Applying for Disability in Vermont
How to apply and qualify for SSD, SSI in Vermont (VT)
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 - In a typical year, a person SSI award.
Nationally, in most years, the average rate of denial at the initial claim, or disability application, level has been approximately 70 percent. This high rate of denial has been fairly consistent over many years and has dictated that the majority of claimants must file appeals in order to be awarded disability benefits.
Qualifying for SSD or SSI disability benefits in Vermont involves filing a claim through the Social Security Administration at one of its local offices and then having it processed at a disability determination services agency within the state.
In other words, the claim is simply taken at a Social Security office (where the disability interview is conducted, the claimant's information is obtained, and all the necessary paperwork is completed) but is medically processed at the state's DDS agency, where a disability examiner will evaluate the totality of the evidence and render a decision of disabled or not disabled.
Decisions that are made by disability examiners can take as little as several days in some cases, to several months, even up to a year (this length of time, however, is somewhat rare).
When disability cases take a very long time to process, it is usually because the examiner has had difficulty obtaining all the needed medical evidence, or that, for whatever reason, the claimant has had to be sent to multiple Social Security examinations, or consultative exams.
When cases are decided very quickly, this generally occurs because the evidence has been obtained by the examiner quickly and is overwhelmingly in favor of approval.
In such instances, it may be that the claimant is approved on the basis of meeting or equaling the disability requirements of a listing in the Social Security list of impairments. Yet in other cases, it may be that the claimant submitted their medical records at the time of application and, thus, eliminated some of the work that was required of the examiner.
In the latter example, when the submitted medical evidence A) covers all the appropriate time periods (the evidence should substantiate that the individual is currently disabled, and disabled back to the time they allege their disability began which is crucial in terms of payable back pay) and B) effectively illustrates that the claimant's case satisfies the SSA definition of disability, the examiner can approve the case and the claimant can look forward to receiving ongoing monthly benefits.
In most cases, as well, the claimant will also receive some amount of Social Security back pay -- which for SSI can be payable back to the date of application; while SSD backpay can be paid to the date of application plus 12 months retroactive to this date.
As stated, the majority of claims, however, will not be approved at the initial claim level. For these individuals it will be necessary to file one or more appeals in order to receive benefits.
Level II: Request for Reconsideration - Reconsideration is the first step in the Social Security Disability appeal process.
Reconsideration is exactly what the name implies. The Social Security Administration takes a second look at the claim. Though not officially the case, this is arguably to see if A) the claim should have been approved previously at the disability application level or B) if the claim should now be approved due to a change in the claimant's medical condition or as a result of new medical evidence.
Note: Since the Social Security evaluation process is identical at the reconsideration and application stages, the odds of being approved on a reconsideration will be unlikely unless an error on the part of the first disability examiner is discovered by the reconsideration-level examiner, or strong, new medical evidence is introduced into the case.
Reconsiderations are only requested after a disability application has been denied. A reconsideration must be submitted within the appeal deadline period. That period, for any appeal, is 60 days from the date of the last denial (the denial date is usually stamped in the upper right hand corner of the letter of denial).
However, claimants should use caution when mailing appeal documents. Any mailed appeal must be received at a Social Security office before the expiration of the appeal period, not just mailed and postmarked.
Qualifying for disability on a reconsideration
The qualifications for disability are the same at this level as at the application level. This is because the requirements for disability are mandated in a single definition of disability which is used by SSA. That definition specifies that a person must have a severe medical condition that lasts one full year and which either satisfies the requirements of a listing (in the Social Security Disability list of impairments) or results in a medical vocational allowance, a type of decision in which it is determined that the capacity for substantial and gainful work activity no longer exists.
A claimant who is represented by a disability lawyer or a non-attorney disability representative should contact their representative as soon as their disability application denial is received. This is to verify that both parties have received the denial notice and to ensure that the appeal deadline is not missed.
A claimant who is not represented should, prior to submitting the appeal, keep a copy for their personal records. After submitting the appeal, a followup status call should be made to the Social Security office within two weeks to verify that the appeal has been received.
If the reconsideration is denied, the claimant should once again appeal. This time the appeal will be to request a Social Security hearing. At the hearing level, the statistical odds of being approved are much greater provided that the case is well-prepared and well-presented to the AlJ, or administrative law judge, presiding at the hearing.
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
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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