Friday, May 23, 2008



Decisions on Disability Applications - Fully and Partially Favorable

Most individuals who apply for disability naturally assume that there are two types of decisions on disability applications: disability denial and disability approval.

And, for the most part, they are correct. At the intial claim level and at the request for reconsideration level, there are two outcomes, approval and denial.

However, at other steps in the social security disability process, there are decision types that you don't ordinarily hear about. One is the technical denial. This is a type of denial that occurs before a SSD case or SSI ever gets to DDS (disability determination services). That's because it never does get to DDS. A technical denial occurs when a claimants applies for disability at a social security office and it is quickly learned that the applicant is simply ineligible.

What would make you ineligible before your medical records are even gathered and looked at? Well, for SSI, if you have assets exceeding $2000.00, you are automatically ineligible for SSI disability, simply because SSI is a need-based program. For SSDI (social security disability insurance) OR SSI, however, a person could receive a technical denial if, at the time they apply for disability, they are working and earning more than the current limit for SGA.

At the disability hearing level, there are also two basic outcomes (approval and denial), but with a "twist". Claimants who are approved by a disability judge may receive a favorable notice of decision, but this notice may be either A) Partially Favorable or B) Fully Favorable.

What's the difference? If your decision is fully favorable, this means that the judge has granted disability benefits back to the AOD. AOD stands for alleged onset date and this is the date you claim your disability began. If your decision is partially favorable, this means the judge has granted you disability benefits, but not completely in agreement with when you believe your disability began.

In most cases, a partially favorable decision will be one where the judge has read the evidence and believes that the claimant became unable to work at the SGA level on a date later than the one stated by the claimant. In a small percentage of cases, however, partially favorable means that a claimant will not receive ongoing monthly disability benefits, but, instead, will only receive benefits for a specific and finite period in the past. This is known as a closed period and it essentially means that the judge has decided that you were at one time disabled, but are no longer disabled according to social security disability criteria.

And, finally, of course, there are Unfavorable notices of decision, meaning that an ALJ has denied a claim. What happens when a judge denials a case? The claimant can

1. Give up.

2. Request a review of the ALJ's decision (this is the appeal involving the appeals council).

3. File a brand new claim.

4. File a brand new claim and simultaneously send a request for review off to the appeals council.




Return to the Social Security Disability SSI Benefits Blog



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Who is eligible for Social Security Disability or SSI Disability?
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How Does Social Security Decide Your Disability Claim ?

4 Comments:

Blogger sweety said...

hi!my name is sweety1269 i just wanted to ask a question.i was fully approved for my ssi case i was wondering when my backpay was suppose to start,i already spoke with my case worker over the phone for my interview,to start my paperwork ive already received my copies back in the mail,is this when i can be looking for my backpay,as well as my check on the first also.do they pay you a lump sum or installments for ssi,how does this work.HELP!

2:08 PM  
Blogger Disability Blogger said...

Hi, I always people to call their D.O. or F.O. (district office/field office) on these issues because one little detail can make a difference sometimes. However, I'll address the question in general terms on a post.

Here's the url:

SSI Back pay Question

9:32 AM  
Blogger Rager65 said...

Thanks so much for this Blog...it has been very informative to me throughout this entire process.

My questions: I received a partially favorable decision. I originally filed with a lower back problem but sometime last year SSA sent me to see a psychologist because of depression issues. The psychologist diagnosed me with major depressive disorder assigning a GAF of 55. I don't even know what a GAF is to be honest. The vocational expert says there are no jobs in the national economy that I could perform. So the ALJ's decision set my beginning disabled date to February 2008. My attorney says I should appeal. I am worried because I don't want to get the decision reversed on appeal to where I don't receive any benefits. I am wondering if in the future it is possible to add my back troubles on as an addition and just forget about the back pay my attorney wants to go after.

Regarding my back problem, the records in this letter are wrong...should I worry about correcting them?

The ALJ also says in the letter that the claimant's earnings record shows that the claimant has acquired sufficient quarters of coverage to remain insured through December 31, 2011. Thus, the claimant must establish disability on or before that date in order to be entitled to a period of disability and disability insurance benefits. Does this mean that I will be cut off after this date?

Also wondering if my monthly benefits will be less because this is only partially favorable and for depression?

It is so difficult to get any answers for these issues. I would be so appreciative if you could answer.

4:28 PM  
Blogger Disability Blogger said...

Hi Rager65, I posted a response to your comments on this page:

I see several questions so I will answer each of them individually

7:46 AM  

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