It is pretty common knowledge that the majority of social security disability claims are denied when first made. Even more are denied after an appeal. In fact, statistically, the denial rate of initial claims is approximately 65% and the denial of reconsiderations is around 85%. In light of these discouraging odds, many clients wonder how a disability decision is made?
First, who is responsible for making the decision?
The purpose of Social Security Disability benefits is to provide replacement income for those who are unable to work because of a long-term injury or illness. You may be surprised to know that it is not actually the Social Security Administration that is responsible for making the decision regarding disability claims.
Instead, when your disability application is submitted, the file will be sent to the designated state office for review of your medical records and any other medical evidence you submit with your claim. This office has a different name in each state. In Arkansas, it is called the Arkansas’s Disability Determination for Social Security Administration. In Missouri, it is called the Missouri Disability Determination Services.
How is “total disability” defined?
Under the Social Security Administration’s rules, you are disabled “if you cannot do work that you did before and we decide that you cannot adjust to other work because of your medical condition(s).” It is expected that your disability be either long term (lasting for at least one year) or result in death.
How is my Social Security Disability claim processed?
Most Social Security disability claims are processed through the local Social Security Administration field offices. This means, your state’s social security agency will determine your medical eligibility for disability benefits. The process for making this determination has been standardized throughout the United States. This means that each analyst in each state will utilize the same questions in determining whether a claimant meets the disability standards.
If you appeal an unfavorable determination, it will be decided either by a Disability Determination Services agency or by an administrative law judge in the Social Security Administration Office of Disability Adjudication and Review.
What is Social Security looking for?
Social Security analysts typically expect to see at least a 12-month medical history, relating to the applicant’s condition for which disability is being claimed. This medical information should be “current,” meaning records of medical treatment received within the last 90 days.
However, in many cases, applicants have run out of money or insurance to pay for treatment, making current medical information hard to obtain. Unfortunately, many individuals applying for social security disability are already financially strained because they have been unable to work due to their medical condition.
Why are claims denied?
The most common reason that Social Security disability applications are denied is lack of sufficient medical evidence. In many cases, applicants need to submit to a consultative examination, during the application process. This extra step is most often required when an applicant either has not medical evidence or the evidence they had submitted is too old to be considered.
If you have questions regarding social security disability claims, or any other social security disability concerns, call the Cottrell Law Office at (888) 433-4861.
He is licensed to practice law in the United States District Court for the District of Kansas, eastern Arkansas, western Arkansas, and western Missouri. He was Deputy Prosecuting Attorney in Crawford County, Kansas from 1987-1989.
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