Disability Claims Process...
Applying for Social Security Disability is
a lengthy and time consuming process. Advantage 2000 consultants can help you
all along the way. SSA's disability
claims process consists of an initial application and up to three levels of
REDESIGN PROTOTYPE STATES
The medical and vocational forms needed for the basic disability
application total 22 pages-more if specific additional information is required.
SSA estimates it will take over an hour to complete the basic
application forms. Your Advantage 2000 representative will complete
all of the application and required forms
and forward them to your local Social Security office.
There it is reviewed for verification that you meet the non-disability
requirements, such as, having enough work credits under Social Security. Your claim is then sent to the State Disability Determination
Services (DDS) office for a medical decision of disability.
An examiner there will contact your medical sources for information
regarding your impairment. At this level, you will not normally need to
meet face to face with anyone responsible for making the medical
decision, however, you may be sent for a medical exam at Social Security's
expense. On average, Social
Security DENIES two out of three initial claims. If your case is
denied, we will help you request an appeal of
reconsideration is the first step in the appeals process.
Social Security is currently piloting a program in 10 states that
abolishes this level of appeal. [See Disability
Redesign Prototype States] When
filing a Request for Reconsideration, there are additional forms that must be
completed. SSA estimates it will
take over 30 minutes to complete the basic reconsideration forms. Your
Advantage 2000 representative can complete these forms on your behalf.
Again, at this level, the person responsible for making the decision on
your case is a DDS examiner, one who was not involved in the original decision.
Social Security, on average, DENIES 85% of the reconsiderations
filed. If you should receive an
unfavorable reconsideration decision, we will help you request a hearing before
an Administrative Law Judge.
this level, you and your Advantage 2000 representative, will be given the chance
to appear before an Administrative Law Judge (ALJ).
Many times, it is possible to avoid actually appearing at the hearing by
submitting well-documented medical records and reports.
Your Advantage 2000 representative will work with you in securing the
necessary information. If it is
necessary to appear at the hearing, you, together with your representative, can
give testimony and submit any additional medical evidence to support your claim.
The ALJ will make an independent decision on your case without regard to
the earlier denials. A greater number of claims are awarded at this level than the
previous levels. SSA awards just
over 50% of the claims at this level.
However if you are dissatisfied with the decision of the ALJ, you have
still one more administrative appeal available. You may request a review of the ALJ's decision by the Appeals
final level of administrative appeal is also completed with the decision maker
never seeing you. The AC,
generally, will not consider new evidence about your disability regarding
the period of time after the hearing decision.
Therefore, it is very important that you, and your Advantage 2000
representative, were fully prepared at the hearing and submitted all available
medical evidence to support your disability.
The decision of the AC can be, to reverse the ALJ's decision, uphold the
ALJ's decision, or send the case back to the ALJ for a new hearing.
SSA dismisses, denies or remands back to the Administrative Law Judge
98% of the requests for Appeals Council review. You will be notified in
writing of the AC's Decision. If you are dissatisfied with the AC's decision, there are no
additional levels of administrative appeal.
If you wish to continue in your pursuit of benefits, you will need to
take your request to the United States District Court and/or file a new initial
REDESIGN PROTOTYPE STATES-Effective
October 1, 1999, a pilot program is being tested to streamline the disability
process. Under this prototype the reconsideration step in the appeals
process is eliminated for disability issues.
Appeals on disability denials are sent for a hearing decision as the
first step of the appeals process. The
states involved in this process are: Alabama, Alaska, California (Los Angeles
North and West only), Colorado, Louisiana, Michigan, Missouri, New Hampshire,
New York (Albany-begins April/May, 2000 and Brooklyn only), and Pennsylvania.
If you are involved in a prototype state it is very important that
your case is well documented. Advantage
2000 consultants are there for you all though your disability claims process.