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Anonymous
Rating: N/A
Votes: 0 (Vote!) | | Posted on Tuesday, March 06, 2001 - 12:24 pm: | 
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My husband had filed for disability in Oct. 2000.
We have not received a determination yet but was informed today that the file has been closed by the state disability determination center and sent to SSA in Atlanta for review. I was told this takes a few more weeks, and then we should be receiving a determination letter from SSA. Why do they send it there for a review? Is this normal for all cases? I thought the review would be done during reconsideration if he is denied benefits? |
Paul
Rating: 
Votes: 1 (Vote!) | | Posted on Tuesday, February 20, 2001 - 8:18 pm: |
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The official Social security line is that a certain percentage of cases prepared by the state agency are randomly selected to be reviewed in by the Administration. In my experience, the recommended favorable decisions seem to be reviewed a lot more than the recommended denials, so I consider a review good news, though it does cause a delay. If this is so, it means you definitely should appeal any denial. |
Anonymous
Rating: N/A
Votes: 0 (Vote!) | | Posted on Sunday, February 18, 2001 - 5:42 pm: |
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When My attorney appealed the reconsideration denial of my SSI Disability, she told me to appeal my medicaid denial, which I did. My hearing before an ALJ for the SSI Disability was November 22, 2000. Since that hearing I recently had the medicaid hearing and received approval 8 days later. Should I send information to the ALJ regarding the medicaid approval? Will that help my SSI Disability case?
I am a 50 year old divorced female with severe Crohn's Disease and unable to work. I am having a difficult time - healthwise and moneywise. I realize I must win my disability case at this stage after reading the information at this site. I live in North Carolina. |
Paul McChesney
Rating: N/A
Votes: 0 (Vote!) | | Posted on Tuesday, February 20, 2001 - 4:54 am: |
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I am not supposed to give advice to anyone who has an attorney. But I can tell you to give the favorable medicaid decision to him and ask him the same question. Good luck. |
BILL
Rating: N/A
Votes: 0 (Vote!) | | Posted on Thursday, May 03, 2001 - 11:47 am: |
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bill from n.c. i have c.o.p.d. with two dr. letters and have an attorney , and getting ready for admin judge appeal . do i have a chance to be approved for dis ben |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Saturday, May 05, 2001 - 8:11 am: |
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Ask your attorney; I am sure he can tell you. He will have a more complete picture than I will, and will probably give you better advice. Good luck. |
Bobbie Crummie
Rating: N/A
Votes: 0 (Vote!) | | Posted on Wednesday, May 23, 2001 - 8:34 pm: |
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I am a 55 year old woman who is waiting for a hearing .I live in south carolina. they told me it would be 4 months, in July it will be a year and I still havent heard anything. Is there something I can do to help this process along? We are desperate and I can not afford medical help and I am getting alot worse. This is for ssd |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Friday, June 01, 2001 - 7:02 am: |
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There is something wrong. There are several possibilities. Your case might have gotten lost. Or, it might be because of the new system, which is delaying cases. In any event, you need to look into this. I assume you don't have an attorney; you certainly need one any time you are at the hearing level |
bill everett
Rating: N/A
Votes: 0 (Vote!) | | Posted on Monday, June 25, 2001 - 9:02 am: |
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hi i have found out some of the things i need,but can you tell me ,what does it take for an admim. judge to deside case without a oral hearing? i do have two dr. letters suporting me.
Reply by Paul:
It takes strong, uncontradicted medicals that say you either meet a listing or the "grids," with good objective suppporting data. A doctor letter that says you are "disabled" is almost worthless. |
stanley meadows
Rating: N/A
Votes: 0 (Vote!) | | Posted on Wednesday, June 20, 2001 - 8:40 am: |
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Ilive in fl.I was told a decision had been made on my disability claim. but due to the fact that it has been pulled for QA They could not disclose their decision.could you enlighten me on what this means. thank you |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Thursday, June 21, 2001 - 6:18 am: |
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"Quality Assurance" is the Administration's name for a review process in which the administration reviews selected state agency decisions. The administration tends to select the favorable decisions for review, so review is a good sign in one sense. But it adds about a month or so of additional delay. The reviewing body might reverse the recommended decision, or affirm it. |
Joyce M
Rating: N/A
Votes: 0 (Vote!) | | Posted on Monday, June 04, 2001 - 9:27 pm: |
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I received a letter stating that I have passed the requirements for the medical an they are still deciding on the nonmedical requirements, what does this mean? How long do I have to wait now, this is after an appeal? Thank you |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Wednesday, June 06, 2001 - 5:44 am: |
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That's great! Not long now. In most cases, that means that you will
eventually get benefits. When you first file they check to see if you meet
the nonmedical requirements (You must be broke to get SSI, and you must have
worked enough to get Social Security disability.) They check once again to
see if you qualify at the very end, which they are doing now.
They send this notice out when they are issuing a favorable decision at the
initial and reconsideration levels. In my experience, at these levels, if
they award you, they often claim you became disabled much later than you
actually did. Check the notice carefully to see if this is so. If so, when
the final notice comes out, you might want to appeal, which will maybe get
you more back time money; but be aware that the ALJ can review the whole
case and say you are not disabled. NEVER do this on your own! I would only
do this with a lawyer who knew the individual judge very well.
Take care. |
Joyce M
Rating: N/A
Votes: 0 (Vote!) | | Posted on Wednesday, June 06, 2001 - 2:31 pm: |
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Mr. McChesney..Thank you for answering my question. I do so very much appreciate it. |
stanley meadows
Rating: N/A
Votes: 0 (Vote!) | | Posted on Wednesday, June 20, 2001 - 8:24 am: |
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Ilive in fl. I had a heart attack one year a go .I applied for disability at that time. I was told on 6/19/2001 that a decision had been made but they said they were not allowed to tell me,because my file was pulled for qa.I couldn,t get any information that i understood.any help you give me will be appreicated.
Reply by Paul:
"QA" probably means "Quality Assurance." In a case involving medical issues, a state agency, usualy a division of your state's vocational rehabilitation service, makes a recommended decision. A supposedly random sample of those derecommended decisions are reviewed by the Administration. I have no firm statistics to back me up, but I am fairly well convinced that more recommended favorable decisions are reviewed, so in a way this is a good sign for you. It also suggsets that if you are denied, you probably have a strong case and should appeal. And as you probably know I always suggest getting an attorney. I hope it works out for you. |
Lisa M
Rating: N/A
Votes: 0 (Vote!) | | Posted on Friday, July 13, 2001 - 12:38 am: |
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When the AC gets a motion from QA to review an ALJ favorable decision and the AC decides to review based on the QA report. Does it take as long to get a decision from AC as the typical case. I read on hear that it took 8months to 2years at the AC level. Also does interim benefits last through the whole process or does it only last a month or two?
Thank you in advance.
Reply by Paul In a rare case, after the ALJ issues a recommended favorable decision at the hearing level, the Appeals Council will review the case. If the case is not paid by a certain time, benefits will be paid during the rest of the time that the Appeals Council takes to review the case. The time it takes for the Appeals Council to review any case is highly variable, and I confess I have never solved the mystery of why one case is reviewed quickly and another takes two years. I am not certain, but I think that these types of cases are reviewed more quickly than some others. In general, review used to take about 9 months, and has stretched to 2 years in some modules. But certian case are reviewed much more quickly, and the Appeals Council might be catching up, too.
The interem benefits that you are paid during such a review last until the Appeals Council issues a decision. |
Kemper
Rating: N/A
Votes: 0 (Vote!) | | Posted on Sunday, December 02, 2001 - 10:42 pm: |
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I live in the Piedmont section of South Carolina and just had my disability hearing. Although I liked the judge and he seems to be fair...is there any way I can go online to see how most of his cases have turned out?
Reply by Paul In general, about the only way to find out is to ask an attorney who practices in front of him or her. You could ask your attorney if you have one, and me if you don't. |
Les S.
Rating: N/A
Votes: 0 (Vote!) | | Posted on Saturday, December 08, 2001 - 1:26 pm: |
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Paul I applied for SSD in June,2001 because of chronic pain in my back and legs after two back surgeries. I had to go see a psychiatrist, Deanna McNeil, for SC vocational Rehab in late Oct. How long do you think it will be before I hear anything else?
Reply by Paul In SC, probably about a month or two. Give me a call if you are turned down. Good luck. |
Cathy Ross
Rating: N/A
Votes: 0 (Vote!) | | Posted on Wednesday, January 09, 2002 - 8:35 am: |
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I was involved in a mva in July, 1999 in which I sustained blunt trauma to the top and left side of the head. After the accident I am suffering from vertigo, headaches, confusion, memory problems, neck problems and fatigue. I applied for SS benefits which were denied both times and now I am scheduled for a hearing soon. Several physicians told me that I had 8th cranial nerve damage, mild traumatic brain injury, post traumatic epileptic seizures and disc problems in my neck. This also involves workers comp. I have an attorney for both of these cases. My concern is the SSD benefits will be denied again. What can I do to help in the process and what are the chances my case will be approved by the SS judge? Thank you. |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Friday, January 11, 2002 - 4:30 am: |
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Cathy, I don't want to answer your question specifically because you have an attorney, and I am sure he could give you a higher quality answer than I could. The problem is that when someone lists medical conditions without indicating what limitations they cause, it is impossible to say how they might affect your ability to work.
I can give you the approximate success rate at each decision level in SSI and Social Security Disability claims:
initial claim 1/3 are successful
reconsideration claims: 1/10 are successful
hearing level: 6/10 are successful |
Isabel
Rating: N/A
Votes: 0 (Vote!) | | Posted on Thursday, April 11, 2002 - 8:33 pm: |
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Hello and I'm very happy to have discovered this board and glad I'm not the only person with so many questions, lol. I have been reading this board for hours now and felt inclined to post. I have so many unanswered questions regarding Social Security Disability, I hope you won't mind my jumping right in, any input, advice, answers will be greatly appreciated.
I'll start at the beginning, I'm sorry if I ramble. I'm a 39 year old, single, female residing in St. Louis. I have always worked all my life until I had my first panic attack in June of 1996. I was so terrified I didn't leave my home for 7 months after that. I finally decided to try to get well and started seeing a psychiatrist. I've been on loads of meds and finally applied for disability for the first time in 1997, when I moved back home with my parents in North Carolina. I was devastated when I was declined, SSI said they felt I could work part time. So, I decided to try to go back to work. I had two jobs within the next 5 months, but was let go from both because of constant panic attacks. My parents didn't understand what was wrong with me and kept telling me to "snap out of it" so things were quite tense. I decided to move from home since I wasn't getting any better. I then relocated to St. Louis, where I am now. I immediately found another doctor who put me on Paxil, which has helped SO much. But since then I have become agoraphobic and never venture out of my house. Anyhow, I reapplied for disability in July of 1998, 3 months later, I was declined again and devastated. I felt I couldn't deal with the appeal process, plus I just didn't understand it. So, I continued to live off my savings and selling personal belongings to live. I decided to try one last time for disability and also decided when I was turned down this time to get an attorney and appeal. During the past few years I've learned a great deal about the system and feel I am disabled. So, I reapplied on January 10th of 2002. First thing I found out, because I had an appointed worker who filled out my forms, was that I was eligible from March of 1998, since I hadn't worked at all since then. My last job ended in February of 1998. My appointed worked called the Social Security office while I was there to get this information. They also told me I was eligible to receive $653 a month, based on my previous jobs.
My first question is: when I get approved are my payments retroactive back to that date of March of 1998? What about Supplemental Insurance? Is that retroactive?
Today, I called and spoke with my disability case worker, who has been handling my claim since I reapplied in January. I normally would of been denied by now since it's been 3 months. She told me she approved an allowance for me on April 5th. I asked what that meant, she said basically it was an approval for disability. Well, of course, I'm flabbergasted! I never expected this! Then she told me that because she is at the state level of disability that the federal level pulled my case and is reviewing it. She told me this was not abnormal, since it was an approval and that they were basically checking "her" work and reviewing her decision/recommendations. She told me it could still be months before I hear anything. She also told me to call the disability office one month from today to check the status of my claim. She said if they found something wrong that the claim application would come back to her or she might not ever see it again. I had so many questions for her, but she had to go so I'm not sure if I should be excited by this news or not, lol. Can the federal disability people now still decline my claim? Is this normal for this to happen after applying for disability? Because the state approved me, does that not mean I "really" approved? Anyone gone through this have any idea how long this process takes...of the federal level taking over my claim.
Any insight would be greatly appreciated. I feel so stupid when it comes to these issues, I feel like I need to go back to college just to learn about it, lol. My apologies again for such a very long post.
Thank you so very much in advance.
Isabel |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Saturday, April 13, 2002 - 5:35 am: |
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I will ask your questions briefly and answer them as best I can.
Q. When I get approved are my payments retroactive back to that date of March of 1998?
A. Possibly, possibly not. You can potentially draw benefits under a particular Social Security Disability application back to the earlier of a year before the application or 5 months after you become disabled, whichever is later.
The Administration can reopen and old Social Security Disability application for any reason within one year; for good cause, such as new and material evidence, for 4 years, and, if you can show a mental condition that made it impossible for you to understand how to proceed, or impossible to actually proceed, you might be able to get it opened even if it is older than that.
How far back benefits will go in your case depends on two things: What date your caseworker finds that you became disabled, and whether he or she actually re-opens your old cases.
What about Supplemental Insurance? Is that retroactive? Yes, but the rules are different, to keep us all confused, I guess.
You can draw SSI from the date of the application if you otherwise qualify.
You can re-open old applications under the same rules as for Social Security Disability, except that the 4 year deadline becomes 2 years.
Q. My disability case worker told me she approved an allowance. She told me that because she is at the state level of disability that the federal level pulled my case and is reviewing it. Can the federal disability people now still decline my claim?
A. Yes. The federal "quality review" process seems to occur more with recommended favorable decisions. What she said is exactly true.
To answer a question you didn't ask:
Often, when a claim is approved at the initial or reconsideration level, it can be appealed, asking for an earlier onset date. This is a two edged sword, since the entire claim is appealed, meaning that your benefits could be terminated if the higher level finds that you are not disabled. You will probably get such a partially favorable decision, if it is a favorable one.
If that happens, you must sit down with an attorney and all of your medical records and carefully decide whether to appeal. Sometimes it is foolish to appeal; sometimes foolish not to. |
Isabel
Rating: N/A
Votes: 0 (Vote!) | | Posted on Wednesday, April 24, 2002 - 8:55 pm: |
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Hello and thank you very much for the insight. I had typed here last week, right after you answered me but that post seems to have disappeared into cyberspace, lol.
Since my last posting, I have learned some new things. Also, some of the things you said, that I didn't understand, make perfect since now, woohoo, lol!
My federal review lasted two weeks, which wasn't very long, I was approved "officially" on April 19th. I got a call from my local SSA office, they were updating my SSI information. I will be getting 3 months total SSI benefits, as they told me that my first SSDI check will be direct deposited on the 3rd Wednesday in May, next month. She also mentioned at that time that my backpay was for $9,000. This surprised me since I had anticipated closer to $29,000. She told me I would only get back one year previous to my application, which was January of 2002. I told her I had previously applied in June of 1998 and my caseworker told me I would "definitely" get quite a bit of backpay, as they found me disabled since March of 1998. NOW, this other woman from SSA is telling me I've got the wrong information. She said no way can I get backpay unless I had first appealed my first denial. This makes no sense to me! I hardly know anything about SSDI now and back in 1998 I had no clue I could even appeal, it was foreign to me. When I got my original denial letter it said I was able to work at least part time, so I tried to, lol! That didn't work out.
So, from what I'm reading in your answer post, you are saying I "can" appeal this and ask for an earlier onset date. BUT, this also jeopardizes my current approval?? I'm expecting the $9,000 backpay anytime, does that mean I shouldn't touch that at all? Will that then mean I can't appeal any longer?
I know this will be a tough decision. I just hate to "lose" $20k because of a stupid technicality. I'm so in debt with tons of loans owned to family and friends, the $9k will help obviously, but won't get me out of debt.
What is your opinion? Thank you again for taking the time to read all of this, your expertise and advice is greatly appreciated. It's like pulling teeth to find out this information, lol. |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Saturday, April 27, 2002 - 7:32 am: |
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Your evaluation is precisely correct. There is both risk and benefit in an appeal of your current decision. I would never recommend appealing, or not appealing, a partially favorable decision, such as you have, without carefully going over the evidence with an attorney so that you will understand the odds of success and failure in your particular case. Then you are going to have to make a hard decision on your own.
If I were you I would talk to an attorney right now, before the 60 day deadline for appealing your decision expires. You might or might not be able to do something more after the 60 days, but before the 4 year deadline on the earlier claim.
The law in this area is extremely complex, I have set some but not all of it here, and if you think you understand it, that only shows that you don't realize how complex it is. This is a very dangerous area for claimants and attorneys, because of the complexity of the law and potential for unfortunate result. |
Isabel
Rating: N/A
Votes: 0 (Vote!) | | Posted on Saturday, April 27, 2002 - 11:58 am: |
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Thank you again so much! Honestly, I've been to tons of SSDI/SSI boards, including the connect board, and you are the "only" person who does not give me one line answers and actually explains in detail, for that I'm especially grateful.
I did contact several attorneys yesterday. I looked for those who specialized in disability law and actually talked to three of them on the phone.
I have yet to receive an award letter from SSA. Though they've already given me my SSDI deposit date. Each attorney did tell me we need that letter first, which I understand. What I was hoping was that each one would basically say the same thing, lol. One felt there was little to zero risk since I was approved at the initial level. Another felt there was substantial risk, unless I found a sympathic judge. Another really couldn't tell me anything because they don't even know what my disability is and feel it'll be quite difficult to get all my medical history at this point.
You are correct, I have a difficult decision. Not only deciding if I should appeal, but then what attorney to pick, lol!
One question I didn't get answered that maybe you can shed some light on. Worst case scenerio, I appeal for an earlier onset date, the judge decides I'm not disabled at all and I lose my claim and now owe SSA for overpayment. Does that close this case forever? Are appeals done at this stage again?
I guess I would like to know what else I'm risking besides my initial favorable decision and one year's backpay.
Thank you again and I'll keep in touch. Hopefully if anyone else might be going through this, this thread will be incredibly helpful to them. |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Saturday, May 04, 2002 - 9:23 am: |
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Isabel: Boy can you ask questions! Answers, as best I can answer:
Question: Worst case scenerio, I appeal for an earlier onset date, the judge decides I'm not disabled at all and I lose my claim and now owe SSA for overpayment. Does that close this case forever?
Answer: No.
Question: Are appeals done at this stage again?
Answer: You can appeal almost forever.
Bonus Question: How long does the next appeal take?
Answer: Assuming that you have just been allowed at the initial level, in North Carolina, from 3 to 8 months. It varies in other areas of the country.
Question: Will they look at my case closely?
Answer: No. Reconsideration is usually a rubber stamp, since the same office that considered it before is doing so again. But at the next level, before the Administrative Law Judge, it will be looked at closely. |
Heidi
Rating: N/A
Votes: 0 (Vote!) | | Posted on Monday, April 29, 2002 - 6:28 pm: |
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I hope you have time to read this, it will be kind of lengthy. My husband applied for SSDI one year ago this month. He received initial denial in Oct 2001, we have attorney and he is waiting for appeal. He has peripheral polyneuropathy, degenerative bone and disk disease and osteoporosis from 7 years of steroids. Our attorney is submitting a package this week for an OTR due to dire need. I am on SSDI also and cannot get any financial assistance because my monthly amount is too high. We are going into foreclosure next week, only have money to pay for husband's meds and my meds. The attorney said that OTR's are not normal procedure and that it's kind of like "schmoozing" to get a staff attorney to look at it. We have good medical records, affidavits from family and his Drs. I'm really scared, how long is it going to take for someone to look at this and then what happens, the mortgage Co. is coming after us. My husband is too sick to move anywhere, we have been in our home for 16 years. I've seen on other message boards that the OHA is supposed to look for OTR's, so why is our attorney saying that this is not standard procedure. |
Paul McChesney (Admin)
Rating: N/A
Votes: 0 (Vote!) | | Posted on Saturday, May 04, 2002 - 9:25 am: |
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Heidi:
I do not give advice to someone who has an attorney. But I will say that asking for an OTR, or in other words on the record decision early is about all I know to do to speed things up. The long delay to a hearing is a terrible problem for many. |
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