Top 5 Ways to Ruin Your Social Security or ERISA Long-Term Disability (LTD) Appeal--Don't do this!
Appealing a disability determination from the Social Security Administration (SSA) or from your insurance company under the Employee Retirement Security Act (ERISA) can be complicated. Below are a few steps you should NOT take!
Appeal the disability denial on your ownThis is the number one mistake. Everyone needs a good attorney. There's a point in the "Chicago" musical where one of the main characters, Billy Flynn--an attorney portrayed by Richard Gere--claims that had Jesus hired him as his lawyer, things would have turned out differently. He is exaggerating to make a salient point. An attorney can be of tremendous assistance as you appeal your case. No one wants to pay an attorney if it's not necessary. But what you don't know about disability rules and regulations can cause tremendous harm to you and your family; you need an attorney by your side.
Disability cases are based on complicated rules and regulations. The cases are time-consuming and can be discouraging. Having skilled representation by your side to face bureaucrats, insurance representatives or judges is crucial. Most disability attorneys work on a contingency fee basis.
If you are thinking of appealing the decision yourself, first ask yourself, do I even have a complete copy of my claims file or insurance policy? If not, you have already demonstrated the need for sound legal advice.
ERISA disability cases are equally complicated and confusing as you may believe the insurance claims representative is "on your side". In fact, the claims representative is on the insurance company's side (just like the Social Security representative is on the government's side) and, no matter how nice he or she may seem, owes no allegiance to you and has no incentive to help you win your appeal. Hire an attorney with no upfront fee to put your mind at ease.
Exaggerate your medical impairmentsWe all exaggerate. Sometimes claimants exaggerate their symptoms by declaring "I can't get out of bed" or "I can only lift 2 pounds" in order to underscore the pain or other symptoms they are experiencing. This will not persuade most adjudicators who are trained to look for objective evidence for the cause of your symptoms. Remember, if you are over the age of 50, proving disability becomes a little easier. Don't hurt your chances by ruining your credibility.
More importantly, you do not need to be bedridden to be eligible for benefits, you only need prove you meet the specific definition of disability whether it is an inability to perform substantial gainful activity, an inability to return to your past job or an inability to perform any work.
Minimize your medical conditionsOn the other hand, many times the tough guy loses his case by being, well, a little too tough. Don't feel ashamed. If your symptoms are limiting your ability to perform your daily activities and making it impossible for you to return to work, your doctors and the adjudicators need to know this! Being the strong, silent type can harm your economic, physical and mental health for you and your family. On the disability application you should list every doctor who has examined or treated you. You should be prepared to explain how those limitations prevent you from doing your job duties.
Now is not the time to diminish your symptoms.
Miss your deadlinesDeadlines for returning documents to SSA or an insurance company are serious matters. The deadlines vary widely. Sometimes you have 60 days, sometimes you have 10 days.
As outlined in your notices from the Social Security Administration or the insurance company, there are deadlines for appealing, deadlines for submitting documents, deadlines for filing your case in federal court. If you feel you will not be able meet these deadlines, you need to consult an attorney immediately.
At the very least for social security, you need seek an extension in writing before the deadline passes Remember, it's not what you did, it's what you can prove you did. Like all communications to SSA and the LTD insurance company, put it in writing and keep a copy.
Ignore your doctor's adviceIf you have a physical limitation that your physician agrees would limit your ability to perform yard work, should you post a Facebook picture of you chopping wood? By exploring your online accounts, conducting surveillance and forcing you to complete reams of paperwork, the Social Security Administration and insurance companies are scrutinizing your case for consistency. Performing tasks outside of the restrictions and limitations imposed on you, is the best way to lose your case.