For Those Who Need it Most, the SSD System Can Be Hard to Navigate

June 08, 2012

Social Security Disability benefits are designed to aid those who are unable to work due to an injury, disease or other medical condition. Although the application process may appear easy after browsing the Social Security Administration's (SSA) website, many people who meet the required qualifications and should receive benefits are often initially denied. In fact, initial claims for disability benefits are denied 65 percent of the time.

There are ways to fight a social security disability denial. Unfortunately, although an appeals process is available, it can take a great deal of time. One man fighting terminal cancer was recently stuck in the process for over a year, as the Social Security Administration served him repeated requests for additional information regarding his medical condition. The man ultimately received a letter granting him benefits. Unfortunately, these benefits were granted nine days after his death.

Although this system is intended to aid those who need it most, it fails many. There are many avenues to fight denials but the process continues to take a great deal of time. The amount of time it generally takes to request benefits can be mitigated by enlisting the aid of a Social Security Disability benefits attorney to help with the initial request process.

Even if counsel is not used during the initial application phase, an attorney can still provide aid during the appeals process and may be able to decrease the overall amount of time it will take to receive benefits. In addition to the use of a lawyer, a basic knowledge of the disability process and various routes available to resolve a denied disability claim may help shorten the process.

Disability Process

An applicant's file is reviewed by the Disability Determination Services 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

The group will ultimately review a number of other factors, including whether the applicant is currently working, the severity of the medical condition and whether the applicant could possibly do a different type of work.

In addition, in an attempt to manage the disability claims system's major backlog, Compassionate Allowances (CAL) are granted for certain terminal diseases. CALs allow the SSA to quickly identify diseases which qualify under a pre-existing list of impairments. The list includes 165 medical conditions like leukemia and other forms of cancer, kidney disease and Alzheimer's.

The CAL system is intended to promptly provide benefits to obviously disabled applicants. However, even with this system in place, those suffering from these terminal diseases can wait up to six months to receive their first benefits check.

After review of the application is complete, The Social Security Administration 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. An appeal must be requested in writing within 60 days after the initial letter is received.

Avenues Available to Resolve a Denied Disability Claim

There are three levels of appeal for denied disability claims:
- Hearing by an administrative law judge
- Review by Appeals Council
- Federal court review

The levels of appeal are chronological, and an applicant must begin with the hearing before moving to the next stages. If granted a hearing, 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 SSA will send the applicant a letter and copy of the administrative law 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 reviews the request and file, but may deny the appeal without a hearing if it agrees with the administrative law judge's determination.

At this time, a third denial can lead to the final appeals process. This step requires the applicant filing a lawsuit in federal district court.

In 2009, the initial determination took an average of 119 days. If appeals were required, the process could take almost 2,000 days. As a result, it is wise to seek the counsel of an experienced Social Security Disability attorney as early in the process as possible. An attorney can aid the process by helping to create an effective initial application and gathering the evidence needed for a successful appeal if needed.

Article provided by Olinsky Law Group
Visit us at www.windisability.com