A formal argument is a written case presentation identifying the cause and effect of a claimant’s impairment. You can also think of a formal argument as a way to execute your case strategy. The argument is your opportunity to bring forth issues that may not have been properly addressed at the Initial or first appeal levels.
Unknown to most disability advocates, the formal argument is the most important correspondence used in a Social Security disability claim. If used properly, a case argument can significantly increase your chances of winning a case.
The Objective of the Formal Argument
The primary objective of a Formal Argument is to make the claimant appear as disabled as possible without altering the facts of the case. In reality, you are organizing the facts of a case into a chronological presentation that demonstrates the path of the client’s impairment. You are not required to write a formal argument. We create formal arguments to make it easier for SSA to agree with our position in the case. If you present SSA with a logical argument supported by the medical evidence, your chances of winning are significantly increased.
Argument Quality Counts
The quality of a formal argument is not just about sentence structure and good grammar. The most important issues within an argument are those that help the client to win. What helps the client to win is your ability to present their case in chronological order. You start from the date the claimant stopped working and move forward in time to the present date. This approach also enables you to attach dated evidence to support the claimant’s alleged timeline of disability.
Things to Mention in a Formal Argument
Present the facts within a Formal Argument in chronological order based on the claimant’s impairment history. Important elements to include are:
Claimant’s identifying information
A brief introduction and impairment history
A brief discussion of the reason for the previous denial, if applicable.
List each impairment and explain how each limits the claimant.
List all medical sources used and a discussion of their contribution, opinions, etc.
Present a brief but concise discussion of case issues.
Discuss the limiting effects of the claimant’s impairment with references supporting evidence
Brief vocational presentation indicating claimant’s RFC and their inability to do past or other work
A summation of your opinion of the claimant’s condition and your expected case outcome.
Point out reasonable physical, mental, educational, or age-related limitations that are directly supported by the evidence.
Preparing a Formal Argument
The primary duty of a disability advocate is to create the most effective formal argument possible, given the evidence in the case. Once you acquire the claimant’s evidence, you must extract those key points that support the claimant’s alleged impairment. If you are not comfortable with reviewing medical evidence, please visit our key-point extraction segment in module two of this course.
To build a good argument, start collecting the right information early in the case. What you learn in these early stages of a case often directs your strategy and argument. Here are the seven most important categories of fact which have the greatest impact on case outcome:
Claimant’s age
Claimant’s educational level
Claimant’s past work history
Claimant’s transferable skills
Debilitating effects of the disease
Specific medical findings in the case
Claimant’s perception of and response to their condition
Claimant’s Age Criteria:
Several internal SSA policies allow clients with certain characteristics to enjoy a more liberal interpretation of their disabling condition. One of the most important of these liberalizing criteria is age. SSA uses the more liberal childhood medical listings and age-appropriate-activity standards to determine disability if the claimant is under age eighteen.
If the claimant is between the ages of twenty-one to forty-nine, disability requirements are more stringent. In order to win the case for a person in this age range, you must argue for a less than sedentary RFC to win.
If the claimant is between the ages of fifty to sixty-four, SSA disability criteria ease as age advances. After age fifty, you may not need to lower the claimant’s RFC to less than sedentary to win. The criteria are more liberal, and you may begin winning cases even at a sedentary RFC.
How do you know what RFC level will be necessary for an allowance decision? Don’t worry about it! Go for the lowest RFC possible that is supported by the medical evidence.
Claimant educational level:
For argument purposes, the poorer a claimant’s education, the more likely they will be allowed. Therefore, poor education increases a claimant’s chances of winning benefits.
Claimant’s past work history
SSA uses a claimant’s past work to determine step 4 of the sequential analysis process. SSA looks at the diagnosis, signs, and symptoms and formulates an RFC. They then compare the RFC to the duties of the claimant’s past work. If it appears that despite the claimant’s impairment, he/she can still perform past work duties, the case is denied. The case is also denied if the claimant cannot do past work but can do other less demanding work.
Debilitating effects of the disease
Limitations caused by the claimant’s primary or secondary impairment are used to determine if the claimant can perform past or other less demanding work.
Specific medical findings in the case
These are the facts extracted from the client’s medical evidence. These facts are used to support the claimant’s alleged limitations. The claimant’s perception of and response to their condition also plays a part. If a claimant stayed active despite his impairment, he would be perceived as being less limited, resulting in a denial.
As you can see, Vocational Analysis, Module four, is closely related to argument creation. That’s because the majority of the cases you win will be based on medical-vocational issues.
Auto-Argument Creation
Within your Olivia prime software, you will find a tool called the MW Composer. This is the new version of our Memo-write argument creator. The composer is built into Olivia and will enable you to create arguments faster and with much less effort.
