Nancy Withers, Michelle Parsons, and Maureen Nowak
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The Application Process

The Social Security Disability Claim Process

If you believe you may be entitled to Social Security disability benefits, you may apply in person at your local Social Security office or by phone, mail, or internet. It is highly recommended that if at all possible you file your papers in person and save copies and receipts for everything. Initial processing of disability claims usually takes at least 60 to 90 days. A decision will be made as to whether you are disabled under the Social Security law, based upon a review of your medical evidence, and possibly even a consultative medical exam.

The denial of a Social Security disability case is frequently reversed at the hearing level. If you decide to pursue your claim you should hire an experienced Social Security Disability representative. The disability representative you retain can decide what medical conditions and disabilities can be shown to contribute to your total inability to work. An experienced disability representative can ascertain what if any medical records or medical reports may be needed to demonstrate that you are totally unable to work under Social Security administration regulations. A representative can direct the questioning of the claimant at the hearing to bring out the strongest evidence in the case. Experienced Social Security representatives are familiar with the Social Security regulations, and know which parts of the regulations pose the most difficulty in certain cases. A claimant should not be surprised at the denial of his/her claim at the early stages and certainly should not hesitate to appeal the denial.

Once a decision is made, the claimant will receive written notice from the Social Security Administration. If approved, the claimant will receive a notice showing the amount of benefits he/she will receive and when the payments will begin. Social Security Disability benefits can be paid retroactively for up to twelve months prior to the date the claim was filed, not including a five month waiting period. On the issue of retroactive benefits, it should be noted that SSI cannot start before the date of the application.

How much would benefits be?

The law provides that the receipt of certain types of other benefits will result in a reduction of Social Security benefits. Taking into account other benefits which a claimant may be receiving, such as workers’ compensation or federal, state or local government disability, a claimant’s total combined payments cannot exceed 80% of his/her average current earnings.

How is it determined my disability?

The Social Security Administration regulations required to follow a sequential evaluation process in order to determine whether a claimant is disabled. The first step is to determine whether the claimant is doing any work at all. If the claimant is working and his/her earnings average more than 940.00 per month, he/she cannot be considered disabled. The second step is to determine if the combination of medical conditions or disabilities of the claimant is severe, or, the impairments interfere with basic work-related activities. Step three decides whether the condition is found in a list contained in the regulations of disabling impairments that are considered so severe they automatically qualify as a disablement. If the condition is not on that list, it is determined if the condition is of equal severity to an impairment on the list. If the condition is severe, but not at the same or equal severity as an impairment on the list, step four determines if it interferes with the claimant’s ability to do the work he/she did in the last fifteen years. If the claimant is found unable to do the work he/she did in the last fifteen years, step five takes into account the claimant’s age, education, past work experience and transferable skills to determine if there are jobs he/she can perform in the national economy.

What if the Judge issues an unfavorable decision?

If the claimant is denied Social Security disability benefits by the Administrative Law Judge, an appeal can be taken the Appeals Council. Experienced Social Security Disability representatives are generally familiar with the regulations pertaining to such appeals. No hearing is held at this level, but the decision of the Administrative Law Judge is reviewed for error. The appeal to the Appeals Council must be filed within sixty days of the decision by the Administrative Law Judge. A further appeal can be taken from a denial by the Appeals Council to the United States District Court, which also must be filed within sixty days of the denial by the Appeals Council. No evidentiary hearing is held at this level, but the attorney will be given ample opportunity to present legal arguments. It is not unusual for experienced Social Security Disability lawyers to obtain reversals of administrative law judges’ decisions, even at this stage of appeal.


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