Applying for Disability in Nevada
How to apply and qualify for SSD, SSI in Nevada (NV)
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 applying for SSDI or SSI disability benefits in Nevada have an approval rate slightly better than thirty percent. Between 68 and 70 percent of initial claims are likely to be denied, though statistics will vary from year to year.
The disability application process in Nevada is a two-step process that first involves initiating a claim through Social Security and then having the claim processed by a disability examiner at DDS, or Disability Determination Services, a state-level agency that conducts disability determinations for SSA.
Filing for disability may begin with initiating the claim online or through the SSA teleclaims center. The preferred method of filing, however, is by contacting a local Social Security field office. There are several advantages in doing this:
1. Applying locally will allow the disability interview to be conducted in person. This will allow the claimant, during the intake phase, to directly ask questions and receive answers--regarding the application, appeals process, and qualifications criteria.
Note: For claimants who have difficulty going to a local office due to medical or transportation issues, the disability application interview may be done over the phone. When the interview is done via phone, the CR, or claims representative, will mail the paperwork to the claimant to sign and return.
2. The online process does not allow an SSI disability claim to be taken online. Since many claims are for SSI only, or are concurrent claims for Social Security Disability and SSI simultaneously, and since claimants will not know in advance which programs will apply to their claim, using the online process will not be as efficient as applying for disability in person.
3. Applying for disability in person will allow a claimant the opportunity to present their medical records to the CR. Personally obtaining one's medical records and supplying them at the time of filing for disability is not required. However, it can sometimes save considerable processing time as long as the claimant includes all records that are relevant to their condition or conditions and, furthermore, supplies records that are both current and which also go back to the time they allege their disability began.
4. Filing for disability in person allows the Social Security Claims Representative the opportunity to clarify various points of information with the claimant, such as regarding the work history for the 15 year period prior to becoming disabled, the claimant's alleged onset date, the claimant's treatment sources, and the effect the claimant's condition has on their ability to engage in basic daily activities.
Note: The accuracy of the information that is obtained during the disability interview is of paramount importance, since this information will be used by the disability examiner at DDS to complete the medical and vocational evaluation of the SSD or SSI claim.
Qualifying for disability in Nevada
Qualifying for SSDI or SSI disability will require satisfying the Social Security Administration definition of disability. The federal definition of disability, cited in title 20 of the code of federal regulations, requires that an individual have at least one mental or physical impairment that is severe enough to last for at least one full year and which prevents the ability to work (either at a past job or at some type of other work) at a substantial and gainful level.
Note: A claimant does not have to wait one full year before filing for disability. If the claimant's condition has not lasted this long at the time of application, the disability examiner who will be assigned to the case will simply use the medical records that are gathered to make a projection as to whether or not the claimant's disabling condition will last for this minimum durational length.
The qualifications criteria for children filing for disability are the same, except that in place of determining whether or not the claimant can return to work activity, the focus will be on determining whether or not the child claimant is capable of engaging in activities that are age-appropriate. For children of school-age, this will typically necessitate an evaluation of the child's school and testing records.
The Process of making a decision on a disability claim
After a disability claim is taken at a Social Security field office, it is transferred to a disability examiner. The examiner's first task will be to request medical records from all the medical treatment sources listed by the claimant at the time of application. Obtaining the records may take weeks or months.
However, this illustrates the importance of providing detailed information regarding treatment sources (including names of physicians and names and addressess of hospitals, clinics, and doctor's offices). How long a disability decision takes is often a direct reflection of how long it takes the disability examiner to obtain the medical records.
Once the medical records have been received, the examiner will review them with two possible approval scenarios in mind:
The first method of qualifying for disability
If the medical records reveal the existence of a medical condition, either physical or mental, that satisfies the approval criteria of a listing in the Social Security Disability list of impairments (also known as the blue book), the claimant will be approved for disability benefits.
Note: Not all conditions are contained in the listings. Moreover, since the approval criteria is very specific, most claims will not qualify this way. In actuality, most claims that are approved will qualify in the form of a medical vocational allowance.
The second method of qualifying for disability (the medical vocational allowance)
When a claimant does not have a condition that satisfies the requirements of a listing, the disability examiner will review both the medical records and the work history information. The medical records will be evaluated to determine what functional limitations are possessed by the claimant. These will be used to give the claimant an RFC, or residual functional capacity, rating. An RFC rating is basically an assessment of what a claimant can still do despite their medical condition.
The RFC rating is compared to the requirements of the claimant's past work (potentially, all jobs worked within the last 15 years). If the disability examiner concludes that the claimant is so functionally limited that they cannot go back to their past work, and is also so limited that they cannot be expected to switch to some form of other work, they may meet the qualifications for disability and be approved.
How long does a decision on a disability claim take?
An application for disability benefits in Nevada will typically be decided within four months from the date of filing. Some claims may be decided faster if the disability examiner does not have difficulty obtaining the claimant's records. Claims that require one or more consultative medical examinations may take longer.
Level II: Request for Reconsideration - In the event that a claimant is denied on their application for disability, they should immediately consider filing an appeal. The first appeal in the SSA disability system is the request for reconsideration.
To request a reconsideration, a claimant who is not represented should contact the office where their initial claim was filed and request that the appropriate forms be mailed out to them. Upon receiving them, they should be completed and returned as soon as possible. The deadline for the submission of the reconsideration appeal is 60 days from the date of the disability application denial (SSA allows an additional 5 days for mailing time).
Claimants who are represented by a disability representative or disability attorney will have their appeal completed by this individual. However, as a precautionary note, claimants who receive a denial notice should immediately contact their representative. This is to ensure that both parties are aware that the disability application was denied so that the appeal will be submitted within the allowed deadline.
Claimants who are not represented should send in their appeal paperwork as soon as possible and may wish to consider finding representation since the odds of approval at the reconsideration level are not high and the next appeal involves a hearing held by a federal judge. In fact, the rate of denial at the reconsideration level is markedly higher than the disability application level. Nationally, more than 80 percent of these first appeals are denied.
For most claimants, the primary justification for filing a request for reconsideration is simply the fact that once this stage is completed, the claimant may request a disability hearing. At the hearing level, the odds are statistically in the claimant's favor, assuming that their case is well-supported by medical records, supporting statements from treating physicians, and a well-reasoned argument for approval, or "theory of the case".
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 figure quoted for disability hearings in the state of Nevada is an average. The disability award rate for the hearing office in Las Vegas NV is 45.7 percent and the disability award rate for the hearing office in Reno NV is 43.7 percent. Both statistics are lower than the national average for decisions made by judges at disability hearings. Both Nevada hearing offices also approve fewer claims, percentage-wise, than the region that Nevada is a part of, SSA Region 9.
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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