The Social Security Disability Process: Part 1

This article is part of a two part series on how to navigate each step of the Social Security disability process.  In this article, we cover determining what disability program fits your situation, and the steps needed to take if you were denied benefits.  Part 2 discusses what to expect at the Request for Hearing stage, including pre and post hearing.

The Initial Disability Claim

The Initial Claim stage is the very beginning of the Social Security Disability process. Before even submitting an application, you must determine  which type of social security that you qualify for.  There are two different types of social security benefits. One of which is called Disability Insurance Benefits (DIB), also known as Title II benefits or Social Security Disability Insurance (SSDI). The other of which is called Supplemental Security Income (SSI) or also known as Title XVI benefits.  Keep in mind, there is a chance that you may qualify for both. Once you establish this, you can file for your disability claim which includes a disability report.  The application, along with the disability report, will then proceed to a local social security office nearest you. The local office only determines if you qualify for Social Security Benefits.  This means that the local office does not determine if you are medically disabled.

If you qualify on technical terms, your claim will then be sent to the DARS Division for Disability Determination Services (DDS). DDS is responsible for deciding if you are considered medically disabled. At this time, DDS will also request two more forms, a work history report and a function report. DDS may ask you to attend a medical appointment (physical or mental) with a doctor that social security provides for further determination. This doctor's appointment is mandatory. Also, DDS will request all of your previous medical records necessary to prove that the disabilities you listed are true. During the initial claim level, law firms are not responsible for ordering medical records. , Lastly, DDS will make a decision determining whether or not you are considered disabled.

After the medical determination, your case will be sent back to the local office where they will occasionally do a quality review. The local office will then send you multiple letters regarding the decision and the amount you will be awarded. For your case to be won at the initial claim level, you must be considered disabled both financially and medically.  If you receive an unfavorable decision, you may appeal the decision and proceed forward to the next level called the reconsideration level. It is important to keep in mind that 80% of people are denied during the initial claim level, therefore, it is encouraged to continue on in the Social Security appeals process

Social Security Disability Reconsideration

The first step of the appeal process is the reconsideration level. This, as the name applies, asks the Social Security offices to reconsider your case. Now that you know what type of disability you are applying for (SSI or SSDI), you may go right into the appeals process. You will send the application along with the disability report, just like before, to the local Social Security office. The local office will then determine if you qualify for benefits based on the technical definition of disabled, and if the office determines that you do, they will send your application to DDS.

DDS is responsible for deciding if you are considered medically disabled. At this time, DDS may also request two more forms, a work history report and a function report. At this level though, DDS does not usually ask for the work history report again because they assume that it has not changed. DDS may again ask you to attend a medical appointment (physical or mental) with a doctor that social security provides for further determination if you do not have sufficient medical documentation concerning your medical diagnoses. This doctor's appointment is mandatory. Also, DDS will request all of your previous medical records necessary to prove that the disabilities you listed are true. Lastly, DDS will make a decision determining whether or not you are considered disabled.

After the medical determination, your case will be sent back to the local office where they will occasionally do a quality review. The local office will then send you multiple letters regarding the decision and the amount you will be awarded. For your case to be won at the reconsideration level, you must again be considered disabled both financially and medically, as defined by the Social Security Administration (SSA).  If you receive an unfavorable decision, you may appeal the decision and proceed forward to the next level which will be the hearing level. Do not become discouraged if you receive a denial at this level, because only about 10% of cases at the reconsideration level are granted. It is encouraged to continue on in the appeals process, because you have now reached the hearing level. You will finally have the opportunity to explain your disabilities in person.

 Part 2: Request For Hearing Stage

 

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