Why do disability claims take so long in California?

Here's my list of answers to the question.

1. The disability application claim process in California has always taken a long time. Even before the current backlogs began to develop, it was not unusual for an initial claim to take four to six months, or even longer. The processing time, of course, had much to do with how long it took to get the necessary medical records. However, with an increase in disability applications, which occurs both with a graying population and with a changing economy, longer processing times at the initial level are to be expected.

2. Cases that are denied at the disability application level proceed to the first appeal level, which occurs after a request for reconsideration has been filed. Reconsiderations are often determined faster than applications. Nonethless, the simple fact that a claim has to proceed through another step adds a significant amount of time to the claim process.

3. If a disability case is denied at the reconsideration level, then a claimant should, in most circumstances, file a request for a hearing. A number of years ago, a hearing request might have, depending on which part of the country you live in, resulted in a hearing date within three to five months. This, obviously, added a significant, additional block of time to the process. However, with current backlogs, the wait for a hearing can easily be as long as two years in some areas.

Is it possible to win a Social Security Disability or SSI case in California prior to the hearing level, saving months or years of valuable time, and, thus, avoiding harsh financial consequences as a result of this overly extended process? In some cases, it may be possible. As I've said before, disability determinations are based solely on medical evidence. And, amazingly, many applicants who file for benefits do not include on their applications the information that a disability examiner needs to expeditiously gather the medical records, such as the names of treatment facilities (hospitals, clinics, doctor's offices), and the addressess and phone numbers of the same. In many cases, in fact, claimants will only list one or two medical sources, for some reason leaving off three or four sources of treatment.

Tip: when you apply for disability, provide full and extensive information regarding where you've been treated. Because without doing this, the individual who works on your case (the examiner) won't be able to gather the information that may prove helpful in getting your case approved.

Second tip: after you apply for disability, attempt to contact the examiner who has been assigned to your case (the number for the agency where the examiner is based can usually be obtained from the social security office where you filed your claim) to see if they need any additional information and also to see if they have been able to obtain your records from each medical provider. It is not unusual, in cases where the examiner is having difficulty getting records, for a claimant to personally visit a doctor or hospital to obtain the records and then send them to the examiner.

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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