What is the Application Process for Social Security Disability and SSI?

The application process for both Social Security Disability and SSI disability is the same; when you apply for disability there are no discernable differences between the two programs. To initiate an application for disability, you have several options. You can apply for disability online, you can call the social security administration's toll free line to initiate the process, or you can contact your local social security office to get things started.

I won't bother to list the SSA toll free line because, over the course of many years, I've found that the telecenter workers for SSA so often give out incorrect information and lead applicants down improper pathways that this simply isn't prudent or wise. As for filing online, this is something that the social security administration is pushing quite heavily and SSA is even marketing the online process as something more efficient and streamlined.

However, this claim of efficiency is far from the case and the online process is essentially a technique by which the social security administration attempts to reduce costs by reducing the involvement of personnel. The online process DOES NOT rule out having to speak with a social security representative and, in fact, in the majority of claims, SSA will have to contact the claimant to verify or clarify information that was provided online. This being the case, why should one even bother with an online application?

Then, of course, there is one very important factor that the online process does not address: the ability to ask a flesh-and-blood person a question. By and large, the most productive means by which to apply for disability will always be...to contact your local social security office.

After you make the initial contact, forms will be sent to you to complete and return and, more importantly, a face to face interview appointment will be set. During this appointment, the social security representative can ask you the proper questions and gain clarification as to your answers. You, the claimant, may also ask questions about the process to ensure that there is no misunderstanding or knowledge gap on your end.

After your claim has been taken in a field office, it will be sent to a state level agency where it will be assigned to a processing specialist known as a disability examiner. In most states, this agency will be known as DDS, or disability determination services. However, it goes by other names in different states such as the bureau of disability determination and the disability determination division.

What happens after your case gets assigned to a disability examiner?

Almost immediately, the disability examiner will begin to request your medical records from the various medical treatment sources you listed on your disability claim.

After the electronically generated requests for MER (medical evidence of record) have been sent out, the examiner will typically be forced to wait and do very little until the records arrive. This is because the foundation of any Social Security Disability or SSI disability decision will be what the records have to say about the claimant's condition, i.e. how severe the condition is and does the condition make it unlikely for the claimant to engage in what the federal government refers to as substantial gainful activity.

Because the wait for medical records can be so long, sometimes literally months (some doctors offices and hospitals take a long time to respond to medical record requests), it can be beneficial for a claimant to gather their own records and submit them at the time of application. Of course, the trick to supplying medical records and eliminating a delay on a case is supplying both current medical records as well as older medical records.

To approve a claim for disability, social security will need recent medical records

Ideally, the records should be no older than sixty days. This ensures that the social security administration has an accurate picture of how a claimant's condition affects their ability to work. However, SSA will also need older medical records in order to establish when the claimant's disability actually began. This is important because, claimants, when they initially file, are asked to provide an alleged onset date for their disability.

Of course, supplying older records is also important because the further back one can establish their disability, the more they can potentially receive in disability back pay, which is often numbered in tens of thousands of dollars.

The social security examiner will rely principally on the information submitted by the claimant at the time of application. However, in most cases the examiner will attempt to contact the claimant to gather additional information regarding doctors, dates of treatment, the types of jobs that were performed, the duties of each job, as well as the types of daily activities currently engaged in by the claimant.

Social Security will base most of its decision on the claimant's medical records, which can include supporting statements from one's treating physician or physicians. However, vocational information, such as one's past work history, is also used.

The importance of one's work history should not be underestimated, meaning that how thoroughly a claimant describes their work history (jobs worked, titles of jobs, duties performed, length of time worked, etc) can absolutely have an impact on the outcome of their case. And for this reason, a claimant should supply detailed information about their work history, just as they should supply detailed information about their medical treatment history.

How many cases for disability are approved or denied? Roughly seventy percent of all claims for disability are denied at the initial claim level. Individuals who are denied have the option of starting over with a new claim. However, this is usually the least productive option since in most instances this subsequent disability application will also be denied. What should a claimant who has been denied do? They should utilize their appeal rights and file their first available appeal , which is a request for reconsideration.

Reconsideration appeals are, unfortunately, overwhelmingly denied. However, after a claimant has been denied on a reconsideration, they have the option of requesting a hearing before an administrative law judge where, with representation, they will have a better than sixty percent chance of being approved for benefits.

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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