Successfully Applying for Disability Benefits in Maryland

Applying for Disability in Maryland

How to apply and qualify for SSD, SSI in Maryland (MD)

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 who apply for disability in Maryland will generally have a 22-29 percent chance of receiving a disability award. This is true whether the claim is filed under the title 2 Social Security Disability program, or the title 16 SSI disability program, or filed concurrently under both programs.

As most claims filed are likely to be denied in any given year, claimants should prepare themselves for the possibility of needing to file one or more appeals in order to receive benefits.

However, in all candor, since the rate of denial at the first appeal level, the reconsideration, is typically higher than the initial claim denial rate, the majority of claimants will actually need to file two appeals.

The second appeal is the request for hearing before an administrative law judge. Fortunately, the disability hearing level provides many claimants their best opportunity for winning benefits, provided their case is properly prepared and a logical theory of the case is advanced to the judge.

Filing for disability online or through the Social Security office

An SSD disability claim can be filed online. However, the online process does not allow a claimant to directly ask questions and receive answers to those questions.

Additionally, the online process does not allow an SSI disability claim to be taken. This is an impediment to anyone whose claim might be for SSI or may involve SSI (a large percentage of cases involve both SSD and SSI as "concurrent claims"). For both these reasons, filing for disability at a local field office will be more practical.

The processing of qualifying for disability in Maryland begins typically with speaking with a CR, or claims representative, in a local Social Security office. It is with a CR that an interview will be held, during which the claimant can supply all the necessary information for processing the claim (for the most part, the history of medical treatment and the vocational work history for the prior 15 years).

The interview is usually conducted in person. However, it can be done over the phone for individuals who have difficulty getting to a Social Security office for whatever reason. This may also be requested for claimants who simply prefer a phone interview.

Individuals who file for disability in Maryland can make the process easier and more efficient by writing down a full list of their medical treatment sources, as well as their work history before going to apply for disability at the Social Security office.

It is important to remember that the more information that is given to Social Security, the quicker the claim may potentially be processed, and, in many cases, the higher the odds of approval.

Providing information to Social Security

When supplying the medical history, the names and address of medical facilities should be provided, as well as dates of treatment, diagnoses received, and the names of treating physicians. This information will allow the disability examiner to obtain medical records that establish the onset of the claimant's condition (onset, or how far back a condition began, is important for determining how much back pay a person may receive), and the current status of the condition.

When supplying the vocational work history, it will be important to list all jobs performed within the last 15 years. This is what SSA refers to as the relevant period. Job titles should be included, dates worked for each job, but also a description of the duties of each job. This information will allow the disability examiner to properly identify the claimant's past work, and the physical and mental demands of their past work, which may have an impact on the outcome of their claim.

Qualifying for disability

Qualifications for disability benefits in Maryland are based on:

1) Proving the existence of a severe medical impairment (in other words, the medical evidence must show that there has been a definitive diagnosis of a condition and that the condition has undergone treatment) and

2) Proving that the condition is severe enough to last for at least one full year while having a limiting and restrictive effect on ADLs, or activities of daily living, particularly with regard to the ability to perform basic work activities.

A restricted ability to engage in normal daily activities may effectively translate into an inability to perform work activity (doing one's past work, or doing other work that their skills might qualify them for) at a substantial and gainful earnings level.

In the case of a child filing for disability, restrictions in daily activities may significantly interfere with school work and other age-appropriate activities.

The requirements for disability claims are substantiated largely by the information contained in a claimant's medical records. Information gathered by a disability examiner from a claimant's treating physician and other medical sources, is used to "paint a picture", so to speak, of a claimant's physical and mental functional limitations.

This picture basically becomes what SSA refers to as a residual functional capacity rating, which is an assessment of what a person can, and can no longer do, as a result of their condition, or various conditions.

An RFC assessment rating is used to compare what a person is still able to do versus what their past work required of them. By making this comparison, a disability adjudicator can do the following:

A) Determine whether or not the person can go back to their past work (defined as potentially any job they held in the last 15 years, provided they did the job long enough to learn it)

B) Determine whether or not a person, if they cannot do their past work, is still capable of switching to some type of other work.

Decisions on disability claims

Obviously, the decision that is made on a Social Security Disability or SSI disability claim will depend heavily on the information contained in both the medical records and the job history. While the medical records will allow an adjudicator to decide how functionally limited the individual is, the work history information will allow the adjudicator to make a comparison between the claimant's current level of functional capability and their past work demands.

Though some claims are approved on the basis of medical information only (such as satisfying a listing in the Social Security Disability impairment listings, otherwise known as the blue book), in the vast majority of claims the decision as to whether or not a person is approved or denied for disability benefits will be medical-vocational, meaning the work information will play as equal a role as the medical information.

Unfortunately, it is a reality of the process that most claims will be turned down at the level of an application for disability. Despite this fact, however, the majority of claimants will ultimately be awarded benefits if they do not give up on their claim, but, instead, follow the appeal process.

  • Disability application denial rate: 71 percent.
  • Disability application approval rate: 29 percent.

    Level II: Request for Reconsideration - The request for reconsideration is the appeal that is filed upon receiving a denial of an application for disability.

    The reconsideration process is identical to the application process, the only difference being that a different disability examiner will review the case and render the decision. Because only a few short weeks separate the disability application and the reconsideration appeal, there is typically not much to distiguish the two.

    Accordingly, most reconsiderations are turned down as well. In some cases, a reconsideration will be approved if the second disability examiner finds that the first examiner has made a clear error in evaluating the evidence, or in applying a guiding rule. But this is not the norm, and, nationally, approximately 85 percent of reconsideration appeals are denied.

    With such a high rate of denial, the primary reason for filing a request for reconsideration will be to move the case to the hearing level in the event that the reconsideration is denied. At the hearing level, claimants who have been previously denied will, statistically speaking, have their best chance of being awarded disability benefits.

    A request for reconsideration must be submitted within 60 days of the date of the application denial. This date is usually stamped on the notice of disapproved claim. SSA will allow an extra 5 days for mailing time.

    However, it is important to note that Social Security must receive the reconsideration appeal by the 65th day (from the date of the denial) versus the claim simply being mailed and postmarked by this date. Otherwise, the appeal will not be timely and the claimant will be forced to start over with a new claim unless good cause for late filing can be shown.

    Claimants who submit a reconsideration should do the following:

    1) Make a copy of the appeal in case it does not appear in the Social Security system.

    2) Make a followup call to the Social Security office within 10-14 days of submitting the appeal to verify that it was received.

    Claimants who are represented by a disability lawyer or non-attorney disability representative will have their appeal submitted by them. Represented claimants, however, should contact their representative after receiving a denial letter to make sure both parties have received the notification.

  • Reconsideration appeal denial rate: 86.3 percent.
  • Reconsideration appeal approval rate: 13.7 percent.

    Level III: Request for Hearing before an Administrative Law Judge - The disability hearing is the second Social Security appeal available to claimants and may be requested only after a reconsideration appeal has been denied.

    Like all appeals, the hearing must be requested within 60 days of the date of the prior denial, but, ideally, should be requested immediately after receiving notification of the denial of the reconsideration appeal to avoid unnecessary case processing delays, as well as the possibility of a missed appeal deadline.

    Basic facts about disability hearings

    1. Getting medical record evidence for the hearing - The request for a disability hearing is submitted to the Social Security office which will transfer the claimant's case to ODAR, the office of disability adjudication and review. ODAR is government-speak for "hearing office. Cases generally get tied up at the hearing office for several months before they are assigned to a particular judge who will eventually schedule the case for a hearing.

    During this extended wait (which can range anywhere between six months to a year or longer), there will be little for a claimant to do. However, this does not mean that case preparation should not continue. At the hearing, the medical records that were in the file at the time the case was transferred from the Social Security office will be "aged", meaning older than 90 days. They will not be acceptable, according to SSA standards for making an approval on the disability claim. Therefore, it will be vital for the claimant or their disability attorney to acquire and submit recent medical records prior to the hearing.

    Unfortunately, since an unrepresented claimant will have no idea when the hearing will be scheduled, it will be very difficult to know when to send requests to doctors for additional records. Obviously, if the requests are sent too soon, those newly acquired records may be old by the time the hearing occurs. If the requests are sent too late, they may not arrive in time for the hearing.

    A disability lawyer or non-attorney disability representative will typicall try to gauge, based on past experience, when to send out requests for updated medical records. The hearing notice itself will provide some help in this area. Hearing appointment notices must be received by a claimant and their disability representative at least 20 days in advance of a hearing. However, hearing notices are usually sent out at least a month before the hearing which offers some cushion for gathering additional records.

    2. Will my disability lawyer get a statement from my doctor? - A disability lawyer who does not attempt to get a medical source statement from a claimant's doctor will be doing their client a disservice. This is because while such statements usually carry little firepower at the lower levels (disability application and reconsideration appeal), at the hearing level where judges respect qualified medical opinions from treating physicians, an objective and detailed statement can easily mean the difference between winning or losing the case.

    3. Can I bring witnesses to my hearing - This is allowed. However, it is almost never done simply because there is little if anything that a claimant's witness can add to the hearing proceedings that would be of benefit to the outcome of the case. Disability claims are fought and won on the basis of objective evidence: medical evidence and vocational evidence (i.e. information regarding the claimant's work history, such as the types of jobs they worked, and the mental and physical requirements of those jobs). Testimony from a claimant's witnesses, such as friend, neighbor, relative, or former employer, would generally not aid the decision process.

    4. What is the decision process at the hearing? - The disability decision process is, in most respects the same at the hearing level as at the application level. The qualifications, criteria, and requirements for receiving benefits do not change. At all levels, a disability examiner or judge will approve or deny a claim on the basis of the evidence.

    Approvals may be made in two separate ways. The first method of approval occurs when the medical evidence reveals that the individual has a physical or mental medical condition that satisfies the approval criteria of a listing (in the Social Security list of impairments). Listing approvals happen in a minority of cases. In most instances, if a case will be approved it will be because the decision-maker determined that the person filing for disability had functional limitations that were severe enough to make work activity at a substantial and gainful earnings level impossible.

    5. If the case is denied at the hearing, can it be appealed? - A denial at a Social Security hearing can be appealed. At this level, the appeal would be handled by the appeals council which reviews, and sometimes overturns, the decisions of Social Security judges. However, few cases are approved by the appeals council. For most claimants, the best opportunity to win disability benefits after their claim has been turned down at the application stage will be the disability hearing level.

    6. Will I need a disability attorney for my hearing - Claimants are not required to have Social Security representation at any level of the system. However, for a variety of reasons, it is never a good idea to go to a hearing unrepresented. In fact, most judges will advise claimants who show up unrepresented that their hearing may be rescheduled if they would like additional time to locate a disability lawyer or disability representative.

  • Disability Hearing denial rate: 40 percent
  • Disability Hearing approval rate: 60 percent

    Note: The approval rate for the Baltimore MD hearing office is actually higher than the disability award rate nationwide, as well as the disability award rate for SSA region 3 (48.7 percent).

    However, in any given year, it should be expected that between 40-60 percent of all cases that are brought to the hearing level in Maryland will be denied, thus necessitating the need for either a new claim, or an appeal to the Appeals Council.

    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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