Wednesday, September 19, 2007

Always Review Your File

If your Social Security Disability claim has been denied, you do not have to wait for a hearing, which typically takes close to two years to schedule. You can make an “on the record” (“OTR”) request that your claim be approved based on the information already contained in the file. The OTR summarizes the medical and vocational evidence and then asserts the legal arguments why the application should be approved.   

        As you may suspect, OTR’s are normally approved only where there is little doubt that the State agency, which makes the initial disability decision, erroneously denied the application. Most of the time, the denial is erroneous for refusing to give adequate weight to evidence from treating sources or for ignoring favorable vocational factors. However, the State agency also makes obvious errors, such as completely overlooking certain evidence or losing evidence, with surprising regularity. Alerting the hearing office to those errors in an OTR is likely to result in the claim being approved.

       I received an OTR today that illustrates how a careful review of a file led to a rapid approval. The claimant’s medical evidence was not that strong. In fact, her long time treating doctors refused to complete reports to support the claimant’s application because, like many doctors, they don’t want to get involved in the disability process. The State agency had denied the application based on the report from the “Consultative Examiner (“CE”),” who is essentially the doctor from Social Security. An exacting review of the file however revealed a note from the State agency disability analyst, which to my shock and glee actually stated in writing that the CE report had to rejected because its conclusions were too vague.

       The claimant did have one doctor who recently began treating her who supported her claims. Because the disability analyst rejected the CE report, there was no medical evidence to contradict the treating doctor’s opinion. Consequently, although the claimant is only 45 years old, and only has one relatively new treating doctor to support her claim, the claimant’s OTR was approved in two weeks.

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