Social Security disability determinations normally take a long time. Most can expect your Social Security disability case to progress through three different stages before approval.
The stages are (1) the initial consideration stage, (2) the reconsideration stage, and (3) the hearing stage.
Initial Consideration
The first thing you need to know about the initial consideration phase is that you need to get it started as quickly as possible.
You start the initial consideration phase when you call or go down to your local Social Security office to apply for benefits. If you don't know who to call, then call us and we will help you.
The agent at the Social Security office will take your personal information -- things like your Social Security number, your date of birth, your address and telephone number.
The agent will also ask you the date when you first became disabled. For most people, this is the day you last worked.
The date you became disabled, or your "date of onset", is important for several reasons. First, your eligibility for benefits under Title II, will be calculated starting with the sixth month following the date you first became disabled. If you have been eligible for Title II benefits for two years, then you are also eligible for Medicare.
Also, your back-benefit is calculated from the date of your eligibility. You can think of your back-benefit as the "back pay" that Social Security should have been paying you.
How much of that back benefit you get depends on when you apply. If you apply for benefits within a year of becoming disabled, and the Administration agrees with you about your date of onset, then you should get all of your back benefit. In some cases, that is a substantial sum of money.
You will not get paid for back benefits that accrued more than a year before your application. That is why it is important to apply as soon as possible. As soon as you are pretty sure that you won't be able to go back to work for at least a year, you should apply for your benefits.
The second thing you need to know about the initial consideration phase is that most people get turned down for Social Security benefits at the initial consideration stage.
Nationwide statistics suggest that the denial rate is between sixty-five and seventy percent. You should return the packet we sent you as quickly as possible so that we can help enhance your chances of getting approved at the initial stage. (There are, of course, a few obvious cases in which a potential client is almost certainly assured of getting their benefits approved. In those cases, it would be unethical for us to accept a fee. In those cases, you need to use the Social Security local office locator to find your local Social Security office's telephone number. If you get approved, please drop us a note to let us know. Any services we may have provided will be pro bono (free). In those cases, you need to return the signed packet only in the unlikely event you get denied.)
However, unless we tell you that you are almost certain to get your benefits approved, you need to return the packet as quickly as possible. We can help you enhance your chances of getting approved at the initial stage, and if you don't get approved, we can make sure your case moves into the [next stage] in the best posture possible for success.
Again, expect to get denied at the initial consideration phase.
The most important thing for you to remember at the initial stage is to stay positive. When you get your first denial letter from the Administration, come back to this website, come back to this page and remind yourself that your attorney told you to expect it. It's just the first step in the process.
For so many of our clients, our encouragement at the first stage is almost a cruel joke. You've been out of work so long, you are suffering so severely from your physical or mental impairments (and even if you were psychologically fine before you became physically disabled, by now you are probably suffering from what mental health professionals call "situational depression").
We understand that denial at the first stage leaves you feeling defeated and disheartened. YOU know you can't work and you know EXACTLY what physical or mental impairments keep you from working. But the people at the Social Security Administration don't seem to be listening to you. This is surprising to you because you probably had a positive experience with the Social Security agent who interviewed you.
When you applied for your Social Security benefits, you went down to the local Social Security field office to apply, you applied online, or you spoke on the phone with an agent at the field office. The agent was probably encouraging, and then you were crushed when you got the letter denying your benefits.
First, don't feel like the Social Security Administration is against you. Most of the work at the initial stage is not done by the United States Social Security Administration. The people at your local Social Security Field Office have little say over whether you get you benefits at the initial phase. Federal law doesn't even allow the Administration to review the facts of your case. The law requires the Social Administration to submit your case to an agency of your state, which is where the initial decision is made.
In Georgia, your case will be referred to the Disability Adjudication Section (the "DAS" for short) of the Georgia Department of Labor's Rehabilitation Services division. In Florida, your case will be referred to the Florida Department of Health's Division of Disability Determinations (the "DDD" for short).
Most people who apply for Social Security disability benefits get denied at the initial consideration phase by their state agency, not by the United States Social Security Administration. One explanation is that while the Social Security Administration has a built-in institutional bias in favor of getting benefits to people who qualify for them, the state agency that reviewed your claim has a built-in institutional bias that favors putting people back to work.
The institutional bias is explicitly stated in Georgia, where the DAS is a section of Georgia Department of Labor's Rehabilitation Services. On its website, Rehabilitation Services specifically states that it "operates five integrated and interdependent programs that share a primary goal -- to help people with disabilities to become fully productive members of society by achieving independence and meaningful employment."
This is not a bad thing, in theory at least. In fact, it's wonderful to have a state agency with the primary goal of helping people with disabilities find jobs. But it makes problems for you when you have the burden of proving that you are no longer able to do ANY job that is available in the national economy. The fact that you have applied for Social Security benefits inherently implies that you have recognized yourself to be past the type of help that DAS's parent division holds as its primary goal.
You have probably been trying to work for years, suffering the humiliation defeat of being pressured by employers to retire, being first in line for layoffs, and never getting call-backs or follow-up interviews from prospective employers. After months and years of soul-searching, you've come to the ultimate decision that despite your desire to work -- despite your desire to be productive member of society -- engaging in substantial gainful activity is longer part of your life, and it has not been part of your life for a long time.
(By the way, disability does not mean that you're life is over. It just means that you're not able to make a living. You might not be a productive member of economic society anymore, but you can still lead a full and active life. This website is an on-going project, and in the future, I hope to have pages dedicated to the stories of particular clients who, after getting their Social Security benefits started, have been able to lead happy, meaningful lives despite the burden of disability.)
For now, however, you've made the huge decision to resign yourself to the fact that you can no longer participate as a productive member of economic society, and now DAS is telling you that it's goal is to help you find a job?
If it seems to you like the system is designed to discourage you from going forward, then your suspicions may be correct.
There is a basic and easily understandable political theory that underlies the built-in conflict between federal and state agencies: the checks and balances inherent in the separation of powers. If you put power centers in conflict with each other, you prevent each power center from becoming too powerful. While the Founding Fathers designed the federal government with checks and balances in mind, the administrative apparatus that has grown up around the federal government over the centuries does not have internal, built-in checks and balances. When Congress created the Social Security Administration as part of the New Deal, it began to follow the path of development that bureaucracies have always followed throughout history. It has done the job that Congress assigned it, but like all bureaucracies it expanded the scope of its influence to the fullest conceivable limit of its legislative mandate.
That's what the political pundits mean when you see them on the news talking about the expansion of "entitlements." The system is doing what it is supposed to do -- it is increasingly getting better at getting benefits to those who qualify for them.
The political theorists' "solution" to what was actually the success of the Social Security system was to mix checks and balances into the recipe. The Social Security Administration's institutional bias in favor of providing benefits to those who quality has been pitted against the institutional biases of state agencies that favor helping people find jobs.
The Office of Disability Adjudication and Review (ODAR) was created to act as a "third estate" charged with resolving the disputes between these opposed institutional goals. But I am jumping ahead. If you are turned down on initial review, our ultimate goal will be to take you to a [hearing] before an Administrative Law Judge. However, before we can get there, we have to go through the [reconsideration phase].
Reconsideration
The reconsideration stage is more like a courtesy to your state's agency than anything else. It is like a opportunity for them to get it right.
Ultimately, it is a step in the process that you probably won't even notice. For you, it will just seem like the calendar is running.
For the most part, it is an opportunity for a second set of eyes at the state's agency to review the file to determine whether the first set of eyes made a mistake. Approximately 85 percent of the time, the state's agency responds to the Social Security Administration that it did not make a mistake.
Nevertheless, the reconsideration phase gives us an opportunity to review your file to make certain that the state agency got all of your medical records and included them in your Social Security file. We can alert the agency to the absence of important records, help the agency get the records if the health care provider is being difficult, or even obtain the records ourselves and provide them to Social Security.
Hearing Stage
Under Construction
