1. Question: My neighbor is receiving Social Security disability, but he does not appear to be disabled. I was denied disability, but I am disabled. Why was I denied and he was not?
Answer: This is one of the most frequently asked questions by people who have been denied disability by the Social Security Administration. It is almost impossible to accurately answer the question since the person who asks normally does not know the exact medical and mental conditions of the other person at the time the disability was awarded. Also, the person asking the question usually does not know the exact reason why the person was awarded disability. Without knowing the facts and circumstances of the neighbor’s disability, the question cannot be answered. If the person asking the question suspects Social Security fraud, the Social Security Administration asks that person to report the fraud by visiting: http://oir.ssa.gov/ or by calling the Inspector General’s Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).
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2. Question: What are my chances of winning my Social Security disability case?
Answer: As everyone knows, no one can give a guarantee of winning a disability case. For the same reason, there is no certain method as assessing the percentage of whether a disability case will be won or lost. There are statistics kept by the government regarding the percentages of case which were awarded disability and those which were not award disability. For example, at the initial application level, about 1/3 of the application are paid or awarded disability, and about 2/3 are not awarded disability. The next step on the appeal ladder is asking for a reconsideration. At the reconsideration stage, in Indiana, about 4% of the persons asking for reconsideration are awarded disability. 96% of the people asking for reconsideration are denied. The next step on the ladder is the hearing stage. At this stage, on average, between 40% to 60% of the persons going to a hearing are awarded disability benefits. The final stage of the administrative process is a review by the Appeals Council. At this last stage, about 18% of the persons asking for a review have their cases sent back for another hearing (this is called a remand), less than 1% of the persons seeking review at the Appeals Council are awarded disability benefits and 82% of the persons seeking review are denied.
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3. Question: Should I hire an attorney to represent me applying for disability or appealing a denial?
Answer: Yes. The statutes, regulations, rules, and rulings are complex, numerous and sometimes difficult to understand. An attorney who is experienced in practicing Social Security disability law can assist a person in understanding the rules as they apply to your case, prepare and develop the case, present evidence, question witnesses and argue your best case.
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4. Question: What does an attorney charge?
Answer: If an attorney accepts your case any fee which the attorney charges must be approved by the Social Security Administration. The fee agreement must be in writing and signed by the client. While some cases vary, the typical fee, at the administrative level, is the lesser of 25% of the past due benefits or $6,000, whichever is less. Normally, there is no fee charged if the case does not result in an award of past due benefits.
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5. Question: How long will take for the Social Security Administration to decide my case?
Answer: At the initial stage, it usually takes about 90-120 days. At the reconsideration stage, the average time is between 60-90 days. Once a hearing has been requested, the average wait for a hearing at the Office of Disability Adjudication and Review is between one and a half to two years. At the Appeals Council level, the average time is about a year and a half from the time a review at the Appeals Council has been requested.
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5. Question: How long will take for the Social Security Administration to decide my case?
Answer: At the initial stage, it usually takes about 90-120 days. At the reconsideration stage, the average time is between 60-90 days. Once a hearing has been requested, the average wait for a hearing at the Office of Disability Adjudication and Review is between one and a half to two years. At the Appeals Council level, the average time is about a year and a half from the time a review at the Appeals Council has been requested.
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6. Question: Why does it take so long to have a hearing?
Answer: Lack of government resources. The office workers, the technicians and the administrative law judges all work very hard. Unfortunately, the hearings offices, nationwide, have a high number of cases to consider and low numbers of staff and resources with which to process the cases, get them ready for a hearing, decide on whether to ask for additional evidence, decide on whether to call expert witnesses at the hearing and if so, who. There are a limited number of hearing judges and a limited number of slots available on a weekly basis. These things delay the hearings. Once the case has been heard, it must be decided and then written. There are a limited number of decision writers who write the decision for the administrative law judges’ review, so cases are held up at that juncture as well.
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7. Question: Is there any way to make my case go faster?
Answer: Yes. There are some things to help it go faster. At the initial application stage, it is important to complete all of the sections as accurately as possible. The section on the initial application which many people have a difficult time is the medical history section. In fact, some people become so overwhelmed in trying to complete this section that they leave it blank! If the section is not completed the Social Security Administration will deny the claim. The person is then faced with filling a new application and causing a delay. Another important thing to remember is to attend all examinations set by Social Security timely. These examinations usually are a physical or a mental status evaluation. Sometimes the Social Security Administration will send a claimant out for testing such as a breathing test or imaging studies. It should go without saying that it is important to appear at the time and place of the scheduled hearing on time.
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8. Question: Can my special circumstances cause my application to be decided more quickly?
Answer: Yes. The Social Security Administration is aware that its system deciding disability claims is very slow. Here are some of the ways a person’s special circumstances can make the case be decided more quickly:
Wounded Warriors and Veterans. Military service members who have received a compensation rating of 100% permanent and total or a veteran who has a VA compensation rating of 100% permanent and total can receive expedited processing of applications for Social Security disability applications. (For more information see https://www.ssa.gov/people/veterans/)
Compassionate Allowances Conditions. There are some medical conditions (many of which are deadly types of cancer) which the Commissioner of Social Security believes will result in a finding of disability. If a person who applies for Social Security disability and has one of these conditions, they are entitled to expedited processing. For a complete list of those conditions see https://www.ssa.gov/compassionateallowances/conditions.htm.
Terminal Illness. If a person’s condition has been determined to be a condition which is irreversible, non-treatable and will result in death then that person is entitled to special processing. (https://secure.ssa.gov/poms.nsf/lnx/0411005601).
Dire Need. If a person has no food and is unable to obtain food, or has no medicine or medication and cannot obtain either, or is without shelter, then that case will be entitled to expedited processing. (https://www.ssa.gov/OP_Home/hallex/I-02/I-2-1-40.html.) The decision about whether a case is a “Dire Need” case is one which Social Security has had a lot of experience. Many times, Social Security will ask if a mission or a homeless shelter are available in the community where the person lives. Often the Social Security person deciding whether the case is a “Dire Need” case will require that the person submit a letter explain why the homeless shelter will not accept that person. If a person is staying with relatives or friends, then that person is not considered homeless.
Potentially Violent. If the claimant is homicidal, suicidal or potential violent, then that person’s care will be expedited. (https://www.ssa.gov/OP_Home/hallex/I-02/I-2-1-40.html.)
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