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HOW ARE DISABILITY BENEFITS DETERMINED ?





The manner in which disability benefits are determined is, in some regards, a complex process. And very often, depending on the extent to which a social security disability or ssi disability claimant decides to pursue a claim, it can be one that involves a number of different agencies and individuals working on a case.

All disability claims, of course, begin with a claimant's application at the social security office (generally, the one that is nearest to where they live). It is there that an applicant for benefits will speak to a CR, or claims representative. This individual is the contact person for an individual seeking to apply for ssd or ssi. A CR will take a person's disability application and then forward this application to a state agency that, in most states, is known as DDS (disability determination services) or the Bureau of disability determination. This is where a person's disability benefits are determined at the initial application level.

Case processing at this agency can vary widely. A claim can be decided in as little as a few weeks, or take as long as a half year or longer to be determined. Eventually, though, a decision will be made and an applicant will be notified of the decision.

Unfortunately, most of the time, the answer received is a turn down. However, claimants who have an experienced attorney working on their claim will often have been warned that such an outcome is likely, allowing them to mentally prepare for a denial letter.



A claimant who gets denied on an ssi or ssdi claim for benefits should, in almost every instance, consider filing an appeal. Appeals are generally the most advantageous route for a disability applicant to take. And, not surprisingly, the appeal route that offers the most advantage is the second appeal, the "request for hearing before an administrative law judge" (which can be filed after a denial on a reconsideration or review---the first appeal---has been received).

At the ALJ hearing level, a claimant's eligibility for benefits is determined by, of course, an ALJ, or administrative law judge. ALJ's hold hearings at which a disability claimant and their designated attorney are present. At a hearing, a claimant's medical records will be discussed and a claimant's attorney will present an argument as to why a claimant should be awarded benefits.

Following a hearing date, the disposition of a claimant's case will be determined by their judge. If the ALJ has determined that a claimant should be approved, a favorable decision letter will be sent. If, on the other hand, the ALJ has determined that a claimant should be denied, an unfavorable decision notice will be sent. This notice will state the basis for the denial and explain the claimant's appeal rights (appeals must always be filed within 60 days from the date of the denial).

How disability benefits are determined is no light matter and at all levels of case processing (the social security office, disability determination services, and the office of hearings and appeals), the handling of a disability claim is taken quite seriously. Despite that fact, though, more claims are determined to be ineligible than vice-versa. And too often, this occurs because a claimant's case was not given due and proper consideration. For this reason, any disability claimant filing a claim, or the appeal of a denial, should make a concerted effort to stay on top of their case. How is this done? By staying in touch with the social security office or DDS, by getting a consultation with a qualified attorney, and by making sure that all required paperwork is filed in accordance with stated deadlines.



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Additional Questions & Answers re: ssd ssdi ssi


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  2. How long does it take for SSD and SSI cases?

  3. How do you appeal an denial on an SSD or SSI claim?

  4. Why do you need a lawyer or attorney on an SSD or SSI case?

  5. Denied on first try for SSD, how do I appeal ?

  6. What do they do in a disability reconsideration appeal?

  7. Can I work part-time while applying for ssd disability?

  8. What are the qualifications for SSD or SSI disability ?

  9. Can you win a disability case without a lawyer working on your case ?

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  24. Disability benefits for children

  25. How do you start an appeal for social security disability?


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If you suffer from a medical disability such as

hip, neck, shoulder, ankle, wrist, back, or other joint problems, disc herniation, degenerative disc disease, spinal stenosis, carpal tunnel syndrome, rsi or repetetive stress injury, inflammatory bowel disease, ulcerative colitis, irritable bowel syndrome, arthritis, dysthymia, depression or other mood disorders, congestive or chronic heart failure, type 1 diabetes, type 2 diabetes, diabetic neuropathy, high blood pressure (hypertension), seizure disorder, stroke, copd, emphysema, hearing loss or poor hearing, statutory blindness, peripheral field problems or other vision loss, clinical obesity, attention deficit hyperactivity or, simply, adhd, bipolar disorder or manic depression, panic disorder, schizophrenia, autism, head trauma, memory loss, low iq, mental retardation, learning disability, epilepsy, cancer, chronic fatigue, multiple sclerosis, lupus, anxiety, inner ear problems, meniere's, vertigo or dizziness, kidney failure requiring dialysis or other renal problems, cirrhosis, hepatitis, or other liver disease, pancreatitis, osteoarthritis, osteoporosis, asthma, bronchitis, cystic fibrosis, rsd or reflex sympathetic dystrophy, crohn's disease, sarcoidosis, peripheral vascular disease, lyme disease, cerebral palsy, down syndrome, hiv, aids, anemia, sickle cell, thyroid problems including hypothyroidism, esrd or end stage renal disease, reflux, gerd (gastroesophageal reflux disease), cfids, muscular dystrophy, coronary artery disease, cardiomyopathy, or tachycardia, bradycardia or other arrhythmia

and have initiated or been denied on a social security disability, or ssi, claim for benefits, this site may assist you with your case. Social Security Disability benefits are often difficult to win; however many claims for social security disability are lost simply because a claimant did not know enough about the disability process to their social security or ssi claim. For information re: representation on a social security disability or ssi claim (attorney or non attorney representative), see the "questions" & "how" pages.












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