IS SOCIAL SECURITY REQUIRED TO GIVE YOU A DECISION ON YOUR DISABILITY CASE IN A CERTAIN AMOUNT OF TIME?



Is Social Security required to give you a decision on your disability case in a certain amount of time?



 
No, unfortunately, there are no deadlines for processing a Social Security Disability or SSI disability claim and arriving at a decision. This is unlike the medicare for disabled adults program which is required to deliver a decision to the claimant in 90 days or less.

However, the fact that there is no deadline for SSD and SSI claims is probably a good thing. The simple fact of the matter is that it is often impossible for a disability claims examiner to obtain all the medical and vocational evidence that is needed to arrive at a decision on a disability claim, let alone reach an approval.

By contrast with the medicaid for disabled adults program, if the disability examiner cannot accumulate the evidence that might be needed to approve the claim in the 90 day deadline, they are required by law to issue a denial of the medicaid claim. This is hardly the type of system that would be helpful for Social Security Disability and SSI disability claimants.



What makes a Social Security Disability or SSI case take so long?

As was indicated, it is the wait for medical records that usually comprises most of the delay. However, there are other factors that typically add time to the processing of a case.

1. One factor is whether or not the disability examiner has had difficulty obtaining additional information that is needed from the claimant. This is not as infrequent as many might think. Very often, a claimant will move without leaving the social security administration (SSA) with a forwarding phone number or address. This makes it nearly impossible for the disability examiner to conduct needed inquiries about the claimant's medical history, the jobs that they have held (and the duties of each job), and ask about their ADLs, or activities of daily living.

Lack of contact information, can also make it impossible for the examiner to schedule the claimant for a medical exam--known as a CE, or consultative medical exam--if one is needed (usually, a CE will be needed if a claimant has not been seen for one of their conditions in more than 90 days).

2. A second factor is if the disability examiner needs to schedule a consultative medical examination, as mentioned in the preceding paragraph. These medical exams are paid for by SSA, but they are performed by independent doctors (and psychologists in the case of mental status and IQ exams). That means the scheduling of such exams depends on the availability of whichever doctors are available in the immediate area.

It also means that when claimants are scheduled for such exams but miss their appointments (this happens routinely), it can add many weeks to the processing time for a case. However, even when appointments are not missed, it is still a fact that the exam will need to be conducted and it may take weeks before the examining physician or psychologist submits a report of the examination findings to SSA (specifically, to the disability examiner at disability determination services).

And...further complicating many cases is the fact that some claimants will need to be sent to multiple consultative examinations, particularly if they are applying for disability on the basis of a number of both physical and mental impairments.

Is it possible to speed up a disability case? Generally, the answer is no. However, most claimants can avoid adding unnecessary time to their disability case by making sure that they:

A) Keep SSA up-to-date with their contact information,

B) Go to scheduled medical exam dates,

C) Respond quickly to notices from SSA,

D) Provide information that is both detailed and accurate when requested,

E) Complete and return any forms they have been sent by either the social security office where they initially filed, or by the disability examiner who is processing the claim, and

F) Conduct status inquiries on their case -- Occasionally doing this is a good safety feature since claimants who do not receive notifications that have been mailed to them by SSA can become aware of this via a status call to the social security office.


About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.







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