A Flawed SSD Process: More Claimants, Longer Waits, Routine Denial

September 03, 2010 (Press-News.org) It is certainly ironic that current Social Security Administration (SSA) disability claimants - many who have paid taxes for decades in support of the system and have even worked with disabilities until their jobs were terminated - are confronted in recessionary times with unprecedented waiting periods and, in many cases, multiple rejection notices regarding their claims.

How bad is it? Consider this: there has been nearly a 10 percent spike in claims just within the past year, with strong evidence that the uptick is undermining the government's ability to respond in any meaningful way. According to an internal agency study, 58 percent of callers in 2008-2009 were not even able to get through to the SSA.

And when they do, the waiting begins. There are close to two million Americans waiting now for disability decisions, and many of them have waited for years. Statistics from the Congressional Research Service cite to an average of 777 days to complete the process.

It is interesting to note, however, that those who endure through repeat failures - especially those who secure the assistance of an experienced disability attorney - often ultimately prevail. These successful claimants may also get retroactive payments back to the start of their claim.

Why is this so? A brief sketch of the process sheds some light.

Traversing the Government Bureaucracy: Disabling in Itself

A central premise of the SSD claims system is this: although most filers are honest people with bona-fide disabilities, some are not, and the process must necessarily weed out fraud and frivolous claims.

It begins doing so at the outset, commencing with an applicant's initial filing with the SSA. The agency routinely turns over claims to state agencies under its umbrella. It is at the local level where a disability examiner takes over the claim and requests medical records.

It is also here where nearly two-thirds of all claims are rejected, usually after many months have passed.

That's the end of it for many people. In certain cases, the medical disability may in fact not be severe enough to qualify for benefits. In other cases, despite having a strong medical claim, applicants might erroneously believe that rejection is final and they do not pursue an appeal. If they do appeal, the fight continues to a second level where an even higher percentage of applicants are denied.

The Critical Juncture: The Administrative Law Judge (ALJ) Hearing

Over 60 percent of claims are denied at the first level. Approximately 80 percent of claims are denied at the second level. But more than 60 percent of claims are approved at the third level - the ALJ hearing.

By this time, an attorney is often involved in the case. Evidence from many sources suggests that a claimant with legal representation at any stage in the process is more likely to succeed. But the claimant should hire an experienced Social Security disability lawyer for the ALJ hearing. The attorney can help the claimant in the following ways:
- Gather medical records and ensure that the records are updated
- Secure detailed statements from physicians and other medical professionals
- Read and evaluate medical documents and other evidence
- Apply his or her knowledge and understanding of the process in the hearing
- Review the SSA impairment listing manual and the medical-vocational rules
- Expedite the process and, in some cases, reschedule the hearing for an earlier date

This last point is obviously of vital importance to many claimants. For example, when appropriate, the attorney can help the applicant submit a "dire need letter" with relevant documentation.

From experience, a disability attorney will know the type of documentation to submit and the requisite detail required. Perhaps the claimant has an unduly pressing medical condition. Perhaps there is imminent financial hardship. Perhaps veteran's status is a factor.

Other evidence might include documents related to home foreclosure or apartment eviction; copies of rents past due or mortgage payment delinquencies; unpaid utility bills; and evidence showing an inability to pay for needed medical treatment or prescribed medications.

Strong advocacy goes far toward positively influencing the scheduling, pace and outcome of a case, from initial application to the ALJ hearing and beyond.

A great number of SSD claimants are caught in a system that is not efficient and often denies benefits; however, many people ultimately succeed if they do not give up.

Article provided by Midwest Disability
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