SSI/SSDI Process: Doctors are doctors, lawyers are lawyers

One issue that often arises for SSDI advocates and claimants is unsupportive doctors. Most advocates will find out a doctor’s level of support for a patient’s case as a matter of course throughout the claim process either through medical records, procuring a medical source statement, a conversation with the doctor, or a combination of the above. Generally, doctors will be mostly supportive of a claim, however, some doctors are skeptical at best.

Potentially the most significant manner in which this issue manifests itself has nothing to do with a claimant, but the decision to apply itself. Similar to this example, many physicians seem to be inherently distrustful of the SSI/SSDI system. So, when doctors are asked by their patients if they should apply for disability many times the answer is a firm “no.” The question is, should it be? Wouldn’t the better answer be, “it’s your choice”?

The AMA’s Journal of Ethics states that the majority of doctors will encounter a disability claim at one point in their careers or another and will be given substantial influence over the outcome. This is because physicians’ records will be given substantial or controlling weight depending upon the patient’s relationship to the doctor, the doctor’s specialty, and the completeness of the doctor’s evaluation(s), among other considerations.

So, why, when he or she has so much control over the outcome of a case, would a doctor be uncomfortable in suggesting that a person apply for disability?

One reason appears to be that, due to repeated exposure to the SSDI and SSI systems doctors have seen some “bizarre and inequitable awards,” or generally view some of their patients as “gaming the system.” In the case that caused that article’s author, Dr. Mokotoff, to use such strong language, his patient suffered from hepatitis C. He goes on to point out that his patient was not, at the time, dying from hepatitis C.  This was something that Dr. Mokotoff, a cardiologist, became quite familiar with because, sadly, his wife passed away from the condition.

However, buried in the doctor’s words and the manner in which he seems to relate to disability is evidence that he does not understand that the SSDI and SSI systems are not just for people suffering from end-stage diseases. He goes on to say that he has seen many people awarded benefits who appeared to be healthy middle-aged individuals seemingly capable of holding down jobs. As well he should. Many people with cardiac conditions do not visibly appear to have a heart problem, but it is highly likely that the doctor encountered at least one patient that was awarded benefits who did not appear to be on death’s door at the time of the award, and whom the doctor would have agreed deserved the benefits.

Lack of understanding of the disability process or its qualification criteria is probably one of the most common issues advocates face when trying to work with doctors. While they are free to express their opinions, doctors like Dr. Mokotoff might not have considered the AMA’s stance that, “It is important that [doctors] understand and feel comfortable with the implications of diagnoses and other professional actions that have wider repercussions, particularly legal ones, for their patients.”

Overcoming erroneous negative comments or opinions expressed by medical professionals in your disability case is another way in which a skilled advocate can help you win your case.

If you would like to learn more about how advocates and doctors interact or are interested in disability services please contact us today.

The Stigma of Public Assistance

Disability Stigma

The question of whether to apply for Social Security Disability Insurance or Supplemental Security Income is a tough one for many people with a number of personal, social, political, religious, etc. elements to be considered. In reading about social assistance programs you encounter people who believe that everyone living with some form of  social assistance is very excited and happy to be doing so, others that note that there is still a stigma and that there are those out there trying to enhance it, and, generally, the middle ground.

It turns out, unsurprisingly, that many of the people harboring extreme opinions about social assistance programs are the least informed about them. Very often, these people are ignorant of programs like work incentives for people collecting disability or even the general eligibility requirements for people to even qualify for, let alone collect benefits. Unfortunately, these less than educated opinions have very much worked their ways into the national political discourse and really colored the way people choose to pursue benefits to which they may be entitled.

The reality of the situation is that most people collecting benefits do not want to be on any form of public assistance, but need to be. Think of this objectively: in order to qualify for SSDI you must be out of work for twelve months or more, have a severe condition or conditions, not be able to physically or mentally (or both) maintain any work in your old field or a new one, and not have any substantial income. Earnings over $1,130, or $13,560 for the year, are considered “substantial” for 2016. You can have severe conditions and still not be approved. Not being able to find a job is not the same as being unable to maintain one and will not be considered the same way, if at all.

So, with an objective look at the eligibility requirements, we see that a person’s situation would already have to be pretty dire in order for them to qualify for SSDI, let alone actually collect it. Who has ever lived a full adult life without any real income, let alone with no earnings for multiple years? And this is even considering that SSDI is a type of insurance that anyone who has been gainfully employed has paid for themselves through their contributions to payroll taxes. A person would probably not be shamed for collecting on a renter’s policy for thefts from an apartment or billing healthcare costs to their health insurance, so why is it that they should be ashamed for attempting to collect SSDI?

The simple answer is that they should not. However, this is the way such benefits are often regarded in the United States.

But this is also a good reason to have a representative for your SSDI claim. Attorneys and direct-pay advocates have a number of responsibilities that should help anyone thinking of applying with the stigma aspect of the application. Most importantly, representatives are responsible for only representing individuals with legitimate claims for benefits. Doing otherwise may substantially prejudice an individual’s rights down the line which ultimately is a form of malpractice. Representatives can actually also help make the system more efficient by presenting completed files to the agency, making sure claimants stick to claim-related appointments, and concisely stating an individual’s case to the Agency, thereby eliminating administrative waste. And those are only a few of the advantages of having a representative for your SSDI  (or SSI!) claim.

If you are thinking about applying for benefits, or if you have received a denial and contemplating what to do next, use our contact form or give us a call at 1-866-262-8595.