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Decision and Appeal
It is important to understand how the government decides if you are eligible for Social Security Disability benefits. With this knowledge, you can present your application in the best light possible. You should also understand your appeal rights if you fail to receive a favorable initial decision. An experienced attorney can answer your Social Security Disability benefits questions and help you through all levels of the qualification process.
The Initial Application
The entire process of the initial determination of disability can take three to five months. Following the receipt of your application for disability benefits, a Social Security representative will review the information you have provided. If he or she is satisfied that the application meets certain basic criteria, he or she will forward the application and evidentiary materials to the state vocational rehabilitation agency charged with making a decision regarding your disability. Social Security works in tandem with a state vocational agency in every state.
The state agency may gather more evidence to further develop your file. Most state agencies employ doctors to review your medical records and collect additional information from your treating doctors. The agency may also send you to a doctor for a consultative examination.
The Standards Used to Determine "Disability"
The Social Security Administration uses a five-step sequential evaluation process to determine if you are "disabled" according to its standards and definitions.
- Are you working?
Generally, if you make more than $900 per month on average (as of 2007), you will not be found to be disabled. If you are not working or make less than $900, the state vocational agency will analyze your medical condition at step two.
- Is your medical condition severe enough to render you disabled?
The medical condition must "significantly limit your ability to do basic work activities" for at least one year to qualify you as disabled. If your condition is not found to be severe, you will not be found to be disabled. If your impairment or combination of impairments is sufficiently severe, the agency will proceed to step three.
- Is your impairment on the List of Impairments that the government considers so severe that a person with a listed impairment is automatically found to be disabled?
If not, does the severity of your condition equal that of a listed impairment? If your impairment meets or equals a listed impairment, you will be found disabled; if not, the agency will continue to step four.
- Does the disability leave you unable to do the work you did before?
If you can still do your previous work, you will be found not to be disabled. If you cannot return to that type of work, the agency will consider step five.
- Can you do another type of work?
For this analysis, the agency will examine your age, education, past work experience, job-related skills, and medical condition to see whether you could adjust to different work. If you can do other work, you will not be considered disabled. If you cannot adjust to new work, you will be considered disabled.
These rules vary for blind applicants.
You will receive a letter of confirmation or rejection. If you have been found eligible for benefits, this letter will include the amount of the payments you will receive. If you are found not to be eligible, you may appeal the adverse decision.
Appeal
You have the right to appeal the decision. In most jurisdictions, the first level of appeal is called a reconsideration during which your file is reviewed again by the state agency. The next appeal goes before an administrative law judge (ALJ) for a hearing at the Social Security Office of Disability Adjudication and Review (ODAR). Following this stage, you have a right to appeal to the Social Security Appeals Council. Finally, you may appeal to the federal courts. Obviously, an attorney can greatly assist you at all levels of the appeals process.
Conclusion
All levels of the Social Security Disability benefits process can be time consuming and complex. An experienced attorney can answer your Social Security Disability benefits questions and help you through all levels of the qualification process.
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DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.
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