social security disability SSD Disability

A blog by a former social security disability claims examiner about social security disability and SSI Disability issues and questions, but also general, health, and medical news.

Sunday, February 21, 2010

How Long Does It Take To Get An Answer For Disability From Social Security?

Here's a recent question: "How Long Does It Take To Get An Answer For Disability From Social Security, It’s Been Two Months?"

Unfortunately, there is no hard rule as to how long Social Security has to make a decision on a disability claim. Social Security strives to meet processing time goals; however there are times when disability claims take longer.

Generally, Social Security would like for all disability claims to be processed in a hundred and twenty days or less. Most disability claims are processed to a decision within that time frame. Disability claims that involve terminal conditions receive expedited processing. In fact, Social Security endeavors to process these claims within thirty days.

Many wonder why does it take so long for Social Security to make a medical disability determination. Actually, considering that Social Security has to request individual’s medical sources and wait to receive them, an overall processing time of one hundred twenty days or less does not seem so out of line.

Additionally, if an individual has no current medical treatment records addressing their alleged impairments, they have to be scheduled for consultative examinations. This means processing days are used waiting for the consultative examination and the resulting physician's report. Usually, it takes at least a couple weeks to get to the consultative examination and the consultative examination physician has 10 days to get the their report to Social Security.

Medical record retrieval and consultative examinations are not the only factors that can slow down the processing of disability claims.
Disability applicants can hamper their own disability claim processing.

You may be thinking: "How could disability applicants slow down their own disability claim?". Disability applicants often miss their consultative examination appointments, which causes a delay because of rescheduling time. There are other times that the disability examiner cannot contact the disability applicant because the applicant's contact information has changed since they first provided it at their initial interview (without notifying Social Security). If the examiner needs information or needs to schedule medical examinations, outdated contact information (pertaining to a phone number or mailing address) could cause significant delays or even a disability claim denial for failure to cooperate.

Sometimes, slower disability claim processing times are due to problems within the state disability processing agencies (in most states, these agencies are referred to as DDS, or disability determination services). Many disability processing agencies are short staffed and overwhelmed with the ever-increasing number of disability claims.

However, if an individual’s claim is processed within three months or so, it is considered to be timely processing. Consequently, disability applicants should not worry too much if they have not received a medical decision and it has been two months or even three month (and quite frankly, these days it is not unusual for claims to take 4-6 months at the disability application level, though this may vary according to the state in which you live).

This does not mean that it is not advisable to check the status of a disability claim from time to time to make sure there has been no decision made (or if there has been a decision to learn if it was an approval or denial).

If the decision is a denial, the social security appeal period begins with the date of the notice so it is important to know this date and, for this reason, to keep up with the status of your disability claim.





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    Other Posts

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    Hepatitis, particularly hepatitis C, is often seen on applications for social security disability and SSI disability
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    What is the Maximum You Can Earn While Applying For Social Security Disability?
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    Disability denied, disability denial information
    What makes for a denied disability case?

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  • Monday, November 23, 2009

    Why Do I Have A Claim For SSI Instead Of Social Security Disability?

    Generally, individuals who have only SSI disability claims are those who A) have not worked much in recent years, B) have not worked at all, such as minor-age children, and C) individuals who worked but did not work enough to be insured for title 2 social security disability benefits. SSI, otherwise known as Supplemental Security Income disability, is a need based disability program that does not depend upon “insured status” like Social Security disability; rather it is based upon an individual’s income and resources.

    Most adults who apply for disability benefits with the Social Security administration will be evaluated for both Social Security disability and SSI disability eligibility. And many will be entitled to SSI benefits during the five-month waiting period that is applied to all Social Security beneficiaries.

    Additionally, SSI is the only true disability program for minor age children. A child’s eligibility depends upon their parent’s income and resources until they are age 18.

    If an individual is entitled to SSI disability only, is the medical determination process any different? Absolutely not. All disability applicants must go through the same medical determination process. All disability claims are sent to state disability agencies--typically known as DDS, or disability determination services--for a medical determination.

    What happens at a DDS? A disability examiner will obtain all of the disability applicant’s medical treatment records from the medical sources the individual provided at their initial disability interview. If the disability examiner determines there is enough information in the individual’s medical records (after the medical evidence of record, of course, has been requested from the claimant's medical treatment sources and then received), they make a medical decision.

    If there is not enough information in the claimant's medical records, meaning that the claimant does not have recent medical record documentation, or the claimant has one or more physical or mental conditions that are not sufficiently addressed by the medical evidence that has been obtained, social security may schedule the individual for a CE, or consultative examination, to obtain the information necessary to make their medical determination.

    For those who are unaware, a consultative exam, or social security medical exam, will be conducted by an independent physician or, in the case of a mental impairment, an independent psychiatrist or psychologist. These exams are paid for by the social security administration. If you are scheduled to go to such an exam, it is generally a signal that the disability examiner is attempting to get your case decided and closed. Note: if you are scheduled for a consultative examination, by all means go. Not going can slow a case down at the very least, or have an adverse effect on the case at the worst.

    Social Security disability and SSI have different non-disability criteria. For instance, Social Security disability does not have resource (assets)limitations and SSI does not depend upon insured status (insured status is based on quarters of coverage that are earned through an individual's work activity). SSI has no waiting period for disability benefits while Social Security disability has a five-month waiting period before being eligible to receive monthly disability benefits.

    Finally, Social Security disability has no "end of the line" review once a medical decision has been made on a case. SSI applicants must have a final income and resource review even after being medically approved for disability. And if they are over the limits, their disability claim may still be denied. By contrast, Social Security disability applicants will receive their disability benefits when approved (once they have served their five-month waiting period, of course--which is very many instances, due to how long cases can drag on as a result of the appeals process, may already be served out by the time a claimant receives a favorable notice of decision.






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    Other Posts

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    What makes being approved for disability so difficult?
    What to bring to a social security disability interview
    Don’t Miss Your Social Security Medical Exam Appointment
    A denial of social security disability benefits can be appealed

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  • Tuesday, April 28, 2009

    Social Security Disability Deadlines

    The topic of deadlines as they relate to social security disability comes up fairly often. Mainly, however, the subject is addressed due to false assumptions by applicants regarding the processing of initial disability applications.

    Unlike various programs operated by state and local governments, SSD applications and SSI applications do not have processing deadlines. In other words, after you apply for disability, your claim may take one month to process...or five months to process. There is simply no time limit on how long a claim may inevitably take, though its safe to say that the averages quoted by the social security administration are fairly accurate. As a disability examiner, I found that most cases were usually decided within a three to four month time frame following the filing of a claim.

    Of course, it bears mentioning that the one factor that accounts for the most processing time on a case, and the longest delays, is the wait for medical records. Social security makes every attempt to get a claimant's medical records so that a decision can be made as fast as possible. In fact, as soon as a case lands on a disability claim examiner's desk, the examiner's first primary task will be to send out requests for records to every medical treatment source listed by a claimant on their disability application.

    However, in the end, however long it takes for a doctor's office or hospital to comply with the request and send records back...is entirely up to them.
    As an examiner, I found that it was not unusual to have to make repeated calls to medical records departments and repeatedly fax over the same request for records multiple times. Working in representation, I found that the difficulties in obtaining records were no less, though some doctor's offices seemed to respond more quickly to followup calls from the office of a disability representative (not always the case, certainly).

    So, back to the topic, are there deadlines for social security disability and SSI disability applications? No, there are not.

    However, in an unofficial sense, there are deadlines of a type. And what I mean by that is this: each disability examiner who works on SSD and SSI claims is rated according to how fast they process cases. And the more cases they have that are "getting older" (often, not due to the examiner's fault), the worse it looks for the examiner's statistics.

    Therefore, disability examiners have every clear incentive to get decisions made as quickly as possible. So, while there are no official deadlines on the the processing of disability claims, each disability examiner is expending effort to get cases off their desk ASAP.

    This brings up, of course, the subject of what a claimant can do to help speed their case along. And that's fairly simple:

    1. Always respond to correspondence related to a disability case. This includes letters from the social security office and letters from the disability examiner who is attempting to make a decision on the claim. Sometimes, failing to respond to a request for information can add significant time to the processing of a case.

    2. Always report new information regarding treatment sources, diagnoses, and work activity to social security.

    3. Always go to scheduled social security medical exams. Failing to do so can, at the very least, add significant amounts of processing time to a case. And, typically, for no good reason (failing to have transportation to a consultative exam is not the best reason for missing an appointment considering how long claimants are notified in advance that they have a medical exam scheduled).

    4. Supply complete and detailed information when initially filing for disability.

    It's extraordinary to think about it, but many claimants file an application for disability with only the barest details about their work history and medical treatment history. It's almost as if they seem to think that the social security administration has a crystal ball into which it can look and glean all the information that is required. However, that's not the case and if you give incomplete information when you apply for disability, you only disadvantage your claim by doing so.








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    Additional Posts

    How do you prepare for a social security disability review?
    Continuing disability review for social security disability
    How often will my case be reviewed for social security disability?
    Social security disability appeal
    How to get a social security disability hearing scheduled faster
    How to request a social security disability hearing
    Social Security Disability Appeals Process
    Filing for Disability
    Filing for disability as soon as you are eligible

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  • Monday, December 1, 2008

    Should you Hire a Non Attorney for your Social Security Disability Claim

    I recently read some statements from a practicing social security disability attorney who seemed to have a problem with the fact that non-attorneys are allowed to represent claimants in social security disability cases.

    Many claimants probably have the notion that they can only be represented by a lawyer for a disability case, or that a lawyer will necessarily provide the best disability representation.

    Here's what I always say. A) Representation can usually help you. B) If your case is going to a social security disability hearing, you should be represented because it will increase your chances of winning--honestly, most claimants will have no idea of how to prepare for a disability hearing, or what certain terms and concepts mean.

    However, having said that, your representation does not need to be a lawyer. You can get a non-attorney and get representation that is as good or better. Why? Because the quality of representation on a social security disability or SSI case does not have anything to do with whether a rep is a trained attorney. It has more to do with knowing how social security cases are decided and what the requirements for eligibility are.

    Needless to say, it helps for a representative to be either a former disability examiner, a former social security claims rep, or even a nurse.

    Now it may surprise some people, but only recently were lawyers even allowed to represent initial veterans disability claims. Before that point, only non-attorneys were allowed to represent early cases. Basically, it was the thinking of the veterans administration that individuals pursuing va disability could get by just fine without an attorney as a representative. Therefore, it should not be surprising that the social security administration allows both attorneys and non-attorneys to represent applicants for social security disability and SSI disability. After all, some non-attorney reps used to work for the social security administration.

    Also, consider this fact: the decision makers on initial disability claims (applications) and first appeals (requests for reconsideration) are disability examiners...and examiners are not legal professionals. How much sense would it make if non-attorneys could issue decisions on disability claims (as disability examiners), yet non-attorneys representatives could not represent claimants? Answer: it wouldn't make any sense at all.

    Here's the truth of the social security disability system---it does not become a "legal environment" until one gets to federal district court. This is where you must have an attorney to represent you. However, at all levels prior to this,including the disability hearing before an administrative law judge, your representative can be a non-attorney because...the disability evaluation process is administrative not legal.

    In the end, though, whether you choose an attorney or non-attorney to help you, you should make your decision based on a gut instinct about the representative. Or based on someone else's gut instinct. Recommendations are often a great way to weed through the chaff and get a great representative.







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    Additional Posts

    Social security definition of disability for SSD and SSI claims
    Social security disability definition
    How does social security define disability?

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    Social Security Disability Prior Posts

    Social Security Disability Secrets Blog
    Eligibility for disability benefits
    Requirements for Disability Benefits
    Representative for a Social Security Disability Hearing
    Social Security Disability - Mental Impairment Qualifications
    Representation for a Social Security Disability or SSI Case
    Social Security Disability Attorney Fee
    Social Security Disability Decision Process
    Qualifying for disability on the first application
    Winning your Social Security Disability
    Disability Questions 7
    Disability Questions 8
    Disability Questions Page 9
    Disability Determination for Social Security Disability Benefits
    Social Security Disability Forms and letters
    Social Security Disability Application Interview
    SSD Benefits, Depression, and Mental Testing




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