Saturday, August 15, 2009



Review of a Social Security Disability Claim

Here is a recent question left as a comment by "Giftbearer" The comment is reprinted below and is followed by my response to it.

This is not about overpayment, but I wanted to ask you this question someplace recent where you would see it (and it looks like you haven't written about this scenario yet). My situation is this; one disabling condition has improved while it has been replaced with another just as disabling. The State Dept. of Labor (now in charge of Social Security Disability Adjudication in my state) has been reviewing my Disability for close to a year. Wach time I fill out papers and send them back they wait awhile and then come up with yet another hoop for me to jump through. It appears that my case for continuing on Disability is pretty strong so they keep looking for something else, and then something else that they can use to cut off my income. By the way; I'm not sure when the Dept. of Labor was assigned to do Disability Adjudication. In all my previous reviews this was done at the Federal level; not at the State level and only required one set of forms to fill out and was taken care of within about 30 days. I get the impression the Dept. of Labor knows nothing about SSDI regulations and how to apply that policy. Needless to say this is scary and it's as if I'm applying all over again from scratch. I feel like maybe I should get an attorney but don't know how that would be handled fee-wise since I won't be getting backpay, as all I'm doing is trying to retain my current status. There may be others in my same situation who can benefit from this information, so I hope you'll write an article on this topic. Thanks!


Giftbearer,

I am assuming that you are receiving disability and have been receiving disability for some time as you have had prior continuing disability reviews that took thirty days or so to process. Generally, continuing medical reviews are processed in a more timely manner than a year, however many factors could be affecting your disability review's processing time.

Some factors may have nothing to do with your particular claim, as state disability determination agencies across the nation are suffering record attrition with regard to their ability to retain enough employees to process the ever-increasing amount of new disability claims, along processing continuing medical reviews.

To my knowledge, Social Security disability decisions and reviews have always been processed by federally funded state disability determination agencies.

Although,there has been much talk over the years about federalizing all aspects of the disability process, state disability agencies continue to make Social Security medical determinations. And, although states have different agencies handling Social Security disability determinations, the disability examiners receive uniform disability training with regard to the medical and vocational rules used in making Social Security disability medical determinations.

Personally, I feel that your continuing review may be a little bit more difficult to process because the condition that your initial disability decision was based upon has improved. In a way, the disability examiner processing your disability review is making a new disability determination based upon your "new" disability condition.

You may wish to wait to talk to an attorney or non-attorney representative until you receive your continuing disability review decision, but it probably wouldn't hurt to have a consultation either. If you receive a denial due to medical improvement you can request a disability cessation hearing at the state disability agency and ask for benefit continuation while they make a decision.

I can understand your concern since your disability benefit is your livelihood, and with your new condition you are not able to work. Actually, I would not be excessively worried however (though I know full well that it is very easy for someone else to make that statement) as your review may be taking longer because of problems at your local state disability agency.

For example, if the disability examiner who has been handling your disability review has left the agency, your disability review may have been transferred to another disability examiner, and if the new disability examiner finds the information in your file is more than ninety days old they have to redevelop your medical information, thus the continuing request for additional information.

I know that I have provided no concrete answers to your dilemma, however it may be comforting to know that, statistically, far more continuing disability reviews end with a continuance of benefits than a cessation of disability benefits.

In fact, I knew several disability examiners who made off-handed complaints that it was too difficult to cease a claimant's benefits at the time of review---which is just another example of how adversarial the system really is, despite the thin veneer of objectivity with regard to disability claim processing that the social security administration would like us all to believe in.


Return to the Social Security Disability SSI Benefits Blog




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Are you automatically denied for Social Security Disability
Considering applying for Social Security Disability
Who is eligible for Social Security Disability or SSI Disability?

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2 Comments:

Blogger tld said...

I have been diagnosed with Trigeminal Neuralgia and have a 6 inch thick Notebook of all Medical Records as well as Personal Records of Doctor visits, Meds, history of pain. I have applied for Social Security Disability soon after I lost my job of 25 years (which was eliminated after being off on Short Term Disability) the end of October, 2009. I made a copy of my complete file and hand delivered to the Social Security Office after I completed the online Application which I did very vaguely as I could not put all my medical info online. On Nov 23, 2009, I called for a status and found that it was being reviewed by a Medical examiner. I wasn't prepared for what was about to happen. At first, the Examiner was cold and started asking me many questions about my daily activities of what I could and could not do. And what I do all day long. I had a bad night and was in a lot of pain so again I wasn't prepared so I answered the questions but I felt that this wasn't going very well. I continued to ask her if she rec'd my Medical packet and she at first she couldn't find it, but later she found my very large thick packet of Medical Reports. After being on the phone for over an hour and half, she then began to inform me that she was very aware of my condition of Trigeminal Neuraglia and knows that it is the most excruciating pain a person can go through. She said that she understands the pain that I am in. I began to cry and said that it is difficult because not many people know about this and that it is severe pain. I think she started to cry too and she began to tell me about a personal neurosurgeon experience she had and the pain associated with that. I know Trigeminal Neuralgia is not well known but she said that she knows about it. I believe after she saw my records, the mood changed. She was very understanding and said that the only thing I need to do is to go to a Psychologist as I have not seen one for the depression from pain. She said that she would set that up for me and that is all that I needed to do. She said that she didn't need to wait for Doctor reports as I have provided almost all the reports needed. So what I am wondering is, what does this mean as far as my case? Is this a positive sign that my case will be approved? Or am I reading too much into it? I was diagnosed in Aug, 2007 (pain records started Sept, 2006 though) but continued to work until Oct, 2009, when would they consider my start date of disability for payments?

12:56 PM  
Blogger Disability Blogger said...

TLD, I've posted a response to your question here: Social Security Disability Payments Start Date

8:51 AM  

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