Types of decisions on disability applications

Most individuals who apply for disability naturally assume that there are two types of decisions on disability applications: disability denial and disability approval.

And, for the most part, they are correct. At the intial claim level and at the request for reconsideration level, there are two outcomes, approval and denial.

However, at other steps in the Social Security Disability process, there are decision types that you don't ordinarily hear about. One is the technical denial. This is a type of denial that occurs before a SSD case or SSI ever gets to DDS (disability determination services). That's because it never does get to DDS. A technical denial occurs when a claimants applies for disability at a social security office and it is quickly learned that the applicant is simply ineligible.

What would make you ineligible before your medical records are even gathered and looked at? Well, for SSI, if you have assets exceeding $2000.00, you are automatically ineligible for SSI disability, simply because SSI is a need-based program. For SSDI (Social Security Disability insurance) OR SSI, however, a person could receive a technical denial if, at the time they apply for disability, they are working and earning more than the current limit for SGA.

At the disability hearing level, there are also two basic outcomes (approval and denial), but with a "twist". Claimants who are approved by a disability judge may receive a favorable notice of decision, but this notice may be either A) Partially Favorable or B) Fully Favorable.

What's the difference? If your decision is fully favorable, this means that the judge has granted disability benefits back to the AOD. AOD stands for alleged onset date and this is the date you claim your disability began. If your decision is partially favorable, this means the judge has granted you disability benefits, but not completely in agreement with when you believe your disability began.

In most cases, a partially favorable decision will be one where the judge has read the evidence and believes that the claimant became unable to work at the SGA level on a date later than the one stated by the claimant.

In a small percentage of cases, however, partially favorable means that a claimant will not receive ongoing monthly disability benefits, but, instead, will only receive benefits for a specific and finite period in the past. This is known as a closed period and it essentially means that the judge has decided that you were at one time disabled, but are no longer disabled according to Social Security Disability criteria.

And, finally, of course, there are Unfavorable notices of decision, meaning that an ALJ has denied a claim. What happens when a judge denials a case? The claimant can

1. Give up.

2. Request a review of the ALJ's decision (this is the appeal involving the appeals council).

3. File a brand new claim.

4. File a brand new claim and simultaneously send a request for review off to the appeals council.

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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