Social Security Disability – Claims Procedure
When injury, disease, physical disabilities or mental impairments leave you unable to work, then Social Security laws may provide you with income benefits and access to medical care.
Filing your Claim. Social Security provides two basic types of assistance to those who meet the disability requirements – Social Security Disability (SSDI) for disability benefits for a disabled insured worker, and Supplemental Security Income (SSI) for benefits for a disabled person on a need basis. The starting point to obtain benefits under either or, in some cases, both of these programs is to contact the Social Security Administration to file a claim application. A claim application can be filed at one of the Social Security offices located throughout North Georgia to assist claimants in Acworth, Atlanta, Canton, Cartersville, Dallas, Marietta, Rome, Woodstock and other communities. You can also file your application online at www.ssa.gov. You will be asked to complete the following:
- A Disability Application form providing basic information including your name, address, phone number, Social Security number and similar information;
- A Disability Report which will provide the Social Security Administration with information on your injury, illness or disability, work history and medical treatment; and,
- An Authorization to Release Medical Information form to allow those processing your claim to obtain information from doctors, hospitals and medical providers about your medical condition.
If your income and assets are low enough to meet the requirements for filing for Supplemental Security Income (SSI), then you can file for both Social Security Disability benefits and SSI benefits.
Processing your Claim. After you have filed your claim, the Social Security Administration will handle the processing of your claim. The Georgia Department of Labor – Disability Adjudication Services will do most of the work involved in processing the claim. They will obtain medical records based on the information you provided in the Disability Report. They might request additional information from you on your condition. They might request information from family or others about your condition or on its limitations on your ability to work or to perform daily living activities. It might requested that you see a doctor they assign to you or that you take medical tests to assist in the evaluation of your condition.
Initial Decision. After evaluating your claim SSA will send you a letter setting out their initial decision on your claim. You should receive this determination within about 120 days from the date of the filing of the Disability Application. As a rough estimate, only 25% to 30% of the cases filed will be successful at this stage of the process. Approved cases will generally be those that are clearly within SSA’s medical guidelines (Medical Listings) and that are well supported by medical information from treating physicians. If granted you will begin receiving income benefits in approximately 30 to 90 days.
Appealing a Denial of your Claim. If your claim is denied, then you still could be awarded benefits by appealing the decision. So, do not give up. The first step is to make sure that you file your appeal on a timely basis. You must file your appeal within sixty (60) days from the date of the decision (Note: Always read the decision carefully, and follow any instructions set out in it about when, where and what to file.) The appeals process is similar to the procedure for filing an initial claim for benefits. You will be required to file a Disability Application, to update the Disability Report and to sign an Authorization to Release Medical Information form.
There are several appeal levels:
- Request for Reconsideration. After you file a Request for Reconsideration, the SSA will conduct an in-house review of the initial decision and the evidence supporting it. Again, they will request medical records, doctor visits, testing or other claim related information. You should receive a letter with their decision within about 90 days from the date of filing the appeal. Only about 15% of those who file a Request for Reconsideration are successful.
- Request for Hearing. If your Request for Reconsideration is turned down, you can file a request for a hearing before an SSA Judge. Your request will be granted, and a hearing will be scheduled. The SSA Judge has a broader range of authority and can consider more factors in making his decision than those who have previously reviewed the case. This is probably your best opportunity for success in your claim with 40% to 50% of the appealed claims being granted some level of benefits. Unfortunately, it often takes a year or more before the hearing is held. During this time SSA will continue to process the claim. They will employ vocational and/or medical experts to assist in the evaluation of the claim and to testify at the hearing.
IF YOU DO NOT HAVE AN ATTORNEY TO REPRESENT YOU, THEN YOU NEED TO EMPLOY AN EXPERIENCED ATTORNEY DURING THE HEARING STAGE OF THESE PROCEEDINGS .
- Other Appeals. If you have still not been awarded benefits, then you can appeal to the Appeals Counsel and even take your case into the Federal Courts for review. Appeals at these levels are generally based on errors in your hearing of special legal or factual situations. Speak with your attorney about these errors if they arise.
Submitting Evidence. SSA will obtain medical records from your listed physicians and hospitals, and they will obtain consulting opinions from doctors whom they employ. However, you can submit medical records, the results of medical tests, doctors’ opinions, and other evidence supporting your case. It is advisable to review the records that SSA has received to make sure they have obtained all relevant supporting medical documents. If documents are missing, you should obtain them and file them for the record. Your attorney will assist you in evaluating what records need to be filed, in obtaining those records and in drafting requests to doctors for their opinions.
Critical Case Request. It is possible in some limited cases to “speed-up” the process. There are three situations that allow you to file a special request to expedite the handling of the claim. These include situations which the claimant’s condition is terminal, the claimant is suicidal or homicidal, or the claimant is at risk of going without food, medicine or shelter. This last form of request is called a “Dire Need Request”, and it is probably the most common type of critical case request.
The Hearing. Many people worry about or are even frightened about appearing at their hearing. If you are, try to relax. A Social Security hearing is generally an informal proceeding. It is frequently held in a small, private room at the SSA offices. Normally, only the Judge, a court reporter, the claimant, claimant’s attorney, a vocational expert, and, sometimes, a medical expert or doctor will attend the hearing. The medical expert and the judge might be present via telephone or video conferencing.
You should expect the hearing to last thirty (30) minutes to an hour. The judge has already reviewed the claim file before the start of the hearing. Typically, your attorney will make a short introductory statement including an outline your condition, medical and lifestyle evidence supporting your claim, and a specific theory or basis of law which would allow you to receive benefits. The judge and/or your attorney will ask you questions concerning your condition and its impact on your life. The doctor and the vocational expert will then be questioned. The judge will usually close the hearing without issuing a ruling. A written decision will be issued by the judge within approximately 30 days from the date of the hearing.
An experienced attorney familiar with Social Security disability law can help you protect your rights and can help you get the benefits you deserve. We have the knowledge, experience and skill to assist you in dealing with the process of obtaining help from these Social Security benefits programs. We represent disabled individuals in SSA Disability claims throughout North Georgia including Cobb County, Cherokee County, Bartow County, Floyd County, Paulding County, Fulton County and Forsyth County. Contact us today to discuss your situation and the benefits you are be entitled to receive.