When deciding to file a case for Social Security, most individuals are not aware of how the process works. Completing an application and filing your claim correctly can be overwhelming and time-consuming. Having no prior knowledge of how the Social Security Administration operates may cause problems that can prolong or possible cease your claim.
Diane came into the office with a story that demonstrates how easily you can fall into the pit falls of the SSA. Diane filed her claim with the understanding that she could likely wait for two years to receive a decision on her claim. Eighteen months after filing she did not hear a word from the Social Security Administration. Diane finally called SSA to find out an update on her case. According to the Social Security Administration, they had sent Diane a form requesting additional information. She never received the form so in consequence her case was dismissed for failure to respond. Diane was understandably disheartened to find out that all her work and the long wait had been ineffective. This meant she would have to start the process all over.
Unfortunately, I have heard Diane’s story many times. Applicants rely on the Social Security Administration for information. The advice they receive is not always reliable or credible. When claimants count on the only source they know, they become vulnerable to oversights and even mistakes. Misunderstandings which can cost them their case. With Diane’s case, I was able to find out that her case had been halted early on. What should have taken two weeks to resolve, had been prolonged. I was able to find out what Diane needed to get her case back on track. I submitted the information SSA had requested which subsequently progressed case, ultimately Diane won her case in four months.
Diane was unacquainted with the system and relied on the instruction she had received. Understanding the Social Security Administration and how it operates is key component to having a claim move along as quickly as possible. There are multiple levels and stages that a claim goes through when it enters the Social Security Administration. Within each stage, there are several steps that must be taken before a claim can be advanced to the next level.
The first process is the initial claim (IC), a claim is filed with the local field office via telephone, online or in person. The local office uploads the claimant’s information and performs a financial background to determine if he/she meets criteria for a disability claim. If the requirements are satisfied for either Supplemental Security Income (SSI) or Disability Insurance Benefits (DIB), the file is sent to the State Agency also known as the Disability Determination Service which is in Austin.
At this next level, the State Agency (DDS) does all the medical evaluations. An “examiner” decides if the claimant meets medical criteria for disability. This stage can get tricky, because examiners will usually request additional information. Information from the claimant, medical records from Doctors, hospitals, clinics and any facility that was given by claimant. The examiner may also schedule a consultative examination with the claimant. When SSA requests this information, they do it by mail and if the claimant fails to receive or send back the appropriate information, this is where a claim can get delayed or postponed. The initial claim (IC) process takes about 4-5 months.
If an applicant’s claim is denied at this stage, there is a recon process (RC) which is basically an appeal to the denial. The case is then resent to Austin for quality review. A new examiner will look over file and give a second opinion. Again, they may request additional information during this process. Reconsideration (RC) stage takes about 3-4 months.
The next level, if claimant is denied a second time is the hearing process. The claimant will file a request for hearing before an administrative judge (ALJ). This is the longest process there is. This request process level takes anywhere between 12-18 months to get a date scheduled. Under special circumstances a request to expedite the claim can be made in this stage. A letter with additional proof and information is submitted with this request.
Understanding these levels and stages is not enough. Having an attorney on your case who has the expertise and knowledge on how the Social Security works at every degree can be crucial. Following a case at every level and micro stage on a weekly basis is a vital way to avoid any delays. A well-equipped attorney can handle any claim that has been flagged or halted. Additionally, an attorney will call and ask questions to pin point what level and at which stage a case is at. Furthermore, if at any point of the case, misconduct or mismanagement is taking place with regards the Social Security Administration or in obtaining medical records, an attorney will know the appropriate steps to follow to resolve such issues.
For claimants like Diane who are not aware of what happens behind the Social Security Administration curtain, it can look especially complex or complicated. Facing this dilemma, an applicant can easily hit stumbling blocks. More so, if you are in desperate need of Social Security benefits. It can be frustrating to find yourself stuck in a system you’re not familiar with while being overwhelmed by your disabilities and financial strain. Having an attorney who knowledgeable with the Social Security system can undoubtedly speed up your case.When looking for an attorney, ask the questions that can be pivotal to winning your case. Does the attorney have experience working with the Social Security Administration? Does he conduct inquiries on claims regularly to see how case is progressing? Does he know what steps to take to resolve issues that may come up? Can he troubleshoot and undergo an investigation to correct and resolve claims that have been prolonged?