Inside the Social Security Disability System: Scams, Delays, and How to Protect Your Claim

Welcome to Season 1, Episode 42 of Winning Isn't Easy: Navigating Your Social Security Disability Claim. In this episode, we'll dive into the complicated topic of "Inside the Social Security Disability System: Scams, Delays, and How to Protect Your Claim."

Most people applying for Social Security Disability face the same frustrations: endless waiting, inconsistent updates, and a flood of confusing - sometimes threatening - phone calls. Between the growing backlog of disability claims and the rise of scams targeting vulnerable applicants, it’s easy to feel lost in a system that seems impenetrable. But the reality is more layered than it looks. Delays don’t mean your case has been forgotten, and not every call claiming to be from Social Security is legitimate. There are patterns behind the slowdown, and there are ways to protect yourself while you wait. In this episode of Winning Isn’t Easy, we break down how the system really works beneath the surface. We start with the scams that prey on disability applicants - what they look like, why they’re increasing, and how to spot the red flags before you lose money or personal information. Then we take you behind the curtain of Disability Determination Services to explain what’s driving the backlog, how claims are actually evaluated, and why the wait times have grown so dramatically. Finally, we give you concrete strategies for staying proactive while your claim is pending: keeping medical evidence current, strengthening your file, and supporting your mental and financial well-being during the long stretch between filing and decision. You’ll come away with a clearer picture of the Social Security Disability process, the safeguards you can rely on, and the steps that genuinely move your claim forward. Understanding the system is the first step - navigating it with confidence is the next.

In this episode, we'll cover the following topics:

One - Slam the Scam - How to Spot and Stop Social Security Scams

Two - The Growing Backlog in Social Security Disability Claims

Three - Staying Proactive While You Wait - Taking Control of Your Disability Claim

Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.


Listen to Our Sister Podcast:

We have a sister podcast - Winning Isn't Easy: Long-Term Disability ERISA Claims. Give it a listen: https://wiedisabilitypodcast.buzzsprout.com


Resources Mentioned In This Episode:

LINK TO YOUR RIGHTS TO SOCIAL SECURITY DISABILITY: https://mailchi.mp/caveylaw/your-rights-to-social-security-disability-benefits

FREE CONSULT LINK: https://caveylaw.com/contact-us/


Need Help Today?:

Need help with your Social Security Disability claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.

Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.

Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

Transcript

Nancy Cavey [00:00:14]:
 Welcome back to Winning Isn't Easy. Social Security Disability Benefits this is a podcast where we break down everything you need to know about the Social Security Disability claims process. I'm your host, Nancy Cavey, and before we get started, I've got to give you a legal disclaimer. This podcast is not legal advice. The Florida Bar association says I have to say it. So now that I've said it, nothing will ever prevent me from giving you an easy to understand overview of the Social Security Disability and SSI claims process, the games that are played during that process, and what you need to know to get the benefits you deserve. So off we go. Now, today I'm going to be taking you inside the Social Security Disability system so that you understand what's going on, including the growing backlog of claims, the scams that are targeting applicants, and what you can do to protect yourself while you're waiting for a decision.
 
 Nancy Cavey [00:01:11]:
 If you applied for Social Security Disability benefits, you already know that this process can feel endless, not only for you, but for us. You file the paperwork. Actually, we help you file the paperwork. You wait for months, sometimes more than a year or a year and a half, before Claims examiner is even assigned to the claim, and you're left wondering if anybody is looking at your file, including us. Now, at the same time, that phone might ring with somebody claiming to be from the Social Security Administration, warning of urgent legal issues or demanding immediate payment. It's no wonder that people feel anxious and powerless. But let's be straight. There are real, effective ways to take control of your case.
 
 Nancy Cavey [00:01:54]:
 Even in the middle of these delays, there are clear warning signs that there are false communications with you, and there are signals that will help you separate those false communications with legal communications. Now, there are also smart steps that you can take to make your claim stronger while you're waiting for a decision. In this episode, I'm going to start by explaining how to recognize and report Social Security scams before they cost you money or personal information. Then I'm going to dig into why there is a disability claim backlog and what's really happening behind the scenes at DDS Disability Determination Services and how strategic preparation can help you with a faster and fairer decision. And finally, I'm going to share with you practical tips for staying proactive while your claim is pending, from keeping your medical records up to date to protecting your mental and financial health during the wait. By the end, you're going to have a clear understanding of how the system actually works, how to safeguard your benefits, and how to turn what can feel like an overwhelming process into one that you can navigate with confidence. So let's get started. I'm going to talk about three things today.
 
 Nancy Cavey [00:03:09]:
 Number one, slam the scam, how to spot and stop Social Security scams. Number two, the growing backlog in Social Security disability claims. And number three, staying proactive while you wait, taking control of your disability claim. Got it. Come back with some paper and a pen because we're going to give you some really insightful information. But in the meantime, let's take a break.
 
 Narrator of Disability Insurance Advertisements [00:03:34]:
 Are you considering filing for Social Security disability or has your claim been denied already? Either way, you require a copy of your rights to Social Security disability benefits, which will cover everything you need to know about the Social Security disability claims process. Request your free copy of the book@kvlaw.com today.
 
 Nancy Cavey [00:03:59]:
 Welcome back to Winning Isn't Easy. Let's slam the scam, how to spot and Stop Social Security Scams. Have you ever gotten a phone call from someone claiming to be from the Social Security Administration? Well, you're not alone. Every year, thousands of Americans are targeted by scammers pretending to be government officials, people who sound professional and confident and convincing. But their goal is simple. It's is to steal your money or your identity. So how do you know if a call is legitimate? I want you to watch for these telltale red flags. Number one, they call you unsolicited to suspend your Social Security number.
 
 Nancy Cavey [00:04:40]:
 Number two, they claim that there have been crimes committed in your name or that your Social Security number has been compromised. Or they'll offer to fix identity theft or benefit issues. In exchange for payment. They demand immediate payment through retail gift cards, prepaid debit cards, wire transfers, cryptocurrency, or by mailing cash. They insist on secrecy, telling you not to speak with anyone or to make up a story for friends, family, or store employees. And they provide an official sounding name and even tell you to look them up on the SSA website. They send emails or documents with fake Social Security Administration letterheads or the logo from the Office of Inspector General oig. Now, any one of these actions is a clear sign you are dealing with a scam.
 
 Nancy Cavey [00:05:34]:
 The real Social Security Administration will never call, text, or email you out of the blue about a problem with your Social Security number. They'll never threaten to have you arrested or legal action if you don't comply. And they will never, ever request payment by untraceable methods like gift cards or cryptocurrency. Now, if you truly owe money to the Social Security Administration, they're going to send you an official letter by mail, one that clearly sort of explains what you owe, your payment options and your right to appeal. They aren't going to demand secrecy or pressure you into immediate action. So why do scams work and how to outsmart them? Scammers rely on fear and urgency. They want to catch you off guard and make you panic and act before you think. That's why it's important to pause.
 
 Nancy Cavey [00:06:26]:
 And verify. Hang up, don't engage. Instead, contact the Social Security administration directly at 1-800-772-1213 or visit ssa.gov to to confirm that there really is an issue. If you receive a suspicious call, email or letter, report it right away. At.
 
 Nancy Cavey [00:06:54]:
 Your report is going to help the Social Security Administration track patterns and shut down fraudulent operations. Remember, protecting your Social Security information is protecting your identity and and your future benefits. Staying alert to scams is the first step toward keeping your disability claims safe. Got it. Let's take a break.
 
 Nancy Cavey [00:07:30]:
 Welcome back to Winning Isn't Easy. Talk about the growing backlog in Social Security disability claims. Now, I know that deciding to apply for your Social Security disability benefits is hard enough, and waiting for a decision can feel endless, and many times it is endless. Delays are worse than ever, and I want you to understand why there are delays because I think that will help you manage your expectations and avoid pitfalls. So let's talk about who handles claims. Your initial application in a subsequent appeal, known as a request for reconsideration, is handled by your state's disability determination services, DDS. Now, before the COVID pandemic, it took about 45 to 60 days to receive a decision.
 
 Nancy Cavey [00:08:13]:
 But after the COVID pandemic, what happened is that they weren't necessarily equipped to deal with claims remotely because everybody was in the office. Worse yet, what happened is that the number of claims dramatically increased. And that was compounded by the fact that when we came out of COVID there was a need for workers and many Social Security employees decided that they were done with the hassle of working for DDS and that they could find another job that paid much more with less stress. So there were a lot of people who left. However, that also caused delay because Social Security had to hire new employees and train them. And I will tell you, in my experience, I think it takes at least 12 months to maybe 18 months before someone really understands the Social Security claims process. Unfortunately, what has happened is that process has also been exacerbated by the 25% cut in Social Security staff, which is absolutely ridiculous. And I think it's part of the Project 2025.
 
 Nancy Cavey [00:09:34]:
 Game, if you will, to ultimately privatize the Social Security system, which is a whole other game and scam. But as a result, it is now taking at least a year to a year and a half to get a claims examiner assigned at the initial claim claims level now. So what happens at dds? Well, once your application is received, it will eventually be assigned to a claims examiner. That claims examiner reviews your forms, requests records from your medical providers, sends out additional paperwork for you to fill out, and may even schedule what's called a consultive exam. They may call you to clarify details or verify information. And you should talk with them now, after all of that, they're going to make an initial decision. And if your claim is denied, as unfortunately about two thirds of them are denied, you have 60 days to file this call to request for reconsideration, an rfr. The process sort of starts all over again with a new examiner who reviews your case, gathers updated medical information, and makes a new decision.
 
 Nancy Cavey [00:10:45]:
 That process is taking anywhere from eight months to a year and a half, depending on where you live. So the backlogs are pretty bad.
 
 Nancy Cavey [00:10:58]:
 And I will tell you, for example, in 2021, Social Security received over 1,820,000 disability claims, which was maybe a lower number than they had gotten. But that number started to increase, and it's increased exponentially in 2022, 2023, 2024, and back in those days, as I have said before, the initial claim would take about four to six months to get a decision. Reconsiderations were about four to five months. So it was, quote, unquote, moving faster. But that's again, not what is going on. Because of staffing and funding issues, that delay has gotten worse. And that's really hard for me to tell prospective clients. And many times I'm asked, well, if I hire you, can you make the claims process go faster? Unless it's a compassionate allowance process program, the answer is no.
 
 Nancy Cavey [00:12:05]:
 Nobody can make this go faster. So people will say, well, why should I hire a lawyer to represent me? And I've got some very good answers to that. At KV Law, we've developed strategies to streamline the process. Now we assist in filling out the application. And I think that that's important assistance because many mistakes can be made in, in the application unwittingly, that can result in a claim denial. One of the most important forms you're going to be filling out is information about your medical providers. And some people will say, well, I don't really think that's important. I'm not really claiming I'm disabled as a result of that medical condition, not understanding that Social Security will look at each medical condition individually, but they're going to look at your entire medical condition collectively.
 
 Nancy Cavey [00:12:54]:
 And it may be that it's the combination of medical problems that will cause you to be disabled. Number two.
 
 Nancy Cavey [00:13:03]:
 I want my clients to give a really good interval history. I want them to explain in the medical records to the doctor what their symptoms are by medical condition and how those symptoms impact their ability to function. So, for example, I want my client who has a herniated disc and has undergone back surgery to say when they next see their doctor. Truthfully, I have back pain that radiates down my left leg to my toes 247 with tingling and numbness. And I can only sit for 30 to 45 minutes at a time. And I have to get up and move around. And by the way, I can only stand at the kitchen sink for about 20 minutes. And after that I have to get a stool.
 
 Nancy Cavey [00:13:46]:
 And there are times, maybe three or four times a week, where I am actually in a recliner for hours, only to get up to use the restroom or to eat something because of my back pain. That's the kind of information that will tell a story about your symptoms and functionality. The other thing that we do and we think is absolutely crucial is to have our clients get what's called residual functional capacity forms filled out. Now, when we're interviewing a client, I'm listening to the story of their medical conditions, and I'm identifying what medical conditions I think would be the basis of the claim. And I will say to my prospective client, I'm going to send you a residual functional capacity form for your spine issues, for your hand issues, for your pots issues, for your fibromyalgia, whatever it is. I will tell you we Social Security lawyers have developed over 70 residual functional capacity forms for 70 different medical conditions. They have this morning I just told a prospective client I'm going to send them 9 residual functional capacity forms because it's important that we understand, and ultimately Social Security, whether or not you meet a listing at step three and what your functional restrictions and limitations are, both physically, cognitively, or even psychologically, that would impact your ability to do your past work at step four and other work at the mythical, hypothetical, not real world, national economy stage. And it's those forms that will quantify your restrictions and limitations.
 
 Nancy Cavey [00:15:22]:
 Rarely do medical records even address that. So the idea is that when the applicants claim finally makes it to the claims examiner. The claims examiner understands why you meet the five step sequential evaluation Being out of work Severity of the impairment Medically determinable impairment do you meet a listing? Can you do your past work? Can you do other work? So we want to give DDS a clear roadmap to follow, reducing confusion, delay and unnecessary denials. And I think that that is crucial. And we have a really high award rate at the initial application level because we are submitting this documentation to Social Security DDS so that when they get it, it's there on that silver platter. So please don't give DDS a reason to deny your claim or delay that decision. Be proactive. Stay organized.
 
 Nancy Cavey [00:16:23]:
 Make sure your application tells the full story. Make sure that your medical records tell the story. Make sure that you've got residual functional capacity forms. And if that sounds overwhelming, you should be hiring an experienced Social Security disability attorney who can help you navigate through the initial and recon process. Got it. Let's take a break.
 
 Narrator of Disability Insurance Advertisements [00:16:45]:
 Struggling with your Social Security disability case. The right attorney can make all the difference. Get our booklet the key to hiring a great attorney for your Social Security disability case Discover how to find an experienced attorney who will fight for your rights and navigate the process with ease. Don't leave your future to chance. Request your free copy@kvlaw.com today and ensure you have the expert support you deserve.
 
 Nancy Cavey [00:17:31]:
 Welcome back to Winning isn't easy Staying proactive while you wait Taking control of your disability claim now you're going to be waiting not only months, but possibly a year or longer for the initial Social Security decision. Your life is in limbo. I know that. But you are not powerless. There are steps that you can take right now to strengthen your case, protect your benefits and prepare for what is going to come next. So number one, keep your medical treatment consistent. The most common reason the claim is denied isn't the lack of diagnosis. It's a lack of documentation and medical treatment.
 
 Nancy Cavey [00:18:12]:
 You need to continue to see your doctors and follow prescribed treatment. And you need to be advising Social Security of who you're seeing so that they can get updated medical records. I will tell you that gaps in treatment can be used against you.
 
 Nancy Cavey [00:18:27]:
 The Social Security Administration and ultimately a judge may say, well, you know this problem can't be that severe, can't prevent them from working or do their past other work because they're not getting treatment or they're not compliant. So even if you can't afford visits, ask your providers about sliding scale payment, sliding scale clinics or telehealth Check ins and be proactive about maintaining your treatment and being consistent and compliant with your treatment. Now, number two, depending on the nature of your medical condition, it might be appropriate for you to keep a journal.
 
 Nancy Cavey [00:19:04]:
 So if I have a migraine client, a seizure client, if I have a person who has pots, I want them to keep a daily or weekly record of the number of migraines or the number of seizures or the number of times in a POTS case where they've had problems with their heart rate or crashes.
 
 Nancy Cavey [00:19:29]:
 It's crucial that you are keeping this information. And if it's not a condition like that, I want you to keep what I call like an interval journal, if you will. Not overwhelming, but we need to understand what are your symptoms? What's your pain? Do you have fatigue issue? Are you having mobility issues? Are you having side effects from medication? How does all of that impact your activities of daily living? Sitting, standing, walking, stooping, bending, lifting? Do you have trouble just staying on pace at your house, doing just average things? Do you have problems with starting a task and completing that task? Do you need assistance with bathing or dressing? Do you use any sort of supportive devices like canes, crutches, or mobility devices? That's really crucial. Now, number three is I want you to watch out for scammers. People applying for disability benefits, I think, are targets for scams, and they can be all sorts of scams. Recently I was getting barraged with calls from companies that said, we've approved your loan. And it's like, well, I didn't ask for a loan, and I certainly wouldn't want to get a loan from you guys because your interest rates are crazy. And this is really a scam, and you are probably under financial stress and you're looking for a way to pay your bills.
 
 Nancy Cavey [00:20:58]:
 You got to be careful about that because you may be signing up for bigger problems than you currently have, because these kinds of loans are, I think, in many cases, usurious. In other words, they're charging outrageous interest rates and.
 
 Nancy Cavey [00:21:19]:
 You'Re vulnerable. Now, there are also fraudsters who are calling you saying, I can expedite your Social Security claim for a fee, and I promise guaranteed approval. You may actually see this at the initial application process, and I will tell you that that's fraud. A competent, qualified Social Security lawyer is not going to claim that they can expedite your claim or expedite your claim for a fee or guarantee approval. That's just not what lawyers do and certainly shouldn't be what claims representatives do or any organizations claiming to have expertise in Social Security. So I will tell you that only Social Security and myself, a verified approved Social Security lawyer, can access your case information. Now, number four is going to be preparing.
 
 Nancy Cavey [00:22:20]:
 For a hearing. If your initial application and request for reconsideration is denied, you can request a hearing in front of an administrative law judge. And you want to start preparing early by gathering updated medical records, reviewing your RFC forms and getting updated RFC forms. And of course, if you haven't gotten an attorney at that point, get one. This is not for the faint of heart. And I will tell you, even though Social Security will say that the judges are to be fair and follow the law in awarding benefits, I don't ever think that that is the case. We prepare our clients for hearing. We gather updated medical records.
 
 Nancy Cavey [00:23:01]:
 We get the updated residual functional capacity forms to you so you can get them updated. We have two videos that we show our clients. One is a video, a mock Social Security hearing, about an hour long because you, you can't go in and watch one. We also do another video that we call the direct exam video. And in that video, which is an hour long, we go through all the questions that a person potentially could be asked and we explain how to truthfully tell your story in a way that the judge understands symptoms and functionality. And we also have a practice session a couple weeks, maybe a month before the hearing. I have a call with my clients. We go through the logistics of the hearing, but we practice.
 
 Nancy Cavey [00:23:44]:
 I play the judge, they play the client, and we work through the answers. Well, why I going to use those answers on the direct exam sheet I'm sending you at the hearing and so can you. It's an open book exam, if you will.
 
 Nancy Cavey [00:24:00]:
 Now, many times people get nervous, can't remember things, and this is a fast paced hearing. Maybe it lasts an hour, hour and a half, but you're the first witness and that's about 30 minutes. And I or the judge are going to be firing questions at you. So you want to be prepared. Remember, this is about winning your Social Security disability benefits. And being ready will make a huge difference in whether you get your disability benefits or not. So what are my closing thoughts? Staying proactive is just not about paperwork. It's about protecting your future.
 
 Nancy Cavey [00:24:32]:
 You can't control the backlog other than to call your congressman and say, don't destroy the Social Security system. We want it properly funded. But you can control how you respond to the Social Security disability system.
 
 Nancy Cavey [00:24:50]:
 So every medical record you update is crucial in updating that with Social Security or updating it with your lawyer. Every scam you avoid, every form that you fill out needs to be double checked. So we want to avoid scams. But you're going to get lots of forms and what you put on those forms can make or break your case. So we want to be able to review that, approve it, and make sure that it accurately reflects what's going on with your medical condition. I will tell you many times, Social Security judges will deny claims based on what's in those forms or what third party function forms have to say. That's a huge mistake that you can avoid as this process is unfolding. So doing it right and having the right representation can make all the difference.
 
 Nancy Cavey [00:25:41]:
 When it comes to winning a Social Security disability claim, you should be informed and be persistent and be prepared. That's your best strategy now. If you have found this episode of Winning Isn't Easy helpful, please take a moment to like our page, leave a review, share it with your family or friends, and of course, subscribe to this podcast. We look forward to providing you with another episode of Winning Isn't Easy. Got it. See you next episode.
 
 Nancy Cavey [00:26:17]:
 Sam.