Qualifications to obtain SSD benefits from the SSA.

Calling the Social Security Administration (“SSA”) office is unlikely to help you understand whether or not you qualify for Social Security Disability. This is because when you call the SSA office you will be speaking with a service representative, who is not qualified to make a determination regarding a person’s disability. That is a decision that is assessed by disability examiners who work at DDS, Disability Determination Services, a state agency which is entirely separate from SSA.

DDS assesses many factors in determining a person’s ability to return to the workforce. First, the determination is made whether the claimant can return to their old job. If they can, their claim is denied. Next, DDS will consider whether the claimant has transferrable skills, and will consider factors such as the claimant’s level of education, past work experience, and age. After the age of 50, a person is generally not expected to learn a new trade or skill. Assessing these factors along with a claimant’s physical or mental disabilities or limitations is part of a complex process that service representatives at SSA cannot and should not attempt to inform potential claimants on. This is why you are better off seeking an attorney who is knowledgeable and experienced in navigating the process of proving one’s qualifications to obtain SSD benefits from the SSA.

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Social Security Disability: It’s Often A Long Road

It’s a standard question: How long will it take for me to be approved for Social Security Disability Benefits? (SSDB)

As with so many other things, the answer is: it varies. In truth, it can take from one month to up to two years or more!

Let’s look at this a little closer. First of all, not every one’s disability case is the same. Some individuals will present medical impairments on their disability applications that will immediately stand out as obvious approvals (though this happens in only a small percentage of cases). Examples of clear cut cases include ALS, advanced cancer, severe kidney disease, blindness, AIDs, and double amputations.

Social Security has a list of “225 compassionate allowance” diagnoses. The Compassionate Allowances program expedites disability decisions for Americans with the most serious disabilities to ensure that they receive their benefit decisions within days instead of months or years.

But what about the most common disorders—back injuries, depression, heart attack, etc? How long does the average case take?

Nationally, it takes an average of 120 days for a Social Security disability applicant to receive an answer from the Social Security Administration on his or her initial application. 35% are awarded benefits at this level.

In 2013, here was how many days it took to process an appeal from an initial denial (remember, at that point you’ve already waited 4 months) and have a hearing in front of a Judge on an appeal (in NY, this is the second step in the process) in some local regions:

Brooklyn: 478 days

Manhattan: 320 days

Bronx: 359 days

Queens: 363 days

Long Island (Jericho) : 292 days

just to get a hearing!!!!

Source: NOSSCR Social Security Vol. 5, No. 5,  May 2013

The waiting time for the Jericho (Long Island) Hearing Office, by the way, in 2013 was 8th fastest among 165 hearing offices in the country!

So to recap- if you file an application for benefits and you live in Long Island, it takes about 4 months to get a decision, and if you are denied, another 10 months to get a hearing. (And then a couple of months to get the actual decision from the Judge.)

And that’s comparatvely quick. In St. Louis, Mo., the worst hearing office in the country in terms of time to wait for a hearing, the wait to get a hearing in 2013 averaged 547 days!!!

And let’s not forget that since almost all SSDB applicants are not working, that’s an awfully  long time to wait for income.

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Age Matters: Filing for Social Security Disability

Age Matters: Social Security Disability Favors Older (50+ years old) Workers

 

Does age matter when filing a Social Security Disability claim? Yes it does. Here are the four categories that the Social Security Administration (SSA) uses when evaluating age:

 

“Younger Individual”— Ages 18 to 49;

 

“Closely Approaching Advanced Age”— 50-54;

 

“Advanced Age”— 55-59

 

“Closely Approaching Retirement Age”- 60-65

 

The three factors most often used to evaluate a claimant’s case other than medical condition are AGE, education, and work experience. Let’s look at an example.

 

Two construction workers suffer similar, severe back injuries. They are both unable to lift anything heavy and in fact are limited by the injury only to the physical ability to do easy, sitting-down , “sedentary” work.

 

Comparing the age,education and work experience of the two construction workers who can only do “sedentary” work:

 

Worker A: 48 years old. Can speak and write English. No skills other than construction work. High School Graduate.

 

Decision by Social Security: NOT Disabled- (Regulation 201.18)

 

Worker B: 50 years old. Can speak and write English. No skills other than construction work. High School Graduate.

 

Decision by Social Security: Disabled- (Regulation 201.12)

 

SSA’s regulations would grant benefits to the 50 year old, but not to the almost identical 48 year old. Why?

 

The regulations state that “Individuals (50 and over) may be significantly limited in vocational adaptability….(if they have) no transferable skills…” (Regulation 201.00 g.)

 

Translation? SSA doesn’t expect 50 year old and older workers to learn a new trade or skill that would allow them to work a sedentary (physically easy) job. But it does expect those under 50 to do so. Hence, the bias in favor of 50 and over workers.

 

It is much easier to win if you are 50 or over, period.

 

So, when you contact a Social Security attorney such as myself, the first question they will ask you is: How old are you? Because age really does matter in the world of Social Security Disability Claims!

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