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WHY SOCIAL SECURITY DOES NOT MAKE DECISIONS ON DISABILITY CLAIMS

The US Social Security Administration (SSA) is the largest agency in the United States government, apart from the military.  Yet, the Social Security Administration does not make the decision about whether you are disabled when you apply for disability benefits.

The SSA will send your application to a state agency for a decision.  In Alabama that agency is the Disability Determination Service (DDS) in Birmingham, AL.

Your Social Security office will gather all the forms and basic information from you, the claimant, then send it to the DDS in Birmingham.  The DDS will order medical records from your doctors and other providers.  It will spend the next 5 to 12 months reviewing your application to determine if you meet the requirements for an SSDI benefit.  Often, the DDS will send claimants to a consultative examination with an approved doctor before making a decision.  The DDS will also flood the claimant with additional forms to complete, such as a Work History Report, Function Report and possibly other questionnaires.  

Usually, DDS will provide an initial decision within 12 months of the application date.  Sometimes it takes longer.  Approximately 1 out of 4 applications will be approved at DDS and the others will need appeals.

So it is actually an Alabama state agency (DDS) which makes the initial decision about whether you qualify for disability benefits.  

Let me just say here that dealing with the DDS is a nightmare.  They are difficult to get on the phone, difficult to talk to, slow to take action and overall are just your worst nightmare. While you wait in pain and financial despair, wondering how you will make it from one month to the next, the state keeps stalling your application for months on end.  Sometimes it can take a year or more just to have your case assigned to an examiner.

If the DDS denies your application, you are not done with them yet.  You are required to file for "reconsideration" as your first appeal--where the Disability Determination Service (DDS) will again take months to "reconsider" your case.  About 9 times out of 10, your application will be denied a second time at "reconsideration."  So, for most claimants, "reconsideration" is a waste of time because the initial denial will be rubber stamped.

Now you are ready for an appeal that may actually give you a chance of being approved.  You are ready to take your case before an administrative law judge for a hearing.  So, here, in this third stage, your case moves from the state level back to the Social Security Administration (SSA).  If you consider national statistics, you have about a 50/50 chance for approval with the judge (hearing).  That's the best chance you're ever going to get.

So, for the first 12 to 24 months in a Social Security disability claim, you will be dealing with the state, not the Social Security Administration.  The state agencies appear to be stalled, backlogged, short handed and underfunded, incapable to rendering prompt decisions, even though nearly a million individuals nationwide are desperately waiting for benefits. Many of these individuals do qualify for benefits but must wait months or years for the state agency to examine, prod, investigate, reexamine and delay.

Getting a lawyer may help you keep your sanity during this heartbreaking process; however, it probably won't speed up your decision.  A lawyer will probably increase your chances for approval, at least eventually--in the appeals process.  A study by the Government Accountability Office (GAO) found that you are about 3 times as likely to be approved if you use a lawyer or qualified advocate.

 

 

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