3 Reasons Your Doctor’s Opinion Might Not Help Your SSD Application

Submitting a doctor’s statement supporting their Social Security Disability (SSD) application is a step that many people think will ensure their claim is accepted. While it can certainly help your case, that document alone doesn’t prove eligibility. And it can be discouraging when you have a strong case – one supported by a medical expert familiar with your condition – and still be rejected.

The fact is, the Social Security Administration (SSA) sets a high bar for people applying for disability benefits. There are just as many reasons an application might be denied as accepted. Your doctor’s statement will be considered along with your medical history, work situation, and many other factors. Many people end up reapplying even if their treating physician made a strong initial case for eligibility.

What a Doctor’s Statement Provides

A doctor’s statement is intended to help the SSA understand the nature and severity of a person’s disability, as well as the expected duration of their condition. As part of the application process, your doctor will be asked how your condition limits your daily activities, what your tests show, and what treatments you have received. This process is useful in explaining how your disability prevents you from performing a specific job or maintaining employment.

If there is insufficient information to make a decision, the SSA might request additional medical information about your condition or ask you to attend a special examination.

So, why wouldn’t a doctor’s opinion help someone’s chance of approval?

1. Incomplete or Contradictory Medical Information

A statement that doesn’t align with other information in your claim probably won’t help your chances. But, even if your doctor provides an accurate report regarding your disability, many other factors could still outweigh the report. A failure to submit all of the required documentation will likely lead to a rejection, as will the perception that someone is not cooperating with the application process. A doctor’s opinion won’t be enough to offset an incomplete application, even if the disability is real.

Be sure to familiarize yourself with the main reasons for denial before submitting your application:

  • If your condition has improved to the point where the SSA considers you able to work.
  • A failure to show up to scheduled medical exams.
  • Giving false or misleading information in a previous application.

A history of denials might also raise an applicant’s risk of rejection. Again – these factors can change and don’t have to keep you from reapplying if you need assistance.

2. Failure to Follow Treatment

If a patient doesn’t follow the treatment prescribed by his doctor, that could cause his claim to be denied. The medical records submitted with an application play an important role in helping the SSA understand your medical history. If you opted out of prescribed therapies, the examiner might not be able to determine whether or not your disability prevents you from being able to work.

However, the doctor’s statement only gives part of the picture. There might be a valid reason for choosing not to follow a particular treatment plan. Your explanation should be included in your application, and if not, then introduced during the appeals process. The purpose of a consultative exam is to provide a more complete picture of your disability and the limitations it poses. Agreeing to attend might end up validating your reasons for opting out of something that wasn’t right for you.

3. Your Income or Work Situation

The SSA seeks to approve claims for people who are unable to work due to their disability. Therefore, your work situation is another factor that could cause your claim to be denied, even with a statement from a doctor affirming your disability.

While there are conditions under which you can collect benefits and continue working, several work-related factors can figure into a rejection of a claim:

  • If it is determined that you can work following vocational training.
  • If advances in your medical treatment enable you to work.
  • If it is determined that your medical condition doesn’t sufficiently affect the kind of work you do.

It’s important to understand the role that a physician’s opinion can play in the larger picture that your application presents. If you choose to appeal a claim, it might be in your best interest to have an SSD attorney represent you. An attorney familiar with the process can help you understand what information your physician can provide that will most support your claim.

To talk to a Social Security Disability lawyer who can help you better understand the role of your doctor’s statement, fill out our online form or call Walner Law at 480-508-8800 to schedule a free case evaluation.

Tips for Finding the Right SSD Lawyer for You

There’s a lot more to receiving Social Security Disability Insurance (SSDI) benefits than completing an application. Presenting a persuasive case is often a necessary step that can either get you the critical help you need or set you back to square one. That’s where finding the right Social Security Disability (SSD) lawyer comes in to play.

Disability law is complicated, and so is the application process. It’s not uncommon for people who apply for benefits to be denied at first review. While legal representation isn’t necessary, a seasoned SSD attorney can help you navigate the system, review your case, and argue on your behalf if necessary. The right person will not just help you win, but will also make this process as painless as possible.

So how do you find the right match for you?

Inquire about Experience

When searching for the best SSD attorney for your individual case, take the time to talk to people and research how different firms operate. Claims can be approved initially, at the review level, after a hearing, or during appeals. Therefore, you will want to look for someone whose experience will maximize your chances of succeeding at any of those stages.

You can find a lot out by exploring a firm’s website or simply inquiring about a specific lawyer’s qualifications. Top qualities in an SSD lawyer include:

  • Social Security Disability law as their primary focus;
  • Proven track record of success;
  • Familiarity and expertise with the disability system; and
  • Personalized services.

Request Free Consultation

Most lawyers will offer a free consultation or in-person meeting to find out about your case. This is your chance to find out things like:

  • Their history of cases like yours;
  • Their overall claim approval rate, including ones that were initially denied;
  • What kind of time commitment goes into a case;
  • Their staff support and typical caseload; and
  • How much contact they have with clients like you.

When speaking with someone new, it’s always helpful to have them walk you through the process you’re about to face. For better results, prepare your questions in advance. An SSD lawyer can provide many different services, from reviewing your documentation to ensuring that appeals and medical records are submitted properly. They should be able to talk about paperwork you’ll need to provide, who you’ll interact with, and what types of timelines to expect.

Look for Compatibility

Your consultation is also an opportunity to find out what the person is like and get a sense of how you’ll be treated. Trust and compatibility are very important traits to look for in SSD lawyers. At some point you might have to review your medical history and reveal sensitive information about your physical or mental health. Such details can be hard to discuss with a stranger, and you deserve to feel comfortable during your interactions.

Ask about Other People’s Experiences

Do you know other people who have had legal assistance navigating the SSD system? Reach out to them to ask about their experiences. Maybe you can find out if their lawyer:

  • Could answer questions and explain the SSD process;
  • Was available and accessible to their client;
  • Followed through on deadlines and commitments; and
  • Knew the ins and outs of the system.

Even if you don’t get a recommendation, you’ll gain a sense of what traits were helpful or not to others.

Beware of Promises

Your search is also an opportunity to look out for red flags. Some lawyers will make guarantees about fast results or claim approvals. Others might ask for upfront fees. If something doesn’t feel right or you find it difficult to communicate with each other, you may not be a match.

Check Legal Groups to Assist with Finding the Right SSD Lawyer

To find out more about Social Security Disability insurance lawyers and what you can expect from one, websites and industry groups like your local Bar Association are a good source of information. You could always make sure the lawyer you’re considering has a Letter of Good Standing issued by the State Bar of Arizona, which confirms they’re compliant with state regulations. The Arizona Center for Disability Law is another good resource for people with disability-related legal questions.

If you’re looking for help with your SSD case in Arizona, start with Walner Law. As an experienced SSD attorney, Jon Walner has worked on thousands of disability cases. Call 480-508-8800 if you have questions or to schedule a free case evaluation. We’re happy to tell you about our experience with disability cases, as well as our winning track record.

Tips for Your SSD Hearing: How to Respond to Questions

Social Security Disability Insurance (SSDI) is a crucial resource for those who have faced life-challenging injuries. When you can no longer work due to a disability, SSDI benefits are a critical lifeline providing financial assistance to meet your everyday needs. Unfortunately, there has been a great deal of fraud concerning SSD and people who cheat the system to get benefits. Because of this, the Social Security Administration has become skeptical of anyone who makes an application for benefits, regardless of whether they tell the truth or not. Consequently, it’s not uncommon for people who apply for benefits to be denied at first review. Fortunately, if you have been denied benefits, this is not the end of the road. You can apply for an appeal to have your case reviewed before a judge at an SSDI hearing.

How Does an SSDI Hearing Work?

To get an SSDI hearing before a judge, you must apply for an appeal after your denial. It is important to keep in mind that you must request a hearing within 60 days of your denial.

During the hearing, a judge will ask you and your witnesses questions about the nature of your disability. The answers you give and the way that you give them are critical to whether he or she rules to overturn your rejection or not.

Responding to the Judge’s Questions

Although answering a judge’s questions at an SSDI hearing may seem overwhelming, being prepared is the key. There are some essential guidelines to keep in mind when answering questions. Following these guidelines can increase the chances of getting the benefits you need.

Answer the Question

One of the most common mistakes made at an SSDI hearing is that the claimant fails to answer specific questions calmly and directly. When answering questions, you should stick to the point with short and effective responses and not deviate from the question. You can offer details but keep these on topic and relevant. Don’t exaggerate. Although you may be nervous, do not ramble or provide long-winded explanations.

Be Specific

The more concise and specific you can be, the better. This will help the judge understand how your disability affects you on a daily basis. Don’t offer vague information. Use concise descriptions for your pain and your limitations. The judge will be looking to see if your symptoms are medically consistent with your condition.

How Has Your Life Changed?

A judge will want to know how your life has changed in light of your disability. You want to offer what your life looked like pre-condition and how it has changed, particularly if you cannot even do sedentary activities. If you require assistance in your daily life, from family or friends, this is important to divulge. Describe the help you get and why. If you have trouble concentrating or remembering, or sitting still for any period of time, this offers a glimpse of how you would function in a work setting.

It can be useful to have a family member or friend who assists you act as a witness at your hearing or write a brief letter on your behalf.

Addressing Uncomfortable Facts

Your medical records may bring some uncomfortable information to light that you will need to address honestly and forthrightly. For instance, many who suffer from chronic pain have come to rely on prescription pain medications or even alcohol to get through their day. It is important that you don’t address these defensively or deny facts that bear out in the records. If drug or alcohol use is a contributing factor to your condition, however, you may be denied benefits.

During the hearing, you may be required to discuss very personal things regarding your condition and symptoms. Divulging personal information may be embarrassing, but it is important to understand that the judge has heard testimony from hundreds of people applying for benefits with every imaginable disability. Try to set your embarrassment aside so you can be as concise and honest as possible about your condition and how it affects your life.

Gaps in Medical Treatment

If there are periods of time that you have not been getting medical treatment for your condition, the judge will question these. You want to answer this honestly. You may have found yourself without insurance, or your symptoms may have improved temporarily.

Honesty is the Best Policy in Your SSDI Hearing

Your honesty is critical when answering all questions posed to you by the judge. Anything that comes across as untruthful will make the judge question your credibility and may put you at risk of losing your claim.

Getting Skilled Legal Assistance from an Arizona SSD Lawyer

Although you have the option to attend an SSDI hearing without a lawyer, having the assistance of an experienced Social Security disability lawyer in Arizona who has navigated the system over the years is helpful and further ensures your success.

At Walner Law, we have worked on over 10,000 SSD and personal injury cases in and around Arizona, guiding clients and ensuring they get the assistance they need. If you have questions about your SSDI claim, fill out our online form or call us at 480-508-8800 to schedule a free case evaluation to understand how having an Arizona SSD attorney on your side may be critical to the success of your claim.

Filing Taxes When You’re Collecting Disability

If you are collecting disability income, it is crucial to know whether or not you have to pay taxes on this income. The answer, however, is not completely straightforward, yet it depends on numerous factors.

What is Disability Income?

Disability income is a financial benefit that provides supplementary income to qualifying persons who are unable to work due to a disability and meet certain medical criteria. Disability income can come from either the government or the private sector. Private sector disability income is referred to as disability insurance. The tax rules for both of these sources differ, but we will be focusing solely on Federal disability programs from the Social Security Administration (SSA).

Social Security Disability Programs

The Social Security Administration manages two government disability programs:

  • Social Security Disability Insurance (SSDI) is an earning-based benefit program that supports disabled individuals (and certain family members) with qualified work history. This program is fully funded by payroll taxes withheld from the worker’s paychecks or self-employment checks.
  • Supplemental Security Income (SSI) is a need-based benefit program that supports disabled adults (65 and over) and disabled adults and children with limited income, assets, or resources. This program is funded by General Revenues.

You can learn more about these two Federal benefits programs, and their differences, in our recent blog, here.

Is My Disability Income Taxable?

The short answer is it depends. IRS regulations have varying rules on tax liabilities for different types of disability benefits.

Tax Considerations for Social Security Disability Income

Generally, Supplemental Security Income is not taxable.

It is a little more complicated for SSDI beneficiaries. SSDI must be reported on your tax return. However, SSDI beneficiaries do not always have to pay federal income taxes on their disability income. The rules are as follows:

You must pay taxes on your Social Security disability benefits if you 1.) file as an individual and you have more than $25,000 of combined income, or 2.) you file jointly and your combined income with your spouse is greater than $32,000. Combined income is your adjusted gross income, any tax-exempt income, and half of your Social Security benefits. If you are married and file a separate tax return, it is likely that you will have to pay federal income taxes on your Social Security benefits.

If you do have to pay taxes on your Social Security benefits, it’s important to note that you will never pay taxes on more than 85% of your benefits.

If you fall into the first category as a single filer and have a total income between $25,000 and $34,000, you may only be responsible for paying income tax on up to 50% of the Social Security benefits you receive. If your income falls over $34,000, you may have to pay taxes on up to 85% of your benefits.

If you fall into the second category as a joint filer and you and your spouse’s combined total income falls between $32,000 and $44,000, you may only be responsible for paying taxes on 50% of the Social Security benefits you receive. If you and your spouse’s combined total income is more than $44,000, then up to 85% of your benefits may be taxable.

Can Taxes Be Withheld on Disability Income?

The short answer is yes.

To withhold taxes from your SSDI or SSI, you can request that the SSA withhold taxes when you first initially apply for benefits. If you do not do this, you can do so later by completing Form W-4V.

Contact Walner Law to Learn More About Filing Taxes on Your Disability Benefits.

Filing taxes is often a complicated subject on its own and can be even more so when disability benefits are involved. Jon Walner is here to make sure you understand your tax obligations as a disability beneficiary. If you’re looking for an experienced and skilled Social Security Disability lawyer, contact Walner Law for a free consultation.

Your Application for Disability Benefits Was Denied. Now What?

Social Security doesn’t only provide benefits for retirees. For those who are unable to work, Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), and/or Disabled Widow/Widower benefits are relied upon for many who would otherwise be unable to care for themselves financially. Consequently, when benefits have been denied, many applicants become dismayed and feel like they are at the end of their rope. Fortunately, there are things that can be done if you have been denied SSDI benefits.

Denials Are Common

Social Security Disability Insurance applicants are often denied on first submission. Social Security has very stringent conditions when it comes to criteria that make someone “disabled.” These requirements are extremely narrow and the application process complicated. Consequently, people who really need benefits often receive denials instead of the benefits they so desperately need.

Reasons for SSDI Claim Denials

Over 2 million people applied for Social Security Disability Insurance benefits in the year 2019. Of those who applied, only 723,900 were awarded benefits. The balance of these applicants either were not insured for disability benefits or were denied. Typically, around 30 percent of applicants are approved at the initial level of the process. Why are so many of these claims denied?

SSDI denials typically fall into a few categories:

  • Lack of adequate medical evidence for the disability — Applicants must have hard evidence proving a disability, making an applicant unable to work. A physician must document how you are disabled and how it impacts your ability to work.
  • Previous denials — filing a new claim instead of appealing the original one can send a red flag up for a reviewer, often leading to another rejection. Because of this, the appeals process is more advantageous than filing a new claim.
  • Your income — If you make more than what Social Security calls “substantial gainful activity” you may be denied. In 2021 that figure is $1,310 per month or $2,190 if you are blind.
  • You have failed to follow treatment plans — If you fail to follow the treatment that your physician has set out for you, you have demonstrated yourself unwilling to cooperate with treatment. This will get you denied for SSDI.
  • Failure to cooperate with Social Security — It is always in your best interest to cooperate with Social Security when they make requests for documentation or medical exams.

Appealing When Your Disability Benefits Are Denied

Fortunately, you can appeal your denial under specific guidelines set out by the Social Security Administration.

When you appeal a decision made by Social Security, your initial request goes back before the Social Security Administration with any new or additional supporting evidence. At that time, they will review new supporting documentation. Unfortunately, most denials are not overturned at the initial appeal process, with the average appeal success rate at less than 14 percent.

A Disability Hearing

You have a better chance for appeal success at the disability hearing level. Here you will be questioned by an administrative judge who will ask questions regarding your medical condition, the treatments you are receiving, and your past employment and education. You will be able to discuss your issues and bring expert witnesses who can support your claim.

If you bring a lawyer to the hearing, he or she can speak on your behalf and argue for your claim. The judge then has the authority to uphold or to overturn a denial. In most cases, you will receive the results of the judge’s decision within 30 days of the hearing. The average success rate at this level is over 60 percent.

You may also request an appeals council review if your denial does not get overturned at the hearing level. However, the council only looks for mistakes made by the administrative judge at the hearing level. If no errors are found, the denial is unlikely to be overturned.

Getting Professional SSD Help

The entire process of applying for SSDI benefits can be complicated and overwhelming for most people. Getting the assistance of a skilled Social Security Disability (SSD) lawyer can help an applicant navigate the complexities of the process.

An experienced SSD benefits attorney will advise and guide an applicant through the appeals process, ensuring that each step is completed correctly in accordance with Social Security guidelines and rules. He or she will understand the deadlines involved, know what information must be included, ensure that all documents are completed correctly, and know what added information may strengthen the case. An SSD lawyer can be brought in at any point in the application or appeals process.

If you need professional assistance with your application for SSDI benefits or you have received a denial for benefits, the disability benefits lawyers at Walner Law can help. Contact us for a free consultation to discuss your claim or call us at (480) 508-8800.

SSI vs. SSDI: Understanding the Differences

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are two of the most common federal financial assistance programs administered by the Social Security Administration. Generally, these cash payment programs are available to individuals who meet the federal definition of “disabled.” However, it is important to keep in mind that these two programs have different eligibility requirements and benefits.

Understanding the key differences between these two programs would allow you to plan accordingly and avail the most benefits.

Eligibility Requirements

Supplemental Security Income (SSI) is a need-based benefit program available to older adults and disabled persons with limited income, assets, or resources. This program is funded by General Revenues and is considered an “entitlement” program, so a person’s work earning history is not a factor for eligibility. Rather, the focal basis to be eligible under this program is whether a person has very little money and is either age 65 and above, or blind or disabled.

Social Security Disability Insurance (SSDI) is an earnings-based benefit program that supports disabled individuals with qualified work history, whether through their own employment or a family member (typically, a spouse or parent). Employers and wage contributions fund this program, so a person’s income, assets, or resources are generally not considered for eligibility. However, wages may affect benefits if a person is under full retirement age or disability benefits. A disabled person’s work history credit is the basis for eligibility under this program. In essence, SSDI allows workers who become disabled to receive their Social Security retirement benefits early, even if they are high-income earners.

Access to Medicare or Medicare Benefits

In most states, including Arizona, a person eligible for SSI benefits automatically qualifies for Medicaid. The Social Security Administration (SSA) determines Medicaid eligibility using the SSI criteria, so a person’s SSI application is also an application for Medicaid.

However, a person who is eligible for SSDI is not automatically eligible to receive Medicare. Rather, a person has to be eligible for SSDI benefits for two years before receiving Medicare benefits. It is also good to note that Medicare is not as comprehensive as Medicaid. Medicare covers most, but not all, primary medical care, so many Medicare beneficiaries end up having to purchase private policies to fill in the gaps in their Medicare coverage.

Financial Payment Benefits

Benefit calculations and payouts dramatically vary between the two programs. SSI bases its benefits amount on Federal laws, while SSDI benefits amount is calculated based on a person’s average lifetime earnings.

Currently, the federal SSI payment standard is $783 per month for an individual and $1,175 for a couple. However, this standard payment is subject to reduction by any other income received by the SSI recipient.

In contrast, an SSDI payment is not affected by any income received by the SSDI recipient since SSDI payments are based on a person’s working earning record instead of income. However, it is good to note that a person who receives an SSDI payment that exceeds the SSI monthly payment set by the federal law would not be eligible for SSI.

Timing of Benefits Payment

Another difference between SSI and SSDI is when a person can expect to receive their disability benefits.

Under SSI, a waiting period begins with the first full month after the date that the SSA had decided when a person’s disability began. However, an SSI recipient is paid their disability benefits for the first full month after the date they filed their claim, or, if later, the date they become eligible for SSI.

Whereas, under SSDI, a five-month waiting period is imposed before eligible recipients can begin their benefits. SSA will pay the first benefit for the sixth full month after the date that they have determined the disability began.

Family Auxiliary Benefits

Another critical difference between the two programs is whether auxiliary benefits are extended to eligible family members of the recipient. Auxiliary benefits are dependent benefits that are extended to certain family members of the beneficiary, which may include: spouse, ex-spouse, minor children, adult children, grandchildren, or parents.

Under SSI, auxiliary benefits do not extend to a recipient’s family members.

On the contrary, SSDI allows eligible family members to collect auxiliary benefits when a recipient collects disability benefits.

Under SSDI rules, a dependent may be eligible for up to 50% of the amount received by the disabled recipient. However, Social Security limits the family benefits up to 150-180% of the disabled individual’s benefits.

Contact Walner Law to Learn More About SSI and SSDI

Understanding the many differences between SSI and SSDI can be an arduous task. Jon Walner is here to simplify this process for you and make sure you get the benefits you deserve. If you need a lawyer specializing in Social Security Disability, contact Walner Law for a free consultation.