What To Expect When Filing a Social Security Claim
Filing an application for Social Security disability benefits can be a confusing and often frustrating process. It may seem like you are being asked the same questions and asked to complete the same forms repeatedly. It may also seem like the process is taking an inordinate amount of time. This article will attempt to clear up some issues you may encounter while pursuing your Social Security disability application.
How long does the process take?
Most applicants go through three levels of the application process: initial, reconsideration, and administrative hearing. Social Security Administration (SSA) may take from four (4) to six (6) months to issue a decision at the initial level, six (6) to eight (8) months at the reconsideration level, and about twelve (12) months or more at the hearing level. This is because different SSA entities are reviewing and developing the file, and requesting medical evidence.
Initial application
When you file your initial application, you will be providing the SSA representative with all the information regarding the medical conditions. SSA will then request medical records from all the entities that have provided you medical treatment. Most claims are denied at this level.
Reconsideration
When your initial application is denied, you file a Request for Reconsideration. This means a different SSA examiner will review your file and the medical evidence within it, and determine whether your impairment(s) satisfy SSA’s regulations. Most claims are also denied at this level.
Hearing
When your reconsideration is denied, you file a Request for Hearing by Administrative Law Judge. This means that your file will now be transferred from the regional/field office to the Office of Disability Adjudication and Review. At this office, an administrative law judge (ALJ) will get the opportunity to review your file.
The ALJ has the ability to award benefits based on the records already within the file or schedule a hearing to obtain testimony from the applicant.
This level is where most applicants are awarded disability benefits.
Prior to a hearing, you and your representative/attorney will have the opportunity to review the file that SSA has developed, and submit additional evidence as necessary. Once at the hearing, the ALJ will elicit testimony from you, often from a Vocational Expert, and sometimes from a Medical Expert when necessary.
What can I do to strengthen my case?
There are many things that can help or hurt your case. We have described some of the most critical ones below.
Obtain medical treatment. SSA requires objective medical evidence to support a finding of disability. This means everything from emergency room visits, to your primary-care physician’s office notes, to diagnostic testing, such as MRIs, EEGs, and bloodwork. Even if you are unable to attend appointments as frequent as recommended, maintaining a journal – including your diagnoses, the symptoms you suffer, the treatment you have attempted, and the effect of the treatment on your impairments – can be helpful to yourself and your physician(s), and can also be submitted for SSA’s review.
Maintain compliance with medical treatment. This means attending all appointments that your treating physician(s) schedule, following up on referrals, and following medication as prescribed. If you have complaints about a prescribed treatment, tell your doctor, they may be able to provide a more comfortable alternative; do not decide to discontinue a particular treatment without consulting medical advice.
Also worth mentioning: taking anything that your physician(s) have not prescribed can damage the value of the medical evidence and your credibility; abstaining from the use or abuse of alcohol or illegal substances can only help your case.
Maintain contact with SSA. SSA will be corresponding with you by phone and mail. You need to be accessible to them, so you must keep your contact information with them current. For example, once you receive a denial, SSA requires that you file the appropriate appeal within sixty (60) days of the date on the notice of denial. If your contact information with SSA is not current, you may not receive the denial and subsequently miss the appeal deadline, and have to start your application over from the beginning. SSA rarely grants exceptions for when an appeal deadline is missed. Another example: SSA may schedule an appointment for you to meet with an interviewer, a doctor, or an administrative law judge. If you fail to attend that appointment, they may dismiss your claim, again causing you to start your application from the beginning.
Maintain compliance with SSA’s requests for information and evidence. SSA considers any and all medical impairments you are suffering from, including physical and mental health issues. If you do not inform them of an impairment, they do not know to consider it. SSA may pay for certain medical evaluations, so it is important that you keep your contact information up to date, and that you attend all appointments they schedule.
Maintain contact with your attorney. If you retain an attorney to assist you in your claim, make sure you stay in contact with them. Be sure to update them with current valid contact information for you, and for an emergency contact should they be unable to reach you. If you move or change your phone number, be sure to inform your attorney.
Keep your attorney up to date regarding any new diagnoses or treatment you are receiving, especially if it involves new providers/hospitals/clinics/ERs. This is important so that your attorney can make sure all relevant medical records will be obtained and submitted to SSA.
Very important: be open and honest with your attorney. If your attorney knows everything about your case, then he/she will be able to advocate for you effectively. It is better for the attorney to know about something negative in your history and be able to prepare for it, than to be surprised by it at the hearing. Contradictory information will damage your credibility in front of the ALJ, and negatively impact your chances of being awarded benefits.
The law firm of Greenberg & Bederman has years of experience in representing Social Security disability claims, for disabled children, disabled adults, and disabled widows/widowers.
Should you, or someone you know, require representation, please contact our office for a free consultation.