What happens after a Social Security Disability claim gets taken in Florida?

In actuality, though a Social Security Disability or SSI disability claim in Florida gets taken at a local social security administration office (including the disability interview and all the accompanying paperwork), it doesn't get processed or worked on there.

After the claim is taken, it is transferred to the agency that handles the medical and vocational evaluation of the claim. In other words, an agency where the decision on the claim gets made. Despite the fact that SSI and SSDI are federal disability benefit programs, this agency is not a federal one, but, rather, a state-level agency. It is known in most states as DDS, or disability determination services. And it is where disability examiners, the individuals who make decisions on cases, are based.

Typically, for the average disability examiner, one of the first things they will do in any given day, is open the cases they have received for that day. New daily cases for a disability examiner can range from one to five new disability claims to work on. Given that fact, it is vital that a disability examiner start working on new cases practically from the moment they arrive. And, therefore, for this reason a disability examiner will usually take all new cases that have been received for the day and begin to send out requests for MER.

MER is an acronym that stands for medical evidence of record. Medical evidence is what forms the basis for all disability decisions and decisions cannot be made on SSDI and SSI claims until the records have been gathered. Of course, since many hospitals and doctor offices take a lengthy amount of time to respond to requests for medical records, it is not surprising that sending requests for the records is typically the first thing that a disability examiner will do.

What happens next on a Social Security Disability claim or SSI disability claim? Very often, nothing happens after the requests for medical records have been made. This is because in most instances there is nothing to work on until the records come in.

As I've said before, the wait for medical records comprises the biggest block of waiting time for the majority of disability cases. And it is for this one basic reason that claimants really need to do the following: When submitting an application for disability, make sure you indicate all your medical treatment sources and also indicate as much detailed information as possible, including the names, addresses, and contact information for each facility, as well as the types of treatment received, the diagnoses received, and the names of physicians who provided treatment.

Why is this level of detail important when you are applying for disability? Because gaps in information can potentially lead to delays. As a disability examiner, I found it very common for claimants to leave off some, or many, of their medical treatment sources when they were filing a claim. Many times, the name of the hospital or doctor's office was listed in correctly, or the contact information was wrong, or the names of physicians were incorrect.

Also, it was very common for claimant's to leave off the names of doctors and facilities who had provided treatment years earlier---these claimants, I am sure, did not realize that medical records from long ago can help to prove an earlier onset date for the start of their disability benefits, meaning more back pay benefits.

After the records come in, or begin to come in, is typically when the work begins on a disability case. Some disability examiners will wait until all the medical evidence arrives before even touching the file again, and others will read and evaluate the medical evidence as it arrives, piece by piece.

However, the task is still the same. The disability examiner will review the medical records, looking for indications of various diagnosed conditions, in addition to the conditions listed on the disability application. The examiner will also scan the records for signs that may indicate whether or not the claimant's condition meets the disability criteria for a listed impairment in the Social Security Disability list of impairments, i.e. the blue book.

In most cases, even if the claimant has a physical or mental condition that is in the blue book, their medical records will not offer the proof needed to qualify them for benefits on the basis of the blue book's requirements. However, most claims that are approved are not approved on the basis of satisfying blue book requirements. Instead, most claims that are approved are awarded on the basis of a medical vocational allowance.

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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