Has Your Claim For Social Security Disability Been Denied – Do You Know What To Do?

Dealing with disability is tough. Apart from the physical pain, you also have to deal with the emotional trauma and impact on your family.  You probably did not want to file for disability, but that was your only option. When you get the news that your social security disability benefits have been denied, it seems like the last straw. Naturally, you are disappointed and feel like giving up.  This is possibly the biggest mistake you could make.

A majority of social security disability claims are denied at the initial level.  Don’t give up!

1.   Make Sure To Appeal Your Denial ASAP 

You have a specific time period (usually 60 days) within which you must your appeal.  Failing to appeal or missing the deadline for filing your appeal means you will need to file a new claim unless you have “good cause” for failing to appeal in a timely manner.   Additionally, you may lose valuable back benefits if you do not file a timely appeal.

2. Find out why your Application was Denied 

The Social Security Administration (SSA) requires you to provide information regarding your medical condition, your work history, your age and education, and how your conditions affect your ability to work in order to review your application and make a decision. If you forgot some information in your application because you did not have it, or did not know that it was important, your application could be be denied. Ensuring that your appeal has the correct information is important.  It is also extremely helpful for a social security attorney to know the reasons for the denial.

3. Know the Various Stages of Appeal 

After the first denial, most states (including Florida) require you to file a “Request for Reconsideration.” In this appeal, your case will be reviewed once again by a different set of social security examiners.  If your claim is denied at this stage, the next step is to file an appeal called a “Request for Hearing” in front of an Administrative Law Judge (ALJ).  A hearing can be quite intimidating and if you are not familiar with the Social Security Disability rules and regulations, you may not understand why your claim has been denied and what is required in order to strengthen your claim.

4. Have an Attorney Who Practices in the Area of Social Security Disability Represent You 

An experienced social security disability attorney understands what is required in order to prove that someone is disabled under the Social Security Disability system.  Additionally, an experienced attorney can review the facts of your case and identify what may be needed in order to prevail on your claim.  A local social security disability attorney is familiar with the physicians in the area and the Judges who will hear your claim.  In many instances, an attorney will be able to communicate with your physicians, employers, and coworkers and obtain information that strengthens your case.

If you have any questions regarding a Social Security Disability or Supplemental Security Income claim, please feel free to contact Sims & Stakenborg at 352-629-0480 for a free consultation.



Open Enrollment For Medicare ends December 7, 2014

If you are eligible for Medicare, make sure to choose your plan before December 7, 2014 when the open enrollment period ends.  If you are already enrolled, you may change your health care plan and your prescription drug coverage.  For additional information please check the following websites:




Veterans Day

Sims & Stakenborg will be closed to observe Veterans Day on November 11.  We thank all of our service men and women for the brave sacrifices they have made protecting our rights and freedom.  Please make sure to thank a veteran!

News for Those Experiencing Chronic Fatigue Syndrome

A new study reveals that those who have been diagnosed with Chronic Fatigue Syndrome actually have similar changes in the brain.  The study revealed those with CFS have less white matter  in the brain and, using DTI, a relatively recent study, abnormalities are found in the frontal and temporal lobe as well.  This study is important to those who are filing for Social Security Disability benefits as objective medical evidence is required in order to prove that a disabling condition exists.    For additional information please visit: http://med.stanford.edu/news/all-news/2014/10/study-finds-brain-abnormalities-in-chronic-fatigue-patients.html

If you have any questions regarding a social security disability and/or a supplemental security income matter, please contact us at Sims & Stakenborg for a free consulation at 352-629-4080.

Social Security to Review Program Used to Collect Debts

On April 14, 2014, Carol W. Colvin, Acting Commissioner of Social Security directed an immediate halt to attempts by the agency to collect debts owed to the agency that are 10 years old and older.  Many of these debts resulted from overpayments assessed to Social Security Disability and Supplemental Security Income recipients decades ago and the debt has carried to the children of the recipients.  The agency has seized tax refunds to help recoup the debt.  The agency will be conducting a review of the program.  If you hhave been assessed with an overpayment for which you do not believe you are responsible, you are urged to contact the Social Security Administration  and request an explanation or seek options to resolve the overpayment.  Many of these overpayments occurred due to incorrect payments made to a parent or guardian on behalf of a child.  If an overpayment occurred, the child could be held responsible years later.

Supplemental Security Income Updates?

At Sims & Stakenborg, we see many disabled people who meet the medical requirements for disability, but because of outdated policies which control the determination for financial need under the Supplemental Security Income program, many of those people are ineligible for benefits and medical care.

The Supplemental Security Income program is in need of change.  There are many people who qualify as disabled due to their medical conditions, but are ineligible for benefits due to income and assets.  There is currently a resource limit of $2000.  If someone has in excess of $2000 in assets, this would disqualify them from receiving SSI benefits.  This resource limit has increased by only one third over the past 41 years.  Additionally, there is the “In-Kind Support and Maintenance” rule which reduces an SSI beneficiary’s benefits by one-third if that person is living in the household of another person and receives in-kind support such as room and board.

There is a proposal to update the SSI program which would increase the resource limit and repeal the in-kind and support maintenance provision.

Additional information about the need to update the program can be found on the National Senior Citizens Law Center website at  www.nsclc.org

If you have any questions about a Social Security Disability or Supplemental Security Income claim, please contact us for a free consultation.


Congratulations to Our Own Archie Blair!

We are very pleased to announce that Archie Blair has been voted the 2014-2015 Florida Association of Legal Support Specialists (FALSS)President Elect! This position leads to the presidency of FALSS in 2015-2016. Way to go Archie! This is quite an accomplishment and we are very proud of you!

Is my local politican able to help me with my Social Security Disability claim?

Should you contact a politician to help expedite your claim? Many of your congressional representatives have staff who assist in contacting the social security office to determine the status of claims filed by their constituents.  If you contact your local Congressman or Senator’s office, a Congressional Inquiry can be made into the status of your claim.

Such inquiries (which generally involve a telephone call or the writing of a letter) are made by an office holder’s staff member and may help to speed up an ALJ disability hearing, or help to resolve an outstanding issue with your disability claim.

How do you go about initiating such an inquiry? First you must determine who represents you.  Your local telephone book normally has a list of your congressmen and women and senators and contain their address and telephone numbers.  An internet search can also provide this information.   http://www.opencongress.org/people/zipcodelookup

If you are being represented, your representative should have access to your electronic folder and will be able to determine the status of your claim through a simple inquiry.  If you have any questions about a social security disability or supplemental security income claim, please feel free to contact us for a free consultation at 352-629-0480.

The Social Security Administration Adds 25 New Compassionate Allowances Conditions

On January 15, 2014, acting Social Security Adminstration commissioner, Carol Colvin, announced the addition of 25 new compassionate allowances conditions.  The list includes 12 cancer conditions.  The Compassionate Allowance program is designed to help expedite the disability approval process for those social security disability applicants with the most serious disabilities.  The program identifies conditions and diseases which meet the agency’s criteria for disability allowing a decision to be made more quickly for those applicants.  The normal processing time from the date a person files for Social Security Disability benefits until the date of approval is often 18-24 months.  The Compassionate Allowances program is designed to significantly reduce that processing time.  For a complete list of all Compassionate Allowance conditions, please visit: http://www.socialsecurity.gov/compassionateallowances

New Compassionate Allowances Conditions

  1. Angiosarcoma
  2. Atypical Teratoid/Rhabdoid Tumor
  3. Chronic Idiopathic Intestinal Pseudo Obstruction
  4. Coffin- Lowry Syndrome
  5. Esthesioneuroblastoma
  6. Giant Axonal Neuropathy
  7. Hoyeaal-Hreidarsson Syndrome
  8. Intracranial Hemangiopericytoma
  9. Joubert Syndrome
  10. Leptomeningeal Carcinomatosis
  11. Liposarcoma- metastatic or recurrent
  12. Malignant Ectomesenchymoma
  13. Malignant Renal Rhabdoid Tumor
  14. Marshall-Smith Syndrome
  15. Oligodendroglioma Brain Tumor- Grade III
  16. Pallister-Killian Syndrome
  17. Progressive Bulbar Palsy
  18. Prostate Cancer – Hormone Refractory Disease – or with visceral metastases
  19. Revesz Syndrome
  20. Seckel Syndrome
  21. Sjogren-Larsson Syndrome
  22. Small Cell Cancer of the Thymus
  23. Soft Tissue Sarcoma- with distant metastases or recurrent
  24. X-Linked Lymphoproliferative Disease
  25. X-Linked Myotubular Myopathy

If you have any questions about a Social Security Disability or Supplemental Security Income claim, please feel free to contact us at 352-629-0480 for a free consultation.

6 Ways to Lose Your Social Security Disability Claim

#1 Exaggerating your impairments. If your complaints are not supported by the evidence in your claim, this will most often result in a denial of your claim. It is very important to be as straightforward as possible about how your impairments affect your every day activities. Sometimes it is difficult to remember how long you are able to do an activity before you need to stop due to pain, medication side affects, fatigue, etc. We suggest that you keep a diary (which you can find on our website) so that you are able to let your physician know how you are limited. In this way, hopefully your complaints will be documented in your medical records. If you can perform an activity, admit it, do not deny it.

#2 Failing to submit your medical records. It is extremely important that your medical records be submitted as evidence in your claim. It is important to check with the Social Security Administration to ensure that all of the relevant information has been submitted by your treating doctors. Occasionally, the Administration will request records from your physician and we will review the file only to find that the records were not submitted. Medical records cannot be hidden or altered and can result in criminal charges if you misrepresent your condition.

#3 Failing to obtain opinions from your treating physician regarding your physical and mental limitations. Your treating physicians opinion is given great weight in the Social Security proceedings as long as that opinion is supported by the medical records and objective medical findings. Your Social Security file will contain opinions from physicians who have not met or spoken with you regarding your limitations. It is very important for the Judge to know what your own physicians thinks you are capable of doing based upon your complaints and the treatment that you have received.

#4 Failing to mention side affects you may have from your medication. It is very important to remember that sometimes the side affects you may have from the medications being recommended by your treating physician, can be as disabling as the medical condition itself. Unfortunately, these medications are essential in providing the treatment that is necessary in your claim. Often the medications that are being prescribed can even adversely interact with each other. It is a good idea to speak with your doctor and pharmacist regarding the adverse affects your medications may have on each other that could result in those medications not being effective.

#5 Failing to address drug and alcohol addiction issues. If you have a history of drug and/or alcohol abuse, your claim will be denied if that abuse is a material factor in your disability. Often people with depression and chronic pain will alcohol and/or drugs to help them cope with these conditions. Many times, the substances themselves actually contribute to the problem. It is important to seek treatment for any substance abuse issues that you may have, address these issues with your physician and make every attempt possible to seek treatment to help with the abuse. If your medical records indicate an abuse problem, it is your burden to prove that you would be disabled regardless of the substance abuse and this can be very difficult to do.

#6 Not complying with the Social Security Administration’s request for information. If the Social Security Administration asks you to complete forms (I know, there are sooo many forms), it is because additional information is necessary prior to a determination being made on your claim. Failure to complete the forms or to attend a consultative examination, will almost always result in a denial of your claim.

As always, if you have any questions about your social security disability or supplemental security income claim, please feel free to contact us for a free consultation at 352-629-0480