When you receive a decision from the Social Security Administration for a Social Security Disability Insurance and/or a Supplemental Security Income claim in Delaware, you receive a notice that lists medical records that were considered to decide your eligibility for disability. The notice can be misleading if you do not understand the process. Below is a sample of the first page of a disability decision in Delaware. Although federal law governs Social Security, these notices look very different in each state since the decisions are actually made by the State Disability Determination Service.
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Sample Social Security Disability Denial Letter
My clients are often concerned that they were denied benefits because their doctors indicated to Social Security that they could work. The notice specifically states, “the following reports and records were used to decide your claim”. It is often assumed that if a doctor is listed in the notice, that a medical report was provided regarding the individual’s disability status. This assumption is normally wrong. In my experience, 99% of the time only medical records were provided to the Social Security Administration after the Disability Determination Service requested information. The notice is simply providing a list of any doctors that provided medical information to the Disability Determination Service.
What Information did my Doctor Provide to Social Security?
Often your physician does not even realize that he or she has sent information to the Social Security Administration. This is because your doctor’s staff normally responded to the medical request on your doctor’s behalf. In Delaware, the Disability Determination Service is only authorized to provide a flat fee of $15 for any medical evidence requested from your doctor. Most doctors are not willing to provide a detailed medical opinion regarding your disability and to make copies of all of your medical records for $15. Consequently, they simply provide a copy of your medical records.
The reason that it is important to understand that Social Security simply relied on medical records, is because otherwise you may assume your doctor believes that you can work and that you are not disabled. I have had multiple clients that have told me that they did not appeal a decision because they believed that their doctor indicated to Social Security that they could work. They never discussed the decision with the doctor, and sometimes even switched to a new doctor because they blamed the denial on their doctor’s report.
But if Social Security Denied me, doesn’t that mean that my Medical Records don�t Support Disability?
If you are pursuing disability benefits, it is important that you discuss your disability application with your doctor. Tell your doctor that you plan to apply for benefits, and ask for him or her to provide you with a letter in support of your disability application. If your physician provides detailed information indicating the limitations that you experience because of your medical condition, it is more likely that the Social Security Administration will actually know your doctor’s medical opinion.
It is not sufficient for your doctor to indicate that he or she believes that you are disabled; he or she also needs to provide an explanation to support that conclusion. Ask your doctor to provide a detailed description of your medical diagnosis, any test results that support your diagnosis, your symptoms and limitations, and how your medical condition would interfere with your ability to complete a normal workday or workweek. The Social Security Administration normally rejects a simple conclusion that you are unable to perform work. Social Security needs to know why your doctor believes that you cannot perform work. Without this detailed information, the Disability Determination Service must try to determine what your doctor thinks based on his or her records alone.
After you receive a denial from the Social Security Administration, I recommend again discussing your disability with your doctor. Ask your doctor to read your decision and determine if your doctor agrees with the decision. If your doctor disagrees with the determination, ask your doctor to provide another letter explaining why he or she disagrees with the conclusion. Ask your doctor if additional treatment is available or if you should be referred to a specialist. Make sure your doctor understands the importance of you receiving disability benefits.
Work with an Attorney to Review and Appeal your Denial.
It is important to remember that the notices sent by the Social Security Administration are form letters. You will not receive a detailed explanation of why your records do not support your disability, instead you will receive only a short summary indicating that your condition will not last long enough in order for you to qualify for Social Security Disability, that you can still perform some type of work, or that you do not meet other non-medical requirements of the disability program. Because this information can be misleading, it is important that you simply do not abandon your claim and accept the conclusion of the Social Security Administration without understanding the decision.
The majority of attorneys that handle Social Security disability claims will see you on a free consultation basis, and usually are willing to review your decision and try to make a determination if additional information can be provided to the Social Security Administration that will establish that you meet the disability eligibility requirements. Take advantage of this free consultation before deciding to abandon your claim, and find out how an attorney can help improve your claim.
This article was written by Steven Butler. Steven is a partner at Linarducci & Butler, PA and his practice is limited to Social Security Disability/SSI claims. Steven offers free initial consultations for Social Security Disability/SSI claims to residents of Delaware, Maryland, New Jersey and Pennsylvania. To schedule a consultation with Steven, please use the Linarducci & Butler Contact Form or call 302-613-0707 to schedule an appointment.