TSSA Blog
Everything about Social Security Disability
There is no time limit for collecting social security disability or SSI disability benefits. This is largely due to the way that the social security administration views disability benefits. When you are approved to receive monthly benefits, it is only after an extensive review of both your medical records and work history has been conducted. And whether your approval was granted by a disability judge at a hearing office, or by a disability examiner who handled your case at the disability application level (or reconsideration appeal level), the process for determining your benefits was the same. That process really boils down to the conclusion that--
A) You cannot work and earn a substantial gainful living, either by doing your past work, or by attempting to do some type of other work
and
B) That your condition is both totally disabling and potentially permanently disabling.
What do we mean by "potentially permanently disabling"? Simply that social security views all approved claims as situations in which a person may always be disabled and unable to work. Nonetheless, social security also holds open the possibility that a claimant's condition may undergo medical improvement to the point that they can re-enter the workforce and earn a living. Medical improvement can only be verified through medical records and this is why all approved disability claims are scheduled to be reviewed at certain intervals.
Some cases will be reviewed each year, and some will be reviewed no sooner than every seven years. For the most part, though, the majority of cases will undergo a CDR, or continuing disability review, every three years (note: many cases that are "diaried" for three year reviews are often not actually reviewed until the fourth or fifth year, due to heavy workloads in social security field offices).
However, regardless of when a claimant's continuing disability review occurs, the fact remains that the vast majority of claims are continued (i.e. "re-approved") upon review, which simply means that very individuals ever have their disability benefits stopped due to the conclusion that they were no longer disabled.
As we said, whether or not social security can take someone off benefits at the time of their review hinges upon "medical improvement". Medical improvement is very difficult to prove on a disability case. And it is especially difficult for the social security adminisration to prove if the claimant received their disability approval from an administrative law judge at a disability hearing.
Disability judges tend to be more balanced in their decision-making, whereas disability examiners must report to unit supervisors who attempt to keep down the number of approvals (due to a culture of denial that exists in most DDS agencies). Yet disability examiners, who make the decisions on continuing disability reviews (CDRs), must abide by what was set in place by a judge if the claimant's previous approval was made by a judge.
In short, there is no time limit for how long a person can collect disability benefits. And if a person is approved to receive disability benefits, the chances are good that they will continue to receive them for the remainder of their lifetime, unless they attempt to go back to work.
all information found http://www.ssdrc.com/disabilityquestions1-84.html
Disability claims that are filed with the social security administration usually proceed in one of two different ways. Either the claimant is approved for disability benefits after filing a disability application, or the claimant will be denied and will then face the decision of A) giving up on their claim, B) filing a new claim, or C) or filing an appeal.
The first disability appeal is the request for reconsideration, a step that is practically identical to the initial claim (i.e. the disability claim). Most claims that are reviewed at the reconsideration level are denied, just as with the initial claim.
The second appeal is the hearing which is held at a federal hearing office (formerly known as the office of hearings and appeals and now known as the office of disability adjudication and review). The disability hearing primarily involves the claimant, a disability attorney, and an administrative law judge. In cases where claimants are represented, the majority of claims are won. However, claimants who do not have a disability representative are denied at up to a sixty percent rate, and even claimants who have representation are sometimes denied as well (the denial rate for represented claimants is lower, roughly 40 percent).
If you are denied by a disability judge, can you still appeal? Yes, in fact there are two levels of appeal beyond the hearing level. The first level of appeal after the hearing level is conducted at the appeals council. The appeals council is located in Falls Church, Virginia and one of its primary purposes is to evaluate decisions made by administrative law judges. When a case is sent to the appeals council, there are three separate outcomes.
1. The case can be overturned and approved. This rarely happens.
2. The appeals council can respond by stating that the request to review the decision of the administrative law judge has been denied. In other words, the appeals council is notifying the claimant (and/or their attorney) that they will do nothing.
3. The appeals council may send a notice stating that the case will be remanded. When a case is remanded, it is sent back for a second hearing. Unfortunately, this second hearing tends to be with the same disability judge who denied the case in the first place. Despite this fact, however, many remand hearings do result in approvals, particularly if the appeals council has notified the adminstrative law judge that they failed to consider a key piece of medical evidence in the disability cliamant's file.
The next appeal level that exists beyond the disability hearing level is federal district court. Relatively few cases proceed to this appeal level. Also, district court is the only level in the disability appeal system where the claimant's chosen representative must be a disability lawyer versus being a non-attorney claimant's representative (though, oddly enough, a claimant can proceed pro se, meaning unrepresented).
If the judge denies your claim, is it better to appeal or to start over with a new claim? Very often, a claimant's attorney will advise them to do both. This is because cases that are sent to the appeals council can stay there for well over a year and, very often, a claimant will receive an answer on their new disability claim before they receive a decision from the appeals council on their old claim.
all information found http://www.ssdrc.com/disabilityquestions1-55.html
How does social security decide whether your can work or not? By evaluating your medical evidence, rating how limited you are, and then comparing this rating to the kind of work you did in the past. By using this sequential evaluation process, the social security administration can decide if you are capable of returning to one of the jobs you performed within the fifteen year period prior to becoming disabled, or whether or not you are capable of doing some type of other work that you have never done before.
In terms of physical RFC ratings, a claimant may be given a sedentary RFC, meaning they can only do sedentary work, a light RFC, meaning that they are considered incapable of doing anything other than light capacity work, or they may be given a medium RFC, meaning they can only do medium exertional work and nothing more.
RFC ratings can also rule out certain activities that the medical evidence of record suggests they can no longer do. For instance, an RFC may indicate that a person cannot have exposure to chemical agents, cannot use their hands for tasks requiring high dexterity, cannot tolerate heights (possibly due to vertigo or lower back problems, or seizure disorder), or cannot engage in activities that rely heavily on using a particular sense, such as sight or smell, or hearing.
In terms of mental RFC capacity ratings, the RFC determination may indicate that the claimant's capacity for work activity may be compromised by shortcomings in memory, shortcomings in the ability to attend to tasks and concentrate, shortcomings in the ability to learn new information and tasks and transmit informaton to others in the work environment, and shortcomings in the claimant's ability get along with co-workers or supervisors.
How are RFC ratings used? They are first compared to the past work of the claimant and what those individual jobs required (in terms of physical requirements and mental requirements). If the RFC rating indicates that the claimant no longer possesses the ability to do their former work, they will have passed one step of the disability evaluation process.
The next step is to evaluate whether or not the claimant has the ability to do some type of "other work" based on their age, work skills (and whether or not these skills are transferrable), and education. If the claimant, through their various RFC restrictions-limitations, is found to be unable to do their past work and is also found to be unable to do some type of other work, they will receive a social security disability award, or an SSI award, depending on which program their claim was filed in.
Disability examiners make decisions on cases at the first two steps of the social security disability system: the initial disability application, and the request for reconsideration appeal. The third step of the system (which is also the second appeal in the system) is the hearing. To get to a hearing you have to file a "request for hearing before an administrative law judge". Administrative law judges, or ALJs, of course, are the individuals who make decisions at this level of appeal. How do disability hearings and administrative law judges differ from other levels of appeal and from disability examiners? Judges for one thing tend to approve higher percentages of claims. This may be because claimants usually have disability representation in the form of a lawyer or a non-attorney disability advocate. It may also be because ALJs work somewhat independently and are free of the culture of denial that seems to be permeate the state disability agencies where disability examiners work.
all information found http://www.ssdrc.com/prem16.html
If you call to get the status of your disability claim, nine times out of ten you will be told that your claim is still pending. What does this mean? Simply that your case is still being worked on (wherever it happens to be, which could, depending on the level your claim is, be the hearing office or with a disability examiner at disability determination services).
On this page, I'll answer a few basic questions regarding the status of a social security disability or SSI claim. First of all,
1. How often should you call to get the status of your claim? Frankly, you probably shouldn't need to do this very often. That's because claim processing can take quite a while. It's not uncommon for a disability application to be in processing for six months or longer. The same holds true for reconsideration appeals. And if your case is at the hearing level, either waiting for a hearing to be scheduled, or waiting for a decision to be made following a hearing, the wait could be much longer. Having said that, though, it is not a bad idea to call every 90 days or so to check the status of your claim. By doing this, you can avoid the unenviable situation in which a decision has been made and you were not aware of that fact, thus losing the opportunity to file an appeal.
Of course, if you have representation in the form of a disability attorney or a disability representative, that individual or firm should be able to quite easily obtain the current status of your claim at any given time should you request it.
2. If you call to obtain the status of your disability claim and you are told that a decision has been made, will you be told what that decision was? No, as a disability examiner, I was acutely aware of the fact that even if a decision had been made on a case, this information could not be passed on to an inquiring claimant over the phone.
From the social security administration's standpoint, the only proper way to notify the claimant was through the written notice that is mailed out. Why is this the case? Because some claims are selected for a quality control review at something called DQB (the disability quality branch).
At DQB, a claim that has been pulled for review can potentially be changed. In other words, an approval can be changed to a denial, and a denial can be changed to an approval (though it is usually the other way around). When this happens, it is because DQB reviewed the decision made by the disability examiner and found that the examiner was in error, in the application of a medical-vocational rule, or in the interpretation of the claimant's medical evidence.
all information found http://www.ssdrc.com/prem12.html
Disability hearings are, fairly often, somewhat short. It is not unusual to even have a hearing last as little as 10-15 minutes.
How can this be the case? If the administrative law judge presiding over the case has already, for the most part, made up his or her mind to "pay the case" (approve the claimant for disability benefits), then there is relatively little to discuss between the judge and the claimant, or the judge and the claimant's disability lawyer. The fact that disability judges have the claimant's entire file available to them prior to the hearing ( including whatever medical records and other evidence has been gathered by either the claimant or their attorney and then submitted to the hearing office) facilitates this.
How can you tell if a disability hearing may take longer? If the judge has requested the appearance of expert witnesses, such as a vocational expert or a medical expert (judges do this to provide additional expert evaluation regarding a claimant's residual functional capacity or their ability to find employment in the national economy based on their condition and work abilities), it is less likely that the hearing will be over in 10-15 minutes.
When expert witnesses are called to be present at a social security hearing, such witnesses will communicate with the judge and the claimant's disability lawyers, usually over hypothetical situations that speculate as to A) the claimant's remaining mental or physical functionality, B) the availability of certain jobs and C) the claimant's ability to perform the work involved in those jobs.
all information found http://www.ssdrc.com/disabilityquestions1-56.html
