Why does a disability claim take so long and is it harder if I am under age 55?

Someone recently asked the following question:

Why does it take so long and why they don't want to grant it to me because I'm not 55.

To be honest, claims have always taken a very long time. This has been true ever since I was a disability examiner in the 90's and I am sure it was the case before then. As to why, there are at least two reasons: first of all, the time it takes to process a Social Security Disability or SSI claim is directly affected by how long it takes to get the medical records gathered from all the sources that have been indicated by a claimant at the time of application. And that can be a matter of weeks and sometimes even months.

However, even when the records have come in, there are often issues that come up in the processing of a case:
  • Will there be a need to send the claimant to a consultative medical exam (which can be physical or mental, or both)?
  • Has the claimant had a recent surgery that requires deferring action on the case until the claimant's response has been assessed?
  • Is there difficulty in obtaining either medical or vocational, or even educational information necessary to adjudicate the claim.
Every claim is different and sometimes a variety of issues come up.

However, in most cases, the amount of time to process a decision has to do with how long it takes to get all the medical evidence together. Examiners will request records from treatment sources usually on the first day they are assigned a case, and often they will have to do multiple followups with the hospital or practice in question. I can remember many instances of having to resend the same request for records several times. That slows cases down.

And, of course, there is the fact that most claims will be denied at the initial claim/application level. That then means having to file one or more appeals. The first appeal, the reconsideration, can take several months. But the second appeal, the hearing request, can take up to a year or longer before a hearing is granted.

Now, as to the second issue of whether or not Social Security will grant benefits to someone who is under the age of 55---younger individuals routinely win disability benefits. But, the medical vocational rules do make it a bit easier for those who are 55 or older to be awarded. Age, educational level, work skills, and one's residual functional capacity are all taken into consideration. And this is because SSA assumes that an older individual who cannot go back to their past work may face more of a challenge in being able to switch to some type of other work.

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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