COOFIA Claimant Advocacy Group

California Office Of Federal Insurance Advocacy

8050 North Palm Avenue

Fresno, CA 93711

 

 

Contact: 

 

Board Chairman - Dr. Zabian Crosby, D.H.Ed.

 

Regional Director: Advocacy Services - Emory Long, J.D.

 

General Office Inquiries - writehand2000@coofia.org

 

 

Dr. Crosby’s 9 Myths About Filing For Social Security Disability Benefits:

 

MYTH #1: Applying for disability benefits is a non-adversarial process.

FALSE: From the moment you enter a Social Security office you are being scanned, analyzed, and notated regarding several subjective factors that will be used against you at each step of the appeals process. SSA heavily relies upon the miseducation of the public in its complicated determination process to deny claims and continue the denial until the claimant either:

1- Gives up
2- Has exhausted the appeals process
3- Returns to work despite illness
4- Dies

 

MYTH #2: My doctor(s) said I am no longer able to maintain employment due to my health problems, so the SSA will eventually approve my claim.

FALSE: The SSA uses a scoring system based on RFC (Residual Functional Capacity) to determine other types of work that the claimant can do, despite the array of health problems. These types of work are usually repetitive, unskilled tasks such as sorting laundry or filling cans (laundry sorter/can filler), and are used at the Administrative Law Judge Hearing with the aid of a Vocational Expert to recommend any kind of non-skilled, repetitive task(s) for claimants. Note that such recommendations only describe the types of work that the claimant is qualified to apply for, but not necessarily maintain for 8 hours per day, 5 days per week, as required in the regulations.

 

MYTH #3: To qualify for disability, I must be blind, paralyzed, missing one or more limbs, comatose, or near death.

FALSE: Social Security has a Listing of Impairments, divided into Parts A and B, each with 14 categories of body systems, each category divided into several subsections of impairments. Duration of any one listing for 12 months or longer that has been medically certified is all that is required to qualify for benefits. Separate conditions not specifically mentioned in the Listing, when considered in combination, may also equal one or more listings to qualify.

 

MYTH #4: If my Alleged Onset Date for disability covers a period of time that I worked, then I do not qualify for benefits, and am committing fraud.

FALSE: Social Security considers any period of employment that lasted six months or less to be an Unsuccessful Work Attempt (UWA), if the claimant had to stop working due to one or more medical conditions. Social Security allows claimants to collect benefits that include unsuccessful work attempts in the period of disability. This does not constitute fraud.

 

MYTH #5: Any Social Security Disability lawyer or law firm is qualified to help me with my claim for benefits.

FALSE: Not all disability attorneys are alike: Some have limited experience in the machinations of the agency, some have multiple clients and may not pay much attention to your individual circumstances, some law firms use paralegals to do most of the work and limit contact with the attorney, other law firms do not represent clients beyond the Administrative Law Judge Hearing, while those attorneys who do represent clients in federal court sometimes lack sufficient knowledge of SSA policies and guidelines to successfully defend their clients against the statements made by SSA attorneys. For all such reasons, claimants must exercise due diligence in researching a qualified disability attorney to represent them throughout the appeals process.

 

MYTH #6: If I apply for SSI/SSDI, I am really applying for welfare.

Partly TRUE and Partly FALSE: Supplemental Security Income (SSI) is a disability program established for those who have not worked and are unable to work due to disability and have limited assets. Since claimants have made no contribution to this program, applying for SSI is applying for welfare. However, Social Security Disability Insurance (SSDI) is an insurance program whereby payroll deductions are made from each paycheck, and claimants must earn a required number of work credits to be eligible to apply for benefits. Hence, SSDI is not welfare, but an insurance program, with premiums deducted from each paycheck.

 

MYTH #7: If I am a veteran and I receive VA disability benefits, then I do not qualify for Social Security disability benefits.

FALSE: VA Compensation payments are made to veterans with service-connected disabilities. SSA disability payments are made to those who are no longer able to maintain employment due to one or more medical conditions. These are two separate programs with independent criteria for entitlement. Many veterans receive both VA and SSA disability payments. This does not constitute fraud.

 

MYTH #8: If I file a civil action in federal court, at the very least I can expect to receive fair and impartial judicial review of my case and claim for benefits.

FALSE: Less than 5% of the cases appealed in federal court are reversed. The reasons for the low reversal rate have little to do with the merits of each case, and are based more on subjective factors such as the demographic characteristics of the claimant, the financial standing of the claimant, the egoistical relationship between the SSA and the judicial system, and the reward system within SSA that pays yearly bonuses to SSA attorneys that range from $10,000 to $20,000 based on the number of claims successfully denied. Of all federal district courts in California, The United States District Court for the Eastern District of California (handling the entire Central California Valley) has been deemed the least claimant-friendly forum for Social Security cases in the last 10 years.

 

MYTH #9: Social Security is facing insolvency due to the prevalence of disability fraud- there are too many people committing fraud, and too many applications being approved for benefits.

FALSE: According to the Government Accountability Office (GAO), less than 1 percent of all disability payments can be attributed to fraud. Up to 65% of all initial claims for Social Security Disability payments are denied. Less than 5% of all claims appealed in federal court are reversed. The Central California Valley has the highest denial rate of claims in the United States: Fresno, California has only a 44% approval rate at the Administrative Law Judge Hearing (touted as the stage with the best chance of winning a claim). And, of all administrative law judges in Central California, one administrative law judge has the lowest approval rate of them all with less than 30% of the cases brought before this judge approved for benefits…

 

 

Most Experts recommend that Social Security Claimants find some means of financial support when filing a claim. The problem confronting many claimants occurs when disability strikes and their faith in others becomes misplaced. Suddenly, many Claimants find themselves forced into public assistance and low-income housing. Others end up homeless, unable to afford the cost of even basic medical assistance. If you have an experience to share about a disability claim with SSA or VA, contact our office. COOFIA was created for you, the claimant, as your experiences help us to offer services that will enable the community and educate the public about this issue.