Frontiers in Medical Case Reports (FMCR)
1. Gather Information - Presenting a Strong Case with Complete Medical Documents
Gather information and present a strong case with complete, comprehensive medical documents, particularly of those prepared by the claimant’s physicians. Be as thorough as possible.
Refer to the Adult Disability Checklist to figure out the formal documents (e.g. birth certificate and Social Security card) needed to apply: https://www.ssa.gov/hlp/radr/10/ovw001-checklist.pdf
The strongest cases are presented as a narrative account of the claimant’s personal treatment history (SAMHSA 2020).
2. Begin the Process - Visit a Local Social Security Office In-Person
Begin the application process by visiting a nearby Social Security office in-person. It is important to go in-person to begin establishing the personal connections necessary for a timelier processing of the application.
The application process can also be phone, mail, or online.
Online applications do not require an appointment and efficiently allow individuals to complete their applications at their own pace but does not guarantee the timely receipt of the benefit compared to applications that are done in-person.
*In circumstances prior to the COVID-19 outbreak.
3. At the Appointment, Completing the Application
Verify the insured status and other nonmedical eligibilities at a nearby Social Security office with a disability examiner/clerk. Answer questions with a structured interview – recorded online on a computer. Having an up-to-date mailing address/P.O. Box is also advised since it is the primary means by which Social Security communicates with its clients.
4. Assure Application Submission Has Been Entered into the System with the Social Security Office by Positive Reinforcement
Seek the clerk’s supervisor and ideally work your way up to the field site operation supervisor of the office by means of relaying praise of staff member’s assistance to their supervisor or manager and assuring that the application has been sent to the DDS office, the process center.
To the clerk: Thank you so much for being so patient (e.g. when I was searching for my son’s social security number). I would like to speak to your supervisor to tell them how helpful you’ve been to me…
To the supervisor (of clerk): (Clerk) was incredibly helpful. I wanted to also ask you.
Where am I in the application process?
How does the timeline look like?
To the office/district manager (or the deputy director of social security): Repeat the process with the supervisor along with the request to be connected with a staff member at the DDS.
5. Regular follow-ups and continuing relationship with the state Disability Determination Services (DDS)
Follow-up regularly and establish a relationship with the referred staff member the state’s Disability Determination Services (DDS), again by means of positive reinforcement, to assure the completion, where it is entered into the system with all the correct information, and timeline of the application.
Discussions: Reinforcement and Follow-Up
The steps the case-study has taken provide guidelines for building relationships and follow-up. These guidelines provide the means to regularly support and recognize the federal employees who have a significant influence over the outcomes of the application by implementing personal, face-to-face (if possible) positive reinforcement and follow-up from start to finish. In health behavior changes interventions, showing human support is an important component to the effectiveness and adherence of both face-to-face and online interactions and the same principles can applied in claimants building a supportive accountability into the federal system to obtain their SSDI benefits (Sanatarossa et al., 2018).
Face-to-face interactions are observed as a better alternative to online applications because despite online applications being increasingly efficient and convenient, these services so far can only guarantee saving the few days it may take to schedule an appointment and certain cases may not qualify (Shane, 2020).
By paying attention to setting the necessary interactions, the case-study was able to ensure that their application was not lost, sent to the correct offices, and validate that it has the complete and accurate information required for a timelier processing. The face-to-face positive reinforcement is the acknowledgment of the staffs’ work and a means to hold them accountable in case there may have been incomplete submission of the application in the many steps required. Federal workers were more open to provide the application with the time and care it demanded when given positive feedback, especially when it is relayed to their supervisors or managers who can offer them greater benefits in return for their better work performance and improve their feeligns of contributing to their organization’s productivity (Liet__ampersandsignatilde;o J et al., 2019). Although, the process of intentionally establishing these face-to-face, personal relationships to attain a timelier benefit in the system is arguably self-serving, manipulative and bound to spark controversy, but it is efficient for the claimant’s sake.However, the timelier receipt of the case is also attributed to the severity of the case-study’s disability that tend to be fast-tracked in the application process.
The steps outline the checkpoints claimants can create to assure the processing of the application and address the inefficient, flawed accountability system of the SSDI process that still faces key management challenges in its human capital with the ongoing retirement wave and hiring freeze; incorporation of the modern concept of disability in its programs; modernization of information technology services and information security; and evaluation of its physical infrastructure placement (SSA, 2017; Shane, 2020). Target populations that are at a severe disadvantage for accessing SSDI like the poor, illiterate, and mentally disabled can benefit the most from these steps (Goldman et al., 2018; SSA, 2016). And, this method can also be applied to the processes of finding doctors or for any benefits.
The earlier receipt of SSDI benefits in this presented case-study can be attributed to the continual follow up and monitoring of each step to accelerate the traditionally slow application process via building relationships and communication expectations and the severity of the diagnosis of the claimant’s disability and the face-to-face interactions (e.g. building a relationship with the office manager) that are more difficult to achieve in the present crisis. Building relationships and communication expectations are promising means to build accountability to an otherwise dysfunctional system and provide claimants with more sustainable resources by these connections to people working in institutions and organizations.
This is in honor of Lee Bone’s son Robert R Bone who died from early onset dementia and was on SSDI. We would like to extend our sincere gratitude to Elizabeth Caroline Mason, the Medical Relations Director from the Maryland Disability Determination Services, and her staff for the assurance they have provided Bone in helping secure SSDI for her son. We would also like to acknowledge the help of Erica Brown as a contributor for lending us her insight based on her previous experience working in SOAR and the techniques the program used to make the processing of SSDI applications more efficient. Dr. Bone and Michelle Cho were in charge of writing the paper with Dr. Miller, Dr. Segal, and Dr. Levine as the co-authors who have provided guidance in determining the applications this manuscript may have in the medical education and practice.
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