What is the Application Process for Social Security Disability and SSI?
How do you Win Benefits under Social Security Disability or SSI?
If I am determined disabled, how far back will Social Security pay benefits?
How do you prove your disability case if you have a mental condition?
What Can I Do to Improve My Chances of Winning Disability Benefits
Common Mistakes after Receiving a Denial of Social Security Disability or SSI Benefits
How to File for Disability - Tips for Filing
If You Get Approved For SSDI Will You Also Get Medicare?
How much does a Social Security disability attorney get paid?
Social Security Disability SSI Criteria and the Evaluation Process
How long does it take to be approved for SSI or Social Security disability?
What do you Need to Prove to Qualify for Disability Benefits?
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Social Security Disability SSI and Degenerative Disc Disease
Can I Qualify For Disability and Receive Benefits based on Depression?
Answers to questions about SSD and SSI disability
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Social Security Disability Status
Social Security Disability Tips — how a claim gets worked on
Social Security Disability, SSI Disability - Terms, Definitions, Concepts
Still Waiting For My Social Security Disability Decision
How to prove you are disabled
and win disability benefits
I recently came across this question in a Social Security disability forum and I thought it would be good to address how long disability determinations take and what is involved in the medical evaluation process.
“I applied in May, but still have heard nothing from DDS since July when my case work said I do not have to have a consultative exam as their doctors would know nothing about my rare condition. Can you shed some light on why I still do not have an initial decision?”
As a former disability examiner, I can say that there are many conditions for which there would be no need to send an individual to a consultative examination. Consultative exams are generally used to give the social security administration a current medical status. This is for disability claims in which the disability examiner does not have any current medical information, or for which the information they have is inadequate.
To be honest, there are some conditions for which there is no way for a consultative examination to address the claimant's limitations or the status of their condition. For instance, consultative examinations are not scheduled to evaluate cancer, or genetic or other rare diseases. This is because there is no way objectively evaluate these kinds of conditions. And, frankly, the physician performing the consultative examination would not be qualified to do so.
Now back to this person’s question. In this particular situation, the person filed in May and it is now July. This is not a long time for a medical determination, since most initial disability claims take an average of about 130 days. Of course, some disability claims take less and some take more. If an individual has a terminal condition, the disability decision is usually completed within thirty days so that the individual can be paid as soon as possible.
Barring a terminal illness, it could take some time to be approved. Secondly, Social Security is more interested in how a disabling condition limits an individual’s ability to perform substantial work activity rather than what the specific disease or condition is. If the disability examiner has a hard time determining the limitations of a disease or condition, it could take more time to evaluate what the disabled person’s residual functional capacity is (what they are able to do in spite of their disabling condition) and how that might affect their ability to perform past work or any other kind of work.
The disability process takes time because all of a disability claimant’s medical information must be requested and reviewed. If there is not enough information available from the records that are gathered, consultative examinations must be completed. And after all of this, the disability examiner must evaluate how the condition affects the disability claimant’s ability to work.
It is not surprising that the individual who asks the question is still waiting for a medical decision if only a couple months elapsed since they filed their claim, simply because most disability claims take this long or longer to get a decision even if they do not involve a rare disease or condition.
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SSD and SSI are Federal Programs
The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states:
Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Recent approval and denial statistics for various states can be viewed here:
Social Security Disability, SSI Approval and Denial Statistics by state
Special Section: Disability Lawyers and unnecessary claim denials