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What Happens If You Suddenly Become Disabled

Wednesday, October 11, 2017   (0 Comments)
Posted by: Travis Finseth
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When a person becomes disabled and needs to replace their income by accessing the Social Security Disability benefit, the process can be overwhelming. It involves paperwork preparation, meetings with administrators, hearings, appeals and other time consuming and sometimes confusing tasks. However, the Social Security Administration (SSA) has designed a process to make filing for the disability benefit a little easier.

 

Pre-Application Preparation

First, you must consider if your current monthly income exceeds the substantial gainful activity (SGA) limit. If it is above this SGA, you are ineligible to apply and will be quickly denied. To see the current SGA amount, please visit the link http://www.ssdrc.com/disabilityquestionsmain2.html.

Next, find out if your physician will support your disability claim. If your claim is denied at the disability application level and the reconsideration appeal level (as the majority of claims are), the next step is a hearing before an administrative judge. At this point, an attorney might need a medical source statement from your physician saying that you cannot earn a substantial or gainful income due to limitations caused by your disability. You may want to find a doctor who is willing to dedicate the time to the process.

 

You will also need to organize your medical records so SSA has information on your complete medical history, including medical conditions, dates and locations of treatment, and contact information for the attending physician at the time of treatment. SSA will place the most emphasis on medical records from the last 90 days, however, you also need to provide older records because they provide the onset date of your disability, how soon you may be eligible for Medicare, and how much you can receive in disability back pay.


SSA will also need your work history for the last 15 years, including duties of each position, so the examiner can decide whether you can or cannot perform in your current medical condition. By supplying all this necessary information and omitting the need for your examiner to gather the necessary documents, your disability claim can move more quickly through the system.

Initial Application Process

Once all the information is gathered, you can apply for disability three different ways. You can complete your application on line by following the link https://www.ssa.gov/applyfordisability. The SSA will inform you of the decision by mail. You can call the toll-free number 1-800-772-1213 or make an appointment at your local Social Security office to meet with a disability examiner.

 

Appeal Process

Nationally, the SSA denies 64% of cases at the initial application level. (Rate of denial varies greatly from state to state.) At this point, you can ask them to reconsider your application. The denial notice will explain the appeal process and give you 60 days to file an appeal. If the denial was based on your severity of your disability, you can appeal online at https://secure.ssa.gov/iApplsRe/start. If the denial was based on non-medical reasons, contact your local Social Security office to request an appeal.

During the initial appeal process, your claim is reviewed by someone who did not take part in the original review. About 14% of claims are approved at this level. If you are denied and wish to further appeal, you may ask for a hearing which will be conducted by an administrative law judge within 75 miles of your home. At the hearing, the judge will question you and your witnesses either by phone or video conference. If possible, you and your representative should attend the hearing. You will be notified of the judge’s decision by mail. This hearing has the highest rate of approval with a rate of 62%.

If the judge also denies your claim, you may ask for a review by Social Security’s Appeals Council. They may or may decide to review your case. If the Appeals Council denies your request for review, they will send you a letter explaining the denial. If the Appeals Council reviews your case and makes a decision itself, they will send you a copy of the decision. The Appeals Counsel may also return the case to the administrative law judge. Success at this level is only 13%. The last step in the appeal process is the Federal Courts. If you disagree with the Appeals Council’s decision, you may file a lawsuit in a federal district court. Details on how to file the lawsuit are contained in the decision letter by the Appeals Council. National statistics show that 40% of cases at this level are approved.

Sources:

Tips to Prepare for Filing for Social Security Disability or SSI,” Social Security Disability SSI Resource Center
http://www.ssdrc.com/disabilityquestions4-40.html

 

“Disability Planner:  How You Apply, ”Social Security Administration

https://www.ssa.gov/planners/disability/dapply.html

“Social Security Disability, SSI: What is the Rate of Approval” Social Security Disability SSI Resource Center 

http://www.ssdrc.com/5-72.html

 

“The Appeals Process” Social Security Administration

https://www.ssa.gov/pubs/EN-05-10041.pdf

 



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