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The Social Security Disability Claims Process

Paul F. Woodrow

Filing for Social Security Disability (SSD) benefits involves a sometimes lengthy administrative process.  A claim is filed by contacting the Social Security Administration (SSA), which may be done online, over the telephone, or in person at your local SSA office.  The SSA representative will ask you for information about when you became disabled, your work history  and,  most importantly,  the medical and /or mental health conditions that prevent you from working.  It is very important that this information be complete and accurate, so that SSA can thoroughly evaluate your claim.  Once they have obtained this information, SSA will transfer your claim to the Bureau of Disability Determination, an agency of the state of Ohio, which will actually process your claim, using SSA’s rules and regulations for evaluating disability.

The state agency will contact your doctors and other medical providers, and gather all of the medical evidence pertaining to your disabling conditions.  They may send you to a doctor for an examination, at their expense, in order to get a better picture of your medical condition.  They may also contact you or your representative for additional information.  Once the state agency has gathered all the evidence, your claim will be reviewed by a state agency doctor, who will determine the severity of your medical conditions, how they may limit your ability to function in a work setting, and whether they meet the SSA definition of disability.  Your claim will then be returned to SSA, who will send you a written decision.  At the initial level, this process usually takes about six months.  If SSA finds you disabled, they will then process payment of your benefits.

If your claim is denied, you have the right to appeal.  This is called requesting a reconsideration.  At this level, SSA and the state agency will obtain updated medical evidence, review your claim again, and make a new decision.  This process usually takes three to six months.  If SSA finds you disabled at this level, they will notify you and process your benefits.

If your claim is denied at the reconsideration level, you have the right to request a hearing.  At the hearing level, you will have the opportunity to appear and testify at an informal hearing before an Administrative Law Judge.  Your representative will make sure all the evidence is up to date, and will present your claim to the Judge, making arguments on your behalf.  The Judge does not have to follow the earlier decisions which denied your claim, but will make a brand new decision after considering the medical evidence, your testimony, and the arguments of your representative.  Because of the large backlog of claims at the hearing level, it usually takes about nine to twelve months for a hearing to be scheduled.

When filing for disability benefits, it is very important to be in treatment for all of your medical and/or mental health conditions, so that they can be documented for your claim.  It is also vital that SSA be kept informed of any changes in your medical condition or treatment, so that they will have complete and accurate information when evaluating your claim.  Your attorney representative can help you make sure SSA has all the information they need at all stages of the claim, and can help present your claim in a way that will maximize your chance of success.

 

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