Applying for Disability in Montana
How to apply and qualify for SSD, SSI in Montana (MT)
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 - An individual filing for disability in Montana will stand between a 60-70 percent chance of being denied on their initial claim.
This will mean that the majority of claimants, in any given year, will find it necessary to file one or more appeals before their claim satisfies the requirements for disability and either a Social Security Disability award or SSI disability award is issued.
non-medical criteria. Most prominently, SSI is subject to an asset limit of $2000 in countable assets; whereas SSD has no asset limit.
The disability appproval process
To be approved for benefits, applicants in both programs (very often, a claim will be concurrent, involving both programs) undergo the same process of evaluation.
This process begins with A) submitting an application for disability in a Montana Social Security field office and B) having the claim transferred to the state's DDS, or disability determination services, agency where it will be become part of a disability examiner's caseload.
The examiner, upon receiving the case, will make it a priority to send electronically-generated requests for medical evidence to all the treatment sources listed by the claimant on their disability report form.
When the requested records have been received, the examiner will first use the medical evidence to determine if the claimant has a medical condition that satisfies the requirements of a listing in the Social Security list of impairments.
If the claimant does not appear to have a listing-level condition, the disability examiner will continue to review the medical evidence for signs of functional limitations in order to determine if the claimant has the ability to return to work activity.
The claimant's limitations (such as a reduced ability to sit, stand, or walk for more than a certain length of time, or difficulty lifting more than a certain weight, or difficulty maintaining attention or concentration) will be rated on a residual functional capacity assessment. Its purpose is to determine what the claimant is limited from doing as a result of their impairment, or impairments, as well as what the claimant is still capable of doing.
Qualifying for disability in Montana, as well as every other state, is both a medical and vocational determination process. For this reason, the assessment of the claimant's capability is compared to the demands of their past work.
It cannot be overemphasized that it is in a claimant's best interests to submit a detailed listing of their employment history when they file their disability claim (the individual should list all job titles, date ranges for jobs, and full job descriptions for the 15 year period prior to becoming disabled).
The examiner will rely on this submitted information to identify the claimant's job in a reference source known as the DOT, or dictionary of occupational titles.
The jobs listed in the DOT include both the skill levels and the physical and mental requirements of each job meaning that a misidentification of a job as a result of information submitted by a claimant on their disability application report form can have an adverse effect. It can even potentially form the basis for a denial of the claim.
Claimants, therefore, are advised to submit detailed work histories, in addition to detailed medical treatment histories, when they apply for disability.
If the examiner determines that the claimant's current level of functional limitations rules out a return to their past work, and that they do not possess the ability to do some type of other work based on their vocational skills and education, they may be found disabled and awarded benefits.
Applying for disability for a child
To qualify for disability as a child in Montana, the child filing for disability must be found to have a severe impairment that lasts one full year or longer. The case must also present a level of severity that restricts the ability of the child to engage in age-appropriate activities.
For children, the disability evaluation process is not medical-vocational in nature, but, instead, focuses (aside from the medical aspect of the claim) on determining whether or not the child is on-pace with their peers. For school-age children, the evaluation of the claim will necessarily involve reviewing academic and testing records (e.g. IQ and achievement scores).
Level II: Request for Reconsideration - When an application for disability is denied, a claimant may file an appeal known as a reconsideration.
Reconsiderations are handled exactly the way disability applications are handled. Once more, the case is assigned to a disability examiner who will review the claim to determine whether one of the following scenarios applies:
1. The claim will be approved on the basis of the claimant meeting the disability requirements of a listing in the Social Security list of impairments.
2. The claim will be approved on the basis of a medical vocational allowance where consideration is given to how severe the claimant's functional limitations are and whether or not they will prevent the claimant from returning to substantial and gainful work activity (either in the performance of their past work, or in the performance of some type of other work).
3. The claim will denied.
Unfortunately, most reconsiderations are denied. The rate of denial at the reconsideration appeal level tends to be significantly higher than the rate of denial at the disability application level.
This is not surprising when one considers that the reconsideration process is identical to the application process. Therefore, except in cases where new medical evidence is introduced, or the claimant's medical condition significantly worsens, or a mistake is discovered in the decision process used by the original disability examiner, a reconsideration appeal will rarely result in the reversal of a disability application denial decision.
How to file a reconsideration
The request for a reconsideration may be made by contacting the Social Security office where the initial claim was started. The Social Security office will mail the appeal paperwork to the claimant to complete, sign, and return. The appeal forms must be returned by the 65th day following the date of the denial of the disability application (60 days for the appeal period plus an added 5 days for mailing time).
Claimants who are represented by a disability lawyer or disability representative should contact their representative immediately upon receiving a letter of denial to avoid the unenviable situation of a missed appeal deadline (which may result in a less favorable filing date on a new disability application, as well as the potential for less disability back pay).
Note: Social Security is required to send copies of all correspondence to the representative, but, occasionally, this does not occur.
Claimants who are denied on the reconsideration appeal should, again, immediately request an appeal, this time a request for a Social Security Hearing. Hearings have a markedly higher chance of success provided that the claimant is represented and the representative presents a case that is well-supported by the accumulated evidence and Social Security rules and regulations.
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
Note: The ODAR (office of disability adjudication and review, more commonly referred to as the Disability Hearing office) in Billings MT has disability award rate that approximates the national average. The disability award rate for the Social Security Administration region that Montana is a part of (SSA Region 8) is 51.3 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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