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Will I Qualify For Disability Benefits in North Carolina?
In North Carolina, about 26 percent of initial disability claims i.e. disability applications are approved compared to an average national initial claim approval rate of about 32 percent.
For most claimants, the prospect of receiving a denial will be high, but the chances of being approved by the second appeal level, the request for hearing before an administrative law judge, will be significantly higher--typically 60 percent or greater, on average, when representation is involved.
Filing for disability in North Carolina
If you file a disability application in North Carolina, your disability claim will be taken and processed by one of 37 local Social Security offices located across the state.
To start the application process, you need only contact a Social Security office and arrange to have an appointment made for a disability interview, the purpose of which is to supply all the information that will be necessary to render a decision on your claim. For the most part, of course, this will focus on information regarding your medical treatment history and work history.
In child claims, vocational work information is obviously not an issue, but, rather the child's ability to engage in age appropriate activities; therefore, school records and academic, achievement, and psychological testing records are often reviewed, in addition to IEPs and questionaires completed by teachers.
Individuals filing for disability in North Carolina do have the option of applying online through the SSA website. However, filing online has several disadvantages. A disability interview with a field office claims representative is not conducted and, thus, a claimant will lose the opportunity to ask questions and receive answers regarding the filing process, as well as the appeal process if that becomes necessary.
Additionally, despite the fact that a high percentage of claims are concurrent, meaning they involve both SSD (Social Security Disability) and SSI, the Social Security Administration does not allow SSI claims to be taken online. For this reason, the online process may not be nearly as productive as simply contacting a local Social Security office.
For individuals who have medical mobility or transportation issues and cannot easily get to a Social Security office, SSA always allows the option of having the claim taken over the phone.
Processing a disability claim in North Carolina
After an application for disability is taken, it is sent to a centralized state disability processing agency known as Disability Determination Services, or simply DDS. Once a disability claim is at the agency, it is assigned to a disability examiner. Disability examiners gather medical records from the doctors, hospitals, and other medical treatment sources you listed when you filed your disability claim and then use this information to determine the outcome of the claim.
In some cases, the examiner will review the medical records and determine that 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 have a condition that meets the requirements and qualifications of a listing, the examiner will then review the medical evidence to determine in what ways, and to what extent, the claimant is functionally limited, both physically and mentally, and, thus, restricted in their ability to engage in work activity that earns a substantial and gainful income.
This second type of decision is known as a medical vocational allowance and it relies on an examination of the claimant's work history, in addition to reviewing the medical treatment history.
In conducting this examination, the examiner must first determine the claimant's functional limitations. Limitations can include, but are not limited to a reduced ability to sit, stand, or walk, or a reduced ability to reach, grasp, lift, bend, hear, see, smell, remember, concentrate, etc.
Secondly, the examiner must compare the claimant's remaining functional abilities (known as their RFC, or residual functional capacity) to the types of jobs they have held in the previous 15 year period to determine A) if they can go back to a past job or B) if they perform some type of other work, assuming that they can no longer perform their past work.
Individuals who can no longer do their past work, and who, based on their age, education, work skills, and RFC rating, cannot transition to some type of other work, may qualify for disability benefits under the SSD or SSI program.
When it is necessary to go to a Social Security Medical exam
If the disability examiner finds that the claimant does not have current medical record information, they will typically schedule a consultative medical examination, or CE, to obtain it.
This is done because Social Security requires that current medical information be used to make each disability determination; in other words, an approval cannot be made on a claim if there are no recent records to prove that the individual is disabled, regardless of what the older records may say.
Social Security will consider older medical evidence/records and, in fact, older information is essential for establishing a claimant's onset date which directly impacts how much they may be owed in disability back pay. But a claimant must have current medical evidence in order for an approval to be made on a claim. Medical evidence that is "recent" is considered to be medical treatment records that are less than ninety days old.
If your disability file does not have enough current medical information, you may have to attend one or more consultative examinations (paid for by Social Security) to evaluate the status of your disabling conditions. The examination may be a physical exam, an appointment for xrays, a neurological exam, or possibly a psychiatric examination, or psychological testing for IQ or memory deficits.
The doctors who perform these examinations are not employed by SSA but are private physicians contracted to perform consultative exams. After an exam is performed, the doctor will send a medical report to the disability examiner. If your disability claim is denied the Disability Determination Services will send you a denial notice. If you qualify for disability, your disability file will be sent back to your local Social Security office for the final processing of your claim before you are notified of the approval.
Rates of denial in North Carolina and filing appeals
Most initial disability claims are denied. If your disability claim is denied, you can file a reconsideration appeal. Unfortunately, the reconsideration appeal approval rate in North Carolina is even worse than the initial disability claim approval rate.
In North Carolina, the reconsideration appeal rate of 10.4 percent is somewhat lower than the national average of 11.0 percent. Either way, about 89 percent of all reconsideration appeals end in a denial for disability benefits.
Fortunately, the disability hearing appeal level (the second appeal level) offers disability applicants the best chance of qualifying for disability benefits. Administrative law judges make their own medical disability decisions and are not subject to having their decisions altered by supervisors or quality control units.
That said, to win a case at the hearing level, a claimant must present a rationale for approval that is well supported by objective medical evidence. Very often, a strong knowledge and understanding of Social Security regulations (title 20 of the code of federal regulations), Social Security court rulings, and the medical vocational grid rules that direct decisions on claims will be required to successfully present a case to a Social Security administrative law judge.
Both national and North Carolina disability hearing statistics show that more disability applicants qualify for disability at this level of the Social Security disability SSI process.
North Carolina’s disability hearing approval rate of 61.7 percent is slightly higher than the national disability hearing approval rate of 58.6 percent.
Return to: Social Security Disability Resource Center, or read answers to Questions
Filing for NC disability benefits
Applying for Disability in North Carolina - How to apply, qualify, and meet filing requirements
Applying for NC disability benefits
More about filing for disability benefits in North Carolina
How to claim disability benefits in North Carolina
What happens on a disability application in North Carolina?
How long will it take to receive NC disability benefits if your application is approved?
Basic questions about disability benefits in North Carolina
How much can you receive in disability backpay in North Carolina?
How far back do you get disability benefits in North Carolina?
Can You Work and Collect Social Security Disability in North Carolina?
How to Get the Status on Your Social Security Disability Claim in North Carolina
How do I get help to win my disability claim in North Carolina?
The disability process in North Carolina
What condition or conditions qualifies for disability in North Carolina?
How long does it take to get through the disability system in North Carolina?
Is it hard to get disability benefits in North Carolina?
What are my chances of being approved for disability benefits in North Carolina?
How long does it take to receive North Carolina disability benefits after you are approved?
Disability determination services in North Carolina
Disability decisions in North Carolina
How long does it take for the disability decision in North Carolina?
How does the North Carolina Social Security disability determination process work?
Getting disability benefits in North Carolina
Getting denied for disability in North Carolina and filing appeals
What does getting disability benefits in North Carolina involve?
How to get on disability in North Carolina
NC Disability requirements and qualifications
Will I Qualify For Disability Benefits in North Carolina?
What is the criteria for disability benefits in North Carolina?
What are the disability qualifications in North Carolina?
Proving the requirements for disability in North Carolina
How do you meet the Disability qualifications in North Carolina?
SSI and Social Security Disability requirements in North Carolina
How do I Know If I Qualify For Disability in North Carolina?
Winning Disability benefits in NC
How do I win disability benefits in North Carolina?
Improving your chances of getting disability in North Carolina
How to improve the chances of winning a North Carolina disability hearing
Will an attorney or representative help me win North Carolina disability benefits?
Winning disability benefits in North Carolina
Mental Disability benefits in NC
Receiving disability for a mental condition in North Carolina
How do you receive benefits for a mental disability in North Carolina?
Getting approved for mental disability benefits in North Carolina
Disability awards and award notices in North Carolina
Getting a Social Security disability award in North Carolina
The Social Security disability award notice process in North Carolina
What affects how much time it takes to get a disability award in North Carolina?
Disability representation in North Carolina
Should I get a disability representative or lawyer in North Carolina?
Who can provide disability representation in North Carolina?
Hiring a Qualified Disability Lawyer in North Carolina
How do Disability Lawyers in North Carolina get paid their fees?
Denied for disability in North Carolina, should I get an attorney or representative?
Disability attorney fees in NC - paying your lawyer or representative
How does a disability lawyer or representative get paid in North Carolina?
How much does the fee cost for a disability attorney in North Carolina?
Do you pay your disability lawyer in North Carolina or does Social Security pay the fee?
Will your North Carolina disability lawyer charge you upfront for taking your case?
Will your NC disability attorney charge you for any expenses other than the main fee?
NC disability hearings
What kind of decision will you get at a disability hearing in North Carolina?
NC disability hearing - how long for a decision?
Do you have to go to a Social Security hearing in North Carolina to get approved for disability?
The disability hearing in North Carolina- things to keep in mind
How do you prepare for a disability hearing in North Carolina?