Social security disability applications going forward

According to the Social Security Administration over the ten years between 2001 and 2010, applications for Social Security disability benefits increased 250%. The percentage of favorable awards of disability benefits over that same time declined from 46.1% to 35.7% (as a percent of all applications). The last five years has seen a 28% increase in applications and an acceptance rate decline to 33%. The Congressional Budget Office (“CBO”) attributes the increase in applications to characteristics of the population, federal policies, and declining opportunities for employment. The CBO further reports that of the applications received for disability benefits in 2005 that were rejected, appeals were filed in one-third of those cases. In three-quarters of the cases appealed, the initial decisions were reversed. CBO also reports that the number of beneficiaries tends to increase even after the economy begins to recover from downturns. You can expect to get calls, or continue to get calls, concerning the Social Security disability appeals process.
Under the Social Security Act, “disability” means the “inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or has lasted or can be expected to last for a continuous period of not less than twelve (12) months.” There are five major types of Social Security disability benefits. Calls concerning Social Security Disability Insurance benefit are the most common (“SSDI”). It is paid to individuals who have worked in the recent past (5 out of the last 10 years in most cases) who are now disabled. The other income benefit commonly asked about is Supplemental Security Income benefits (“SSI”). These benefits are paid to individuals who are poor and who are disabled. Both these disability benefits are increasingly applied for online in addition to being applied for in person at a local Social Security field office or by mailing the application to a local office. Unless the disability is catastrophic, such as terminal cancer, a heart condition that is so bad that you are on a heart transplant waiting list, or total paralysis of both legs, there is no easy way for the lawyer or client to know whether an applicant will be found disabled by Social Security. The decision of whether or not to appeal a denial of disability benefits should be based upon whether or not the applicant genuinely feels that he or she cannot engage in any substantial gainful activity.
Only about 27% of Social Security applications are approved upon the initial application level in Florida. The first review of a denial is done by the Social Security Administration and is obtained by requesting a “reconsideration.” Only about 9% of the reconsideration requests filed in Florida are won. If the claim is denied on reconsideration, the next level of review is performed by an administrative law judge who will conduct a “non-adversarial” hearing where the applicant testifies. Currently, a little over half of the hearings result in a favorable award of benefits. In my experience, there is a large measure of subjectivity to these decisions. Within the Jacksonville, Florida regional office where most of the cases from the Gainesville area are decided, there is a judge with a favorable award rate consistently around 85% while another’s is consistently around 15%. Similar examples exist in the Orlando and Tampa regional offices. Hearings are fairly informal. Applicants are entitled to a live hearing, however, with consent they are sometimes done remotely via video-conference. The only people present are the applicant/claimant, the judge, a person operating a recording devise, a vocational expert and or a medical advisor, and the claimant’s representative. Most of the judges in my experience begin to get impatient with claimant’s representatives if you take more than 45 to 60 minutes to question the claimant and discourage calling witnesses other than the claimant.
Disability can result from a single medical or psychiatric problem or, as is often the case, from a combination of medical and or psychiatric problems. Medical documentation is essential to advancing a claim. At the initial stage of application, the Social Security Administration is supposed to gather all of the claimant’s medical records. However, I have found the completeness of this effort to be lacking, and a large part of my time and effort is spent keeping up with where my clients are getting treatment and making sure these records are made a part of the Social Security Administration’s file.
Applicants without access to medical care are at a serious disadvantage in proving disability. In addition to the medical issues, age, past work experience, and education are important factors in evaluating an applicant’s disability claim. The disabling conditions that are the basis of the application need not be permanent, but applicants must have been disabled for one year or be expected to be disabled for at least one year, or have a condition that can be expected to result in death within one year.
The initial application typically takes three to four months to be reviewed. The reconsideration likewise takes three to four months. The processing time for a hearing in the Jacksonville office is currently reported to be 341 days. The Social Security Administration’s website, www.ssa.gov, is a valuable internet resource as is the website created by the National Organization of Social Security Claimants’ Representatives found at www.nosscr.org.

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