Why does it take so long to get Disability benefits when I start over?
WOW! This question comes up a few times. Here’s how it usually plays out:
1) You have applied and you got denied. So you decided to reapply, OR
2) You went all the way to a Judge and got denied. So you decided to reapply, OR
3) You went all the way to an Appeals Council Decision and you got denied. So you decided to reapply, OR
4) You were receiving disability benefits and you were cut off. So you decided to reapply, OR
5) You got a closed period of disability benefits. So you decided to reapply!
In any event, most people ask the same question “Why does it take so DAMN long to get Disability when you reapply??” And trust me, DAMN, is usually thrown in there somewhere.
Unfortunately, the short answer is “Just because you went through the process once, doesn’t mean you get preferential treatment when you go through the system again.” In other words, every time you go through the system, a new set of hands and eyes will be evaluating your case. As such, your case is treated as if you are filing for the very first time.
Now, I know what you’re thinking. You’re thinking “What about those earlier applications?”, “Do they check those records?”, or “What about the fact that I was disabled before?”. All of those are good questions so let’s go through the scenarios I provided:
1) You have applied and you got denied. So you decided to reapply, OR
OOOOOO, please don’t do this. SO many times, people think that if they just keep reapplying, they will ‘hit it’. Ladies and Gentlemen, this is NOT LOTTO!!! You have to go through the system to get the best results. Now, I’m not saying that you shouldn’t reapply. I’m saying that you should be mindful of the fact that you are starting over every time you reapply. They will go and get the info from your previous application (depending on how soon you reapply) but you are still starting over.
2) You went all the way to a Judge and got denied. So you decided to reapply, OR
I’ve said it to people a million times that you don’t usually get your best opportunity unless you actually go through the process. The process usually means from initial application to a Judge. Now, for Social Security’s purposes, your disability period is the day after the judge’s decision. Why? In their eyes, the Judge has already determined that you are NOT disabled up to the date of his or her decision so even if you were found disabled, SSA is probably not going to back beyond that date (Sometimes they do but most times they don’t).
3) You went all the way to an Appeals Council Decision and you got denied. So you decided to reapply, OR
Sometimes, people want to wait until they go all the way through the administrative process. Most representatives will probably tell you that while your case is pending before the Appeals Council, you should start a new application. In any event, if you reapply, the earliest date of benefits would be the day after the judges decision.
4) You were receiving disability benefits and you were cut off. So you decided to reapply, OR
This situation comes up a lot. You’ve been receiving benefits for an extended period of time. Then, for whatever reason, SSA determines that you are no longer disabled or no longer entitled to benefits. So you decide to reapply. Now, in your mind, you’re thinking that since you were receiving benefits before, you should have a leg up. NOT SO FAST, my good friend (in the words of ESPN’s LEE CORSO). You don’t get preferential treatment just because you were receiving benefits before. Remember, a determination was made that you no longer need the benefits so you have to prove the you do.
5) You got a closed period of disability benefits. So you decided to reapply!
This one is tricky. A closed period is a clearly defined start and stop. You were determined to have been disabled from one point to another. Let’s say from Jan. 1, 2008 through Jan. 1, 2009. Now, you decide to reapply. The same rules apply. You’re treated as if you have started from scratch.
Please remember that you are not entitled to any special privileges or opportunities just because you started over. You still must go through the process as if you are starting from scratch.
What happens after you file a claim for Social Security benefits and beyond!
Alright, so you get the word. You have an appointment with Social Security coming up. You got your papers. You got everything you need. You go to your appointment. Now what?:
1) Make sure you complete what they give you and send it back.
In some situations, Social Security is going to probably give some forms to sign. These forms are designed to assist Social Security in obtaining the records and information that they need for you. If you DON’T complete this information, Social Security can’t develop your case. If that happens, your case could be closed for lack of evidence or failure to comply.
2) Your case may be LEAVING SSA to DDS.
Depending on your state, once Social Security has your forms, your case may be referred to a state agency responsible for developing your case. This agency is called the Disability Determination Services.
3) What does it mean “DEVELOP my case”??
When you apply for Social Security Disability, you are indicating that you are DISABLED. In order to determine if you ARE disabled, they need to get your medical records. In essence, they have to develop your file to determine if you have medical records to support your disability.
4) There is no time line so stop being a pest.
Social Security recognizes that they have a lot of cases so they take every effort to aggressively push their cases forward. However, they don’t drag their feet because they are trying to keep you back. In most cases, Social Security and DDS are awaiting the evidence they need to make a determination. So the WAIT is what they are doing as well.
5) Get your point of contacts right (i.e. 3d parties)
Most people don’t realize that part of the delay in your case is due to lack of response from your 3d parties (you know, the people you listed that Social Security could talk to about your case). Make sure you inform your third parties that they may be getting a call from Social Security about YOU!
6) Get your doctors right (i.e. medical records)
Docs get request for records ALLLLLLL the time so please take the time to make sure you inform them that these request are on the way so they can make the effort to ensure the records are available. Here’s a little tip for you. Social Security works on a budget just like any other organization so they are not going to pay $200 to $400 and above for a huge file on you.
7) They have to consider everything so if you SAY it, they will consider it.
You have to think about what it is that keeps you from being able to work. The law regards the Social Security Administration to consider your combination of impairments. With that being said, be careful. If you mention something new every time they talk to you, Social Security is going to investigate it and THAT may take time.
YOU don’t run the show. THEY do!
Alot of times, CLAIMANTs will want to TELL SSA or DDS exactly what it is that is keeping them from working and what specifically they need to look at in terms of medical records. In other words, if you’ve been to 4 doctors but one of them says you’re disabled, you may tell SSA or DDS to ignore those other 3 because the one that says you’re disabled is the one they should focus. NOT! Social Security has to consider everything.
9) I got a DENIAL! Now what?
APPEAL! APPEAL! APPEAL! Most people don’t realize that you don’t get your best opportunity for results unless you appeal your case. Take it to the next step.
10) If I appeal, what happens?
Depending on the state, you either case will be re-reviewed (Reconsideration) or go before a Judge (Hearing). If it’s reconsidered, you will go through the whole process again so they can determine if they got it wrong. If it’s a hearing, it goes from the Local Office to the Hearing office for a hearing date.
The biggest thing that you need to know is that you need to be patient. The process is not short but be mindful that YOU may do things that may cause the process to go on longer.
The little things that may affect your Social Security Benefits AFTER you win your case
Watch out dere now! It’s PARTY TIME! You’ve applied for disability benefits. Now, after several months or several years of forms, doctor’s appointments, questions/answers, and waiting, you have FINALLY been approved. YAAAAY!! It’s amazing how people are so dedicated to doing what it takes to get their benefits. After a long and stressful process, you have finally arrived.
Now here the comes the song you’ve been waiting for, “MONEY, MONEY, MONEY!!!”.
However……………………….
Here’s the part of the process that usually throws people off. People don’t realize that there are ALOT of ‘little things’ that may effect not only HOW MUCH money you will get but it may also effect if you get any AT ALL!!!
Before you get ‘Coo Coo for Cocoa Puffs” and start counting all that “CHEDDAR” you THINK you’re going to get from the Disability process and all of that back pay, here’s a few things that you need to remember so you don’t get your feelings hurt:
1) WARRANTS. Most people know that if you’re in jail or incarcerated, you’re not entitled to benefits. What most people don’t know is that if there is a WARRANT for your arrest, this warrant has the same effect as if you were arrested. So what does that mean? That means if there is a warrant for your arrest, the Social Security Administration may not administer your benefits until you get that Warrant resolved. Get it fixed or no money for you.
2) CHILD SUPPORT. Please don’t sit over and think that just because you are disabled, you are exempt from paying your child support. Even more so, if you owe BACK child support, most states have arrangements through their Department of Revenue and the Social Security Administration to garnish some of your back pay. So if you’re thinking you’re going to get a JAMMING back pay check but you owe child support, your check may be smaller than you think.
3) WORKERS COMPENSATION. Workers Compensation cases and Social Security Administration cases tend to go hand and hand. However, in some instances, if the combined amount of mothly amount of your WC benefits and your SSA benefits is greater than 80% of your Average Current Earnings, you may see a REDUCTION in your benefits to compensate for the difference.
4) VETERANS BENEFITS. Veterans benefits fall into two separate categories: Service Connected and Non Service Connected. If you are receiving Service Connected benefits, you may not see an impact on your Disability Insurance Benefits (SSI is totally different. Go to Bullet 15 for a discussion). However, if the benefits of the VA are NON service connected, these benefits may possibly reduce the amount of DIB benefits you’re entitled to receive.
5) LONG TERM / SHORT TERM DISABILITY BENEFITS. This portion is usually very tricky because every Long Term / Short Term Disability policy is different. It’s important to ask your disability carrier what impact receiving SSA benefits will have on your LTD/STD policy. For some policies, it’s a one to one reimbursement. This reimbursements means if they were paying you during months when SSA should have been paying you, they want their money back for that period. So, for instance, if your LTD/STD carrier was paying you $1000 a month from Jan. 2008 to Jan. 2009 and you get SSA benefits retroactive from Jan. 2008 in the amount of $1200, your carrier MIGHT require a reimbursement for the same time period. Check your carrier just to make sure.
6) WORK & SSA don’t always mix. I always have at least one or two people who want to be slick and try to draw a disability check and work a little bit at the same time. The SSA does allow for what is called “A trial work period” (Please comment if you want me to discuss that in greater detail). However, after a certain period of time, SSA may wonder if you are REALLY disabled or not.
7) MEDICARE. If you’re getting Social Security Disability, you may be entitled to receive MEDICARE. Medicare is NOT free. A small portion of money is taken out of your check every month in order to pay for your medicare. If you choose to NOT take it and ask for it later, you may face a penalty.
CDR. For those of you who don’t recognize this acronmym, it’s called a CONTINUING DISABILITY REVIEW. It’s like this, Social Security doesn’t expect you to be disabled FOREVER so they are going to come back at some point in time (Usually more than once) to determine if you are STILL disabled. If you’ve gotten better, your check may STOP!
9) FEDERAL DEBTS. Recognize, if you OWE the federal government some money, they gonna GET their money. Don’t think that the government will totally excuse your debt because you’re on disability.
10) SOCIAL SECURITY FRAUD. Most people bust their butts in order to properly demonstrate that they are disabled. However, there are a FEW people out there who are trying to get their HUSTLE on! Recognize that Social Security has a department dedicated to investigating fraud. As such, if you are attempting to defraud Social Security, don’t think you won’t get caught.
11) WINFALL. Now, this particular point really applies more to Supplemental Security Income. A WINFALL is when you get a big lump sum of money unexpectantly. This money could be an inheritance, a settlement, or even the lottery. Now, you’re sitting there with a monthly check and a big sum of money and you’re thinking, BOOM, I’ll just live on my monthly SSI check and ride out with my money in the bank. Unless you have your LUMP SUM of money in some type of special needs trust, that money will be counted against your SSI. What does that mean? THis means until you spend the money down to a particular amount, SSI won’t pay you a DIME!
12) SUSPENSION / TERMINATION. Some of the things that I am addressing may result in your disability benefits being temporarily discontinued. This process is called SUSPENSION. SSA may suspend paying your benefits until you have resolved whatever issue that is effecting your case. However, this suspension is not permanent. If you have not resolved your siutation after a certain period of time, SSA may terminate your benefits. What does that mean? You have to start over!
13) REPRESENTATIVE PAYEE. This portion doesn’t have to focus so much on how much you get paid as much it focuses on WHO is responsible for your money. If you’ve had issues with money in the past, or some psychological issues, or some cognitive issues due to significant pain medications, or you’ve had problems with drugs and alcohol, SSA may determine that someone else needs to handle your money.
14) DEDICATED ACCOUNTS. These accounts are typically utilized in kids ‘ cases. These accounts are tricky because if SSA determines you need to set one up, the requirements for maintaining these accounts are very detailed. You have to be very careful as to what you spend the money.
15) SSI & everything. Most people don’t realize that SSI is a “NEED BASED PROGRAM”. In other words, if you have money coming from other sources, you don’t NEED the money from SSI (and this includes other SSA disability programs).
16) LUMP SUM MAY NOT BE LUMP SUM. Ok, here’s the tricky part. Most people don’t realize that even though you may win your case, you may not get as MUCH money as you think. Here’s an example. Say, you applied for SSI benefits on Jan. 1, 2009 for the first time but you said you had been disabled since Jan. 1, 2005. So SSA approves you. So you think you’re getting all the way back to Jan. 1, 2005, right? WRONG! SSI only pays from the date of the application so your lump sum would be from Jan. 1, 2009 to the present. Let’s use the same example but you applied under DIB. Under the DIB program, you’re entitled to go back before the date of the application. So you think you’re getting all the way back to Jan. 1, 2006, right? WRONG!! DIB only pays up to one year before the application so at best, you’re going to get money from Jan. 1, 2008 to present.
17) COUNTY REIMBURSEMENT. Some Counties, in an attempt to work with those persons who are unable to work, have arrangements with the Social Security Administration. As a result, if you find yourself receiving some type of housing assistance, SSA may automatically deduct money from your benefits (typically the SSI benefits) in order to ensure the County is reimbursed.
18) JAILS / PRISONS. As I stated above (Bullet #1), if you’re incarcerated, you are not entitled to receive SSA benefits. This point gets tricky if you find yourself being arrested because you may not have time to notify SSA. It’s important that your loved ones notify SSA as soon as possible because if you come out and you are still getting benefits, you may owe the government for the time you were incarcerated.
19) APPEALS OF PARTIALLY FAVORABLE DECISIONS. Partially Favorable Decisions or PFD are decisions by the Social Security Administration. These decisions are the governments way of saying that you are disabled but not for the length of time or time period that YOU think you are. You have the right to appeal this decision if you don’t agree. If you do, 3 things can happen. One, you can win and get the entire period you asked for in the beginning. Two, you can lose and SSA and social security will leave your benefits the way they are. Three, SSA can determine that they were wrong and that you were never entitled to benefits. This part is really tricky because if SSA thinks you should have been awarded benefits to begin with, you may have to reimburse SSA for everything they gave you.
I know I covered alot of information but I spend alot of times explaining to people why their benefits are impacted after they’ve gone through a lengthy process to get them. I hope this helps you.
Social Security Disability delays
If you’ve followed some of previous posts, I’ve spent a few times talking about the social security process. In an attempt to further help with the situation, it is important for me to take it upon myself to give you some additional insight into the process so you can understand WHY it takes so long and WHAT you need to consider:
1) There IS no deadline for deciding your case so STOP asking! Every case is on a ‘case by case’ basis. So please stop getting ‘coo coo for cocoa puffs’ when a representative from the government says your claim will be completed in “_______” days. Some times it is just simply NOT possible to get the information that is needed in the time period that you were told.
2) You HAVE to go through the process! Some people out there think that they should keep reapplying until they hit the jackpot. What they DON’T understand is that they are just starting over again and again. Think of like this. Starting a new application after an old one has been denied is like driving a car in the daytona 500 and when the car runs out of gas at lap 55, you get a new car and start from the beginning at lap 1.
3) When it gets to the Hearing level, you have to wait!! It’s crazy because the largest backlog tends to be at the hearing level because those cases are sitting and waiting to be heard. If you’re in a district that has 18,000 cases in waiting, when your case comes into the district, your case will be number what?? That’s right 18,001!!!!!!
4) Even if your case is CRITICAL, you still have to wait! I represented a man who was homeless and living under the interstate and it took a couple of weeks to get before the court. Now, I know you say that that is sad but let’s be real here. I know your situation is crucial but do you REALLY think you’re the ONLY one who’s situation is crucial? Think about it. Say you’re in a district where there 18,000 cases before you. Now, let’s assume that about 10% of those are critical. Now, you’re at 1800. Now, if you only have 18 judges, you have 100 critical cases per judge. Now, if each judge already has cases scheduled for hearing for the next month, where can they fit you??? See how it gets crazy?!
Listen, you will find articles ALLLLL over the internet about the backlog and the delays. It’s an unfortunate thing but it is OUR reality! The hardest part of the process is usually and almost always the WAIT! Don’t let it beat you down. Hang in there!
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