Stay calm and file the appropriate forms…

When you have been waiting for months for a decision on your Social Security disability application, and you get a denial letter with very little information, it can be hard not to feel distress.  When you have been receiving benefits for months, or even years, and you get a letter saying that your benefits are being reduced or stopped, it can be hard not to panic. 

But the reality is that even if you have made a mistake somewhere along the way, most mistakes can be rectified.  Not to mention the fact that the Social Security Administration, itself, makes mistakes, which proper research and persistence can persuade it to rectify.  It can help your peace of mind to understand the process for addressing a decision that you feel has been made in error.  It can also help you to become aware of some of the common mistakes that come up.  Here are some examples:

• Follow-up forms or requests by the SSA for additional information are sent to the wrong address or sent in a format that is not accessible to the applicant; for example, sent in writing to an applicant who is legally blind.

• Social Security include as a “countable resources” bank accounts that formerly belonged to the applicant but have been closed and the funds spent. 

• The recipient’s Supplemental Security Income (SSI) benefit is reduced for “in-kind support and maintenance”, because the recipient and her/his family did not use “fair share” to calculate the recipient’s contribution to household expenses.  Other methods are permissible, but some SSA agents do not know this.

• Students who are under the age of 22 and regularly attending school are not recorded as such.  Given that many students with disabilities stay in the public school system for additional years of “transition”, often up to the age of 22, it is surprising how often the SSA has this piece of data incorrect.  For the under-22s, student status matters, because the much more generous Student Earned Income Exclusion applies when their Supplemental Security Income (SSI) benefits are calculated.

• When the person with a disability is the beneficiary (but not the owner) of a 529 plan, and plan withdrawals are used entirely for qualified educational expenses, the withdrawal may be erroneously attributed as income to the person with a disability.  This happens when the distribution goes directly to the financial institution on behalf of the student or to the student to pay educational expenses, and the IRS form 1099-Q carries the Social Security number of the student/beneficiary with the disability.

• A recipient of SSI or Social Security Disability Insurance (SSDI) who works reports monthly earnings in a timely fashion, but the reports are mislaid or improperly processed.  This is a huge issue, because the SSA may, erroneously, attribute an overpayment to the recipient and send a scare letter asking her/him to return a large sum of money.

The Social Security disability application and review processes require the collection and processing of a large amount of data.  When the Administration makes a particular decision that later proves to be incorrect, it is either because they have insufficient data or because they have not evaluated the data correctly according to their rules because the rules are complex and can be nuanced and the subtleties may be beyond the scope of the staff who process the application or review at the first level.

If you receive an initial or subsequent decision from the Social Security Administration that you believe is in error, your first step is to determine, to the best of your ability, from what lack of data or data mis-analysis the error might stem.  Sometimes, the letter itself will inform you, although you might have to read through pages before you find that information.  Other times, you will need to call the office listed on the letter and inquire.  Have reading material on hand and be prepared to sit on hold for a while.

The next step is to file a Request for Reconsideration (form SSA-561) within 60 days of the date of the letter, which informed you of the decision.  This can be done online or with a paper form by fax or mail.  Include as an attachment with the form all documents containing data that supports your request.  For example, if the issue is mis-attribution of a 529 plan distribution, include a copy of the 1099-Q, giving the amount of distribution as well as a copy of the IRS form 1098-T that shows an amount greater than or equal to the distribution paid to the educational institution as tuition and fees.  If a transition or postsecondary student under the age of 22 is not recorded as regularly attending school, provide a transcript of the student’s most recent school term.  If the monthly earned income has been improperly recorded, re-send the paystubs.

If the Request for Reconsideration is denied, you can then file a request for a hearing with an administrative law judge (ALJ)—again, within 60 days.  If that decision is not in your favor, you can request that the Appeals Council review the ALJ’s decision.  Finally, you can take your appeal to a US federal district court.  At each step of the way, you will want to document, document, document some more, and make sure not only that you have sufficient evidence to support your case, but also that the evidence is presented in a way that makes sense within the Social Security Administration’s complex set of rules and regulations.  Note that you will not necessarily need to go through all steps of this process to resolve your issue in certain cases.  It may be helpful, particularly as the case moves on, to designate a representative who thoroughly understands the rules and regulations and how to present data best within that context.

It is hard to stay calm when Social Security benefits are a part of your financial stability, and you receive an unexpected communication from the Administration that the benefits have been changed or discontinued.  But errors are made and can be fixed.  Even if the fixing takes a long time, the SSA will, eventually, put your benefits on track an catch you up on any you are owed.