if you're currently able to work but have a condition that could worsen and make you unable to work in the future, here are some tips for preparing in case that happens! [U.S.]
understand that what they are looking for is that you cannot maintain full-time work. are you unable to stay on task for 8 hours? do you have to take lots of breaks? do you have to call out multiple times a month? are you inconsistent? the bar may actually be lower than you are expecting, BUT the hard part is proving with documentation that you meet it.
when you see doctors, make sure to include how your condition is limiting you. if you apply for disability, they will look at all your records and what they care about most isn't your diagnosis/symptoms but how they are actually limiting you. if you have this documentation from before you became unable to work, this can strengthen your case.
if you mention things you do, always include how you had to accommodate yourself or the repercussions you had to be able to do them. for them to see "i went to a party over the weekend" comes across differently than "i went to a party over the weekend but i had to sit down most of the time and when i got home i crashed."
be sure to review your doctor's notes in mychart and correct anything that is wrong. your medical record is weighted more than what you say. even if it was your doctor misunderstanding something you said to them, because it's your medical record that would count more than what you tell social security yourself.
keep documentation of work accommodations, absences, write-ups, etc. related to your disability. again this can strengthen your case even if it was before you became unable to work.
keep documentation of what previous jobs and doctors you had because they will ask for this info and it can be hard to remember!
SSI and SSDI are different programs. in short, to qualify for SSDI you have to have a certain number of work credits. SSI is the one you might hear about where they cannot have much income/savings, whereas SSDI is more flexible since you have paid into it with your work taxes. if you have the work credits, don't be scared off by some of what you see about "disability benefits" where they don't specify - check if it applies to SSDI or only SSI.
if you become unable to work, apply as soon as you can. there is backpay but it cuts off at 1 year before your application date.
get a lawyer from the beginning!! you don't need to have money. they are paid a set percentage of what you get awarded if your case is approved. you don't have to pay anything unless you win. there are many ways you can shoot yourself in the foot by answering questions incorrectly. you think you know but you don't 😂 the lawyer understands exactly how to navigate the system and present your case in the best way. don't wait until you are denied to get a lawyer, because now you've already submitted things which harmed your case.
be prepared that it can take a long time, even years for people to get approved. many people go through multiple denials even if they have a strong case. have a plan for how you will get through the wait, and don't give up. ♥
Also an important US healthcare access tool:
Fight Health Insurance is a generative AI tool to help you fight your health insurance denial. Just take a picture of your denial and it wil
Listen: GENERATIVE AI SUCKS, OBVIOUSLY
But the insurance companies are using AI to instantly deny you care and write your denial letters
Sometimes fighting fire with fire works - especially when it's you, your time, and your budget, vs. the unbelievable amounts of money, time, staff, and lawyers that insurance companies have
Anyway it's free for everyone permanently and the source code (? is that still the term with AI??) is available for anyone to fork on Github
Fight Health Insurance uses AI to help you draft health insurance appeal letters. Our AI is a tool to assist you — it is not a replacement for professional medical or legal advice. You should always review and customize any generated appeal before submitting it.
How It Works
When you submit a denial or chat with our system, we use fine-tuned medical language models (like MedGemma) to draft an appeal letter tailored to your situation. We run multiple AI models in parallel. Our system also searches PubMed for relevant medical literature to strengthen your appeal with citations.
Training & Data
We generate synthetic training examples from publicly available state appeal decisions from California, and other states, and use those examples to fine-tune our models. These public decisions describe the diagnosis, treatment, denial reason, and outcome of real appeals, but contain no private patient information. No real patient appeal letters are used in training.
We fine-tune using LoRA (Low-Rank Adaptation), an efficient technique that adapts a small fraction of model parameters while preserving the base model's "knowledge." After fine-tuning, we quantize the models to reduce their size and power consumption while maintaining quality. In general generating an appeal uses less power than playing a video game on a modern PC.
We update which base models we use as better open language models become available.
For more details on how we handle your data, see our Terms of Service. You can also request deletion of your data at any time.
Sustainability
We care about the environmental impact of running AI. A few things we do:
Low-power inference: Our models are quantized so they run on a single GPU, consuming a fraction of the energy that large cloud-hosted models require.
Solar powered when possible: During the day, our inference servers run on solar power. We aim to shift compute to daylight hours when solar generation is available.
Efficient serving: We use vLLM, a high-throughput inference engine that maximizes the work done per watt.
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I haven't done a lot of research on them, but I've been following them since they publicly launched, and everything I've seen so far has sounded legit. Allegedly they've generated over 10,000 health insurance appeals
I also like them because of their motto (which you can see in the above screenshot):
Make your health insurance company cry too
I'm fucking here for it
