Answers to winning a disability case in NC| Social Security Disability Resource Center

How to claim disability benefits in North Carolina

Note: The SSDI, SSI disability system is federal and nationally standardized, though there are state differences in approval rates, wait times, the number of appeals available–as of the time of this writing–and even the name given to the stage disability agency (DDS, or the Bureau or Division of Disability Determination). Now, to answer the question…

1. You will need to file an application with the Social Security Administration. You can do this in several different ways: you can file online; you can file in person at a local Social Security office; or, you can contact the local Social Security office and arrange to have your disability application interview conducted over the phone.

My own advice is that the last two options are preferable to filing a claim for disability benefits online.

This is because speaking with a representative at the Social Security office, whether on the phone, or directly across from you in person, will give you the opportunity to ask many questions that you may never have the chance to have asked answered so conveniently and directly again.

Also, most likely, you’ll probably not know in advance of filing your claim for disability benefits whether or not your claim will be for title II Social Security Disability, title 16 SSI disability, or both types of benefits in the form of what is called a “concurrent “claim.

The issue here is that an SSI disability claim cannot be taken online because SSI involves a more thorough investigation of a person’s income and assets. Therefore, if there is even a slight chance that your claim will involve SSI, you will probably want to work directly with the Social Security office, versus the SSA website.

2. When you are interviewed by a Social Security CR, or claims representative, it would be most helpful to have already written down both your work history and your history of medical treatment.

Chances are, the decision that is reached on your case will be based on both vocational and medical information, and it is for this reason that it is crucial that you do not leave out any important information, such as names of doctors, places of treatment, detailed descriptions of the jobs you have performed in the past, etc.

Writing down your medical treatment history and your work history before your interview will help ensure that you do not leave out any important information. All of this information that is recorded at the disability application interview will end up going to the disability examiner who will be evaluating your claim and making a decision on your case.

3. After your disability claim has been started, your case file will be transferred to NCDDS, otherwise known as North Carolina disability determination services. At DDS, it will be assigned to a disability examiner. The examiner will send off for your medical records and will wait until either all, or the majority, of these records have been received.

Once the examiner receives the records, he or she will go through them to see if you have a condition that fits the qualifications for a specific medical condition that is listed in the Social Security bluebook, I.e. the Social Security Disability list of impairments.

Most likely, your case will not be approved through a listing, since the approval criteria is fairly detailed and requires a high level of detail and documentation from a person’s medical records.

The majority of individuals who do receive a Social Security Disability award, or SSI disability award in North Carolina, will be approved through what is known as a medical-vocational allowance, where the decision is made that a person has too many functional limitations to allow them to go back to a former job, or switch to some type of new “other work”.

Of course, the more medical information the disability examiner has at their disposal, potentially the more limitations they will be able to find for you. Functional limitations are things such as reduced ability to sit, stand, walk, lift more than a certain amount of weight, hear or see normally, etc.

Functional limitations can take practically any form, because it is simply a reduction in your ability to do any basic daily activity. If your condition affects your ability to remember, or concentrate, or interact with people, this would also be a functional limitation. If you have trouble bending at the waist or reaching overhead, this, as well, would be a functional limitation.

4. While your claim is being worked on by the disability examiner, they may call you to obtain additional information about your work history, medical condition, or any of the treatment that you have received.

They may also call you to conduct what is known as an activities of daily living, or ADL, questionnaire. This is simply where they ask you about your daily activities, and the point of this is to determine how you are affected by your condition on a normal daily basis.

5. If you have not been to a doctor in a fair amount of time, or if you have not been treated specifically for any of the conditions that you listed on your disability application, there’s a very good chance you’ll be sent to a CE. This stands for consultative examination; it is basically a medical examination conducted by a private doctor, paid for by Social Security.

A CE may be a mental examination, or it may be a physical examination. If the examination is physical, then it will probably be fairly short, usually about 10 minutes in length. If the examination is mental, it will either be a type of interview, such as a mental status exam, or an IQ test, or a memory exam.

The results of the CE will usually have very little impact on the outcome of your case, though it will be more likely to affect the outcome of your case if the exam is a mental examination. As we stated, a consultative examination is usually ordered when you do not have current medical record documentation, or you do not have records to address one of your conditions.

How long will it take to reach a decision on your case? On most cases, an examiner will be able to determine if your claim should be approved or denied within 120 days. Some cases do take longer, and there is no deadline for a decision on a case; meaning, essentially, that your case will simply take as long as it will take.

What are the odds of being approved, especially at the initial claim level? Only about one in three disability claims in NC are approved initially.

This means, unfortunately, there is a high degree of chance that you will have to file one or more appeals before winning disability benefits in North Carolina.

Typically, of course, a person will have to file a reconsideration appeal which is likely to be denied and then, after that, a request for hearing where the chances of being approved rise to more than 60% when representation is involved on the case.

Contact Tim Moore and Mac Travis in North Carolina for help with your SSD or SSI claim. Complete the form or call 919-278-7874. After submitting, scroll to the bottom to see the confirmation.
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