At Premier Disability Services, LLC, we provide complete assistance throughout the Social Security Process. Whether you’re filing for the first time or have an ongoing claim, we can improve your chances of obtaining benefits with our years of experience and our services. Below you will find an explanation of the entire process of filing for disability benefits. As you will see, doing this without expert help can result in the loss of cash and health benefits you have earned through paying Social Security taxes.
The New Disability Application Process
The process of filing for Social Security Disability begins by filing an application. The full application consists of over 25 pages of questions. After the application is completed, Social Security will prepare and send an application summary and an authorization to receive medical information form to the claimant. The claimant will need to confirm the accuracy of the information, sign the medical release, and return the forms to Social Security.
During the next step in the application process, Social Security will confirm that the technical qualifications are met for the claim. These include current earnings and past work credits for Title II and current earnings and financial resources for Title XVI.
Once technical qualifications are met, the claim will be sent to the Disability Determination Services (DDS) Offices. (This state agency is used by Social Security to determine if the medical conditions meet Social Security standards for disability). They will also send questionnaires to the claimant and schedule a consultative exam to gather more information.
Questionnaire: The questionnaire(s) that the DDS office sends vary based on each claimants conditions. Typically they ask the claimant how their conditions limit their ability to work and affect their activities of daily living. They may also send a Work History questionnaire. This questionnaire asks about the activities that were a part of past jobs. It is used to review the differences between how a claimant was asked to perform their job, compared to how the job is defined within an occupational base.
Consultative Exam: If DDS has insufficient medical evidence to make a determination they will set up a Consultative Exam. These are exams that the DDS office sets up with physicians to examine a claimant regarding the specific conditions that interfere with their ability to work. They are not intended to treat and are typically very short. It is not uncommon that these reports come back unsupportive, which is why we recommend that claimants treat for their conditions regularly with their own physician.
Once all relevant medical and vocational information is received by the DDS examiner, the claim will be sent for a medical decision. After the decision is reached the claim will then be sent back to the local Social Security field office. If the medical portion is awarded the claim will be sent to a payment processing center to process the payments and send out the award letter and benefits statement. If the claim is denied a Notice of Denial letter will be sent.
Appeal and Denial Process:
The reconsideration stage uses the same process as outlined in the new disability application process. Once all steps in the process are completed, the claim will be reviewed for disability determination. Although the same state agency will determine disability, the individual that makes the decision must be different than on the initial application. The process to appeal a denied application involves the completion of a series of questions. The next step in the process is determined by the state you live in. You will either move to the reconsideration or hearing level. Social Security only provides 60 days to file an appeal.
The hearing stage is your opportunity to see an administrative law judge to argue your claim. Once you file your appeal, a judge will contact you after approximately 12 months to schedule an in person hearing to review your medical documentation and question you about how your conditions affect your ability to work. The primary reason it takes about 12 months after your appeal is filed to get a hearing date is because of the backlog of cases waiting ahead of you. It is important not to give up because starting over can result in loss of benefits in some claims.
The Appeals Council
If your disability claim is denied after a hearing in front of an Administrative Law Judge, you have the option to file a Request for Review with the Appeals Council. An appeal to the Appeals Council must be filed within 60 days of the hearing decision.
The Appeals Council is located in Falls Church, Virginia. They are comprised of approximately 68 Administrative Appeals Judges, 42 Appeals Officers, and several hundred support personnel. Upon reviewing your appeal, the Appeals Council will take one of the following actions:
- Deny the Request for Review.
- Remand the case to the Administrative Law Judge (return the case back to the ALJ for a new decision), or
- Issue a new decision and award disability benefits on your case.
In the event that the Appeals Council denies your request for review or you disagree with their decision, you will have 60 days to file an appeal in federal court.
Federal Court Appeals
You have the right to appeal the Social Security Appeals Council’s refusal to review your case or enter a reversal of the unfavorable determination by the Administrative Law Judge. Under these circumstances, you must file a civil complaint against the Social Security Administration in the United States Federal District Court.
You have 60 days from the date of the Appeals Council’s decision to file your complaint in the appropriate federal court. It is important to note that filing a civil complaint in federal court is the last stage of the appeal process. Consulting with an attorney or advocate experienced in handling federal court appeals is particularly beneficial at this stage of the appeal process.
Premier is committed to ensuring our clients are aware of benefits and compensation that they may be entitled to in all areas.
Military Service Related Disability:
Military Veterans may be eligible for benefits from both Social Security and the Veterans Administration. More than 1 out of 5 individuals receiving Social Security Disability payments has served in the military and our company is committed to ensuring our clients are aware of all benefits they may be entitled to. The men and women who served our country suffer from a wide range of physical and mental health problems. Premier Disability Services, LLC provides assistance to Military Veterans toll free at 1-888-878-4368 .
Medicare is a health insurance program for individuals older than 65 and those with disabilities. Medicare beneficiaries may have choices for receiving health care services. There may also be additional benefits for which you may qualify and we are here to take that extra step to make sure you are not lost in the process. Call us if you have questions about Medicare at 1-888-878-4368 .