If a person has filed for social security disability benefits and they have been denied, what are the next steps is the process that one goes through to obtain social security disability benefits and SSi? Before a hearing there are two stages. Stage 1 is called initial consideration. At that stage Social Security Administration and your lawyer will obtain all medical treatment records and sometimes send claimants out for examinations. If you have an attorney, you attorney will assist in getting the records and make sure they are all filed correctly. That process takes about 6 months.

If claimant is turned down in initial consideration (IC), then the next step is called Reconsideration or Recon. At that point, SS will send out questionnaire to claimant, ask how they are doing, if condition has changed and if there are new medical records, then those are refiled for the claimant and that process takes about 6 – 8 months. If you are denied at that point then you must request a hearing before an Administrative Law Judge.

Based upon the caseload it takes between a year to 18 months to get a hearing. If you are unsuccessful before a judge, there is another step called appellate review before the appeals counsel. That takes a minimum two years to reach this stage.

How long does this process take and what are the stages involved? The entire process can take up to several years to complete.

What can I expect at my Social Security Disability Hearing? The Social Security Hearings office is where the majority of SSDI and SSI disability hearings are held. Many people mistakenly think that their hearing will be similar to a court room appearance that they have seen on TV. This is not the case. Social security disability hearings are usually short and very informal. You will appear before an administrative law judge (ALJ).

The ALJ and social security office are extremely busy with a heavy backlog of cases.  You have waited a long time for your hearing, and you need to make sure you are there on time. It is in your best interest that you are prepared with the proper document and records to prove your case. A licensed attorney who specializes in Social Security Disability can help you with your case.

At Downard and Associates, only licensed attorneys with experience in Social Security Disability will be present at your hearing to represent you. We will make sure you are fully prepared and will help you deliver all the necessary medical records needed to win your appeal. We will be there with you every step of the way in preparing for your hearing. So you will have the peace of mind that everything possible has been done to take the burden off you and your family.

If I am denied a second time, can I still appeal?

Yes. If you were denied at the Initial Consideration Stage 1 and also at the next stage called Reconsideration or Recon, you may request a hearing before an Administrative Law Judge.

How do I know if I am disabled and qualify for SS disability benefits? The process used in determining if a person is disabled generally is (a) not working; (b) have a physical, mental or a combination of physical and mental impairments that significantly impact on the person’s ability to work; (c) the impairments must impose limitations that would  prevent the person from doing any of his/her past work; and (d) given the nature of the impairments, limitations imposed upon the person by the impairments, the persons age, work skills and past work history are there any jobs existing in significant numbers in the national economy that the individual can perform —if yes then not disabled and if no job exist then disabled.

Why should I choose a lawyer to represent me as opposed to a non-attorney advocate and what is the difference? Attorneys have received as many as four years of specialized training in the law. Attorneys have been trained and are capable of examining and cross-examining both medical expert witnesses and vocational expert witnesses as well as lay witnesses that are routinely called to testify in disability cases. Attorneys are trained in rules of evidence and procedures and how to deal with situations in a courtroom setting. Attorneys have successfully passed a 16-hour examination called the BAR EXAM and are licensed by the State Supreme Court to practice law. Attorneys are authorized to file civil actions against SSA in federal court on behalf of their clients.

Non-Attorney advocates have no specialized training in any area of the law or in social security law. The SS regulations alone cover more than 1,300 pages of detailed law. Additionally there is the Social Security Act, the HALLEX (rules of procedures utilized with the SSA Judges), POMS (which are internal rules used by SSA and DDS) , Social Security Rulings and appellate court rulings that must be followed during the process of a disability case. As mentioned above, the non-attorney advocate is not required to have any training in the law and they are not authorized to file civil actions in federal court as they are not licensed attorneys. At a recent court hearing that I attended, the Judge suggested to a non-attorney advocate not to come back before him until the advocate knew the difference between the regulations and the rulings.

How are SS disability and SSI cases processed? The process of both SS disability called DIB and SSI is essential the same. The person who believes he/she is disabled files a claim for disability with the local Social Security office. The claims process requires completing the formal application for disability and other documents including such things as a work history report, disability report, and then depending on the impairments alleged the person may have to complete a  pain questionnaire, seizure questionnaire, functional ability report or other questionnaires again depending on the alleged impairments. SSA will refer the case to the DDS (a state agency working under contract with SSA) DSS will be presented with medical treatment records, the reports completed by the person claiming disability, the work history and at time DDS will send the person for examinations  either physical, mental or at time both. DDS staff physicians or psychologists or both will review the medical evidence and offer their opinion on the limitations imposed upon the person by the medical evidence. Then DDS will provided the limitations, work history, skills from past jobs and the person age and education level to a vocational consultant who will offer an opinion as to what jobs, if any, the person could be expected to perform. If no jobs exist then the person is found disabled and if the consultant identifies jobs then the person is ruled to be not disabled. The SSA goes through what is called initial consideration and this is the first shot at establishing disability and if the person is turn down at (IC) then they have the option of have the unfavorable determination review on reconsideration and at that time SSA will have a group of different physicians/ psychologists review the medical evidence and a second determinations is then made. If SSA determines on the second go-around that the person is not disabled then the third step is for the person to request a hearing before a Social Security Judge. If the SSA Judge rules the person is not disabled then an appeal can be made to the Appeals Council and if the Judge is affirmed by the A/C then next step is to file a civil action in federal court.

What is the difference between Social Security Disability and SSI disability?  SSI disability is like a private insurance plan administrated by the federal government.A person pays into the SSA system and receives disability coverage. If the person stops paying into the system then at some point the disability coverage terminates. Generally speaking SS disability benefits are paid at a higher rate than SSI disability benefits. SSI is a needs based program administrated by the SSA and the amount of disability benefits one might receive under the SSI program is dependent upon the persons resources and what the household income may be. Currently the highest rate a disabled person can receive under SSI alone is $674 per month. Some people qualify for both SS disability and SSI disability and they may receive more monthly benefits. SSI does not require the person to have ever paid any money into the SSA system it is somewhat like welfare for the disabled.

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