Recently, NPR published an article discussing the rise in the number of people on Social Security Disability, arguing that Social Security Disability and Supplemental Security Income are now being used as a “de facto welfare” program for people without job skills and some medical issues. The article can be viewed at: http://apps.npr.org/unfit-for-work/. We would like to take this opportunity to address some issues that were not addressed in the article, and make sure a more complete picture is shown. This 4-part series will be outlining the fight the average claimant has to go through to get on Social Security Disability or Supplemental Security Income, as well as evidentiary and policy issues.
The Timeline – Initial Application and Request for Reconsideration
A person can initiate a claim online at socialsecurity.gov, on the phone with the National Office (1-800-772-1213), or in person with their local district office. The claimant will be asked about their conditions, treatment, work history and all other questions needed to technically evaluate the claim. After a person is found to meet the technical requirements for Social Security Disability or Supplemental Security Income (i.e. having paid enough wage credits into the system and/or having the requisite few assets) their claim is sent off to Disability Determination Services for their respective case for a medical evaluation.
At Disability Determination Services (DDS), medical records get requested from everywhere that you have been treating, that you told Social Security about. Forms are also requested of the claimant about his/her day to day life and past job duties. The claim is then medically evaluated. If not enough information is given, the claimant may have to get sent to a Consultative Examiner (a doctor of Social Security’s choosing to examine the claimant for further information about his/her conditions).
Disability Determination Services tends to average around 2-5 months to process the claim. In more understaffed states, such as Wisconsin, it is not atypical to have an initial claim progressing 5-8 months, and sometimes even longer. All the while, many claimants cannot afford much food, certain necessary medical treatment, or to even pay rent. Some claimants may lose their home during this process, as they are not able to continue working. All the while, they are waiting and hoping that DDS will see what they have been suffering through.
Nationally, 75% of claimants will not receive a favorable decision letter. This means, in 40 out of 50 states, they have 60 days from the denial to file a Request for Reconsideration. This is assuming the claimant understands the 60 day deadline to appeal, or are represented and have someone else who can understand the letter. Many claimants do not understand this, miss their deadline, and have to start back at square one.
For claimants who do understand this, they file the appeal, and fill out an updated form with Social Security, noting new treatment and changes to their conditions since filing the initial application. It then gets sent back to the same Disability Determination Services for a new medical determination, with a different disability examiner. This examiner then requests new records, and sends out any new forms to the claimant as necessary. This process also takes approximately the same amount of time as an initial application.
Nationally, approximately 90% of people who file a Request for Reconsideration are denied. This means that this is simply a 2-5 month (or longer) wait for the next phase for all but one tenth of the people who appeal. All the while, many claimants’ situations are getting more and more dire, as their conditions worsen, they financially struggle to feed themselves and/or their families and continue to struggle to keep a roof over their heads.
By now, many claimants are nearly at, or even past the one year mark since they have started their claim. This may be the reason why 10 states have stopped the Request for Reconsideration phase: Alabama, Alaska, parts of California, Colorado, Louisiana, Michigan, Missouri, New Hampshire, parts of New York and Pennsylvania. In these areas, your next step after the initial application is what is considered step three for all other states.
If denied on the Request for Reconsideration, you have 60 days to file the Request for Hearing.
