Thursday, September 13, 2007

Disability Determination

Disability determination can be a fairly frustrating and trying process for an individual who has filed for either social security disability or SSI benefits and for the following reasons:

1. The disability determination process is typically slow. So slow, in fact, that it can take years to get through the system if your case is denied at the disability application level, is denied again at the social security reconsideration level, and proceeds to the hearing level.

Going through the application and reconsideration phase may cumulatively take a long number of months, of course. However, simply waiting for a disability hearing request can take one to two years, depending on where you live (most major metropolitan areas face significant backlogs, but backlogs are increasingly become part of the norm for social security disability and SSI cases).

2. The disability determination system typically denies the great majority of SSD and SSI claims. The statistics tend to vary between individual states; however, the national statistics indicate that approximately seven out of every ten claims for disability are denied at the application level, while 85% of all reconsideration appeals are denied. This tends to produce the following outcome: if you apply for disability and get denied, you will probably need to go through the appeals process, at least as far as the disability hearing stage, in order to win benefits.

3. The disability determination system is flawed in the sense that adjudicators (disability examiners make decisions on cases at the initial claim and disability reconsideration levels, while disability judges make decisions on claims at the hearing level) do not request detailed statements from treating physicians.

Such statements---known as residual functional capacity statements---have a proven track record with administrative law judges at hearings. Why this is not done as a simple matter of rendering a medical determination on a case is not clear. Perhaps SSA simply does this to contain costs. Many physicians already charge a substantial fee for this, and would likely charge even more if the social security administration routinely sent out requests to doctors for the completion of medical statements.

Return to the Social Security Disability SSI Benefits Blog

Disability in the Various States:

Tennessee Disability
New York Disability
Pennsylvania Disability
Washington Disability