The majority of individuals applying for Social Security disability have to appear before a judge to win their case; therefore, it is critical to understand how judges think and why they approve claims.
But if you've never appeared before a Social Security judge, how would you know how they think? One way is to spend time with them.
During my career as a Social Security Disability attorney I have appeared and won cases before over 300 judges in over 40 states. More important is the fact that whether the judge is in Phoenix, Tucson, Las Vegas, or Reno, my firm has consistently won difficult cases at a significantly higher rate than the average claimant.
This experience has provided a unique understanding of how judges think, the evidence they find persuasive and why claims are approved.
There is no "one size fits all," but the following evidence either singularly, or in combination, is what almost every Social Security judge must resolve in your favor before approving a claim.
My experience confirms Social Security Disability Insurance claims are approved because of these reasons. Thus, I suggest you try to incorporate some or all of the following reasons why judges approve claims in preparing your disability case.
Reason #1: The judge finds you have a solid work record
Credibility is the central component of your case.
Judges base credibility determinations on work history, medical records, physicians' opinions regarding work and to a lesser extent, what attempts if any, you've made to return to work.
Work history is important…indeed, one judge told me it is the first thing he reviews. A judge is not concerned with how much you made, but whether you have consistently worked and paid Social Security taxes.
If you have a solid work history, the judge will usually find your story credible. If you do not, your claim is not automatically denied but a judge is more likely to scrutinize inconsistencies in your story.
Reason #2: The judge finds your case is well documented
I have represented clients in countless hearings where it was clear the judge decided to approve the claim before the hearing; the hearing was a mere formality.
In fact, most disability claims are won or lost prior to the hearing. Why? Because proving you are disabled is the product of many months or years of medical and vocational documentation that cannot be manufactured the day of the hearing. I often tell people if you're actually trying to win the case on the day of the hearing, you're probably in trouble.
Prior to the hearing, judges expect your claim to be well documented with relevant medical records, disability letters / work limitations from your physicians, and statements from lay people who know you well. This documentation should be obtained and submitted for review by the judge before your hearing. The totality of this evidence should tell the judge what they want to know before they ever see you.
Developing your case and having a strategy to win literally years prior to the day of the hearing is critical and a compelling reason to retain an attorney who specializes in disability law before or soon after filing your claim. It costs nothing to hire an attorney and you only pay a fee from your back benefits if you win; therefore, I recommend hiring one even before you file your claim
Reason #3: The judge finds your medical records are consistent with your testimony at the hearing
When your medical records confirm your testimony at the hearing, you should win your case. Why? Well documented medical records are the number one reason judges approve claims.
Disability can be based on any documented medical diagnosis that has a significant impact on your ability to function. Judges listen to your testimony at the hearing, but what they really want is to see the story reflected in your medical records. Do you have a proper diagnosis? Have you treated consistently with physicians and have you been seen by a medical specialist or specialists? Have you complied with treatment recommendations?
Do your records confirm your testimony regarding the frequency, severity and duration of your symptoms and why they limit your ability to function?
Are you taking medication or medications, or receiving treatment which suggests your medical condition is serious and debilitating? Do you have significant side effects from medications that would affect you in a work environment? Judges will thoroughly review medical records on these issues and before approving the claim must find the answer to most of these questions is "yes."
Reason #4: The judge finds your treating physicians support your claim and have rendered persuasive written opinions regarding your inability to work
In a Social Security Disability claim, medical records are the "cake" and treating physicians' opinions are the "icing."
Judges want to see that your doctors support your disability claim and usually expect to see written opinions in the form of narrative letters and medical source statements prior to the hearing. It is possible to win without a physician's support, but it is much more difficult.
Federal law requires the judge to carefully consider your physician's opinion and may require the judge to actually adopt their opinion. Thus, if the doctor believes you are disabled and specifically states why, the judge may be bound to accept the opinion which means you're now in the homestretch to claim approval.
Treating physician's opinions must be specific and set forth physical and/or psychological limitations you have in a work environment. In other words, restating your diagnosis is usually not enough; the doctor needs to explain why your medical conditions prevent you from working.
Medical records are critical at this step because your physician's opinion can only be adopted and will only make sense if his or her medical records support and document the reasons why the physician believes you are disabled.
Treating physician's opinions are critical to success and like medical records cannot be manufactured on the day of the hearing, it usually takes months and years to earn the trust and support of a doctor in a disability claim.
Reason #5: The judge is persuaded by other evidence that supports your claim
Judges frequently find "other evidence" in my clients' cases such as affidavits from co-workers, family and friends and personnel records documenting excellent or poor performance (and work absences) prior to the date you became disabled to be compelling. I use this evidence (and suggest you do) in literally every case because judges have to consider it. This evidence corroborates and provides lay witness support for your testimony, your physicians' opinions and your medical records.
I wish you the best of luck and remember…winning your case is a matter of perseverance, preparation and executing a thoughtful strategy that should be created many months before your hearing before a Social Security administrative law judge.
Scott E. Davis is a Social Security and long-term disability insurance attorney in Phoenix, Arizona. Mr. Davis represents clients throughout the United States. Although Mr. Davis has experience representing clients with a broad spectrum of physical and/or psychological disorders, the majority of his disability practice is devoted to representing individuals with chronic pain and chronic fatigue disorders. In almost every case, a fee is charged only if his client obtains benefits. Mr. Davis invites your questions and inquiries regarding representation. Call (602) 482-4300, 8:30 am to 5:30 pm, Mon. to Thu., or email: email@example.com. Visit his website at www.ScottDavisPC.com.
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