The Social Security Disability Process

This page will show how the Social Security Disability (SSDI) and SSI process works.  This will show what steps are taken and how the file is processed.  If you are wondering:  How does Social Security determine if someone is disabled then got to page called are you disabled?  If you have already decided you need a lawyer for your claim click on Find a Lawyer.  You can also call me at 1-877-527-5529 and ask for Karl.

What steps to take in a Social Security Disability Claim

The first thing you need to do is apply for Social Security disability benefits. Applications are taken at the local Social Security Administration offices. If you are applying for Social Security disability (SSDI) you can apply by phone, mail, on-line or in person. Your Lawyer or representative can also file your application. Supplemental Security Income (SSI) on the other hand must be done in person at a local Social Security office. Your claim for disability benefits will then be processed by Social Security field offices and state agencies. The Social Security field office will verify your age, marital status, employment and if you are covered under Social Security by paying into the system thru your taxes. The file is then sent to Disability Determination Services (DDS) to determine if you are medically disabled. The DDS is responsible for getting the medical information needed from your doctors and usually consultative examining doctors that are paid by the Social Security Administration. Ounce DDS determines they have enough medical evidence they will make the first decision if you are disabled. If you are found disabled the DDS will then send the file back to the Social Security field office to asses the amount of your disability benefits and will then begin paying those benefits. If the DDS finds you not disabled then the file is also sent back to the Social Security field office were the file waits to see if you appeal the decision. If you appeal the decision in some states you go to the process of reconsideration. This is basically a repeat of the above process. In other states if you appeal your initial denial you will go straight to the hearing stage before an administrative law judge. In states that have reconsideration if you are denied this second time you go to the hearing stage. Your case is now in another office called the Office of Hearing and Appeals (OHA). On a side note the Office of Hearings and Appeals is now called the Office of Disability Adjudication and Review or ODAR. The wait time for a hearing is long usually anywhere from 12-18 months and sometimes longer. If you win at this stage and your case is not reviewed by the Appeals Council it will be sent to local field office for payment. If you lose at this stage you can appeal the decision to the Appeals Council. The Appeals Council can deny your appeal, remand the case for another hearing, or find you disabled. If you lose at the Appeals Council your only recourse is to file civil action in United States Federal Court.

SOCIAL SECURITY
News Release dated February 11, 2010
Social Security Adds 38 New
Compassionate Allowance Conditions
Expansion Will Speed Benefits to Thousands of Americans with Disabilities 

Michael J. Astrue, Commissioner of Social Security, today announced that the agency is adding 38 more conditions to its list of Compassionate Allowances.  This is the first expansion since the original list of 50 conditions - 25 rare diseases and 25 cancers - was announced in October 2008.  The new conditions range from adult brain disorders to rare diseases that primarily affect children.  The complete list of the new Compassionate Allowance conditions is attached.
“The addition of these new conditions expands the scope of Compassionate Allowances to a broader subgroup of conditions like early-onset Alzheimer’s disease,” Commissioner Astrue said.  “The expansion we are announcing today means tens of thousands of Americans with devastating disabilities will now get approved for benefits in a matter of days rather than months and years.”
Compassionate Allowances are a way of quickly identifying diseases and other medical conditions that clearly qualify for Social Security and Supplemental Security Income disability benefits.  It allows the agency to electronically target and make speedy decisions for the most obviously disabled individuals.  In developing the expanded list of conditions, Social Security held public hearings and worked closely with the National Institutes of Health, the Alzheimer’s Association, the National Organization for Rare Disorders, and other groups.
"The diagnosis of Alzheimer's indicates significant cognitive impairment that interferes with daily living activities, including the ability to work," said Harry Johns, President and CEO of the Alzheimer's Association.  "Now, individuals who are dealing with the enormous challenges of Alzheimer's won't also have to endure the financial and emotional toll of a long disability decision process."
“This truly innovative program will provide invaluable assistance and support to patients and families coping with severely disabling rare diseases,” said Peter L. Saltonstall, President and CEO of the National Organization for Rare Disorders (NORD).  “On behalf of those patients and families, I want to thank Commissioner Astrue and his enthusiastic team for creating and now expanding a program that will have a direct impact on the quality of life of thousands of individuals."
“The initiative not only assists those whose applications are quickly processed, but also assists those whose applications need more time and attention from SSA adjudicators,” said Marty Ford, Co-Chair, Social Security Task Force, Consortium for Citizens with Disabilities.  “We are pleased to see today's expansion and look forward to working with Commissioner Astrue on further expansion of this decision-making tool and other ways to expedite determinations and decisions for disability claims.”
“We will continue to hold hearings and look for other diseases and conditions that can be added to our list of Compassionate Allowances," Commissioner Astrue said.  “There can be no higher priority than getting disability benefits quickly to those Americans with these severe and life-threatening conditions.”
Social Security will begin electronically identifying these 38 new conditions March 1.
For more information about the agency’s Compassionate Allowances initiative, go to www.socialsecurity.gov/compassionateallowances.



SSA to Find Ways to Shorten Disability Process

Previously in this section I described the planned change to the social security disability process. I am happy to report that the Disability Service Improvement Process will not be coming to the rest of the country and is terminated in the Boston region for all new cases in that region. I expect there will be changes to the process made at some point but for the most part the process to remain as it has been. One exception is a growing trend of the elimination of the reconsideration stage of the process. This is probably not a bad thing since the denial rates at this stage in the process are usually 80% and above. So in many states now and probably all states in the near future claims that are denied at the application stage will then request a hearing and go right to the hearing stage of the process. This may cut down the processing time of claims. The most important thing is that it looks like Social Security will be keeping the Appeals Council. This is important because it allows a claimant who was denied the hearing level to have it reviewed by a separate entity without having to file a claim in US District Court. However, if you are denied at the Appeals Council you will still have the right to file a claim in US District Court. Commissioner Astrue appears committed to trying to find ways to shorten the process. One example is in the Social Security press release which you can find on the left of this page. The Commissioner in an attempt to address the backlog and baby boomer population is formulating a plan with four specific goals according to another Social Security press release. The plan calls for elimination of the hearings backlog and preventing a recurrence of it. Improving the speed and quality of the disability process. Improving retiree and other core services. And preserving the public's trust in the Social Security system. As I learn more about specifics of his plan to achieve these goals I will write about them on the site.



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