Disability Redesign Prototype

If you receive a phone call from the Single Decision Maker informing you of the pending denial and giving you the opportunity to respond, it is preferable not to respond to any substantive questions during the call.

Instead -

• Takes notes. If you don't have something with which to write handy, ask for a moment while you get a pen and paper to make notes. Start by making note of the date.
• Get:
  • The full name of the person calling (and how to pronounce the name if it is unusual)
  • The office from which the person is calling
  • The person's direct phone number
  • The person's mailing address
• Ask why you are being denied. Generally it will be that the medical record does not support your claim to be disabled.
• Ask what records went into making the decision. Write down a list of all the records. If necessary, make the caller repeat the list and wait until you have written down all the information. It helps to read back your copy of the list to be sure you both have the same list.
• Ask what is needed to change the denial to an approval. This is an open-ended question which the Single Decision Maker may refuse to answer or not answer directly. Still, it doesn't hurt to try. Ideally, you want to get the person to talk about your claim and what she or he found missing. Some people will tell you right off the bat. Others will require more talk with questions that vary. Listen carefully: if you get the Single Decision Maker talking, the person will usually provide clues about what she or he is looking for even if the caller doesn't come right out and say it.
• Ask about what specific evidence would help your case. Consider mentioning other possible evidence such as medical records, the existence of other medical problems, and other types of proof like a letter from a doctor or third party testimony. (This is not the time to volunteer what additional records you may have or can get.)
• Set an appointment for an interview. Set the date far enough in the future to give you time to get the evidence you need. This can take time - especially if you have to get records or a letter from your doctor(s). Stress that you need time to prepare for the actual Pre-Decision Interview. Jacques Chambers, a benefits specialist, suggests that you set an in person interview if you can. That way you can deliver the new documentation yourself and cover any questions that may come up. If the Single Decision Maker insists on a phone interview, set an appointment far enough in the future to allow time to collect documentation and to send it in before the telephone appointment.

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