about being persistent, and that’s what pays off.”