The purpose of Social Security Disability benefits is to provide aid to those people who are unable to work due to a medical condition. Unfortunately, many disabled people who meet the requirements are often turned down the first time they apply. In fact, 65% of all initial claims for disability benefits are denied.
While there is an appeals process, it is very time-consuming, sometimes taking years to resolve. Enlisting the assistance of an attorney at the beginning of the process can cut down on the amount of time spent waiting for a decision.
Even if an attorney is not retained during the initial phase, seeking legal counsel during the appeals process may decrease the overall amount of time it will take to obtain a decision and start receiving benefits. In addition to the use of a lawyer, a basic knowledge of the disability determination process may also help shorten the wait.
An applicant’s file is reviewed by the Disability Determination Service in the applicant’s state. This group is composed of doctors and disability specialists who evaluate the application and then contact the applicant’s doctors to determine:
– Status of the applicant’s medical condition
– Date of onset of medical condition
– Limitations resulting from medical condition
– Results of medical tests
– Treatment received
This group will review several other factors, including the severity of the medical condition, whether the applicant is currently working, and whether the applicant can perform any other type of employment.
In order to manage the system’s backlog, Compassionate Allowances (CAL) are granted for some terminal diseases that qualify from a list of 165 medical conditions (includes many types of cancer). This system is meant to promptly provide a determination for benefits to obviously disabled applicants; however, even these applicants have been known to wait up to six months for benefits.
After the Social Security Administration has reviewed the application, they will issue a letter explaining whether an applicant has been found eligible for benefits or not. If benefits are denied, the decision can be appealed but it must be requested in writing within 60 days after the initial letter is received.
There are three levels of appeal for denied disability claims:
1. Hearing by an administrative law judge
2. Review by Appeals Council
3. Federal court review
An applicant must begin with the hearing before moving to the next stages. If a hearing is granted, the applicant is allowed to attend, review the file used to make the decision and provide additional information. The administrative law judge may question the applicant and any witnesses the applicant chooses to bring along. After the hearing, the applicant will receive a letter and copy of the judge’s decision.
If another denial is issued, the applicant can appeal by requesting a review by the Social Security’s Appeals Council. The council will review the information, but may deny the appeal without a hearing if it agrees with the administrative law judge’s determination.
The last step requires the applicant to file a lawsuit in federal district court.
In 2009, the initial determination took an average of four months. If appeals were required, they could take several years. Having the counsel of an experienced Social Security Disability attorney as early in the process as possible greatly increases the chance of receiving an accurate, timely decision, by helping to create an effective initial application and gathering the evidence needed for a successful appeal if needed.