Still Waiting For My Social Security Disability Decision

I recently came across this question about Social Security Disability in a 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.

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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