12 Mistakes That Can Hurt Your Social Security Disability Claim: Lessons From 23 Years of Practice

Key Takeaways

• A diagnosis alone usually isn't enough. Social Security wants to know what your conditions prevent you from doing.
• Be accurate with your doctors and on every form. Don't minimize your symptoms, and don't exaggerate them.
• Gaps in treatment and missing records can leave Social Security deciding your claim from an incomplete picture.
• You generally have 60 days to appeal a denial, and a first denial isn't the end of your claim.

Most disability claims that run into trouble don't fail because the person isn't really sick. They run into trouble because of something small that either gets left out of a file or ends up in the file that hurts the claim.

After more than 23 years representing people in Social Security disability claims, I have seen just about every kind of case imaginable.

I have represented people with devastating physical injuries, serious mental health conditions, chronic pain, cancer, heart disease, autoimmune disorders, neurological problems, and combinations of conditions that made it impossible for them to continue working.

I have also seen good disability claims become much more difficult than they needed to be because of mistakes made along the way.

Most of these mistakes are not intentional. People applying for disability are usually dealing with medical problems, financial stress, family responsibilities, and a Social Security system they have never dealt with before. They don't necessarily understand which details are important or how something they say today might be viewed six months or a year later.

Unfortunately, Social Security does not always give you a chance to go back and explain what you really meant.

Here are some of the most common mistakes I have seen during more than two decades of handling Social Security disability claims—and, more importantly, how you can avoid them. 

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Mistake #1: Assuming Your Diagnosis Is Enough to Win Your Case

One of the biggest misunderstandings about Social Security disability is that having a serious diagnosis automatically means you qualify for benefits. It doesn't. Social Security is ultimately concerned with what your medical conditions prevent you from doing.

I have met with people who brought me an MRI report and said, "This proves I'm disabled." The MRI may show significant problems, but it doesn't tell the whole story. Social Security also wants to know things like: How long can you sit? How far can you walk? How much can you lift? Do you need to lie down during the day? How often do you have bad days?

Can you use your hands repeatedly? Can you concentrate long enough to finish a task? How often would your condition cause you to miss work?

The same principle applies to mental health conditions. A diagnosis of depression, anxiety, PTSD, or bipolar disorder is important, but Social Security also needs evidence showing how the condition affects your ability to function.

The potential consequence: A very real and serious medical condition may not result in an approval if the records don't explain how it actually limits your ability to work.

What to do instead: When you talk with your doctors, don't just discuss your diagnosis. Make sure they understand what you are struggling to do in everyday life. Social Security specifically considers evidence about work-related abilities, and the effect symptoms such as pain and fatigue have on daily functioning.

Mistake #2: Telling Your Doctor You're "Doing Fine" When You're Not

This is one I have seen more times than I can count. A doctor walks into the examination room and says:

"How are you doing?"

The patient automatically responds:

"I'm doing pretty good."

Five minutes later, that same patient tells the doctor that his back pain is an eight out of ten, he can barely sleep, he can't stand long enough to cook dinner, and he hasn't been able to leave the house for three days.

But sometimes the medical record simply says:

"Patient reports doing well."

Months later, that sentence may end up in a Social Security disability file.

I understand why people do this. Most of us are conditioned to say "I'm fine" when someone asks how we're doing. Some people don't want to complain. Others have lived with pain for so long that a terrible day has become their version of "normal." But your medical records are extremely important in a disability case.

The potential consequence: If your medical records repeatedly say you are "doing well," "stable," or "improving," Social Security may question why you are also saying that you cannot work.

What to do instead: Be accurate with your doctors. You don't need to exaggerate anything, but don't minimize it either. Explain what a typical week actually looks like.

Instead of simply saying, "I'm doing okay," it may be more accurate to say, "The medication has helped some, but I still have three or four days a week when I can't function normally." That gives a much clearer picture.

Mistake #3: Going Months Without Medical Treatment and Not Explaining Why

Gaps in medical treatment can create serious problems in a disability case. I have had clients tell me:

"I didn't go back because the doctor told me there wasn't anything else he could do."

Others couldn't afford treatment. Some lost their insurance. Some lived in areas where it took months to get an appointment. Others were dealing with depression or other mental health problems that made it difficult for them to follow through with treatment. Those can be very different situations from someone simply deciding that treatment isn't necessary. But unless someone explains the reason for the gap, the medical records may simply show that the person stopped going to the doctor.

The potential consequence: A long period without treatment may leave Social Security with very little medical evidence showing how severe your condition was during that period. Medical records are one of the primary sources Social Security uses to evaluate a disability claim.

What to do instead: Continue reasonable medical treatment whenever possible. If you can't get treatment because of cost, insurance problems, transportation, appointment availability, or another legitimate reason, make sure that reason is documented somewhere.

Don't assume Social Security will know why there is a six-month hole in your medical records.

Mistake #4: Completing Social Security Forms Too Quickly

Some of the most important evidence in a disability case doesn't come from a doctor. It comes from the claimant.

Social Security may ask detailed questions about your daily activities: cooking, cleaning, shopping, driving, taking care of pets, doing yard work, spending time with other people, handling money, and many other things. The problem is that people often answer these questions too casually.

For example:

"Do you prepare meals?"

A claimant checks yes.

That answer might technically be correct.

But what if "preparing meals" means putting a frozen dinner in the microwave because the person cannot stand at the stove for 20 minutes?

"Do you shop?"

Yes.

But perhaps the person goes to the grocery store once every two weeks, uses a motorized cart, gets help lifting groceries, and spends the rest of the afternoon recovering.

"Do you drive?"

Yes.

But perhaps the person only drives short distances and avoids driving on days when medication makes them drowsy.

I have reviewed countless forms where the claimant's answers made the person sound far more capable than they actually were simply because nobody explained the context.

The potential consequence: Months later, a decision-maker may point to those answers as evidence that you are more physically or mentally capable than you claim. Social Security specifically considers a person's daily activities when evaluating the effects of symptoms.

What to do instead: Answer every question truthfully, but explain your limitations. There can be a huge difference between being able to do something occasionally and being able to do it eight hours a day, five days a week. That distinction matters.

Mistake #5: Exaggerating Your Limitations

Minimizing your problems can hurt your case. So can exaggerating them.

After more than 23 years doing this work, one thing I tell clients repeatedly is that you do not need to make yourself sound worse than you are. If you tell Social Security that you "never leave the house," but your medical records say you regularly attend church, visit family, or go shopping, you have created an unnecessary problem. If you say you "can't lift anything," but later explain that you sometimes carry a gallon of milk, someone may wonder what else you overstated.

The better answer is usually more specific:

"I can lift a gallon of milk, but I can't carry it very far."

Or:

"I leave the house for medical appointments and occasionally go to church, but I usually have to leave early because I can't sit through the entire service."

Those answers can be both truthful and consistent with disability.

The potential consequence: Exaggeration can cause the person deciding your case to question the accuracy of other things you say, even the parts that are completely true.

What to do instead: Don't try to figure out what you think Social Security wants to hear. Tell the truth. Be specific. Explain the good days and the bad days. Your goal isn't to sound disabled. Your goal is to accurately describe your life.

Mistake #6: Only Talking About Your "Main" Medical Problem

People frequently come into my office and identify one condition as the reason they cannot work.

"My back is the problem."

Then, as we talk, I learn that the person also has neuropathy in both feet, diabetes, depression, migraine headaches, sleep problems, and significant medication side effects. Every one of those conditions may matter. Social Security isn't limited to looking at the one condition you consider the most serious. The bigger question is what you can and cannot do when all of your medical problems are considered together.

The potential consequence: Leaving conditions out of your application or failing to discuss them with your doctors may mean important limitations aren't fully developed in your case.

What to do instead: Tell Social Security about all of your significant medical conditions, including mental health conditions.

Don't be embarrassed about discussing depression, anxiety, memory problems, panic attacks, or other mental health symptoms. They may be an important part of understanding why you are unable to maintain employment.

Mistake #7: Assuming Social Security Will Automatically Get Every Medical Record

This is another common misconception. A claimant may say:

"They have everything."

Then we obtain the Social Security file and discover that an orthopedic surgeon's records are missing, a hospitalization isn't there, or several months of treatment from a pain-management clinic were never received.

Sometimes the claimant forgot to list the provider. Sometimes the provider didn't respond to a records request. Sometimes records simply didn't make it into the file. Whatever the reason, the result is the same: the person making the decision can't consider medical evidence that isn't there.

I have seen cases where one missing set of records contained some of the strongest evidence in the entire claim.

The potential consequence: Social Security may make a decision based on an incomplete picture of your health.

What to do instead: Keep a simple list of your doctors, hospitals, clinics, therapists, emergency-room visits, tests, and new treatment. Update that information as your case moves forward. Don't assume someone else knows about a new doctor you started seeing three months ago.

Mistake #8: Ignoring Letters or Missing Appeal Deadlines

If Social Security sends you a letter, open it. That sounds obvious, but disability claims can last a long time. People move. Mail gets misplaced. Claimants become frustrated and stop opening letters from Social Security.

I have had people contact me with a very good disability case but say something along the lines of:

"I got a denial a few months ago, but I didn't do anything with it."

That can create a major problem. Social Security generally gives a claimant 60 days to appeal an unfavorable disability decision. There are circumstances where Social Security can accept a late appeal for good cause, but you don't want your case to depend on getting an exception.

The potential consequence: Missing a deadline can cause you to lose your appeal rights and, depending on the circumstances, may force you to start over.

What to do instead: Open every Social Security letter immediately. Keep your address and telephone number current. If you receive a denial, don't put it in a drawer and think about it for two months. Find out what needs to be done right away.

Mistake #9: Working During Your Claim Without Understanding How It May Affect the Case

Working while pursuing a disability claim is not automatically fatal to your case. Life doesn't stop just because you've applied for disability. People have mortgages, rent, utilities, groceries, and children to support. Many people try desperately to keep working even after their health has deteriorated.

In fact, an unsuccessful attempt to return to work can sometimes provide important information about a person's limitations. The mistake is failing to accurately report the work or failing to explain how the work was actually performed.

I have seen situations where someone worked a few hours for a friend or family member, received extra breaks, missed days, worked at a reduced pace, or had coworkers perform the hardest parts of the job. On paper, however, all Social Security sees may be earnings. That doesn't tell the whole story.

The potential consequence: Work activity can affect eligibility for disability benefits, and unexplained earnings can raise questions about whether you are capable of working more than you claim.

What to do instead: Report work accurately. Keep track of your hours, earnings, missed days, special accommodations, extra breaks, help from coworkers, and why the job ended. Never hide work from Social Security. The explanation surrounding that work can be just as important as the paycheck.

Mistake #10: Missing a Social Security Examination or Treating It Like It Doesn't Matter

Sometimes Social Security sends a claimant to an examination with a doctor or psychologist it selects. This is generally called a consultative examination. Don't assume it is just a formality.

I have seen claimants spend months describing serious problems and then walk into one of these examinations and tell the doctor:

"I'm doing pretty good today."

Again, there is nothing wrong with having a good day. But if today is unusually good, say so. I have also seen people show up without knowing their medications, forget to mention important symptoms, or give very short answers because they are nervous and want to get the appointment over with.

Even worse, some people simply don't go.

The potential consequence: If Social Security doesn't have enough medical evidence and has scheduled an examination to obtain more information, missing the examination can leave the agency deciding your claim from an incomplete record.

What to do instead: Attend the appointment. Be cooperative. Don't exaggerate, but don't minimize your symptoms either. Be prepared to explain your medical conditions, treatment, medications, and the things you struggle to do.

Mistake #11: Waiting Until the Hearing to Take the Case Seriously

I have met many people for the first time after they have already been denied twice and are waiting for a hearing. They will bring me a stack of papers and say:

"I didn't think I needed an attorney until I got to the judge."

Sometimes we can straighten everything out. But I have also opened a file and found an answer the claimant gave a year earlier that now has to be explained. Maybe an important condition wasn't listed. Maybe the claimant gave an incomplete description of a past job. Maybe a daily-activity form was filled out poorly. Maybe important treatment was never reported.

Those early forms don't disappear just because you've reached the hearing stage.

The potential consequence: Mistakes made early in the process can follow you throughout the claim and become harder to correct later.

What to do instead: Whether you hire an attorney or handle the early stages yourself, treat your claim seriously from the beginning. Read forms carefully. Keep copies. Keep track of your medical treatment. Ask questions when you don't understand something. The application you complete today may still be important when your case is being reviewed many months later.

Mistake #12: Giving Up After the First Denial

This may be the saddest mistake I see. Someone receives a denial and assumes Social Security has decided that there is nothing wrong with them. That's not what a denial means. The Social Security disability system has multiple levels of appeal, including reconsideration and, if necessary, a hearing before an administrative law judge.

I have represented many people over the years who were eventually approved after an earlier denial. What concerns me are the people I never meet—the person with a legitimate disability who receives the first denial letter, becomes discouraged, and simply gives up.

The potential consequence: A person may abandon a claim that could have eventually resulted in benefits.

What to do instead: If you receive a denial, read the letter carefully and determine why you were denied. Then decide whether you should appeal. And remember the deadline. In most disability cases, you only have 60 days to file the next appeal.

The Biggest Lesson I've Learned in 23 Years

If I could give someone pursuing a Social Security disability claim one piece of advice, it would be this:

Be honest, be consistent, and be specific. Don't exaggerate how bad things are. Don't minimize how bad things are. Don't tell Social Security what you think they want to hear. Explain what your life actually looks like. If you can only stand for 15 minutes, explain what happens after 15 minutes. If you can go grocery shopping but need help carrying the groceries and spend the afternoon lying down afterward, explain that. If you have three good days followed by four terrible days, don't describe yourself based only on the three good ones—or only on the four bad ones.

And don't forget the question that sits behind almost everything Social Security is trying to determine:

Could you reliably do a job, day after day, week after week?

There is a significant difference between being able to perform an activity once and being able to perform it consistently enough to maintain employment.

After more than two decades representing disability claimants, I have found that many of the strongest cases are not the ones with the longest list of diagnoses. They are the ones where the medical records, the claimant's statements, the work history, and the rest of the evidence all tell the same story. That is what you should be working toward from the beginning of your claim.

If you're not sure your file tells that story yet, that's exactly what we can look at with you, whether you're just applying or holding a denial letter right now.

Need help? Have questions?

Our dedicated Social Security disability team at The Injury and Disability Law Center is here to help you. Contact us today to schedule your free initial consultation by calling our office at 575-300-4000, starting a chat, or filling out our online form. If you want even more information, feel free to download our free Online Social Security Disability Application Guide.