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What Social Security considers disabling

Medical Evidence and Disability

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The Social Security Disability and SSI appeals process in Texas




 
In the state of Texas, there are multiple appeals available to an indvividual who has been denied on their claim for disability benefits. Here are the two appeals which most denied claimants can expect to have to file for.

1. Request for reconsideration - Just as the initial disability claim, or application, in Texas is decided by a disability claims examiner at a Texas DDS agency (disability determination services) so, too, is this first appeal decided by a disability examiner. This time by a reconsideration-level examiner.

The reconsideration may be filed online, or a person may contact their local Social Security office and request that paper forms be mailed out to them. If they are represented, of course, their representative should file the appeal. Individuals who are represented at the time they receive a notice of denial should immediately contacted their representative's office to make sure the rep has received a copy. This way both parties will be aware of the status of the case and the appeal can be filed as soon as possible.

The reconsideration appeal must be filed (meaning received at a Social Security office) within 60 days of the date of the disability application's denial. If it is not received in a timely manner, a claimant will be forced to start over with a new application which will result in a considerable loss of valuable case-processing time.

The reconsideration decision will be made the same way as the disability application, meaning that if the medical evidence alone does not warrant an approval based on a disability listing, then both the medical evidence and work history information will be used to decide whether or not a person has the ability to return to substantial and gainful paid employment.

Because the process is the same, reconsideration appeals are usually denied. Approximately speaking, only about one out of ever six appeals at this level are won. This translates to 16 percent approved, 84 percent denied.

Fortunately, because most the case development will already have been done on the disability application, and very often the medical evidence will still be usable (meaning that at least some of it is still considered recent), a decision on this this appeal can often be received much more quickly.


Common questions about filing for disability in Texas
2. Texas disability hearing - If the reconsideration appeal is turned down, and this is usually what happens, then the claimant files the second appeal for a Social Security hearing, known as a "request for hearing before an Administrative law judge".

To request a hearing, simply contact the same Social Security office where the intial claim and reconsideration appeal were filed and ask that the appropriate appeal forms are sent out. As with the reconsideration, the hearing request appeal can be done online or paper forms can be submitted by the claimant. If the claimant has a disability lawyer or non-attorney claimant's representative, that person should file the appeal.

How long for a hearing in Texas?

The hearing level in Texas takes much longer than reconsideration appeals. This is due primarily to how long it takes to get a hearing. And how long this takes will depend on where you live in Texas and which hearings office will receive your appeal. There are two hearings offices in Houston, two in Dallas, one in San Antonio, one in Rio Grande Valley, and one in Forth Worth.

The amount of time it takes to get a hearing date at each is different. However, it ranges from 11 to 18 months so claimants can expect to wait at least a year for a hearing date to be received.

The problem, of course, with waiting so long is that, by the time the hearing occurs, all of the medical evidence in the file will be out-of-date. What do we mean by this? The evidence will be still be usuable for determining the history of the conditions and for establishing when the claimant became disabled according to SSA criteria (which is vital for determing things like back pay owed, and medicare coverage).

However, since SSA requires current and recent medical evidence to establish that a person is disabled now in order to award disability benefits, this will mean that a claimant will need to obtain recent medical records and send them to the judge assigned to hear the case. When should this be done? After all, if the records are sent too soon, they will again face the risk of becoming too old again.

When to get evidence for a hearing

Generally, the new record gathering should be done as soon as the claimant learns that their case will be scheduled soon. In many states, this will be when the hearings office sends out something known as the exhibit list, which is a listing of all the evidence on a case, including copies of prior applications and appeals. This can be construed as a tipoff that the hearing will be scheduled in the very near future.

In all likelihood, however, the individual handling the disability case, who can be a disability attorney or a non-attorney claimant's representative (if a non-attorney is involved, they may be a former SSA field office representative or even a former disability examiner), will know when the appropriate time is to begin acquiring medical record updates to send to the administrative law judge.

What does other preparation for the hearing include? Most likely, the claimant's representative will try to obtain a statement from a doctor supporting the case. These statements can provide information that the medical records by themselves usually will not provide. Therefore, they are very valuable and often help win the case.

How long will a Texas disability hearing take? As in other states, the hearing can occur in as little as 10 minutes and may last a half hour.

How long does it take to receive a decision from a Texas disability hearing? There is no way to know the answer on this question. Sometimes, a notice of decision may be received within 30 days. Sometimes, it may take months because the judge may still be waiting on outstanding medical evidence or simply because there is a large backlog at that hearing office. Claimants who are represented can have their representative occasionally perform case status followups.

How many Texas disability hearings are won? In a recent year, it was found that Texas judges approved 47 percent of the cases they heard while nationally about 56 percent of claims were awarded benefits by judges.















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General information

Filing for disability in Texas
What are the qualifications for disability in Texas?
When do you file for Texas disability benefits? - when you become disabled
SSI vs Social Security Disability in Texas
Winning a Social Security Disability or SSI award in Texas
Disability for depression in Texas
Disability approval process - Getting disability in Texas
Resource links for Filing a Texas disability application
Can I apply for temporary and later permanent Disability in Texas?
How much can I get from Social Security Disability in Texas?
Eligibility and qualifying for disability in Texas
Social Security Disability Status in Texas


Disability appeals in Texas

What if you get denied disability in Texas?
Can you avoid a Social Security Disability Denial in Texas?
The Social Security Disability and SSI appeals process in Texas
Starting an appeal on a disability claim in Texas
What are the chances of winning a disability appeal in Texas?
How many disability appeals do you get in Texas?
Filing a Texas Disability Appeal


Disability Hearings in Texas

How long does it take to get a disability hearing decision in Texas?
Going to and getting ready for a disability hearing in Texas
Don't waste your Texas disability hearing - be prepared
Qualifying for disability at a hearing in Texas


Texas Disability Attorney questions

Get a qualified disability attorney, lawyer, advocate in Texas
Should you get help from a disability attorney in Texas if you have not filed yet?
What does a disability lawyer in Texas do to help you win benefits?
How Much Are The Fees For A Disability Lawyer In Texas?
How do Disability Lawyers in Texas get paid their fees?
Qualifying For Disability in Texas, will I qualify?





Information on the following topics can be found here: Social Security Disability Questions and in these subsections:

Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI


These pages provide answers to basic questions about pursuing disability benefits

Disability qualifications - Who will qualify is based on functional limitations
What do you Need to Prove to Qualify for Disability Benefits?
How to file for disability and the information needed by Social Security
What conditions do they Award Disability Benefits for?
How does back pay for Social Security disability work?
What makes you eligible for Social Security Disability or SSI? Part I
To get a Social Security Disability or SSI Award do you have to have a Permanent Disability?
Social Security Disability Status - when should I call to check
Do Lawyers Improve The Chances of Winning Social Security Disability or SSI?
What is qualifying for disability based on?
How to qualify for disability - The Process of Qualifying for Benefits
Receiving a Social Security Disability Award Letter
How long does it take to get disability?