SSA: Changes to New Applications

 

07/31/18:  Upcoming Changes to SSA New Applications in West Alabama/Birmingham

Summary: The Social Security Administration (SSA) intends to make some  changes to how individuals file for Social Security Disability (SSDI) and Supplemental Security Income (SSI).  Once individuals are denied benefits for their initial application they no longer have the option to file a Request for Hearing by Administrative Law Judge. This includes roughly 7 out of every 10 people who apply.  Hence, claimants will go through the additional step of a Request for Reconsideration (Recon).  If you have any questions about initial applications or the Recon process, feel free to contact my office for a free consultation.

Hourglas time running out

There is a chance to win your SS case faster!

This is a chance to win your case early!

A Recon allows SSA some additional time to review updated documentation provided by the claimant or his representative.  If SSA receives adequate documentation to overturn the initial denial, an award of benefits will be granted to the disabled claimant.  This is an important step in the process. It gives sick and injured people an opportunity to develop and resolve their claim, quickly!

I have discussed the switch from hearings to Recons with an Assistant District Manager in Birmingham.  For now, SSA’s goal is to process a Recon decision within 90 days.  As a result I expect the average time to lengthen as the workload shifts.  It will be even more important to identify what documentation SSA needs to make a favorable decision and award benefits to those in need.  Below you will find a couple of examples of my typical clients and some tips on how to document a claim at the Recon level.

Doctor checking blood pressure

A specialist doctor can help proof your case

Example I:

A female professional, age 41, suffering from rheumatoid arthritis.  She reaches the point at which time continuing to work is causing more harm than good.  She is starting to have joint deformity, chronic pain, and fatigue.

Inflammatory arthritis is a difficult condition to treat.  Conditions like rheumatoid arthritis, lupus, and connective tissue disease have unusual symptoms.  They tend to come-and-go. Thus it can be difficult to prove why you are completely disabled from one day to the next.

It is important to remember that SSA’s primary determination is whether you can perform full time work.  They do not simply review your claim and decide what you can do on your best day. It’s what you can do five days a week, four weeks a month, and for one full year.

At the Recon level, the above example becomes tricky.  How can we document a condition that waxes and wanes?  Certainly it is a good option to consult with a specialist. This should be a rheumatologist or maybe a joint specialist or surgeon.  We can focus our efforts in obtaining what SSA calls “Longitudinal Medical Evidence”.  That’s a fancy word for how your conditions affect you over a long period of time.  A specialist can provide an opinion on how your chronic conditions affect you. And this not just on your good day but also your bad days as well.

Example II:

A male life-long worker, age 55, with a recent injury requiring surgery. Therefore he is unsure of whether to try to return to the workforce or file for disability.  This one is easier than it sounds.  Ask your doctor.

After catastrophic injuries, it is important to ask your physician about the timeline for how long it will take for you to return to full health.  If your doctor expects you to have a lengthy recuperation period, it may be best to file a claim for disability.  But beware, these types of cases have some of the highest rates of denial for initial applications.  This is because the SSA must receive documentation that your disabling condition is expected to last one full year, at least.

The Recon level, after an initial denial, is an important step for individuals who have been denied due to inadequate evidence confirming disability for a year. By the time many claimants reach the Recon level they have probably been out of work for almost a year.  Should a physician provide an opinion that you remain disabled at the one-year mark, there is a chance SSA will have the documentation needed to award disability benefits.

 

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