How much time is needed for a Social Security Disability Decision?
It can take several months to receive a decision on a decisions on initial claims and reconsiderations are made at state agencies, which make all disability decisions at these first two levels of consideration for the Social Security Administration. In most states, this agency is referred to as Disability Determination Services (DDS), although it may go by other, similar names depending upon the state, such as the Bureau of Disability Determination, etc.
After being assigned to a claim, a disability examiner will review the claimant's medical records to determine if the claimant is impaired enough to prevent him from working at his current job, any job he has held within the past 15 years, or any other work for which he may be qualified. Most disability claims are not denied because there is no existing impairment, but rather because a disability examiner has been able to find some job in the national economy at which the claimant "should" be able to earn a minimum amount each month (known as the substantial gainful activity (SGA) amount).
For this reason, those applying for disability, either SSD or SSI, should be very specific on the work history submitted with the initial application. Don't just throw out job titles; instead, list actual duties performed, job skills, etc. Otherwise the examiner may assume that you have work skills, software knowledge, management experience, etc., which you do not possess.
One way to really slow down a decision on a claim is to fail to supply the examiner with correct contact information for a treating physician or physicians. Put in the time necessary to get this information correct on your medical history up front, rather than delaying your case for several months down the road as your disability examiner attempts to locate your records (see What if the disability examiner cannot find all the medical records?).
However, even after a disability examiner has made a decision on a disability claim, there are other steps that must be taken within DDS before the examiner's decision is finalized. First, the doctor assigned to the examiner's unit will review the claimant's medical records and either agree or disagree with the decision. Typically the opinion of the doctor (or psychologist if the claim is based on a mental impairment) will carry more weight than that of the examiner.
After the unit doctor has reviewed the examiner's decision, it then goes to the unit supervisor (case consultant), who also gets a chance to either agree or disagree with the examiner's findings.
Under the best of circumstances everyone within DDS agrees on the decision, and it becomes final. However, in some cases there is yet another hurdle a claim must pass before a decision is sent out to the individual seeking disability. This is known as the "quality control" review. If a claim is randomly selected for such a review, it could take many more weeks before it is cleared, sent back to the Social Security office, and ultimately mailed out to the claimant.
And for those whose initial application and first appeal were denied for disability by DDS, there is yet another lengthy wait before a final decision is reached on their claim, provided they file a second appeal, a request for a social security hearing before a federal administrative law judge (ALJ).
The upside of the disability hearing is that the ALJ can act much more independently than the examiner, without an entire unit looking over his shoulder and second guessing his opinion. The downside is that it can take anywhere from 1 to 2 years to get a disability hearing diaried on the judge's calendar, simply because there are currently so many disability cases filed each year (see Speeding up the Request for a Social Security Hearing - Documentation that is needed).
One thing to keep in mind about the Social Security Decision'if you stay the course and follow your claim through to the second level of appeal, you are more likely to be awarded disability benefits. ALJs overturn more than half of all claims previously denied by DDS, and the rate of approval increases even further when the claimant is represented by a disability attorney or non-attorney rep at his hearing .
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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