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…
Continued from: Applying for NC disability benefits
3. While your application for disability in North Carolina will be taken at a local Social Security office, the actual decision itself will not be made by the Social Security office. The decision will be made by a disability examiner (I am a former North Carolina disability examiner myself) at NC DDS, which stands for North Carolina disability determination services.
4. DDS is the state-level agency where decisions on disability applications and reconsideration appeals are made. The examiner at DDS will gather medical records from the treatment sources that you listed when you filed your claim for disability.
Usually, the single largest delay on a claim will be the wait for medical records and this is why you want to make very sure when filing for disability benefits in North Carolina that you supply all your treatment sources, their full addresses, the names of all of your treating physicians, as well as all of your diagnosed conditions, and complaints, especially if pain is involved.
5. When the North Carolina disability examiner obtains your medical records, they must find at least some records that are not older than 90 days in order to make a decision on your case, and at the very least to make an approval on your claim.
If you have not been to a doctor in some time and, as a result, the examiner cannot locate recent records, then you will probably be sent to a CE, or what is commonly called a consultative examination.
This is a medical examination that is performed by an independent physician, or psychologist if the exam is mental in nature. The examination is scheduled by, and paid for, by the Social Security Administration. You must go to this examination if one is scheduled for you. If you do not attend a scheduled CE, your case can be denied for failure to cooperate.
6. The disability examiner who is assigned to work on your case will probably contact you at some point, through either the mail or by attempting to call you, to discuss either your medical treatment history, your work history, or you’re ADLs, otherwise known as your activities of daily living.
You will want to provide in detail whatever information is requested of you. This will allow the disability examiner to make progress on your claim, and possibly make a better decision, I.e. an approval.
If the examiner send you a letter, be sure to respond within 10 days. If the examiner leaves a message for you, be sure to return the call. In either case, if the examiner attempts to contact you and you do not respond, there is the potential of your case being closed.
7. If you’re denied on your initial claim, then you’ll probably want to consider getting a disability lawyer or disability representative in North Carolina.
And here is the reason: if you get denied, your first appeal is something called a request for reconsideration. The request for reconsideration has approximately an 87% chance of denial. In most cases, the only reason for filing the reconsideration request is so that once you complete the reconsideration, which is almost guaranteed to be denied, then you can proceed to the next appeal level, the request for hearing before an administrative law judge.
At this disability hearing, you will certainly want to be represented. If you go to the hearing unrepresented, your chances of winning benefits may be lessened dramatically.
Therefore, if your initial claim is turned down, you should probably seek a representative to help you. Because most likely, you will wind up at a disability hearing, and at the hearing you will need representation, if for no other reason than to maximize your chances of winning disability benefits–particularly in light of the fact that getting to a disability hearing after requesting one can sometimes take between one and two years.