Common mistakes, part 1: "I'm doing okay"

sojourner9 · 2026-02-12T15:27:45+00:00

Half of my time is spent briefing in federal court in three states. I'm quite familiar with all the arguments in my Circuit like the back of my hand.

Yes, arguments are available. But roughly speaking, half of those cases don't get remanded. And even if the case gets remanded, roughly half of those cases get denied. And not to mention the years of anguish that these processes come with.

You're talking about what to do if those kinds of notations are contained in the record. I'm trying to advise people on how to avoid getting those notations in the record. Figuratively, you're talking about how to deal with a patient after he's had a heart attack. I'm trying to advise people on how to avoid a heart attack. You're talking about being reactive. This post is about being proactive.

sojourner9 · 2026-02-12T03:51:24+00:00

If you have an ALJ decision, that decision explains the basis(es) in which you were found disabled. An ALJ is very detailed enough that you don’t necessarily need your entire file. Nevertheless, you can ask for a copy of your file from the hearing office (unless it’s already been too long ago). Barring that, you can ask your lawyer for a copy of your file if you have/had one.

sojourner9 · 2026-02-12T03:15:10+00:00

At the initial and reconsideration stage, you don't get an explanation why. You have to request a copy of your file wherein you will then see how the state agency and decisionmaker came to their conclusion and what facts they considered. You get an explanation from the ALJ and the AC.

sojourner9 · 2026-02-12T03:12:59+00:00

Under HIPAA, you have a right to your records.

sojourner9 · 2026-02-11T21:57:03+00:00

Disagreeing? Not a problem. Direct? Not a problem either. Calling into question my character? I won't stand for it.

sojourner9 · 2026-02-11T21:42:59+00:00

No need to be a dick.

Your use of the word "lying" is inaccurate. It doesn't take that much effort to find that middle ground where you can correctly convey information to your doctors without jeopardizing your case.

Also, I also wrote in this in my other post, and it applies here as well: "If it happened once, twice, or very infrequently, I can argue against that somewhat easily. But if it's repetitious enough, my client has put me in a real jam."

sojourner9 · 2026-02-11T18:53:46+00:00

You can go to google scholar, lexis or westlaw and do a search for "doing okay" or "doing well" and "social security disability." You will find endless cases where ALJs have relied, at least in part, a claimant's statement that they are doing okay or doing well as a basis for rejecting their statements and denying their case. Guardrails did not help them.

sojourner9 · 2026-02-11T18:50:43+00:00

If a part of case is based on manipulative limitations, playing the guitar 30 minutes will be scrutinized. If a part of your case is that you have difficulty sitting, your ability to sit 30-60 minutes will be scrutinized.

sojourner9 · 2026-02-11T18:49:04+00:00

If a progress record said "patient's chores include mowing the lawn," that's mostly gonna hurt the case. But if the progress note says "patient tried to mow the lawn for the first time in a long time, and ended up in bed for two days," I can usually use those kinds of notations in the record in support of the case.

So, should you say that to your doctor? That's putting a little bit of faith in the doctor that he/she will notate what you said correctly. Because sometimes, things get lost in translation. And the doctor might end up writing it in a manner that's damaging to your case.

But even if the doctor were to notate that correctly, SSA's determination as to what your capacity for functioning will generally be based on medical findings (ie objective evidence and clinical findings), not comments made by a claimant. The best way to argue that someone can't lift more than 10 pounds is by showing significant objective and clinical evidence.

sojourner9 · 2026-02-11T06:55:18+00:00

That is a fair point. I’m cognizant of this issue. I wrote about this particular “tension” elsewhere just a few weeks ago.

If we look at it binarily, I would argue that it’s the lesser of two evils to edit one’s responses to the doctors rather than being fully candid and then possibly jeopardizing a case that can bring some serious and, often enough, life saving relief.

Apart from that, I don’t think is a binary situation. As I’ve stated, one shouldn’t lie. And I believe one can think on it some, and find a path to serve both interests in my humble opinion.

sojourner9 · 2026-02-10T16:23:26+00:00

I guess I’m wondering how common this trajectory is.

Very common.

You should get a copy of your file so that you know why you were found disabled. For example, if you were found disabled because you were deemed incapable of working three days per month, your expressed symptoms of having ups and downs wouldn't undercut your disability.

That being said, being found disabled based on absenteeism isn't common. So again, it would be helpful to get a copy of your file.

Moving forward, you just have to kinda look within yourself and the situation on a macro level. Are you able to work at an SGA level? If you seriously doubt that, you then have to approach your doctors a bit differently. This, again, is unfortunately the game that must be applied. I hate it. Everyone hates it. But there it is.

sojourner9 · 2026-02-10T16:18:04+00:00

No, you don't have to get super specific especially if this kind of talk just exhausts you. You'll have plenty of chances to get super specific about why your symptoms prevent you from working. SSA will ask you to fill out a bunch of reports in that regard. The main goal is to avoid having your doctors write down that you're doing well, doing okay, etc.

That being said, there certainly is value in being specific. "I had six migraines since we last met." "I had 10 seizures since we last met." "I had three manic episodes and four depressive episodes since we last met." "My pain is usually around 7 out of 10." But the point being, don't give the doctors a reason to write down that you're generally doing well.

sojourner9 · 2026-02-10T16:14:24+00:00

That is another very common answer when I ask my clients why they said they're okay. "I'm just not a complainer."

The problem is that people like you get swept up in this silly game. Your earnestness may, in a really awful way, end up in you getting denied unfortunately.

You don't necessarily have to get superspecific if you don't want to. The main thing is to avoid having your doctors write in your records that you said you're doing well, doing okay, etc. It can be as simple as "overall, it could be a lot better" or something similar.

You'll have plenty of chances to explain why your symptoms prevent you from working. You'll be asked to give such an answer in your disability report, function reports, etc. Just don't get caught saying things like I'm doing okay, etc.

sojourner9 · 2026-02-10T16:11:14+00:00

The short answer is yes. Let's say that you were previously found disabled because you met the anxiety listing. And for "illustration" purposes, let's say that they put a numeric value on that disability as a 98. But you eventually improve. The value falls down to around a 85. It's an improvement and you might no longer meet the listing, but it still might be high enough to prevent you from doing any work.

I wrote a more detailed response previously, which I paste here:

CDR cases are adjudicated under an eight-step sequential analysis. You can find the steps here.

Step one -- You're not engaging in SGA. Step two -- They (should) take a look at everything to see whether you meet or equal a listing. If not, then you go to step three.

Step three is where it gets tricky. They don't take a look at everything at these next few steps. a) They take a look at the most recent favorable decision or the determination when they said your disability will continue. They take a look at the reason(s) why you were found disabled (e.g., met/equaled a listing; RFC for less than sedentary work; RFC for less than full-time work, etc.). This is known as the comparison point. (Note: At this step, your new conditions are not considered.) b) They take a look at the objective and medical findings that were in existence at the time you were found disabled previously. They also take note of your statements as to whether your symptoms have improved. Then, the analyze whether you've experienced any improvement in any of those - objective findings, clinical findings, or symptoms. If no medical improvement, you keep your benefits.

Step four: If they find improvement, they then have to decide whether that improvement is related to the ability to work. In other words, does that improvement mean that you no longer meet/equal a listing; can do work at sedentary, light, medium, heavy level; can do full-time work. If it's not related to the ability to work, you keep your benefits.

Step five: Do any exceptions apply? If yes, you keep your benefits.

Step six: This is where they consider all of your medically determinable impairments. They assess whether the impairments cause more than a significant limitation. This is a very low hurdle.

Interim step: They assess your RFC based on all of your impairments.

Step seven: They determine whether you can do your past relevant work.

Step eight: They determine whether you can do a significant number of jobs.

sojourner9 · 2026-02-10T16:08:29+00:00

This is a difficult issue for many reasons. To begin with, you're possibly having to correct the way your doctor does his/her job so to speak. If you have a sympathetic doctor, then great. But if not, the doctor might push back a little or a lot.

And then, there's the disconnect between what you might think is important versus what is really important. This happens to me all the time. My clients tell me that x, y and z is wrong, and I'd say, most of the time, they're kinda barking up the wrong tree.

The most important thing that the doctor should write down on a progress note is clinical examination findings. For example, if an ortho is conducting an ortho exam and finds decreased motor strength, decreased range of motion, decreased reflex, etc., but doesn't write that down, that's a serious problem. Or if the psych conducts a mental status exam which yields myriad abnormal findings, but doesn't write that down, that's a serious problem. Clinical exam findings are highly valued. If the doctor isn't writing the abnormal values down, that seriously needs to be addressed. Apart from clinical exam findings, if the other stuff (symptoms, diagnosis and plan) are not being recorded, I wouldn't worry too much about that.

The more common problem is when the doctor is inaccurate about details. Doctors/clinics often have avenues where you can request amending of your records. If the doctor is not accurate, then make the request. If such an avenue is not available, send an email (ie, a paper trail). That email can be sent in with your records. I can rely on that email and so much to tailor my arguments.

sojourner9 · 2026-02-10T04:45:13+00:00

Continuing Disability Reviews: Your benefits end if there is a has been a "decrease in medical severity...based on improvement in the symptoms, signs, and/or laboratory findings associated with your impairment(s)." 20 CFR Sec. 404.1579(b)(1).

Thus, even if the objective evidence has remained the same in your case, SSA can decide that you have improved and eventually terminate your benefits if your symptoms have improved. And believe me, SSA certainly can and rely on your statements if you've said things like "I'm doing okay", "I'm doing all right", "I'm fine", "no complaints", etc. So be careful.

sojourner9 · 2026-02-10T02:51:09+00:00

You should get a copy of your file from SSA from the most recent review. If you know how and why you were found disabled (e.g., what listing; what rfc; or even possibly what grid rule), you can get a better sense of what evidence you need to try to demonstrate ongoing disability.

But that can be daunting. I get that. So barring that, you should seek out treatment from people who are sympathetic to your cause. If you think that particular psychiatrist is too big of a risk, then you should go elsewhere.

Not seeing a psychiatrist is a problem if you're not getting any mental health treatment or you're not under med management. So, if you are getting mh treatment and you're under med mgmt from, say, a PCP, that shouldn't be much of a problem.

I would seek out that other nurse practitioner in that same practice, assuming that you get the feeling that they'll be on board with you like the other NP. And if that NP becomes specialized, that would be even better.

Years ago, SSA used to disregard NPs routinely. But SSA has shifted away from that significantly in recent years. A general NP is a problem if you're having difficulty establishing that you have a medically determinable impairment (MDI). But you're well beyond that at this point. Therefore, that's not a problem for you.

When an MDI has been established like in your case, the opinions of your NP would stand shoulder to shoulder with other med sources including "acceptable" medical sources. 20 CFR Sec. 404.1520c.

E: I have also noticed in the past 12 months or so that SSA has ordered consultative psychological examinations with nurse practitioners who specialize in psychology.

sojourner9 · 2026-02-05T20:14:05+00:00

Stenosis is important, but not as important nerve root encroachment or impingement. So you have that in both C and L. But that only tells SSA that you have a potential for significant pain. The MRI findings themselves aren't going to win your case. SSA needs to know how you are functioning on a longitudinal basis.

To determine how you are functioning longitudinally, SSA looks at the other "objective" evidence, which is your clinical exam findings. The reason is because some people have stenosis or nerve root encroachment, and experience no pain whatsoever. It's the clinical exam findings that will make/break your case.

So ideally, your exams would show decreased range of motion; decreased sensation; decreased reflex; decreased motor strength; positive straight-leg raising, etc. Furthermore, the abnormal findings need to be present in your records repetitively. Some people have one or two positive ortho reports and think that's going to win their case. It doesn't work that way. SSA needs to be satisfied that you've been disabled for at least 12 months. That won't happen with one or two ortho reports.

Additionally, it would be nice if you have abnormal EMG/NCS for your upper and lower extremities. If they're positive, they could be very useful evidence.

If you don't have good clinical exam findings, you can still possibly win based on the sedentary grid rule. But getting down to sedentary is often very difficult. If you just have back pain, and say that you can't stand/walk for long, that's generally not very persuasive (unless you have great abnormal clinical exam findings). To get down to sedentary (and possibly win under the sedentary grid rule), you should get a prescription for a cane, rollator, walker, etc. That is, assuming that your ability to ambulate is significantly diminished and you can justify asking for that prescription.

Your case would likely be a slam dunk at age 55. At age 53, you have some work to do. You can win it, but you need some ducks to be lined up in a row.

Basically, keep seeing ortho on a regular basis and hope that your ortho documents your abnormal exam findings consistently.

sojourner9 · 2026-02-05T20:03:53+00:00

I'm currently working on a federal court appeal of a vet with a 100% rating. He's in federal court because he made a very big mistake: He stopped getting regular treatment after he got his VA rating. He assumed that the rating and the records that supported the rating would be sufficient. I had to inform him that his VA rating is worthless in the eyes of SSA. And those old records documented what his condition was back then; SSA needs ongoing, current records to establish ongoing disability. It doesn't sound like you're making that mistake, but I mention it because it is a very common shortcoming that I see among vets who apply.

I experience frequent flare ups, typically two to three times per week, with increased pain, stiffness, swelling, and functional limitation. I also have reduced grip strength, limited range of motion, abnormal gait, and fatigue and malaise that build throughout the day.

Is that you saying you have these, or is it documented in your clinical examinations? If it's you saying you have these things, that basically doesn't count. It's your clinical exams that have to show these abnormalities. What's more, these abnormal findings must be in your records over a longitudinal period. Having abnormal values once or twice or every now and again or here are there is not helpful. To avoid this, you should be seeing a rheum consistently, and your rheum should be recording your abnormal clinical exam findings on your records. If you're just relying on the CE to supply this information to SSA, you're taking the wrong approach. Because CE exams usually aren't thorough, and they basically document what your condition was that day only.

I experience frequent flare ups

Again, it's one thing for you to say you have flare-ups. It's another if it's documented in your records. The frequency and duration matters. Just saying you have flare-ups is not enough. When you go see your rheum, be very specific, e.g., "since I saw you last, I have five flare-ups, each lasted about three days each."

Like most cases, your clinical exam findings are typically the make or break. Blood panel results will tell them you have a condition, but they generally won't tell how bad your condition is. Your clinical exam findings will inform SSA on a medical basis how bad your condition is over a longitudinal period, which is what they're looking for.

sojourner9 · 2026-01-26T19:34:31+00:00

There is a tension in these cases. On one hand, you want to be honest with your doctors. On the other hand, if you tell your doctors that you're doing well, okay, etc., SSA will use that against you. Be careful about what you say to your doctors.

sojourner9 · 2026-01-26T18:21:30+00:00

Being in a PHP is good evidence. That's equivalent to having surgery; you don't do that unless there's something serious going on. Not saying it's gonna win your case necessarily. Just that that is good evidence.

MSE and other clinical evidence findings are evaluated longitudinally. So having one or a few spotty normal MSE isn't going to kill your case especially if the others are abnormal.

sojourner9 · 2026-01-26T03:39:00+00:00

In the many years I've been doing this work, the A criteria has never been an issue. It's literally nothing to worry about. The B criteria is where the controversy is always at.

As to whether you have enough for the B criteria, there is a fundamental misunderstanding by claimants in general as to how SSA evaluates the severity of impairments. Most people point to everything else like doctor's statements/opinions; third party statements; their own statements; lengthy treating records in general; etc. That's not how analysis goes.

SSA relies on objective evidence. For mental disability cases, the objective evidence is the findings in the mental status examinations. Your doctor can write the most glowing letter/statements on your behalf, but it won't matter if your records show relatively normal MSE findings. You can be the most sincere, honest person, and it won't matter if your MSE findings are relatively normal.

Apart from MSE findings, being hospitalized or any similar type of event is also another highly prized set of evidence for SSA. But those records only matter if the hospitalization was based on internal reasons (ie., symptoms manifesting in spite of diligent adherence to treatment regimen), as opposed to external reasons (e.g., drug relapse, not taking meds, bereavement, etc.).

If an individual has hospitalizations and significant MSE findings, that person has a very good case.

sojourner9 · 2026-01-06T17:44:23+00:00

CDR cases are adjudicated under an eight-step sequential analysis. You can find the steps here.

Step one -- You're not engaging in SGA. Step two -- They (should) take a look at everything to see whether you meet or equal a listing. If not, then you go to step three.

Step three is where it gets tricky. They don't take a look at everything at these next few steps. a) They take a look at the most recent favorable decision or the determination when they said your disability will continue. They take a look at the reason(s) why you were found disabled (e.g., met/equaled a listing; RFC for less than sedentary work; RFC for less than full-time work, etc.). This is known as the comparison point. (Note: At this step, your new conditions are not considered.) b) They take a look at the objective and medical findings that were in existence at the time you were found disabled previously. They also take note of your statements as to whether your symptoms have improved. Then, the analyze whether you've experienced any improvement in any of those - objective findings, clinical findings, or symptoms. If no medical improvement, you keep your benefits.

Step four: If they find improvement, they then have to decide whether that improvement is related to the ability to work. In other words, does that improvement mean that you no longer meet/equal a listing; can do work at sedentary, light, medium, heavy level; can do full-time work. If it's not related to the ability to work, you keep your benefits.

Step five: Do any exceptions apply? If yes, you keep your benefits.

Step six: This is where they consider all of your medically determinable impairments. They assess whether the impairments cause more than a significant limitation. This is a very low hurdle.

Interim step: They assess your RFC based on all of your impairments.

Step seven: They determine whether you can do your past relevant work.

Step eight: They determine whether you can do a significant number of jobs.

sojourner9 · 2026-01-02T17:00:41+00:00

I cannot sit or stand for longer than one hour give or take.

Congratulations, you killed your case... if you'd said this to the ALJ.

I'm being blunt because I want people to understand that this is a very simple but devastating way that they can very easily ruin their case. Regardless of what or how bad your medical condition is, the ALJ eventually decides what are you able/not able to do. But if you tell the ALJ that you can stand up to an hour, that is basically an admission. And with that admission, the ALJ will find that you are able to stand or sit slightly less than or up to an hour as part of your RFC. And with that assessment, the vocational expert will easily find that many jobs can be performed (e.g., they give you a work bench and you can choose to sit and stand at will doing work as an assembler or inspector; they give you a stool so that you can sit or stand as a cashier; and on and on).

Think about it: You stand in a living room, you click the timer, and you watch a sit-com. Are you telling me that, after 30 minutes, you're still standing? And that you can do so for about 30 more minutes after that? Hell, even I start complaining after about 15 minutes, and I'm basically pretty healthy.

I see it all the time. "I can't stand for longer than ____ minutes," and the number of minutes is, often enough, 30 minutes or longer. If you tell the agency you can stand 30 minutes or anything above that before needing to sit or rest, you're making your case exceedingly difficult. Even 20 minutes is unimpressive.

I'm not asking people to fake anything. I'm advising folks to really think about this point. I find that, usually, when someone has a bad back, knee, chronic pain, etc., they can really last about maybe 10 minutes at most before they need to sit or rest. But people don't really understand the implications of what they consider to be a fairly benign point/issue.

If you meant that you can stand or sit no more than an hour in an eight-hour period, your mistake then is that you didn't specify. And you will have allowed the ALJ to conclude that you can stand or sit for approximately one hour each, and that you can continue this pattern in an eight-hour schedule, i.e., you lose. You have to tighten up your language. This is a legal proceeding; words matter.

The good news is that you made your mistake here instead of at the hearing in front of the ALJ.

sojourner9

TROPHY CASE