US Government Information/SSI claim was denied
QUESTION: Hello Darlene. Unfortunately our SSI claim for my 25-year old son has been denied. Even though we've submitted the doctors' and hospitals' records for over 10 years of him being struggling and treated for severe OCD, Anxiety and Panic disorders and on top of it the blood clotting disorder, and we are seeing him getting progressively worse and often not being able even to leave the house, the denial letter says "it does not prevent doing lighter work that does not require lifting over 20 pounds and limiting social interaction with others". Now in addition of trying to keep our jobs and taking care of our son, we also need to engage in the appeal process. I would appreciate your opinion on how we should go about it. Is there some organization that can help us with the process? Is there anything that we should do better next time? Thank you!
ANSWER: I suggest that you obtain a representative to help with the appeal process. It may be difficult to find someone that will take the case contingent on approval when the appeal is at the first level. This is because their fee is based on approval at 25% of back pay and if not in the 2nd stage of appeal, there is not much back pay accumulated.
I could refer you to a colleague if you cannot find someone in your area.
The person that files the appeal will need to request your son's file from Social Security to evaluate the evidence used and to determine what is needed.
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QUESTION: We've talked to one representative and he is asking to establish a guardianship for my son before doing anything else. Do you think it's a good idea? The charge is around $3000, does it sound reasonable? Thanks!
ANSWER: Is your son mentally incompetent? Being an appointed guardian usually means that a court has determined a person to be mentally incompetent. Maybe he sees this as a way to get your son's claim approved. Or, maybe he is trying to make money knowing he will not make much on the claim. I would recommend getting a second opinion. I have no experience with the cost of a guardianship, but I think it seems excessive. Perhaps you could pose this question to an attorney who volunteers their time to answer questions via AllExperts.
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QUESTION: The difficulty is that when he is too anxious or really bothered with the thoughts and compulsions, he might not be able to communicate well. He usually doesn't call because it's too stressful, so we need to call for him. So I am wondering if he should maybe sign some paper so that they can talk to me instead. Usually nobody wants to talk to me because he is an adult. But you are right, I don't need to be his guardian. Thank you!
You can submit a form appointing yourself as his representative when you request your appeal. This will allow you to speak on his behalf.
You can also request a copy of his file and review the medical evidence as his representative. Sometimes decisions are made before all of the evidence has been received. Submitting the missing evidence with the appeal may get his claim approved at the reconsideration level (first level of appeal).
If benefits are approved, you can file to be his representative payee. Medical evidence must support that he is not capable of managing his own benefits. The benefits are paid in your name for your son.