Applying for Disability in Arizona
How to apply and qualify for SSD, SSI in Arizona (AZ)
Note: If you have already filed a claim and been denied for disability, or are wondering what to do in the event of a Social Security denial, proceed to the reconsideration and hearing appeal sections below.
Level I: Disability Application - Individuals filing for disability in Arizona have approximately a 25 to 30 percent chance of being awarded benefits. Conversely, this means that up to 70 percent of claimants will face the prospect of being denied at the initial claim level and having to utilize the Social Security appeal process.
The first level of appeal, the request for reconsideration, usually results in an even higher percentage of claim denials. This is not surprising considering the fact that the reconsideration process is identical to the disability application process in nearly all respects.
By the second appeal level--the request for hearing before an administrative law judge--the statistical odds of approval tends to shift in favor of claimants, provided their case is well represented and/or strongly supported by medical evidence, vocational evidence, and a well-developed rationale for approval, also known as the theory of the case.
Note: The appeal system is sequential, meaning that before a disability hearing may be requested, the reconsideration phase must first be completed.
Social Security Disability and SSI
Disability benefits in Arizona may be received under either the title 16 Supplemental Security Income (SSI) disability program, or the title 2 Social Security Disability (SSD) program. Which program applies to an individual's case is dependent upon non-medical requirements, specifically whether or not they have achieved and maintained insured status for SSD benefits.
Individuals who have never attained insured status as a result of work credits earned through work activity (such as minor-age children) will have their claim filed under SSI. Individuals who were previously insured for SSD but have not worked for an extended period and, therefore, have had their insured status lapse (meaning they are past their DLI, or date last insured) will also have their disability claim filed through the SSI program.
Lastly, individuals who are insured for SSD benefits at the time of filing for disability but are only eligible to receive a small monthly SSD benefit amount may potentially have a concurrent claim filed; the purpose of a concurrent claim is to maximize how much a benefit recipient may receive each month.
Eligibility for SSD, SSI, or both SSD and SSI as a concurrent claim, will be determined by a CR (claims representative) at a Social Security field office at the time of application.
Applying for disability in Arizona
Applying for disability in Arizona mirrors the process in other states. Since the Social Security Administration's disability programs are federally mandated, the qualifications and eligibility requirements are likewise the same.
Disability claims may be filed online or at a Social Security field office. The online filing process, however, does not provide for a face-to-face interview with a claims representative (which facilitates receiving answers to questions that may minimize confusion and reduce opportunities for making mistakes).
Nor does it allow for an SSI disability claim to be taken. As most claimants will have no way to determine in advance if their claim will involve SSD, SSI, or both programs, the online process may not be as advantageous.
Under most circumstances, it will be to the claimant's advantage to file a disability application at a Social Security Field office. This involves contacting a local office and arranging an appointment date for a disability application interview.
Note: Claimants who have medical mobility or transportation issues may request that their disability interview be conducted over the phone (or may simply request this if they prefer a phone interview).
The purpose of the interview is for the claimant to supply information that is needed to process the claim, i.e. render a disability determination. The principal areas of importance, however, will concern the claimant's history of medical treatment and their vocational work history. Because both areas may be critical in determining the claim, claimants may wish to write down both their treatment history and work history prior to the disability application. Doing this may allow for more detailed information and avoiding the omission of critical information.
Making the decision on the disability claim
After the claim is taken by a CR (claims representative) at a Social Security office, the file is transferred to a state disability agency for processing. In most states, the agency is referred to as DDS, or disability determination services. At DDS, the medical decision on the case will be made by a disability examiner who has been trained to evaluate both medical records as well as work history records.
The examiner's first duty will be to request the claimant's medical records, based on the information provided at the time of application. The amount of time it takes the examiner to receive the records will depend on the medical sources themselves, but also on the completeness of the information provided by the claimant (for example, the full names and addresses of hospitals and clinics).
Once the records have been received, the examiner will generally be in a position to determine whether or not the claimant may be approved via a Social Security Disability listing or via a medical vocational allowance, a type of disability approval that takes into account the functional limitations possessed by the claimant and whether these limitations are severe enough to rule out the claimant's ability to return to their past work, or transition to some form of other work.
Filing a disability claim for a child
For a child filing for disability in Arizona, the disability requirements will focus on the child's ability to stay on pace with peers, i.e. their ability to engage in age-appropriate activities. If the child is of school-age, this involves an examination of the child's school and academic records, as well as their medical records.
Level II: Request for Reconsideration - The reconsideration is the second step of the Social Security Administration's disability evaluation system and it is the first level of the appeal system. Filing requirements remain the same at this level and the criteria to qualify for disability in Arizona does not change at this step of the process.
Reconsiderations, like disability applications, are handled by disability examiners at state disability-processing agencies (known in most states as DDS, or disability determination services).
Two facts about reconsideration appeals stand out:
1) Reconsiderations generally take less time to process - it is not unusual to receive a decision in less than six weeks.
2) Reconsiderations are usually denied at a far higher rate than the initial disability application in Arizona - nationwide, reconsideration appeals have an 85 percent average rate of denial.
Because the likelihood of being denied on a reconsideration is so high, and this is consistent in all states, most claimants should view this appeal as a stepping stone to a disability hearing.
Level III: Request for Hearing before an Administrative Law Judge - Disability hearings are where most claimants who have been denied on a disability application will finally be approved. The wait for a hearing can be extensive. In prior years, it was not unusual for hearings to take up to two years to get scheduled following the submission of a request for hearing.
Hearing decisions are rendered by ALJs, or administrative law judges. Disability judges in Arizona are required to employ the same disability requirements for determining a claimant's eligibility as is the case for initial claims and reconsideration appeals. The qualifications process, therefore, still focuses on an adult claimant's ability to engage in work activity, which may be restricted by functional limitations caused by medical conditions.
Claimants should take note that ALJs do not perform case development. This is very different as opposed to when a case is being decided by a disability examiner (examiners render decisions at the application and reconsideration levels) who will gather medical records, obtain work history data, and activities of daily living questionaires, and potentially even interview a claimant's former employer.
Essentially, when a claimant arrives at a hearing, the disability judge will rule on the basis of whatever evidence is available--which is why it is extremely important for a claimant to provide further medical evidence updates to the judge prior to the Social Security hearing date.
Note: There are multiple hearing offices in Arizona and the approval and denial rates listed here are averages supplied by the DIODS extract prepared by the Office of Disability Programs. The several hearings offices in Arizona actually have approval rates ranging from a low of 38.2 percent of cases being awarded to a high of 55.3 percent of cases being awarded.
The average rate of approval at the hearing level in Arizona is minimally better than the national average for hearings; however, it does illustrate the need for careful case preparation and provides an argument for disability representation at this level of the system.
The Phoenix AZ hearing office has a disability award rate of 55.3 percent; The Phoenix North AZ hearing office has a disability award rate of 38.2 percent; The Tucson AZ hearing office has a disability award rate of 55.4 percent.
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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