Over 64 million Americans collected Social Security benefits in 2020. Social Security benefits keep up with the increase in the cost of living. These benefits provide a valuable source of income and health insurance to those workers who have become disabled.
If your initial application for SSDI benefits is denied, you have the option of filing an appeal. The first step in the process of appeal is a request for reconsideration. Many applicants make the mistake of filing a fresh SSDI application rather than filing a request for reconsideration of an existing claim. Do not let that happen to you!
If you file a fresh claim, you most likely will not be entitled to all of the back pay had you appealed. If you request for reconsideration and are successful in getting disability benefits, then typically you can receive more backpay than if you had started over.
THE PROCESS OF DISABILITY DETERMINATION
There are generally four levels in North Carolina in the administrative process for Social Security disability benefits:
- Initial Application
- Hearing before an Administrative Law Judge, and
- Appeals Council
It is in the claimant’s best interest to enlist the services of a North Carolina Social Security disability lawyer who is skilled and experienced at handling various issues that may arise throughout the application process. Attorney Charlie Hall has successfully handled hundreds upon hundreds of disability claims in North Carolina.
SOCIAL SECURITY ADMINISTRATION (SSA)
The Social Security Administration (SSA) is an independent agency of the US Federal government. It administers Social Security benefits and has a budget of over a trillion dollars. It employs more than 60,000 individuals.
WHO PROCESSES AND DETERMINES YOUR INITIAL APPLICATION FOR SOCIAL SECURITY DISABILITY INSURANCE (SSDI) BENEFITS?
Initially, the disability claims are processed through a network of Local Social Security Field Offices and State agencies called Disability Determination Services (DDSs).
- SOCIAL SECURITY FIELD OFFICES
When a Claimant (person requesting disability benefits) applies online, or in person, by telephone, or by mail, the application is initially processed at the local SSA field office. The application helps gather information about the Claimant’s impairments, names, addresses, and telephone numbers of medical sources, and other information relating to the alleged disability.
The field offices verify non-medical eligibility requirements, which may include the claimant’s age, marital status, employment details, citizenship status, residency information, and Social Security coverage information. For Social Security eligibility, the field offices verify income, resources, and living arrangement information. The case is then sent to a DDS for disability evaluation.
- STATE DISABILITY DETERMINATION SERVICES (DDS)
The DDS are State agencies that are fully funded by the Federal government. They are responsible for making an initial determination about whether a claimant is or is not disabled or blind under the law.
The DDS obtains evidence from the claimant’s own medical sources first. If evidence is unavailable or insufficient to make a determination, the DDS may arrange a Consultative Examination (CE) to obtain additional evidence. The claimant’s own medical source is the preferred source for the CE. However, the DDS may also schedule a consultation examination from an independent source.
The determination is made by an adjudicating team consisting of a medical or psychological consultant and a disability examiner.
The DDS may refer a case to the State Vocational Rehabilitation (VR) agency if it feels the claimant is a candidate for vocational rehabilitation. The vocational rehabilitation provides a win-win for the claimant. If vocational rehabilitation can locate a job for the claimant that accommodates his or her disabilities, then the claimant no longer needs disability. However, if the vocational rehabilitation cannot, then the claimant has more evidence that he or she is disabled.
The DDS returns the case to the field office after making a disability determination. If the DDS finds that the claimant is disabled, SSA will compute benefits and begin paying them. If the claimant is found not to be disabled, then the file of the case is retained by the field office in case if the claimant decides to appeal the determination.
Well over 2/3rds of claimants receive a notification of their claim being denied after it has been reviewed and adjudicated for the very first time. If your initial application is denied, you must file a request for reconsideration within 60 days of receiving the notice of the adverse decision. If you fail to submit your request for reconsideration within the stipulated time, you most likely will have to begin the application process all over again.
Reconsideration is the second step in the Social Security Disability administrative process and the first step in the appeal process.
It takes months to complete the Reconsideration process. Once the SSA has made a decision regarding your reconsideration appeal, it will send you a letter in writing notifying you of its decision. If your request for reconsideration is denied, you may take your case before an Administrative Law Judge at an appeal hearing. And if you lose there, you can file a Request for Review of the Administrative Law Judge’s denial.
WHO HANDLES AND DECIDES YOUR REQUEST FOR RECONSIDERATION?
When you file a request for reconsideration with the SSA, your application is sent back to the same office that handled your initial application. At this stage, your reconsideration appeal will not be reviewed by the same examiner who had worked on your initial application.
The examiner entrusted with reviewing your reconsideration appeal is bound by the same rules as the examiner who determined your initial claim.
HOW MANY APPLICANTS RECEIVE BENEFITS AFTER THE RECONSIDERATION APPEAL?
Only a small percentage of applicants are successful at the reconsideration stage. A staggering 80-90% of applicants face the pain and despair of being denied benefits again.
TIPS TO SUCCEED IN THE RECONSIDERATION APPEAL.
While filing the request for reconsideration, you should provide the SSA with the latest information on your disability or impairment. Some tips that can enhance your chances of success at this stage include:
- Although you are not required to be represented by an attorney during this process, your chances of a successful appeal increase significantly if an experienced disability lawyer represents you in the matter.
- Submit your request for reconsideration as quickly as possible. You may have 60 days to submit the request, but the longer you take to submit it, the longer it will take to receive a decision.
- Inform the SSA regarding your latest visits to your treating doctor. If you are undergoing any new treatment, let the SSA know about it. Seek a letter from a medical provider explaining how your disability makes it impossible for you to work and why he believes you should qualify for disability benefits.
- Review the Blue Book to ensure that your disabling condition meets the specific criteria for a listing in the Blue Book.
- Go through your initial application thoroughly. Sometimes applicants discover that they have inadvertently left out key information from their initial application. Having an experienced attorney can help ensure that the appeal is done efficiently and well.
THE IMPORTANCE OF BOARD CERTIFICATION FOR ATTORNEYS.
In the ever-changing and constantly evolving legal field, it is important for an attorney to keep abreast of changes in the Laws. Board-Certified Specialization is a benchmark that guarantees that a lawyer has met strict standards regarding knowledge, education, experience, and reputation. This gives clients confidence in the lawyer’s abilities and his dedication to his or her practice. A Board Certification sets a lawyer apart from his colleagues and peers. North Carolina Disability Lawyer Charles F. Hall, IV has earned his certification in Social Security Disability from the North Carolina State Bar Board for Legal Specialization.
CONTACT A NORTH CAROLINA SOCIAL SECURITY DISABILITY ATTORNEY
Attorney Charlie Hall and his team understand the criteria in the SSA’s Blue Book and the Sequential Evaluation Process that SSA uses to determine disability. During the reconsideration appeal process, we help clients gather supporting evidence and documentation that helps them prove that they are unable to work due to their disability. We also help our clients shore up weaknesses in their claims. We do not charge a single penny until we have won your claim. We give 100% free, obligation-free, consultations to help claimants better position their claims.
Call Attorney Charlie Hall so we can discuss your case today.